Flashback

“Yeah. I brought him to Dr. Tak.”

“Let me in, Gunny. Buzz the door open.”

“I can’t, Mr. B. Not ’til you surrender the two guns you checked out this morning. You know the rules.”

“I know the rules,” said Nick. He came back to the counter and slipped a $50 old-bucks bill across. He was nearing the last of his “advance” from Nakamura.

Gunny G. buzzed the heavy door open.

Dr. Tak’s real name was Sudaret Jatisripitak but everyone in the mall called him Dr. Tak. He’d fled from Thailand during their last “Thai Rak Thai—Thais Love Thais” revolution that had killed a fifth of the nation’s population and found that he could make a decent living, without ever being medically certified in the United States, simply by giving black-market medical care to the few thousand residents of the Cherry Creek Mall Condominiums. Accordingly, Dr. Tak’s cubie was one of the largest in the mall, half of the upstairs part of the former Macy’s department store, and Nick found Leonard asleep in one of the ER cubicles near the entrance to Dr. Tak’s lair.

Nick’s heart leaped in terror when he saw the IV drip and other tubes going into his father-in-law. No, he wouldn’t be forgetting NCAR any time soon.

Tak, a small man in his seventies but still with short jet-black hair, came into the cubicle, shook hands with Nick, and said, “He will live. Mr. Gunny G. found your father-in-law unconscious in your cubie and I directed he be brought here. I’ve done various diagnostic tests. Professor Fox regained consciousness briefly but he is currently sleeping.”

“What’s wrong with him?” asked Nick. Leonard looked much older to him than the old professor had five years earlier when he’d dropped Val off in L.A. in his care.

“I believe it was an attack of angina brought on by aortic stenosis,” said the old Thai doctor. “The syncopic episode was a result of the pain and lack of oxygen to the heart.”

“What does ‘syncopic episode’ mean, Doc?”

“Fainting. His loss of consciousness.”

“I think I know what angina is, but what’s the… aortic stenosis?”

“Correct, Mr. Bottom. Aortic stenosis is an abnormal narrowing of the aortic valve. At certain times—say, times of great exertion or tension—this narrowing can shut off blood from the left ventricle of the heart. His symptoms were the sudden onset of angina and the fainting.”

“Is it fixable?” Nick asked softly, staring at the sleeping old man’s face. Dara had loved her father. “Will he survive it?”

“Two quite different questions,” said Dr. Tak with a smile. “About four percent of the time, the initial symptom of aortic stenosis is sudden death. Your father-in-law was lucky that his symptoms were limited to angina and loss of consciousness. From my initial tests—and I have good diagnostic equipment here, Mr. Bottom—my first guess is that this was a form of the heart problem called senile calcific aortic stenosis…”

“Senile!” said Nick, shocked.

“Used only in the sense that it occurs naturally in people over sixty-five years of age,” said Dr. Tak. “As one ages, protein collagen of the valve leaflets is destroyed and calcium is deposited on the leaflets. Turbulence then increases, causing thickening and stenosis of the valve, even while mobility is reduced by calcification. Why this progresses to the point of causing aortic stenosis in some patients but not in others is not known. It has in Professor Fox’s case.”

“What about fixing it?” said Nick.

Dr. Tak turned away from his patient and spoke very softly. “Once the symptoms of shortage of breath, angina, or fainting occur, there’s little that can be done for a patient of Dr. Fox’s age short of the surgical procedure called aortic valve replacement.”

“Is that expensive?” asked Nick. “Can he get it on government coverage?”

Dr. Tak smiled grimly. “I am not a surgeon. Since the health care meltdown in your country, Mr. Bottom, the waiting time for the National Health Service Initiative–covered aortic valve replacement is a little over two years. Bioprosthetic valves taken from horses or cows are used in the procedure and that harvesting itself takes a long time and must be prioritized for patients. Also, all surgical recipients of mechanical prosthetic valves require immune-system drugs, including lifelong anticoagulation treatment with blood thinners such as warfarin—also known as Coumadin—to prevent clot formation on the valve surfaces. This is a very expensive drug and not covered under Medicare Two.”

“And, don’t tell me, let me guess,” grated Nick through his teeth, “most people suffering this… aortic stenosis… don’t live long enough to get to the government-subsidized surgery. And if they do, they can’t afford the blood thinner they’ll need.”

“That is correct,” said Dr. Tak. “Years ago, when I was a young physician in Bangkok, we all expected breakthroughs in genetic research to produce cloned human heart valves which would make such valve transplants not require immune-system and anticoagulant medications—since even the rare transplant of valves from human cadavers in this procedure had avoided the autoimmune problems—but, of course, with the crash of the great pharmaceutical companies in North America after your so-called health care reform, and in the absence of government-funded research in America and the post–EU countries, those hopes have disappeared.”

“So there’s nothing you can do for Leonard, Dr. Tak? Nothing we can do for him? Nothing I can do?”

“I will give him painkillers for when the angina returns,” said the old Thai. “And he must avoid all strenuous exercise. And, of course, any great excitement or tension.”

Nick couldn’t keep himself from laughing at that. When Dr. Tak frowned at him as only a doctor can frown, Nick said, “Leonard just escaped from Los Angeles and got my son out of that war zone, Doc. I don’t know how he did it, but I’ll be grateful to him for the rest of my life for saving my son. If I could give him my entire heart now in a transplant, I’d do it.”

“I accept,” came Professor Emeritus George Leonard Fox’s reedy voice from behind them. “Dr. Tak, please prep my son-in-law for an immediate heart transplant to me. And while you’re at it, take his kidneys and prostate. Mine keep me awake all night.”

Nick and the doctor turned, but only Nick blushed. He went to one knee by the bed. “How long have you been awake, Leonard?”

“Long enough to hear all the bad news,” said the old man. “Did I miss any good news about this condition?”

“Well,” said Nick, “four percent of those who have it show a first symptom of sudden death. You didn’t.”

Leonard smiled. “I’ve always enjoyed being in the bland majority. Actually, I feel sort of good for a doomed old fart who’s just had a near-death experience. Mellow. Did you give me something in this IV, Dr. Tak?”

“A mild tranquilizer.”

“Please give me a few hundred of those pills in a doggie bag when I leave,” said Leonard. He squeezed Nick’s hand. “And we will be leaving soon, won’t we?”

“I think we have to,” said Nick.

“Did Val return?” asked Leonard and his grip intensified.

Nick shook his head. “I have trouble believing he got out of the building.”

As if just remembering something, Leonard whispered, “The phone,” and released Nick’s hand, beckoning him to lean closer.

Nick put his ear almost to the old man’s mouth.

“Dara’s phone, Nick. It’s in your cubie. It’s double-password-protected. The first password is ‘dream’— d… r… e… a… m. The second-level password is ‘Kildare,’ the name of her pet parakeet. I just figured out that second-level password. ‘Kildare.’ That opens text files from the months before she died, Nick. The text I understand. It’s important. Very important. More important than finding Val. You need to go read it… see the videos. Her diary… or notes she made for you, I think… it changes everything.”

Nick blinked in response. More important than finding Val? What could be more