Nanobe, A Harry Grouch Mystery

By Robert Tell

"You can't kill something that isn't alive!" That shocking discovery is the key to this compelling whodunit. A mysterious pathogen is infecting neurosurgical patients at Bard Memorial Hospital. Dementia and rapid death follow. The microorganism causing this disease is surviving all known sterilization techniques. Why isn't the disinfection process used by the Operating Rooms destroying this astonishing bug?

Bard Memorial Hospital, it's Administrator, Abner Fabian, it's Laboratory Director, Mickey Barrie, and other key doctors on the staff, will be familiar to readers of my earlier work, "The Medical Director's Divorce, and Other Stories." In "Nanobe," these characters are further developed as important players in helping Harry Grouch to unravel the mystery of the neurosurgical patient deaths.

Things look bleak for the hospital. The County Medical Examiner is accusing the hospital of a malpractice cover-up, while the doctors argue furiously over the many theories about what is happening. The Police Chief suspects foul play. The media and public have condemned the hospital and doctors.

Harry Grouch and Judy Pacas rush to the rescue. They tour the laboratories, monitor surgery, stroll the patient units at 2 am, and befriend hospital staff to dig up the facts. It's up to them to figure out why patients are dying. Is it a mini-epidemic that, once understood, can be scientifically explained and controlled? Or is a creative killer using this newly discovered biological entity, this nanobe, as a murder weapon. And if it's murder, what's the motive, how is it being accomplished, and who are the suspects?

All of this leads to a juicy, hospital-based detective thriller unlike any other on most library and bookstore crime shelves.

• Language: English
• Publisher: Robert Tell
• Release date: Dec 13, 2014
• ISBN: 9781311769831

Robert Tell

Robert Tell was born in Brooklyn, New York, and educated at Columbia University. He now lives in Farmington Hills, Michigan, and winters in Boynton Beach, Florida. Tell is grateful that his parents didn't name him William Tell. He last saw snow in 2004. His award winning fiction, poetry, columns, articles, and creative non-fiction have appeared in many periodicals. He has a growing catalogue of published books including works of fiction, memoir and poetry. "The Witch of Maple Park (Harry Grouch Mystery Series #1)" is an Eric Hoffer Book Award Grand Prize Finalist, and First Runner-Up in their Ebook Fiction category. It is compelling fiction inspired by a true story. "Nanobe (Harry Grouch Mystery Series #2)" is a hospital based medical thriller based on Tell's years as a hospital CEO and Public Health executive. "Stradella's Revenge (Harry Grouch Mystery Series #3)" retells the legend of Italian composer Alessandro Stradella's 17th Century assassination from the point of view of a modern murder mystery. In "Deep Pockets (Harry Grouch Mystery Series #4)," Detective Grouch busts up an international Mafia controlled scam bilking millions of dollars through fraudulent medical malpractice lawsuits. "Thirsty Planet" was a finalist for the prestigious Montaigne Medal award for thought provoking writing. It was recently translated and released in China by a Chinese publisher. "Dementia Diary, A Caregivers Journal" uses compassion and humor in a memoir about caring for a loved one with dementia.

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Nanobe

A Harry Grouch Mystery

By Robert Tell

Smashwords Edition

* * *

Published By:

Robert Tell on Smashwords

Nanobe

Copyright 2014 by Robert Tell

License Notes

All Rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means without the prior written consent of the author, nor be otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition being imposed on the subsequent purchaser. Your support and respect for the property of this author is appreciated.

This is a work of fiction. Names, characters, places, and incidents either are the product of the author's imagination or are used fictitiously, and any resemblance to actual persons, living or dead, events, or locales is entirely coincidental

Cover Design By: The Cover Collection (http://www.thecovercollection.com/)

For all the Talented

Surgeons

OR Nurses

Laboratory

&

Hospital Staff

Who Mentored Me

NANOBE, A HARRY GROUCH MYSTERY

PART 1

Nanobe: A tiny filamental structure that may or may not be a living organism, and if living, would be the smallest form of life, 1/10 the size of the smallest known bacteria. Source: Wikipedia

CHAPTER ONE

I can't move my right arm. It's heavy and dead like the broken limb of a tree I've seen somewhere. I can't remember where but it doesn't matter. I roll over and wait and soon I feel my arm tingling. This reassures me but I have another sensation now. I don't recognize it at first but my pajamas are getting wet so I know I need to pee.

Damn. What to do? I need a toilet. I kick off the covers. My arm feels better now. I use it to support my weight on my elbow. I twist my body to the edge of the bed and push myself up. My arm muscle starts to twitch. Now, slowly, I put my feet on the floor. First my left foot. Feels solid. Now my right foot. I better hurry. I feel more leakage down below.

I stand up. Good. I feel steady. Weak, but steady. Maybe if I lean on the wall I can make it to the toilet. I really need to get to a toilet. But where is the toilet? That door across the room looks familiar. Is it behind that door? That seems right, but I'm not sure anymore. Wasn't I supposed to call someone for help? I have an image of a person, a woman who said I should call her, but who is she?

I take a step. Then another step. I feel confident and push away from the wall. Mistake. Down I go with a thud. It doesn't hurt, but I can't get up and I can't hold my pee anymore. I'm in a big puddle and I'm stuck. I'm scared and don't know what to do.

How did I get here? Oh yeah, I was trying to get to the toilet. Well, I don't have to do that anymore. I laugh. I don't have to pee anymore. I already did. That strikes me as funny but I have a bigger problem now. I can move my legs and arms but I still can't get up. Maybe if I yell someone will hear me.

Helllp, I manage to say. But it's weak. I'll try again.

Help! a little louder.

HELP...HELP, louder still.

Ernest, are you calling me? Are you alright? It's a voice from beyond my room.

A woman comes into the room. She looks very familiar. Maybe she'll help me. She's talking.

ERNEST, she shouts at me. You got out of bed again. Why didn't you use the bell I left on your table? Are you hurt? Oh my god, you're all wet. Why didn't you use that urinal I left for you? You know you can't walk without falling.

Ernest? That's my name isn't it? How does she know it? It's so annoying not to remember.

The woman leaves and returns with a large black man. He also looks familiar but I can't recall why. He's smiling.

Ernie, he says, I'm gonna help you up and get you to the toilet. Let's get you out of those wet pj's.

A strong arm pushes me into a sitting position and two strong arms help me to stand up. They support me as we slowly make our way to the toilet. One step at a time. I feel reassured that everything will be OK now.

I'll change the sheets, I hear the woman say as I enter the bathroom.

***

Irena Szurgalsky stood in the doorway to her living room where the hospital bed had been installed. It was the only room with space enough to hold it comfortably. Tears welled up in her eyes. From her vantage point, she watched her 67-year-old husband, Ernest, stare blankly and without recognition at his old friend, Filip Grouch. She felt her heart sink when it was clear that Ernest had no idea who Filip was, even though the friendship between the two men went back half a century.

A half hour earlier, at her kitchen table, Irena had poured her heart out to Filip about Ernest's continuing decline. He's getting progressively worse and he shows no signs of being his old self. He's confused most of the time now, and is almost delirious sometimes, much the way an Alzheimer's patient might be. The only thing is that it's happening much too quickly to be Alzheimer's.

Filip had shrugged his shoulders as if to express his own despair at the situation. Will he recognize me?

Irena had looked away from Filip's probing eyes. Don't get upset if he doesn't. His memory is slipping fast, he doesn't speak much, he's too weak to get out of bed for much else than going to the bathroom, and even that is fraught with risk. And his muscles keep twitching. I never know what will happen. Will he fall and hurt himself seriously? Carlo, his aide, can hardly handle him anymore.

Where is Carlo?

I gave him the morning off, knowing you would be here.

Now, sitting on the edge of Ernest's hospital bed, Filip looked as though he too was ready to burst into tears. Ernest was screaming at Filip. Get off, get off. Go away. I don't want you there. Get the hell off, you son of a bitch!

Filip turned to look at Irena, who was shaking her head in the doorway. She saw herself in a nearby wall mirror and was dismayed at her appearance. To Irena, her reflected face portrayed the fear and pain she was feeling, and her sense of utter helplessness at Ernest's condition. His language also upset her. He was always a gentle man and a gentleman who never used profanity. Who was this stranger in her living room?

Filip, she said. You better listen to him, and please use a very quiet voice in talking to him. It might help to calm him down.

As she spoke, Ernest turned his head to look at her, but it was also without recognition.

Filip got off the bed and, standing, turned to face Ernest. Let's try one more time, Ernie, he whispered. It's me, Filip, your old buddy. Don't you recognize me?

The response was silence, but it was obvious to Irena that Ernest Szurgalsky had no idea who this man was, this person who seemed so determined to annoy and threaten him. He turned his head away from Filip. The interview was over.

Come, Filip, Irena begged. Let's leave him for now. Come. I'll make us some tea.

Wait, don't leave me. Ernest was suddenly alert and meeting Filip's gaze. Filip looked at Irena who nodded and he turned back to Ernest.

I'm not going anywhere, Ernie, as long as you want me to stay. Do you know who I am?

Of course I do, Filip. What a question!

Well, old friend, a few minutes ago you didn't recognize me.

I didn't? I can't believe it. You know what? I haven't been myself lately. I don't know what's happening to me, but I'm sorry if I offended you. Sometimes I just can't think clearly.

Standing in the doorway, Irena choked back an audible sob. Ernest looked toward her. Irena, what are you doing there? Why are you so far from me? Come closer.

***

Later, over a steaming cup of tea, Filip asked, What was that all about? Is he starting to get better?

Irena dabbed her eyes with a tissue. I'm afraid to hope. He has periodic moments of clarity that fool me into thinking that. But it never lasts.

Filip reached across the table and took Irena's hand, and she let him.

I'm here for both of you. Whatever you need, I... The chimes of the doorbell interrupted him. Just sit, he continued when Irena began to rise. I'll go see who it is and I'll send them away, unless it's important.

Irena waited, still teary eyed, grateful to Filip for his support and presence. A few minutes later, he returned accompanied by a tall, shapely woman who appeared to be in her early forties. She was dressed in a charcoal gray business suit and had long blond hair cascading down around her shoulders. Irena was thrilled to see her and rose to greet her.

I was sure you'd want to see Dr. Cutty, Filip said.

Absolutely. Welcome Dr. Cutty. Please sit. Make yourself comfortable. Can I get you something? Some tea, maybe?

Dr. Ann Cutty smiled and sat. Nothing, please. I just came to see how you and Ernest were doing. Please call me Ann. We've been through too much together to depend on formalities. But who is this gentleman who answered the door?

Filip joined the ladies at the table and introduced himself.

Very pleased to meet you, Ann Cutty said. Irena, may I go to see Ernest alone? I have a few new tests I want to perform.

Certainly, Irena said, hoping that these tests might lead to something hopeful and definitive. If he gets aggressive, just call me.

When the doctor left the room, Irena noticed the quizzical look on Filip's face.

Isn't it unusual, he asked, for a surgeon to make house calls and to continue such close watch on a patient following surgery?

Of course it is. It's extremely unusual, but these are special circumstances. On an impulse, Irena decided to tell Filip what she knew about Dr. Ann Cutty. I know Ann seems awfully young, but she's an experienced and board certified neurosurgeon who came to us highly recommended by the Chairman of the Surgery Department at the hospital. Ann is a very compassionate person and takes her work very seriously.

I understand, Irena, but a follow-up house call is way above and beyond the call of duty, isn't it? Is she feeling guilty about something?

I don't think it's guilt. I'd like to believe it's genuine professional concern. Ann and I have talked about what is happening to Ernest. She seems deeply committed to never harming a patient or... Irena choked up briefly and continued, ...or to losing one through the fault of her surgery. She's totally dedicated to finding a way to get Ernest past this crisis.

Filip flinched. No one is thinking about losing him, are they? he asked after staring at his fingers for a few minutes.

My God, Filip, I pray not, but I'm very frightened.

They both sat in an awkward silence for a while. Then, Filip broke the quiet. On a lighter subject, may I ask about the doctor's funny name?

Irena understood that Filip was trying to get her mind off the possibility of a bad end for Ernest and she was very grateful to him for his sensitivity. You should know about funny names, Filip Grouch, she said with a crooked smile.

That's why I mention it, Irena. Don't you remember the story about my father, Augustus?

I do. Didn't he shorten his name from Gruzauskas to Grouch way back in WWI?

He did. Anyway, I can't help wondering, where does 'Cutty' come from?

Irena shrugged. Ann says she's often teased about her name but she's unclear about its history. She likes to quip that with a name like 'Cutty,' she had to become a surgeon. She has quite a good sense of humor.

Irena started to chuckle but was suddenly pulled back into the moment by Ann Cutty's return. Looking at the doctor's face, she no longer felt like laughing.

May I join you? Dr. Cutty asked.

CHAPTER TWO

Harry Grouch, private eye, sat at his desk in his newly rented office in downtown Maple Park, Michigan. He was alone and enjoying a brown bag lunch of Italian salami, hard cheese, tomato, onion and mustard, the deli kind, sandwiched on a submarine loaf, and washed down with real root beer from Trader Joe's. Several ledgers were open on his desk.

He smiled as he thought about his current bank balance, flush and healthy now, in 1995, with fees from recent successful projects. His work on the monstrous axe murder case known as the Witch of Maple Park provided a generous check that went straight into his account.

At last, he thought, as he looked around and admired the two-room suite, I can finally afford a real business office with Harry Grouch and Associates, Private Detectives, stenciled on the door. He'd hated having to work out of his and Judy's apartment. He took a deep, satisfied breath and reflected on how nice it was to have a professional place to receive clients.

On the other hand, he realized, the money from past work wouldn't last forever. What he needed now was a new case to keep the fee revenue flowing and, maybe, to allow him to upgrade the office furnishings. A new car would be nice, too. Maybe a Cadillac or Lincoln.

The office suite was entered through a small reception area, although Harry did not yet have the resources to hire a receptionist. Glancing at the wall clock with the cartoon image of Sherlock Holmes, he noted that Judy Pacas was late again. He also noted that the minute hand covered Sherlock's calabash and he chuckled.

I love that dopey clock, he said to himself just as his assistant, lover, distant cousin, and sandwich maker barged into the room.

Sorry to be late, Judy said, gasping for breath. It's freezing out there and the car windshield was covered with a layer of ice. Had to chip it off before I could get going. From now on I'm keeping my car in the garage and you can tough it out in the street.

Harry grinned. Stop complaining. It's just a typical winter day in the Detroit area. You should be used to it.

Only it's not winter anymore, Judy said. It's March, for God's sake, almost spring, and I'm sick to death of the snow. Oh what's the use? I won't get any sympathy from you, will I?

Judy's cheeks were still red from the cold and, Harry thought, it enhanced the features of her pretty face. Crowned by her jet-black hair, with not a sign of gray, she looked like a lovely fashion model. Judy removed her coat and gloves but left her sweater on over a checkered blouse. Harry always loved seeing her body wrapped tightly in a skirt and sweater. She has a knack for looking sexy, he thought, without being flashy, and she's always perfectly well groomed. Quite a contrast to a fashion-challenged nerd like me.

Harry never regretted his decision to teach Judy the detective ropes and to make her his partner. And he never looked back at his choice to cohabit with her.

There was still an ache in his heart for his first love, his wife Cindy, killed by a bullet meant for him. But enough time had passed for him to move on, and it didn't hurt that Judy was so attractive and so bright. Yes, life was looking good for Harry Grouch, private eye.

Okay, you have my sympathy, Harry quipped, but the peeved look on Judy's face told him he'd better move on.

How are the roads? he asked.

Sloppy but drivable.

Harry looked out the window at the snow accumulating down below. From his second floor vantage point he spotted his father, Filip, across the street walking and struggling against the wind in his Alaskan parka. Filip's face was wrapped in a bright red scarf. He appeared to be heading toward Harry's building.

Here comes Dad. Come see.

Judy had settled into her office in the two-room suite and had begun organizing her papers. But now she left her desk and joined Harry at the window. We really have to get one of those personal computers. Doing all this stuff by hand doesn't make sense anymore.

Judy's campaign to modernize the office just made Harry nervous. It was inevitable, he knew, but he hoped to postpone having to deal with things like computers for as long as he could get away with it.

Gosh, Filip looks cold, Judy said. At his age it's dangerous to be out walking in this weather. Wonder what he's doing in downtown Maple Park?

Harry and Judy's combined breath fogged up the inside of the glass and they both pulled away. Harry gave Judy's appearance the once-over and he planted a quick kiss on her cheek. She giggled and pushed him away.

What'd you do that for?

Couldn't resist your charms, he said, turning back to the glass, which had cleared up a bit. Anyway, we'll find out in a minute why Dad is out there. He just turned into our building.

A few moments later, stamping his feet from the cold, Filip Grouch entered the office and Harry rushed to greet him.

Morning, Dad. Let me take your coat.

I'll just keep it on for now, thank you. It hasn't been this cold in Michigan since Grandpa Augustas emigrated from Lithuania. I grew up listening to his stories, how he got frostbite working construction jobs in 1918.

And I grew up listening to you repeat those stories. But that's OK. I never minded. Actually, I enjoyed hearing them.

Judy gave Filip a hug. Well, welcome to our gumshoe palace, Papa Grouch. What brings you here on a day like this? You could be nice and toasty at home.

Filip shivered. He wrapped his parka more tightly around him, but he had a twinkle in his eye. I couldn't get one of your hugs in my toasty home, now could I?

You didn't come all that way just for one of Judy's hugs, did you Dad? What's on your mind?

Filip laughed. You always like to get right to the point, Harry. Well, you're right. I need your advice on something, and a phone conversation wouldn't have worked for me. Do you have some time for your old man this morning?

Sure, Dad, but let's get you warmed up first. How about some hot coffee or tea.

Filip got a sheepish look on his face. I'd love some hot cocoa if you have any.

Actually, Judy said, we do. I always like a cup of cocoa in the afternoon. I'll get you a cup.

Half an hour later, after some more small talk and some shared hot liquids, Filip was warm enough to surrender his parka. Okay, kids, let's get down to business. I want to tell you why I came.

Good, Dad. And I won't start the meter yet. The first visit with a new client is always free.

Harry, Judy piped in, stop acting like a jerk with your father. Ignore him Fil. Take a seat and tell us how we can help you.

Thanks, sweetie, but I prefer to stand until my toes thaw out. I don't know if I need advice or just a chance to ventilate about a situation with my friend, Ernie Szurgalsky. He's in big trouble and I want to help him. But I don't know what to do.

I remember Ernie, Harry said. Nice man. It's been a long time since I've seen him. What's his problem?

It's a medical situation, Harry. Very strange and very tragic. Three months ago, he was hospitalized at Bard Memorial Hospital for a microdiscectomy.

A what?

Irena...that's Ernie's wife...

I know, Dad. I remember her.

Of course. Well, anyway, Irena told me a microdiscectomy is surgery on the spine to remove a piece of protruding disc that's compressing a nerve root. It sounds complicated, but the doctor told her she used a new, minimally invasive procedure.

So what's the issue, Dad? Did Irena tell you anything else?

She did. She said Ernie wanted to avoid the surgery and he tried to live with the pain, but he eventually had no choice but to seek relief. The irony is that he healed perfectly from the surgery, but then went dramatically and rapidly downhill physically and mentally.

Judy frowned. Poor man. Isn't that unusual following such a minor operation?

Exactly! It's unheard of, yet Ernie Szurgalsky's mind is fuzzy and confused. They have a hospital bed in the living room and a live-in aide, a nice man from Haiti, to help his wife cope.

Harry scratched his head. That must be expensive.

Hell, it's breaking them. They can't afford it but Irena can't do the heavy lifting. Ernie keeps trying to get out of bed to go to the bathroom and each time he falls he loses control of his bladder. It's a mess. Carlo...that's the aide...has to pick him up and get him changed, turn him over in the bed, and do stuff that's beyond Irena. But that's not why I'm here.

Judy was chewing furiously on a chronic hangnail. Okay, Filip, please get to the point. I'm getting very upset listening to this awful story.

Well, Judy, how do you think I feel? Here's the point. Irena tells me that her husband, my friend Ernie, seems to be sinking into a kind of dementia. I met the surgeon while I was there. She's a striking woman with a funny name, a Dr. Ann Cutty, who can't explain what is happening. There's no medical reason she can think of for a microdiscectomy to result in the kind of decline Ernie is experiencing. It's 1995, Harry, not the Middle Ages. The experts should know what to do, shouldn't they? Something's not right and I want you to find out what.

Harry Grouch leaned back in his chair and squinted at his father across the file folders and piles of paper strewn sloppily across his desk. That's quite a tale you're telling. Why didn't you come to see me sooner? I hate to see you so worked up.

Filip stared back. You don't understand, Harry. I have good reason to be upset. Ernie and I are best friends. I can't stand watching him fall apart like this. And, Irena...the poor lady broke down and cried pathetically when Dr. Cutty reported her diagnosis. It broke my heart.

Actually, Dad, I understand more than you think. Judy and I watched a good friend die a slow death from lung cancer last year. Do you remember Sam Jasper? He was my supervisor at the Michigan State police. Sam was a great guy and a fabulous cop and I miss him. Listen, Pop, why don't you sit down. I'm getting a stiff neck looking up at you.

Filip Grouch took the empty chair facing the one in which Judy Pacas was sitting. She'd been very quiet during the tense dialogue between father and son. Now, she watched as the older man put his head in his hands. He took a handkerchief from his back pants pocket and blew his nose loudly. He looked at Judy who smiled at him. Then he