Michael Palmer - The Second Opinion

Copyright 2009 by Michael Palmer. All rights reserved.

To Jane-Elisabeth Jakuc, for more than three decades a worker of miracles for special-needs children, and to her hench-veggies, Steve Lyne, Kathy Faria, Chesley Wendth, Judy Seligman, Cara Morine, Jake and Dan O'Hara, Elsa Abele, and all the rest of the staff, past and present, of the magical Corwin-Russell School at Broccoli Hall

ACKNOWLEDGMENTS

My deepest thanks to everyone at St. Martin's Press, especially my brilliant editor, Jen Enderlin, and Matthew Shear, Matthew Baldacci, and Sally Richardson.

Thanks, too, to everyone at the Jane Rotrosen Agencyespecially Jane, Meg, Don, Michael, and Peggy. Thirty years, and I never once even considered changing agencies.

In addition, my deepest gratitude to Dr. Steve Defossez and his staff at the Beverly Hospital Imaging Center; Kate Bowditch of the Charles River Watershed Association; Daniel, Matt, Susan, Donna, Ethan, Chef Bill, Kate, Howard, Sensei Howard, and Robin, for the ideas and readings; Luke, for the inspiration; Stanley, for the phone calls, the carrots, and the sticks; hlkt, for the puzzling initials and the example of how good a doctor can be; Bill Wilson, Dr. Bob Smith, and their friends, who have taught me all the tricks of the trade.

And special thanks to Trish Psarreas, writer, philosopher, and enthusiastic lover of all things Greek. Seven stars to you.

Contents

PROLOGUE

'I'm afraid I have some bad news.'

Hayley Long, just two weeks past her fifty-first birthday, heard her physician's words as if they were being spoken through a long steel tube.

I'm afraid I have some bad news

She wondered fleetingly how many thousands of people heard the same thing from their doctor every day? How many patients every hour, maybe every minute, rode those words screeching through a sudden right-angle turn in their lives.

I'm afraid

Stephen Bibby, a graduate of Emory Med, had been her physician since a bout of pneumonia twenty or so years ago. He was a man Hayley respected, if for no other reason than that Bibby knew his limitations and never hesitated to make a phone call and arrange a specialist referral for a second opinion.

Hayley felt a wave of nausea sweep over her, and thought for a moment she was going to have to excuse herself to go and get sick even before she found out precisely what she was up against. She made a largely unsuccessful attempt at a calming breath, and tried to maintain an even gaze.

'It's cancer?'

Hayley heard the word in her own voice, but couldn't believe she had actually uttered it. Her thoughts wouldn't stay still.

Cancer How could that be? Oh, God, no.

Her initial symptom had been nothing more than an annoying sequence of belly pain and gas. She almost hadn't even bothered to mention them to her executive assistant. He was the one who had talked her into calling Bibby. It was his fault.

The MRI Bibby had requested was of her abdomen.

Cancer.

The dizziness and nausea intensified.

David didn't handle illness at all well, in himself or others, but at some point she would have to tell him. Not yet, though. Not until all the data were in. He was off skippering his boat in a round-the-world racehis lifetime dream. He had lost his first wife to a brain aneurysm, and had waited more than ten years before marrying again.

Now this.

She had to tell him soon, but not yet.

Bibby, a Southern gentleman in his early sixties, looked toward the door as if hoping that another doctor would march into the office and take over.

'I asked, is it cancer?'

Biting at his lip, the physician nodded.

'Operable?' she asked.

Come on, Stephen! Help me out here!

'I I don't know. It looks to have started in your pancreas. That's the organ which'

'I know what the pancreas is. I hear Jimmy Carter talking about pancreatic cancer every time I turn on the damn TV. Has it spread?'

'It's it appears to be in some places in your liver.'

Bibby turned on his computer with a click of his mouse and rotated it so Hayley could see. A child could have picked out the cancer in her MRIan obscene white mass, dead center in her belly. Dead center. How ironic that her mind's default for something in the middle would have been those words.

Please let this be a dream. Please let it be a fucking dream.

Hayley rubbed at her eyes as if trying to paw away the disbelief. She had everything she could ever have wantedmarriage to a wonderful, caring man; stepchildren who treated her like their birth mother; more money and influence than most people could even dream of; and a perspective on life that made everything make sense.

Now this.

Pancreatic cancer Inoperable God, don't let it be, Hayley Long thought desperately. Let it be a dream Let it be nothing but a bad dream.

Petros Sperelakis's awareness returned gradually and spasmodically. The pain came firsta dull throbbing in his groin and burning sensation in his low back. He tried to move, to shift his position, but his body did not respond.

Please, I don't think I can move. Someone please help me. I'm Sperelakis, Dr. Petros Sperelakis. I can't see and I can't move.

'Connie, why don't you take a break. I'll be here for another hour.'

'Okay, thanks. Listen, Vernice, he could use some range-of-motion work on his wrists and ankles.'

Connie? Vernice? I can hear you. I can hear you. Are you Beaumont nurses? It's me, Dr. Sperelakis. What do you mean, range of motion? Am I paralyzed? What happened to me? An accident? A stroke? A tumor? Why can't I see? Why can't I speak?

The man many considered to be among the premier diagnostic physicians in the world struggled to make sense of his own symptoms. He knew he was having difficulty holding on to a thought, and that fact frightened him more than almost anything.

Why am I in such pain? Can someone please tell me what happened? What happened to me? I can feel that, Vernice. I can feel you moving my ankle. Oh, my God