A Teaser of My Next Novel, Venoms

CHAPTER 1

MIA

“My husband has vanished.”

Mary Francis, a supervising nurse I knew at the hospital, tracked me down on the pulmonary service at the end of my first year of residency. Recently married to Mike Francis, an infectious disease fellow, she managed Station 6600, a short-term treatment area where the sixth-floor general medicine services admitted new patients for short-term evaluation before sending them to the floor or the ICU (or the morgue). She was smart and a hard worker. Over the past two years, I had learned to value her leadership.

I knew her husband from my ID rotations. He was in his second year of training in a sub-specialty that ranges from hospital-acquired infections to tropical medicine. He worked under Professor Franklin Delano Rousseau, a superstar of infectious diseases, famous for his work on tropical envenomations but well known among the glitterati, LA’s high culture. Under Rousseau’s tutelage, he collected snake venom in Southeast Asia to produce antivenoms, a noble task that might earn his mentor a Nobel Prize.

She told me that, after his Saturday morning bike ride in Topanga Canyon, Mike didn’t return home. She reported him missing to the Sheriff’s Department and received no atisfaction. In my role as the newly elected president of the LA County/USC Intern-Residents Association, she asked me to help manage the fallout from his absence. I assured her that his benefits and pay would continue but wondered how much I could help.

The LA County sheriffs covered Topanga Canyon from the Malibu substation. Their jurisdiction was unincorporated areas scattered throughout the county, a patchwork of cities that were interwoven among autonomous communities that had their own police departments. The LAPD is responsible for the Los Angeles megalopolis, roughly five hundred square miles in one of America’s largest counties. The different jurisdictions didn’t have a high degree of collaboration as each one “did its own thing.”

By mid-week, the sheriffs still had no evidence of his whereabouts. They found his car on Old Topanga Road at the trailhead for his bike ride. His bicycle remained missing. They doubted that someone murdered him to steal a bicycle. Furthermore, no unidentified corpses were found in the area. They asked Mary unflattering questions about her marital life, implying that he had run off with another woman.

Her situation was precarious. He may have been killed and his body disposed where it never would be found. She said she felt disoriented and continued to listen for him at the time he normally came home. Her problem was far from the skills of an internal medicine resident. I sought advice from my consigliere, Abe Grant. He had taken an interest in Mary at one time but gave up when she moved in with her fiancée, Mike Francis.

Abe and I met for lunch in the doctors’ dining room, an anachronism from the bad old days. It featured harried waitresses serving doctors who were in a hurry to get back to work. At the insistence of the association, administration eliminated table service and trained former waitresses as nurses aids. Black women waiting on white doctors was awkward and inappropriate according to the values at the end of the sixties. We were in the vanguard of a generation of reformers inspired by the civil rights movement and infuriated by the Vietnam War. In fact, we felt that a separate dining room for doctors was elitist if not de facto segregation.

Abe was a nephrology fellow, my best friend, my confidante, and my guru. As an intern, I found his analytical skills awe-inspiring. He could evaluate a new patient in a blink. The son of a communist longshoreman who worked the docks in Oakland, Abe fomented conflicts proffered in correct Marxist dialectic. We struggled against the inadequacies of America’s class-based healthcare system that required private insurance or philanthropy, neither being readily available to the indigent population of Los Angeles. In short, the county hospital suffered from too many patients and too little money.

At Abe’s suggestion, in June 1971 I ran for president of the Intern-Resident Association (IRA) so that we could control the narrative. Thanks to Abe’s machinations, I won the contest by a rolling-paper-thin margin. I’m Max King, a resident starting my second year of internal medicine at the LA County/USC medical center. I have two small children, and I’m married to a pediatrics resident, Jan King, whom I met in the second year of college.

My marriage was love at fifth sight, but it has thus far endured the tribulations of medical education. As students, we were cautioned that medical marriages seldom survive the long years of training. Sometimes they ended before they began. Two years ago, a surgical intern from Ohio State met his fiancé at LAX and sent her back home. After two months in LA, he’d taken a walk on the wild side and wanted nothing to do with the prosaic Midwest.

“Mike is a mysterious guy,” Abe said. “He works with FDR on his antivenom project, traveling to Thailand to milk snakes.”

“Milking snakes? They’re reptiles.”

“Collecting their venom for his boss’s antivenom manufacturing program.”

“Don’t they realize there’s a shooting war going on in that part of the world?”

“Rousseau can run between raindrops.”

“What’s so mysterious about Mike?” I asked.

“At first, he seems ordinary enough, but on closer look, he has a rebellious side. I was surprised that he joined the great man. He has a genuine hatred of authority—something about his childhood, he despises stuffed shirts and phonies.”

I smiled. “FDR is many things, but not a phony. He’s famous nationwide, maybe worldwide. A PBS special showed his latest wife and him at the opera. He mentioned that he has rediscovered modern culture in his spare time.”

“Rousseau collects a Nobel Prize, and Mike Francis gets buried in Topanga Canyon.”

“The big guy is still waiting for his award, but he rewards himself with a new wife every two or three years.”

“What does Mary have to say?”

“To stay in shape, he takes a bike ride on weekends usually in Topanga Canyon. Last Saturday, he took off for his usual circuit of Topanga. On Monday, the sheriffs found his car at a trailhead off the old road by the Village. They haven’t located the bicycle or any signs of him.”

“I bet he wandered across a marijuana farm,” Abe said.

“They protect their turf with lethal force.”

“As in shooting trespassers?”

“Something like that.”

“I thought that a bunch of stoned hippies live in the canyon. That was the case for my classmates that lived there.”

“A couple of drug dealers with whom I’ve done business live there too.”

“I don’t know what I can contribute to this matter. His fellowship director is aware of the situation, and the sheriffs do not want my input into their investigation.”

“Have you spoken with Rousseau?”

“He’s in India, working with his antivenom manufacturer. His next stop is Thailand. He won’t return for a month.”

“He must know what happened. Has he spoken with anyone here?”

“A cursory chat with the program director.”

“I’ll give him his due, his work is important.”

“I assume so.”

“Calmette’s centuries-old technique of inoculating horses and collecting serum antibodies is still the way it’s done. There has to be a better approach, rather than using non-human species to produce a vaccine. Allergy to horse protein causes serum sickness in about ten percent of exposed people, a well-known problem with equine tetanus antitoxin.”

“Maybe fame and wealth lie in the snake business.”

“When I was on ID, Mike told me that envenomations kill tens of thousands of people a year in Southeast Asia. The banded krait is the worst, producing a neurotoxin—a painless

bite followed by death in six to eight hours.”

“I wonder if his disappearance is related to his overseas work,” I said. “Does snake venom have a military application? Or perhaps he saw something suspicious while wandering around Thailand looking for snakes.”

Abe smiled. “CIA spooks and opium growers. That’s not a part of the world conducive to a long and healthy life. Northern Thailand has an area of dedicated opium production that allegedly produces tons of it annually.”

“My friends in the drug rehab world tell me that they produce opium and manufacture pure heroin. Dealers sell it cheap to American soldiers.”

“I don’t see how it’s pertinent.”

“As a favor to his wife, I will insinuate myself into the investigation.”

“I have fond memories of that lovely lady.”