A Case of Need: A Novel (18 page)

“That’s right.”

“What’s the dx
¹
there?”

“It’s uncertain on the basis of the gross,” I said. “Nothing clear at all.”

“And the slides?”

“I haven’t seen them yet.”

“What was your impression at autopsy?”

I hesitated, then made my decision. He had been honest with me; I’d be honest with him.

“Not pregnant,” I said.

“Hmmm,” he said. “Hmmmm.”

He scratched his stomach again, then held out his hand.

“That’s very interesting,” he said.

We shook hands.

¹
See
Appendix IV: Abbreviations
.

W
HEN I GOT HOME
, a big squad car with a flashing light was waiting at the curb. Captain Peterson, still crew-cut and tough-looking, leaned against the fender and stared at me as I pulled into my driveway.

I got out of my car and looked at the nearby houses. People had noticed the flasher and were staring out of their windows.

“I hope,” I said, “that I didn’t keep you waiting.”

“No,” Peterson said with a little smile. “Just arrived. I knocked at the door and your wife said you weren’t back yet, so I waited out here.”

I could see his bland, smug expression in the alternating flashes of red from the light. I knew he had kept the light on to irritate me.

“Something on your mind?”

He shifted his position on the car. “Well, yes, actually. We’ve had a complaint about you, Dr. Berry.”

“Oh?”

“Yes.”

“From whom?”

“Dr. Randall.”

I said innocently, “What kind of complaint?”

“Apparently you have been harassing members of his family. His son, his wife, even his daughter’s college friends.”

“Harassing?”

“That,” said Peterson carefully, “was what he said.”

“And what did you say?”

“I said I’d see what could be done.”

“So here you are.”

He nodded and smiled slowly.

The flasher was beginning to get on my nerves. Down the block, one or two kids were standing in the street, watching in silence.

I said, “Have I broken any law?”

“That hasn’t been determined yet.”

“If I have broken a law,” I said, “then Dr. Randall may go to court about it. Or he may go to court if he feels he can show material damage as a result of my alleged actions. He knows that, and so do you.” I smiled at him, giving him some of his own. “And so do I.”

“Maybe we should go down to the station and talk about it.”

I shook my head. “Haven’t got time.”

“I can take you in for questioning, you know.”

“Yes,” I said, “but it wouldn’t be prudent.”

“It might be quite prudent.”

“I doubt it,” I said. “I am a private citizen acting within my rights as a private citizen. I did not force myself upon anyone, did not threaten anyone. Any person who did not wish to speak with me did not have to.”

“You trespassed on private property. The Randall home.”

“That was quite inadvertent. I was lost, and I wanted to ask directions. I passed a large building, so large it never occurred to me it might be a private dwelling. I thought it was some kind of institution.”

“Institution?”

“Yes. Like an orphanage, you know. Or a nursing home. So I drove in to ask questions. Imagine my surprise when I discovered that by purest chance—”

“Chance?”

“Can you prove otherwise?”

Peterson gave a fair imitation of a good-natured chuckle. “You’re being very clever.”

“Not really,” I said. “Now why don’t you turn off that flasher and stop drawing attention? Because otherwise I will file a complaint of harassment by the police. And I’ll file it with the Chief of Police, the District Attorney’s office, and the Mayor’s office.”

He reached indolently through the window and flicked a switch. The light stopped.

“Someday,” he said, “all this may catch up with you.”

“Yes,” I said. “Me, or somebody else.”

He scratched the back of his hand, as he had done in his office. “There are times,” he said, “when I think you’re either an honest man or a complete fool.”

“Maybe both.”

He nodded slowly. “Maybe both.” He opened the door and swung into the driver’s seat.

I went up to the front door and let myself in. As I closed the door, I heard him pull away from the curb.

I
DIDN’T FEEL MUCH LIKE ATTENDING A COCKTAIL
party, but Judith insisted. As we drove to Cambridge, she said, “What was it all about?”

“What?”

“The business with the police?”

“It was an attempt to call me off.”

“On what grounds?”

“Randall filed a complaint. Harassment.”

“Justified?”

“I think so.”

I told her quickly about the people I had seen that day. When I was finished, she said, “It sounds complicated.”

“I’m sure I’ve barely scratched the surface.”

“Do you think Mrs. Randall was lying about the check for three hundred dollars?”

“She might have been,” I admitted.

Her question stopped me. I realized then that things had been happening so fast, I hadn’t had time to consider everything I had learned, to sift it out and put it together. I knew there were inconsistencies and trouble spots—several of them—but I hadn’t worked on them in any logical way.

“How’s Betty?”

“Not good. There was an article in the paper today …”

“Was there? I didn’t see it.”

“Just a small article. Arrest of physician for abortion. Not many details, except his name. She’s gotten a couple of crank calls.”

“Bad?”

“Pretty bad. I try to answer the phone, now.”

“Good girl.”

“She’s trying to be very brave about it, trying to go on as if everything was normal. I don’t know if that’s worse or better. Because she can’t. Things aren’t normal, and that’s all there is to it.”

“Going over there tomorrow?”

“Yes.”

I parked on a quiet residential block in Cambridge not far from the Cambridge City Hospital. It was a pleasant area of old frame houses and maple trees along the road. Brick-paved sidewalks; the whole Cambridge bit. As I parked Hammond pulled up on his motorcycle.

Norton Francis Hammond III represents the hope of the medical profession. He doesn’t know it, and it’s just as well; if he did, he’d be insufferable. Hammond comes from San Francisco, from what he calls “a long line of shipping.” He looks like a walking advertisement for the California life—tall, blond, tanned, and handsome. He is an excellent doctor, a second-year resident in medicine at the Mem, where he is considered so good that the staff overlooks things like his hair, which reaches almost to his shoulders, and his moustache, which is long, curling and flamboyant.

What is important about Hammond, and the few other young doctors like him, is that they are breaking old patterns without rebelling against the Establishment. Hammond is not trying to antagonize anyone with his hair, his habits, or his motorcycle; he simply doesn’t give a damn what the other doctors think of him. Because he takes this attitude, the other doctors cannot object—he does, after all, know his medicine. Though they find his appearance irritating, they have no ground for complaint.

So Hammond goes his way unmolested. And because he is a resident, he has a teaching function. He influences the younger men. And therein lies the hope of future medicine.

Since World War II, medicine has undergone great change, in two successive waves. The first was an outpouring of knowledge, techniques, and methods, beginning in the immediate postwar period. It was initiated by the introduction of antibiotics, continued with understanding of electrolyte balances, protein structure, and gene function. For the most part, these advances were scientific and technical, but they changed the face of medical practice drastically, until by 1965 three of the four most commonly prescribed drug classes—antibiotics, hormones (mostly The Pill), and tranquilizers—were all postwar innovations.
¹

The second wave was more recent and involved social, not technical, change. Social medicine, and socialized medicine, became real problems to be solved, like cancer and heart disease. Some of the older physicians regarded socialized medicine as a cancer in its own right, and some of the younger ones agreed. But it has become clear that, like it or not, doctors are going to have to produce better medical care for more people than they ever have before.

It is natural to expect innovation from the young, but in medicine this has not been easy, for the old doctors train the young ones, and too often the students become carbon copies of their teachers. Then, too, there is a kind of antagonism between generations in medicine, particularly now. The young men are better prepared than the old guard; they know more science, ask deeper questions, demand more complex answers. They are also, like young men everywhere, hustling for the older men’s jobs.

That was why Norton Hammond was so remarkable. He was effecting a revolution without a rebellion.

He parked his motorcycle, locked it, patted it fondly, and dusted off his whites.
²
Then he saw us.

“Hiya, kids.” As nearly as I could tell, Hammond called everyone kid.

“How are you, Norton?”

“Hanging in.” He grinned. “Against all obstacles.” He punched my shoulder. “Hey, I hear you’ve gone to war, John.”

“Not exactly.”

“Any scars yet?”

“A few bruises,” I said.

“Lucky,” he said, “taking on old A. R.”

Judith said, “A. R.?”

“Anal Retentive: that’s what the boys on the third floor call him.”

“Randall?”

“None other.” He smiled at Judith. “The kid’s bitten off quite a chunk.”

“I know.”

“They say A. R. prowls the third floor like a wounded vulture. Can’t believe anybody’d oppose his majestic self.”

“I can imagine,” I said.

“He’s been in a terrible state,” Hammond said. “He even chewed out Sam Carlson. You know Sam? He’s a resident up there, working under A. R., rooting about in the nether regions of surgical politics. Sam is A.R.’s golden boy. A.R. loves him, and nobody can figure out why. Some say it’s because he is stupid, Sam is, blindingly stupid. Crushingly, awesomely stupid.”

“Is he?” I said.

“Beyond description,” Hammond said. “But Sam got chewed out yesterday. He was in the cafeteria, eating a chicken-salad sandwich—no doubt after asking the serving ladies what a chicken was—when Randall came in, and said, ‘What are you doing here?’ And Sam said, ‘Eating a chicken-salad sandwich.’ And A. R. said, ‘What the hell for?’”

“What did Sam say?”

Hammond grinned broadly. “I have it on good authority, that Sam said, ‘I don’t know, sir.’ And he put aside the sandwich and walked out of the cafeteria.”

“Hungry,” I said.

Hammond laughed. “Probably.” He shook his head. “But you can’t really blame A. R. He’s lived in the Mem for a hundred years or so, and never had a problem. Now, with the headhunt, and then his daughter …”

“Headhunt?” Judith said.

“My, my, the grapevine is collapsing. The wives are usually the first to know. All hell’s broken out at the Mem over the Clinic pharmacy.”

I said, “They lose something?”

“You bet.”

“What?”

“A gross of morphine ampoules. Hydromorphine hydrochloride. That’s three to five times more powerful on a weight basis than morphine sulfate.”

“When?”

“Last week. The pharmacist nearly got the ax—he was off hustling a nurse when it happened. It was lunchtime.”

“They haven’t found the stuff?”

“No. Turned the hospital upside down, but nothing.”

“Has this ever happened before?” I said.

“Apparently it has, a few years back. But only a couple of ampoules were taken then. This was a major haul.”

I said, “Paramedical?”

Hammond shrugged. “Could be anybody. Personally, I think it must have been a commercial move. They took too much. The risk was too great: can you imagine yourself waltzing into the Mem outpatient clinic and waltzing out with a box of morphine bottles under your arm?”

“Not really.”

“Guts.”

“But surely that’s too much for one person,” I said.

“Of course. That’s why I think it was commercial. I think it was a robbery, carefully planned.”

“By somebody outside?”

“Ah,” he said. “Now you get down to the question.”

“Well?”

“The thinking is that somebody did it from the inside.”

“Any evidence?”

“No. Nothing.”

We walked up the stairs to the wooden frame house. I said, “That’s very interesting, Norton.”

“You bet your ass it’s interesting.”

“Know anybody who’s up?”

“On the staff? No. The word is that one of the girls in cardiac cath used to shoot speeds,
³
but she kicked it a year ago. Anyhow, they went over her pretty hard. Stripped her down, checked for needle marks. She was clean.”

I said, “How about—”

“Doctors?”

I nodded. Doctors and drugs are a taboo subject. A reasonable number of doctors are addicts; that’s no secret, any more than it’s a secret that doctors have a high suicide rate.
⁴
Less widely known is a classic psychiatric syndrome involving a doctor and his son, in which the son becomes an addict and the doctor supplies his needs, to the mutual satisfaction of both. But nobody talks about these things.

“The doctors are clean,” Hammond said, “as far as I know.”

“Anybody quit their job? Nurse, secretary, anybody?”

He smiled. “You’re really hot on this, aren’t you?” I shrugged. “Why? Think it’s related to the girl?”

“I don’t know.”

“There’s no reason to connect the two,” Hammond said. “But it would be interesting.”

“Yes.”

“Purely speculative.”

“Of course.”

“I’ll call you,” Hammond said, “if anything turns up.”

“Do that,” I said.

We came to the door. Inside, we could hear party sounds: tinkling glasses, talk, laughter.

“Good luck with your war,” Hammond said. “I hope to hell you win.”

“So do I.”