Fertility: A Novel

Fertility

A Novel

By

Denise Gelberg

Permission sought for use of excerpts from “My Mother,” by Abraham Sutzkever.
A, Sutzkever: Selected Poetry and Prose
, translated by Barbara Harshay. University of California Press, 1991.

The characters and events depicted in
Fertility: A Novel
are fictional. Any similarity to actual persons or events is coincidental.

Kindle Edition

Copyright 2012, Denise Gelberg. All rights reserved.

Yiddish Terms

A be kezunt — be well

Alter kocker — lecherous older man

Boychik — little boy

Brokh — misfortune

Bubbe — grandmother

Chutzpah —audacity, nerve

Efsha — perhaps

Essen — eat

Farblondjhet — confused, to wander aimlessly

Gevalt — oh my God

Gott in himmel — God in heaven

Kayn aynhoreh — knock on wood, spare us the evil eye

Kinder — children

Kleine kint — little child

Kleine mamela — sweet little girl

K’naker — one who self—aggrandizes

Kvell — to burst with pride

Landsmen — countrymen

Macher — a big shot

Maidel — girl; maidela — little girl

Mandelbrot — hard pastry, similar to Italian biscotti

Mazel tov — best of luck

Mein kint — my child

Mensch — an admirable human being; plural, menschen

Meshuggena — crazy person

Meshugge — crazy, mad

Mishegoss — insanity

Mitzvah — blessing

Momzer — bastard

Schlep — carry, pull

Schmuck — a bastard

Schpiel — story

Seichel — wisdom, street smarts, ingenuity

Shana — beautiful

Shankeit — a beauty

Shlong — penis

Shtarker — strong one

Tsoures — troubles

Tushie — rear end, bottom of a child

Vai iz mer — woe is me

Zadda — grandfather

Dedicated to my mother,

the Rivka in my life

CHAPTER ONE

The screams were a primordial code alert to the hospital staff, sending them sprinting toward the source. Entering the pediatric isolation room, the staff instantly understood the distraught mother’s protests to the gods. Her two-week-old daughter lay bleeding from every orifice. With mounting dread, the parents watched the red stain spread across her tiny diaper. Had the physician on call been a man of faith, he would have prayed for help. As it was, he methodically set to work to save the tiny infant’s life
.

* * *

Sarah Abadhi opened her eyes to a cold, dark Monday in November. Listening to the wind howling outside the windows of her third floor walk-up, she decided to ignore the alarm, for a few minutes at least. Closing her eyes again, she drifted off, hearing nothing of the six a.m. news droning from the clock radio. Then a thought intruded: the phone call from Harry that had awoken her in the middle of the night. She threw off the covers and got out of bed.

Harrison Meinig, Sarah’s boss, had a way of demanding attention. Harry, as he was known by everyone, led the health care practice in the white-shoe law firm where she was a fifth-year associate. His call was about the university hospital a few blocks from her Manhattan apartment. Apparently, there had been a medical error involving the child of a VIP. Sarah had to meet Harry there by seven; there would be no time for her usual Monday morning swim.

But not to worry. Sarah was, above all, a practical person. After being miserable for a long time, she reconciled with the life she led. She didn’t expect to be happy — in fact, she swore off hope, particularly when it came to men, which gave her the courage to tackle each day. Few people would have guessed the lovely looking woman with the impressive
vita
worshipped at the altar of low expectations.

Right after hanging up with Harry, Sarah had gotten up and chosen her clothes for the early morning meeting. Now, as she struggled to rouse herself, she caught the forecast: a cloudy day with highs in the 30s. After a quick shower, she opted for textured black tights and the black pumps that wouldn’t annoy the blisters she had earned during the NYC marathon the week before. With a dab of lipstick and some gold jewelry for her neck, wrist and ears, she was satisfied that she’d achieved the right look for an attractive but serious attorney. She shoveled a bowl of microwave oatmeal into her mouth, put her coffee in a travel mug and was out the door by 6:40.

Harry was already in the conference room of the risk manager’s office when she arrived at 6:57. He wore the label “distinguished” like a birthright with his thick, silver-gray hair, steel blue eyes and still sharply angled jaw. He was tapping his fingers on the table as Sarah came through the door. Julie Bonner, the hospital’s vice president for public relations, and an exhausted-looking John Mess, head of the risk management office, rounded out the group. An air of anxiety hung in the room as Sarah joined them at the conference table.

“Good morning,” she said as she waited for the news that would undoubtedly make it anything but a good morning for either the hospital or the patient involved in the case.

John Mess didn’t waste any time outlining the events that brought them together. “Yesterday afternoon the two-week-old infant of Mark Arkin was brought into the ER with what appeared to be a staph infection. After evaluation in the ER, the infant was admitted to an isolation room in our children’s wing. The pediatric fellow, Dr. Richard Smith, followed protocol, ordering the antibiotic clindamycin, and the blood thinner heparin for the IV flush. The infant appeared to be stable when the parents left for a consultation with one of our lactation specialists. When they returned, the infant was in a medical crisis — bleeding from her eyes, ears, nose, mouth, rectum and vagina.”

Sarah prided herself on seeming unflappable at work, but the image of a two-week-old baby bleeding out made her regret eating breakfast. The fact that the father of the baby was real estate mogul Mark Arkin only served to make matters worse.

Julie Bonner sensed the change in Sarah’s mood straight away. “Are you all right, Sarah?”

“Absolutely. Please continue, John. How did the staff respond?” Sarah replied without hesitation.

Mess checked his notes and then looked up. “Dr. Smith immediately suspected a dosing error with the heparin. He attempted to counteract its blood-thinning properties by administering vitamin K and protamine sulfate. The attending physician, Dr. Esther Cho, was called in. She concurred with Dr. Smith’s treatment. The bleeding was slowed. This morning the infant is in critical but stable condition. It is considered to have a good chance of survival.”

Sarah noticed that Mess didn’t use the child’s gender when he spoke. She wondered if that impersonal approach allowed him to deal more easily with hospital-induced suffering.

“Where are you in your investigation of the dosing error?” Harry asked.

Now it was Mess’s turn to grow pale. “Well,” he began slowly, “we’ve discovered a couple of problems. It appears the floor was understaffed for RNs. You know, people have started their Christmas shopping and it’s hard to get staff willing to come in for weekend shifts this time of year. Plus, a stomach flu has run through a lot of the staff over the last couple of weeks. I know, I know,” he said, raising his hands, “no excuse that will help in a lawsuit, but that’s the reality.”

Sarah jumped in. “How short staffed was the floor?”

Bonner, as smooth as ice, had her story prepared. “As John indicated, the hospital was overtaken by a virulent strain of gastroenteritis last week. It decimated our ranks at all levels. Yesterday we were down three RNs on the floor where the Arkin baby was being treated. Some of the remaining RNs volunteered to work extra hours, but the nursing staff was still shorthanded. It is possible this unavoidable staff shortage may have contributed to the mistake in the dosage of heparin given to the baby.”

“How big a mistake are we talking about?” Harry asked.

“A thousand times the correct dose,” Mess replied.

All the air seemed to be sucked out of the room. Sarah couldn’t get the picture of the bleeding baby out of her mind. Finally, she asked, “Could the overdose be the result of an illegibly or incorrectly written order?”

Mess was pleased he could put that question to rest. “We’ve just instituted computer entry for all medication orders. We have the order for heparin and it was correctly typed into our system.” He quietly added, “We believe that perhaps someone misread either the order or the heparin label.”

“So you think the dosing error can be traced to either the pharmacy or the floor nurse?” Harry asked.

Bonner offered up a possible culprit. “One of our most senior and trusted nurses, Joyce Hilker, was assigned to the Arkin baby. She administered the heparin. I hear she’s inconsolable.”

“Contrition doesn’t usually help when there’s a dead or damaged baby involved,” Sarah pointed out as she shifted in her chair. “How could she have made the type of mistake we’re talking about?”

“Well, that’s the point we’re at,” Bonner said. “We think it’s possible that the mistake wasn’t entirely hers. As Harry speculated, it’s likely the pharmacy was involved as well. That’s something we hope you can figure out ASAP.”

Then Harry asked the obvious question, given the father’s tough-guy reputation. “So what is Arkin threatening us with? Did he have his lawyer crib-side through the night?” He posed the question only partly in jest.

“Amazingly, no lawyers yet and no threats to sue,” Mess said. “Arkin and his wife haven’t left the baby. They are understandably upset. Well, that’s something of an understatement. I guess the mother, especially, is beside herself. But Arkin isn’t too far behind.”

Harry’s level of agitation — always at a simmer — was bubbling up. “Okay, so we’ve got to jump on this before Arkin has the chance to get his troops in position. Sarah will do some preliminary interviews of the staff today. Then we’ll know more about where we stand.”

Sarah nodded in agreement, but she had to wonder how Harry could be so cold in talking about a two-week-old baby. She knew there was some history between Arkin and him, though the specifics were sketchy. Something about a real estate deal where Harry and his client got clobbered. In any case, she knew what she had to do.

“I’d like to go back to our office, get some files, a digital recorder and a stenographer. I can be back here by 8:30 at the latest. Can I use this room for my interviews?” Mess nodded his assent.

“I’d like to sit in on the interviews,” Bonner said.

“I’d rather you didn’t,” Sarah responded, without missing a beat. “I find I get a better result if I do the interviews without the employer in the room. The recorder and the stenographer are sufficient reminders that the stakes are high. You and John will have a full report of my findings after all of the preliminary interviews are completed — which I hope will be by the end of today.”

Sarah could tell that Bonner wasn’t pleased, but Harry backed her up. “You’ll have your chance with them, Julie, but we find that the first interview right after the incident — conducted by an outsider — yields the best information.”

Mess turned to Bonner. “Any sign that the media have gotten wind of this yet?”

“Not yet, but I figure that it’s just a matter of hours, maybe a day at best. I’m working on a statement.”

“Okay, so Sarah will be back shortly. And by the end of the day, we’ll know better where we stand.” Harry got up to leave. Sarah was right behind him.

“Thanks, Harry. I’d like a report — at least a verbal report — from Sarah by, shall we say, five o’clock?” he said, directing his attention now to Sarah.

“Of course,” Sarah nodded. “You can facilitate my work by calling in the pharmacist that filled the order, and the nurses and doctors that treated the baby yesterday. Some of them may have the day off since they worked the weekend, but see what you can do.”

“Don’t worry about that. I’ll round everyone up,” Bonner assured her. They all shook hands before Sarah and Harry left.

Hailing a cab outside the hospital, Harry could hardly contain himself.

“What a cluster fuck. Cluster fuck, Sarah — a military term — when everything and everybody fucks up. Shit. No wonder we get paid so well. Defending a bunch of fuck-ups.”

Sarah responded calmly. “We’ll get this sorted out and figure out how to contain the damage. Let’s just hope that baby makes it — and makes it intact.” Settlements for damaged babies were often astronomical — rightfully so, Sarah thought.

The Ethiopian cabbie that picked them up drove like he was on a mission, which in fact he was. Sarah had called ahead to get a steno lined up. When she got to the office she quickly scanned the hospital’s voluminous malpractice insurance policy, e-mailed her paralegal to highlight the provisions pertinent to a case such as this, canceled her noontime dental cleaning and headed back to the hospital with Doris Ostrom, the firm’s most trusted steno, in tow.