Authors: Robin Cook
“Whew!” whistled Bellman, not sure what to write in his pad.
“The most exciting thing,” said Charles with enthusiasm, “is that it all makes scientific sense. Cancer today is a vestigial aspect of an ancient system whereby organisms could accept new cellular components.”
“I give up,” said Bellman. He closed his pad with a snap.
“What you are also saying, Dr. Martel,” said Dr. Ibanez, “is that you have a long way to go in this work of yours.”
“Absolutely,” said Charles. “But the pace has been quickening.”
“But there's no reason, except your preference, that you couldn't put this work aside for a period of time.”
“Only that it appears so promising. If it turns out to be as fruitful as I expect, then it would be tragic, if not criminal, not to have it available as soon as possible.”
“But it is only in your opinion that it appears so promising. I must admit it sounds interesting and I can assure you the Weinburger will support you as it has in the past. But first you are going to have to help the Weinburger. Your own interests must be postponed; you must take over the Canceran project immediately. If you refuse, Dr. Martel, you will have to take your research elsewhere. I want no more discussion. The issue is closed.”
For a moment Charles sat there with a blank face reflecting his inner uncertainty. The enthusiasm he'd built up in presenting his work had elevated his expectations so that Ibanez's dismissal had a paralyzing effect, especially combined with the threat of being turned out of his lab. The suggestion of being fired was far more terrifying coming from Ibanez than from Morrison. Work and Charles's sense of self had been so closely connected that he could not imagine them severed. He gathered up his lab books with an effort.
“You're not the most popular man on the staff,” added Ibanez gently, “but you can change that now by pitching in. I want you to tell me, Dr. Martel: Are you with us?”
Charles nodded his head without looking up, suffering the
final indignity of unconditional surrender. He turned and left without uttering another word.
After the door closed, Bellman looked back at Ibanez. “What a strange reaction. I hope he's not going to be trouble. That evangelistic attitude scares me to death.”
“I feel the same way,” said Ibanez pensively. “Unfortunately he's become a scientific fanatic, and like all fanatics, he can be difficult. It's too bad because he's such a first-rate researcher, maybe our best. But people like that can put us right out of business, especially in this era of reduced funding. I wonder where Charles thinks the money to run this place comes from. If the people down at the National Cancer Institute heard that monologue of his about chemotherapy, they'd throw a fit.”
“I'm going to have to keep the press away from him,” said Bellman.
Dr. Ibanez laughed. “At least that part will be easy. Charles has never cared for publicity.”
“You sure he's the best man to take over Canceran?” said Bellman.
“He's the only man. No one else is available who has his professional reputation. All he has to do is finish the study.”
“But if he screws up somehow . . .” worried Bellman.
“Don't even suggest it,” said Ibanez. “If he mishandles Canceran at this point, we'd have to do something drastic. Otherwise we'll all be looking for a job.”
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Disgusted with himself, Charles dragged his way back down to his lab. For the first time in almost ten years, Charles nostalgically recalled private practice. It wasn't the one-on-one of clinical medicine that he longed for, but rather the autonomy. Charles was accustomed to being in control and until that moment he had not realized how little control he had at the Weinburger.
For the second time in the day, Charles slammed the door to his lab, rattling the glassware on the shelves and terrifying the rats and mice in the animal room. Also for the second time
he startled Ellen, who deftly caught a pipette she'd knocked off the counter when she spun around. She was about to complain but when she saw Charles's face, she remained silent.
In a fit of misdirected rage, Charles slung the heavy lab books at the counter. One hit the floor while the others crashed into a distillation apparatus sending shards of glass all over the room. Ellen's hand flew up to protect her face as she stepped back. Still not satisfied, Charles picked up an Erlenmeyer flask and hurled it into the sink. Ellen had never seen Charles like this in all the six years they'd worked together.
“If you tell me I told you so, I'll scream,” said Charles, flinging himself onto his metal swivel chair.
“Dr. Ibanez wouldn't listen?” asked Ellen, guardedly.
“He listened. He just wouldn't buy, and I caved in like a paper tiger. It was awful.”
“I don't think you had any choice,” said Ellen. “So don't be so hard on yourself. Anyway, what's the schedule?”
“The schedule is that we finish the Canceran efficacy study.”
“Do we start right away?” asked Ellen.
“Right away,” returned Charles with a tired voice. “In fact, why don't you go get the Canceran lab books. I don't want to talk to anyone for a while.”
“All right,” said Ellen softly. She was relieved to have an errand to take her out of the lab for a few minutes. She sensed that Charles needed a little time by himself.
After Ellen left, Charles didn't move and he tried not to think. But his solitude did not last long. The door was thrown open and Morrison stormed into the lab.
Charles swung around and looked up at Morrison, whose veins were standing out on the sides of his forehead like strands of spaghetti. The man was furious.
“I've had just about all I can tolerate,” he shouted through blanched lips. “I'm tired of your lack of respect. What makes you think you're so important that you don't have to follow normal protocol? I shouldn't have to remind you that I am your department head. You're supposed to go through me
when you have questions about administration, not to the director.”
“Morrison, do me a favor,” said Charles, “get the hell out of my lab.”
Morrison's small eyes became suffused with a pale crimson. Minute beads of perspiration sprung up on his forehead as he spoke: “All I can say is that if it weren't for our current emergency, Charles, I'd see that you were thrown out of the Weinburger today. Lucky for you we can't afford another scandal. But you'd better shine on this Canceran project if you have any intentions of staying on staff here.”
Without waiting for a response, Morrison stalked out of the lab. Charles was left with the low hum of the refrigerator compressors and the ticks of the automatic radioactivity counter. These were familiar sounds and they had a soothing effect on Charles. Maybe, he thought, the Canceran affair wouldn't be too bad; maybe he could do the study quickly, provided the experimental protocol was decent; maybe Ellen was right and they could do both projects by working some nights.
Suddenly the phone began to ring. He debated answering, hearing it ring three times, then four. On the fifth ring he picked it up.
“Hello,” said the caller. “This is Mrs. Crane from the bursar's office at Northeastern University.”
“Yes,” said Charles. It took him a moment to associate the school with Chuck.
“Sorry to bother you,” said Mrs. Crane. “But your son gave us the number. It seems that the $1650 semester tuition is way overdue.”
Charles toyed with a small tin of paper clips, wondering what to say. Not being able to pay bills was a new experience.
“Mr. Martel, are you there?”
“Dr. Martel,” said Charles, although as soon as he made the correction he felt foolish.
“Excuse me, Dr. Martel,” said Mrs. Crane, genuinely compunctious. “Can we expect the money in the near future?”
“Of course,” said Charles. “I'll have a check on its way. I'm sorry for the oversight.”
Charles hung up. He knew that he'd have to get a loan immediately. He hoped to hell that Chuck was doing reasonably well and that he wouldn't major in psychology. He picked up the phone again, but didn't dial. He decided it would save time if he went directly to the bank; besides, he felt like he could use some fresh air and a little time away from the Morrisons and Ibanezes of the world.
F
lipping the pages of an old issue of
Time
magazine, Cathryn wrestled with a resurgence of anxiety. At first Dr. Wiley's waiting room had been a sanctuary from the horrors of the rest of the hospital, but as time passed uncertainty and foreboding began to reassert themselves. Glancing at her watch she saw that Michelle had been back in the examining area for over an hour. Something must be wrong!
She began to fidget, crossing and uncrossing her legs, checking her watch repeatedly. To her discomfort there was no conversation in the room and almost no movement except for the hands of a woman who was knitting and the erratic gestures of two toddlers playing with blocks. All at once Cathryn realized what was bothering her. Everything was too flat, without emotion. It was like a two-dimensional picture of a three-dimensional scene.
She stood up, unable to sit still for another moment. “Excuse me,” she said walking over to the nurse. “My little girl, Michelle Martel. Do you have any idea how much longer she'll be?”
“The doctor hasn't told us,” said the nurse politely. She sat
with her back painfully straight so that her substantial buttocks protruded out the back of her chair.
“She's been in there for a long time,” said Cathryn, searching for some reassurance.
“Dr. Wiley is very complete. I'm sure she'll be out shortly.”
“Does he frequently take over an hour?” asked Cathryn. She felt superstitiously ambivalent about asking any questions at all, as if the asking would influence the ultimate outcome.
“Certainly,” said the nurse receptionist. “He takes whatever time he needs. He never rushes. He's that kind of a doctor.”
But why does he need all that time, wondered Cathryn as she returned to her seat. The image of Tad with his plastic cell kept returning to Cathryn's troubled mind. It was a horrifying shock to realize that children do get serious illnesses. She had believed that it was a rare occurrence that happened to someone else's child, a child one didn't know. But Tad was a neighbor, her daughter's friend. Cathryn shuddered.
Picking up yet another magazine, Cathryn glanced at the advertisements; there were smiling, happy people, shining floors, buying new cars. She tried to decide what to fix for dinner but never completed the thought. Why was Michelle taking so long? Two more mothers arrived with pink swathed parcels that were obviously babies. Then came another mother and child: a small boy about two with a huge violaceous rash that covered half his face.
The waiting room was now packed and Cathryn began to have trouble breathing. Getting up to make room for the second mother carrying her infant, Cathryn tried to avoid seeing the two-year-old with the horribly disfiguring rash. Her fears mounted. It had been over an hour and twenty minutes since she'd left Michelle. She realized she was trembling.
Once again she approached the nurse and self-consciously stood before her desk until the woman acknowledged her presence.
“Can I help you?” she said in a painfully courteous manner. Cathryn wanted to reach over and shake this woman whose starched whiteness inflamed Cathryn's precarious emotions.
She didn't need politeness, she needed warmth and understanding, an ounce of sensitivity.
“Do you think it could be possible,” asked Cathryn, “to find out what's taking so long?”
Before the receptionist could respond, the door to her left opened and Dr. Wiley leaned into the room. He searched the waiting area until his eyes found Cathryn. “Mrs. Martel, can I speak to you for a moment?” His voice was noncommittal and he turned back inside, leaving the door ajar.
Cathryn hurried after him, nervously touching the flowered combs in her hair to be sure they were in place, and closed the door behind her carefully. Wiley had retreated to his desk but had not sat down in the chair. Instead he was half-sitting on the front edge, his arms folded across his chest.
Exquisitely sensitive to every nuance, Cathryn scrutinized Dr. Wiley's broad face. His forehead was deeply lined, something Cathryn hadn't noticed on her first encounter. The man didn't smile.
“We need your permission for a test,” said Dr. Wiley.
“Is everything all right?” asked Cathryn. She tried to sound normal but her voice was too high.
“Everything is under control,” said Dr. Wiley. Unfolding his arms, he reached out for a paper on his desk. “But we need to do a specific diagnostic test. I'm going to need your signature on this form.” He handed the paper to Cathryn. She took it, her hand quivering.
“Where is Michelle?” Cathryn's eyes scanned the form. It was written in standard medicalese.
“She's in one of the examining rooms. You can see her if you'd like although I'd rather go ahead with this test before you do. It's called a bone marrow aspiration.”
“Bone marrow?” Cathryn's head shot up. The words evoked the awesome image of Tad Schonhauser in his plastic tent.
“It's nothing to be alarmed about,” said Dr. Wiley, noticing Cathryn's shocked response. “It's a simple test, very similar to taking a sample of blood.”
“Does Michelle have aplastic anemia?” blurted Cathryn.
“Absolutely not.” Dr. Wiley was perplexed at her response. “We want to do the test in order to try to make a diagnosis, but I can assure you Michelle does not have aplastic anemia. If you don't mind my asking, what made you ask that?”
“Just a few minutes ago I visited our neighbor's child who has aplastic anemia. When you said bone marrow, it . . .” Cathryn struggled to complete her own sentence.
“I understand,” said Dr. Wiley. “Don't worry. I can assure you that aplastic anemia is not a possibility here. But we still want to do the test . . . just to be complete.”
“Do you think I should call Charles?” asked Cathryn. She was relieved that Michelle couldn't have aplastic anemia and grateful to Dr. Wiley for eliminating it as a possibility. Although Charles had said aplastic anemia wasn't infectious, its proximity was frightening.
“If you'd like to call Charles, by all means. But let me explain a little. Bone marrow aspiration is done with a needle similar to the one we use for drawing blood. We use a little local anesthesia so it's practically painless, and it only takes a few moments. And once we have the results we'll be done. It's truly a simple procedure, and we do it often.”
Cathryn managed a smile and said they could go ahead with the test. She liked Dr. Wiley, and she felt a visceral confidence in the man, especially since Charles had undoubtedly picked him from a group of pediatricians he knew well, back when Chuck had been born. She signed the forms where Dr. Wiley pointed, then allowed herself to be escorted out of the office and back into the crowded waiting room.
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Michelle lay very still on the examining table. Even with her head propped up on the pillow her view was mostly ceiling with frosted glass over fluorescent lighting. But she could see a little wallpaper, enough to make out images of laughing clowns, rocking horses, and children with balloons. There was a sink in the room, and although she couldn't see it from where she was, she could hear the water dripping.
For Michelle the hospital had lived up to her fears. She'd
been stuck with needles three times. Once in each arm and once in a finger. Each time she'd asked if it was the last but no one would say, so she was afraid it might happen again, especially if she moved too much, so she stayed very still.
She felt embarrassed to be dressed so scantily. She had on a nightie of sorts, but it was open in the back, and she could feel her skin on the paper which covered the table. By looking down, she could see the mounds made by her toes beneath the white sheet that covered her. Even her hands were under the cover, clasped together over her stomach. She'd been shivering a little but didn't tell anyone. All she wanted was her clothes and to go home. Yet she knew the fever was back and she was afraid someone might notice and then want to stick her again. They had told her that the reason they needed her blood was to find out why she kept getting the fever.
There was a scraping sound, and the door to the examining room opened. It was the fat nurse, and she was backing into the room so that her form filled the doorway. She was pulling something, and Michelle heard the telltale sound of metal jangling against metal. Once clear of the door, the nurse swung around, pushing a small table on wheels. The table was covered with a blue towel. As far as Michelle was concerned, it didn't look good.
“What's that?” she asked anxiously.
“Some things for the doctor, sweetheart,” said Miss Hammersmith, as if she were talking about treats. Her name tag was pinned high on her shoulder like a battle ribbon, above the band of her bosom which went around her chest like an innertube. There seemed to be as much flesh in the back as the front.
“Is it going to hurt?” asked Michelle.
“Sweetheart, why do you ask that kind of question? We're trying to help you.” Miss Hammersmith sounded offended.
“Everything the doctor does hurts,” said Michelle.
“Now that's hardly true,” scoffed Miss Hammersmith.
“Ah, my favorite patient,” said Dr. Wiley, opening the door with his shoulder. Coming into the room he kept his hands
away from his body because they were wet and dripping onto the floor. Miss Hammersmith broke open a paper package, and Dr. Wiley carefully pulled out a sterile towel with his thumb and forefinger. Most alarming to Michelle, he was wearing a surgical mask.
“What are you going to do?” she asked, her eyes opened to their physical limits. She forgot her resolve about staying still and pushed herself up on one elbow.
“Well, I'm afraid I've got good and bad news,” said Dr. Wiley. “I'm afraid you have to have one more little needle stick but the good news is that it will be the last for a while. What do you say?”
Dr. Wiley tossed the towel onto the counter by the sink and plucked out a pair of rubber gloves from a package Miss Hammersmith held open for him.
With growing dismay, Michelle watched him pull the gloves onto each hand, snapping the wrist portion into place and tugging on each finger in turn.
“I don't want any more needles,” said Michelle, her eyes filling with tears. “I just want to go home.” She tried not to cry but the harder she tried, the less successful she was.
“Now, now,” soothed Miss Hammersmith as she began stroking Michelle's hair.
Michelle parried Miss Hammersmith's hand and tried to sit up, but she was restrained by a cinch about her waist. “Please,” she managed.
“Michelle!” called Dr. Wiley sharply, then his voice softened. “I know you don't feel well, and I know this is hard for you, but we have to do it. It will be over in a moment if you help us.”
“No!” said Michelle defiantly. “I want my father.”
Dr. Wiley gestured to Miss Hammersmith: “Maybe Mrs. Levy could come in here for a moment and give us a hand.”
Miss Hammersmith lumbered out of the room.
“Okay, Michelle, just lie back and relax for a moment,” said Dr. Wiley. “I'm sure your dad will be real proud of you when
I tell him how courageous you were. This is only going to take a moment. I promise.”
Michelle lay back and closed her eyes, feeling the tears run down the side of her face. Intuitively she knew that Charles would be disappointed if he heard that she'd acted like a baby. After all, it was going to be the last stick. But both her arms had been punctured and she wondered where they would do it.
The door opened again and Michelle propped herself up to see who it was. Miss Hammersmith came in followed by two other nurses, one of whom carried some leather straps.
“We won't need restraints, I don't think,” said Dr. Wiley. “Okay, Michelle, now just lie back quietly for a moment.”
“Come on, sweetheart,” cajoled Miss Hammersmith, coming up alongside Michelle. One of the other nurses went around to the opposite side while the nurse who had been carrying leather straps went down to the foot of the table. “Dr. Wiley is the best doctor in the world and you should be so thankful he's taking care of you,” said Miss Hammersmith as she pulled Michelle's sheet down over the child's legs. Keeping her arms stiffly against her side, Michelle half-heartedly tried to resist when Miss Hammersmith pulled up the nightie to expose the child's body from her nipples to her bony knees.
She watched while the nurse whisked the towel from the table with the wheels. Dr. Wiley busied himself with the instruments on it, his back to her. She could hear the tinkle of glass and the sound of fluid. When the doctor turned, he had a wet piece of cotton in each hand. “I'm just going to clean your skin a little,” he explained as he began scrubbing Michelle's hipbone.
The water felt alarmingly cold to Michelle as it ran down her hip and pooled beneath her buttocks. This was a new experience, not like the previous needles. She strained to see what was happening, but the doctor gently urged her to lie back.
“It will be over in just a moment,” said Miss Hammersmith.
Michelle looked at the faces of the nurses. They were all
smiling but they were fake smiles. Michelle began to feel panic. “Where are you going to stick me?” she shouted, trying again to sit up.