Terminal (2 page)

With his head still stabilized in the vise-like apparatus for the MRI, Howard was unaware of the technician’s presence until the man spoke.

“You okay?” he asked as he began to release Howard’s head.

“Okay,” Howard managed to reply. He was lying. His heart was thumping in terror. He was afraid of what the test would reveal. Behind a glass divider he could discern a group of white-coated individuals studying a CRT screen. One of them was his doctor, Tom Folger. They were all pointing, gesturing, and, most disturbing of all, shaking their heads.

The trouble had begun the day before. Howard had awakened with a headache, a rare occurrence unless he’d “tied one on,” which he hadn’t. In fact, he’d not had anything to drink since New Year’s Eve. After taking a dose of aspirin and eating a bit of breakfast, the pain had abated. But later that morning in the middle of a board meeting, with no warning whatsoever, he’d vomited. It had been so violent and so unexpected, with no preceding nausea, that he’d not even been able to lean aside. To his utter mortification, his undigested breakfast had spewed over the boardroom table.

With his head now freed, Howard tried to sit up, but the movement caused his headache to return in full force. He sank back to the MRI table and closed his eyes until his doctor gently touched his shoulder. Tom had been the family internist for over twenty years. He and Tom had become good friends
over the years, and they knew each other well. Howard did not like what he saw in Tom’s face.

“It’s bad, isn’t it?” Howard asked.

“I’ve always been straight with you, Howard…”

“So don’t change now,” Howard whispered. He didn’t want to hear the rest, but he had to.

“It doesn’t look good,” Tom admitted. He kept his hand on Howard’s shoulder. “There are multiple tumors. Three to be exact. At least that’s how many we can see.”

“Oh, God!” Howard moaned. “It’s terminal, isn’t it?”

“That’s not the way we should talk at this point,” Tom said.

“Christ it isn’t,” Howard snapped. “You just told me you’ve always been straight with me. I asked a simple question. I have a right to know.”

“If you force me to answer, I’d have to say yes; it could be terminal. But we don’t know for sure. For the present we’ve got a lot of work to do. First thing we have to do is find out where it’s come from. Being multifocal suggests it’s spread from someplace else.”

“Then let’s get on with it,” Howard said. “If there’s a chance, I want to beat this thing.”

January 4, 1:25 P.M.

When Louis Martin first awoke in the recovery room, he felt as if his throat had been scorched with an acetylene torch. He’d had sore throats before, but nothing had even come close to the pain he’d felt as he tried to swallow after his surgery. To make matters worse, his mouth had been as dry as the central Sahara.

The nurse who had materialized at his bedside seemingly out of nowhere had explained that his discomfort was due to the endotracheal tube the anesthesiologist had inserted prior to his operation. She gave him a damp washcloth to suck on and the pain had abated.

By the time he was wheeled back to his room, a different pain had started, located somewhere between his legs and radiating into the small of his back. Louis knew the cause of that discomfort. It was the site of his surgery to reduce an enlarged prostate gland. The damn thing had been forcing him to get up to urinate four or five times each night. He’d scheduled the surgery for the day after New Year’s. Traditionally that was a slow time for the computer giant he ran north of Boston.

Just as the pain was getting the best of him, another nurse gave him a bolus of Demerol through the IV which was still attached to his left hand. A bottle of fluid hung on a T-shaped pole protruding from the head of his bed.

The Demerol put him back into a drugged sleep. He wasn’t sure how much time had passed when he became aware of a presence next to his head. It took all his strength to open his eyes; his eyelids felt like lead. At the head of his bed was a nurse fumbling with plastic tubing coming from the IV bottle. In her right hand was a syringe.

“What’s that?” Louis mumbled. He sounded inebriated.

The nurse smiled at him.

“Sounds as if you’d had one too many,” she said.

Louis blinked as he tried to focus on the woman’s swarthy face. In his drugged state, the nurse was a blur. Yet she was correct about how he sounded.

“I don’t need any more pain medicine,” Louis managed to say. He struggled to a half-sitting position, leaning on an elbow.

“It’s not pain medicine,” the nurse said.

“Oh,” Louis said. While the nurse completed the injection, Louis slowly realized he still didn’t know what he was being given. “What kind of medicine is it?” Louis asked.

“A wonder drug,” the nurse said, quickly capping the syringe.

Louis laughed in spite of himself. He was about to ask another question, but the nurse satisfied his curiosity.

“It’s an antibiotic,” she said. She gave Louis’s shoulder a reassuring squeeze. “Now you close your eyes and rest.”

Louis flopped back onto his bed. He chuckled. He liked people with a sense of humor. In his mind he repeated what the nurse had said:
a wonder drug.
Well, antibiotics were wonder drugs, there was no doubt. He recalled that Dr. Handlin had told him he might be put on antibiotics as a precaution after his operation. Louis vaguely wondered what it had been like to be in a hospital before antibiotics had been discovered. He felt thankful that he was living when he was.

Closing his eyes, Louis followed the nurse’s suggestion and let his body relax. The pain was still present, but because of the narcotic, it didn’t bother him. Narcotics were wonder drugs as well, and so were the anesthetic agents. Louis was the first to admit he was a coward when it came to pain. He could never have tolerated surgery back when none of the “wonder drugs” were available.

As Louis drifted off to sleep, he wondered what kind of drugs the future would bring. He decided he’d have to ask Dr. Handlin’s opinion.

January 4, 2:53 P.M.

Norma Kaylor watched the drops fall into the millipore chamber hanging below her IV bottle. The IV ran through a large-bore catheter into her left arm. She had such mixed feelings about the medicine she was getting. She hoped the powerful chemotherapeutic agents would cure her breast cancer which, she’d been told, had spread into her liver and lungs. At the same time she knew the medicines were cellular poisons, capable of wreaking havoc on her body as well as on her tumor. Dr. Clarence had warned her about so many dreadful side effects that she’d made a conscious effort to screen out his voice. She’d heard enough. She’d signed the consent form with a feeling of numbed detachment.

Turning, Norma looked out the window at the intensely blue Miami sky, filled with massive bubbles of white cumulus clouds. Since her cancer had been diagnosed, she tried hard
not to ask
why me?
When she’d first felt the lump she had hoped it would go away of its own accord, like so many lumps had done in the past. It wasn’t until several months had passed, and the skin over the lump had suddenly dimpled, that she’d forced herself to see a doctor, only to learn that her fears had been justified: the lump was malignant. So just before her thirty-third birthday she’d undergone a radical mastectomy. She hadn’t fully recovered from the surgery before the doctors began the chemotherapy.

Determined to end her self-pity, she was reaching for a novel when the door to her private room opened. She didn’t even look up. Staff at the Forbes Cancer Center was constantly in and out adjusting her IV, injecting her medicine. She had gotten so used to the constant comings and goings, they barely interrupted her reading anymore.

It was only after the door had closed again that she became aware she had been given some new drug. The effect was unique, causing the strength suddenly to drain from her body. Even the book she was holding fell from her hands. But what was more frightening was the effect on her breathing; it was as if she were being smothered. In agony she tried to get air, but she had progressive difficulty, and soon she was totally paralyzed except for her eyes. The image of her door being quietly opened was the last thing she knew.

February 26
Friday, 9:15 A.M.

“
O
h, God, here she comes!” Sean Murphy said. Frantically he grabbed the charts stacked in front of him and ducked into the room behind the nurses’ station on the seventh floor of the Weber Building of the Boston Memorial Hospital.

Confused at this sudden interruption, Peter Colbert, a fellow third-year Harvard medical student, surveyed the scene. Nothing was out of the ordinary. It appeared like any busy internal medicine hospital ward. The nurses’ station was a beehive of activity with the floor clerk and four RN’s busy at work. There were also several orderlies pushing patients on gurneys. Organ music from the soundtrack of a daytime soap could be heard drifting out of the floor lounge. The only person approaching the nurses’ station who didn’t belong was an attractive female nurse who Peter felt was an eight or nine out of a possible ten. Her name was Janet Reardon. Peter knew about her. She was the daughter of one of the old Boston Brahmin families, aloof and untouchable.

Peter pushed back from the counter where he had been sitting next to the chart rack and shoved open the door to the back room. It was an all-purpose office with desk-high countertops, a computer terminal, and a small refrigerator. The nurses held their reports in there at the end of each shift, and those who brown-bagged it used it as a lunchroom. In the back was a lavatory.

“What the hell’s going on?” Peter demanded. He was curious
to say the least. Sean was against the wall with his charts pressed to his chest.

“Shut the door!” Sean commanded.

Peter stepped into the room. “You’ve been making it with Reardon?” It was part question, part stunned realization. It had been almost two months ago at the outset of Peter’s and Sean’s rotation on third-year medicine that Sean had spotted Janet and had asked Peter about her.

“Who the hell is that?” Sean had demanded. His mouth had gone slack. In front of him was one of the most beautiful women he’d ever seen. She was climbing down from the counter after retrieving something from the inaccessible top shelf of a wall cabinet. He could tell she had a figure that could have graced any magazine.

“She’s not your type,” Peter had said. “So close your mouth. Compared to you she’s royalty. I know some guys who have tried to date her. It’s impossible.”

“Nothing is impossible,” Sean had said, watching Janet with stunned appreciation.

“A townie like you could never get to first base,” Peter had said. “Much less hit a home run.”

“Want to bet?” Sean had challenged. “Five bucks says you are wrong. I’ll have her thirsting for my body by the time we finish medicine.”

At the time, Peter had just laughed. Now he appraised his partner with renewed respect. He thought he’d gotten to know Sean over the last two months of grueling work, and yet here he was on the last day of medicine surprising him.

“Open the door a crack and see if she’s gone,” Sean said.

“This is ridiculous,” Peter said, but he opened the door several inches nonetheless. Janet was at the counter talking to Carta Valentine, the head nurse. Peter let the door shut.

“She’s right outside,” he said.

“Damn!” Sean exclaimed. “I don’t want to talk to her right now. I’ve got too much to do, and I don’t want a scene. She doesn’t know I’m leaving for Miami for that elective at the Forbes Cancer Center. I don’t want to tell her until Saturday night. I know she’s going to be pissed.”

“So you
have
been dating her?”

“Yeah, we’ve gotten pretty hot and heavy,” Sean said. “Which reminds me: you owe me five bucks. And let me tell you, it wasn’t easy. At first she’d barely talk to me. But eventually, utter charm and persistence paid off. My guess is that it was mostly the persistence.”

“Did you bag her?” Peter asked.

“Don’t be crude,” Sean said.

Peter laughed. “Me crude? That’s the best example of the pot calling the kettle black that I’ve ever heard.”

“The problem is she’s getting serious,” Sean said. “She thinks because we slept together a couple of times, it’s leading to something permanent.”

“Am I hearing marriage here?” Peter asked.

“Not from me,” Sean said. “But I think that’s what she has in mind. It’s insane, especially since her parents hate my guts. And hell, I’m only twenty-six.”

Peter opened the door again. “She’s still there talking with one of the other nurses. She must be on break or something.”

“Great!” Sean said sarcastically. “I guess I can work in here. I’ve got to get these off-service notes written before I get another admission.”

“I’ll keep you company,” Peter said. He went out and returned with several of his own charts.

They worked in silence, using the three-by-five index cards they carried in their pockets bearing the latest laboratory work on each of their assigned patients. The idea was to summarize each case for the medical students rotating on service come March 1.

“This one has been my most interesting case,” Sean said after about half an hour. He held the massive chart aloft. “If it hadn’t been for her I wouldn’t even have heard about the Forbes Cancer Center.”

“You talking about Helen Cabot?” Peter asked.

“None other,” Sean said.

“You got all the interesting cases, you dog. And Helen’s a looker, too. Hell, on her case consults were pleading to be called.”

“Yeah, but this looker turned out to have multiple brain tumors,” Sean said. He opened the chart and glanced through some of its two hundred pages. “It’s sad. She’s only twenty-one and she’s obviously terminal. Her only hope is that she gets accepted by the Forbes. They have been having phenomenal luck with the kind of tumor she has.”

“Did her final pathology report come back?”

“Yesterday,” Sean said. “She’s got medulloblastoma. It’s fairly rare; only about two percent of all brain tumors are this type. I did some reading on it so I could shine on rounds this afternoon. It’s usually seen in young children.”