A Case of Need: A Novel (3 page)

“I was pretty horrified. I was fresh from my residency, and I still had a little starry idealism in me. She was in a terrible fix; she was a wreck and acted as if the world had collapsed around her. I guess in a way it had. All she could see was her problem as a college dropout, the unwed mother of a possibly deformed child. She was a nice enough girl, and I felt sorry for her, but I said no. I sympathized with her, feeling rotten inside, but I explained that my hands were tied.

“So then she asked me if it was a dangerous operation, to have an abortion. At first I thought she was planning to try it on herself, so I said it was. Then she said she knew of a man in the North End who would do it for two hundred dollars. He had been a medical orderly in the Marines, or something. And she said that if I wouldn’t do it for her, she’d go to this man. And she walked out of my office.”

He sighed and shook his head as he drove.

“I went home that night feeling like hell. I hated her: I hated her for intruding on my new practice, for intruding on my neatly planned life. I hated her for the pressure she was putting on me. I couldn’t sleep; I kept thinking all night. I had a vision of her going to a smelly back room somewhere and meeting a leering little guy who would letch her and maybe even manage to kill her. I thought about my own wife and our year-old baby, and how happy it could all be. I thought about the amateur abortions I’d seen as an intern, when the girls came in bleeding and foaming at three in the morning. And let’s face it, I thought about the sweats I’d had in college. Once with Betty, we sat around for six weeks waiting for her period. I knew perfectly well that anybody can get pregnant by accident. It’s not hard, and it shouldn’t be a crime.”

I smoked a cigarette and said nothing.

“So I got up in the middle of the night and fought it out with six cups of coffee, staring at the kitchen wall. By morning I had decided that the law was unfair. I had decided that a doctor could play God in a lot of crappy ways, but this was a good way. I had seen a patient in trouble and I had refused to help her when it was within my power. That was what bothered me—I had denied her treatment. It was just as bad as denying penicillin to a sick man, just as cruel and just as foolish. The next morning, I went to see Sanderson. I knew he had liberal ideas about a lot of things. I explained the whole situation and told him I wanted to do a D & C. He said he would arrange to do the path examination himself, and he did. That was how it all started.”

“And you’ve been doing abortions ever since?”

“Yes,” Art said. “When I’ve felt that they were warranted.”

After that, we went to a bar in the North End, a simple place, filled with Italian and German laborers. Art was in a talkative, almost confessional mood.

“I often wonder,” he said, “about what medicine would be like if the predominant religious feeling in this country were Christian Scientist. For most of history, of course, it wouldn’t have mattered; medicine was pretty primitive and ineffective. But supposing Christian Science was strong in the age of penicillin and antibiotics. Suppose there were pressure groups militating against the administration of these drugs. Suppose there were sick people in such a society who
knew
perfectly well that they didn’t have to die from their illness, that a simple drug existed which would cure them. Wouldn’t there be a roaring black market in these drugs? Wouldn’t people die from home administration of overdoses, from impure, smuggled drugs? Wouldn’t everything be an unholy mess?”

“I see your analogy,” I said, “but I don’t buy it.”

“Listen,” he said. “Morality must keep up with technology, because if a person is faced with the choice of being moral and dead or immoral and alive, they’ll choose life every time. People today know that abortions are safe and easy. They know it isn’t a long, tedious, dangerous operation. They know it’s simple and they want the personal happiness it can give them. They demand it. And one way or another they get it. If they’re rich, they go to Japan or Puerto Rico; if they’re poor, they go to the Marine orderly. But one way or another, they get that abortion.”

“Art,” I said. “It’s illegal.”

He smiled. “I never thought you had so much respect for the law.”

That was a reference to my career. After college, I entered law school and stuck it out for a year and a half. Then I decided I hated it and quit to try medicine. In between, I did some army time.

“But this is different,” I said. “If they catch you, they’ll toss you in the clink and take away your license. You know that.”

“I’m doing what I have to do.”

“Don’t be an ass.”

“I believe,” he said, “that what I’m doing is right.”

Looking at his face, I saw he meant it. And as time went on, I personally encountered several cases where an abortion was the obvious, humane answer. Art handled them. I joined Dr. Sanderson in covering up in the path department. We fixed things so that the tissue committee never knew. That was necessary because the tissue committee of the Lincoln was composed of all the chiefs of service, as well as a rotating group of six doctors. The average age of the men on the tissue committee was sixty-one, and, at any given time, at least a third were Catholic.

Of course it was not a well-kept secret. Many of the younger doctors knew what Art was doing, and most agreed with him, because he exercised careful judgment in deciding his cases. Most would have performed abortions too, if they had dared.

A few didn’t agree with Art and would have been tempted to turn him in if they’d had the guts. Anal retentives like Whipple and Gluck, men whose religion precluded compassion and common sense.

For a long time, I worried about the Whipples and the Glucks. Later on I ignored them, turning away from their nasty knowing glances and pinched, disapproving faces. Perhaps that was a mistake.

Because now Art was down, and if his head rolled, so would Sanderson’s. And so would mine.

THERE WAS NO PLACE TO PARK
near the police station. Finally I came to a lot four blocks away and walked quickly back to find out why Arthur Lee was in jail.

¹
Geriatrics

²
The files containing the history of treatment of patients in the hospital. Called a “chart” because the bulk of the file consists of daily charts of temperature, blood pressure, pulse, and respiration, the so-called “vital signs.”

³
Diagnosis.

⁴
Crepitant means it is crackly and filled with air. This is normal.

⁵
Emergency ward.

⁶
Chief complaint, the term for the medical disorder that brings the patient to seek treatment.

⁷
A test of the amount of hemoglobin, or red cells, in the blood.

W
HEN I WAS IN THE ARMY
a few years back, I served as an MP in Tokyo, and the experience taught me a lot. MP’s were the most unpopular people in the city in those days, during the last phases of the occupation. In our white helmets and uniforms, we represented the final reminders of a tiresome military authority to the Japanese. To the Americans on the Ginza, drunk with sake or whiskey if they could afford it, we represented all that was frustrating or constricting about rigid military life. We were therefore a challenge to anyone who saw us, and more than one of my friends ran into trouble. One was blinded by a knife in the eye. Another was killed.

Of course, we were armed. I remember when we were first issued our guns, a hard-nosed captain said to us: “You have your weapons, now take my advice: never use the gun. You shoot a rowdy drunk, even in self-defense, and you’ll find out later his uncle is a congressman or a general. Keep the gun in sight, but keep it in your holster. Period.”

In effect we were ordered to bluff our way through everything. We learned to do it. All cops learn to do it.

I remembered this as I faced the surly police sergeant in the Charles Street Station. He looked up at me as if he’d enjoy breaking my skull.

“Yeah? What is it?”

“I’m here to see Dr. Lee,” I said.

He smiled. “The little chink’s uptight, is he? Too bad.”

“I’m here to see him,” I repeated.

“Can’t.”

He looked back at his desk and shuffled the papers on it in a busy, irritable dismissal.

“Would you care to explain that?”

“No,” he said. “I wouldn’t care to explain that.”

I took out my pen and notebook. “I’d like your badge number, please.”

“What are you, a funny guy? Beat it. You can’t see him.”

“You are required by law to give your badge number upon request.”

“That’s nice.”

I looked at his shirt and pretended to write down the number. Then I started for the door.

He said casually, “Going somewhere?”

“There’s a phone booth right outside.”

“So?”

“It’s a shame. I’ll bet your wife spent hours sewing those stripes on your shoulder. It takes them ten seconds to get them off. They use a razor blade: doesn’t even damage the uniform.”

He stood up heavily behind the desk. “What’s your business here?”

“I’ve come to see Dr. Lee.”

He looked at me evenly. He didn’t know if I could have him busted, but he knew it could be done.

“You his lawyer?”

“That’s right.”

“Well, for Christ’s sake, you should have said so before.” He took a set of keys from his desk drawer. “Come on.” He smiled at me, but his eyes were still hostile.

I followed him back through the station. He said nothing, but grunted a couple of times. Finally he said over his shoulder, “You can’t blame me for being careful. Murder is murder, you know.”

“Yes,” I said.

ART WAS LOCKED IN A NICE CELL
. It was tidy and didn’t smell much. Actually, Boston has some of the nicest cells in America. They have to: lots of famous people have spent time in those cells. Mayors, public officials, people like that. You can’t expect a man to run a decent campaign for reelection if he’s in a lousy cell, can you?

It just wouldn’t look right.

Art was sitting on his bed, staring at a cigarette between his fingers. The stone floor was littered with butts and ash. He looked up as we came down the hallway.

“John!”

“You have him for ten minutes,” the sergeant said.

I entered the cell. The sergeant locked the door behind me and stood there, leaning against the bars.

“Thank you,” I said. “You can go now.”

He gave me a mean look and sauntered off, rattling the keys.

When we were alone, I said to Art, “You all right?”

“I think so.”

Art is a small, precise man, a fastidious dresser. Originally he’s from San Francisco from a large family of doctors and lawyers. Apparently his mother was American: he doesn’t look very Chinese. His skin is more olive than yellow, his eyes lack epicanthic folds, and his hair is light brown. He is very nervous, constantly moving his hands in fluttering movements, and the total effect is more Latin than anything else.

He was pale now and tense. When he got up to pace the cell, his movements were quick and abrupt.

“It was good of you to come.”

“In case there’s any question, I’m the representative of your lawyer. That’s how I got in here.” I took out my notebook. “Have you called your lawyer?”

“No, not yet.”

“Why not?”

“I don’t know.” He rubbed his forehead and massaged his eyes with his fingers. “I’m not thinking straight. Nothing seems to make sense …”

“Tell me your lawyer’s name.”

He told me, and I wrote it in the notebook. Art had a good lawyer. I guess he figured he’d need one, sometime.

“Okay,” I said. “I’ll call him when I leave. Now what’s going on?”

“I’ve been arrested,” Art said. “For murder.”

“So I gathered. Why did you call me?”

“Because you know about these things.”

“About murder? I don’t know anything.”

“You went to law school.”

“For a year,” I said. “That was ten years ago. I almost flunked out, and I don’t remember a thing I learned.”

“John,” he said, “this is a medical problem and a legal problem. Both. I need your help.”

“You’d better start from the beginning.”

“John, I didn’t do it. I swear I didn’t. I never touched that girl.”

He was pacing faster and faster. I gripped his arm and stopped him. “Sit down,” I said, “and start from the beginning. Very slowly.”

He shook his head and stubbed out his cigarette. Immediately he lit another, then said, “They picked me up at home this morning, about seven. Brought me in and started questioning me. At first they said it was routine, whatever that means. Then they turned nasty.”

“How many were there?”

“Two. Sometimes three.”

“Did they get rough? Slap you around? Bright lights?”

“No, nothing like that.”

“Did they say you could call a lawyer?”

“Yes. But that was later. When they advised me of my constitutional rights.” He smiled that sad, cynical smile of his. “At first, you see, it was just for routine questioning, so it never occurred to me to call one. I had done nothing wrong. They talked to me for an hour before they even mentioned the girl.”

“What girl?”

“Karen Randall.”

“You don’t mean
the
Karen—”

He nodded. “J. D. Randall’s daughter.”

“Jesus.”

“They began by asking me what I knew about her, and whether I’d ever seen her as a patient. Things like that. I said yes, that she had come to me a week ago for consultation. Chief complaint of amenorrhea.”

“What duration?”

“Four months.”

“Did you tell them the duration?”

“No, they didn’t ask me.”

“Good,” I said.

“They wanted to know other details about her visit. They wanted to know if that was her only problem, they wanted to know how she had acted. I wouldn’t tell them. I said that the patient had spoken in confidence. So then they switched tacks: they wanted to know where I was last night. I told them I had made evening rounds at the Lincoln and then taken a walk in the park. They asked me if I had gone back to my office. I said no. They asked me if anyone had seen me in the park that night. I said I couldn’t remember anyone, certainly nobody I knew.”