Doctors (101 page)

Then they looked at one another helplessly.

“Do you want me to inject him?” Barney asked softly.

“I can do it,” she replied numbly.

Barney then confessed, “Please, Castellano. I’m no good with needles. And I can’t stick one into my own son.”

Harry yelled as Laura injected an ampoule of the fluid into his anterior thigh. And then he suddenly went quiet.

They were terrified. Had they killed him?

They stood like statues on either side of the bed, staring at their son.

After a few seconds that seemed like an eternity, Laura leaned over and put her fingers on Harry’s wrist.

“He’s got a pulse, Barn. It’s as steady as before.”

“Do you think the medicine conked him out?”

She shook her head. “We’ve all had a helluva two days. Imagine how tired he must be.”

Then she gathered Harry in her arms and held him close.

Barney touched his son’s forehead. “Still like the Sahara Desert,” he commented. “How long’s it been since you gave him the shot?”

“Four, maybe five minutes. Stay loose, Barn. Even if it
is
a miracle drug …”

The word “miracle” stuck in her throat. If there is a God, she thought, He doesn’t owe me any favors.

“Laura,” Barney said softly, “lie down—or at least
sit.
”

“I’m too nervous,” she replied, gently placing Harry on the bed.

“Would you like something from room service?” he offered.

“I’m not hungry—are you?”

“No, but it passes the time. And … it gives me something to
do.
”

“There are some vending machines down the corridor—why not get something from there?”

He welcomed the assignment. “What can I bring you?”

“Nothing—anything. As long as it doesn’t taste good.”

He knew what she was saying: I abjure all earthly delights—even the sweetness of a candy bar—so that my abstinence might prove the final molecule of sacrifice needed to placate an angry divinity. He darted out of the room.

The long corridor was carpeted in what seemed like gray Astroturf. Racing down it gave Barney some physical release.

But he could not outrun his thoughts.

Oh, Christ, Harry, the dreams I had of the two of us jogging together along a leaf-strewn forest path. How we would talk, man to man. How I was gonna tell you all the stupid mistakes I made in my life—so you could learn from them. What can I teach you
now
?

At this moment all I want is for you to keep breathing. Something I can’t teach you. Or do for you.

He walked slowly back to the room, carrying two drinks in paper cups.

Laura was seated now, staring at Harry’s face, afraid to blink lest she miss the minutest hint of change.

“He hasn’t moved,” she announced like an automaton.

“Maybe it’s just a deep sleep. Did you notice any REM eye movements?”

“No.”

In other words, if he was sleeping, he wasn’t dreaming.

Laura placed her Coke on the night table, and merely took out a piece of ice to suck. All the while, her eyes never left Harry. Perhaps her overwhelming feelings of love could somehow heal him.

“Can we talk?” Barney asked hesitantly.

Laura nodded. “What do you want to talk about?”

“Oh, you know, stuff. Like should he go to public school or prep school. Or you could talk about yourself.”

“What could I possibly tell you that you don’t already know?” she said, smiling wearily.

“You could speculate on what your life would have been if your folks hadn’t emigrated to Brooklyn.…”

She looked at him and answered without words. Her eyes were saying, Without you I would have nothing to live for.

Which he believed with equal fervor.

But they both were wondering how—or if—they could survive the loss of Harry.

No
, dammit. We don’t have to face that yet. They could not even face the thought.

“Can I hold him a little, please?”

Somehow half an hour passed. Barney touched the sleeping boy’s forehead. He looked up at Laura and said with perhaps self-induced optimism, “Castellano, I think his fever’s down.”

Laura felt Harry’s face, looked at Barney, and said to herself, Wishful thinking. But she answered, “Maybe, Barn.” And thought, Let him cherish his illusions if they keep him sane.

The sick boy continued to sleep while Laura and Barney breathed to the clock, waiting for a hundred and twenty minutes to pass, so that they could try the second dose.

This time the shot wakened Harry, and Laura wanted to take advantage of the moment to get some more liquid into him. But all they had at hand was Coke and Dr. Hsiang’s potion. She opted for the herbal drink.

Though half-asleep and febrile, Harry had strong opinions. As Laura brought the medicine to his lips he shook his head and protested, “Yech, want appa juice.”

“Tell you what, kiddo,” Laura cajoled, “you drink some
of this stuff, and I promise you’ll have all the apple juice you want tomorrow.”

At which point his thirst overcame his taste buds and Harry swallowed, grimacing.

“How do you feel?” Barney asked his son.

“I feel sleepy, Daddy,” Harry replied.

“Well,” Barney replied in his best imitation of happy-go-lucky. “Why not go to beddie-bye?” His voice dropped, “Sleep’s good for you.”

By the time they each had kissed him he was slumbering again.

Laura put him down, and they returned to their posts on either side of his bed to continue their watch.

By now they were too frightened even to speak to one another, and so Barney flicked on the radio, found a San Francisco all-talk station, and half-listened to a debate on the subject of topless restaurants. (“If they can have nude beaches, why can’t women show their boobs anywhere they want? I mean, man, the law’s got to be consistent.”)

After fifteen minutes of silent brooding, Barney interrupted the broadcast colloquium and murmured, “Do you believe this, Castellano? Two qualified doctors are actually sitting in a motel in Loonyland with a dying child trying to believe that some egomaniac’s snake oil is gonna save the kid’s life. Do you think we’re in our right minds?”

Laura shook her head. “I don’t know,” she confessed. “I honestly don’t know.” She paused for a moment and then, looking straight at Barney, added, “But if Harry dies I don’t want to go on living—”

“Laura—”

“I mean it, Barney. And you won’t be able to stop me.”

He protested no further, knowing that he himself was not sure how he could live … without his son.

All the while they could hear Harry’s breathing rise and fall as the radio host, still broadcasting, was questioning a caller from the so-called Church of Eros. Their situation was getting too serious. Barney rose and shut off the babble.

He looked at Harry and touched his forehead once again.

This time he was certain.

“Castellano, I swear to God, he’s got
no
fever. Come on, feel.”

But Laura did not have to feel; she could tell merely by the
change in Harry’s color that Barney was right. She quickly palpated his abdomen.

“Oh, good Christ,” she said, “his spleen.”

“What?” Barney asked in terror

“His spleen is less enlarged, Barn.
It’s already less enlarged.
I think this damn thing is gonna work!”

They kept vigil through the night. This time not watching their son die but rather watching him return to life.

At seven-thirty in the morning, Laura startled Barney by saying, “I want to go to church.”

Barney nodded. “I know just how you feel.”

Laura put it into words. “Barn, I have to say
thank you
to someone. And today for once I hope there is a God to hear me.”

“You’re right, let’s all go.”

They looked at their son, who was sitting up in bed.

“Mommy, I wanna go home,” squealed little Harry. “My teddy misses me.”

The Stanford University Church was a mere ten-minute, treelined walk from the motel. At this early hour the huge cathedral-like building (belying its humble designation) was so empty and silent they could almost hear one another’s hearts beating.

For the first time in her adult life, Laura knelt to pray—and did not know how to begin. But she bowed her head, and hoped her thoughts would reach the proper destination.

Barney stood, holding Harry in his arms, and gazed at his son. The soft early light shining through the tall stained-glass windows played on his face, making it glow with a kind of magic aura.

And for a moment he could reflect calmly on the dark night of the soul—or was it night of wonder?—he and Laura and Harry had just experienced.

What
was
it, he asked himself. Wyman’s enzyme? The Chinese potion? A doctor’s touch? A parent’s love?

He had spent most of his lifetime studying the art of medicine and realized now that he would never really understand its mysteries.

For medicine is an eternal quest for reasons—causes that explain effects.

Science cannot comprehend a miracle.

Laura stood up. “I’d like to hold him now,” she whispered.

Barney returned Harry to his mother’s arms. He embraced Laura and their son. And they walked out together into the morning sunshine.

T
hough in the course of researching this book I walked hospital corridors with a name tag that legitimately identified me as “Dr. Segal,” my degree is in comparative literature, not comparative anatomy. I therefore had to rely in great measure on many secondary sources as well as the medical knowledge of several experts who are not only good doctors but good friends.

They include Professor A. B. Ackerman M.D., of the New York University Medical School; Professor Alan Beer M.D., of the Chicago Medical School; Dennis Gath M.D., of Oxford University; Professor Norman Charles M.D., of NYU; the late William W. Heroy M.D., Chief of Surgery at the Huntington (N.Y.) Hospital; Dr. Geoffrey Leder of the Devonshire Hospital, London; Professor John Leventhal M.D., of Harvard Medical School; Alison Reeve M.D., of the National Institutes of Health; Rodney Rivers M.D., of St. Mary’s Medical School, London; Professor Richard Selzer M.D., of Yale; and Professor Victor Strasburger M.D., of the University of New Mexico Medical School.

I am not personally acquainted with Professor Harry Jergesen M.D., of the University of California at San Francisco Medical School, but am grateful that he agreed to wield his scalpel on several crucial scenes.

These generous physicians—and some of their colleagues—read portions of the manuscript (and in the case of my oldest friends, Bernie Ackerman and Victor Strasburger, the entire book), offering valuable suggestions and pointing out errors of fact and procedure. What scientific mistakes remain result from my invocation of dramatic license or, more likely, my own ignorance.

There are an extraordinary number of books that chronicle the student experience at Harvard Medical School. Since they describe more or less the same events, the accounts are inevitably similar and differ only in their authors’ perspectives. Charles LeBaron’s stimulating
Gentle Vengeance
was the first of this
genre I read and therefore drew upon most often, though I greatly admired Kenneth Klein’s
Getting Better
, as well as Melvin Konner’s recent
Becoming a Doctor.

William Nolen’s works, especially
The Making of a Surgeon
, were rich in detail and anecdote. I derived much information about the psychiatric
cursus honorum
from David Viscott’s
The Making of a Psychiatrist.

I am also indebted to books by Joseph Califano, David Hellerstein, David Hilfiker, Perri Klass, Elizabeth Morgan, William Nolen, Richard Selzer, and Victor Strasburger, as well as the writings of George E. Vaillant, Professor of Psychiatry at Harvard—particularly his probing and compassionate essay, “Why Doctors Fail to Care for Themselves,” prompted by the publication in 1982 of the fact that six M.D.’s of the Harvard class of 1967, people in their late thirties, had already died, all but one from “maladaptive lifestyles.” Vaillant’s conclusion is chilling: “I fear that this is no more than one of the painful realities of life in an unbelievably demanding profession.”

My principal medical reference sources have been
The Oxford Companion to Medicine, The Oxford Textbook of Medicine, The Atlas of General Surgery, The Merck Manual
, and, most often,
Taber’s Cyclopedic Medical Dictionary.

Many of the ethical issues argued at Seth’s trial owe their substance to James Rachels’s important book
The End of Life: Euthanasia and Morality.
Much of the chronology draws upon the bibliography in William Manchester’s
The Glory & the Dream.

Some of the medical scenes in this novel were based on descriptions by the aforementioned authors—who had already camouflaged the identities and personal details of their patients. Since I, in turn, altered their cases, the result might be called a “fictionalized fiction.” There was no intent on my part to identify any physician, hospital, or patient.

There is one exception: the case of Mrs. Carson was drawn directly from Dr. Leon Schwartzenberg’s exceptionally moving
Requiem pour la Vie.
I am grateful to the author for permitting me to use several pages of his book almost verbatim.

The law firm of Morgan, Lewis & Bockius, especially Carolyn Jaffe and James B. McKinney of the New York office, was extremely helpful with points of law and judicial procedure. Edie Lederer of the Associated Press provided valuable details of the last days of Saigon.

My thanks, as always, to Jeanne Bernkopf, the only editor who can perform major surgery without an anesthetic.

At various points in this novel, some doctors are treated with sarcasm and deprecation. But in the course of my research, I became increasingly aware that the gruesome deals of malpractice and venality are the sins of a minority whose cynical behavior gives them a higher profile. The medical profession contains far more saints than sinners.

I think Dr. Konner’s words in
Becoming a Doctor
express the majority view: “… healing is possible—indeed, it is ubiquitous. It goes on in every creature every day. And among our privileges as the most sentient, most clever creatures on this planet is the ability, occasionally, to perform acts in aid of it. In a spiritual as well as in a technical sense—not just for the sake of healing but for the sake also of meaning—we would do well to take that privilege seriously.”