Doctors (71 page)

“Hey, Laura,” Emily said quietly, “Let me be totally frank with you. There were two reasons why I wouldn’t marry Barney. And you were one of them.”

At which she closed the door.

“Castellano, it’s not your fault. I told Emily a million times about our relationship and if she still doesn’t believe me, too bad.”

“Now look who’s being a martyr, Barney.”

“I’m not, I’m not, we had no future. She was never going to marry me.”

“Come on, you made a perfect couple. I mean, you loved her, didn’t you?”

“Yes.”

“And you still love her?”

“Yes. But it doesn’t change anything. It’s just that I’ll have to start getting over it now instead of later.”

“She said I was one reason why she couldn’t marry you. What was the other?”

“I think that’s a private matter, Laura.”

“Barn, under any other circumstances I wouldn’t ask you.
But if you’re going to help me get this off my conscience, you’ve got to tell me that there really was another reason.”

Barney paused for a moment and said, “She can’t have children. I said it didn’t matter. I said that all I wanted was our marriage.”

“And—?”

“She didn’t believe me,” he said softly. He was lost in thought for a moment. And then he added, “Do you know something, Castellano, I’m ashamed to say it—but in a way she was right.”

Seth was puzzled by the nurse’s identification of his final patient of the day. It was in fact a trio—a man in his mid-sixties and what looked like his son and daughter.

They entered his office without a word and stood respectfully until Seth signaled them to chairs.

“Are you Dr. Lazarus?” asked the older man.

“Yes, I am. But who are you? Why didn’t you give your names to the receptionist?”

Seth waited for a moment, as the trio looked at one another.

Then the father said uneasily, “We didn’t want anybody else to know about this. I mean, this will all be confidential, won’t it?”

“All physicians have taken the Hippocratic Oath and are sworn to secrecy about what’s told them.”

“That’s not always true,” the daughter interposed.

“I’ll grant there are indiscreet doctors, Miss, but I can assure you I’m not one of them. Now may I know your names?”

“Carson,” said the older man, “like Johnny—only no relation.” He gave the kind of chuckle that must have become second nature to him by now.

“I’m Irwin,” the man continued. “This is Chuck, my son, and Pam, my daughter.”

Seth looked at them and wondered out loud, “Who exactly has the problem?”

To Seth’s surprise, the father answered, “We all do.”

At this the elder Carson sat forward on his chair and spoke in hushed tones.

“It’s actually about my wife—their mother—she’s very ill.”

“Where is she?” Seth inquired.

“Back home. She’s much too sick to travel.”

“Where’s home?”

“In Hammond.”

“You came here from Indiana? Just what exactly’s wrong with Mrs. Carson?”

The older man bit his lip, looked first at his daughter, and then at his son, both of whom nodded to indicate that he should continue his plea.

“A year ago they found a malignant tumor in her stomach. They operated. They took it out.”

“And?” Seth inquired.

“Well, it was tough at the start, but we helped her to sort of readjust. For a while there, things seemed fine. I even took her on an anniversary trip to the Caribbean.”

He paused, breathed deeply, and continued. “Then it sort of started all over again. So we went back to see the doctor. He did some x-rays. Would you like to see them?”

“Yes, of course.”

Seth took the large envelope, withdrew the films, and put them up against an illuminated cabinet.

He saw the situation at once. “To be frank, they don’t look very promising.”

“We know,” said the young man.

At which the father took up the narrative again. “I asked the doctor if he’d operate again. And then he said—”

He broke into tears.

“Sorry, Dr. Lazarus. I’m really sorry,” the old man sobbed. “It’s just the awful way he answered me. It was so brutal. He said straight out, ‘No, it’s not worth the trouble.’ ”

“That was hardly the kindest way of putting it,” Seth remarked. “But these pictures do show a large growth at the juncture of the digestive tube where she was operated.”

At which point, the man tearfully repeated, “When I pleaded with him, he just waved me off.”

“Didn’t he suggest any other possibilities of dealing with the neoplasm?”

“Well, there’s x-ray treatment. But even our G.P. told us that in stomach cancer it’s almost useless.”

“I’m afraid your G.P. was correct, sir,” Seth commented.

Mr. Carson’s narrative accelerated. “So then he comes up with the idea of chemotherapy, another useless procedure. I mean, the only thing it’s guaranteed to do is make your hair fall out—and turn you into a tired skeleton.”

Seth merely nodded.

“So what was left? Nothing. Zero. They just sent her home to die.”

As he continued, Carson’s voice became more and more of a supplication. “Doctor, she can barely swallow anymore. We have to feed her baby food. Things like Gerber’s applesauce.”

“And even that is getting difficult to keep down,” the daughter added.

“Now,” said the son, “she needs antispasmodic drugs and tranquilizers just to be able to swallow sugar water.”

“So we went to the doctor again,” the elder Carson said, picking up the tale. “Now, all of a sudden he’s back to the idea of an operation: ‘gastro—’ I can’t even pronounce the name.”

“A gastrostomy,” Seth explained. “It’s what you might call a re-plumbing of the whole digestive tract that would bring the food directly to the intestines through a tube into the skin.”

Seth paused to await further details.

“Well, Doctor, I don’t have to tell you,” Carson said, raising his voice and betraying some of his bitterness, “that it’s a hell of an operation and the guy actually admitted it wouldn’t stop the cancer growing. He wasn’t even sure it would stop the pain. He just said it would give her more time.”

Seth wanted to get to the heart of the matter. “I’m sorry to say, from what you’ve told me, I don’t think there’s any possible way of saving her. I mean, certainly nothing within my knowledge or power.”

“We know that,” said the father, as the son and daughter echoed, “Yes, we know. We know.”

“That’s why we’re begging you to
help
her, Doctor,” the elder Carson said.

“I don’t understand,” Seth answered, with a troubling intuition that he did.

“Doctor, don’t let her just sit there and become a subhuman thing with plastic tubes everywhere. Don’t let her suffer like this. Let her go now, while her life still has a shred of dignity. She wants to die.”

There was a pause and then Carson spoke his concluding words. “Please help us, Doctor. I mean, help
her.
”

The rest was silence. They had said their piece.

Seth was dumbfounded. And petrified at the thought that his long-ago “act of compassion” for Mel Gatkowicz had somehow escaped the confines of the hospital—and even crossed state lines.

“How did you get my name?” he inquired as calmly as possible.

“A new internist in our hospital. Dr. Bluestone.”

“Have Dr. Bluestone call me this evening at my home.” He stood up.

The family rose at once, as if a prelate of the church were passing by, and walked out into the darkness.

Seth put out the office lights. And as he locked the door and headed for his car, he thought of the consequences of what he had all but pledged to do.

Now death would make a house call.

T
he moment he arrived home, Seth recounted the whole incident to Judy, who shared his apprehension.

“If that’s what Tim wanted, why didn’t he do it himself?” she said angrily. “He’s put
all
our lives in jeopardy.”

Seth merely acknowledged her words with a glance. He was all too aware that what they regarded as mercy would be seen by many others as murder.

“Tim’s supposed to be calling tonight,” Seth reminded her. “I don’t really know what to say.”

“You’ve got to tell him to go to hell.”

Seth was deep in thought. At last he said quietly, “What about the Carsons?”

“Oh, God,” Judy responded with agonized frustration, “you’re not thinking of doing what Tim’s asked—”

“I don’t give a damn about Bluestone,” he replied, eyes focused in the middle distance. “But I care about those people. The whole family is in torment—and there doesn’t seem to be an end to it.”

“No, Seth,” Judy objected. “Don’t take the risk.…” Her voice trailed off. For she could sense that he was so sympathetic to Mrs. Carson’s plight that he had already made up his mind.

A little after 9
P.M.
the phone rang. It was Tim Bluestone calling from Indiana.

“Seth,” he began, “I think I’d better explain—”

“You certainly had,” Seth interrupted. “I want to know exactly what you told the Carsons and why.”

“I told them I knew a very compassionate doctor who might be able to help. I haven’t got the guts to do it alone, Seth. Besides, I saw you leave Mel Gatkowicz’s room the night he died. And afterward I wondered.”

Seth could not answer him. And dared not ask whom else he had told.

“These are special circumstances, Seth,” Tim pleaded. “The Carsons are good, decent people. And Marge—that’s the wife—is just a fragment of a human being. She’s in excruciating pain. I’ve put the significant data in a letter to you. You’ll probably get it in tomorrow’s mail. Look, the family is so desperate they asked me if I wouldn’t—you know—do something. At first I resisted the idea. But these past few days, watching Marge deteriorate, I think they’re right.” He paused and then blurted out, “If we could just do it together, Seth. That would kind of share the burden.”

Tim, you fool, Seth thought to himself, don’t you realize this is something you can’t share? Even if you collaborate, you still get the full weight on your shoulders.

“Okay, let me read her case notes and I’ll get back to you.”

“At my home, not my office, please.”

“Obviously,” Seth replied, not disguising his annoyance.

The dossier was in the next morning’s mail. Seth called Tim a little before ten.

“You’re right,” he said, “nobody deserves to suffer like this. We should go ahead on your … proposal. But it’ll have to be on the weekend.”

“Yes. Of course.”

“Now tell me exactly how to get to their place.”

After giving him specific directions, Tim added, “Thank you, Seth—God, this whole thing is frightening.”

Seth did not even address Tim’s statement. For that would have meant haranguing him about the ghosts he saw in countless dreams. Bluestone had nothing to teach him about fear.

“Listen, Tim, where do the son and daughter live?”

“The boy’s an Engineering grad student up at Northwestern. The daughter’s married to a guy who owns a restaurant. Sometimes she helps him out as a cashier.”

“Well, make sure neither of them is around this Sunday. Can you do that?”

“Sure, sure.”

“Now I’ve got to know one last thing—is the woman conscious?”

“Most of the time. It’s just that to give her some relief from pain, we have to drug her very heavily.”

“I’ll have to talk with her, so make sure she’s lucid Sunday evening. I’ll be there at nine.”

It was a typical lower-middle-class suburb with nearly identical two-family houses, each with the same shrubbery and a similar tree in front. It was 9:05
P.M.
The road was pitch dark. And Tim Bluestone was pacing nervously in front of the Carson house when Seth suddenly materialized.

“Bluestone?” he said softly.

“Hi, Seth. What happened to your car?”

“Never mind. I’m parked in a suitable spot. Let’s go inside.”

Seth did not add that he had taken Judy’s station wagon—which lacked “M.D.” plates.

From outside the front door they could hear the sounds of baseball on the TV. Seth suspected that the husband kept it loud to drown out—from his ears if not his mind—the sounds of his wife’s suffering.

“Hello, Doctor,” Irwin Carson said, in a voice drained of emotion. “Thank you for coming.”

“Where’s Mrs. Carson?”

“She’s upstairs. Her bedroom’s upstairs. Uh—she’s expecting you.”

Seth merely nodded. “Would you like to go up and speak to her?”

Her husband thought for a moment and then replied, “We’ve done nothing all afternoon but talk. We’ve said goodbye. I don’t think I can …” His voice trailed off.

The two doctors nodded and walked slowly up the stairs.

“Good evening, Marge,” Tim said, “this is Dr. Lazarus.”

The woman was barely a wraith, her face like a skull. An I.V. ran into her right arm, sustaining her life drop by little drop.

She reached out a bony hand toward Seth and, with effort, whispered, “Thank you for coming, Doctor.”

Seth nodded and sat down to exchange a few words with the pain-wracked woman.

“Mrs. Carson, it must be hard for you to talk, but there are things I have to know. Are you aware of why we are here tonight?”

“Yes, Doctor.”

“Were you absolutely sure of what you asked Dr. Bluestone? I mean, have you had any second thoughts since then?”

“No. I want to die.” To which she added, almost in a moan, “
Please
, Doctor.”

At this moment Seth’s eyes hit upon a small replica of the crucified Christ on her night table. She was a Catholic, and yet by inviting him this evening, was she not committing a kind of suicide—a mortal sin? Marge answered the question before he could ask it.

“Don’t worry, Doctor,” she murmured, “do what you have to do. The rest will be for me to face. I’ve prayed to Him so often, I know He’ll understand.”

At this point Seth looked at Tim to see if he, as her family physician, wanted to say anything. But he seemed unable to speak. Seth turned again to Mrs. Carson.

“I’m just going to put some medicine into your I.V., Mrs. Carson. In a few minutes you’ll go to sleep—”

“—and no more pain?”