Strong Medicine (3 page)

"If you don't mind," Andrew said, "I prefer not to be the pioneering

doctor."

The saleswoman raised an eyebrow skeptically; her voice sharpened. "Not

even if your patient is dying and there isn't anything else? How is your

patient, Doctor? The one you told me about."

"Worse than yesterday." He hesitated. "She's gone into a coma."

"Then she is dying?"

"Look," Andrew said, "I know you mean well, Miss de Grey, and I'm sorry

about the way I spoke when you came in here. But the unfortunate fact is,

it's too late. Too late to start experimental drugs and, even if I wanted

to, do you have any idea of all the procedures, protocols, all the rest, we

would have to go through?"

"Yes," the saleswoman said; now her eyes were blazing, riveting Andrew, and

it occurred to him he was beginning to like this forthright, spunky

girl-woman. She continued, "Yes, I know exactly what procedures and

protocols are needed. In fact, since I left you yesterday I've done little

else but find out about them-that, and twist the arm of our director of

research to let me have a supply of Lotromycin of which, so far, there's

very little. But I got it-three hours ago at our labs downstate, in Camden,

and I've driven here without stopping, through this lousy weather."

Andrew began, "I'm grateful," but the saleswoman shook her head

impatiently.

"What's more, Dr. Jordan, all the necessary paperwork is taken care of. To

use the drug, you would have to get permission from this hospital and the

next of kin. But that's all."

He could only stare at her. "I'll be damned!"

"We're wasting time," Celia de Grey said. She had the attach6

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case open and was pulling out papers. "Please begin by reading this. It's

a description of Lotromycin prepared for you by Felding-Rotb's research

department. And this is a memorandum from our medical

director-instructions on how the drug should be administered."

Andrew took the two papers, which seemed to be the first of many.

As he began reading, he was immediately absorbed.

Almost two hours had gone by.

"With your patient in extrernis, Andrew, what have we got to lose?" The

voice on the telephone was Noah Townsend's. Andrew had located the chief

of medicine at a private dinner party and had described the offer of the

experimental drug Lotromycin.

Townsend went on, "You say the husband has already given permission?"

"Yes, in writing. I got the administrator at home. He came to the

hospital and had the form typed up. It's signed and witnessed."

Before the signing, Andrew had talked with John Rowe in the corridor

outside his wife's room and the young husband reacted eagerly. So

eagerly, in fact, that Andrew warned him not to build great hopes or

expect too much. The signature on the form was wavery because of John

Rowe's shaking band. But it was there, and legal.

Now Andrew told Noah Townsend, "The administrator is satisfied that the

other papers sent by Felding-Roth are in order. Apparently it makes it

easier that the drug didn't cross a state line."

"You'll be sure to record all those details on the patient's chart."

"I already have."

"So all you need is my permission?"

"For the hospital. Yes."

"I give it," Dr. Townsend said. "Not that I hold out much hope, Andrew.

I think your patient's too far gone, but let's give it the old college

try. Now, do you mind if I go back to a delicious roast pheasant?"

As Andrew hung up the phone at the nurses' station from where he had been

calling, he asked, "Is everything ready?"

The head night nurse, an elderly R.N. who worked part time, had prepared

a tray with a hypodermic. She opened a refrigerator and added a clear

glass drug container which the Felding-Roth saleswoman had brought. "Yes,

it is."

"Then let's go."

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The same resident who had been with Mary Rowe this morning, Dr. Overton,

was at her bedside when Andrew and the nurse arrived. John Rowe hovered in

the background.

Andrew explained Lotromycin to the resident, a burly Texan extrovert, who

drawled, "You expectin' a damn miracle?"

"No," Andrew answered curtly. He turned to Mary Rowe's husband. "I want to

emphasize again, John, this is a long shot, a very long shot. It's simply

that in the circumstances . . ."

"I understand." The voice was low, emotion-charged.

The nurse prepared the unconscious Mary Rowe for an injection, which would

be intramuscular into the buttocks, as Andrew told the resident, "The drug

company says the dose should be repeated every four hours. I've left a

written order but I'd like you to - - ."

"I'll be here, chief And okay, q-4." The resident lowered his voice. "Say,

how about a bet? I'll give you even odds against-"

Andrew silenced him with a glare. The Texan had been in the hospital

training program for a year, during which time he had proven himself highly

competent as a doctor, but his lack of sensitivity was notorious.

The nurse completed the injection and checked the patient's pulse and blood

pressure. She reported, "No reaction, Doctor. No change in vital signs."

Andrew nodded, for the moment relieved. He had not expected any positive

effect, but an adverse reaction had been a possibility, particularly with

an experimental drug. He still doubted, though, that Mary Rowe would

survive until morning.

"Phone me at home if she's worse," he ordered. Then, with a quiet, "Good

night, John," to the husband, he went out.

It was not until he was in his apartment that Andrew remembered he had

failed to report back to the Felding-Roth saleswoman, whom he had left in

the doctors' lounge. This time he remembered her name-de Grey. Was it

Cindy? No, Celia. He was about to telephone, then supposed that by now she

would have found out what had happened. He would talk with her tomorrow.

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2

Normally on Saturday mornings Andrew saw patients in his office from 10

A.M., then dropped into the hospital around midday. Today he reversed the

procedure and was at St. Bede's by 9 A.M.

Last night's storm and rain had been replaced by a fresh, clear morning,

cold but sunny.

Andrew was ascending the hospital front steps when, ahead of him, the

main door slammed open and Dr. Overton, the resident, appeared to hurl

himself out. Overton seemed agitated. His hair was disordered as if he

had gotten out of bed in a hurry and forgotten about it. His voice was

breathless. He grabbed Andrew's arm.

"Tried to call you. You'd already left. Janitor at your apartment said

you were coming. I just had to catch you first."

Andrew pulled his arm away. "What is this?"

The resident swallowed hard. "Never mind. Just come on."

Overton, hurrying, preceded Andrew down a corridor and into an elevator.

fie refused to speak or even look Andrew in the eye as they rode to the

fourth floor. The resident hastened from the elevator, Andrew following.

They stopped outside the hospital room where, last night, Andrew had left

the unconscious Mary Rowe, her husband, the nurse and the resident.

"In!" Overton motioned impatiently. "Go on in!"

Andrew entered. And stopped. Staring.

From behind him the resident said, "Should've taken my bet, Dr. Jordan."

He added, "If I hadn't seen, I wouldn't have believed."

Andrew said softly, "I'm not sure I believe it either."

Mary Rowe, fully conscious, propped up in bed and wearing a blue lacy

nightgown, smiled at him. Though the smile was weak, and clearly so was

Mary Rowe, her condition was so much in contrast to the deep coma of last

night, it seemed a miracle. She had been sipping water; a plastic cup was

in her hand. The yellow skin tone, which had deepened yesterday, was

noticeably lighter.

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As Andrew came in her husband stood up, smiling broadly, his hands

outstretched.

"Thank you, Doctor! Oh, thank you!" That Adam's apple of John Rowe's

bobbed up and down as Andrew took his hand.

From the bed Mary Rowe added a soft but fervent, "Bless you, Doctor!"

It was the resident's turn. Overton pumped Andrew's hand.

"Congratulations!" He added, uncharacteristically, "sir." Andrew was

surprised to see tears brimming in the burly Texan's eyes.

The head floor nurse, Mrs. Ludlow, bustled in. Normally preoccupied and

serious, she was beaming. "It's all around the hospital, Dr. Jordan.

Everybody's talking about you."

"Look," Andrew said, "there was an experimental drug, Lotromycin. It was

brought to me. I didn't-"

"Around here," the nurse said, "you're a hero. If I were you I

wouldn't fight it." -

"I ordered a blood test, stat," the resident reported. "It showed ammonia

below toxic level. Also, the bilirubin isn't rising, so the rest of the

cure will be routine." He added to himself, "Unbelievable!"

Andrew told his patient, "I'm happy for you, Mary." A thought occurred

to him. "Has anyone seen that girl from Felding-Roth? Miss de Grey."

"She was around here earlier," Nurse Ludlow said. "She may be at the

nursing station."

"Excuse me," Andrew said, and went outside.

Celia de Grey was waiting in the corridor. She had changed her clothes

from last night. A soft smile played around her face.

As they regarded each other, Andrew was conscious of a constraint between

them.

"You look a lot better with your hair dry," he said.

"And you're not as stern and fierce as yesterday."

There was a pause before he said, "You heard?"

"Yes."

"In there Andrew motioned toward the hospital room. "In there they've

been thanking me. But the one we should all thank is you."

She said, smiling, "You're the doctor."

Then suddenly, all barriers down, they were laughing and crying together.

A moment later, to his own surprise, he took her in his arms and kissed

her.

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Over coffee and a shared Danish in the hospital cafeteria Celia de Grey

removed her glasses and said, "I telephoned our company medical director

and told him what happened. He's talked with some of our research people.

They're all happy."

"They have a right to be," Andrew said. "They made a good drug."

"I was also told to ask: Will you write up a case report, including your

use of Lotromycin, for publication in a medical journal?"

He answered, "Gladly."

"Naturally, it would be good for Felding-Roth." The saleswoman's tone was

businesslike. "That's because we expect Lotromycin to be an important drug

and a big seller. But it won't do you any harm either."

Andrew acknowledged with a smile, "Probably not."

He was thoughtful as be sipped his coffee. He knew that through mere

chance, a fluke engineered by what he now saw as this remarkable and

delightful young woman seated opposite, he had participated in a piece of

medical history. Few physicians ever had that opportunity.

"Look," Andrew said, "there's something I want to say. Yesterday, Celia,