Page 11 of Diagnosis


  “Anything else numb?”

  “Both hands and arms.”

  “I see,” said Bineas, shaking his head gravely. “You are quite right to see a doctor.”

  “What do you think I have?” asked Bill.

  “You could have a pinched nerve. Or possibly some kind of tumor or disease. But we laymen can only guess at these things.”

  Just at that moment the receptionist called out Bineas’s name. He stiffened, then visibly sagged, like an animal taking a bullet. Avoiding Bill’s eyes, he gathered up his papers and meekly followed the nurse.

  When Bineas was gone, Bill again surveyed the room and was surprised to discover that everyone who had been waiting earlier was now gone, and a completely new group of patients sat in the dingy chairs, nervously pursuing their activities. Neither the man who had stepped outside to make calls nor the woman with the laptop had returned. Bill sighed and returned to the Trag.dat1 file, estimating that he had glanced through the first 1 percent in half an hour. Times a hundred would take fifty hours of reading.

  A few minutes later, his name was called. He looked at his watch. It was 11:45. A nurse appeared with a brisk but affable manner, as if all were on schedule. “You should bring your briefcase with you, Mr. Chalmers,” she chirped. “You may not be coming back through the waiting room.”

  “Do you realize that I’ve been waiting for over an hour?” said Bill angrily.

  The nurse didn’t reply but led Bill down the same corridor that he had glimpsed earlier. In the middle of the hall, they turned into an examination room. Here, the nurse asked him a battery of questions about his general health and recent symptoms, took his temperature, weight, height, heart rate, and blood pressure. “Very good,” she suddenly said without explanation. She washed her hands quickly with some liquid that evaporated instantly. “Dr. Petrov will be with you shortly. Just slip out of your clothes so you’ll be ready for the doctor.”

  Bill had always disliked undressing in the examination room. While waiting in his underpants, he never knew whether to sit on the examination table, like a laboratory specimen, or in a chair with his legs casually crossed, like a guest. Maybe he should simply stand barefoot on the cold floor, crouching and on guard. At any moment, the door could be thrown open, exposing him to the nurses or to other patients. Should he drape his shirt over himself? Could he work? As he was pondering this familiar quandary, his phone rang in his briefcase.

  “Where are you?” said Jenkins. “I hear doctor’s office music in the background.”

  “That’s none of your business, Robert,” said Bill. “Please get to the point.” He was beginning to find Jenkins too cheeky for his own good. Didn’t the man have any sense of propriety? Evidently, Jenkins felt he could take liberties now that Bill was in a precarious position at the office.

  There was a superior silence on the other end of the line. Finally, Jenkins said: “Your appointment with Fred Loeser has been rescheduled for 2:30 this afternoon. And I thought you should know that Mr. Linden is walking around the office bragging about some kind of deal with a Mr. Olswanger that was apparently supposed to be yours.”

  “I can’t believe it,” Bill shouted into the telephone. He sat down on the red vinyl chair, which felt too cold and too intimate through his thin jockey shorts.

  Jenkins’s voice: “I would strongly advise that you attend Monday’s staff meeting in Mr. Hamilton’s office.”

  “Thank you for your advice, Robert.” He slammed the phone shut and returned glumly to the examination table. He had to get back to the office immediately. How long had he been waiting in this awful little closet? Thirteen minutes.

  Suddenly there was a knock and the door opened and closed. Dr. Petrov was in the room, flying about and talking in a blur, small silver instruments dangling from his pockets. The doctor immediately set to work hammering different parts of Bill’s body. When did the numbness begin? Any weakness in the hands or arms? Had he been suffering from headaches? Any trouble with vision? Was his appetite strong? “I’ll be right back.” The doctor vanished.

  Bill waited. After a few minutes, he rose warily from the examination table. Still grasping his cellular phone, he put his ear to the closed door. He could hear people running down the hall, a toilet flushing, some unidentifiable buzzing sound. He waited a few minutes more, then returned to the examination table. Something hissed, like gas escaping from a tank. Where was the doctor? Petrov had run from the room so very suddenly. Possibly he had been alarmed by what he had seen and needed to consult with other physicians. Bill tried to remember whether Petrov had appeared concerned. Now that he thought of it, the physician’s face did seem pinched and tight. Could he have gone out to instruct the receptionist to call Melissa with bad news? Or to gather more instruments for an additional examination? Bill crossed and uncrossed his legs and began shredding the silly white paper that covered the examination table. After another few minutes, he cracked the door and poked his head out, shielding the rest of his body. The hallway was empty. Eventually, he spotted a nurse coming out of a room. “Nurse,” he called down the hall. She looked up. “What happened to Dr. Petrov? He said he was coming right back.”

  “Dr. Petrov is waiting for you in his private office,” said the nurse.

  “Do you mean I can see him right now?”

  “Certainly. His office is at the end of the hall.”

  “I should go like this, in my underwear?”

  “No, of course not in your underwear. Put on your clothes first.”

  When Bill entered the doctor’s office, it appeared empty. The room was quite still and there was no one at the desk, which was piled to the height of a man’s shoulders with papers and journals. Indeed, reports of various kinds covered nearly every horizontal surface, including the three chairs, the coffee table, and the length of the baseboard heater winding around the walls. All the documents were arranged in neat stacks, each labeled with a small yellow tab, giving the appearance of an archive in the process of reorganization by a librarian. A single window looked out on a concrete parking garage across the street. Bill was just about to call again for the nurse when he heard a little cough from behind the desk. Peering around a stack of lab reports, he found himself gazing down at the head of Dr. Petrov. He gave a start, then was further surprised to comprehend, from this unusual perspective, that Petrov wore a toupee. It was immaculately combed and gave itself away only where it joined his reddish sideburns.

  “I’m sorry, Doctor, I didn’t see you,” said Bill, quickly backing away.

  “No problem,” said Petrov. The doctor coughed again and swallowed a small pink pill with a glass of water. “Take a seat, Mr. Chalmers. We will talk.” The doctor remained at his desk.

  Bill hesitated, not certain where he should go, then cleared off one of the vinyl chairs and carefully relocated the papers on top of another stack of papers, aligning the columns of yellow tabs. Unfortunately, from this vantage Dr. Petrov was completely invisible. Bill sighed and sat down. Now he was being treated worse than a laboratory specimen—he was being ignored. He would not stand for it. Letting his eyes roam about the room, he noticed at once the various diplomas hanging prominently on the wall. He thought of his own diploma in a box in the basement, his useless degree in history from a sleepy college he chose to forget. Twisting around in his chair, he strained to read the fancy lettering of Petrov’s diplomas, where the man had attended medical school, where he had taken his internship and residency. But Bill couldn’t read the print and instead began counting the pharmaceutical samples on the bookshelf.

  “At this point,” came a hidden voice from behind the stacks, “I’m afraid to say that we understand very little about your difficulty. It could be many things, some minor, some not minor. Some illnesses disappear on their own. We’ll need to run tests.” A buzzer went off. “Not now, I’m with someone.… Yes, I’m logged on, you can do that.… Five or ten minutes.” There was a click. “We will begin some tests.”

  “Are you ta
lking to me?” said Bill. He stood up in an attempt to see over the mounds of papers.

  “Yes.”

  “What kind of tests?”

  “I will order an MRI immediately,” said Petrov. “Depending on the results of those tests, we might proceed further with a CT scan, a myelogram, some blood work, or even a biopsy if it’s warranted.”

  “What do you think the problem is?”

  The doctor didn’t answer. Instead, a soft clicking noise came from behind the desk, as if he were typing at his keyboard.

  “Dr. Petrov?”

  “Yes.”

  “You’re doing tests for some reason. What do you think is my problem?”

  “Please, Mr. Chalmers,” came the invisible voice. “I would only be speculating. There is so much to learn. We should now just be gathering information and ruling things out. Your eyes are a bit glassy. You have numbness. It could be any number of things. We begin by ruling things out.”

  “Like what?” Petrov was silent. “What should we be ruling out?”

  A sigh came from behind the desk. “You must understand,” said the doctor, “that anything I say now is only a possibility. Some possibilities have greater or lesser probability, none of which we can know at this time.” He paused and coughed. “Numbness can be caused by a metabolic deficiency, such as lack of sufficient vitamin B-12. Numbness can also be caused by lead poisoning, or a viral infection. You could have something very rare, such as leprosy.”

  “Leprosy!” Bill shouted. Hadn’t leprosy disappeared in the thirteenth century? Would he have to be quarantined, dragged from his home in Lexington to God knows where? “What’s the MRI test?”

  “Magnetic resonance imaging,” said Petrov, his voice taking on an intensity. “MRI is a relatively recent technique that uses short bursts of powerful radio waves and magnetic fields to get the patient’s hydrogen atoms to emit other radio signals. Next time you come, I’ll show you some of the images from the MRI. They are really splendid. With MRI we can get high-resolution pictures of tumors or plaques in the spinal cord and brain.” Now Bill could hear an unmistakable clicking from behind the desk. “You could have multiple sclerosis, which involves a disintegration of the myelin sheath around the spinal cord and nerves. Is there any history of multiple sclerosis in your family, Mr. Chalmers?”

  Despite his irritation with the doctor, upon hearing for the first time a list of possible problems, all of them sounding serious, Bill grew more frightened than he’d been at any time during the past twenty-four hours. “Oh my God,” he muttered.

  “I believe I’ve unnecessarily distressed you, Mr. Chalmers. We really know practically nothing about your difficulty at this time. That is why I don’t like to give possibilities. But you pressed me. Didn’t you.”

  Papers rustled behind Petrov’s desk. Perhaps he was taking notes. “I understand from your chart that the numbness began about two days ago,” said the doctor, “and it was accompanied by an initial loss of memory.”

  “Is that significant?”

  “It could be significant,” said the doctor. “On the other hand, it might not be significant.”

  “Significant or not significant?” Bill shouted and stood up. “I’ve been here since ten-thirty! When can I be treated? I came here to be treated!”

  “Treatment?” said Petrov, without raising his voice. “Why certainly, we will begin treatment, as soon as we have a diagnosis. We have much to learn about this illness of yours. Do you have any other questions?” There was the sound of a chair being moved. The doctor was rising. He stared for a few moments at the stack of papers that Bill had moved. Then he smiled at Bill and touched him lightly on the shoulder and mumbled something about illnesses in the abstract.

  “I have to get back to my office,” said Bill. “I have a wife and a son.”

  “Good,” said the doctor. “We will work together toward your speedy recovery. Let me show you out.” As Bill entered the hallway, he passed another patient, looking distraught. Muffled thumps came from the two examination rooms. “You can call tomorrow to get the exact date and time of your MRI,” said Petrov. Bill ran down the hall. He did not look back, but hurried through the waiting room, to the elevator, and out to the street. It was 12:45. Not even bothering with the subway, he leaped into the first taxi at the Emergency circle and shouted to the driver to head for the Marbleworth Building.

  TAXI

  As the cab navigated its way around blinking ambulances, Bill made a hasty call to Plymouth, to inform Jenkins of his imminent arrival, then sat back uncomfortably in his seat. The taxi lacked air conditioning, and the sun was exploding in the sky. “Which way you want to go?” said the driver, who was soaked in sweat. “We can go direct by Cambridge Street or loop around Storrow and Ninety-three. Makes no difference to me.”

  “The fastest way,” said Bill, squirming out of his jacket.

  “You got it.”

  They turned onto Cambridge Street and were immediately swallowed in a thick molasses of lunch-hour traffic. At once, Bill gagged. Squinting through the bright metallic heat, he saw a cloud of soot and exhaust trapped over the stalled autos. There should be some kind of pollution control, he said to himself and inhaled through his handkerchief. The taxi came to a dead stop, then crept along for three feet, then abruptly stopped again, nudging the rear bumper of a Toyota. A hundred automobile horns screeched in the sweltering air. It was useless, but the motorists did not stop honking at each other, inching along, stopping and starting, stopping and starting, radios blaring through open windows. Bill threw his hands over his ears. A number of travelers, evidently unable to wait, had leaped from their taxis and ran along the sidewalk, clutching their briefcases and shouting into their phones. Bill considered doing the same, and he began making estimates of the time differentials. Up ahead, a woman stuck her head out of her window and yelled profanities at the vehicle in front of her. A half-eaten ice cream lay melting on the hood of her car. “Summer in the city,” the taxi driver said and turned on his radio. “What did you say?” shouted Bill.

  His phone rang. “I’ve been trying to reach you,” said Melissa. “What happened? What did the doctor say?” “He doesn’t know anything,” Bill shouted through his handkerchief, covering one ear. “He’s going to run some tests.” “I can’t hear you,” said Melissa. “Please come home.” “I can’t come home, I’m on my way to Plymouth.” “What? I can’t hear you. I called Henry to get the names of some good neurologists.” “Henry!” “I really think we could use Henry’s help.” “I can take care of this myself. I don’t need Henry. I don’t want Henry.”

  Bill tried to undo his tie with his numb fingers but could succeed only in loosening it. He stared at his hands, still in disbelief at the rejection by his own body. He felt betrayed. What were his hands? Were they not part of him, more muscle and nerve and flesh? With these hands he had thrown baseballs, with these hands he had held Alex when he was a baby, tied and untied his shoes. He had lived with his hands for forty years. He loved his hands. Why had they stopped loving him? He jabbed his left hand with his pen, drawing blood, and felt nothing. Let him at least feel pain, he wanted to feel pain. His hands were denying him even pain. He jabbed himself again. The blood mixed with perspiration, turned the color of rosé wine, and trickled over his palm. He blotted the blood with his handkerchief, then wiped the dripping perspiration from his face. He was only forty years old. His father had died at age sixty-eight. People were supposed to live longer and better. Wasn’t that the point of medical science? He was entitled to live longer than his father, he should have at least twenty-eight years left. And his father had gone so easily, with a sudden heart attack at his office, dead by the time he had slid from his chair to the carpet. That was the way Bill wanted to go, but several decades from now. The coward Petrov, hiding behind his mountain of paper, had suggested that he might have a tumor. That miserable physician had suspected a tumor from the beginning, Bill felt sure of it. Why hadn’t he said so directly? How could B
ill have a tumor? No one in his family had ever had a tumor. Tumors were usually cancerous. Tumor. The word sounded ugly and blunt, like a small heavy black gun pressed against the side of his head. It now struck Bill that Petrov had asked very few questions, considering the circumstances, a good reason to dismiss anything he said.

  With a nervous twitch of his arm, Bill wiped more perspiration from his face. He had to stop thinking about his medical problem, it was wasted effort until tests could be run. To get his mind on something else, he gazed purposefully out the window, to discover that his taxi had advanced to the middle of Court Street. Diners sat under the outdoor striped canopies of Maison Robert, eating and talking into their phones. Again wiping his forehead with his useless handkerchief, Bill began mentally composing a message to Jasper Olswanger, conciliatory and forceful at the same time. Yes, he would be happy to work with Olswanger on the Teneco ChicagoCorp new products line. That spiteful worm Nate Linden—trying to worm in on his projects and beat him for promotion—he would deal with later.

  A new barrage of honking and shouting roused Bill from his thoughts. Peering again from his taxi, he saw that some pudgy children had managed to wrench open a fire hydrant and were dancing happily in the sudden fountain. The water gushed forth in a giant arch, splashing nearby cars and shop windows, flooding the sidewalk and street. Steam rose from the burning pavement. In the distance a fire engine started to wail. Meanwhile other children joined in, hollering and drenching themselves. Discarded shoes floated in the gutters. Passersby on the crowded sidewalk stopped for a moment, as if briefly considering that they too might fling off their shoes and jump in the water, but they hurried on. It was 1:10. As his taxi crept past the fountain, Bill held out his hand and was rewarded with a few drops.

  Now, the car began squeezing through the crooked streets of the financial district, where older, three-story brick buildings alternated with modern skyscrapers and people rushed along the hot pavement with even greater urgency. Finally, Bill’s taxi stopped at the corner of Milk and Pearl. There, soaring some forty-three stories into space and towering over the tiny plaza below, was the Marbleworth Building. Although huge, it curved and it hovered. Its tinted glass reflected the sky. Bill always knew when he had arrived at the Marbleworth, even without looking up, for a section of the rude concrete sidewalk in front of the building had been replaced with pink marble. That marble was scrubbed once a day by the same uniformed porter who scrupulously tended the two white mandevillas in painted fiberglass urns by the revolving glass doors.