Doctors
Yet the NIH hospital itself is the largest red-brick building in the world, with no fewer than nine miles of corridors.
And genius is the norm.
At least eighty-eight Nobel Prize winners have worked in the area behind the huge hospital, which is dotted with laboratories of all kinds. Here pioneering research goes on three hundred and sixty-five days a year to fight cancer, heart disease, neurological disorders, and other more arcane but equally savage afflictions.
The tenured Senior Fellows supervise those lucky enough to have run the difficult gauntlet of application and been appointed for a two- or three-year Junior Fellowship. Selection depends largely on the importance of the proposed research project and the committee’s estimation of whether the applicant is gifted enough to pursue it.
Very few of the Fellows do any work in the hospital. They mostly remain buried in their red-brick labs, peering with electronic microscopes, waiting for a minuscule miracle to swim into their field. Within the profession, they are sometimes jokingly referred to as ‘Rat Doctors.’
But it is an unassailable fact that a country doctor who trudges five miles in the snow to treat a patient in a log cabin is far better equipped if he is carrying the latest drug discovered in an NIH lab.
Laura Castellano had known that her chance for acceptance as a Research Fellow was particularly small. For working at the NIH could fulfill a doctor’s military obligation. And the average physician preferred Bunsen burners to burning villages.
But Laura’s project also impressed that selecting committee for several important reasons.
First, those still in the process of building a family realized that an early-warning system to detect imminent hemorrhaging in preterm babies might be of genuine value to them personally. Her proposal was sound and pragmatic:
Thanks to the latest developments in ultrasound scanning, we can now document the timing and extent of the hemorrhages and correlate the temporal relationship between the onset of a bleed and other important events occurring in the baby.
For instance, we would regularly measure blood gas tensions (oxygen level, carbon dioxide level, degree of blood acidosis). Fluctuations in blood pressure would also be carefully recorded, as well as monitoring of the neonate’s clotting ability to detect any tendency toward a bleeding diathesis …
Furthermore, Laura’s project seemed like one that could produce results in a relatively short time and would be useful to cite when Congress deliberated the size of its appropriations to the Institutes.
And yet Laura never knew how close she came to having her application rejected – that it was only the new ‘Equal Opportunity’ laws that saved her.
For as long as anyone could remember, applications for schools, colleges, and civil service jobs had to be accompanied by a photo of the applicant – whereby the ethnic background of a candidate could be revealed.
In this braver, more democratic world created by Congress, candidates were to be judged on their merits alone: it was strictly forbidden for the referees to make any allusion whatsoever in their letters to the candidate’s race or creed.
Of course, it was clear to the blue ribbon committee that Laura Castellano was female – a point in her favor. But the lack of a photograph kept her from being rejected on other grounds: the damning fact that she was beautiful.
For it has been common knowledge since time immemorial that beauty and brains cannot possibly go together. Thus, had the arbiters known what Laura looked like, they would have instantly rejected her as a dumb blonde.
During her final weeks at Queen’s, Laura made the rounds of Toronto’s used car dealers to find herself the wheels that are indispensable for anyone working in the Washington area. Her depression had done wonders for her bank account. All that winter, her obsessive commitment to the neonatal ICU rarely allowed her into the light of day, much less a shop that sold anything more than milk and graham crackers. She had not even picked up a newspaper. Her idea of leisure reading was the New England Journal.
She was thus able to afford the two thousand dollars ‘Honest Ernie’ was asking for a ‘slightly pre-used’ Chevrolet Nova. Laura was even canny enough to get him to throw in a new set of tires.
On the last day of June she said goodbye to the few friends she had made – two ICU nurses and the cashier at the cafeteria. She loaded the trunk with her bag and some cartons of books and headed south.
In two hours she had crossed the bridge over the Niagara River into Buffalo, New York, and headed toward Pittsburgh. Only then, having long passed the latitude of Boston and New York, did she turn east, stopping only to feed herself and her car.
She reached Washington at sunrise, which made the still-sleeping city look like a travel agent’s poster. A few lines of Wordsworth popped into her head from the distant memories of Midwood English class – ‘This city now doth like a garment wear/the beauty of the morning.’
After more than a year of unrelieved gloom, she felt hopeful. Maybe Washington would not belie its outward beauty. Maybe she would find happiness here.
Laura had rented an apartment in Bethesda but was too excited to go ‘home,’ even to freshen up. She drove straight to the NIH, where – to her delight – she saw that at 7 A.M. she was far from the earliest arrival. By noon she was ensconced in her lab and had already started looking over her protocol notes.
As she was taking off her fresh white coat with its tiny blue and white nameplate, she heard a woman inquire after her from across the lab.
‘Has Dr Castellano arrived yet? I have a long-distance call in my office for Dr Castellano.’
Puzzled, Laura made herself known and followed the secretary to the director’s office where she picked up the phone.
‘Hey, Castellano. Welcome back to the land of the free and the home of the brave.’
‘Barney! Hey, did you lose my extension number or something?’
‘No, Laura,’ he whispered at the other end, ‘this was just a ploy to get you into the director’s office so you could casually meet him – or at least his secretary. Be real nice to her – they’re usually the power behind the throne.’
‘Dr Livingston,’ she said, now trying to sound as formal as possible. ‘I don’t believe I should be tying up this phone, so I’ll get back to you sometime this afternoon. Is that all right?’
‘Of course – but mark my words, this call will reap dividends. So long.’
As Laura hung up, the secretary inquired, ‘Friend or colleague?’
She knew the right answer to that one.
‘Colleague. Dr Livingston’s on the faculty at NYU.’ As of three months ago, she thought but did not say.
‘What sort of research is he engaged in?’ the secretary asked politely. It was inconceivable to her that a doctor could actually be treating patients.
‘I’m afraid I’m pledged to secrecy,’ Laura replied apologetically.
‘Oh,’ she answered, with undisguised admiration. ‘I can appreciate that. And it’s quite proper of you not to tell me. My name is Florence, and if you have any problems, just come to me.’
Laura thanked her and headed out, thinking to herself, Florence you’d flip if you knew that the lab animals in Barney’s research project were not rats or mice or even monkeys. Just doctors.
Laura’s high expectations of Washington were not dispelled. She daily rubbed white-coated shoulders with some of the greatest medical minds in the world. And as far as resources were concerned, there was no book, no journal, no piece of apparatus – however exotic or outlandish – that could not be produced inside of sixty minutes.
And the Institutes did not seem to have that cutthroat atmosphere so characteristic of college campuses. The Juniors knew that they were there for a limited time and were aspiring to get enough done – and results published – so they could obtain tenure at their own universities. This was not like Chem 20, where your neighbor would sabotage your experiment if you so much as looked out of the window for a moment at an autumn leaf.
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The two other young pediatricians with whom she shared the lab and its computer were both congenial – and happily married. The proof of this was the swiftness with which they invited Laura to dinner at their homes. They wanted their wives to have an entire evening to satisfy themselves that the ‘Boston Bombshell’ (as she was referred to behind her back) was not about to explode in their household. And Laura fully understood that if she hoped to have company while working late, she had better reassure the wives that any nocturnal activities she would undertake with their husbands would be strictly intellectual.
Laura’s commitment to Pediatrics was genuine. But it was a measure of how estranged she had become from her own motivations that she failed to recognize that it also demonstrated a powerful maternal instinct. And she was thirty-six years old. Time on her biological clock was running short.
She began to have terrible nightmares. Though she had no idea where Palmer and Jessica were now living, she was aware that in the same year she and Palmer were divorced, unto them a child was born. A little ‘preemie’ – miraculously weighing in at a hefty eight pounds. Her nightmares reenacted fantasies of meeting the new Mr and Mrs Talbot, seeing their child, and crying out ‘No, no, no, he’s mine! That baby is mine!’
Yet despite Barney’s badgering, she was reluctant to seek psychiatric help. For she was terribly afraid of many things: of letting it be known around the Institutes that she was anything but Wonder Woman, or El peñon – that rock of rocks, Gibraltar. And, more importantly, she was afraid to confront the desperate conflicts in her own mind. She even had bizarre dreams in which she had played two roles; she was her own mother cursing and castigating herself as ‘Little Laura’ for being too unworthy to survive an angel like her sister.
In her waking life there was only one Laura Castellano she had any respect for at all. The one who, along with her supervisor, Dain Oliver, had a paper accepted by the American Journal of Pediatrics before her first Christmas at NIH. (Even by sprinting superbrains this was considered a fast start.) Moreover, she would get to read it at an international congress in Mexico City during the third week of January. As she told Barney on the phone, ‘I’m flying!’
At least she admired her own academic achievements.
42
The first International Conference of Neonatologists was scheduled for Mexico City from January seventeenth through twenty-fifth, 1974. From all indications it would be an important event. When it comes to saving babies, there are no political divisions East or West. There is no Third World, just one single global family. No country had an infant mortality rate of zero; which meant there were battles yet to be won.
The group from NIH came close to being the official ‘American Delegation,’ and all of them were staying at the Maria Isabel Sheraton, where the general meetings were to be held. All during the flight Laura sat next to Dr Oliver and coaxed her kindhearted director into listening to her fifteen-minute paper again and again.
‘You’ll be fine, Laura, you’ll be fine,’ he reassured her. ‘You don’t have to memorize it – after all, you’ll have the text right in front of you.’
‘I know, Dain, but I keep having this terrible premonition that I’ll get up there and suddenly forget how to read.’
Oliver laughed. ‘I hardly think that’s likely, Laura. Just remind yourself of how far you’ve come since the first grade. But I can understand your panic. I still remember being unable to keep my breakfast down the day I read my first paper.’
‘Oh, I’m not worried about that,’ Laura replied. ‘I don’t intend to eat any.’
Just then the plane descended from the halo of smog that constantly crowned La Cuidad de Mexico and began its final approach. There was a polyglot hum in the crowded hotel lobby. Stretched above the elegant marble registration counter was a banner reading ¡BIENVENIDO A LOS SALVADORES DE NIÑOS! Under which was the same welcome to the English, French, and Russian guardian angels of children.
Like her other colleagues from NIH, Laura was preregistered – one of the few real benefits of working for the government, she told herself. There were two messages for ‘La Doctora Castellano.’ One was a telegram whose contents she intuited before opening: good wishes from Barney in some macaronic approximation of broken Spanish, which concluded, ‘Buena suerte y Breaka un leggo.’
The second message came in a handwritten envelope on hotel stationery. She had been looking forward to seeing some old friends from Boston and assumed this was a harbinger of those reunions. Instead it was an astonishing communication.
¡Querida doctorcillita!
¿Porqué no presentas tu disertación en tu lengua materna? No to olvida que todavia eres una verdadera castellana.
Besos y abrazos, Tu afectuoso papacito.
[Greetings my beloved little doctor. Why aren’t you reading your paper in your mother tongue? Don’t forget that ‘Castellano’ means a true Castilian. Hugs and kisses, your loving father.]
‘What’s the matter, Laura?’ asked Dain, who was standing in line behind her. ‘You’re pale. Is it bad news?’
She shook her head, unable to respond.
‘It must be the altitude,’ Oliver concluded. ‘It takes a while to get used to it. Why don’t you go sit down and I’ll take care of the bureaucracy for you.’
She nodded gratefully and looked for the nearest chair in the lobby. As soon as she was seated she tried to assemble her thoughts. What the hell is my father doing here?
How would she get through the hours between now and eleven-fifteen tomorrow morning when she was scheduled to speak? As soon as she got to her room she tried to call Barney – without success. Why tonight of all nights did her workaholic friend not answer his home phone? She called his office – maybe for some reason he was still there.
But all she got was his answering service. ‘Is this an emergency?’ they inquired solicitously.
No, she thought to herself, I can’t have them page him. Forget it – take a couple of those tablets you prescribe for yourself and go to sleep.
She was slightly dizzy the next morning – but that could have been the pills, the altitude, or even the carne asado she had tried to eat for dinner. She revived herself with coffee and gave herself a special dispensation to add sugar – which as a doctor she knew was unhealthy and therefore normally eschewed.
Where would her father be sitting, she wondered. This wasn’t the U.N. after all. The physicians from any one country might be sitting together, but not necessarily in alphabetical order. Luis might be far away. Or be waiting right inside the door closest to the podium, waiting to pounce on her with a huge embarrassing paternal hug.
In any case, it was too late for speculation. She could hear the public address system quite clearly from outside; the speaker preceding her had finished answering his final question from the floor.
The chairman of the morning session was a ruddy-cheeked Rumanian who insisted upon making his introductions in French (one of the official languages of the congress). It was the first time she had ever heard herself referred to as ‘Docteur Laura Castellano.’
She gathered her courage and headed for the podium, eyes downcast, looking neither left nor right. Though the whole purpose of her many hours of rehearsal with Oliver had been to be able to make visual contact with the audience, she read her paper in a hasty monotone, never once looking up from the text.
Chairman Ardeleanu thanked her in florid French and then turned to the audience to ask if there were any brief questions. He recognized a youngish Latin physician who, according to protocol, first identified himself and his provenance: ‘Jorge Navarro, Faculdad de pediatria, Universidad Popular de Havana.’
Laura had been forewarned. The State Department had told them they could expect some provocation from ‘the usual leftist political plant.’ But she had never in a million years imagined that the stooge would be directing his fire at her.
Why was it, asked the good Dr Navarro in rapid Spanish, that in the United States, infant m
ortality for blacks and Hispanics was higher than for whites?
There was a muttering in the audience, some cries of encouragement but mostly groans of distress and disapproval. Even among those of Navarro’s political persuasion there was some dissent at his ungallant choice of an obviously naive young woman as his propaganda target.
‘Do I have to answer that?’ Laura asked the chairman. ‘I consider it to have nothing to do with my topic.’
The Rumanian either did not know English or pretended not to. He bowed slightly and said, ‘Madame peut répondre.’
Okay, thought Laura, her anger at being singled out momentarily overcoming her stage fright, I’ll answer this dogmatic little schmuck with home sophistry of my own.
She responded to the Cuban in the language of his question – indeed, the pure Castilian version. Where did he happen to run across such statistics? Did he know that the black birth rate was twice as large as the white – and that Hispanics had the largest families of any ethnic group in the United States? (She was careful to avoid using the term ‘America’ to refer to her country – which Latin Americans always deemed arrogant.)
She lambasted him with excruciating politeness, humbly asking if ‘our distinguished colleague from the Republic of Cuba could possibly explain the reason – if not the relevance – for his inquiry.’ No mere straw man, Navarro rose to the task.
‘In a so-called “developed” country, the rate of infant mortality is an unerring reflection of its attitude towards the future generation – and especially to ethnic minorities.’
The audience was warming to the debate and the chairman saw no reason to deprive them of this unexpected entertainment by enforcing the five-minute limit on discussion.
‘I find that an interesting philosophy, Dr Navarro,’ Laura said, taking time to formulate her reply. ‘And I sympathize with the Cuban mothers who suffer an infant mortality exactly double that of ours in the U.S. But then of course you are an evolving nation (she was careful not to say “underdeveloped”), and we hope that scientific exchanges at congresses like these will help rectify the situation as soon as possible.’