Doctors

  ‘There’s your book, for one thing,’ she suggested. ‘You could even use this heartrending experience as material.’

  ‘Really – how?’

  ‘Well, you could talk about the perils of countertransference.’

  ‘No thanks, I’ll leave that to your – excuse the pun – bosom buddy, Grete. How is the old girl, anyway?’

  ‘Thriving in Houston from what I last heard. She’s even assisted at her first transplant.’

  Barney instantly regretted his question, for the mention of Houston was an instant reminder of where Bennett wasn’t. To think that a flake like Grete should be hopping merrily up the echelons two at a time, while his best friend was battling in the to-and-fro conflicting wind and rain in Cambridge.

  For, from all he could gather, Bennett was not having a roaring social life.

  (‘I’m sublimating, Barn,’ he had told him. ‘I’m using rage instead of amphetamines to keep me going through the night. In fact, I’m taking extra courses so I can get this damn thing over in two years instead of three. I hate law school because it really teaches you how to use “facts” to convince people of your version of the truth – which may not really be the truth. In medicine, at least, a live man is alive and a corpse is dead. Up here they’d have a mock trial and let the jury decide.’)

  ‘Are you still there, Barney?’ Laura asked.

  Her voice snapped him from his reverie.

  ‘Sorry, Castellano, I was just thinking of a patient.’

  He shifted gears and asked, ‘Is there anything cheerful we can talk about?’

  ‘Well, first of all, I promise you by this time next month you’ll have totally forgotten your beloved patient and be completely wild for some new madonna.’

  ‘That was interesting, what you just said,’ he commented. ‘Do you really think I go for the “unreachable” madonna types?’

  ‘You want the honest version, Barney? Or shall I wrap it in Styrofoam?’

  ‘I can take it. You think I unconsciously go for women who are unavailable.’

  ‘Well, you’ve been pretty pissed off ever since Emily walked out, and I think you’re scared of getting burned again.’

  Barney thought for a moment. Dammit, Castellano was right.

  ‘Hey, listen, Laura, I don’t like this. Suddenly you’re reading me with psychic x-ray vision. That’s supposed to be my job.’

  ‘Don’t worry, Barn, I’ll always give you plenty of material to criticize. Take Marshall Jaffe.’

  ‘Who the hell is he?’

  And then she told him. Nine dollars and eighty-five cents worth.

  To Barney’s mind the whole thing sounded like a losing proposition.

  ‘I don’t care how you try to rationalize it – the guy’s not available. Aren’t you smart enough to leave the married ones alone?’

  ‘Barn, do you know that in Washington the ratio of eligible men to eligible women is five cows to every bull?’

  ‘Do you know that you’re ten times better than the average “cow”? If you only got your act together you could generate a damn stampede.’

  ‘But Barney, I like him. I can’t help it. I didn’t want to, but I really—’

  ‘– feel sorry for him?’

  She did not reply. For she had to acknowledge there was at least an element of that.

  ‘Look, Castellano, I feel sorry for the guy, too. But I’m looking out for you and I don’t see what’s to gain if you get more involved.’

  ‘Barn, I’m over twenty-one. You don’t have to look out for me.’

  ‘Castellano, if I don’t, who will?’

  ‘He’s very attractive,’ she answered, almost as a non sequitur.

  ‘I know, I know. I saw him at the party.’

  ‘In all that mob?’

  ‘It’s not hard to distinguish the only guy in short pants, Laura. Don’t you find that a little creepy?’

  ‘Well,’ she said, only half in jest, ‘he’s got nice legs.’

  ‘So do I,’ Barney replied, ‘but I don’t go to Fritz Baumann’s house in my basketball pants.’

  ‘He’s also one of the brightest guys I’ve ever met—’

  ‘As he himself constantly tells you.’

  ‘Yeah, I’ll grant he’s somewhat enamored with himself. But that kind of balances the two of us.’

  ‘You mean like Mr and Mrs Jack Sprat – he’s too overconfident and you’re too underconfident?’

  ‘Something like that.’

  ‘Have you forgotten that the Sprats were at least married? I’m sorry, Laura, but I really disapprove.’

  ‘But I like being with him, Barn. He’s nice – in a funny kind of way. I mean, at least he’s better than nothing.’

  ‘Okay, okay. Get your heart broken again. But you’re walking up a “down” escalator. Or, to use an appropriate tennis metaphor, I see the score as love nothing. So between games try and give a little thought to where you’re going to be in, say, five years.’

  There was a pause. Had Barney finally won a volley?

  ‘You know something,’ Laura said with wonderment, ‘I never had the slightest illusion it would last half that long.’

  But she knew well what he meant. The female biological clock was ticking away her fertility. She would soon not have to ‘worry’ about getting pregnant.

  Oh, cut the self-pity, Castellano, who the hell knows what can happen in five weeks, let alone five years.

  Laura had at last found something resembling inner equilibrium.

  She and Marshall had a stable – if slightly incomplete – relationship. They would eat dinner at her place one or two evenings a week (he was teaching her to cook), perhaps preceded by a game of tennis (which he was also teaching her). He took her out to theater or a ballgame as often as their schedules allowed. And she was satisfied. At least she did not think she could aspire to more.

  Marshall had a passion to be ‘best’ at everything. And when he made up his mind that he was going to be Number One at something, no force on earth could stop him.

  But he wasn’t in the science game just for the golden prizes. The thing he really cared about was seeing his ideas bear fruit. He wanted to break new ground in bio-engineering and produce results that he would be blessed for generations later.

  And after having worked with Rhodes for eighteen months he felt that they were on the brink.

  ‘This is it, Laura. This is going to be the year a lot of cancers bite the dust.’

  Doctors Rhodes and Jaffe and their junior staff at NIH were on the verge of concluding a five-year collaboration with Professor Toivo Karvonen in Helsinki and his junior staff at Meilahti University Central Hospital. They were well into the final test run of the method they had jointly developed to induce cell differentiation and deficiency in oncogenes.

  ‘Can you believe it, Laura? We’re on the five-yard line, goal to go.’

  He almost made her living room glow with the sparks of his enthusiasm.

  ‘We’ll get those malignant tumors by the genes. Isn’t that fantastic!’

  ‘I haven’t got the words, Marsh. All I think of is the patients that I’ve lost that I could save in – how long till it hits the hospitals?’

  ‘Three years, maybe two if we get lucky. Jesus, I can’t wait to scream this to the whole world!’

  Marshall lived and breathed his project.

  ‘We can produce the synthetic substance at uncytotoxic levels, Laura – isn’t that terrific?’

  Laura’s joy in their relationship was immeasurably enhanced by the fact that he could speak to her as a scientific peer. Perhaps he used the jargon to boast too much, but at least she understood it.

  She accepted her somewhat amorphous status as ‘part-time wife.’ Marshall un-self-consciously escorted her to all the Institute functions. Still she could not help wondering how her lover spent the evenings he and Rhodes were in Helsinki, where, as everyone knows, the nights are very, very long.

  But after all, he had told her categoric
ally that what they had was all she could expect from him. And he had acknowledged that he was prepared for the day when she would tell him that she’d found a full-time husband. He would bow out gracefully.

  Which only bound her more to him, for she had yet another thing she could admire – his generosity.

  At one point he invited her to join him on a trip to Finland. (‘It’s so pure there – a hundred and eighty thousand lakes and none of them polluted.’) Perhaps, he suggested, while the two big boys honed their data, they could steal a day or two and ski.

  ‘I don’t know how,’ she answered.

  ‘I could teach you, Laura. I’m the best instructor you could ever have.’

  ‘Yeah. That’s what my first husband said.’

  The conversation blended to another topic. Though Laura was intent on hiding her embarrassment at her reference to ‘my first husband,’ she knew what she had inadvertently revealed, and surely Marshall had noticed it.

  And yet he never mentioned it.

  Late one evening Marshall woke her with a telephone call. He was in a state of panic.

  ‘Laura, I need help.’

  ‘What’s the matter?’

  ‘Scott, my eight-year-old, has got some kind of FUO. He’s spiked a fever so damn high it’s nearly scorched the mercury. Can you come over quick?’

  She was awake enough to feel the shock.

  ‘Marshall, do you realize what you’re asking?’

  ‘Laura, this is no time to play by the rule book. This is life and death. He needs an expert doctor fast.’

  ‘Then take him to the hospital,’ she answered, feeling torn and angry.

  ‘Laura, you can get here faster than I can get him to the E.R. – and with all that bureaucratic bullshit he could die.’

  He broke off with his plea still hanging in midair.

  ‘All right,’ she sighed, ‘I’ll be right over.’

  ‘Jesus, thanks. You’ll hurry, won’t you? Do you know the way?’

  ‘I know exactly where you live, Marsh,’ she said quietly.

  The Nova rattled as she gunned it up to ninety-five on Route 15. And even as she sped she tried to put a brake on her emotions.

  Listen, Laura, you’re a pediatrician and this child is sick. Whatever you may feel about … his parents is irrelevant. It’s an emergency.

  She kept repeating it, a kind of self-hypnotic litany, so that she could function. So that she could breathe.

  The Jaffes’ home was in Silver Spring just off the Beltway. But the last eight hundred yards were on a dirt road, totally devoid of light. Despite this, Laura scarcely slowed her car.

  She pulled to a sudden halt in front of the two-story white saltbox with a little lawn in front and a mailbox labeled THE JAFFES. It was the only dwelling that was fully lit.

  She got out of the car and reached back for her bag. Marshall stood in silhouette at the front door.

  ‘Jesus, thanks for getting here so quickly. I won’t forget this, Laura. Really—’

  She nodded wordlessly and walked inside.

  Up on the landing a boy no more than five or six, in Sesame Street pajamas, was staring down at her with saucer eyes. ‘Hey, Dad,’ he cried in worried tones. ‘You said you’d called a doctor. Who is she?’

  ‘This lady is a doctor, Donny,’ Marshall answered reassuringly. ‘Now you just tiptoe back to bed and let her see what’s wrong with Scott.’

  Laura hurried up the stairs, trying her best to be invisible, and ran straight to the open bedroom door.

  Marshall had already swathed the boy in cold towels.

  She walked up to the bed and spoke softly to the feverish child.

  ‘I’m Dr Castellano, Scott. I know you’re feeling very warm. But is there anything that hurts?’

  The boy’s gaze was unfocused as he slowly moved his head from side to side. Then Laura turned to Marshall.

  ‘When was the last time you checked his temp?’

  ‘Maybe five minutes. It was one-oh-six plus.’

  Laura felt the child’s burning forehead. ‘I can believe it,’ she replied. ‘Go down to the kitchen and bring up lots of ice, stat. Do you have any rubbing alcohol?’

  Marshall nodded. ‘In Claire’s bathroom. I’ll get it.’

  He quickly left the room, his normally tanned face drained of color.

  She turned and took a good look at her patient. The boy looked so much like his father.

  Laura checked Scott’s lymph nodes – they were badly swollen – and put a stethoscope to his chest. She could hear nothing but an elevated heartbeat, so that pretty much ruled out a respiratory problem.

  At his age Scott’s fever might indicate endocarditis, an inflammation of the lining membrane of his heart – but that was just conjecture. What was important at this moment was to treat the symptoms, get the fever down.

  ‘Excuse me, Doctor,’ came a female voice from the doorway. Laura turned and saw a matronly woman of indeterminate age in a tartan bathrobe. She had a screw-cap glass bottle in her hand.

  ‘Doctor Jaffe said you need rubbing alcohol.’ She now held out the flask. Laura nodded and took two steps forward to accept it. Before she could say thank you, the woman spoke again.

  ‘I’m Mrs Henderson. Can I help in any way? Please, Doctor, we all feel so helpless.’

  ‘Well, we could use a lot of washcloths—’

  ‘Yes, Doctor, right away.’

  The woman turned and disappeared. Almost simultaneously Marshall entered with a bucket full of ice. Young Donny trailed behind him holding a bowl that held a cube or two.

  ‘Is this enough?’ Marshall gasped.

  ‘It’ll have to do. Now quickly, fill the bathtub with cold water.’

  ‘What? Couldn’t that cause shock? I mean, a cardiac arrest or—’

  ‘Marshall,’ Laura snapped, ‘either you trust me or not. If you want to treat your own family, go right ahead. But don’t you dare try second-guessing me.’

  Chastened, Marshall rushed to the children’s bathroom to fill the tub. Then he raced back to help Laura strip Scott and carry him.

  ‘Hey,’ squeaked Don, ‘what are you doing to my brother? He’ll freeze in there!’

  ‘Shut up, Don,’ his father barked. ‘We’ve gotta do exactly what this lady says.’

  Laura turned to the frightened boy and in a much gentler tone said, ‘You could really help us, Donny, if you brought in some ice.’

  But Mrs Henderson was already there with the bucket.

  ‘Thank you,’ Laura whispered. ‘Doctor Jaffe and I will put Scott in the water, and you and Donny can drop ice cubes all around.’

  She turned again to the younger boy and smiled, ‘Not on your brother’s head.’

  Donny’s fright was suddenly dispelled by giggles. The prospect of inserting ice in his brother’s bath seemed amusing. Scott scarcely whimpered as they placed him in the freezing water. As he lay soaking, Laura checked him for clues that might be on the surface of his body.

  ‘How much longer, Laura?’ Marshall muttered anxiously.

  Laura turned to Mrs Henderson and said, ‘I’m sorry, I seem to have left my thermometer in Scott’s bedroom. Could you …’

  The woman disappeared and was back in an instant. Laura now monitored Scott’s temperature. At last she ordered Marshall to pull the boy out, help dry him, and get him to bed.

  ‘But Laura, you just saw, he’s still got a fever.’

  ‘One-oh-two is low enough. Stop backseat driving, dammit.’

  Back in the young boy’s room, Mrs Henderson and Donny set about the task assigned to them by Laura – gently dabbing alcohol all over Scott to get the fever down further. Laura and Marshall stood together at the doorway.

  ‘So what do you think it is?’

  ‘I’ll take some blood and have a complete workup done in the morning. That’ll tell us more than anything.’

  She looked at him and then commented, ‘You don’t seem exactly relieved.’

  ‘I’m worried, Lau
ra. What about rheumatic fever?’

  ‘I don’t think so.’

  ‘Are you sure?’

  ‘Is any doctor ever sure?’ she asked him with exasperation. ‘Marshall, has it been so long since you’ve been in a hospital that you’ve forgotten we’re not omniscient?’

  He lowered his head and scratched the back of his neck. ‘I’m sorry, Laura, but if it were your own kid …’ He stopped himself in midsentence.

  ‘I know,’ she said softly. ‘In fact, doctors tend to be the most hysterical parents I have to deal with. And you, Marshall, are no exception.’

  ‘Sorry, sorry. I just lost my head. I … I’m not trying to pin you down, but can you tell me what you think?’

  ‘At his age, probably CID or maybe Juvenile RA.’

  ‘Tissue inflammation – rheumatoid arthritis?’

  ‘Ah, you still remember one or two things from Med School days. But if it turns out to be RA, it’s not that big a problem in a kid his age.’

  ‘Any other ideas?’ he asked nervously.

  ‘Hey, listen,’ Laura said with annoyance, ‘at this hour of the night I’m not about to give a differential diagnosis. It’s highly unlikely he’s got anything serious, like bacteremia. Just believe me, he’s okay. Meanwhile, give him two of these Junior Tylenols every four hours.’

  ‘Will aspirin do?’ he asked frowning.

  ‘No, Marshall, it’s been linked to Reyes Syndrome in children. Tylenol – or if you want your child to take a drug of last resort like corticosteroids, get another doctor. Which reminds me, don’t you have a pediatrician?’

  ‘Sort of. But I wouldn’t trust the guy with anything more serious than poison ivy.’

  ‘Call me tomorrow at the office, and I’ll give you the names of some good ones.’ She turned to the others in the room and said, ‘Take it easy, Scott, you’re going to be fine. Mrs Henderson and Donny, thanks for all your help. Now it’s time for everybody to go to bed.’

  She had almost made it to freedom.

  But just as she was on the landing a door opened and a very pale, slender woman in a pink silk dressing gown leaned unsteadily against the wall and asked, her voice barely audible, ‘Will he be all right, Doctor? Will my boy get well?’

  ‘He’ll be fine,’ she answered. ‘Please don’t worry, Mrs Jaffe.’ She had turned and started down the stairs when the same weak voice called out, ‘Doctor?’