Doctors

  ‘Calm down, Laura. You’re getting hysterical over nothing.’

  ‘It’s not hysteria, Dr Hastings. It’s incontrovertible scientific fact that with every year over thirty-five, the chance of having a malformed baby grows dramatically. One in a thousand at forty, one in three hundred at forty-two, one in eighty at—’

  ‘Laura, you don’t have to tell me all the possibilities and you shouldn’t worry about them, either – because it can’t do either of us any good. Week after next we’ll do an amniocentesis and we’ll know.’

  ‘But is this guy Levine a good sonographer? Have you worked with him before? Are you sure he can direct your needle so there won’t be any damage? Where did he train? What kind of hardware does he use? Could I arrange a meeting with him just to, you know—’

  Hastings leaned on his desk and put his head on his hands.

  ‘For Heaven’s sake, Laura,’ he groaned melodramatically, ‘maybe I should let you and Barney handle this yourselves. After all, each of you is sleeping with a Second Opinion.’

  ‘Okay,’ Laura sighed. ‘I’ll try to stop. But Barney made me swear to let him come here next time.’

  ‘Good. Give me an hour’s warning so I can get out of town.’

  Laura rose slowly. She was not amused. Hastings could not possibly comprehend how much this baby meant to her and Barney. But as she reached the door, he called out in a soft and calming voice, ‘Laura, please don’t sweat. I promise you that everything will be all right.’

  She gave a wan smile and said, ‘Now, you know and I know that no physician can make promises like that. So let’s make a deal. You spare me the plastic platitudes and I’ll spare you my husband.’

  ‘It’s a deal,’ said Hastings, and he smiled with satisfaction and relief.

  It was bad enough that Barney called him on the phone whenever he discovered an obscure – but hypothetically possible – anomaly described in passing by some obstetrician in the nineteenth century. ‘Breathe, Laura, breathe!’

  Barney was a tyrannical coach when it came to preparing his ‘star athlete’ for natural childbirth.

  ‘Don’t forget … one-two,’ he would encourage her as he was supervising her leg lifts on the floor, ‘you’ll want to get your figure back as soon as possible … three-four.’

  ‘You mean you’ll want my figure back—’

  ‘Yeah – that’s ’cause we share everything,’ he’d smile. ‘Come on … three-four.’

  Laura’s morning sickness was mild. This worried both of them, for nausea, though unpleasant, is a reassuring sign that all the hormones are coursing through the woman’s body at a healthy pace.

  ‘But listen, Laura,’ the poor, bedeviled Hastings protested, ‘there’s no norm about this thing. Your pregnancy is progressing fine – you should be grateful you’re not nauseated.’

  ‘No,’ she’d counter, ‘I’d be happier if I were throwing up my lunch.’

  Hastings increasingly gave silent thanks to God that human pregnancies were only forty weeks. (After all, he told himself, gestation in an elephant is nearly two years.)

  Then suddenly they were at week sixteen. And at Dr Levine’s office for the amniocentesis, Barney dreaded the delicate procedure in which the doctor would insert an alarmingly long needle through the abdomen into the fetal sac to bring out a sample of the fluid surrounding the baby.

  He knew that when analyzed by the laboratory the sample can reveal almost all possible deformities and abnormalities, but he also knew that the procedure is not without risk; it raises the chances of miscarriage by another percentage point. And adds yet another furrow to the brow of a forty-year-old pregnant woman – and her husband.

  ‘How quickly will we know?’ asked Barney – who had demanded to be present.

  ‘I told you when you called yesterday,’ said Hastings. ‘I’m sorry to report that science didn’t come up with any innovations overnight. Amnio results take two weeks. But since you’re both doctors, I’ve arranged a special deal—’

  Barney’s eyes widened with hope. ‘Really?’

  ‘Yes,’ said Hastings with a grin. ‘For you it’ll be only fourteen days.’

  ‘It’s bad news. There’s a malformation – Trisomy-21 – Down’s syndrome.’

  ‘What makes you so sure, Laura?’

  ‘I don’t know, Barn, I just feel it. I mean, I don’t feel it. Surely I should have felt some kicking or something by now.’

  ‘Maybe it’s a night person and only does its acrobatics while you sleep.’

  ‘I couldn’t – I never sleep.’

  But somehow a fortnight passed. And somehow Barney and Laura did not drown in the whirlpools of their own pessimism. At last, Sidney Hastings called at nine one evening.

  ‘I’m sorry I’m so late in getting to you, Laura, but I’ve been in surgery …’

  The doctor suddenly heard sounds of a scuffle. Barney had snatched the phone from Laura’s hands and burst out, ‘Sidney, just one word, is it okay or not? Please, just one word!’

  There was hearty laughter from the other end of the wire as the obstetrician reassured the agitated psychiatrist, ‘Everything’s fine, Barney. And it’s a he.’

  Two days later, Laura called Barney between patients and said tearfully, ‘Harry kicked me, Barn. I felt him kick.’

  ‘Was it the right foot or the left?’

  ‘What difference does it make?’

  ‘If he’s going to be a lefty I’ll have to revise my sports development plan.’

  Perhaps the most terrifying thing about the second trimester of a pregnancy is that nothing happens. That is, nothing seems to happen. The organs are all formed in miniature and now simply need time to grow. All of which gave Laura’s fantasy the freedom to imagine every possible disaster.

  Twenty weeks: A baby born this early would have zero chance of living. Twenty-five: If it came now the odds would be ten to one against viability and even less against normalcy.

  It was only when they measured the baby by ultrasound at twenty-eight weeks that Laura breathed a sigh of relief. If he arrived at this point the chances for his viability – in the hands of a good neonatologist – were in their son’s favor.

  Somehow they calmed each other and – what with natural childbirth classes two evenings a week and ‘Coach Livingston’s’ strict daily regimen of exercises for muscle tone – they were able to retain the remnants of sanity.

  Then at last, week forty. But nothing happened.

  Hastings called them both into his office. Barney was uneasy, for this was the first time Hastings had actually taken the initiative and asked him along.

  ‘Don’t worry,’ he assured them. ‘More than ten percent of pregnancies go over forty weeks, especially with primiparas like yourself, Laura. I mean, it’s still fairly unusual for women to wait till your age to have their first child.’

  A solemn look came over his face.

  ‘Uh, I have a serious question to ask the two of you …’

  Barney’s heart fell. Laura stopped breathing.

  ‘This is in strict confidence, of course.’ He paused and then said, nearly at a whisper, ‘My marriage is in a little trouble. Matter of fact, you might say it’s pretty close to being on the rocks.’

  What the hell could this possibly have to do with us? Laura wondered.

  Hastings explained, ‘Louise and I have agreed to give it one more shot. A friend of ours has offered us his cabin on Lake Champlain. I think five or six days there might very well avert disaster.’

  He stopped and looked at them.

  Barney sensed what he was about to say and was already resentful.

  ‘I’ve seen a lot of pregnancies like this,’ Hastings continued, ‘and I feel certain Laura won’t deliver during the period I’d be away. And besides, if she does go into labor there’s a small airport nearby – I can hop on a private plane and be back in no time.’ His tone then turned parental. ‘Look, I know how important this baby is for both of you. And I’m completely devoted
to you, personally as well as professionally. If you’d feel in any way insecure about my being out of town, say it and I just won’t go.’

  There was a silence. Both Barney and Laura knew this was not a genuine request – it was a guilt trip. They were being emotionally blackmailed with the price of this guy’s marriage.

  ‘Listen, Sidney,’ Laura began, ‘I naturally want you to do the job. But if your backup team is good—’

  ‘Laura, I promised you an all-star team and I’ve made complete arrangements. First of all, Armand Bercovici has just about the best hands of any obstetrician in the country. In all honesty, he’s the only one I’d let near my own wife if she ever needed surgery. I’ve left him all your notes and he’s totally familiar with your history. And instead of a nurse, you’ll actually have our Senior Fellow in Ultrasonography himself – an absolutely brilliant Iranian kid named Reza Muhradi. He’ll be there just to monitor the baby’s state so Bercovici will be able to concentrate completely on Laura.’

  ‘That sounds great,’ Barney replied, his mind obsessively focused – as it had been for the past weeks – on the sight of their child being held upside down before them in the bright lights of the Operating Theater.

  ‘Again,’ Hastings offered, ‘if you’d feel more secure with me around, I’ll put off our trip. This baby’s too important.’

  Barney and Laura looked at each other and saw nothing but doubt and hesitation in each other’s eyes. They were caving in to Hasting’s pressure. Finally Laura spoke.

  ‘What the hell, your marriage is important, too, Sid. Go – I’ll talk the baby into waiting for you to get back.’

  A look of enormous relief crossed Hastings’s face.

  ‘Shit, shit,’ Barney commented as they were driving home. ‘How could two doctors let themselves be conned into agreeing to a thing that we both know is a risk?’

  ‘It’s amazing – even doctors are afraid of other doctors. But actually, there may be a bright side to our cravenness. I know about Bercovici. He’s twice as good as Hastings and, truthfully, I’d rather have him in the room if something went wrong. In fact, it might be lucky if our niño came while Sidney was away.’

  Barney nodded and then spoke to her swollen belly. ‘Hey, Harry,’ he called, ‘you’ve got just five days to come out, so let’s start shaking ass.’

  The child turned out to be a prodigy – antenatally obedient. For less than twenty hours later, Laura was in labor.

  ‘Oh, shit,’ said Barney suddenly in panic, ‘I’d better call Sidney. He’ll have just enough time to fly back here.’

  ‘No,’ Laura disagreed, ‘he’s probably still on the road up there. Help me time the next contraction and then call the hospital and have them get hold of Bercovici.’

  Barney ran for a stopwatch, clocked his athlete at eight minutes, than hastened to the telephone, so nervous that his fingers twice dialed the wrong number.

  ‘No problem, Castellano,’ Barney reassured her. ‘Bercovici is already at the hospital operating on some woman’s carcinoma. He should be out by noon. They said to wait until we break four minutes and come in. I think we ought to leave now.’

  ‘No, Barn, if they say it’s too early we’ll—’

  Her reprimand was interrupted by a uterine contraction.

  At twelve, Barney could wait no longer and he helped Laura to the car, carrying the suitcase they had packed three weeks before, and showed up at the Maternity Ward. Laura just made it to a couch, where she doubled up with increasingly severe contractions.

  Barney asked for Dr Bercovici and was told that he was still downstairs in surgery. He saw this as a good sign. The guy was obviously very careful.

  A wheelchair was brought out and, though she protested, Laura finally allowed herself to be transported to one of the labor rooms.

  It was a small cubicle, actually, with tubes hanging from the ceiling, an oxygen tank and a monitor to measure maternal and fetal heart rates. A huge mural on the wall showed a peaceful New England forest – no doubt to help the mothers gaze at something while they tried to breathe the labor pains away.

  2 P.M. Still no Bercovici.

  ‘What the hell’s he doing?’ Barney asked. ‘Removing every organ in the woman’s body?’

  ‘Shhh,’ Laura ordered. ‘Let’s concentrate on concentrating. Worst comes to the worst, you’ll do the delivery.’

  Her remark did not amuse her husband.

  Three o’clock. A small, slender young man with jet-black hair came in and introduced himself as Dr Muhradi, the Senior Fellow in fetal monitoring.

  ‘Where the hell is Dr Bercovici?’ Barney demanded.

  ‘He’s still in surgery. I’m told that it is a very delicate procedure. But in any case, I’ll be his understudy. Now I’ll check your wife.’

  As he proceeded to examine Laura and check for cervical dilatation, Barney got the uncomfortable feeling that this kid was somehow taking over.

  By now, Laura’s contractions were so frequent and so painful that she was unable to concentrate on anything else.

  ‘I’ll ask one of the nurses to come and stay with Dr Castellano while I take you to get a cup of coffee,’ Muhradi said to Barney. ‘It will calm you down.’

  Barney glanced at Laura, who had managed to understand this last exchange.

  ‘Go on, Livingston,’ she said, forcing a smile, ‘you deserve a break from me.’

  Feeling ambivalence verging on guilt, Barney welcomed the opportunity to get a break from watching his beloved wife in pain. He and the young Iranian stood drinking coffee at the nurses’ station, when a doctor who looked barely old enough to be an intern hurried up to Muhradi. ‘Reza,’ he said breathlessly, ‘I’ve got some trouble with a preemie in Room Five. I’m kind of scared I’m not controlling labor—’

  The Iranian smiled and said, ‘I’ll take a look.’ He put his arm around the younger doctor and went off to give advice.

  Well, Barney thought, he must be pretty good if they run up to him like that with their problems. He went back to see Laura.

  The interval between contractions had diminished slightly but they were lengthening and intensifying.

  ‘Call Bercovici, Barn,’ she muttered, ‘I can’t take much more of this.’

  ‘No need to worry, Dr Castellano,’ came the voice of Muhradi, who had glided into the room. ‘I have spoken to the doctor and assured him that you are nowhere near full dilatation and he had time to take a breather. He was in surgery for seven hours.’

  Barney was growing increasingly anxious. ‘Don’t you think it’s time to give her something for the pain?’

  ‘Oh, she will have an epidural just as you requested, so she can be conscious at the birth. But that will have to wait. Meanwhile I will consult the anesthesiologist about giving her something to ease the discomfort.’

  ‘Great,’ said Barney with relief, ‘that’s great.’

  ‘Hey, tiger,’ Laura weakly called out, ‘have you eaten anything today?’

  Barney came and took her hand. ‘I don’t remember. All I know is that you haven’t eaten anything since yesterday.’

  ‘I can’t. You know that. But that doesn’t mean that you should starve to death. Go down and get a—’

  ‘No, Laura. I intend to stay right here and be a sort of medical Ralph Nader.’

  Just then Muhradi strode back into the room, his modest stature dwarfed by an enormous anesthesiologist, who began the tedious protocol.

  ‘Hello there, my name’s Dr Ball. Is the little lady feeling some distress?’

  Despite her discomfort, Laura could not help but think, Why does this pompous asshole have to be so supercilious?

  But in her helplessness she merely answered politely, ‘Yes, if you’ve got something that can just dull this, but keep me awake.’

  ‘No problem, little lady. No sweat at all. I’ll just give you a little shot and you’ll be higher than a flag on the Fourth of July.’

  ‘She doesn’t want to be high, Doctor,’ Barney interp
osed. ‘Just take the edge off her pain.’

  Unaware that Barney was himself a doctor, Ball merely answered patronizingly, ‘You let me handle this, my boy. I’ve helped more mothers than old Dr Spock.’

  At which, with a speed and dexterity that belied his girth, he injected Laura with scopolamine. It made her dizzy almost instantly. The large man then nodded to the small man and said, ‘Call me when you’re ready for the epidural,’ and padded out.

  Barney sat down to hold Laura’s hand, helping her to breathe. Her pillow was drenched with sweat.

  A nurse came in, holding some papers on a clipboard, which she gave to Barney. ‘We need the husband’s signature to give the analgesic and the epidural. Will you sign here, please, and on the second sheet as well?’

  ‘Barney,’ Laura gasped, ‘this isn’t right. These damn contractions shouldn’t last so long. I mean, that’s not normal.’

  Barney rushed outside to find Muhradi. He was in the waiting room, smoking a cigarette.

  ‘Doctor,’ he called out, ‘her labor’s getting out of hand.’

  ‘That’s good,’ the young man answered with a tiny grin.

  ‘What is?’ Barney asked.

  ‘I put a bit of oxytocin in her I.V. It stimulates the uterus. It will help things along.’

  ‘Well maybe it’s helping just a bit too much. I mean you’d better come.’

  The Iranian snuffed out his cigarette and went toward the labor room.

  From outside they could hear Laura shrieking hysterically.

  ‘Get me that stupid doctor!’

  Dr Ball was among the interns and the nurses gathered around Laura’s bed.

  ‘The woman is hysterical,’ the anesthesiologist said angrily, ‘I think I’d better put her out.’

  ‘You do it, buster, and I’ll put you out,’ Barney snapped, as he rushed to Laura.

  She was gasping, ‘The monitor … the monitor.’

  ‘What’s wrong, Laura? Tell me!’

  ‘I made the nurse turn it around so I could see the printout. Isn’t that moron Muhradi supposed to be some sort of expert? Why the hell didn’t he have his eyes on that damn monitor?’