Page 10 of A Case of Need


  “But not certain?”

  He shrugged. “Nothing is certain in this world.”

  I sipped the drink. It was lousy, mostly vermouth with a touch of vodka.

  “Are you a good friend of the Randalls?” I asked.

  “I know them, yes.”

  “Does that have anything to do with your decision?”

  “Certainly not.” He sat up quite stiffly. “A lawyer learns very early to separate clients and friends. It’s frequently necessary.”

  “Especially in a small town.”

  He smiled. “Objection, Your Honor.”

  He sipped his drink again. “Off the record, Dr. Berry, you should know that I am in complete sympathy with Lee. We both recognize that abortion is a fact of life. It happens all the time. The last figures I saw listed American abortions at a million yearly; it’s very common. Speaking practically, it is necessary. Our laws relating to abortion are hazy, ill-defined, and absurdly strict. But I must remind you that the doctors are much more strict than the law itself. The abortion committees in hospitals are overcautious. They refuse to perform abortions under circumstances where the law would never intervene. In my opinion, before you can change the abortion laws, you must change the prevailing climate of medical opinion.”

  I said nothing. The Passing of the Buck is a time-honored ceremony, to be observed in silence. Bradford looked at me and said, “You don’t agree?”

  “Of course,” I said. “But it strikes me as an interesting defense for an accused man.”

  “I wasn’t proposing it as a defense.”

  “Then perhaps I misunderstood you.”

  “I wouldn’t be surprised,” he said dryly.

  “Neither would I,” I said, “because you haven’t been making much sense. I always thought lawyers got right to the problem, instead of running circles around it.”

  “I am trying to clarify my position.”

  “Your position is quite clear,” I said. “I’m worried about Dr. Lee.”

  “Very well. Let’s talk about Dr. Lee. He has been indicted under a seventy-eight-year-old Massachusetts law which makes any abortion a felony punishable by fines and imprisonment up to five years. If the abortion results in death, the sentence may be from seven to twenty years.”

  “Is it second-degree murder or manslaughter?”

  “Neither, technically. In terms of—”

  “Then the charge is bailable?”

  “Conceivably so. But in this case not, because the prosecution will attempt a murder charge under a common law act which says any death resulting from a felony is murder.”

  “I see.”

  “In terms of the progress of the case, the prosecution will bring forth evidence—good evidence, I’m sure—that Dr. Lee is an abortionist. They will show that the girl, Karen Randall, previously visited Dr. Lee and that he inexplicably kept no records of her visit. They will show that he cannot account for several crucial hours during Sunday evening. And they will present Mrs. Randall’s testimony that the girl told her Lee performed the abortion.

  “In the end, it will come down to a conflict of testimony. Lee, a proven abortionist, will say he didn’t do it; Mrs. Randall will say he did. If you were the jury, whom would you believe?”

  “There is no proof that Dr. Lee aborted that girl. The evidence is wholly circumstantial.”

  “The trial will be held in Boston.”

  “Then hold it elsewhere,” I said.

  “On what grounds? That the moral climate here is unfavorable?”

  “You’re talking technicalities. I’m talking about saving a man.”

  “In the technicalities lies the strength of the law.”

  “And the weaknesses.”

  He gave me a thoughtful look. “The only way to ‘save’ Dr. Lee, as you say, is to demonstrate that he did not perform the operation. That means the real abortionist must be found. I think the chances of doing so are slim.”

  “Why?”

  “Because, when I talked to Lee today, I came away convinced he was lying through his teeth. I think he did it, Berry. I think he killed her.”

  FOURTEEN

  WHEN I RETURNED TO THE HOUSE, I found that Judith and the kids were still at Betty’s. I made myself another drink—a strong one, this time—and sat in the living room, dead tired but unable to relax.

  I have a bad temper. I know that, and I try to control it, but the truth is I am clumsy and abrupt with people. I guess I don’t like people much; maybe that’s why I became a pathologist in the first place. Looking back over the day, I realized I had lost my temper too often. That was stupid; there was no percentage in it; no gain, and potentially a great deal of loss.

  The telephone rang. It was Sanderson, head of the path labs at the Lincoln. The first thing he said was, “I’m calling from the hospital phone.”

  “O.K.,” I said.

  The hospital phone had at least six extensions. In the evening, anyone could listen in.

  “How was your day?” Sanderson said.

  “Interesting,” I said. “How was yours?”

  “It had its moments,” Sanderson said.

  I could imagine. Anyone who wanted me out of his hair would put the squeeze on Sanderson. It was the most logical thing to do, and it could be managed quite subtly. A few jokes: “Say, I hear you’re shorthanded these days.” A few earnest inquiries: “What’s this I hear about Berry being sick? Oh? I heard that he was. But he hasn’t been in, has he?” Then a few choice words from the chiefs of service: “Sanderson, how the hell do you expect me to keep my medical staff in line when you’re letting your path people take off all the time?” And finally someone from the administration: “We run a shipshape hospital here, everybody has his job and everybody does it, no deadwood on board.”

  The net effect would be an intense pressure to get me back in the lab or find a new man.

  “Tell them I’ve got tertiary syphilis,” I said. “That should hold them.”

  Sanderson laughed. “There’s no problem,” he said. “Yet. I’ve got a pretty tough old neck. I can keep it stuck out a while longer.”

  Then he paused, and said, “How much longer do you think it will be?”

  “I don’t know,” I said. “It’s complicated.”

  “Come by and see me tomorrow,” he said. “We can discuss it.”

  “Good,” I said. “Maybe by then I’ll know more. Right now, it’s just as bad as the Peru case.”

  “I see,” Sanderson said. “Tomorrow, then.”

  “Right.”

  I hung up, certain he knew what I was talking about. I had meant that there was something wrong with the Karen Randall business, something out of place. It was like a case we had three months ago, a rare thing called agranulocytosis, the complete absence of white cells in the blood. It’s a serious condition because without white cells, you can’t fight infection. Most people are carrying disease organisms around in their mouth or body normally—staph or strep, sometimes diphtheria and pneumococcus—and if your bodily defenses go down, you infect yourself.

  Anyhow, the patient was American, a doctor working for the Public Health Service in Peru. He was taking a Peruvian drug for asthma, and one day he began to get sick. He had sores in his mouth and a temperature, and he felt lousy. He went to a doctor in Lima and had a blood test. His white count was 600.1 The next day it was down to 100, and the next day it was zero. He got a plane to Boston and checked into our hospital.

  They did a bone-marrow biopsy, sticking a hollow needle into his sternum2 and drawing out some marrow. I looked at it microscopically and was puzzled. He had lots of immature cells of the granulocyte series in his marrow, and while it was abnormal, it was not terribly bad. I thought, “Hell, something is wrong here,” so I went to see his doctor.

  His doctor had been tracing the Peruvian drug the patient was taking. It turned out to contain a substance removed from the American market in 1942 because it suppressed white-cell formation.

  The doct
or figured this was what was wrong with his patient—he had suppressed his own white cells, and now he was infecting himself. The treatment was simple: take him off the drug, do nothing, and wait for his marrow to recover.

  I told the doctor that the marrow didn’t look so bad on the slide. We went to see the patient and found he was still sick. He had ulcers in his mouth, and staph infections on his legs and back. He had a high fever, was lethargic, and answered questions slowly.

  We couldn’t understand why his marrow should seem so basically normal when he was so damned sick; we puzzled over this for most of the afternoon. Finally, about four, I asked the doctor if there had been any infection at the site of biopsy, where they had made the puncture to draw marrow. The doctor said he hadn’t checked. We went to the patient and examined his chest.

  Surprise: unpunctured. The marrow biopsy hadn’t been taken from this patient. One of the nurses or residents had screwed up the tags, mislabeling a marrow sample from a man with suspected leukemia. We immediately drew a sample from our patient and found a very suppressed marrow indeed.

  The patient later recovered, but I would never forget our puzzling over the lab results.

  I HAD THE SAME FEELING NOW—something was wrong, something was out of place. I couldn’t put my finger on it, but I had the suspicion that people were working at cross-purposes, almost as if we were talking about different things. My own position was clear: Art was innocent until proven guilty, and that wasn’t proven yet.

  Nobody else seemed to care whether Art was guilty or not. The issue that was crucial to me was irrelevant to them.

  Now why was that?

  Normal white count is 4-9,000 cells/cubic centimeter. With infection, this may double or triple.

  Breastbone.

  TUESDAY

  OCTOBER 11

  ONE

  WHEN I AWOKE IT FELT LIKE A NORMAL DAY. I was exhausted and it was drizzling outside, cold, gray, and uninviting. I pulled off my pajamas and took a hot shower. While I was shaving, Judith came in and kissed me, then went to the kitchen to make breakfast. I smiled into the mirror and caught myself wondering what the surgical schedule would be like.

  Then I remembered: I wasn’t going to the hospital today. The whole business came back to me.

  It was not a normal day.

  I went to the window and stared at the drizzle on the glass. I wondered then for the first time whether I ought to drop everything and go back to work. The prospect of driving to the lab, parking in the lot, hanging up my coat, and putting on my apron and gloves—all the familiar details of routine—seemed suddenly very appealing, almost enticing. It was my job; I was comfortable at it; there were no stresses or strains; it was what I was trained to do. I had no business playing amateur detective. In the cold morning light, the idea seemed ludicrous.

  Then I began to remember the faces I had seen. Art’s face, and the face of J. D. Randall, and Bradford’s smug confidence. And I knew that if I didn’t help Art, nobody would.

  In one sense, it was a frightening, almost terrifying thought.

  JUDITH SAT WITH ME AT BREAKFAST. The kids were still asleep; we were alone.

  “What are you planning today?” she said.

  “I’m not sure.”

  I had been asking myself that very question. I had to find out more, lots more. About Karen, and Mrs. Randall particularly. I still didn’t know very much about either of them.

  “I’ll start with the girl,” I said.

  “Why?”

  “From what I’ve been told, she was all sweetness and light. Everybody loved her; she was a wonderful girl.”

  “Maybe she was.”

  “Yes,” I said, “but it might be good to get the opinion of someone besides her brother and her father.”

  “How?”

  “I’ll begin,” I said, “with Smith College.”

  SMITH COLLEGE, Northampton, Massachusetts, 2,200 girls getting an exclusive education in the middle of nowhere. It was two hours on the turnpike to the Holyoke exit; another half-hour on small roads until I passed under the train tracks and came into the town. I’ve never liked Northampton. It has a peculiarly repressed atmosphere for a college town; you can almost smell irritation and frustration in the air, the heavy combined frustration of 2,200 pretty girls consigned to the wilderness for four years, and the combined irritation of the natives who are forced to put up with them for that time.

  The campus is beautiful, particularly in autumn, when the leaves are turning. Even in the rain, it’s beautiful. I went directly to the college information office and looked up Karen Randall in the paperback directory of students and faculty. I was given a map of the campus and set out for her dorm, Henley Hall.

  It turned out to be a white frame house on Wilbur Street. There were forty girls living inside. On the ground floor was a living room done in bright, small-print fabric, rather foolishly feminine. Girls wandered around in dungarees and long, ironed hair. There was a bell desk by the door.

  “I’d like to see Karen Randall,” I said to the girl.

  She gave me a startled look, as if she thought I might be a middle-aged rapist.

  “I’m her uncle,” I said. “Dr. Berry.”

  “I’ve been away all weekend,” the girl said. “I haven’t seen Karen since I got back. She went to Boston this weekend.”

  I was in luck: this girl apparently didn’t know. I wondered whether the other girls did; it was impossible to tell. It seemed likely that her housemother would know, or would find out soon. I wanted to avoid the housemother.

  “Oh,” said the girl behind the desk. “There’s Ginnie. Ginnie’s her roommate.”

  A dark-haired girl was walking out the door. She wore tight dungarees and a tight poor-boy sweater, but the overall effect remained oddly prim. Something about her face disowned the rest of her body.

  The desk girl waved Ginnie over and said, “This is Dr. Berry. He’s looking for Karen.”

  Ginnie gave me a shocked look. She knew. I quickly took her and steered her to the living room, and sat her down.

  “But Karen’s—”

  “I know,” I said. “But I want to talk to you.”

  “I think I’d better check with Miss Peters,” Ginnie said. She started to get up. I pushed her gently back down.

  “Before you do,” I said, “I’d better tell you that I attended Karen’s autopsy yesterday.”

  Her hand went to her mouth.

  “I’m sorry to be so blunt, but there are serious questions that only you can answer. We both know what Miss Peters would say.”

  “She’d say I can’t talk to you,” Ginnie said. She was looking at me suspiciously, but I could see I had caught her curiosity.

  “Let’s go someplace private,” I said.

  “I don’t know…”

  “I’ll only keep you a few minutes.”

  She got up and nodded toward the hall. “Men aren’t normally allowed in our rooms,” she said, “but you’re a relative, aren’t you?”

  “Yes,” I said.

  Ginnie and Karen shared a room on the ground floor, at the back of the building. It was small and cramped, cluttered with feminine mementos—pictures of boys, letters, joke birthday cards, programs from Ivy football games, bits of ribbon, schedules of classes, bottles of perfume, stuffed toy animals. Ginnie sat on one bed and waved me to a desk chair.

  “Miss Peters told me last night,” Ginnie said, “that Karen had…died in an accident. She asked me not to mention it to anyone for a while. It’s funny. I never knew anybody who died—I mean, my age, that kind of thing—and it’s funny. I mean peculiar, I didn’t feel anything, I couldn’t get very worked up. I guess I don’t really believe it yet.”

  “Did you know Karen before you were roommates?”

  “No. The college assigned us.”

  “Did you get along?”

  She shrugged. Somehow, she had learned to make every bodily gesture a wiggle. But it was unreal, like a practiced gesture perfected bef
ore the mirror.

  “I guess we got along. Karen wasn’t your typical freshman. She wasn’t scared of the place, and she was always going away for a day or the weekend. She practically never went to class, and she always talked about how she hated it here. That’s the thing to say, you know, but she meant it, she really did. I think she really did hate it.”

  “Why do you think so?”

  “Because of the way she acted. Not going to class, always leaving campus. She’d sign out for weekends, saying she was going to visit her parents. But she never did, she told me. She hated her parents.”

  Ginnie got up and opened a closet door. Inside, tacked to the door, was a large glossy photograph of J. D. Randall. The picture was covered with minute punctures.

  “You know what she used to do? She used to throw darts at this picture. That’s her father, he’s a surgeon or something; she threw darts at him every night, before going to sleep.”

  Ginnie closed the door.

  “What about her mother?”

  “Oh, she liked her mother. Her real mother; she died. There’s a stepmother now. Karen never liked her very much.”

  “What else did Karen talk about?”

  “Boys,” Ginnie said, sitting on the bed again. “That’s all any of us talk about. Boys. Karen went to private school around here someplace, and she knew a lot of boys. Yalies were always coming to see her.”

  “Did she date anyone in particular?”

  “I don’t think so. She had lots of guys. They were all chasing her.”

  “Popular?”

  “Or something,” Ginnie said, wrinkling her nose. “Listen, it isn’t nice to say things about her now, you know? And I have no reason to think it’s true. Maybe it’s all a big story.”

  “What’s that?”

  “Well, you get here as a freshman and nobody knows you, nobody’s ever heard of you before, and you can tell people anything you like and get away with it. I used to tell people I was a high-school cheerleader, just for the fun of it. Actually I went to private school, but I always wanted to be a high-school cheerleader.”