Death Benefit
Some of Bourse’s vinegar lost its acid. She realized that Pia had a point. Still, it didn’t justify what these two otherwise gifted students had done, something totally foolish and out of character. After a pause she asked, “Well, what did you find?”
“Nothing, but we were interrupted. Do you have a report from the epidemiologists?”
“Certainly not from the CDC. Not yet. But I spoke to the head of our own team. Apparently nothing was found amiss.”
Dr. Bourse knew that Dr. Rothman was closer to this student than to anyone in the whole medical community. She knew quite a bit about Pia, more than she guessed Pia surmised. Bourse had had access to all the deliberations of the admissions committee, which she had pored over in great detail. Up until the call from Winston, she’d had high hopes for her, hopes she wanted to maintain. For Pia, Bourse’s intent was to try to keep the damage from the evening’s escapade and poor judgment to a minimum. Such was the burden of being dean of students. Earlier that evening Bourse had had to deal with an even more difficult issue: A third-year student had been caught stealing prescription drugs from the medical floors. Bourse turned her attention to the second delinquent. At least he met her eye, which she couldn’t get from Pia. “So what’s your excuse?” she asked George, with a certain resignation in her voice.
“No excuses. I was helping my friend,” he said as evenly as he could.
Dr. Bourse studied George. He too was a top student, more liked in general than Pia, who could be considered standoffish. Bourse was well aware of George’s apparent infatuation with Pia, so she took his excuse at face value. Once again she marveled at how such an apparently accomplished young man like George could be reduced to such a lovelorn teenager that he’d risk his future like this. If Bourse had allowed Winston to have him arrested, it could have affected his becoming a doctor.
“All right,” Bourse said. She took a deep breath and regarded the ceiling for a moment to clear her head. “Here’s what we’re going to do. You’re going to go back to your rooms and stay there. You won’t fraternize with anyone or talk about this episode with anyone. You’ll monitor your temperatures and take your antibiotics as directed. George, I’ll make sure you get some. And I’ll see both of you in my office at seven tomorrow morning. We’ll discuss your elective then, Ms. Grazdani. Mr. Wilson, tomorrow you will return to Radiology. Both of you will also say a prayer for me and thank the Lord that I’m in a benevolent mood. I’ll now go and square this away with Mr. Winston. If I can.”
With the dean out of the room, George let out a deep sigh and sat back in his chair. “Oh my God, I thought we were dead. If the police aren’t involved, it’s just an internal thing. It won’t be on our records. It’ll be like this never happened.” George looked at Pia, who didn’t respond. Her face was a blank, her mind clearly still back at the lab.
“You can’t let this drop?” George questioned.
“Of course I can’t let it drop,” Pia shot back. “Something had to have happened. Something out of the ordinary.”
“What about one of the technicians messing up, either by accident or design? I mean, Rothman was like a bull in the proverbial china shop. I imagine there are a lot of people who aren’t crying tonight about what happened to him.”
Pia shook her head. “There were people in the lab who found him unpleasant. But the same people admired him greatly. I can’t imagine anyone in the lab being involved in any underhanded way.”
“So what are you thinking?”
“I don’t know what to think,” Pia said. Her mind was swirling. Her first concern was whether or not Rothman would pull through. At the same time she was reconsidering the two possibilities for what had happened: Rothman contaminated himself by accident, or he did it deliberately. But then, another idea started to take shape in her mind. She realized there was a third possibility she hadn’t yet considered.
28.
COLUMBIA UNIVERSITY MEDICAL CENTER
NEW YORK CITY
MARCH 24, 2011, 5:05 A.M.
Although it was only a little after five in the morning, Pia finally quit trying to go back to sleep and got out of bed. The previous night she’d returned to her dorm room from the security office exhausted mentally and physically. Before she and George went to their respective rooms, he gave her the turkey sandwich that he’d saved. It was flattened to a degree but still recognizably a sandwich. Once back in her room, she’d eaten a corner of it, then threw the rest in the trash and went to bed, hoping to get some rest. She’d not slept well, but at least she couldn’t remember her dreams.
Pia showered quickly and dressed. She understood how essential it was to her future that Rothman pull through. Despite the hour, she knew she had to go over to the hospital to check and make sure he was okay. Her hope was that the new antibiotic had worked wonders and was controlling his infection. In that case, she further hoped that his delirium had cleared up and she could have a word with him. She wanted to ask him if he had any idea what had happened in the biosafety lab the previous morning.
Emerging from the dorm onto Haven Avenue, Pia felt conspicuously lonely. It was morning although not yet light. She felt like the only person in the world as she made her way over to the hospital. Once inside, it was different as the hospital never slept. Quickly she made her way up to the infectious disease wing.
When she got to the ward she was perplexed. She felt she must have gotten turned around because the room she thought was Rothman’s was being disinfected in preparation for its next inhabitant. But no, this was his room. So Rothman had been moved, perhaps because he was showing signs of improvement following the new course of treatment. Pia didn’t allow herself to think that anything else could be the case. She checked Yamamoto’s room. His room was also being cleaned. He’d been moved as well.
Pia turned around and went back to the nurses’ station to find out where Dr. Rothman and Dr. Yamamoto had been sent. The station was humming, even at that time of the morning, in preparation for the shift change at seven.
“Excuse me,” Pia said to one of the night nurses standing at the counter filling out one of the millions of forms they were required to do. “I’m looking for Dr. Rothman and Dr. Yamamoto.” Suddenly Pia felt nauseous and an overwhelming sense of panic rose within her. They weren’t moved because they got better.
“Please, tell me where they are,” Pia pleaded, hoping against hope.
“And who are you? Are you related to Dr. Rothman?”
“I’m Dr. Rothman’s medical student. Please, where is he?”
The nurse took Pia by the arm and walked her away from the busy nurses’ station into the waiting room, which was empty at that hour. She didn’t turn the light on and the two women stood in the semidarkness. Pia was worried her legs were going to give out and she would collapse on the floor like a rag doll.
“Listen, we only just told the families,” the nurse said. “I’m sorry, they both passed. Dr. Rothman first, then Dr. Yamamoto about an hour ago.”
“What do you mean they ‘passed’?” Pia asked, but intellectually she knew what the nurse meant. But just maybe . . .
“They died, sweetheart, I’m sorry. Dr. Rothman died being prepped for surgery. That’s all I know. That’s all I can tell you. Look, I have to go.” The nurse put her hand on Pia’s arm and left the room.
Pia went down on her haunches, her mouth open in a silent scream. She clasped her arms around her knees and pulled herself tight into a ball, as if she were trying to hide somewhere within her own body. Pia felt like she’d been punched in the gut. She was disoriented and angry—angry at the hospital, angry at the world, angry at Rothman himself. If she was going to judge a man by his actions, what had he done? She’d been abandoned. Betrayed. Pia stumbled out of the room and off the ward, descended in the elevator, walked outside in a daze. The sky was now light in the east, but the sun had yet to make it up over the horizon.
29.
COLUMBIA UNIVERSITY MEDICAL CENTER
NEW YO
RK CITY
MARCH 24, 2011, 6:30 A.M.
Pia staggered down Fort Washington Avenue like a drunk, clutching her stomach. Thinking she was about to throw up, she stopped by a garbage can, but she was only able to bend over the rim and dry-heave a couple of times. Pia stood up and breathed deeply in and out. She had to get a grip on herself, but what was she going to do? There was an immediate issue to contend with, and she was almost grateful for the distraction: She remembered that she and George had to see the dean of students at seven, so she went to the dorm to find George.
George had set his alarm for 6:15. He was accustomed to sleeping soundly, even if the rigors of medical school meant it might be for only three or four hours at a time. But last night he’d been unable to sleep save for brief snippets, constantly turning over the events of the evening in his mind. At one point he’d given up and sat for almost an hour in the semi-comfortable armchair by the window and nursed a glass of Jack Daniel’s from a bottle that had lasted through his whole medical school career. Through the window he could see a portion of the George Washington Bridge and a bit of the New Jersey Hudson River waterfront. He was totally confused and humiliated about his motivations.
Last night, Pia had come desperately close to wrecking all of George’s plans. George stopped himself; it really wasn’t Pia’s doing that he had tagged along with her. He had to take some responsibility. The problem was that he cared about her too much to let her blindly charge into these predicaments by herself, and whether she acknowledged it or not, she needed his help. Still, he knew there was a point where he’d have to stop and put his own interests first. He just didn’t know where that point would be.
He’d been asleep for only a little more than an hour when the alarm went off, and George unknowingly swept his hand over the snooze button. Nine minutes later he did it again, and he would have done it a third time if Pia’s knocking hadn’t woken him up. He was pleased to see her until he saw the look on her face and realized there was something wrong.
“What happened . . . ? Wait, what time is it? We’ve got the dean . . .”
Pia walked into the room like a reanimated zombie and fell full-length on George’s bed. She mumbled something into George’s pillow.
“What’s wrong?” George saw what time it was and started to get dressed. After a few seconds, he went over to the bed and sat on the edge and moved a few strands of hair from Pia’s cheek. She was a basket case.
“Tell me,” he said quietly.
“He’s dead. They’re both dead.”
“Who? Rothman? Yamamoto?”
“Yes.”
“Oh, Pia, I’m sorry. I’m so sorry.” George laid his hand on Pia’s shoulder. “Pia, I don’t know what to say. God, this is really a tragedy. From what you’ve told me, they were on the verge of something huge. What a setback for regenerative medicine, probably years, maybe even a decade. There’s no one to fill their shoes.”
Pia was silent. George removed his hand. She turned to look up at him. Her face no longer looked blank, just angry.
“Right now, I don’t give a flying fuck about the future of regenerative medicine. Jesus!”
Pia sprang up from the bed and stormed out of the room. George followed her, tucking in his shirt. At first he couldn’t see her but heard footfalls receding down the stairs.
“Pia, wait up!”
George ran down the street after Pia, who was speed-walking toward the dean’s office. He caught up with her and jogged alongside.
“Pia!”
Pia waved her hand, dismissing George.
“Look, I’m sorry.”
She stopped dead in her tracks, clenched her fists with her arms by her sides, and let out a low scream in exasperation. She turned and looked George right in the eye.
“George, don’t tell me you’re sorry. Please just shut up!”
With that she walked off and left George standing in the street like a just-dumped lover. George’s shoulders fell. Condolences clearly weren’t his strong suit although he hardly thought he deserved such a brush-off. He thought back to his long night of self-examination. If this woman needed him, especially now, she sure had a funny way of showing it.
30.
COLUMBIA UNIVERSITY MEDICAL CENTER
NEW YORK CITY
MARCH 24, 2011, 7:00 A.M.
Pia and George arrived separately at the suite of offices of the dean of students. They were each buzzed in by the dean herself as the secretary, due in at eight, had yet to arrive. They sat at either end of the leather couch outside the office proper, avoiding eye contact, not saying anything. For Pia, such silences came naturally, while for George, who’d happily talk to anyone, it was a strain not to communicate. At the same time he had no wish to be told to shut up again by Pia, which was what he was certain would happen since all he wanted to do was apologize, again, for inadvertently upsetting her. It was part of his nature to feel responsible.
A few minutes after the hour, Helen Bourse emerged from her office.
“Thank you for being on time this morning,” Bourse said, beckoning Pia and George to follow her. She gestured to a couple of straight-backed chairs for them to sit in. She had seen a note in Pia’s file, which she’d read overnight, written by a particularly zealous clinical preceptor during her second-year introduction to surgery. It said that Pia had difficulty arriving on time for early-morning appointments, even after being admonished that such behavior was not tolerated in surgery. Although it was usually only about five to ten minutes, it was consistent, and the preceptor indicated that she thought it was a serious lapse.
Dr. Bourse sat down and regarded her two students. “To begin, I’m afraid I have some very bad news.” Her voice had the gravity appropriate to the situation. “There’s no way to say this other than just to say it. Doctors Rothman and Yamamoto both died this morning. They were being prepped for surgery for rapidly developing peritonitis, but they didn’t make it.”
“I know,” Pia said.
“How do you know?” Dr. Bourse was confused. She had just learned it herself.
“I went to the infectious disease unit this morning. I woke up early. I thought maybe the new antibiotic would have had an effect, but I was told they had died.”
Dr. Bourse stared at Pia, whose voice sounded as if all the fight had gone out of her. She could see that the young woman’s eyes were rimmed with emotion and fatigue. Dr. Bourse sighed. Here was yet another example of Pia’s marked willfulness, as she herself had told both Pia and George in no uncertain terms to go back to their rooms, check their temperatures regularly, and stay there until this meeting. Yet Pia had willfully ignored the order.
Dr. Bourse sighed again, still looking directly at Pia, whose eyes were, as usual, diverted. “Okay, I’ll try to overlook the fact that I told you to stay in your dorm room. I gather you went to the hospital because of your closeness with Dr. Rothman?”
Pia nodded. She had an urge to admit that for her, Rothman had morphed into the father she never had, but she held her tongue. It wasn’t in her to be forthright with her secrets.
“At least you made no attempt to go back to the lab, or did you?”
George looked quickly at Pia, worried. The thought that Pia might try to go back to the lab without him had not occurred to George.
“No, I didn’t,” Pia said quietly, and George exhaled.
“Did you both check your temperatures as I asked?”
Both students nodded, although George had had to abandon his thermometer when Pia flew out of his room that morning.
“And I assume everything was fine. Okay. Rothman’s and Yamamoto’s deaths are a blow to everyone here at the medical center, particularly the school. I knew Dr. Yamamoto a little, and he was a fine colleague. Dr. Rothman I knew better, of course, and I understand you got along well with him, Miss Grazdani. He certainly took a keen interest in your progress and afforded you more privileges than he did other students.” And any fellows, thought Dr. Bourse. “I viewed that intere
st as a compliment to your abilities as a researcher and to the potential that Dr. Rothman recognized in you.”
Pia was staring at the ground.
“Of course it’s terribly ironic that Dr. Rothman, who spent so much time uncovering the pathogenicity of salmonella, should die from the same organism he’d come to understand so well. . . .” Bourse let the thought drift.
“So, Miss Grazdani, I have arranged for you to do research, starting today, with Dr. Roselyn Gorin, who is one of the most talented people on campus. She has a Lasker Prize, as you may know, and she’s doing absolutely groundbreaking work on the differentiation of stem cells into specific adult cells. Roselyn is a friend of mine. She’s a wonderfully warm and understanding person. I just talked with her ten minutes ago, and she’s very happy to take you on. Happy’s not the right word in these circumstances, but she’s very willing to help.”
Dr. Bourse smiled hopefully.
“Today? I can’t possibly start today,” Pia said.
George winced as it was apparent to him that Dr. Bourse’s first reaction was of intense irritation.
Dr. Bourse paused in order to gain control of her emotions, as she was as irritated as George had sensed. Roselyn was a friend, but in fact she hadn’t been overjoyed about taking on a new student, especially Rothman’s student, who had built up a reputation of her own, fairly or not. Dr. Bourse wanted to tell Pia to get her act together, but she held her tongue.
“I’m very grateful for what you’ve done,” Pia said quickly, trying to sound sincere. “Really,” she added, as if she sensed she was pushing it. “But I just got this news an hour ago, and I really can’t think straight. I need a couple of days. To get my head together.”
Dr. Bourse sighed again. Pia was not the easiest individual to get along with. At the same time what she was saying was undoubtedly true. Everyone at the center was going to be shaken by the deaths. Dr. Yamamoto was a very popular presence and even if few could tolerate Rothman on a one-on-one basis, his death was still a blow, especially under these circumstances. He was, after all, the center’s scientific celebrity.