Remedies

by Kate Ledger

  “Do you have a list of nearby hotels?” he asked Bev.

  “One thing at a time.” Still scouring her papers for his name. “I don’t have you down here,” she determined finally. She pointed with her pen to the other end of the marble hall. “You can use that phone to call the main conference number and pay your attendance fee. Then I can issue you a name tag.”

  “Look, I’m a little late as it is, and I flew all the way across the country to be here. I can assure you I’ve already paid.”

  “I can issue you a tag once I have your confirmation number.” She was near his age, he estimated, maybe a little younger. Her face had the shape of a horse chestnut, and her eyes were made up to accentuate irises so blue they were almost teal.

  Dutifully, he crossed the lobby, dragging his carry-on suitcase by the handle. He picked up the phone on the wall and glanced back in Bev’s direction. He dialed the number she’d handed him, got a busy signal, hung up and dragged his suitcase back to where she was checking someone else in. He hung by her shoulder until she was finished.

  “The line was busy, which I know is probably a matter of timing and the fact that it’s a well-attended conference. It’s amazing how many details you coordinators need to take care of. I’m amazed by what you do. As it is, I’m late. I’m bringing a new therapy, and it’s important I get in. Can I trouble you for a tag and take care of the technicalities at the first break?” She was not unattractive. Her hair was shoulder-length and cut in feathery layers that all hung down, soft-looking. The eye makeup was overdone, but added drama. On the young side of forty, he decided now. Soothing face, athletic arms. The faint creases around her mouth and under her eyes suggested she’d spent considerable time in the wind and sun, and he revised his impression of her from a hard-nosed secretarial type to a grudgingly tough camp-counselor type, which appealed to him somewhat more. Stomach turning, he realized this was how it would be now: He could flirt with her. He was a man who was soon to be divorced. He ducked his head and conjured a boyish smile. “I’ll get you all the right numbers. Soon as the session’s over.”

  She twisted up her mouth as she considered this deviation from protocol. “Oookay. Just make sure you get back to me.”

  He explained ingenuously, “I’m here all the way from Baltimore. Bringing a new therapy. Absolutely new. I tested it out in my clinic back home, and it’s done wonders. People who couldn’t get off the couch because of pain have been able to walk.”

  “Well, you came to the right place,” Bev declared. “We got everybody you’d want to meet here. All pain specialists. Seventeen states and six countries represented. Just make sure you get me your confirmation number, oookay?”

  “Thanks, Bev.” He turned in the direction of the session and hurried toward it.

  As he was walking away, he remembered Emily, standing behind the chair in the dining room, coolly making her announcement. She’d taken him so by surprise, he hadn’t even had a chance to respond. Hadn’t even questioned her decision. Hadn’t defended himself. He’d accepted it because he’d been expecting for the past fifteen years that she would leave him. He turned back to Bev, who was checking her clipboard. “Maybe I could tell you later about this treatment? Over coffee or something?”

  “Just get me the number at the break,” Bev said, not unkindly, “and we’ll see then.”

  Dollying his suitcase down the hall, past an informational poster propped on an easel, he ducked into the first room on the left where the speaker—a neurosurgeon from Washington State—was already deep into a PowerPoint presentation on the benefits of a new implantable device that delivered electrical impulses to the spine. “So what we’re doing is intercepting the pain signals, if you will,” the clean-shaven speaker explained in a voice that was annoying for its pretend modesty. Simon knew the new treatment with its revolutionary electrode array was only a shot in the dark, nothing more impressive than sulmenamine, when the doctor added, “This system has shown efficacy for individuals with certain pain syndromes and particular constitutions. We’ve proved long-term success in sixty to seventy percent of those we’ve seen,” the man went on, “and of course we choose patients selectively.” The system he was proposing, Simon realized shortly, had a price tag of ten thousand dollars. Simon looked around to see if the audience of physicians seemed receptive.

  “I don’t get it,” he called out, after waving his arm wildly as soon as the floor opened to questions. “Maybe I’m too practical, but ten thousand dollars for a therapy with no guarantee? Who’s going to pay for this?” Simon had his suitcase wedged between his calves, and he was certain he saw other heads in the audience bobbing in agreement.

  He was growing bolder. He sat through a presentation on trigeminal neuralgia and smiled smugly. It was a classic case, just like his patient Florence Rudolph, who had reached up to itch her nose and felt a burning flash across her cheek that was so severe, she thought she’d inadvertently cut herself with the edge of a fingernail. The condition was believed to be caused by the deterioration of the fatty coating around the facial nerve, which made the neuron short-circuit, sending scrambled messages into the brain. Florence was the one who refused to wear eyeglasses because of the sparks that would shoot through her cheeks and into her gums. The patient described in the case study finally had undergone surgery to separate the damaged nerve in her face from a cerebellar artery that had collapsed against it. But Simon had been treating Florence Rudolph with sulmenamine, and he was almost certain he was getting results. What he had brought to the conference would undoubtedly set the pain scholars afire.

  He flipped through the program, reading the abstracts and the bios of the researchers. He wished he’d discussed the conference with Emily, formulated a plan about whom he would approach and how he would present his findings. He’d never met anyone who could deal so coolly with a multitude of people who were experts in their fields.

  He decided the best tactic would be to introduce himself to individual researchers, a grassroots approach. He’d greet them first, casually describe the treatment and what he’d seen so far. That way, he’d generate buzz, a low-level undercurrent awareness of sulmenamine, and he’d wind his way slowly toward some of the more influential scientists. At the end of the second talk, he wheeled his suitcase back out to the hall. Toting it along behind him, he noticed another man leaving, heading toward the elevator. He positioned himself by the elevator, rocking on his heels.

  “Simon Bear.” He thrust forward his hand.

  The hand that met his was strong, the grip competitive. “Bill Marlon.” He had a shiny, ruddy complexion like a guy who golfed or sailed.

  “Exciting stuff going on,” Simon said, looking around. “You from around here?”

  Bill named a teaching hospital in Virginia. “Interventional radiology. You?”

  “Medicine. Private practice in Baltimore. You presenting? Yeah? What’s your topic?”

  “Percutaneous vertebroplasty. For compression fractures in the spine.”

  “Never heard of it,” Simon said. “Is that for osteoporosis?”

  “Or cancer. Osteolytic bone, older patients, seventy years old and so on. It’s a relatively new procedure. I inject liquid cement into cracked vertebrae. Big syringe, X-ray guidance.” He made a pumping motion with his fingers. “When the cement hardens, bye-bye pain.”

  “That works?”

  “A fucking miracle. Stabilizes the collapsed bone, keeps it from breaking further. What’s amazing is that it takes care of the pain, too. The exact mechanism isn’t clear, but patients hobble in, have the therapy and walk right out.”

  “How about that.”

  “It came from Europe. I’m bringing it here.”

  Simon looked at him appreciatively. “Gluing them back together, huh? All the king’s horses, all the king’s men. You’re what Humpty-Dumpty was after. And the exact mechanism isn’t known?”

  “A couple theories, but nothing definitive. How about you?”

  Simon patted t
he pocket of his jacket. “I have a new drug for chronic pain. Sulmenamine infusion therapy.”

  “Never heard of that, either.”

  “It’s brand-new,” Simon said. “I’m introducing it. Actually, it’s an old pharmaceutical with new pain applications.”

  “You’re a drug rep?”

  “No, no!” Simon said, offended. “I’m a physician. I discovered the therapy.”

  “Ah, wow. So did you publish?”

  “Not yet,” Simon acknowledged. “I’m writing it up now. I just came to meet people, get some names behind it, see if I could spread the word some.”

  Bill Marlon glanced down the hall, looking to see who was coming. He looked at his watch.

  Simon continued, “I’ve tested it on several patients so far, and the success rate has been remarkable. I have at least three cases of complete remission.”

  “Um-hm.” He checked his watch. “I’m due upstairs, supposed to meet some people, old friends. Nice meeting you. Best of luck.”

  He thinks I’m a quack, Simon realized. He can’t get away fast enough. It happened again later that morning when he tried to introduce himself to the head of a pain clinic in Minnesota. The guy—Fred Arbermore—shook his hand and listened with his face stretched into a smile. He nodded and stroked his beard. “If it’s all you say it is, I’m sure we’ll be hearing a lot about it,” he said and turned to talk with someone else. Nobody asked for more details about sulmenamine infusion therapy, and nobody asked how he’d made the discovery. He’d flown all the way from Baltimore to be rebuffed by a tight community with its little in-groups and cliques and its hierarchy of publications. Dragging his luggage to the lobby, he decided to leave the conference center and head to his hotel. There was one other mogul he’d spotted: Adele Maples. She led a pain research center in Boston, and she had connections to Harvard and also to some spin-off companies that were developing therapeutics. If he could get to her, he might be able to make some headway, drop the name of the treatment, leave his card. He’d spotted her sitting to the side in one of the talks, but between sessions, she’d been flanked by other people and deep in conversation. He wanted face-to-face time with her in which he could explain himself fully.

  In the morning, after taking a cab back to the conference center, toting his suitcase with him, he found Bev standing at the reception desk. Most of the name tags were gone from her reception table. She pointed at him with her pen. “We had a deal, Dr. Bear.”

  “I didn’t call. I forgot. I’ll phone right now.”

  “I meant coffee.”

  He smiled gratefully. “I could use some.”

  “There’s a place down the block.” She grinned and told him she’d gone ahead and phoned the conference headquarters for him. They’d found his name in the computer and she had the number she needed for her list. She dangled a ring of keys and offered to stash his suitcase in a closet in one of the main rooms. He declined.

  “You pulling around gold in that thing?” she teased.

  “Something like that.”

  She worked for the Pain Studies Council, which was hosting the event. A low-level administrator, he decided as they entered the wood-paneled coffee shop, adorned with dangling tangerine-colored lampshades. He thought maybe she’d be useful down the line getting names and numbers if he wanted to contact some of the scientists, but she didn’t seem to have special access to anyone in particular, and unfortunately not to Adele Maples. In any event, it was helpful to have another human being to talk with. She ordered a decaffeinated latte with skim milk.

  “Nonfat decaf?” he joked, standing behind her in line. “More aptly called ‘nada latte.’ ”

  She seemed amused. As they waited for her drink, she bopped slightly to the music coming out of an overhead speaker, and he couldn’t remember the last time he felt like he was experiencing a moment exactly as it was taking place.

  “What you’re doing is amazing,” she said, sipping her latte, after he’d told her the story of how he found sulmenamine. “All of you. Taking on this great black box. Trying to make sense of it. I was talking to a scientist who said it’s as hard to pin down pain as it is to pin down consciousness. It’s not a thing, it’s not a place. It’s not even a summation of experiences. I don’t have a lot of scientific know-how. I just read about the nerve studies and type up what people are doing, but I’m amazed by all the ways you people approach it.”

  “I didn’t go looking for the answer,” he said. “It found me. All I did was question what I was seeing and connect the dots. I stumbled across this therapy.”

  “Chance favors the prepared mind,” she said brightly. He watched her lift her coffee drink. Her maroon fingernails brought to mind the color of a scab.

  “The trouble is, I can’t get anyone to listen,” he griped. “They want to hear from each other, not from some guy in private practice they’ve never heard of. They wouldn’t care if it’d been handed to me from God.”

  “Why don’t you just go to the drug company?”

  “Because it would look like I’m after money. I could tell the company, but I don’t want anyone to think I’m trying to capitalize on this cure. I’m not about the money. I just want to do something for these patients. Maybe I’ll have to go to the company eventually, but I wanted to get the word out first.”

  “Maybe you need more evidence,” she suggested. “Or maybe you could work with someone. You know, collaborate. Pick someone who’s better connected than you are and work your way in like that.”

  “You can’t even begin to imagine the joy of it,” he said, almost bouncing on the seat. “You have a woman sitting in front of you in the office who’s just a shell of a human being. Really, like a shell on the beach. It’s like the pain has moved in and taken up all the space of her personality. Like her soul’s been evicted. You give a shot of this stuff and she remembers she’s capable of being in control. She’s maybe not herself right away, but she’s moving back in. She’s the master of her fate, the captain of her soul.”

  She smiled and her almost-teal eyes sparkled. “I can tell the kind of person you are,” she said. “Just from your face. I can tell all about you.”

  “How’s that?” he asked.

  “You got smile lines around your eyes. These ones.” She pointed with a maroon-tipped finger without quite touching his face. “People have them who smile a lot. I always look for them when I meet someone new. Small thing, but they tell you a lot. I can tell you’re for real.”

  He looked: She had them, too. Sitting with her in a coffee shop in Salt Lake City, Utah, could not have felt more otherworldly, more like a page borrowed from another person’s life. But the feel of her genuine goodness was like slipping into someone’s coat pocket, safe and warm.

  “I think my wife left me,” he croaked, looking down.

  She put down her latte. “What do you mean, you think?”

  He described what had happened just before he left for the conference. She listened, looking like she was weighing the facts he enumerated. For a few moments, from her expression, he thought she might say, “You completely misjudged what she was saying. She was just going out for a walk, just to cool her heels. You’ll see when you go back home.” But she pursed her lips in grave appreciation, and then she twisted up her mouth, just the way she had when he’d asked if he could report his confirmation number later.

  “Our daughter, Jamie,” he said, feeling weight against his chest. “She’s just a kid. This’s gonna come as a blow.” For a moment, his mind went to his morning ritual, when he stopped on his way down the hall to peer in her bedroom and watch her sleeping. The notion that he would not be able to do that anymore, that the rhythm and the certainty of that habit was halted forever, tightened like a string at his throat.

  Bev tilted her head to one side knowingly. “Relationships have great plasticity,” she said. “Just like nerves. They can get injured, but they also regrow.” She gazed out the window of the coffee shop to the people passing on the
street, and he thought that he liked that idea. He hoped she might say more. “You probably want to get back to the conference,” she said finally.

  The answer, he was convinced, was Adele Maples. The trick would be arranging a private confrontation with her. At the end of the first morning session, she walked out of the room in animated conversation with Fred Arbermore. Simon followed them down the hall, feeling hopeful, and also like an idiot, wheeling his suitcase as if he were walking a dog. She was older, with slightly stooped shoulders and a quick, determined step. Then, they reached the lobby and were joined by two other people, and Simon hesitated. He wanted to talk with her alone so that her response wouldn’t be tainted by others listening, and he decided the moment wasn’t right. He’d bide his time and approach her directly before the end of the conference on Monday. He’d revised his opener: He would ask her advice, as a pioneer in the field and a person who was capable of taking discoveries and making them available to patients. He’d act more circumspect. “What should my next step be?” he would say.

  He plucked a map from a kiosk and brought it back to where Bev was sitting at the front desk. He was growing tired and beginning to question why he’d flown across the country. What had he believed would happen? He’d thought maybe a Fred Arbermore would say, “Let’s order some of that stuff for the clinic and give it a try.” Or an Adele Maples would say, “This is the most hopeful concept I’ve seen in years.” But it wasn’t about what anybody else said, he realized. He was telling the truth when he said he didn’t want money. He wasn’t interested in making a cent. Was he interested in the patients? He wished he could be the answer to their problems, but couldn’t they all find another doctor somewhere else? What he feared was that the only thing he really wanted was to tell Emily about it. The glory, in its boiled-down form, was being able to describe it to her at the end of the day. Fired down further, as if in a crucible, the goal was to have something to say at all. He wanted to go back in time to the months before Caleb was born, when they were still reeling with a sense of their good luck. Hadn’t they believed then that certain powers shined upon them—they had each other, they were skilled, they owned real estate. When they decided to make babies, they considered themselves embarked on the most ambitious endeavor of all.