by Robin Cook
“His new wife seems fine.”
“Oh, she’s a peach. Adopted the kids, treats them like her own. I was afraid when they got married that she’d bit off more than she could chew, but she’s adapted remarkably. She was devastated when I told her Michelle had leukemia, but I was pretty sure she’d deal with it better than Charles. In fact, that’s why I told her first.”
“Maybe we should talk just to her for a moment,” suggested Dr. Keitzman. “What do you think?”
“Let’s try.” Dr. Wiley turned to face the nurses’ station. “Miss Shannon! Could you come over here for a moment?”
The charge nurse came over to the two doctors. Dr. Wiley explained that they wanted to speak to Mrs. Martel without her husband and asked her if she wouldn’t mind going down to Michelle’s room and trying to engineer it.
As they watched Miss Shannon walk briskly down the hall, Dr. Keitzman’s facial muscles jumped. “It goes without saying that the child is desperately ill.”
“I thought as much when I saw her peripheral blood smear,” said Dr. Wiley. “Then when I saw her bone marrow, I was sure.”
“She could be a very rapidly terminating case, I’m afraid,” said Dr. Keitzman. “I think she already has central nervous system involvement. Which means we have to commence treatment today. I want Dr. Nakano and Dr. Sheetman to see her right away. Martel is right about one thing. Her chance of a remission is very slim.”
“But you still have to try,” said Dr. Wiley. “At times like these I don’t envy you your specialty.”
“Of course I’ll try,” said Dr. Keitzman. “Ah, here comes Mrs. Martel.”
Cathryn had followed Miss Shannon out into the hall, half-expecting to see Marge Schonhauser because the nurse had said someone was asking to see her. She hadn’t been able to think of anyone else who knew that she was in the hospital. Once clear of the room, however, Miss Shannon confided that the doctors wanted to speak to her alone. It sounded ominous.
“Thank you for coming out,” said Dr. Wiley.
“It’s all right,” said Cathryn, her eyes darting from one man to the next. “What’s wrong?”
“It’s about your husband,” began Dr. Keitzman cautiously. He paused, trying to choose his words carefully.
“We’re concerned that he may interfere in Michelle’s treatment,” Dr. Wiley finished the thought. “It’s hard for him. First he knows too much about the disease himself. Then he already has watched someone he loved die despite chemotherapy.”
“It’s not that we don’t understand his feelings. We just feel Michelle should have every chance at remission regardless of the side effects.”
Cathryn examined the narrow, hawklike features of Dr. Keitzman and the broad, rounded face of Dr. Wiley. They were outwardly so different yet similar in their intensity. “I don’t know what you want me to say.”
“We’d just like you to give us some idea of his emotional state,” said Dr. Keitzman. “We’d like to have some idea of what to expect.”
“I think he will be fine,” assured Cathryn. “He had a lot of trouble adjusting when his first wife died, but he never interfered with her treatment.”
“Does he often lose his temper as he did today?” asked Keitzman.
“He’s had an awful shock,” said Cathryn. “I think it’s understandable. Besides, ever since his first wife died, cancer research has been his passion.”
“It’s a terrible irony,” agreed Dr. Wiley.
“But what about the kind of emotional outburst he demonstrated today?” asked Dr. Keitzman.
“He does have a temper,” said Cathryn, “but he usually keeps it under control.”
“Well, that’s encouraging,” said Dr. Keitzman. “Maybe it’s not going to be so difficult after all. Thank you, Mrs. Martel. You’ve been most helpful, especially since I know you, too, have had a terrible shock. I’m sorry if we’ve said anything disturbing but we’ll do our best for Michelle, I can assure you of that.” Turning to Dr. Wiley, he said, “I’ve got to get things rolling. I’ll speak to you later.” He moved quickly, almost at a run, and was out of sight in seconds.
“He has some strange mannerisms,” said Dr. Wiley, “but you couldn’t get a better oncologist. He’s one of the top people in the world in childhood leukemia.”
“I was afraid he was going to abandon us when Charles acted up,” said Cathryn.
“He’s too good of a doctor for that,” said Dr. Wiley. “He’s only concerned about Charles because of your husband’s attitude to chemotherapy, and aggressive treatment has to be started right away to get her into a remission.”
“I’m sure Charles won’t interrupt her treatment,” said Cathryn.
“Let’s hope not,” said Dr. Wiley. “But we’re going to count on your strength, Cathryn.”
“My strength?” questioned Cathryn, aghast. “Hospitals and medical problems aren’t my strong points.”
“I’m afraid you’ll have to overcome that,” said Dr. Wiley. “Michelle’s clinical course could be very difficult.”
At that moment she caught sight of Charles emerging from Michelle’s room. He spotted Cathryn and started toward the nurses’ station. Cathryn ran down to meet him. They stood for a moment in a silent embrace, drawing strength from each other. When they started back toward Dr. Wiley, Charles seemed more in control.
“She’s a good kid,” he said. “Christ, all she’s worried about is staying overnight. Said she wanted to be home in the morning to make the orange juice. Can you believe that?”
“She feels responsible,” said Cathryn. “Until I arrived she was the woman of the house. She’s afraid of losing you, Charles.”
“It’s amazing what you don’t know about your own children,” said Charles. “I asked her if she minded if I went back to the lab. She said no, as long as you stayed here, Cathryn.”
Cathryn was touched. “On the way to the hospital we had a little talk, and for the first time I felt she really accepted me.”
“She’s lucky to have you,” said Charles. “And so am I. I hope you don’t mind my leaving you here. I hope you understand. I feel such a terrible powerlessness. I’ve got to do something.”
“I understand,” said Cathryn. “I think you’re right. There isn’t anything you can do right now and it would be better if you can get your mind on something else. I’ll be happy to stay. In fact, I’ll call my mother. She’ll come over and take care of things.”
Dr. Wiley watched the couple come toward him, pleased to see their open affection and mutual support. The fact that they were acknowledging and sharing their grief was healthy; it was a good sign and it encouraged him. He smiled, somewhat at a loss for what to say as they arrived. He had to get back to his office which he knew was in chaos, but he wanted to be there if they still needed him.
“Do you have any extra of Michelle’s blood?” asked Charles. His voice was businesslike, matter-of-fact.
“Probably,” said Dr. Wiley. It wasn’t a question he had expected. Charles had the uncanny ability to unnerve him.
“Where would it be?” asked Charles.
“In the clinical lab,” said Dr. Wiley.
“Fine. Let’s go.” Charles started toward the elevator.
“I’ll stay here with Michelle,” said Cathryn. “I’ll call if there is any news. Otherwise I’ll see you home for dinner.”
“Okay.” He strode off purposefully.
Confused, Dr. Wiley hurried after Charles, nodding a quick good-bye to Cathryn. His encouragement regarding Charles’s behavior was quickly undermined. Charles’s mood had apparently tumbled off on a new and curious tangent. His daughter’s blood? Well, he was a physician.
SIX
Clutching the flask of Michelle’s blood, Charles hurried through the foyer of the Weinburger Institute. He ignored greetings by the coy receptionist and the security guard and ran down the corridor to his lab.
“Thanks for coming back,” taunted Ellen. “I could have used some help injecting the mice wi
th the Canceran.”
Charles ignored her, carrying the vial of Michelle’s blood over to the apparatus they used to separate the cellular components of blood. He began the complicated process of priming the unit.
Bending down to peer at Charles beneath the glassware shelving, Ellen watched for a moment. “Hey,” she called. “I said I could have used some help . . .”
Charles switched on a circulatory pump.
Wiping her hands, Ellen came around the end of the workbench, curious to see the object of Charles’s obvious intense concentration. “I finished injecting the first batch of mice,” she repeated when she was close enough to be absolutely certain Charles could hear her.
“Wonderful,” said Charles without interest. Carefully he introduced an aliquot of Michelle’s blood into the machine. Then he switched on the compressor.
“What are you doing?” Ellen followed all his movements.
“Michelle has myeloblastic leukemia,” said Charles. He spoke evenly, like he was giving the weather report.
“Oh, no!” gasped Ellen. “Charles, I’m so sorry.” She wanted to reach out and comfort him but she restrained herself.
“Amazing, isn’t it?” laughed Charles. “If the day’s disasters had remained localized to the problems here at the Weinburger, I’d probably just cry. But with Michelle’s illness, everything is a bit overwhelming. Christ!”
Charles’s laughter had a hollow ring to it but it struck Ellen as somewhat inappropriate.
“Are you all right?” asked Ellen.
“Wonderful,” said Charles as he opened their small refrigerator for clinical reagents.
“How does Michelle feel?”
“Pretty good right now but she has no idea of what she’s in for. I’m afraid it’s going to be bad.”
Ellen found herself at a loss for words. She blankly watched Charles as he went about completing his test. Finally she found her tongue. “Charles, what are you doing?”
“I have some of Michelle’s blood. I’m going to see if our method of isolating a cancer antigen works on her leukemic cells. It gives me the mistaken impression I’m doing something to help her.”
“Oh, Charles,” said Ellen sympathetically. There was something pitiful about the way he acknowledged his vulnerability. Ellen knew how much of an activist he was and Charles had told her the feeling of powerlessness was what had been the hardest for him when Elizabeth was ill. He had been forced to just sit and watch her die. And now Michelle!
“I’ve decided we aren’t going to stop our own work,” said Charles. “We’ll continue while we work on Canceran. Work nights if we have to.”
“But Morrison is very insistent about exclusively concentrating on Canceran,” said Ellen. “In fact, he came by while you were out to emphasize that.” For a moment Ellen debated about telling Charles the real reason Morrison stopped by, but with everything else that had happened, she was afraid to.
“I couldn’t care less what Morrison says. With Michelle’s illness, cancer has, once again, become more than a metaphysical concept for me. Our work has so much more promise than developing another chemotherapeutic agent. Besides, Morrison doesn’t even have to know what we’re doing. We’ll do the Canceran work and he’ll be happy.”
“I’m not sure you realize how much the administration is counting on Canceran,” said Ellen. “I really don’t think it’s advisable to go against them on this, particularly when the reason is personal.”
For a moment Charles froze, then he exploded. He slammed his open palm against the slate countertop with such force that several beakers tumbled off the overhead shelves. “That’s enough,” he yelled to punctuate his blow. “I’ve had enough of people telling me what to do. If you don’t want to work with me, then just get the fuck out of here!”
Abruptly Charles turned back to his work, running a nervous hand through his disheveled hair. For a few moments he worked in silence, then without turning he said, “Don’t just stand there; get me the radioactive labeled nucleotides.”
Ellen walked over to the radioactive storage area. As she opened the lock, she noticed that her hands were trembling. Obviously Charles was just barely in control of himself. She wondered what she was going to say to Dr. Morrison. She was certain she wanted to say something, because as her fear abated her anger grew. There was no excuse for Charles to treat her as he did. She wasn’t a servant.
She brought the chemicals over and arrayed them on the counter.
“Thank you,” he said simply, as if nothing had happened. “As soon as we have some B-lymphocytes I want to incubate them with the tagged nucleotides and some of the leukemic cells.”
Ellen nodded. She couldn’t keep pace with such rapid emotional changes.
“While I was driving over here, I had an inspiration,” continued Charles. “The biggest hurdle in our work has been this blocking factor and our inability to elicit an antibody response to the cancer antigen in the cancerous animal. Well, I have an idea; I was trying to think of ways of saving time. Why not inject the cancer antigen into a related, noncancerous animal where we can be absolutely certain of an antibody response? What do you think about that?”
Ellen scrutinized Charles’s face. Within seconds he’d metamorphosed from an infuriated child to the dedicated researcher. Ellen guessed that it was his way of dealing with the tragedy of Michelle.
Without waiting for an answer, Charles went on: “As soon as the noncancerous animal is immune to the cancer antigen, we’ll isolate the responsible T-lymphocytes, purify the transfer factor protein, and transfer sensitivity to the cancerous animal. It’s so fundamentally simple, I can’t believe we didn’t think of it before. Well . . . what’s your impression?”
Ellen shrugged. In truth she was fearful of saying anything. Although the basic premise sounded promising, Ellen knew that the mysterious transfer factor did not work well in the animal systems they were using; in fact, it worked best with humans. But technical questions were not foremost in her mind. She wondered if it would be too obvious if she excused herself and went directly up to Dr. Morrison’s office.
“How about getting the polyethylene glycol?” said Charles. “We’re going to want to set up the equipment to produce a hybridoma with Michelle’s T-lymphocytes. Also call the animal room and tell them we want a fresh batch of control mice, which we’ll inject with the mammary tumor antigen. God, I wish there were more than twenty-four hours in a day.”
“Pass the mashed potatoes,” said Jean Paul after debating with himself for several minutes whether to break the silence that had descended over the dinner table. No one had spoken since he announced that the duck he’d put in the garage was “deader than a doorknob, stiff as a board.” Ultimately his hunger had decided the issue.
“I’ll trade you for the pork chops,” said Chuck, tossing his head to remove some stringy hair from his eyes.
The boys exchanged platters. There was the clink of silver against china.
Gina Lorenzo, Cathryn’s mother, eyed her daughter’s family. Cathryn resembled her. They each had the same bony prominence on the bridge of the nose and the same large, expressive mouth. The major difference, other than the obvious twenty-plus years, was that Gina was so much heavier. She admitted she was twenty pounds overweight but in actuality it was more like sixty. Pasta was Gina’s passion and she was not one to deny herself.
Lifting the bowl of fettucini, Gina gestured as if she were about to add to Cathryn’s untouched plate. “You need some nourishment.”
Forcing a smile, Cathryn shook her head no.
“What’s the matter? You don’t like it?” asked Gina.
“It’s wonderful,” said Cathryn. “I’m just not very hungry.”
“You gotta eat,” said Gina. “You, too, Charles.”
Charles nodded.
“I brought fresh cannolis for dessert,” said Gina.
“Oh, boy!” said Jean Paul.
Dutifully Charles took a bite of the fettucini but his stomach rebell
ed. He let the pasta sit in his mouth before trying to swallow it. The reality of the day’s disasters had hit him with hurricane force once he’d left the frenzied environment he’d created in the lab. Work had been an emotional anesthetic and he had been sorry when it was time to pick up Chuck and drive home. And Chuck hadn’t helped. Charles had waited until they were out of the Boston rush hour traffic before telling his son that his sister had a very serious kind of leukemia. Chuck’s response had been a simple “Oh!” followed by silence. Then he had asked if there was any chance he might catch it.
At the time Charles did not say anything; he just gripped the steering wheel harder, marveling at the unabashed depths of his oldest son’s selfishness. Not once did Chuck ask how Michelle was doing. And now as Charles watched Chuck gobble his pork chops, he felt like reaching over and throwing the selfish kid out of the house.
But Charles didn’t move. Instead he began mechanically to chew his fettucini, embarrassed at his own thoughts. Chuck was immature. At least Jean Paul reacted appropriately. He’d cried and then asked when Michelle would be home and if he could go and see her. He was a good kid.
Charles looked at Cathryn, who kept her head down, pushing her food around her plate, pretending for her mother’s sake to be eating. He was thankful that he had her. He didn’t think he could handle Michelle’s illness by himself. At the same time he realized how difficult it was for Cathryn. For that reason he had not said anything about the troubles at the institute, nor did he plan to. She had enough to worry about.
“Have some more pork chops, Charles,” said Gina, reaching over and unceremoniously plopping a chop on his full plate.
He had tried to say no but the chop had already entered its ballistic arc. He looked away, trying to stay calm. Charles found Gina trying even under the best of circumstances, especially since the woman had never concealed her disapproval of her only daughter marrying a man thirteen years her senior with three kids. Charles heard another telltale plop and opened his eyes to see his mound of fettucini had grown.
