by Robin Cook
By a process so gradual as to be imperceptible, Michelle became aware that her room was lighter. The shade over the window now appeared dark with a light border rather than white with a dark border. Along with the gradual increase in illumination, the coming day was also heralded by the increased activity in the hallway. Michelle’s door was open about six inches and the shaft of yellow incandescent light that came through had been a meager comfort for her during the interminable night.
Michelle wondered when Charles or Cathryn would come. She hoped it would be soon because she wanted, more than anything else, to go home to her own room, her own house. She couldn’t understand why she had had to stay in the hospital because after her dinner, which she had barely eaten, no one had done anything to her other than look in and check that she was OK.
Swinging her legs over the side of the bed, Michelle pushed herself into a sitting position. She closed her eyes and steeled herself against a rush of dizziness. The movement exacerbated her nausea which had troubled her all night. Once she’d even gotten up when her saliva had pooled beneath her tongue, and she was afraid she was going to vomit. Holding on to the sides of the toilet, she’d retched but hadn’t brought up anything. Afterwards, it had taken all her strength to get back into bed.
Michelle was certain she’d not slept at all. Besides the waves of nausea, she also had pains in her joints and abdomen, as well as chills. The fever, which had gone away the previous afternoon, was back.
Slowly Michelle slid off the bed onto her feet, gripping the IV pole. Pushing the pole in front of her, she began to shuffle to the bathroom. The plastic IV tubing still went into her left arm, which she kept as immobile as possible. She knew there was a needle on the end of the tubing and she was afraid that if she moved her arm, the needle would pierce her in some damaging way.
After going to the toilet, Michelle returned to her bed and climbed in. There was no way she could feel any more lonely or miserable.
“Well, well,” beamed a redheaded nurse as she came bustling into the room. “Awake already. Aren’t we industrious?” She snapped up the window shade unveiling the new day.
Michelle watched her but didn’t speak.
The nurse went around the other side of the bed and plucked a thermometer out of a narrow stainless steel cup. “What’s the matter, cat got your tongue?” She flicked the thermometer, examined it, bent down, and poked it into Michelle’s mouth. “Be back in a jiffy.”
Waiting until the nurse was out the door, Michelle pulled the thermometer out of her mouth. She did not want anyone to know she still had a fever in case that might keep her in the hospital. She held the thermometer in her right hand, near to her face so that when the nurse came back, she would be able to put it into her mouth quickly.
The next person through the door was a false alarm. Michelle got the thermometer back into her mouth, but it was a man in a dirty white coat with hundreds of pens stuffed in his pocket. He carried a wire basket filled with glass test tubes with different-colored tops. He had strips of rubber tubing looped through the edges of his basket. Michelle knew what he wanted: blood.
She watched, terrified, as he made his preparations. He put a rubber tube about her arm so tight that her fingers hurt and roughly wiped the inside of her elbow with an alcohol swab, even the tender spot where they’d taken blood the day before. Then using his teeth, he pulled the cap off a needle. Michelle wanted to scream. Instead, she turned her head to hide silent tears. The rubber was unsnapped, which caused about as much pain as when it was put on. She heard a glass tube drop into the wire basket. Then she felt another stab as he yanked the needle out. He applied a cotton ball to the puncture site, bent her arm so that it pressed against the cotton, and gathered up his things. He left without saying a single word.
With one arm holding the cotton ball and the other with the IV, Michelle felt totally immobilized. Slowly she unbent her arm. The cotton ball rolled aside revealing an innocent red puncture mark surrounded by a black-and-blue area.
“Okay,” said the redheaded nurse, coming through the door. “Let’s see what we’ve got.”
Michelle remembered with panic that the thermometer was still in her mouth.
Deftly the nurse extracted it, noted the temperature, then dropped it into the metal container on Michelle’s night table. “Breakfast will be up in a moment,” she said cheerfully, but she didn’t mention Michelle’s fever. She left with the same abruptness with which she’d arrived.
“Oh, Daddy, please come and get me,” said Michelle to herself. “Please hurry.”
Charles felt his shoulder being shaken. He tried to ignore it because he wanted to continue sleeping, but the shaking continued. When he opened his eyes he saw Cathryn, already robed, standing by the bed holding out a steaming mug of coffee. Pushing himself up on one elbow, Charles took the coffee.
“It’s seven o’clock,” said Cathryn with a smile.
“Seven?” Charles glanced at the face of the alarm clock, thinking that oversleeping was not the way to increase the pace of his research efforts.
“You were sleeping so soundly,” said Cathryn, kissing his forehead, “that I didn’t have the heart to wake you earlier. We’ve got a big breakfast waiting downstairs.”
Charles knew that she was making an effort to sound gay.
“Enjoy your coffee,” said Cathryn. She started for the door. “Gina got up and made it before I was even awake.”
Charles glanced down at the mug in his hands. The fact that Gina was still there was irritating enough. He did not want to have to feel beholden to her the first thing in the morning, but then he was holding the coffee and he knew she’d ask how it was and gloat over the fact that she’d arisen when everyone else was still asleep.
Charles shook his head. Such annoying thoughts were not the way to begin the day. He tasted the coffee. It was hot, aromatic, and stimulating. He admitted that he enjoyed it and decided to tell Gina before she’d have a chance to ask, and then thank her for getting up before the others, before she had a chance to tell them.
Carrying his coffee mug, Charles padded down the hall to Michelle’s room. He paused outside of the door, then slowly pushed it open. He had half hoped to see his young daughter safely sleeping in her bed, but of course her bed was neatly made, her books and memorabilia compulsively arranged, her room as neat as a pin. “All right,” said Charles to himself, as if he were bargaining with an all-powerful arbiter, “she has myeloblastic leukemia. Just let her case be sensitive to current treatment. That’s all I ask.”
Breakfast was a strained affair, overshadowed by Gina’s forced ebullience and Charles’s reserve. One fed the other in a self-fulfilling prophecy until Gina was chatting nonstop and Charles perfectly silent. Cathryn interrupted with complicated plans about who was going to do what, when. Charles stayed out of the domestic decision making and concentrated on planning his day’s work at the institute. The first thing he wanted to do was check the well mice injected with the cancer antigen for signs of immunological activity. Most likely there would be no response with such a light dose and he would prepare to give them another challenge that afternoon. Then he would check the mice injected with the Canceran and reinject them. Then he would start work on a computer simulation of the way he envisioned the blocking factor worked.
“Charles, is that agreeable to you?” asked Cathryn.
“What?” questioned Charles. He’d tuned out all conversation.
“I will ride with you in the Pinto this morning, and you can drop me at the hospital. Chuck will take the station wagon, drop off Jean Paul, and drive himself to Northeastern. Gina has agreed to stay here and make dinner.”
“I’ll make your favorite,” said Gina enthusiastically, “gnocchi.”
Gnocchi! Charles didn’t even know what gnocchi was.
“If I want to leave early,” continued Cathryn to Charles, “I can go over to Northeastern and pick up the station wagon. Otherwise I’ll come back with you. What do you say?”<
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Charles couldn’t figure out how all these elaborate plans were making things any easier. The old method of his driving the boys and leaving the station wagon for Cathryn seemed far more simple, but he didn’t care. In fact, if he decided to work that night, maybe it would be best if Chuck had the car because then Cathryn could come home with him in the afternoon.
“Fine with me,” said Charles, finding himself watching Chuck who was in his usual breakfast posture, studying the cereal box as if it were Scripture. The boy was wearing the same clothes as yesterday and looked just as bad.
“I got a call from the business office yesterday,” said Charles.
“Yeah, I gave them the number,” said Chuck without looking up.
“I made arrangements at the bank for a loan,” said Charles. “Should be available in a day or so, then the bill will be paid.”
“Good,” said Chuck, flipping the box so he could study the nutritional values on the side panel.
“Is that all you have to say? Good?” Charles turned his head toward Cathryn with a look that said: “Can you believe this kid?”
Chuck pretended he hadn’t heard the question.
“I think we should be going,” said Cathryn, getting to her feet and collecting the milk and butter to put into the refrigerator.
“Just leave everything,” said Gina magnanimously. “I’ll take care of it.”
Charles and Cathryn were the first out of the house. A pale winter sun hung low in the southeastern sky. As cold as it was inside the Pinto, Cathryn was relieved to get out of the biting wind.
“Damn,” said Charles, blowing on his fingers. “I forgot the pond water.”
For Cathryn’s sake, Charles started the car, which was no easy task, before running back into the kitchen for the jar of pond water. He carefully wedged it behind his seat to keep it from spilling before he climbed into the car and fumbled with his seat belt.
Cathryn watched this procedure with the pond water with a certain misgiving. After her little talk to Charles the night before she’d hoped that he would concentrate on Michelle. But Charles had acted strangely from the moment she’d awakened him that morning. Cathryn had the scary feeling that her family was coming apart at the seams.
Watching Charles’s silent profile as he drove, Cathryn began multiple conversations but abandoned each for various reasons, mostly because she feared any discussion would trigger her husband’s temper.
When Route 301 merged with Interstate 93, Cathryn finally forced herself to speak: “How do you feel today, Charles?”
“Huh? Oh fine. Just fine.”
“You seem so quiet. It’s not like you.”
“Just thinking.”
“About Michelle?”
“Yes, and also my work.”
“You’re not still thinking of Recycle, Ltd., are you?”
Charles glanced at Cathryn for a moment, then turned his attention to the road ahead. “A little. I still think the place is a menace, if that’s what you mean.”
“Charles, there isn’t something you’re not telling me, is there?”
“No,” said Charles too quickly. “What makes you ask that?”
“I don’t know,” admitted Cathryn. “You seem so far away since we heard about Michelle. Your mood seems to change so quickly.” Cathryn’s eyes darted over to watch Charles’s reaction to her last comment. But Charles just drove on, and if there had been a reaction, Cathryn missed it.
“I guess I just have a lot on my mind,” said Charles.
“You’ll share it with me, won’t you, Charles? I mean that’s what I’m here for. That’s why I wanted to adopt the children. I want you to share everything with me.” Cathryn reached over and put her hand on Charles’s thigh.
Charles concentrated on the road in front of him. Cathryn was voicing a conviction he’d held until yesterday, but now he realized that he couldn’t share everything. His background as a physician had imparted experiences that Cathryn could not comprehend. If Charles told what he knew about the course of Michelle’s illness, she’d be devastated.
Taking a hand from the steering wheel, Charles placed it over Cathryn’s. “The children don’t know how lucky they are,” he said.
They rode in silence for a while. Cathryn wasn’t satisfied, but she didn’t know what else to say. In the far distance she could just make out the top of the Prudential building. The traffic began to increase, and they had to slow to forty miles per hour.
“I don’t know anything about tissue-typing and all that,” said Cathryn, breaking the silence. “But I don’t think we should force Chuck to do something he doesn’t want to do.”
Charles glared at Cathryn for a moment.
“I’m sure he will come around,” she continued when she realized that Charles wasn’t going to speak. “But he has to agree on his own.”
Charles took his hand off Cathryn’s and gripped the steering wheel. The mere mention of Chuck was like stoking a smoldering fire. Yet what Cathryn was saying was undeniably true.
“You can’t force someone to be altruistic,” said Cathryn. “Especially Chuck, because it will only strengthen the worries he has about his sense of self.”
“A sense of self is all he has,” said Charles. “He didn’t voice the slightest concern about Michelle. Not one word.”
“But he feels it,” said Cathryn. “It’s just hard for him to express those feelings.”
Charles laughed cynically. “I wish I believed it. He’s just goddamned selfish. Did you notice his overwhelming appreciation when I told him I’d applied for a loan for his tuition?”
“What did you want him to do? Cartwheels?” returned Cathryn. “The tuition was supposed to be paid months ago.”
Charles set his jaw. “Fine,” he said to himself. “You want to side with the little bastard . . . just fine!”
Cathryn was instantly sorry she’d said what she had even though it was true. Reaching over, she put her hand on his shoulder. She wanted to draw Charles out, not shut him up. “I’m sorry I said that, but Charles, you have to understand that Chuck doesn’t have your personality. He’s not competitive and he’s not the most handsome boy. But basically he’s a good kid. It’s just very hard growing up in your shadow.”
Charles glanced sideways at his wife.
“Whether you know it or not,” said Cathryn, “you’re a hard act to follow. You’ve been successful in everything you’ve tried.”
Charles did not share that opinion. He could have rattled off a dozen episodes in which he’d failed miserably. But that wasn’t the issue: it was Chuck.
“I think the kid’s selfish and lazy, and I’m tired of it. His response to Michelle’s illness was all too predictable.”
“He has a right to be selfish,” said Cathryn. “College is the ultimate selfish experience.”
“Well, he’s certainly making the best of it.”
They came to the stop-and-go traffic where 193 joined the southeast expressway and Storrow Drive. Neither spoke as they inched forward.
“This isn’t what we should be worrying about,” said Cathryn finally.
“You’re right,” sighed Charles. “And you’re right about not forcing Chuck. But if he doesn’t do it, he’s going to wait a long time before I pay his next college bill.”
Cathryn looked sharply at Charles. If that wasn’t coercion, she had no idea what was.
Although at that time of morning there were few visitors, the hospital itself was in full swing, and Charles and Cathryn had to dodge swarms of gurneys moving tiny bedridden patients to and from their various tests. Cathryn felt infinitely more comfortable with Charles at her side. Still her palms were wet, which was her usual method of showing anxiety.
As they passed the bustling nurses’ station on Anderson 6, the charge nurse caught sight of them and waved a greeting. Charles stepped over to the counter.
“Excuse me,” said Charles. “I’m Dr. Martel. I was wondering if my daughter started her chemotherapy.” He purp
osefully kept his voice natural, emotionless.
“I believe so,” said the nurse, “but let me check.”
The clerk who’d overheard the conversation handed over Michelle’s chart.
“She got her Daunorubicin yesterday afternoon,” said the nurse. “She got her first oral dose of Thioguanine this morning, and she’ll start with the Cytarabine this afternoon.”
The names jolted Charles but he forced himself to keep smiling. He knew too well the potential side effects and the information silently echoed in his head. “Please,” said Charles to himself. “Please, let her go into remission.” Charles knew that if it would happen, it would happen immediately. He thanked the nurse, turned, and walked toward Michelle’s room. The closer he got, the more nervous he became. He loosened his tie and unbuttoned the top button of his shirt.
“It’s nice the way they have decorated to brighten the atmosphere,” remarked Cathryn, noticing the animal decals for the first time.
Charles stopped for a moment outside the door, trying to compose himself.
“This is it,” said Cathryn, thinking that Charles was uncertain of the room number. She pushed open the door, entered, and pulled Charles in behind her.
Michelle was propped up in a sitting position with several pillows behind her back. At the sight of Charles, her face twisted and she burst into tears. Charles was shocked at her appearance. Although he had not thought it possible, she looked even paler than she had the day before. Her eyes had visibly sunk into their sockets and were surrounded by circles so dark they looked like she had black eyes. In the air hung the rank smell of fresh vomit.
Charles wanted to run and hold her, but he couldn’t move. The agony of his inadequateness held him back, although she lifted her arms to him.
Her disease was too powerful, and he had nothing to offer her, just like with Elizabeth eight years earlier. The nightmare had returned. In an avalanche of horror, Charles recognized that Michelle was not going to get better. Suddenly he knew without the slightest doubt that all the palliative treatment in the world would not touch the inevitable progression of her illness. Under the weight of this knowledge Charles staggered, taking a step back from the bed.
