Fever

by Robin Cook

  Carolyn clutched at his sleeve. “Charles, please. You can’t go now. You’re a mess.”

  Looking down at himself, Charles realized Cathryn was right. But did he really care? He hesitated, then ran upstairs where he changed his clothes and washed his hands and face. When he ran back down, Cathryn realized that he had made up his mind. He was going to the hospital that night and had every intention of stopping Michelle’s medicines, her only chance at life. Once again, the doctors had correctly forecasted his reaction. Cathryn realized she had to tell him about the guardianship right away. She could not afford to wait.

  Charles pulled on his befouled jacket, checking for his car keys in his pocket.

  Cathryn leaned her back up against the counter, her hands gripping the Formica edge. “Charles,” she began in a quiet tone. “You cannot stop Michelle’s medicine.”

  Charles found his keys. “Of course I can,” he said confidently.

  “Arrangements have been made so that you cannot,” said Cathryn.

  With his hand on the back door, Charles paused. The word “arrangements” had an ominous connotation. “What are you trying to say?”

  “I want you to come back, take your coat off, and sit down,” said Cathryn, as if she were talking to a recalcitrant teenager.

  Charles walked directly up to her. “I think you’d better tell me about these arrangements.”

  Although Cathryn never would have imagined it possible, she felt a touch of fear as she gazed up into Charles’s narrowed eyes. “After you left the hospital so hastily this afternoon, I had a conference with Dr. Keitzman and Dr. Wiley. They felt that you were under a severe strain and might not be in the best position to make the right decisions about Michelle’s care.” Cathryn deliberately tried to echo the legal talk she’d heard at the meeting. What terrified her most was Charles’s reaction to her complicity. She wanted to emphasize that she had been a reluctant participant. She looked up into his face. His blue eyes were cold. “The hospital lawyer said that Michelle needed a temporary guardian and the doctors agreed. They told me they could do it without my cooperation but that it would be easier if I helped. I thought I was doing the right thing although it was a hard decision. I felt one of us should still be involved.”

  “So what happened?” said Charles, his face becoming a dull red.

  “There was an emergency hearing before a judge,” said Cathryn. She was telling it poorly and at a bad time. She was making a mess of everything. Doggedly she continued, “The judge agreed that Michelle should get the recognized treatment for her condition as outlined by Dr. Keitzman. I was appointed temporary guardian. There will be a hearing on this petition in three days and a full hearing in three weeks. The court also appointed a guardian and listen, Charles, believe me, I’ve done all this for Michelle. I’m not doing anything against you or to come between you and Michelle.”

  Cathryn searched Charles’s face for a flicker of understanding. She saw only rage.

  “Charles!” cried Cathryn. “Please believe me. The doctor convinced me you’ve been under great strain. You haven’t been yourself. Look at you! Dr. Keitzman is world-famous for treating childhood leukemias. I did it only for Michelle. It’s only temporary. Please.” Cathryn broke into tears.

  Gina appeared instantly at the doorway. “Is everything all right?” she called out timidly.

  Charles spoke very slowly, his eyes on Cathryn’s face. “I hope to God this isn’t true. I hope you’re making this up.”

  “It’s true,” managed Cathryn. “It’s true. You left. I did the best I could. You’ll be served with a citation in the morning.”

  Charles exploded with a violence he’d never known he’d possessed. The only handy object was a short stack of dishes. Snatching them off the counter he lifted them over his head and crashed them to the floor in a fearful splintering of china. “I can’t stand this. Everybody is against me. Everybody!”

  Cathryn cringed by the sink, afraid to move. Gina was riveted to the doorway, wanting to flee but fearful for her daughter’s safety.

  “Michelle is my daughter, my flesh and blood,” raged Charles. “No one is going to take her away from me.”

  “She’s my adopted daughter,” sobbed Cathryn. “I feel just as strongly as you.” Overcoming her fear, she grabbed the lapels of Charles’s coat, shaking him as best she could. “Please calm down. Please,” she cried desperately.

  The last thing Charles wanted was to be held down. By reflex his arm shot up and with unnecessary force, knocked Cathryn’s arms into the air. Following through with the blow, the side of his hand inadvertently caught her face, knocking her backwards against the kitchen table.

  A chair fell over and Gina screamed, running into the room and positioning her corpulent bulk between Charles and her dazed daughter. She began reciting a prayer as she crossed herself.

  Charles reached out and rudely shoved the woman aside. He grabbed Cathryn by both shoulders and shook her like a rag doll. “I want you to call and cancel those legal proceedings. Do you understand?”

  Chuck heard the commotion and ran down the stairs. He took one look at the scene in front of him and sprang into the room, grabbing his father from behind, and pinning his arms to his side. Charles tried to twist loose but he couldn’t. Instead he released Cathryn, and lunged back with the point of his elbow, digging it into the pit of Chuck’s abdomen. The boy’s breath came out in a forceful huff. Charles spun, then shoved Chuck backwards so that he tripped, fell, and hit his head on the floor.

  Cathryn screamed. The crisis was expanding in a chain reaction. She threw herself on top of Chuck to protect him from his father and it was at this point Charles realized that he was attacking his own son.

  He took a step forward but Cathryn screamed again, shielding the crumpled boy. Gina stepped between Charles and the others murmuring something about the devil.

  Charles looked up to see the confused face of Jean Paul in the doorway. The boy backed away when he saw Charles staring at him. Looking back at the others, Charles felt an overwhelming sense of alienation. Impulsively he turned and stormed out of the house.

  Gina closed the back door behind him, while Cathryn helped Chuck into one of the kitchen chairs. They heard the Pinto rumble down the driveway.

  “I hate him! I hate him!” cried Chuck, holding his stomach with both hands.

  “No, no,” soothed Cathryn. “This is all a nightmare. We’ll all wake up and it will be over.”

  “Your eye!” exclaimed Gina, coming up to Cathryn and tilting her head back.

  “It’s nothing,” said Cathryn.

  “Nothing? It’s becoming black and blue. I think you’d better get some ice on it.”

  Cathryn got up and looked at herself in a small mirror hanging in the hallway. There was a minute cut on her right eyebrow and she was indeed getting a black eye. By the time she got back into the kitchen, Gina had the ice tray out.

  Jean Paul reappeared at the doorway.

  “If he ever hits you again, I’ll kill him,” said Chuck.

  “Charles Jr.,” snapped Cathryn. “I don’t want to hear that kind of talk. Charles is not himself; he’s under a lot of strain. Besides, he didn’t mean to hit me. He was trying to get free from my grasp.”

  “I think he’s let in the devil,” said Gina.

  “That’s enough, all of you,” said Cathryn.

  “I think he’s crazy,” persisted Chuck.

  Cathryn took a breath in preparation for reprimanding Chuck but she hesitated because the boy’s comment made her wonder if Charles was having a nervous breakdown. The doctors suggested it as a possibility and they had been right about everything else. Cathryn wondered where she was going to find the reserve to hold the family together.

  Her first concern was safety. Cathryn had never seen Charles lose control before. Thinking it best to get some professional advice, she called Dr. Keitzman’s exchange.

  Keitzman called back five minutes later.

  She told him the ent
ire series of events, including the fact that Charles had decided to stop Michelle’s medications and added that Charles had left in his car, presumably en route to the hospital.

  “Sounds like we petitioned for custody at the right time,” said Dr. Keitzman.

  Cathryn was in no mood for self-congratulation. “That may be, but I’m concerned about Charles. I don’t know what to expect.”

  “That’s precisely the problem,” said Dr. Keitzman. “He may be dangerous.”

  “I can’t believe that,” said Cathryn.

  “That’s something that cannot be ascertained unless he’s seen professionally. But, believe me, it’s a possibility. Maybe you should leave the house for a day or two. You’ve got a family to consider.”

  “I suppose we could go to my mother’s,” said Cathryn. It was true she had others to think about besides herself.

  “I think it would be best. Just until Charles calms down.”

  “What if Charles goes to the hospital tonight?”

  “No need for you to worry about that. I’ll alert the hospital, and I’ll let the floor know you have guardianship. Don’t worry, everything is going to be all right.”

  Cathryn hung up, wishing she felt as optimistic as Dr. Keitzman. She still had the feeling that things were going to get worse.

  A half hour later, with a good deal of misgiving, Cathryn, Gina, and the two boys trudged out into the snow with overnight bags and piled in the station wagon. They dropped Jean Paul at a school friend’s house where he’d been invited to stay, and began the drive into Boston. No one spoke.

  ELEVEN

  It was after nine when Charles reached Pediatric Hospital. In contrast to the daytime chaos, the street outside was quiet, and he found a parking spot in front of the medical center bookstore. He entered the hospital through the main entrance and rode up to Anderson 6 on an empty elevator.

  He was accosted by someone when he passed the nurses’ station, but he didn’t even look in the direction of the voice. He got to Michelle’s room and slipped through the partially open door.

  It was darker than in the hall with light coming from a small night-light near the floor. Giving his eyes a chance to adjust, Charles stood for a moment taking in the scene. The cardiac monitor was visible on the other side of the bed. The auditory signal had been turned down but the visual signal traced a repetitive fluorescent blip across the tiny screen. There were two intravenous lines, one running into each of Michelle’s arms. The one on the left had a piggyback connector, and Charles knew it was being used as the infusion route for the chemotherapy.

  Charles silently advanced into the room, his eyes glued to the sleeping face of his daughter. As he got closer he realized, to his surprise, that Michelle’s eyes were not closed. They were watching his every move.

  “Michelle?” whispered Charles.

  “Daddy?” whispered Michelle in response. She’d thought it was another hospital technician sneaking up on her in the night to take more blood.

  Charles tenderly lifted his daughter in his arms. She felt perceptibly lighter. She tried to return the embrace but her limbs were without strength. He pressed her cheek to his and slowly rocked her. He could feel her skin was flushed with fever.

  Looking into her face, he noticed that her lips were ulcerated.

  He felt such powerful emotion that it was beyond tears. Life was not fair. It was a cruel experience in which hope and happiness were transient illusions that served only to make the inevitable tragedy more poignant.

  As he held his daughter Charles thought about his response to Recycle, Ltd. and felt foolish. Of course he could understand his urge for revenge, but under the circumstances, there were more important ways to spend his time. Obviously the people at Recycle did not care about a twelve-year-old girl, and they could conveniently blind themselves to any sense of responsibility. And what about the so-called cancer establishment? Did they care? Charles doubted it, seeing as he had the inner dynamics at his own institute. The irony was that the people controlling the megalithic cancer establishment were ultimately at equal risk to succumbing to the disease as the public at large.

  “Daddy, why is your nose so swollen?” asked Michelle, looking into Charles’s face.

  Charles smiled. Ill as she was, Michelle was still concerned about him! Incredible!

  He made up a quick story of slipping in the snow and comically falling on his face. Michelle laughed, but her face quickly became serious. “Daddy, am I going to get well?”

  Without meaning to, Charles hesitated. The question had caught him off guard. “Of course,” he said with a laugh, trying to make up for the pause. “In fact, I don’t think you’ll be needing any more of this medicine.” Charles stood up, indicating the IV used for the chemotherapy. “Why don’t I just take it out?”

  Michelle’s face clouded with worry. She detested any adjustments to the IV.

  “It won’t hurt,” said Charles.

  Deftly he removed the plastic catheter from Michelle’s arm, keeping pressure on the spot. “You’ll need the other IV for a little longer in case your ticker speeds up again.” Charles tapped Michelle’s chest.

  The room light snapped on, throwing its raw fluorescent glare around the room.

  A nurse came in followed by two uniformed security guards.

  “Mr. Martel, I’m sorry but you are going to have to leave.” She noticed the dangling IV line and shook her head angrily.

  Charles did not respond. He sat on the edge of Michelle’s bed and again took her into his arms.

  The nurse gestured for the security men to help. They came forward and gently urged Charles to leave.

  “We could have you arrested if you don’t cooperate,” said the nurse, “but I don’t want to do that.”

  Charles allowed the guards to pull his arms from around Michelle.

  Michelle looked at the guards and then her father. “Why would they arrest you?”

  “I don’t know,” said Charles with a smile. “I guess it’s not visiting hours.”

  Charles stood up, bent over and kissed Michelle, and said, “Try to be good. I’ll be back soon.”

  The nurse turned out the overhead light. Charles waved from the doorway and Michelle waved back.

  “You shouldn’t have taken out that IV,” said the nurse as they walked back to the nurses’ station.

  Charles didn’t respond.

  “If you wish to visit your daughter,” continued the nurse, “it will have to be during regular hours, and you’ll have to be accompanied.”

  “I’d like to see her chart,” said Charles courteously, ignoring her other comments.

  The nurse continued walking; obviously she didn’t like the idea.

  “It’s my right,” said Charles simply. “Besides, I am a physician.”

  The nurse reluctantly agreed and Charles went into the deserted chart room. Michelle’s chart was innocently hanging in its designated spot. He pulled it out and placed it before him. There’d been a blood count that afternoon. His heart sank! Although he expected it, it still was a blow to see that her leukemic cell count had not decreased. In fact, it had gone up a little. There was no doubt that the chemotherapy was not helping her at all.

  Pulling the phone over to him, Charles put in a call to Dr. Keitzman. While he waited for the call back, he glanced through the rest of the chart. The plot of Michelle’s fever was the most alarming. It had been hovering around one hundred until that afternoon when it had shot up to one hundred four. Charles read the carefully typed cardiology report. The conclusion was that the ventricular tachycardia could have been caused by either the rapid infusion of the second dose of Daunorubicin or a leukemic infiltration of the heart, or perhaps, a combination of the two. At that point, the phone rang. It was Dr. Keitzman.

  Both Dr. Keitzman and Charles made an effort at being cordial.

  “As a physician,” said Dr. Keitzman, “I’m sure you are aware that we doctors frequently find ourselves in the dilemma of adhering to
the established and best principles of medicine or giving way to the wishes of the patient or the family. Personally, I believe in the former approach and as soon as one begins to make exception, whatever the justification, it’s like opening Pandora’s box. So we’re having to rely on the courts more and more.”

  “But clearly,” said Charles, controlling himself, “chemotherapy is not helping in Michelle’s case.”

  “Not yet,” admitted Dr. Keitzman. “But it’s still early. There’s still a chance. Besides, it’s all we have.”

  “I think you’re treating yourself,” snapped Charles.

  Dr. Keitzman didn’t answer. He knew there was a grain of truth in what Charles said. The idea of doing nothing was anathema to Dr. Keitzman, especially with a child.

  “One other thing,” said Charles. “Do you think benzene could have caused Michelle’s leukemia?”

  “It’s possible,” said Dr. Keitzman. “It’s the right kind of leukemia. Was she exposed?”

  “Over a long period,” said Charles. “A factory has been dumping it into a river that feeds the pond on our property. Would you be willing to say that Michelle’s leukemia was caused by benzene?”

  “I couldn’t do that,” said Dr. Keitzman. “I’m sorry, but it would be purely circumstantial. Besides, benzene has only been unequivocally implicated in causing leukemia in laboratory animals.”

  “Which you and I know means it causes it in humans.”

  “True, but that’s not the kind of evidence acceptable by a court of law. There is an element of doubt, no matter how small.”

  “So you won’t help?” asked Charles.

  “I’m sorry but I can’t,” said Dr. Keitzman. “But there is something I can do, and I feel it’s my responsibility. I’d like to encourage you to seek psychiatric consultation. You’ve had a terrible shock.”

  Charles thought about telling the man off, but he didn’t. Instead he hung up on him. When he stood up he thought about sneaking back to Michelle’s room but he couldn’t. The charge nurse was watching him like a hawk and one of the uniformed security men was still there, leafing through a People magazine. Charles went to the elevator and pushed the button. As he waited, he began to outline what courses of action were open to him. He was on his own and would be even more on his own after the meeting tomorrow with Dr. Ibanez.