The Fifth Vial

by Michael Palmer

“Because you’re wrong,” he said simply. “There was everything in it for you—especially since you didn’t think there was. I read the letters, Nat, both of them. Dean Goldenberg asked for my opinion about them—Doug’s, too. They were powerfully written and undeniably from your heart. You can say all day and all night that you’re changing, but those letters say it better.” He paused a moment for emphasis. “Nat, the dean’s going to recommend that the committee on discipline allow him to terminate your suspension.”

  Natalie stared at him, wide-eyed.

  “You’re not messing with me?”

  “I’m cruel,” Millwood said, “but I’m not that cruel. He’s also going to have a talk with Dr. Schmidt about the possibility of reconsidering your residency. No guarantees, but he sounded somewhat optimistic. I really wanted to be the bearer of the news, so Sam gave me permission to tell you. Welcome back, pal.”

  “Oh, man, this is just—I…I don’t know what to say.”

  “You don’t have to say anything that you didn’t already say in those letters. On the track that day you raced the St. Clement’s kids, we talked about how who you are should always be more important than what you are. But there is a balance we all need to find, and it appears you’re in the process of finding it. So”—he reached across and shook her hand—“congratulations.”

  “Hey, thanks, Terry. Thanks for hanging in there with me.”

  “Anything else?”

  “Yeah, just one. Are you going to finish the rest of that sundae?”

  Nearly airborne with excitement, Natalie managed to make it through the Whole Foods Market. When it happened, she had chosen not to tell her mother that she had been suspended from school. Sooner or later, though, especially as graduation time approached, she knew she was going to have to say something. Now, thanks to the dean, and Doug, and Terry, and whoever else had stepped in to speak on her behalf, that wouldn’t be the case.

  Best of all was that what she had told Terry was the absolute truth. She had written the letters taking complete ownership of her actions without any consideration that things would change for her externally. During their second-year course on addiction medicine, her class had been required to attend at least two AA meetings and to read in detail about the famous twelve steps—the tools for changing the person in various programs who found it necessary to drink, or drug, or overeat, or gamble, or sleep around. The eighth of those steps had to do with making a list of those the addict had harmed by word or deed. The ninth required making amends to those people without any adherent agenda or expectation of forgiveness. Perhaps, she was thinking now, it might be time for her to expand her list—beginning with her mother.

  A detour and subsequent four-block tie-up made the drive to Dorchester twice as long as usual. Natalie noted proudly that her profanities, traditionally X-rated in all traffic situations, would barely have made PG.

  Who is this woman, and what have you done with the real Natalie Reyes?

  Humming softly, she pulled up in front of Hermina’s house and looped two plastic bags of groceries around each wrist, then set them down and retrieved the key from beneath the planter on the front porch. She turned to the front door, and at that moment smelled smoke and noticed that gray-black wisps were floating out from beneath the door.

  “Oh, Jesus,” she muttered, plunging the key into the lock and grasping the ornate doorknob, which was hot to the touch.

  “Fire!” she screamed to everyone and no one in particular. “Fire! Call 911!”

  She slipped her hand under her sweatshirt to hold the knob, and turned the key. Then she lowered her shoulder and slammed it against the heavy door with all her might.

  Fifteen

  The people have always some champion whom they set over themselves and nurse into greatness.

  —PLATO, The Republic, Book VIII

  The front door flew inward, and Natalie plunged ahead into a wall of black smoke and heat. The thought flashed through her mind that somewhere she had heard that it wasn’t wise to open the door to a fire because the conflagration would be worsened, but she really had no choice. Her mother and her niece were inside.

  The heat was bearable, but the smoke grew more intense with every step, stinging her eyes, nose, and lung. Halfway down the hallway to the kitchen, sputtering and coughing, she was forced to pull her sweatshirt over her mouth and nose and drop to her hands and knees. To her left, the living room was filling with smoke, and the flowered paper on the wall by the kitchen was smoldering, but there was no sign that the fire had started there. The real trouble was ahead of her.

  “Mom!” she screamed as she reached the kitchen. “Mom, can you hear me?”

  The curtains on the windows were ablaze, as was the wall behind them, the wall adjacent to the living room, the oak table, and parts of the floor. Acrid smoke, lit eerily by the flames, was swirling through the room. Tongues of fire seemed to be shooting across the ceiling, and flickering up from an area of floor by the table.

  “Mom?…Jenny?”

  Natalie inched her way toward the bedrooms. The fire had to have started here, she was thinking, her mind forming a vivid image of Hermina, nodding off at the table, hunched over the Times crossword puzzle, a pencil in one hand, a glowing Winston in the other. But where was she? The heat was intense now, and Natalie began worrying about the gas stove. There were pilots going all the time without flame finding its way backward into the pipes, and she had never heard of a massive explosion from a stove unless unlit gas was actually leaking into the room. The pipes to the stove must offer some protection, she decided. It really didn’t matter. She wasn’t leaving until she found her mother and Jenny.

  The heat and swirling smoke were building. Natalie dropped to her elbows to get more relief from both. Now, in addition, there was noise—a crescendo of snapping wood, falling plaster, and hissing flame. She was squinting ahead, peering through nearly closed eyes, when she spotted her mother lying facedown, no more than five feet away. She was wearing a housecoat and no shoes, and was lying motionless in the doorway that led to the bedrooms. Jenny! Unless Hermina had become disoriented, she had to have been trying to get to her granddaughter.

  Operating off a surge of adrenaline, Natalie grabbed her mother by the ankles, stood up as high as she could tolerate, and began hauling her, six inches at a time, back into the kitchen. The air was significantly hotter than it had been just a minute or so before. Breathing it was like standing in front of an open furnace. There was no movement from her mother—no reaction to being dragged, facedown, across the floor. Natalie fought the urge to check for signs of life. Maybe a heart attack had precipitated all of this. Instead, she pushed backward some more. She had to get Hermina out of the house, then get back inside for Jenny.

  The back door, just beyond the blazing table, was engulfed in a sheet of fire. There was absolutely no way out except back down the hallway to the front door. Had anyone called the fire department? Smoke must be billowing out of that door by now. Would anyone be out there waiting to help?

  Twice Natalie’s hands slipped and she fell backward, gagging and coughing, trying to clear her throat and chest. Each time, she regained her composure and her grip and dragged her mother another few feet. She was nearing the open front door, when Ramon Santiago, the seventy-year-old upstairs tenant, appeared at her elbow, trying to help as much as he was able.

  “Be careful…Ramon,” Natalie sputtered, knowing that the man had arthritis and some sort of heart problem as well. “I don’t…want you…getting hurt.”

  “Is she alive?”

  “I…don’t know.”

  If anything, Ramon was slowing down her progress to the door. Finally, he let go.

  “I think people have called the fire department.”

  “Go be…sure!”

  “It was her cigarettes, wasn’t it?”

  “Ramon, go…get the…fire department!”

  “Okay, okay.”

  He turned and ran off just as Natalie reached the porch.
She was coughing nonstop now and gasping for breath. The burning in her chest was intense. There were several neighbors on the front walk. Only one of them, a fifty-year-old man, who she knew wasn’t working because of some sort of illness or injury, was young enough to be of much assistance.

  “Help me!” she cried, now wondering what she would do if, in fact, her mother wasn’t breathing—trust a neighbor to do effective CPR and go back in after Jenny, or pray the girl was at school, and tend to things with Hermina?

  Together, she and the neighbor rolled her mother to her back and half-dragged, half-carried her down the stairs to the front walk. She was covered with soot and grime, and her long, raven-black hair was badly singed. Quickly, Natalie knelt beside her and checked for a carotid artery pulse. At the moment she felt one, the woman took a rasping, minimally effective breath.

  Thank God!

  Natalie pinched her mother’s nose shut with the thumb and forefinger of one hand, slipped her other hand under her neck to tilt her head back, and gave her three rapid mouth-to-mouth breaths. After the third, Hermina inhaled again—this time more deeply.

  “Ma, can you hear me? Is Jenny in there?”

  Hermina’s head lolled, but she made no response. Natalie scrambled to her feet, working for every breath. “Keep an eye on her!” she yelled to everyone and no one in particular.

  “Don’t go back in there,” the man cried out as she raced back up the stairs and into the smoke.

  From somewhere behind her, she thought she heard a siren, but there was no way she was going to turn back and wait unless she absolutely couldn’t move ahead. Her niece had gotten an incredibly raw deal in life as it was. She couldn’t be left to die this way.

  The smoke, heat, and noise were magnitudes greater now, but close to the floor, there was still breathable air. With her eyes nearly closed and her nose and mouth covered, Natalie drove ahead toward the kitchen. The small, neat living room was ablaze now. Flames had opened a rent in the wall by the kitchen, and embers had set the couch and carpet ablaze. Holding her breath as much as possible, Natalie risked standing. The kitchen was a conflagration, the heat almost unbearable, the noise hideous.

  She tried to gauge whether she was in more immediate danger from the ceiling collapsing or the floor giving way. Halfway across the kitchen, her legs buckled and she pitched forward onto the linoleum. She could no longer see and couldn’t seem to inhale enough of the hyperheated air. It was at that instant, prone on the floor, that she heard Jenny’s voice.

  “Help me! Oh, please help me! Grandma! Aunty Nat! Someone please help me.”

  Driven by the girl’s cries, Natalie pushed to her hands and knees and willed herself forward. She was on the last hundred meters of a fifteen-hundred-meter race, elbow to elbow with another fierce competitor. Her lung was on fire, and her legs were screaming that they could give no more than they were, but the finish line was closing, and she knew she wasn’t going to lose. No matter how much the runner beside her had left, she was going to have more.

  Blinded and smothering, she hurled herself through the doorway to Jenny’s room, and struck heads with the girl, who was lying next to her toppled wheelchair, and whose unbridled hysteria kept her from even registering what was happening.

  “Hi, baby…. It’s okay now…. It’s…Aunty…Nat.”

  Jenny’s only response was a whimper of Nat’s name.

  Compared to Hermina, the ten-year-old was a feather, but she was also virtually dead weight, and Natalie was spent. She pulled Jenny’s tee up to cover her mouth and nose, hooked her hands under the girl’s arms, and pushed back just as she had done with her mother—six agonizing inches at a time. But before she had crossed a third of the kitchen, her legs and her lung would respond no more.

  With flaming embers raining down, she pulled her sobbing niece close to her and shielded the girl with her body. Then she closed her eyes tightly, and prayed that the inevitable wouldn’t be too painful.

  Sixteen

  If you could imagine anyone obtaining this power of becoming invisible, and never doing any wrong or touching what was another’s, he would be thought by the lookers-on to be a most wretched idiot.

  —PLATO, The Republic, Book II

  “Socrates, welcome back to the council.”

  “Thank you, Laertes. My next term actually doesn’t begin for another two months, but I assure you I am looking forward to it. Is everyone on?”

  “They are.”

  The four members of the council, speaking at the same time from three continents, greeted one of the founders of their organization.

  “So?” Socrates asked.

  “So,” Laertes said, “we are calling you about H, client number fourteen on your list. With little warning, his health has begun a fairly rapid deterioration. He needs his procedure done within ten days, his physicians estimate—sooner if at all possible. As you can no doubt extrapolate from his name, there is a great deal at stake politically and financially. We know you have been very busy on our behalf, but we need to know if you can take this case.”

  “I will make it my business to be available. Donor?”

  “We have three possibles. Forty-year-old male baker from Paris, eleven-point match.”

  “Information on him?”

  “Some. He’s a pretty typical Producer. Doesn’t own the bakery, never will. Two children. People in his neighborhood say he makes excellent bread.”

  “Themistocles here. It seems to me that to remove even one good baker from the world would be a sin. I vote we look elsewhere.”

  “The next two are from the United States. First is an actor from Los Angeles—thirty-seven years old. Eleven-point match.”

  “What has he been in?”

  “Grade B horror films, mostly. He’s already been married at least four times, has a gambling problem, and is loaded with debt. Credit rating is poor, doesn’t seem to have much respect in the industry.”

  “No matter,” Glaucon said. “However untalented, he is still an actor, and that makes him an Auxiliary. And furthermore, he’s an eleven. I vote last resort only.”

  “I agree,” Polemarchus chimed in. “Producers before Auxiliaries. That is our policy. Besides, I’m sure Socrates would be first in line for a twelve if we can get him one.”

  “That is true,” Socrates said, “even though our work has shown that the difference in outcome between an eleven and a twelve is minimal. Still, all else being equal, I would certainly prefer a perfect match. An adult Producer, negative health history, the younger the better.”

  “I am pleased that we have such a match,” Laertes said. “Thirty-six-year-old female. Lower-level Producer. Works waiting tables in some sort of restaurant. Divorced. One child. Doesn’t do much of anything outside of her work. Our investigator reports that some of the married women in her town do not trust her.”

  “And she’s a twelve?”

  “She is.”

  “What state is she from?” Socrates asked.

  “Let me see. I think it’s…yes, Tennessee. She is from the state of Tennessee.”

  “Probably listens to that ghastly country music all day,” Polemarchus muttered.

  “We will do her the honor of selection. Objections?”

  “None.”

  “None.”

  “Good choice.”

  “Okay, then, Socrates. As of now, you are on standby. Good day, gentlemen.”

  Seventeen

  You remember what people say when they are sick? What do they say? That after all, nothing is pleasanter than health. But then they never knew this to be the greatest of pleasures until they were ill.

  —PLATO, The Republic, Book IX

  “All right, Nat, it’s time. Your blood gasses are back and they’re pretty good. Your oxygen saturation is ninety-eight. I see no reason we can’t pull that tube out. You ready?”

  Natalie nodded vigorously to her doctor, Rachel French, the head of pulmonary medicine at White Memorial. For many hours she had been on a
ventilator in the intensive care unit, drifting back and forth across the line separating awareness from the beyond, and often, when she awoke, French’s kind, intelligent face was looking down at her.

  It was probably whatever medication they had her on, but the endotracheal breathing tube wasn’t nearly as bad as she had often feared it would be. She had no memory at all of the one that had kept her alive in Santa Teresa’s, and doubted she would remember much of this ordeal, either. God bless the pharmacologists. After blacking out on the kitchen floor, her first indication that she wasn’t dead was the siren of the ambulance that was speeding her up the Southeast Expressway to White Memorial. Apparently her oxygen levels were bad, because, according to Rachel, the tube was immediately inserted by somebody in the emergency ward. But of that turmoil, she had no recollection whatsoever.

  According to the clock on the wall across from her bed, it had been about twelve hours since the sedation and painkillers had been cut back to where she could hold on to a thought for more than a few minutes. Altogether, nearly forty-eight hours had passed since the fire.

  She had to be told several times before she had finally retained the news that both her mother and Jenny were alive and doing well in another hospital, and that she was being given full credit by the fire department and in the press for having saved their lives. Word was that only minutes after the firefighters pulled her and Jenny from the kitchen, the ceiling in Jenny’s room collapsed, and the house went up completely—a total loss. The main unanswered question now in her mind was what, if any, damage had been done to her. It was one of those situations common to medical students and physicians, where she simply had too much knowledge of the possibilities.

  French, the mother of twins as well as one of the youngest department heads in the hospital, was the sort of dedicated, widely regarded female physician that Natalie, herself, had hoped one day to become—assertive and effective without ever compromising her femininity and compassion. During Natalie’s brief hospitalization following her return from Brazil, French had become her physician, and the two of them had spent hours sharing philosophy, life stories, and thoughts about the future.