Rules Get Broken

by John Herbert

  “Let me check, Mrs. Herbert. I’ll be right back to you.”

  A minute passed, then another.

  “Yes, Mrs. Herbert,” the voice on the other end of the line suddenly said. “We have the report from the lab, Dr. Edwards has looked at it, and he does want to see you today. Can you make a three-thirty appointment?”

  “Yes, I can do that,” Peg replied without hesitation. “Did Dr. Edwards say anything else? About the report, I mean?”

  “No, I’m sorry, he didn’t.”

  There was silence on both ends of the line for several seconds.

  “Is there anything else I can do for you, Mrs. Herbert?” the voice asked.

  “No. Nothing at all. I’ll see Dr. Edwards this afternoon at three- thirty.”

  “Have a nice day, Mrs. Herbert.”

  “You too.”

  The voice hung up, and Peg stood in the kitchen looking at the receiver in her hand.

  Nine

  She arrived early for her Wednesday afternoon appointment, at three-twenty to be exact, to be absolutely certain that when her name was called, she’d be there. But that was almost an hour ago. It was now four-fifteen, and for the last fifty-five minutes all she had done was chew on the sides of her fingers, first one hand, then the other. And each time she realized what she was doing, she very consciously clasped both hands together and placed them in her lap before starting to nibble on her lower lip. And when she realized she was biting her lip, she brought a finger to her mouth and repeated the process, over and over again.

  Finally, at eighteen minutes after four, she heard her name being called. “Mrs. Herbert?” yesterday’s nurse again half called, half announced. “Mrs. Herbert?”

  “I’m here,” Peg answered, louder than she had intended to. “I’m here.”

  “I’m sorry you had to wait so long,” yesterday’s nurse said as she led Peg down Internal Medicine’s hall for the second time in as many days. “Dr. Edwards had an emergency over at the hospital this morning, and we still haven’t recovered. Here we are.”

  She stopped at a closed door halfway down the hall, knocked softly, waited a second, then opened the door and stepped just inside. From where she was standing out in the hall, Peg could see she was being ushered into Dr. Edwards’ office and not an examination room. The nurse indicated with a small wave that Peg should come into the office and pointed to the leather armchair next to Dr. Edwards’ desk.

  “Please. Have a seat. Dr. Edwards will be right with you.”

  Peg did as she was told, and as soon as she was seated, the nurse left and closed the door behind her. She was just starting to take in the clutter of patients’ files, medical journals, lab reports, X-ray envelopes and “While You Were Out” messages that covered the desk, part of the floor and the top of a bookcase that ran along the wall, when the door opened and Dr. Edwards came in.

  “Good afternoon,” he said, extending his hand to Peg for a gentle handshake. “I’m sorry I’m so late, but it’s been a difficult day.”

  “So I gathered,” Peg replied with a small smile.

  Dr. Edwards returned her smile, looked at her for a second or two longer than she would have expected, and sat down behind his desk. He rummaged through the pile of patient files stacked in the center of the desk, and when he found Peg’s, he removed the lab report clipped to the inside of the maroon folder. He looked at the report for several moments, then looked up and across the desk at Peg.

  “Based on the results of your blood test,” he began slowly, “I’d like you to see another doctor. I have someone in mind, and I think I can arrange for him to see you this afternoon.”

  Peg swallowed hard. “Today?”

  Dr. Edwards nodded.

  “What kind of doctor?”

  “An oncologist,” Dr. Edwards replied, looking directly into her eyes, measuring the impact of his answer.

  He waited a moment before continuing. “I think you have some form of blood cancer. I’m not an expert in this area, and I could be wrong, but your white cell count is very high, and your red cells are very small and underdeveloped. Which would explain why you’ve been so tired.”

  Peg tried to swallow again, but she couldn’t. She said nothing. Questions at that moment seemed superfluous. She just sat quietly looking down at her hands in her lap, one placed flat on top of the other, and bit her lower lip. Finally, she raised her head and met Dr. Edwards’ gaze. “Okay,” she said with a weak and frightened smile.

  Dr. Edwards turned to the Rolodex file on his desk and found the telephone number of a Dr. Goldstein, an out-of-group oncologist to whom he had referred patients before. He dialed the number and gave Peg a reassuring smile. She could hear the phone ringing at the other end of the line. Then it stopped.

  “Yes, good afternoon. This is Dr. Edwards with North Shore Medical Group.”

  A pause.

  “I’m fine, thank you. I have a patient sitting here with me, a Peggy Herbert, and I’d like to make an appointment for her to see Dr. Gold-stein as soon as possible. When do you think that might be?”

  There was silence on the other end as someone scanned another already overbooked appointment schedule.

  “No, two weeks from today is not what I had in mind. Actually, I was hoping Dr. Goldstein could see Mrs. Herbert this afternoon.”

  The person on the other end asked a question that Peg couldn’t hear.

  “That’s right,” Dr. Edwards replied.

  Another pause.

  “I think that’ll be fine, but let me check.”

  Dr. Edwards turned the mouthpiece of the receiver into his shoulder and looked across the desk at Peg. “Can you make an appointment at five-thirty tonight?”

  “Yes,” Peg answered quietly.

  “Yes, that’ll be fine. Mrs. Herbert will see you tonight at five-thirty.”

  Another pause.

  “Thank you very much for your help. I appreciate it.”

  He hung up the receiver and began to write something on a prescription form. “Here’s Dr. Goldstein’s address and phone number. He’ll see you at five-thirty,” he repeated, and he handed the slip of paper to Peg. “I’ll fax your lab report over to him now so he has a chance to look at it before you get there.”

  He stopped, seemingly in mid-thought.

  “Call me tomorrow if you can, and let me know how you made out and if there’s anything I can do to help.”

  “I will,” Peg replied, and she rose to leave. A quiet “Thank you.”

  An equally quiet “Good-bye.”

  And she was gone.

  Ten

  Peg pushed open the front lobby door of the North Shore Medical Group building. She started to go down the walk leading to the parking lot, but stopped after only a few steps as if she had hit an invisible wall. She brought her hands up to her mouth, clasped almost as in prayer, and looked up at the blue summer sky winking at her through the leaves of an overhanging dogwood tree.

  “Cancer,” she whispered to herself as she stared upward, blinking back tears. “I have cancer,” she continued, allowing the terror that the word generated to well up from inside and wash over her.

  “Cancer,” she repeated incredulously. “I can’t believe it. I have cancer, and this is how I’m going to die. My God!”

  “Are you all right?” a voice next to her asked suddenly.

  She turned quickly to her left and saw an elderly man and his wife on the walk, looking at her with obvious concern. “Is there anything I can do?” he asked before she could answer his first question.

  Peg shook her head while brushing away her tears with both hands.

  “No. No, thank you,” she replied trying to smile, without success. “I’m fine. But thank you anyway. Thank you very much.”

  Unconvinced, the elderly man looked at her for a moment longer and then took his wife’s arm and guided her towards the front lobby door.

  Peg remained where she was standing, breathing deeply, trying to regain control of her emotions
, and with each breath, she felt herself retreat from the precipice of panic.

  When she had finally succeeded in calming herself, she looked at her watch. It was four forty-five.

  What do I do now? she thought. Should I call John?

  She began to nibble on the side of her thumb. No, she said to herself. I won’t do that. I won’t call John until I see Dr. Goldstein. Until I know for sure this whole thing isn’t just a false alarm.

  She sighed and looked at her watch again. It was still four forty-five.

  So what do I do? By the time I get home, it’ll almost be time for me to leave for my appointment. But if I go now, I’ll be more than a half hour early.

  A few seconds of deliberation.

  But there’s no way I can go home now and face the children, and God knows what else. I can’t do that. So…I’ll go over to Dr. Goldstein’s office and just sit and wait for him.

  The decision made, Peg turned around, went back inside and walked across the lobby to the main registration desk. “Is there a pay phone somewhere I can use?” she asked the receptionist.

  “Yes, there is,” the woman behind the counter replied. “Down the hall to the end, on the left.”

  Peg thanked the woman and proceeded down the hall, finding a bank of pay phones on the wall next to the doors leading to the rear parking lot. She rummaged through her pocketbook for change, and after finding the coins she needed and dropping them into the phone one by one, dialed her home number.

  Linda Taylor, the neighbor who was watching the children for the afternoon, answered the phone on the second ring. “Hello?”

  “Hi, Linda. It’s me.”

  “Hi. How’re you doing?”

  Peg hesitated for a second before responding. “Not too well. I’ll fill you in when I get home. But I’ve got a different problem now. While I was with Dr. Edwards, he made an appointment for me to see another doctor this afternoon. At five-thirty.”

  “Why’s that a problem?” Linda asked.

  “Well, if I see this other doctor, I won’t be home by five like I promised. So I was wondering if maybe you could stay a little longer? Maybe until six-thirty? I’m sorry for asking, Linda, but Dr. Edwards really wanted me to see this other doctor today.”

  Linda was more than just a neighbor; she was a close friend of Peg’s and a good person. “Don’t worry about it,” was her immediate response. “Paul can have his dinner a little later than usual tonight. It won’t kill him, and he’ll understand. And don’t worry about the kids either. They’re fine. Go. I hope everything turns out okay.”

  Peg said thanks, smiled sadly to herself at Linda’s last words, and hung up.

  Eleven

  When Peg arrived at Dr. Goldstein’s office, the waiting room was almost full in spite of the late hour. She identified herself to the nurse at the reception window and took one of the last two remaining seats. She immediately picked up a six-month-old issue of Better Homes and Gardens out of reflex, but before opening it, she looked around the waiting room at the other patients.

  They were all ages. Some in their seventies, some in their mid to late fifties, some within a year or two of her, and one probably not yet twenty. Most were women. Some were extremely frail looking, pale and thin. One or two looked downright emaciated. But others seemed to be in perfect health. Several women suffered from hair loss. One woman in her late fifties apparently had no hair at all and wore a brightly colored floral turban. Another woman, only a few years older, also had no hair but no longer cared and left her baldpate exposed for all to see. Each patient was different from the next in terms of age or state of health or general demeanor, but they all shared a look of quiet fear and deep concern. No one smiled. No one talked. Not even to the person sitting next to them who had brought them here. Not a word. The waiting room was absolutely quiet except for the sound of magazine pages being turned.

  For a split second, Peg had the thought that these people were not waiting to see the doctor, but instead were waiting for their turn to die. She shuddered and could feel panic start to rise again from deep inside.

  I can’t let myself think like this, she thought. I mustn’t panic. This is probably just a false alarm. A complete waste of time. There’s probably nothing at all wrong with me other than maybe I’m a little anemic. I don’t smoke. I don’t drink. Well, a little, but not much. I take care of myself. And for God’s sake, I’m only thirty-four. Cancer doesn’t happen to thirty-four-year-olds.

  She looked across the waiting room at the rail thin eighteen or nineteen-year-old girl she had seen when she first walked in.

  Well, maybe it can, but still…that’s the exception, not the rule. Besides, I’ve got too much to live for, and two little kids that can’t be without me. Dear God, you know that’s true. You know how much I love my babies and my husband, and you know how much they love me and need me. You know that. Please don’t let me be sick. Please don’t let me have cancer. Don’t let me die. Please. Not now. Not of this. Please let me see my babies grow up. I don’t know what I’ve done to deserve this, but please don’t punish them for whatever it is. Please, God, don’t. Please.

  She started to think about what she might have done to make this happen to her, but stopped as soon as she began. She knew thinking like that wasn’t going to help. She also knew that although she wasn’t perfect, she was a good person. A good mother. A good wife.

  I’ve got to calm down. This is silly. There’s nothing wrong with me. Nothing. That’s all there is to it. Nothing! I just have to get a hold of myself. Got to be tough. Strong. Everything’s going to be fine. There’s nothing to worry about!

  As if to lend form to her resolution, she forced herself to stop looking around the waiting room, snapped open the Better Homes and Gardens on her lap, more or less to the middle of the magazine, and struggled to immerse herself in an article describing the preferred way to plant boxed rose bushes.

  By five forty-five, the waiting room was empty except for Peg. She was still sitting in the seat she had selected when she first arrived, in the corner next to the magazine table, her Better Homes and Gardens still on her lap and still opened to the article on boxed rose bushes, when the nurse came to the reception window and slid open one of the sliding glass panels.

  “Mrs. Herbert?” she called out too loudly given there was no one else in the waiting room. “The doctor will see you now.”

  Peg closed her magazine and tried to appear calm as she walked across the waiting room to the door that the nurse was holding open. As she entered what appeared to be an administrative area, a young man to her left got up from behind one of the desks and came over to her, his hand extended.

  “Mrs. Herbert? I’m Dr. Goldstein. Nice to meet you.”

  Peg shook his hand, managed a quiet “Hi” and a wan smile, and tried to hide her surprise and disappointment.

  Unlike Dr. Edwards, Dr. Goldstein was young, in his early thirties at most, and unlike Dr. Edwards, his appearance was totally unimpressive. He was about five-six and soft looking. Almost pudgy. He wore wire-framed glasses, and his dark brown curly hair, which came well over his collar, looked as if it had not been combed for days. He wore wrinkled chinos and an equally wrinkled checkered button-down shirt. And although his greeting was polite, his demeanor was abrupt. In short, he wasn’t another Dr. Edwards, and somehow at this moment, another Dr. Edwards was precisely what she needed.

  He picked up a file from the reception nurse’s desk, glanced at it to confirm it was the one he wanted, and started to walk down a short hall. With his free hand and without saying anything more, he gestured to her that she should follow him.

  “Audrey, join us in a minute, will you?” he called over his shoulder to the nurse who had ushered her in from the waiting room. Then without turning around and still a step or two in front of her, he addressed Peg. “Dr. Edwards faxed me a copy of his examination report and your lab report, but I’d still like to examine you before we talk.”

  He stopped, turned to fac
e her and indicated an open door on the left that led into one of his examination rooms. “Right here,” he said with a weak smile.

  Peg entered and stopped in the center of the room, awaiting further instructions.

  “There’s a gown on the examination table there,” he said from the doorway, pointing to a carefully folded square of pale yellow material at the foot of the table. “Get undressed, and I’ll be back in a minute.” Without waiting for a reply, he pulled the door closed.

  Peg did as she was told, carefully laying first her blouse, then her brassiere, then her slacks on one of the two chairs, and pulled on the pale yellow gown. She had just finished securing the gown’s ties behind her neck when she heard several sharp knocks on the door, followed almost immediately by the door opening an inch or two and Dr. Goldstein’s voice. “All set?” he asked.

  Peg muttered yes, and Dr. Goldstein and the nurse stepped into the room.

  “I’m going to take some blood first so we can take a look at it while you’re here,” he announced, and he walked over to a cabinet on the far side of the room. “Have a seat up on the table, would you?”

  Again Peg did as she was told, and within moments Dr. Goldstein had taken a small vial of blood.

  “I’ll look at that when I’m finished here,” he said to the nurse, handing the vial to her. “But before I do,” he added, turning back to Peg, “I’d like to take a quick look at you.”

  Peg sat straight up and perfectly still as Dr. Goldstein undid the gown’s ties and quickly folded it down to her waist. He ran his fingers under each side of her jaw, down each side of her neck and under each armpit. He ran his fingers over and under one breast and then the other. He examined her in silence and said nothing after he had finished. Instead, he picked up her file from the other chair and rapidly entered his observations.

  “Why don’t you get dressed and meet me in my office?” he said when he was done. “It’s just across the hall. I’m going to take a peek at your blood sample, and I’ll meet you there in a few minutes.” A second later and he was gone.