Rules Get Broken

by John Herbert

  Peg reached for her clothes. She tried not to feel violated, but somehow she did. Less than five minutes ago she had been sitting in the waiting room. Now five minutes later she was sitting alone in a cold examination room, half naked, blood taken, examination over. She shook off the feeling and hooked her bra.

  When she was dressed, she opened the door and stepped out into the hall. Directly across from her was an office, its door open, which she assumed was Dr. Goldstein’s. She crossed the hall and looked in somewhat tentatively to confirm it was empty. When she saw that it was, she entered, sat in one of the leather wing chairs in front of the large mahogany desk, folded her hands in her lap and waited.

  The minutes passed slowly. The only sounds were the hum of the air conditioner in the window and occasionally the muted ring of the telephone in the outer office. For some reason, she didn’t think about what Dr. Goldstein might say. Her mind for the moment was blank.

  Footsteps coming down the hall signaled Dr. Goldstein’s arrival. He came into the office holding a mug of coffee in one hand and a file folder in the other. He walked behind his desk, placed both the mug and the folder in front of him, and sat down. He swiveled his chair to his left, hit a key on his telephone console, picked up the receiver and waited.

  “Audrey? Hold my calls for a few minutes, will you? Thanks.”

  He hung up the receiver and turned to face the silent woman sitting in front of him. He looked at her only long enough to make eye contact before picking up the folder he had just laid on the desk. He started to open the file, then stopped, closed it slowly and again looked at Peg.

  “Mrs. Herbert, I wish I had better news for you, but unfortunately I don’t.” He paused. “My review of the lab report Dr. Edwards forwarded to me…in combination with my own examination of you and your blood sample…confirms that you have leukemia, which is a form of blood cancer. And given the rapid onset of your symptoms—for example, the extreme fatigue you told Dr. Edwards about—my guess is it’s probably what we call acute myelogenous leukemia. We’ll be able to confirm that after we’ve examined your blood sample more thoroughly, but for now let’s just say you have a very aggressive type of leukemia.”

  He paused again and seemed to hesitate before he resumed speaking. “My examination also confirms that the disease has progressed considerably.”

  He gave Peg a moment to absorb what he had said.

  “You need to know that this type of leukemia is definitely life threatening, although not necessarily terminal. In other words, although it’s a very serious illness, if we attack it now, immediately and aggressively, we’ve got a reasonable chance of at least getting you into long-term remission. Hopefully, we can even cure you.”

  Peg blinked her eyes several times as she tried to absorb the words she had just heard. She knew she understood the words, but for several seconds she had difficulty believing they had been directed at her.

  “What do we do?” she whispered.

  “We’re having the most success against this type of leukemia with chemotherapy,” Dr. Goldstein replied. “Do you know what chemotherapy is?”

  “I think so. Maybe. I don’t know.”

  “Chemotherapy is a treatment regimen involving the introduction of chemicals into the body. Chemicals which kill the cancer cells, in your case the cancer cells in your bone marrow, while not affecting the healthy cells in the rest of your body. I have to be honest with you and tell you this isn’t the most pleasant form of therapy, but it gets the job done. Usually, treatment continues for two to four weeks. Ideally, at the end of that two-to-four-week period, the cancerous blood cells have been killed, leaving only healthy non-cancerous cells in your body. At that point, you’re in what we call remission. We then discontinue the chemotherapy, and your body begins to repair itself, hopefully free of cancer.”

  Peg stared at him, her eyes wide with terror. I’m not hearing this, she thought, feeling the terror start to engulf her again. This cannot be happening to me. It can’t be. It just can’t be.

  She struggled to find her voice. “What do I do now?” she asked, her voice hoarse from fright.

  “Well, first, if you want me to treat you, I need you to consent to my being your attending physician. Is that what you want?”

  He waited for Peg to answer. “In other words, do you want me to be responsible for your treatment?”

  “Yes,” Peg replied.

  “Okay. Consider that done. Now the next thing we have to do is get you admitted to Huntington Hospital as soon as possible. Can you check in tonight?”

  “Yes.”

  “I’m sorry for the urgency, but given your condition, time is not exactly our friend.”

  “I understand.”

  “I’d also like you to ask your husband to come to my office tonight so I can bring him up to speed on what we’ve found and how we’re going to treat you. I’ll be here for at least another hour and a half. Do you think he can get here in that time frame?”

  “I think so.”

  “Good. I’m going to call the hospital now while you go home and pick up whatever you need.” He looked at his watch. “It’s five after six now. Can you be at the hospital by seven?”

  “Yes,” Peg answered quietly, tears rolling unchecked down her cheeks.

  Dr. Goldstein pushed his chair back, stood up and started to come from behind the desk to escort her back to the outer office. The consultation was over.

  “We can beat this,” he assured her. “Believe me when I say that. There are a lot of things we can do today that were unheard of ten, even five, years ago. We can beat it. Believe me.”

  By the time he had finished saying this, he had come around to the front of his desk and now stood barely three feet from Peg’s chair. But she made no move to rise. Instead, she sat totally still, staring at her hands, still carefully folded in her lap, one on top of the other. Tears ran down her cheeks and fell onto the back of her hand. She tried to wipe the tears away with her fingers, first from one eye, then from the other.

  Finally she spoke. “I have a little girl who’s almost three and a little boy who’s only eight months old. They both love me very much. They both need me very much. What’s going to happen to them if something happens to me? What will they do without me? What will they do without their mommy?”

  Dr. Goldstein took a step closer to her chair. “I’ll see you at the hospital later tonight,” he said, placing his hand on her shoulder.

  Peg nodded quickly, wiped the last of her tears away with the heel of her hand, and rose from the chair. And without so much as a glance at Dr. Goldstein, she turned and left the office.

  Twelve

  Peg stood on the back porch staring at the screen door. She knew she had been standing there too long. She knew she had to open the back door soon or Linda would open it for her, having seen her pull into the driveway several minutes ago. But she wasn’t ready. Not yet. She had to make certain she was okay. She couldn’t risk coming apart in front of Jennie.

  I have to be calm, she told herself, her hand on the screen door handle. I have to be relaxed. Have to look like everything’s all right. I have to be strong for Jennie. Can’t let her know how scared I am.

  How am I going to do that?

  Never mind how. You have to.

  She pulled the screen door open, and the screech of its spring announced her entry. She stepped into the pantry hall, letting the screen door slam behind her, and came around the corner into the kitchen. Linda was sitting at the kitchen table watching the children eat their dinners, Jennie across from her in her booster seat and John next to her in his high chair. Jennie had finished her chicken and most of her mashed potatoes and was busily chasing peas around her plate with a spoon. John was slumped diagonally in the highchair, eyes half closed, as he sleepily sucked at his almost empty bottle.

  “Hi, Mommy,” Jennie called out happily, upraised spoon in hand, when she saw Peg.

  “Hi, sweetheart,” Peg replied as she walked to the kitc
hen counter to put down her pocketbook and keys.

  “How’d you make out?” Linda asked.

  “Not well,” Peg answered, trying to decide how much she could say in Jennie’s presence. “I have to go to the hospital tonight.”

  “Tonight? Why tonight? What’s the rush?”

  Peg turned away from the counter. She started to walk towards the table, but she stopped after the second step, suddenly realizing her knees were shaking so badly they threatened to collapse under her. She put her hand on the counter to steady herself.

  “I have leukemia,” she answered, slowly and deliberately, her voice quivering in spite of her best efforts to sound in control. She inhaled deeply in an attempt to calm herself and then exhaled slowly. “So I have to go upstairs and pack. Right after I call John.”

  “God, Peg, I am so sorry,” Linda said, staring at her in disbelief.

  “Me too.”

  The two women remained silent and motionless for several seconds, looking across the kitchen at one another, across the gulf that exists between the sick and the healthy, tears in their eyes, not knowing what to say or do next.

  Suddenly a three-year-old voice broke the silence. “What’s wrong, Mommy?” Jennie asked, frightened at seeing her mother crying. “Are you sick, Mommy?”

  In an instant Peg was at the kitchen table, lifting her daughter out of the booster seat for hugs and kisses. “Nothing’s wrong, sweetheart,” she said with complete assurance as she kissed Jennie on the cheek, the nose, the forehead, the cheek again. “Nothing serious, anyway. I just have to go to the hospital for a few days so the doctor can fix me up.”

  She looked into those huge eyes only inches away and felt her heart breaking. Breaking because she knew she was lying, and because the little girl in her arms would believe every word she said.

  “Then I’ll come home and be good as new.”

  “Then why are you crying, Mommy?” Jennie asked, as yet unconvinced.

  “Well, I guess I’m crying because I’m not as brave as I should be, sweetheart. That’s all. But there’s no reason for you to be afraid. Mommies cry sometimes too, you know.”

  “Can I have ice cream for dessert?” Jennie asked, her fear erased by these last words and her attention now on other matters.

  “Of course you can, sweetheart. Linda will get it for you while Mommy’s upstairs. Okay?”

  Peg put Jennie back into the booster seat and walked over to John, who was now wide awake. She ran her fingers through his hair and watched them glide across his head as he twisted and turned in his high chair. Then she looked up at Linda.

  “I don’t have much time. It’s almost twenty of seven, and I need to call John before he leaves the office. If he hasn’t already. After that, while I’m packing, could you call the Claytons for me, explain the situation, and see if they can come over to watch the kids until John gets home? So you’re not tied up here anymore? Is that okay?”

  “Sure,” Linda replied. “Not a problem. Go.”

  Peg nodded in thanks, then lifted John out of the high chair and held him close to her chest. She closed her eyes and gave him a lingering kiss on the top of his head, feeling the warmth of his skin and the softness of his hair with her lips. She held him for perhaps half a minute and then slowly, reluctantly, bent down to slide him back into the high chair. Once she was certain he was secure, she straightened up and stood next to the high chair for a few more seconds, one hand on his shoulder, looking first at his upturned face and then at Jennie.

  Suddenly, she leaned across the table, kissed Jennie on the forehead and left the kitchen. John squirmed in his high chair, trying to find his mother, wondering where she had gone. Jennie silently watched her disappear around the corner.

  Thirteen

  I should’ve been out of here a half hour ago, I thought as I surveyed the mountain of paperwork strewn from one end of my desk to the other, exasperated that I was still nowhere near an acceptable breaking off point.

  And why hasn’t Peg called? I asked myself, looking at my watch for what must have been the twentieth time. It was now almost six forty. She should have called two hours ago. She said she’d call as soon as she got home.

  “So why the hell hasn’t she called?” I said out loud without meaning to.

  As I was having this conversation with myself, I heard the receptionist’s telephone ring in the outer office and looked at my phone console to see what line was flashing. A call on any one of the first four outside lines at this hour was probably a customer who didn’t know we were on Eastern Time. A call on the fifth line, “04” as we called it, at this time of night was personal, either my parents or Peg.

  It was “04” that was flashing, but just in case, I answered it officially. “Good evening. Herbert Products.”

  “John, it’s me.”

  “Hey, kid. Where you been? I’ve been worried about you.”

  “I just got in.”

  “I thought your appointment was at three-thirty.”

  “It was. I just got back from seeing Dr. Goldstein.”

  “Who’s he?”

  Peg started to answer me, but before she was able to she began to cry, and within a second or two she was sobbing uncontrollably and unable to speak.

  “Peg? Who’s Dr. Goldstein?”

  No answer.

  “Peg. Talk to me. Who’s Dr. Goldstein?”

  Again Peg tried to speak, but again she failed and continued to sob.

  “Sweetheart, you’ve gotta calm down. I can’t help you if I don’t know what’s wrong. Who’s Dr. Goldstein?”

  Still no answer. Hysteria and panic were now in control.

  “Peg,” I shouted into the receiver. “Stop it! Calm down! Take deep breaths and calm down! You have to calm down!”

  My voice must have reached her because almost immediately I heard her breathing into the phone, rapid shallow breaths at first, and then as the seconds passed, deeper, more regular breaths. I could sense she was regaining control.

  “Are you all right?” I asked hesitantly, hoping I was not going to trigger another panic attack by asking questions too soon after she had calmed down.

  “Yes,” was the muted reply after several more breaths. “I’m sorry for behaving like this,” she continued, “but I’m so scared, John. I’m so scared.”

  “I can see that, sweetheart. But I don’t know why yet. So now, without getting upset, tell me who Dr. Goldstein is.”

  “He’s an oncologist,” she said with a whimper, almost as if she were ashamed.

  “An oncologist? Isn’t that a cancer specialist?”

  “Yes,” she answered, and she started to cry again.

  “Jesus, Peg,” I exclaimed, feeling my head start to spin and momentarily forgetting how terrified she was. “You gotta be kidding me. What happened? What’d Dr. Edwards say?”

  “He said he thought I had some kind of blood cancer. And he wanted me to see another doctor. Today. So while I was in his office, he made an appointment for me to see Dr. Goldstein.”

  “And what’d Dr. Goldstein say?” I asked, dreading the answer.

  “He said I have leukemia,” Peg cried out loudly, on the verge of losing control again. “He wants me in the hospital tonight,” she continued in between sobs. “I’m supposed to be there in fifteen minutes. And he wants to see you tonight at his office. He’s going to wait there for you.”

  I leaned back in my chair while she blew her nose. I looked up at my office ceiling, seeing nothing, at a complete loss for words.

  This isn’t happening, I thought stupidly. Can’t be happening. She was just a little tired. She wasn’t sick. She was tired. Leukemia? My God!

  “Leukemia, John. People die from leukemia. And that’s what I’ve got. Leukemia!”

  What do I say to her? I asked myself, closing my eyes in the face of the enormity of what she had just said. What can I possibly say to this?

  “Are you still there?” Peg asked.

  “Yeah, honey,” I answered,
leaning forward again, the receiver in one hand, my head in the other. “I’m still here.”

  My mind was racing. I had to say something. Something encouraging, comforting, reassuring.

  “We’ve obviously got a major problem here,” I began, struggling to find the right words, the right tone. “But just because you have leukemia doesn’t mean you’re going to die. It just means you’re sick, and we’ve got to make you well. The one thing you can’t do, though, is panic. You can’t let that happen. Because if you do, then you’ve really got a problem. So let’s both try to stay calm until we have all the facts and know what our options are. Okay?”

  “Okay,” Peg murmured weakly.

  “Have you got Dr. Goldstein’s address and telephone number?” I asked, trying desperately to focus on something other than the word “leukemia,” which was by now streaming non-stop through my brain.

  “He’s on East Main Street. 220 East Main. And his telephone number is 271-5349.”

  “I got it. How are you getting to the hospital?” I asked, focusing on the details, the logistics for the next few hours. The details I can handle, I thought. It’s leukemia I’m having a problem with. Gotta stick to the details for now.

  “I’ll ask Amy Bennett to take me. I know she’s home.”

  “Good. I’ll come to the hospital right after I meet with Dr. Goldstein. You’ll be admitted and in a room by then?”

  “I guess.”

  Her voice was flat, mechanical, totally devoid of emotion, and her demeanor now was completely different from what it had been just minutes ago. I wondered if she had truly calmed down or gone into shock. I had no way to know. I was in my office; she was in our bedroom at home. I considered asking her to put Linda on the phone, but decided I would be overreacting. So instead I reverted back to the details, to that which I could control.

  “How long can Linda stay?”

  “She’s going to call the Claytons as soon as I get off the phone with you and ask them to stay here until you get home from the hospital.”