Healer: A Novel

by Carol Cassella

  The digression put her more on edge. “Addison, just say it. It isn’t just the charge card, is it?”

  He turned, stumbled on the edge of the carpet and bumped a crystal table lamp, which teetered until he grasped it, settled it and held both palms up like a traffic cop, cautioning the lamp to stay put. Then he sat down at the other end of the sofa. She could hear the sound of alcohol in his voice, and fatigue, and something else, something she hadn’t heard before. Something forlorn and defeated that made the room feel big and cold.

  “Did I ever tell you about PT Barnum?” Addison asked.

  “Sure. When you sold Eugena. Barnum lost everything, didn’t he? More than once?” Claire waited for him to go on, to look at her or move closer. It felt like the kind of moment when they should be sitting snug up against each other, gripping each other’s hands, she thought. But she didn’t move, either. She cleared her throat and started to ask him something but couldn’t get any words out, bit her lip and began again. “Is that what you’re about to tell me? We’ve lost everything?”

  He didn’t answer. Her brilliant, manic, silver-tongued husband, the shooting star of Seattle’s biotech millionaires, had no answer for her.

  Claire started to laugh. It was the first emotion that overtook her, she couldn’t think why. To break the tension, probably. Or simply that the concept was too ridiculous; there was too much money tied up in this very room to fathom “losing everything.” Later, much later, she would think about it and recognize that she had known on some level for months, sensed some drastic storm in the rare air they had come to accept as their due. She had sensed it in the longer and longer hours Addison spent at the lab, the nights his side of the bed stayed cold and empty. She had heard it in the false cheeriness on his phone calls to investors and employees, and the office door he swung shut if she walked by. So maybe that was why she laughed. Maybe it was her apology to him for the complicity of shameless self-deception.

  Still, the outburst embarrassed her, even with her husband of fifteen years. Addison turned to look at her, his eyes playing over her face and his head cocked a bit to one side. For a minute she thought he might laugh, too, turn it all into a joke and get up to set the table and call Jory for dinner. And then the space between them seemed to yawn dangerous and wide, and she held her breath, picked up his limp hand in both of her own, held it tight against her chest. “Okay. Tell me everything.”

  It was serendipity, really, that brought it to light. If Rick Alperts’s bicycle wheel had not caught the end of a stick in precisely the position to drive it through his spokes, and thus send Rick arcing through the air onto the pavement, Addison would never have checked the mouse cages and done the blood tests himself. And if Addison had not checked the cages, vascumab would likely have marched straight through Institutional Review Board approval and into phase 1 human testing as scheduled.

  Rick Alperts had been Addison’s third major coup. The first, obviously, was the bright light of his initial concept, the two altered moieties on the leading antiangiogenesis drug that led to vascumab. The second coup had been Anna’s husband, Nash, the last crucial investor to come on board, who understood that the risk in the biopharmaceutical industry was high but the enormous start-up costs could be a tax write-off. And the third coup was Rick. At thirty-two he knew more about VEGFR-2 drug development than anyone in the country. Addison hired him out of a California lab, promising Rick a share in the company. Addison had returned from their last courtship meeting saying he probably hadn’t even needed that incentive—when Rick saw Addison’s structure he’d been speechless for a few minutes, and then practically begged Addison for the job.

  Almost every step had gone fluidly forward after that. Vascumab’s pharmacological activity matched all the computer models Addison had worked on for two years. The tissue cell cultures showed tumor clearance and no sign of toxicity. And the mice. Three different strains of mice were infused with no discernible organ damage. They tried it in two primates and the side-effect profile was nil—better than that of any competitor on the market.

  The FDA application for Investigational New Drug status was well past the thirty-day mark with no objections raised, and the review board had been considering their protocol for ten days. Approval was expected within a month or two. Two pharmaceutical companies were already talking offers. If the human trials went as well as Addison and Rick predicted, they could license the drug for a high premium within a year.

  The day of the bike accident Addison was waiting for Rick when he came in, four hours late with his arm in a sling, jocular about being a little high after one Vicodin. Rick had a small abrasion on his cheek, Addison recalled, which made him look that much younger, a schoolkid roughed up on the playground. But from the look on Rick’s face Addison knew immediately these two weren’t the only sick mice. They were just the only sick mice Addison knew about.

  “It only happened in one strain,” Addison told Claire. “The rest showed no problem. Four mice out of fifty-two. Rick was ready to repeat the test on them—he was convinced it was a fluke and we shouldn’t interrupt the board’s review until we knew for sure.” He slumped against the back of the sofa so that she could hardly see his features, the winking Christmas tree lights flickering on his cheeks. “We had so much data already—more than we needed.” He paused before he said what was obvious to her. “So I didn’t report it.”

  Claire waited through some silence until it was clear he didn’t know how to go on. She prodded him. “But the review board found out anyway. And then they denied your trial protocol?”

  Addison looked directly at her then. “They found out because I told them. But when they found out I’d waited four weeks they withdrew approval.”

  He seemed to physically deflate, as if telling Claire had been the worst moment in the entire cascade of the debacle. She was too stunned, still, to know how she would feel about this tomorrow, next month, at the end of their lives. Too stunned even to listen to the part of her that knew the most critical thing for their family at that moment was to recognize how fragile Addison was. So she asked him, “Where is our money in this?”

  “I took some bridge loans to repeat the mouse trials. Rick left—there were delays.” He pressed the heel of his hand against his eyes, first one and then the other. “I had to back the loans, Claire.” And then he listed all that was gone, all he was able to sign away without ever telling his wife. Without ever asking.

  • 24 •

  Frida arrives to drive Claire to the clinic. “You own all this land?” she asks, bouncing the clutch to get her old Volvo started up the driveway. A flock of starlings startles and swerves when the engine grinds.

  Claire looks out the window. The new snow is already melting away, the pale, smoky green tops of the sagebrush show where even the deepest drifts had covered them a few weeks ago. Swaths of brown grass lie flattened against the earth in the wake of retreating winter. “It’s in an easement—it can’t be divided. Otherwise we’d sell some of it off.”

  “Nice to have so much privacy.”

  Claire nods, thinking that the privacy has become a burden of loneliness in these last months. Then she turns to Frida, “I need to find somebody to be with Jory in the afternoons. Sort of like a housekeeper… but with no housekeeping.”

  Frida thinks about it for a minute. “Well, you’re not exactly on the ‘road most traveled’ out here. She getting into trouble?”

  “Close enough.” Claire shrugs and wraps her arms tight around her body, not ready to go into the story. “She’s not happy out here.”

  The car tries to stall in the steep curve just before the drive meets the county road. Frida ratchets the gear down and guns it through the turn. “A lot of people move to the valley thinking it’s the same to live here as it is to vacation here. Broke up my marriage.”

  “I didn’t know you’d been married,” Claire says, immediately feeling bad that she’d brushed by so much of Frida’s personal life. Had she left so little ro
om for it in all their small talk? “Was it recently?”

  “Eight years ago. Eight and three-fourths. It was his idea to move here.” She tilts her head for a second and then squints at Claire, as if only now reaching a conclusion. “I think he couldn’t stand not being anonymous. No place to hide in a town of four hundred people. Kind of funny, though. Once the word got out, I had more people offering me food and company than any other time or place in my life.”

  Claire is quiet, drifting back to the day before they left Seattle. By then most of her friends knew the move was anything but voluntary. The doorbell had rung at seven thirty in the morning, echoing in the empty marble entryway. When Claire opened it she found Sherry, Anna’s neighbor, standing outside with a foil-covered casserole in her hands, the first person on that doorstep in a week, besides the moving men. Her eyes kept darting from Claire to her car, where Sherry’s daughters sat dressed for church. “I can’t stay, just wanted to drop this off.” She’d lifted the corner of the foil like she was reminding herself what she’d cooked. “Chicken-corn chowder—the recipe said put in celery salt, but I didn’t have any. So I just used salt and celery,” she had laughed, talking too rapidly for Claire to add a word. “I don’t even know what celery salt is—me and my cooking!” Then she had handed the casserole over and offered Claire a quick kiss on the cheek, waving behind her as she ran back to the car, late for church. “Keep the pan, sweetie. Call when you’re settled.”

  Frida has her gaze steady on the road, but Claire can tell she’s tuned in to her mood. She says, “So you just let me know if I need to be bringing you any food and company.”

  Frida drops Claire at the garage to pick up the Audi. “She runs,” the mechanic says. “Don’t look so good. I put the bodywork estimate in the envelope there.” Claire had never cared too much about cars but, still, it’s depressing to see it so battered. The towing fee and unavoidable repairs had cost almost twice as much as the necklace, which is nowhere to be found.

  She parks outside the clinic and calls home, hoping the unanswered rings mean that Jory got herself to the bus stop. When she hangs up she sees Miguela sitting on the metal railing of the wheelchair ramp, watching her car. As soon as Claire gets out Miguela jumps off the rail with a little huff, a scratch of gravel. “Doctora. Buenos días.”

  “Hey.” Claire drops her keys in her purse and walks to the bottom of the adjacent stairs. “You okay? No estas enferma?”

  Miguela waves a hand in front of her face once, then sweeps her hair back, the curls immediately rebounding. “Yes. I come to ask again for a job. I see your car. It’s okay?”

  Claire flares her hands open, wishing she knew what the gesture for acceptance might be in Nicaragua, feeling like so much of her communication with patients here is boiled down to an approximation at best. “Dan would have to decide—it’s his clinic. But it’s okay with me.”

  Miguela’s eyebrows dart together but then she smiles. “No. Your car. It does not look okay.” She points to the mangled front fender. “But you and Jory—you are okay?”

  “Oh! Yes. Fine. Thank you. Jory said she saw you at the bakery.”

  Miguela glances out toward the road, then back, with a look on her face somewhere between apology and hope, or so it seems to Claire. “She is very smart, Jory. She’s learning Spanish.” The look intensifies and she adds, “I only talk with her there. At the bakery.”

  “It’s all right. It’s good—I don’t know, you may be her only friend out here so far. We should get you on Facebook.” She says this quickly, almost to herself, and can’t tell if Miguela understands but decides to let it go. “Well. I am late.” She gestures at the clinic door, the shift of colors blurring behind the glass as patients move between the chairs and desk and exam area.

  Anita puts a stack of incomplete charts in her hands as soon as she walks down the back hall into the office. “These are all coded wrong. Dan’s not coming in today so you better get to work.” Her ankles are so swollen in these last six weeks of pregnancy she is wearing tennis shoes with the laces undone, the backs folded under her heels.

  “Get your feet up,” Claire says. “At least during lunch. Did he say why?”

  “He said he and Evelyn had to go to Wenatchee on business. Looks like everybody but me is coming in late or not coming at all.”

  Claire drops the charts on her desk chair, the only clear surface. “I saw Miguela Ruiz outside. She’s looking for a job here.”

  “She already talked to me. She wants to work for free? Then we’ve got a job.” Anita sways down the hall toward her desk, flipping all the exam room flags out to prove she has filled them.

  It is a hard day to be short staffed. Claire has to send two patients to the emergency room across the pass, the first with obvious pneumonia, and the second by ambulance (the spinning red lights stunning the waiting room into silence) when his “acid indigestion” clarifies itself as myocardial ischemia. She doesn’t start sorting through all the incomplete charts she’d thrown on her desk until well after six o’clock.

  She reaches for the phone and knocks an elbow against the pile, sledding a cascade of paper onto the floor. But she feels too overwhelmed to do more than sit back in her chair and stare at the mess, as if some genie might sort it out if she gave up and went home. She can’t even remember if she told Jory to wait at the grocery store or take the school bus—reconsidering, now, who is being most punished by the confiscated cell phone.

  “I hope you feel better than you look.” Frida is leaning against the doorframe eating a pack of gummi bears.

  Claire holds out her hand for one and bites down on it, loving the rush of saliva, feeling her hunger. “You like to surround yourself with Kool-Aid colors, don’t you,” Claire says, propping her feet on the top of the open bottom drawer. She reaches for another piece, choosing orange this time, enjoying the almost forgotten sensation of candy stuck on her teeth.

  “Only my food and my hair bands.” But then she remembers more and waggles one foot in its sandal. “Socks, too, I guess.”

  Claire swivels so she is facing Frida, briefly rejuvenated by the burst of glucose. “I don’t actually know for certain where my daughter is right now.”

  Frida sits down in her own chair, the tops of their desks so close the blizzard of paper makes them look continuous. She spreads open a brochure on STDs and pours out the rest of the package of candy, sorting through to collect the green ones. “Any more thoughts on the housekeeper?”

  Claire lifts one shoulder. “I don’t have any money to pay one.”

  “Room and board might be enough.”

  “You didn’t see the inside of my house. The only space is an oversized closet off the kitchen.” Claire stands up to put on her coat, deciding even without calling home again that Jory trumps the paperwork.

  Frida leans over the desk on her elbows, pushing charts and lab slips and phone memos into random piles. “It’s still probably a lot nicer than where some of these folks live.” She waves her hand around the whole cluttered office, referencing every charity patient on their unprofitable books. “Somebody here would be happy to sleep in your kitchen.”

  They walk out to the parking lot together, the sky a steely blue that is neither night nor day. Frida stands with her car keys in her hand and squints down the valley, where the paler twilight remembers the sun. She takes a long breath, rolls her shoulders up to her ears and then drops them, stretching her arms behind her. Something in the motion reminds Claire of her favorite birds, the blue herons that used to roost in their trees on Lake Washington, hunting along the shallow shore with elastic necks, walloping into the air on ragged wings with pterodactyl cries.

  Frida takes her time absorbing this magnificent sky, then turns to Claire. “You don’t seem quite so gun-shy around here anymore.”

  “What do you mean?”

  “I mean…” She tilts her head up, like maybe there is an answer floating by. “I mean when you first started working here you seemed like you were afra
id you were going to break somebody. Drop some patient on the ground and shatter him to pieces.”

  Claire feels a surge of pride, quickly chased by a surge of embarrassment, like she’s taking credit for something she hasn’t earned yet. “At least I’m speeding up. You didn’t hear anything from Dan, did you?”

  Frida shakes her head. “You’re worried. Aren’t you?”

  Claire stares at a pin of light hovering on the horizon above Frida’s shoulder. An airplane coming at her or moving away. Or Venus. “He wouldn’t tell us, would he?”

  “You’d have to pull it out of him like an old bullet.” She’s quiet for a minute, then adds, as if it were clearly connected, “He’s seen so many patients by this age he almost has a second sight about sickness—I sometimes wonder if that’s how he can run this place on next to nothing. Line up a room of people and he can smell which one is really sick.”

  Frida could have no way of knowing how that remark twists in Claire’s plexus, remembering her last week of residency, that night in the emergency room. She can still see the woman’s face. All the residents knew her—she came in three or four times a month wanting narcotics. “Well,” Claire says. “I won’t be matching that.”

  Frida lets out a low hum. “That man taking TUMS for his heart attack today would disagree, I think.” She opens the door to her car, seems to make a point of dropping the subject. “Go get your girl. See you tomorrow.”

  She drives slowly past the grocery store, scanning the white-lit doorway where Jory usually stands, calls the house one last time and gets no answer, then parks and searches the store without finding her. But as soon as she turns the last bend in their driveway she sees that every light in the house is blazing; the music is so loud she can hear it through the closed windows of the car. The door is locked; Jory doesn’t hear her knock so she lets herself in, she drops her keys and purse on the table. Jory is dancing, oblivious and invisible, her eyes closed so that all she sees is the slow, swaying rhythm, moving her body in places Claire knows a human is not hinged. Near the end she opens her eyes and freezes, abruptly aware of her mother.