Side Effects

by Michael Palmer

  Any ideas?"

  "Ideas?"

  "I don't work with the woman, baby, you do. Doesn't she ever fuck up?

  Blow a case? Christ, the rest of the MD's in this place do it all the time."

  "She's a pathologist, Norty. Her cases are all dead to begin with.

  There's nothing for her to blow except…" She stopped in mid-sentence and pulled a typed sheet from her lab coat pocket. "What is it?"

  "It's the surgical path schedule for tomorrow. Bennett and Dr. Huang are doing frozen sections this month." She scanned the entries. "Well?"

  Sheila hesitated, uncertainty darkening her eyes. "Are you sure she's going to report me to Willoughby?"

  "Baby, all I can say is that Dr. Willoughby asked me for a copy of the union contract, expressly for the part dealing with justifiable causes for termination."

  "She has no right to do that to me after she promised not to."

  "You know about people with MD degrees, Sheila. They think they're better and smarter than the rest of us. They think they can just walk all over people." Sheila's eyes told him that the battle-this phase of it at any rate-was won. "We'll see who's smarter, " she muttered, tapping the schedule thoughtfully. "Maybe it's time Bennett found out that there are a few people with brains around who couldn't go to medical school."

  "Make it good, baby, " Reese urged, "because if she's in, you're out."

  "No way, " she said. "There's no way I'm going to let that happen.

  Here, look at this."

  "What?"

  "Well, you can see it's a pretty busy schedule. There's a lung biopsy, a thyroid biopsy, a colon, and two breast biopsies. Bennett will be working almost all day in the small cryostat lab next to the operating rooms. Usually, she goes into the OR, picks up a specimen, freezes it in the cryostat, sections it, stains it, and reads it, all without leaving the surgical suite."

  "And?"

  "Well, there are a lot of ifs, " Sheila said in an even, almost singsong voice. "But if we could disable the surgical cryostat and force Bennett to use the backup unit down in the histology lab, I might be able somehow to switch a specimen. All I would need is about three or four minutes."

  "What would that do?"

  Sheila smiled the smile of a child. "Well, with any luck, depending on the actual pathology, we can have the great Dr. Bennett read a benign condition as a malignancy. Then, when the whole specimen is taken and examined the next day, her mistake will become apparent."

  "Would a pathologist make a mistake like that? " Reese asked. Again Sheila smiled. "Only once, " she said serenely. "Only once." + Louisburg Square, a score of tall, brick townhouses surrounding a raggedy, wrought-iron-fenced green on the west side of Beacon Hill, had been the address in Boston for generations. Levi Morton lived there after his four years as vice president under Benjamin Harrison. Jennie Lind was married there in 1852. Cabots and Saltonstalls, Lodges and Alcotts-alll had drawn from and given to the mystique of Louisburg Square. Kate had the cab drop her off at the foot of Mount Vernon Street, she used the steep two-block walk to Louisburg Square to stretch her legs and clear her thoughts of what had been a long and trying day at the hospital. Two committee meetings, several surgical specimens, and a lecture at the medical school, combined with half a dozen malicious phone calls and an equal number of hate letters, all relating to her callous treatment of Bobby Geary and his family. Ellen's nose had begun bleeding again-just a slow trickle from one nostril, but enough to require Pete Colangelo to recauterize it. Her clotting parameters were continuing to take a significant drop each day, and the unencouraging news was beginning to take a toll on her spirit. Late that afternoon, the National Institutes of Health library computer search had arrived. There were many articles listed in the bibliography dealing with sclerosing diseases of the ovaries, and a goodly number on clotting disorders similar to the Boston cases. There were none, however, describing their coexistence in a single patient. Expecting little, Kate had begun the tedious process of locating each article, photocopying it, and finally studying it. The project would take days to complete, if not longer, but there was a chance at least that something, anything, might turn up that could help Ellen. At the turnoff from Mount Vernon Street, Kate propped herself against a gaslight lamp post and through the mist of her own breath, reflected on the marvelous Christmas card that was Louisburg Square.

  Single, orange-bulbed candles glowed from nearly every townhouse window.

  Tasteful wreaths marked each door. Christmas trees had been carefully placed to augment the scene without intruding on it. Having, season after season, observed the stolid elegance of Louisburg Square, Kate had no difficulty understanding why, shortly after the death of his agrarian wife, Winfield Samuels had sold their gentleman's farm and stables in Sudbury and had bought there. The two-the address and the man-were made for one another. Somewhat reluctantly, she mounted the granite steps of her father-in-law's home, eschewed the enormous brass knocker, and pressed the bell. In seconds, the door was opened by a trim, extremely attractive brunette, no more than two or three years Kate's senior. Dressed in a gold blouse and dark straight skirt, she looked every bit the part of the executive secretary, which, in fact, she had at one time been. "Kate, welcome, " she said warmly. "Come in. Let me take your coat."

  "I've got it, thanks. You look terrific, Jocelyn. Is that a new hairstyle?"

  "A few months old. Thanks for noticing. You're looking well yourself."

  Kate wondered if perhaps she and Jocelyn Trent could collaborate on a chapter for Amy Vanderbilt or Emily Post, "Proper Conversation Between a Daughter-in-law and her Father-in-law's Mistress When the Father-in-law in Question Refuses to Acknowledge the Woman as Anything Other Than a Housekeeper."

  "Mr. Samuels will be down in a few minutes, " Jocelyn said. "There's a nice fire going in the study. He'll meet you there. Dinner will be in half an hour. Can I fix you a drink?"

  Mr. Samuels. The inappropriate formality made Kate queasy. At seven o'clock, the woman would serve to Mr. Samuels and his guest the gourmet dinner she had prepared, then she would go and eat in the kitchen. At eleven or twelve o'clock, after the house was quiet and dark, she would slip into his room and stay as long as she was asked, always careful to return to her own quarters before any houseguest awoke. Mr. Samuels, indeed. "Sure, " said Kate, following the woman to the study. "Better make it something stiff. As you can tell from your houseguest the last few days, things have not been going too well in my world."

  Jocelyn smiled understandingly. "For what it's worth, " she said, "I don't think Jared is very pleased with the arrangement either."

  "I appreciate hearing that, Jocelyn. Thank you. I'll tell you, on any given Sunday in any given ballpark, marriage can trounce any team in the league." When she could detach the woman from her position, Kate liked her very much and enjoyed the occasional one-to-one conversations they were able to share. "I know, " Jocelyn said. "I tried it once, myself.

  For me it was all of the responsibility, none of the pleasure." The words were said lightly, but Kate heard in them perhaps an explanation of sorts, a plea for understanding and acceptance. Better to be owned than to be used. Kate took the bourbon and water and watched as Jocelyn Trent returned to the kitchen. The woman had, she knew, a wardrobe several times the size of her own, a remarkable silver fox coat, and a stylish Alfa coupe. If this be slavery, she thought with a smile, then give me slavery. It was, as promised, several minutes before Winfield Samuels made his entrance. Kate waited by the deep, well-used fireplace, rearranging the fringe on the Persian rug with the toe of her shoe and trying to avoid eye contact with any of the big-game heads mounted on the wall. Samuels had sent Jared away on business-purposely, he made it sound — so that he and Kate could spend some time alone together talking over "issues of mutual concern." Before her marriage, they had met on several occasions for such talks, but since, their time together had always included Jared. Samuels had given no hint over the phone as to what the "issues" this time might be, but
the separation-causes and cures-was sure to be high on the list. Kate was reading a citation of commendation and gratitude from the governor when the recipient entered the room. "Kate, welcome, " Win Samuels said. "I'm so glad you could make it on such short notice." They embraced with hands on shoulders and exchanged air kisses. "Sit down, please. We have, " he consulted his watch, "twenty-three minutes before dinner."

  Twenty-three minutes. Kate had to hand it to the man. Dinner at seven did not mean dinner at seven-oh-three. It was expected that the stunning cook cum housekeeper cum mistress would be right on time. "Thank you," she said. "It's good to see you again. You look great."

  The compliment was not exaggeration. In his twill smoking jacket and white silk scarf, Samuels looked like most men nearing seventy could only dream of looking. "Rejuvenate that drink? " Samuels asked, motioning her to one of a pair of matched leather easy chairs by the hearth. "Only if you're prepared to resuscitate me."

  Samuels laughed and drew himself a bourbon and soda. "You're quite a woman, Kate, " he said, settling in across from her. "Jared is lucky to have nabbed you."

  "Actually, I did most of the nabbing."

  "This… this little disagreement you two are having. It will blow over before you know it. Probably has already."

  "The empty half of my bed wouldn't attest to that, " Kate said. Samuels slid a cigar from a humidor by his chair, considered it for a moment, and then returned it. "Bad for the taste buds this close to dinner, particularly with Jocelyn's duck l'orange on the menu."

  "She's a very nice woman, " Kate ventured. Samuels nodded. "Does a good job around here, " he said in an absurdly businesslike tone. "Damn good job." He paused. "I'm a direct man, Kate. Some people say too direct, but I don't give a tinker's damn about them. Suppose I get right to the business at hand."

  "You mean this wasn't just a social invitation?"

  Samuels was leaping to equivocate when he saw the smile in her eyes and at the corners of her mouth. "Do you zing Jared like this, too? " he asked. Kate smiled proudly and nodded. They laughed, but Kate felt no letup in the tension between them. "Kate, " he continued, "I've accomplished the things I've accomplished, gained the things I've gained, because I was brought up to believe that we are never given a wish or a dream without also being given the wherewithal to make that dream, that wish, a reality. Do you share that belief?"

  Kate shrugged. "I believe there are times when it's okay to wish and try and fail."

  "Perhaps, " he said thoughtfully. "Perhaps there are. Anyhow, at this stage in my life, I have two overriding dreams. Both of them involve my son and, therefore, by extension, you."

  "Go on."

  "Kate, I want a grandchild, hopefully more than one, and I want my son to serve in the United States Congress. Those are my dreams, and I am willing to do anything within my power to help them come to pass."

  "Why? " Kate asked. "Why?"

  "Yes. I understand the grandchild wish. Continuation of the family, stability for Jared's home life, new blood and new energy, that sort of thing, but why the other one?"

  "Because I feel Jared would be a credit to himself, to the state, and to the country."

  "So do I."

  "And I think it would be a fulfilling experience for him."

  "Perhaps."

  Samuels hesitated before adding, "And, finally, it is a goal I held for myself and never could achieve. Do you think me horrid for wanting my son to have what I could not?"

  "No, " Kate responded. "Provided it is something Jared wants, too, for reasons independent of yours."

  "The time in life when a father no longer knows what is best for his son is certainly moot, isn't it?"

  "Win, what you want for Jared, what you want for me, too, will always matter. But the hardest part about loving someone is letting him figure out what's best for himself, especially when you already know-or at least think you know."

  "And you think I'm forcing my will on Jared?"

  "You have a tremendous amount of influence on him, " she replied. "I don't think I'm giving away any great secrets by saying that." Samuels nodded thoughtfully. "Kate, " he said finally, "humor this old man and let me change the subject a bit, okay?"

  Old man. Give me a break, counselor, she wanted to snap. Instead she sat forward, smiled, and simply said, "Sure."

  "Why do you want to be the chief of pathology at Metro?" Kate met his gaze levelly and said silent thanks for the hours she had spent answering that question for herself. "Because it would be a fascinating experience. Because I think I could do a credible job.

  Because my work-and my department-mean a great deal to me. Because I feel a person either grows or dies."

  "Jared tells me you feel accepting the position will delay your being able to start your family for at least two years."

  "Actually, I said one or two years, but two seems a reasonable guess."

  Samuels rose slowly and walked to the window and then back to the fire.

  If he was preparing to say something dramatic, she acknowledged, he was doing a laudable job of setting it up. "Kate, " he said, still staring at the fire, "when I phoned, I invited you to stay the night if you could. Are you going to be able to do that?"

  "I had planned on it, yes." Actually, the invitation had been worded in a way that would have made it nearly impossible for her to refuse.

  "Good. I'd like to take you for a ride after dinner. A ride and a visit.

  I… I know I sound mysterious, but for the moment you'll have to indulge me. This is something I never thought I would be doing." There was a huskiness, an emotion to the man's voice that Kate had never heard before. Was he near crying? For half a minute there was silence, save for the low hiss of the fire. But when her father-in-law turned to her, his composure had returned. "Kate, " he said, as if the moment by the fire had never happened, "do you think that you are ready to handle the responsibilities of a whole department?"

  She thought for a moment. "This may sound funny, but in a way it doesn't matter what I think. You see, Dr. Willoughby, the only person who knows both me and the job, thinks I can handle it. It's like becoming a doctor-or, for that matter, a lawyer. You only decide you want to do it. They-the bar or the medical examiners-decide whether or not you can and should. From then on, your only obligation is to do your best."

  She paused. "Does that sound smug?"

  "Not really."

  "I hope not, Win. Because actually I'm scared stiff about a lot of things. I'm frightened of taking the job and I'm frightened of not taking it. I'm frightened of having children and I'm frightened of not having them. And most of all, I am frightened of having to face the dilemma of either losing my husband or losing myself."

  "There are other possibilities, " Samuels said. "I know that, but I'm not sure Jared does, and to be perfectly honest, until this moment, I wasn't sure you did, either."

  "There are always other possibilities, " he said with a tone that suggested he had voiced that belief before. "Kate, you know hospital politics are no different from any other kind of politics. There's power involved and there's money involved, and that means there are things like this handbill involved."

  He took the garish orange flyer from his desk drawer and held it up for her to see. Kate shuddered at the sight of it. "Do you think that brilliant effort was aimed at me or at Jared? " she asked. "The truth is it makes no difference. Politics is politics. The minute you start playing the game you have enemies. If they happen to be better at the game than you are, you get buried. It's that simple."

  He held up the flyer again. "My sense of this whole business-assuming, of course, that you didn't send Bobby Geary's autopsy report to the papers — is that someone is determined to keep you from becoming head of your department. If they have any kind of power, or access to power, your department could suffer dearly."

  "My department?"

  "Certainly. Your people end up overworked because of staffing cutbacks and outmoded equipment. Turnover is high, morale low. Quality of
work drops. Sooner or later there's a mistake. You may be the best pathologist in the world, Kate, and the best-intentioned administrator, but unless you play the politics game and get past the competition to people like the Ashburton Foundation, you will end up an unhappy, harried, unfulfilled failure. And take it from me, winning that game means plenty of sacrifice. It means that if you know the competition is getting up at six, you damn well better be up at five-thirty."

  "I appreciate your thoughts, " she said. "I really do. All I can say is that the final decision hasn't been made yet, and that I was hoping to work the whole thing out with Jared."

  "But you have okayed submission of your name."

  "Yes, " she said, averting her gaze for the first time. "Yes, I have."

  Samuels turned and walked again toward the window. For a time, there was only the fire. "Say, Win, " she said, hoping to lead them in other directions, "how much do you know about the Ashburton Foundation?

  " He turned back to her. "I really don't know anything. In the early days of their involvement here, my firm handled some of their correspondence with the hospital. But I haven't dealt with them in years. Why?"

  "Just some research I've been doing at work. Nothing, really. Do you by any chance have their address?"

  "I don't know, " Samuels said, somewhat distractedly. "In the Rolodex over there on my desk, perhaps. I really don't know. Kate, you know it is my way to reason, not to beg. But for the sake of my son and myself, if not for yourself, I'm begging you to put the chairmanship on the back burner and devote yourself for a few years to your family and to helping Jared get his foot in the political door."

  At that instant, a chime sounded from the kitchen. Kate glanced instinctively at her watch, but she knew that it was exactly seven o'clock. She rose. "When is Jared due back? " she asked. "Wednesday or Thursday, I suspect."