“Thirty,” Engleson answered. “No deliveries, no pregnancies, and in fact, no ovaries.”
“What?”
“Oh, they’re there. But they’re unlike any ovaries I’ve ever seen before. Dr. Bartholomew was with me—the woman is his patient—and he has never seen pathology like this either.”
Kate pulled a high stool from beneath the counter and wrapped one foot around its leg. “Explain,” she said.
“Well, whatever this is is uniform and symmetrical. We took a slice from the left ovary, but it could just as well have been the right. Shrunken, the consistency of … of a squash ball—sort of hard but rubbery. The surface is pockmarked, dimpled.”
“What color?” Kate had written down almost every word.
“Gray. Grayish brown, maybe.”
“Interesting,” she said.
“Does what I’ve described ring any bells?”
“No. At least not right off. However, there are a number of possibilities. Any idea as to why this woman was having menorrhagia?”
“Two reasons. One is a platelet count of just forty-five thousand, and the other is a fibrinogen level that is fifteen percent of normal.”
“An autoimmune phenomenon?” Kate searched her thoughts for a single disease entity characterized by the two blood abnormalities. An autoimmune phenomenon, the body making antibodies against certain of its own tissues, seemed likely.
“So far, that’s number one on the list,” Engleson said. “The hematology people have started her on steroids.”
“Was she on any medications?”
“Hey, Kate.” It was Jared calling from the living room. “Do you smell something burning?”
“Nothing but vitamins,” Engleson answered.
Kate did not respond. Receiver tucked under her ear, she was at the oven, pulling out a tray of four blackened lumps that had once been shirred eggs—Jared’s favorite.
“Shit,” she said.
“What?” Both Jared and Tom Engleson said the word simultaneously.
“Oh, sorry. I wasn’t talking to you.” A miniature cumulonimbus cloud puffed from the oven. “Jared, it’s all right,” she called out, this time covering the mouthpiece. “It’s just … our meal. That’s all.”
“Dr. Bennett, if you’d rather I called back …”
“No, Tom, no. Listen, there’s a histology technician on call. The lab tech on duty knows who it is. Have whoever it is come in and begin running the specimen through the Technichron. That way it will be ready for examination tomorrow rather than Tuesday. Better still, ask them to come into the lab and call me at home. I’ll give the instructions myself. Okay?”
“Sure. Thanks.”
“No problem,” she said, staring at the lumps. “I’ll speak to you later.”
“Shirred eggs?” Jared, wrapped in the cashmere blanket, leaned against the doorway. Roscoe peered at her from between his knees.
Kate nodded sheepishly. “I sort of smelled the smoke, but my one-track brain was focused on what this resident from the hospital was saying, and somehow, it dismissed the smoke as coming from the wood stove. I … I never was too great at doing more than one thing at once.”
“Too bad you couldn’t have chosen to let the resident burn to a crisp and save the eggs,” he said.
“Next time.”
“Good. Any possibilities for replacements?”
“Howard Johnson’s?”
“Thanks, but I’ll take my chances with some coffee and whatever’s in that frying pan. You sure that wasn’t Yoda on the phone?”
“Jared …”
He held up his hands against her ire. “Just checking, just checking,” he said. “Come on, Roscoe. Let’s go set the table.”
Kate noted the absence of an apology, but decided that two in one day was too much to ask. More difficult to accept, however, was Jared’s apparent lack of interest in what the call was about. It was as if by not talking about her career, her life outside of their marriage, he was somehow diminishing its importance. In public, he took special pride in her professionalism and her degree. Privately, he accepted it as long as it didn’t burn his eggs. Almost against her will, she felt frustration begin to dilute the warmth and closeness generated by their lovemaking. She walked to where her clothes were piled in the living room and dressed, silently vowing to do whatever she could to avoid another blowup that day.
Minutes later, the crunch of tires on their gravel driveway heralded a test of her resolve. Roscoe heard the arrival first and bounded from his place by the stove to the front door. Jared, now in denims and a flannel work shirt, followed.
“Hey, Kate, it’s Sandy,” he called out, opening the inside door.
“Sandy?” Dick Sandler, Jared’s roommate at Dartmouth, had been best man at their wedding. A TWA pilot, he lived on the South Shore and hadn’t been in touch with them for several months. “Is Ellen with him?”
“No. He’s alone.” Jared opened the storm door. “Hey, flyboy,” he called in a thick Spanish accent, “welcome. I have just what you want, señor: a seexteen-year-old American virgin. Only feefty pesetas.”
Sandler, a rugged Marlon Brando type, exchanged bear hugs with Jared and platonic kisses with Kate, and then scanned what there was of their brunch. “What, no bloodies?”
Kate winced before images of the two men, emboldened by a few “bloodies,” exchanging off-color jokes she seldom thought were funny and singing “I Wanna Go Back to Dartmouth, to Dartmouth on the Hill.” Invariably, she would end up having to decide whether to leave the house, try to shut them off, or join in. When Ellen Sandler was around, no such problem existed. A woman a few years older than Kate, and Sandy’s wife since his graduation, Ellen was as charming, interesting, and full of life as anyone Kate had ever known. She was a hostess with poise and grace, the mother of three delightful girls, and even a modestly successful businesswoman, having developed an interior design consulting firm that she had run alone for several years from their home and more recently from a small studio cum office in town.
Sandy, with his flamboyance, his stature as a 747 captain, and his versatile wit, was the magnet that drew many fascinating and accomplished people into the Sandlers’ social circle. Ellen, Kate believed, was the glue that kept them there.
“So, Sandy,” she said, dropping a celery stick into his drink and sliding it across the table, “what brings you north of Boston? How are Ellen and the girls?” It was at that moment that she first appreciated the sadness in his eyes.
“I … well actually, I was just driving around and decided to cruise up here. Sort of a whim. I … I needed to talk to Jared … and to you.”
“You and Ellen?” Jared’s sense of his friend told him immediately what to ask.
“I … I’m leaving her. Moving out.” Sandler stared uncomfortably into the center of his drink.
At his words, Kate felt a dreadful sinking in her gut. Ellen had stated on many occasions and in many ways the uncompromising love she bore for the man. How long had they been married, now? Eighteen years? Nineteen, maybe?
“Holy shit,” Jared whispered, setting a hand on Sandler’s forearm. “What’s happened?”
“Nothing. I mean nothing dramatic. Somewhere along the way, we just lost one another.”
“Sandy, people who have been married for almost twenty years don’t just lose one another,” Kate said. “Now what has happened?” There was an irritability in her voice which surprised her. Jared’s expression suggested that he, too, was startled by her tone.
Sandler shrugged. “Well, between running the house and entertaining and taking the girls to one lesson or another and scouts and committees at our club and that business of hers, Ellen simply ran out of energy for me. In some areas, meals and such, she still goes through the motions, but without much spark.”
“How is Ellen handling all this?” Kate asked, checking Jared’s face for a sign that she might be interloping with too many questions. The message she received was noncommittal.
“What?” Her exclamation this time drew a be careful glare.
“I just decided yesterday. But I’ve been thinking about it for weeks. Longer. I was hoping you two might have some suggestions as to how I should go about breaking the news to her.”
“Have you been to a counsellor or a shrink or something?” Jared asked the question.
“It’s too late.”
“What do you mean? You just said Ellen doesn’t even know what you’re planning to do.” Jared sounded baffled.
Across the table, Kate closed her eyes. She knew the explanation.
“There’s someone else,” Sandler said self-consciously. “A flight attendant. I … we’ve been seeing one another for some time.”
For Kate the words were like needle stabs. Jared was pressing to get a commitment from her to alter her life along pathways Ellen Sandler could negotiate blindfolded. Yet here was Sandy, like Jared in so many ways, rejecting the woman for not devoting enough energy to him. The image of Ellen sitting there while he announced his intentions made her first queasy and then frightened. The fear, as happened more often than not, mutated into anger before it could be expressed.
“Ellen doesn’t deserve this,” she said, backing away from the table. “ ‘We just lost one another.’ Sandy, don’t you think that’s sort of a sleazy explanation for what’s really going on? How old is this woman?”
“Twenty-six. But I don’t see what her …”
“I know you don’t see. You don’t see a lot of things.”
Jared stood up. “Now just one second, Kate.”
“And you don’t see a lot of things either, dammit.” There were tears streaming down her face. “You two boys work out how you’re gonna break the news to Ellen that she did everything she goddamn well could in life—more than both of you put together, probably—but that it just wasn’t enough. She’s fired. Dismissed. Not flashy enough. Not showy enough. Her services are no longer required. Excuse me, I’m going to the bathroom to get sick. Then I’m going to my hospital. People there are grateful and appreciative for the things I do well. I like that. It helps me to get up in the morning.”
Fists clenched, she turned and raced from the room. Roscoe, who had settled himself under the table, padded to the center of the room and after a brief glance at the men, followed.
Ginger Rittenhouse, a first-grade teacher, had just finished her run by the ice-covered Charles River when she began to die. Like the random victim of a crazed sniper, she did not hear the sound or see the muzzle flash of the weapon that killed her. In fact, the weapon was nothing more malevolent than the corner of her bureau drawer; the shot, an accidental bump less than twenty-four hours before to a spot just above her right ear.
“That’s one incredible lump!” her new roommate had exclaimed, forcing an icepack against the golfball-sized knot. The woman, a licensed practical nurse, had commented on the large bruise just below her right knee as well. Ginger was too self-conscious to mention the other, similar bruises on her lower back, buttocks, and upper arm.
Her death began with a tic—an annoying electric sensation deep behind her right eye. The wall of her right middle cerebral artery was stretching. Bruised by the shock from the bureau drawer, the vessel, narrow as a piece of twine, had developed a tiny defect along the inner lining. The platelets and fibrinogen necessary to patch the defect were present, but in insufficient amounts to do the job. Blood had begun to work its way between the layers of the vessel wall.
Squinting against the pain, she sat on a bench and looked across the river at the General Electric building in Cambridge. The outline of the building seemed blurred. From the rent in her right middle cerebral artery, blood had begun to ooze, a microdrop at a time, into the space between her skull and brain. Nerve fibers, exquisitely sensitive, detected the intrusion and began screaming their message of warning. Ginger, mindless of the huge lump over her ear, placed her hands on either side of her head and tried to squeeze the pain into submission.
Powered by the beating of her own heart, the bleeding increased. Her thoughts became disconnected snatches. The low skyline of Cambridge began to fade. Behind her, runners jogged by. A pair of lovers passed close enough to read the dial on her watch. Ginger, now paralyzed by pain that was far more than pain, was beyond calling for help.
Suddenly, a brilliant white light replaced the agony. The heat from the light bathed the inside of her eyes. Her random thoughts coalesced about woods and a stream. It was the Dingle, the secret hiding place of her childhood. She knew every tree, every rock. Home and safe at last, Ginger Rittenhouse surrendered to the light, and gently toppled forward onto the sooty snow.
2
Monday 10 December
First there was the intense, yellow-white light—the sunlight of another world. Then, subtly, colors began to appear: reds and pinks, purples and blues. Kate felt herself drifting downward, Alice drawn by her own curiosity over the edge and down the rabbit’s hole. How many times had she focused her microscope in on a slide? Tens of thousands, perhaps even hundreds of thousands. Still, every journey through the yellow-white light began with the same sense of anticipation as had her first.
The colors darkened and coalesced into a mosaic of cells; the cells of Beverly Vitale’s left ovary, chemically fixed to prevent decay, then embedded in a block of paraffin, cut thin as a slick of oil, and finally stained with dyes specific for coloring one or another structure within the cell. Pink for the cytoplasm; mottled violet for the nuclei; red for the cell walls.
With a deep breath calculated at once to relax herself and to heighten her concentration, she focused the lenses and her thoughts on the cells, now magnified a thousand times. Her efforts were less successful than usual. Thoughts of Sandy and Ellen, of Jared and the discussion they had had following her return from the hospital the previous night, continued to intrude.
She had come home late, almost eleven, after meeting with Tom Engleson, interviewing Beverly Vitale, examining the frozen section of her ovary, and finally spending an hour in the hospital library. Her expectations had been to find the former roommates in the den, comatose or nearly so, with the essence of a half a case of Lowenbräu permeating the room. Instead, she had found only a somber and perfectly sober Jared.
“Hi,” he said simply.
“Hi, yourself.” She kissed him on the forehead and then settled onto the ottoman by his chair. “When did Sandy leave?”
“A couple of hours ago. Did you get done whatever it is you wanted to?”
Kate nodded. His expression was as flat and as drained as his words. No surprise, she realized. First his wife stalks out of the house with no real explanation; then he has to listen to the agonies of the breakup of his best friend’s marriage. “I … I guess I owe you an apology for the way I acted earlier. Some sort of explanation.”
Jared shrugged. “I’ll take the apology. The explanation’s optional.”
“I’m sorry for leaving the way I did.”
“I’m sorry you left the way you did, too. I could have used some help—at least some moral support.”
“Sorry again.” The three feet separating them might as well have been a canyon. “Anything decided?”
“He went home to tell Ellen and to move out, I guess. It got awful quiet here after you left. Neither of us was able to open up very well. We each seemed to be wrapped up in our own bundle of problems.”
“Three I’m sorries. That’s my limit.” She unsnapped her barrette, shook her hair free, and combed it out with her fingers. The gesture was natural enough, but at some level she knew she had done it because it was one Jared liked. “After what happened this morning—in the car, I mean—I couldn’t listen to Sandy just brush off Ellen and their marriage the way he did. I mean, here I am, scrambling to do a decent job with my career and to be a reasonably satisfying friend and wife to you, and there’s Ellen able to do both of those so easily and raise three beautiful, talented children to boo
t, and …”
“It’s not right what you’re doing, Kate.”
“What’s that?”
“You’re comparing your insides to Ellen’s outsides, that’s what. She looks good. I’ll give you that. But don’t go and cast Sandy as the heavy just because he’s the one moving out. There are things that are missing from that relationship. Maybe things too big to overcome. What’s that got to do with our discussion this morning, anyway?”
“Jared, you know perfectly well what it has to do. Having children is a major responsibility. As it is, I feel like a one-armed juggler half the time. Our lives, our jobs, the things we do on our own and together … Toss in a baby at this point, and what guarantee is there I won’t start dropping things?”
“What do you want me to say? I’m almost forty years old. I’m married. I want to have children. My wife said she wanted to have children, too. Now, all of a sudden, having children is a threat to our marriage.”
“Christ, Jared, that’s not what I mean … and you know it. I didn’t say I won’t have children. I didn’t say it’s a threat to our marriage. All I’m trying to say is there’s a lot to think about—especially with the opportunities that have arisen at the hospital. It’s not the idea I’m having trouble with so much as the timing. A mistake here and it’s a bitter, unfulfilled woman, or a neurotic, insecure kid, or … or a twenty-six-year-old stewardess. Can you understand that?”
“I understand that somewhere inside you there are some issues you’re not facing up to. Issues surrounding me or having children or both.”
“And you’ve got it all together, right?” Kate struggled to stop the tears that seemed to be welling from deep within her chest.
“I know what I want.”
“Well, I don’t. Okay? And I’m the one who’s going to have to pass up a chairmanship and go through a pregnancy and change my life so that I don’t make the same horrible mistakes with our child that my mother made with us. I … Jared, I’m frightened.” It was, she realized, the first time she had truly recognized it.
Side Effects (1984) Page 5
