by Robin Cook
A few hours later when Sean had had a few drafts, and he was feeling more mellow and less an outcast, he joined in the raucous decisionmaking involving a trip up to Revere to one of the strip joints near the waterfront. Just at the moment the debate was reaching a frenzied climax, the entire bar went dead silent. One by one heads turned toward the front door. Something extraordinary had happened, and everyone was shocked. A woman had breached their all-male bastion. And it wasn’t an ordinary woman, like some overweight, gum-chewing girl in the laundromat. It was a slim, gorgeous woman who obviously wasn’t from Charlestown.
Her long blond hair glistened with diamonds of moisture, and it contrasted dramatically with the rich deep mahogany of her mink jacket. Her eyes were almond shaped and pert as they audaciously scanned the room, leaping from one stunned face to another. Her mouth was set in determination. Her high cheekbones glowed with color. She appeared like a collective hallucination of some fantasy female.
A few of the guys shifted nervously, guessing that she was someone’s girlfriend. She was too beautiful to be anyone’s wife.
Sean was one of the last faces to turn. And when he did, his mouth dropped open. It was Janet!
Janet spotted him about the same time he saw her. She walked directly up to him and pushed in beside him at the bar. Brady moved away, making an exaggerated gesture of terror as if Janet were a fearful creature.
“I’d like a beer, please,” she said.
Without answering, Molly filled a chilled mug and placed it in front of Janet.
The room remained silent except for the television.
Janet took a sip and turned to look at Sean. Since she was wearing pumps she was just about eye level. “I want to talk with you,” she said.
Sean hadn’t felt this embarrassed since he’d been caught with his pants off at age sixteen with Kelly Parnell in the back of her family’s car.
Putting his beer down, Sean grasped Janet by her upper arm, just above the elbow, and marched her out the door. When they got out on the sidewalk Sean had recovered enough to be angry. He was also a little tipsy.
“What are you doing here?” he demanded.
Sean allowed his eyes to sweep around the neighborhood. “I don’t believe this. You know you weren’t supposed to come here.”
“I knew nothing of the kind,” Janet said. “I knew I wasn’t invited, if that’s what you mean. But I didn’t think my coming constituted a capital offense. It’s important I talk with you, and with you leaving on Sunday, I think it’s more important than drinking with these so-called friends of yours.”
“And who is making that value judgment?” Sean demanded. “I’m the one who decides what is important to me, not you, and I resent this intrusion.”
“I need to talk to you about Miami,” Janet said. “It’s your fault you’ve waited until the last minute to tell me.”
“There’s nothing to talk about,” Sean said. “I’m going and that’s final. Not you, not my mother, and not my brother are going to stop me. Now if you’ll excuse me, I have to go back in and see what I can salvage of my self-respect.”
“But this can impact the rest of our lives,” Janet said. Tears began to mix with the rain running down her cheeks. She’d taken an emotional risk coming to Charlestown, and the idea of rejection was devastating.
“I’ll talk with you tomorrow,” Sean said. “Good night, Janet.”
TED SHARENBURG was nervous, waiting for the doctors to tell him what was wrong with his daughter. His wife had gotten in touch with him in New Orleans where he’d been on business, and he had gotten the company Gulfstream jet to fly him directly back to Houston. As the CEO of an oil company that had made major contributions to the Houston hospitals, Ted Sharenburg was afforded special treatment. At that moment his daughter was inside the huge, multimillion-dollar MRI machine having an emergency brain scan.
“We don’t know much yet,” Dr. Judy Buckley said. “These initial images are very superficial cuts.” Judy Buckley was the chief of neuroradiology and had been happy to come into the hospital at the director’s request. Also in attendance were Dr. Vance Martinez, the Sharenburgs’ internist, and Dr. Stanton Rainey, chief of neurology. It was a prominent group of experts to be assembled at any hour, much less at one o’clock in the morning.
Ted paced the tiny control room. He couldn’t sit still. The story he’d been told about his daughter had been devastating.
“She experienced an acute paranoid psychosis,” Dr. Martinez had explained. “Symptoms like that can occur, especially with some sort of involvement of the temporal lobe.”
Ted reached the end of the room for the fiftieth time and turned. He looked through the glass at the giant MRI machine. He could just barely see his daughter. It was as if she were being swallowed by a technological whale. He hated being so helpless. All he could do was watch, and hope. He’d felt almost as vulnerable when she’d had her tonsils out a few months earlier.
“We’ve got something,” Dr. Buckley said.
Ted hurried over to the CRT screen.
“There’s a hyperintense circumscribed area in the right temporal lobe,” she said.
“What does it mean?” Ted demanded.
The doctors exchanged glances. It was not customary for the relative of a patient to be in the room during such a study.
“It’s probably a mass lesion,” Dr. Buckley said.
“Can you put that in lay terms?” Ted asked, trying to keep his voice even.
“She means a brain tumor,” Dr. Martinez said. “But we know very little at this point, and we should not jump to conclusions. The lesion might have been there for years.”
Ted swayed. His worst fears were materializing. Why couldn’t he be in that machine and not his daughter?
“Uh oh!” Dr. Buckley said, forgetting the effect such an exclamation would have on Ted. “Here’s another lesion.”
The doctors clustered around the screen, transfixed by the vertically unfolding images. For a few moments they forgot about Ted.
“You know it reminds me of the case I told you about in Boston,” said Dr. Rainey. “A young woman in her twenties with multiple intracranial tumors and negative metastatic workup. She was proved to have medulloblastoma.”
“I thought medulloblastoma occurs in the posterior fossa,” Dr. Martinez said.
“It usually does,” Dr. Rainey said. “It also usually occurs in younger kids. But twenty percent or so of the incidents are in patients over twenty, and it’s occasionally found in regions of the brain besides the cerebellum. Actually, it would be wonderful if it turns out to be medulloblastoma in this case.”
“Why?” Dr. Buckley asked. She was aware of the high mortality of the cancer.
“Because a group down in Miami has had remarkable success in getting remissions with that particular rumor.”
“What’s their name?” Ted demanded, clutching onto the first hopeful news he’d heard.
“The Forbes Cancer Center,” Dr. Rainey said. “They haven’t published yet but word of that kind of a result gets around.”
3
March 2
Tuesday, 6:15 A.M.
When Tom Widdicomb awoke at 6:15 to begin his workday, Sean Murphy had already been on the road for several hours, planning on reaching the Forbes Cancer Center by mid-morning. Tom did not know Sean, and had no idea he was expected. Had he known that their lives would soon intersect, his anxiety would have been even greater. Tom was always anxious when he decided to help a patient, and the night before he’d decided to help not one but two women. Sandra Blankenship on the second floor would be the first. She was in great pain and already receiving her chemotherapy by IV. The other patient, Gloria D’Amataglio, was on the fourth floor. That was a bit more worrisome since the last patient he’d helped, Norma Taylor, had also been on the fourth floor. Tom didn’t want any pattern to emerge.
His biggest problem was that he constantly worried about someone suspecting what he was doing, and on a day that he wa
s going to act, his anxiety could be overwhelming. Still, sensitive to gossip on the wards, he’d heard nothing that suggested that anyone was suspicious. After all, he was dealing with women who were terminally ill. They were expected to die. Tom was merely saving everyone from additional suffering, especially the patient.
Tom showered, shaved, and dressed in his green uniform, then went into his mother’s kitchen. She always got up before he did, insistent every morning as far back as he could remember that he should eat a good breakfast since he wasn’t as strong as other boys. Tom and his mother, Alice, had lived together in their close, secret world from the time Tom’s dad died when Tom was four. That was when he and his mother had started sleeping together, and his mother had started calling him “her little man.”
“I’m going to help another woman today, Mom,” Tom said as he sat down to eat his eggs and bacon. He knew how proud his mother was of him. She had always praised him even when he’d been a lonely child with eye problems. His schoolmates had teased him mercilessly about his crossed eyes, chasing him home nearly every day.
“Don’t worry, my little man,” Alice would say when he’d arrive at the house in tears. “We’ll always have each other. We don’t need other people.”
And that was how things worked out. Tom had never felt any desire to leave home. For a while, he worked at a local veterinarian’s. Then at his mother’s suggestion, since she’d always been interested in medicine, he’d taken a course to be an EMT. After his training, he got a job with an ambulance company but had trouble getting along with the other workers. He decided he would be better off as an orderly. That way he wouldn’t have to relate to so many people. First he’d worked at Miami General Hospital but got into a fight with his shift supervisor. Then he worked at a funeral home before joining the Forbes housekeeping staff.
“The woman’s name is Sandra,” Tom told his mother as he ran his dish under the faucet at the sink. “She’s older than you. She’s in a lot of pain. The ‘problem’ has spread to her spine.”
When Tom spoke to his mother, he never used the word “cancer.” Early in her illness, they’d decided not to say the word. They preferred less emotionally charged words like “problem” or “difficulty.”
Tom had read about succinylcholine in a newspaper story about some doctor in New Jersey. His rudimentary medical training afforded an understanding of the physiologic principles. His freedom as a housekeeper allowed him contact with anesthesia carts. He’d never had any problem getting the drug. The problem had been where to hide it until it was needed. Then one day he found a convenient space above the wall cabinets in the housekeeping closet on the fourth floor. When he climbed up and looked into the area and saw the amount of accumulated dust, he knew his drug would never be disturbed.
“Don’t worry about anything, Mom,” Tom said as he prepared to leave. “I’ll be home just as soon as I can. I’ll miss you and I love you.” Tom had been saying that ever since he had gone to school, and just because he’d had to put his mother to sleep three years ago, he didn’t feel any need to change.
IT WAS almost ten-thirty in the morning when Sean pulled his 4×4 into the parking area of the Forbes Cancer Center. It was a bright, clear, summer-like day. The temperature was somewhere around seventy, and after the freezing Boston rain Sean felt he was in heaven. He’d enjoyed the two-day drive, too. He could have made it faster, but the clinic wasn’t expecting him until late that day so there’d been no need. He spent his first night in a motel just off 195 in Rocky Mount, North Carolina.
The next day had taken him deep into Florida where the depth of spring seemed to increase with every passing mile. The second night had been spent in perfumed delight near Vero Beach, Florida. When he asked the motel clerk about the wonderful aroma in the air he was told it came from the nearby citrus groves.
The last lap of the journey turned out to be the most difficult. From West Palm Beach south, particularly near Fort Lauderdale and into Miami, he fought rush-hour traffic. To his surprise even eight-laned 195 coagulated into a stop-and-go mess.
Sean locked his car, stretched, and gazed up at the imposing twin bronzed, mirrored towers of the Forbes Cancer Center. A covered pedestrian bridge constructed of the same material connected the buildings. He noted from the signs that the research and administration center was on the left while the hospital was on the right.
As Sean started for the entrance, he thought about his first impressions of Miami. They were mixed. As he’d come south on 195 and neared his turnoff, he’d been able to see the gleaming new downtown skyscrapers. But the areas adjacent to the highway had been a melange of strip malls and low-income housing. The area around the Forbes Center, which was situated along the Miami River, was also rather seedy although a few modern buildings were interspersed among the flat-roofed cinder block structures.
As Sean pushed through the mirrored door, he thought wryly about the difficulty everyone had given him about this two-month elective. He wondered if his mother would ever get over the traumas he’d caused her as an adolescent. “You’re too much like your father,” she’d say, and it was meant as a reproach. Except for enjoying the pub, Sean felt little similarity with his father. But then he had been presented with far different choices and opportunities than his father ever had.
A black felt sign stood on an easel just inside the door. Spelled out in white plastic letters was his name and a message: Welcome. Sean thought it was a nice touch.
There was a small lounge directly behind the front door. Entrance into the building itself was blocked by a turnstile. Next to the turnstile was a Corian-covered desk. Behind the desk sat a swarthy, handsome Hispanic man dressed in a brown uniform complete with epaulets and peaked military-style hat. The outfit reminded Sean of a cross between those seen in Marine recruitment posters and those seen in Hollywood Gestapo movies. An elaborate emblem on the guard’s left arm said “Security” and the name tag above his left pocket proclaimed that his name was Martinez.
“Can I help you?” Martinez asked in heavily accented English.
“I’m Sean Murphy,” Sean said, pointing to the welcome sign.
The guard’s expression did not change. He studied Sean for a beat then picked up one of several telephones. He spoke in rapid, staccato Spanish. After he hung up he pointed to a nearby leather couch. “A few moments, please.”
Sean sat down. He picked up a copy of Science from a low coffee table and idly flipped the pages. But his attention was on Forbes’ elaborate security system. Thick glass partitions separated the waiting area from the rest of the building. Apparently the guarded turnstile provided the only entrance.
Since security was all too frequently neglected in health care institutions, Sean was favorably impressed and said as much to the guard.
“There are some bad areas nearby,” the guard replied but didn’t elaborate.
Presently a second security officer appeared, dressed identically to the first. The turnstile opened to allow him into the lounge.
“My name is Ramirez,” the second guard said. “Would you follow me, please.”
Sean got to his feet. As he passed through the turnstile he didn’t see Martinez press any button. He guessed the turnstile was controlled by a foot pedal.
Sean followed Ramirez for a short distance, turning into the first office on the left. “Security” was printed in block letters on the open door. Inside was a control room with banks of TV monitors covering one wall. In front of the monitors was a third guard with a clipboard. Even a cursory glance at the monitors told Sean that he was looking at a multitude of locations around the complex.
Sean continued to follow Ramirez into a small windowless office. Behind the desk sat a fourth guard who had two gold stars attached to his uniform and gold trim on the peak of his hat. His name tag said: Harris.
“That will be all, Ramirez,” Harris said, giving Sean the feeling he was being inducted into the army.
Harris studied Sean who stared back. There w
as an almost immediate feeling of antipathy between the men.
With his tanned, meaty face, Harris looked like a lot of people Sean had known in Charlestown when he was young. They usually had jobs of minor authority that they practiced with great officiousness. They were also nasty drunks. Two beers and they’d want to fight about a call a referee had made on a televised sporting event if you suggested you disagreed with their perception. It was crazy. Sean had learned long ago to avoid such people. Now he was standing across the desk from one.
“We don’t want any trouble here,” Harris was saying. He had a faint southern accent.
Sean thought that was a strange way to begin a conversation. He wondered what this man thought he was getting from Harvard, a parolee? Harris was in obvious good physical shape, his bulging biceps straining the sleeves of his short-sleeved shirt, yet he didn’t look all that healthy. Sean toyed with the idea of giving the man a short lecture on the benefits of proper nutrition, but thought better of the idea. He could still hear Dr. Walsh’s admonitions.
“You’re supposed to be a doctor,” Harris said. “Why the hell are you wearing your hair so long? And I’d hazard to say that you didn’t shave this morning.”
“But I did put on a shirt and tie for the occasion,” Sean said. “I thought I was looking quite natty.”
“Don’t mess with me, boy,” Harris said. There was no sign of humor in his voice.
Sean shifted his weight wearily. He was already tired of the conversation and of Harris.
“Is there some particular reason you need me here?”
“You’ll need a photo ID card,” Harris said. He stood up and came around from behind the desk to open a door to a neighboring room. He was several inches taller than Sean and at least twenty pounds heavier. In hockey Sean used to like to block such guys low, coming up fast under their shins.
“I’d suggest you get a haircut,” Harris said, as he motioned for Sean to pass into the next room. “And get your pants ironed. Maybe then you’ll fit in better. This isn’t college.”
