Artropods and Human Disease 17 page

“Yes, I do. But I can get a job.”

Gently he said, “With a baby?”

There was a moment’s silence. Then Elizabeth said softly, “We may not have a baby.”

The door opened noiselessly and Nurse Wilding came in. She glanced at Elizabeth’s red-rimmed eyes, then discreetly avoided them. To John she said, “If you like, Mr. Alexander, I’ll take you to see your baby now.”

After he had left John Alexander at the nursing station Dr. Dornberger had headed for the hospital nursery.

The nursery lay at one end of a long, bright corridor, decorated cheerfully in pastel shades. It was in a section of the building which had been remodeled two years earlier and reflected the newer trend to spaciousness and light. Approaching, Dornberger could hear, as always, the cries of infants, ranging in pitch and volume from full-lunged, anguished howls to tentative falsettos. More out of habit than thought, he stopped to glance through the thick glass paneling which screened the nursery’s main area on three sides. Business, he reflected, noting the preponderance of occupied bassinets, appeared as brisk as ever. His glance ranged over the orderly rows.

These, he thought, were the normal, healthy animals who had won, for the moment, their battle for existence and in a few days more would go outward and onward into the waiting world. Their destinations were the home, the school, the strife of living, the competition for fame and possessions. Among these were some who would taste success and suffer failure; who, barring casualty, would enjoy youth, accept middle age, and grow old sadly. These were those for whom more powerful and glossier automobiles would be designed, in whose service aircraft would wing faster and farther, whose every whim and appetite would be wooed by others of their kind with wares to market. These were some who would face the unknown future, most with misgiving, many bravely, a few craven. Some here, perhaps, might breach the barriers of outer space; others with the gift of tongues might move their fellow men to anger or despair. Most, within twenty years, would fulfill their physical maturity, obeying, but never understanding, the same primeval craving to copulate which had sown their seed and brought them, mewling, puking, here. But for now these were the victors—the born and urgent. Their first and greatest barrier was down, the other battles yet to come.

Across the hallway was another area with a smaller nursery beyond. In it, quiet and separate, each in an incubator, were the premature babies; these—the doubtful starters, their existence insecure, their first encounter not yet won. Turning away from the main nursery, it was this section that Dornberger entered now.

When he had viewed his newest patient—a tiny fragment of insecure humanity—he pursed his lips and shook his head doubtfully. Then, methodical as always, he wrote careful instructions on the treatment to be followed.

Later, as Dornberger left by one door, Nurse Wilding and John Alexander came in by another.

Like everyone who approached the premature nursery, they had put on sterile gowns and face masks, even though plate glass separated them from the air-conditioned, humidity-controlled interior. Now, as they stopped, Mrs. Wilding leaned forward and tapped lightly on the glass. A younger nurse inside looked up and moved toward them, her eyes above the mask inquiring.

“Baby Alexander!” Wilding raised her voice enough to carry through to the other nurse, then pointed to John. The girl inside nodded and motioned for them to move. They followed her the length of the plate-glass window and stopped. Now she pointed to an incubator—one of the dozen the nursery contained—and turned it slightly so they could see inside.

“My God! Is that all?” The exclamation was torn from John even as it framed itself in mind.

Nurse Wilding’s glance was sympathetic. “He’s not very big, is he?”

John was staring as if in unbelief. “I’ve never seen anything so . . . so incredibly small.”

He stood looking down into the Isolette cabinet. Could this be human?—this tiny, shriveled, monkeylike figure, little larger than his own two hands.

The baby lay perfectly still, its eyes closed, only a slight regular movement of the tiny chest testifying to its breathing. Even in the incubator, designed for the smallest infants, the little helpless body appeared forlorn and lost. It seemed incredible that in such fragility life could exist at all.

The younger nurse had come outside to join them. Wilding asked, “What was the birth weight?”

“Three pounds eight ounces.” The young nurse turned to John. “Do you understand what’s happening, Mr. Alexander—how your baby is being cared for?”

He shook his head. He found it hard to tear his eyes away, even for a moment, from the tiny child.

The young nurse said practically, “Some people like to know. They seem to think it helps.”

John nodded. “Yes; if you’d tell me. Please.”

The nurse pointed to the incubator. “The temperature inside is always ninety-eight degrees. There’s oxygen added to the air—about 40 per cent. The oxygen makes it easier for the baby to breathe. His lungs are so small, you see. They weren’t really developed when he was born.”

“Yes. I understand.” His eyes were back on the faint pulsing movement in the chest. While it continued it meant there was life, that the tiny burdened heart was beating, the thread of survival still unbroken.

The nurse went on. “Your baby isn’t strong enough to suck, so we have to use intubation. You see the little tube?” She pointed to a plastic cord with a hollow center which ran from the top of the incubator into the infant’s mouth. “It goes directly into the stomach. He’ll be having dextrose and water through the tube every hour and a half.”

John hesitated. Then he asked, “You’ve seen a lot of these cases?”

“Yes.” The nurse nodded gravely, as if sensing the question which would follow. He noticed she was petite and pretty, with red hair tucked under her cap. She was surprisingly young, too; perhaps twenty, certainly no more. But she carried an air of professional competence.

“Do you think he’ll live?” He glanced down again through the paneled glass.

“You can never tell.” The younger nurse’s forehead was creased in a frown. He could sense that she was trying to be honest, not to destroy his hopes and yet not to raise them. “Some do; some don’t. Sometimes it seems as if some babies have a will to live. They fight for life.”

He asked her, “This one—is he fighting?”

She said carefully, “It’s too early to know. But those extra eight weeks would have made a lot of difference.” She added quietly, “This will be a hard fight.”

Once more he let his eyes stray back to the tiny figure. For the first time the thought occurred to him: This is my son, my own, a part of my life. Suddenly he was consumed by a sense of overwhelming love for this fragile morsel, fighting his lonely battle inside the warm little box below. He had an absurd impulse to shout through the glass: You’re not alone, son; I’ve come to help. He wanted to run to the incubator and say: These are my hands; take them for your strength. Here are my lungs; use them and let me breathe for you. Only don’t give up, son; don’t give up! There’s so much ahead, so much we can do together—if only you’ll live! Listen to me, and hold on! This is your father and I love you.

He felt Nurse Wilding’s hand on his arm. Her voice said gently, “We’d better go now.”

He nodded, unable to speak. Then with a last glance backward they moved away.

Lucy Grainger knocked and went into the pathology office. Joe Pearson was behind his desk, David Coleman on the far side of the room, studying a file. He turned as Lucy entered.

“I have the new X-rays,” Lucy said, “on Vivian Loburton.”

“What do they show?” Pearson was interested at once. He pushed some papers aside and got up.

“Very little, I’m afraid.” Lucy had moved to the X-ray viewer which hung on the office wall, and the two men followed her. Coleman reached out and snapped a switch; after a second or two the fluorescent lights in the viewer flickered on.

Two at a time, they studied the comparative films. Lucy pointed out, as Dr. Bell had done in Radiology, the area of periosteal reaction created by the biopsy. Otherwise, she reported, there had been no change.

At the end Pearson thoughtfully rubbed his chin with thumb and forefinger. Glancing at Coleman, he said, “I guess your idea didn’t work.”

“Apparently not.” Coleman kept his voice noncommittal. In spite of everything they were still left with a question—a division of opinion. He wondered what the older man would do.

“It was worth trying anyway.” Pearson had a way of making the most ordinary acknowledgment sound grudging, but Coleman guessed he was talking to gain time and to cover up his indecision.

Now the old man turned to Lucy. Almost sardonically, he said, “So Radiology bows out.”

She answered levelly, “I suppose you could say that.”

“And it leaves it up to me—to Pathology?”

“Yes, Joe,” she said quietly, waiting.

There was a ten-second silence before Pearson spoke again. Then he said clearly and confidently, “My diagnosis is that your patient has a malignant tumor—osteogenic sarcoma.”

Lucy met his eyes. She asked, “That’s quite definite?”

“Quite definite.” In the pathologist’s voice there was no hint of doubt or hesitation. He went on, “In any case, I’ve been sure from the beginning. I thought this”—he indicated the X-ray films—“would give some extra confirmation.”

“All right.” Lucy nodded her acceptance. Her mind was working now on immediate things to do.

Pearson asked matter-of-factly, “When shall you amputate?”

“Tomorrow morning, I expect.” Lucy gathered up the X-rays and went to the door. Her glance taking in Coleman, she said, “I suppose I’d better go and break the news.” She made a small grimace. “This is one of the hard ones.”

When the door had closed behind her, Pearson turned to Coleman. He said with surprising courtesy, “Someone had to decide. I didn’t ask your opinion then because I couldn’t take the chance of letting it be known that there was doubt. If Lucy Grainger knew, she would have no choice but to tell the girl and her parents. And once they heard, they would want to delay. People always do; you can’t blame them.” He paused, then added, “I don’t have to tell you what delay can do with osteogenic sarcoma.”

Coleman nodded. He had no quarrel with Pearson’s having made the decision. As the old man had said, someone had to do it. All the same, he wondered if the amputation to be performed tomorrow was necessary or not. Eventually, of course, they would know for sure. When the severed limb came down to the lab, dissection would show if the diagnosis of malignancy was right or wrong. Unfortunately, though, an error discovered then would be too late to do the patient any good. Surgery had learned many ways to amputate limbs effectively, but it had no procedures for putting them back.

The afternoon flight from Burlington landed at La Guardia Airport a little after four o’clock, and from the airport Kent O’Donnell took a taxi to Manhattan. On the way into town he leaned back, relaxing for the first time in several days. He always tried to relax in New York taxis, mainly because any attempt to watch the traffic, or his own progress through it, usually left him in a state of nervous tension. He had long ago decided that the correct attitude to adopt was one of fatalism; you resigned yourself to disaster, then, if it failed to happen, you congratulated yourself on abundant good luck.

Another reason for relaxing was that for the past week he had worked at full pressure, both in the hospital and outside. He had extended his office appointments and scheduled extra surgery to make possible the four-day absence from Three Counties he had now embarked on. As well, two days ago, he had presided at a special meeting of the hospital’s medical staff at which—aided by data prepared by Harry Tomaselli—he had revealed the suggested scale of donations to the hospital building fund for attending physicians and others. As he had expected, there had been plenty of grumbling, but he had no doubt that the pledges, and eventually the money, would be forthcoming.

Despite his mental withdrawal, O’Donnell was conscious of the activity of New York outside and of the familiar angled sky line of mid-town Manhattan, now growing closer. They were passing over Queensborough Bridge, the warm afternoon sun slanting lancelike through drab green girders, and down below he could see Welfare Island, its city hospitals squatting somberly and institutional midway in the gray East River. He reflected that on each occasion he saw New York its ugliness seemed greater, its disorder and grime more strikingly apparent. And yet, even to the non-New Yorker, after a while these things became comfortable and familiar, seeming to hold a welcome for the traveler, as though an old, worn garment were good enough between friends. He smiled, then chided himself for unmedical thinking—the kind that held back air-pollution control and slum removal. Sentimentality, he reflected, was an aid and comfort to the opponents of progress.

They moved off the bridge and along Sixtieth Street to Madison, then jogged a block, turning west on Fifty-ninth. At Seventh Avenue and Central Park they went left in the traffic and stopped four blocks down at the Park Sheraton Hotel.

He checked into the hotel and later, in his room, showered and changed. From his bag he took the program of the surgeons’ congress—ostensible reason for his presence in New York. He noted that there were three papers he wanted to hear—two on open heart surgery and a third on replacement of diseased arteries by grafts. But the first was not until eleven next morning, which gave him plenty of time tomorrow. He glanced at his watch. It was a little before seven—more than an hour before he was due to meet Denise. He took an elevator downstairs and strolled through the foyer to the Pyramid Lounge.

It was the cocktail hour and the place was beginning to fill with pre-dinner-and-theater groups, mostly, he guessed, like himself, from out of town. A headwaiter showed him to a table, and as they moved across he saw an attractive woman, sitting alone, glance at him interestedly. It was not a new experience, and in the past similar incidents had occasionally led to interesting results. But tonight he thought: Sorry, I have other plans. A waiter took his order for scotch and soda, and when the drink came he sipped it slowly, his mind coasting leisurely over random thoughts.

Moments like this, he reflected, were all too rare in Burlington. That was why it was good to get away for a while; it sharpened your sense of perspective, made you realize that some of the things you deemed important on your own home ground were a good deal less so when looked at from a distance. Just lately he had suspected that his own closeness to hospital business had thrown some of his thinking out of balance. He looked around him. Since he had come in the lounge had filled; waiters were hurrying to bring the drinks which three bartenders were dispensing; one or two of the earlier groups were moving out. How many of these people, he wondered—the man and the girl at the next table, the waiter by the door, the foursome just leaving—had ever heard of Three Counties Hospital and, if they had, would care what went on there? And yet, to himself just lately, the hospital’s affairs seemed almost to have become the breath of life. Was this a healthy symptom? Was it a good thing professionally? O’Donnell had always mistrusted dedicated people; they tended to become obsessed, their judgment undermined by enthusiasm for a cause. Was he in danger now of becoming one such himself?

The question of Joe Pearson, for example. Had O’Donnell’s own closeness to the scene misled him there? It had been necessary for the hospital to hire a second pathologist; he was convinced of that. But had he himself tended to criticize the old man unduly, to magnify organizational weaknesses—and every hospital department had a few—out of true proportion? For a time O’Donnell had even considered asking Pearson to retire; was that in itself a symptom of unbalanced judgment, a hasty condemnation of an older man by one his junior in years? Of course, that was before Eustace Swayne had made it clear that his quarter-million-dollar donation was contingent on Joe Pearson’s remaining at the helm of Pathology; Swayne, incidentally, had still not confirmed the gift. But O’Donnell felt his judgment was superior to considerations like that, however important they might seem. In all probability Joe Pearson had a lot to give Three Counties still; his accumulated experience should surely count for something. It was true, he decided; your thinking did improve when you were away—even if you had to find a cocktail bar to do some reasoning quietly.

A waiter had stopped at the table. “A refill, sir?”

O’Donnell shook his head. “No, thanks.”

The man produced a check. O’Donnell added a tip and signed it.

It was seven-thirty when he left the hotel. There was still plenty of time to spare, and he walked cross-town on Fifty-fifth as far as Fifth Avenue. Then, hailing a cab, he continued uptown to the address Denise had given him. The driver stopped near Eighty-sixth, outside a gray stone apartment building. O’Donnell paid off the cab and went in.

He was greeted respectfully by a uniformed hall porter. The man asked his name, then consulted a list. He said, “Mrs. Quantz left a message to say would you please go up, sir?” He motioned to the elevator, an identically uniformed operator beside it. “It’s the penthouse floor, sir—the twentieth. I’ll tell Mrs. Quantz you’re on the way.”

At the twentieth floor the elevator doors opened silently onto a spacious carpeted hallway. Occupying most of one wall was a large Gobelin tapestry depicting a hunting scene. Opposite were double carved oak doors which now opened, and a manservant appeared. He said, “Good evening, sir. Mrs. Quantz asked me to show you into the lounge. She’ll be with you in a moment.”

He followed the man down a second hallway and into a living room almost as large as his own entire apartment at Burlington. It was decorated in shades of beige, brown, and coral, a sweep of sectional settees offset by walnut end tables, their rich darkness in simple, striking contrast to the deep broadloom of pale beige. The living room opened onto a flagstoned terrace, and he could see the last rays of evening sunshine beyond.

“May I get you something to drink, sir?” the manservant said.

“No, thanks,” he answered. “I’ll wait for Mrs. Quantz.”

“You won’t have to,” a voice said, and it was Denise. She came toward him, her hands held out. “Kent dear, I’m so glad to see you.”

For a moment he looked at her. Then he said slowly, “I am too,” and added truthfully, “Until this moment I hadn’t realized how much.”

Denise smiled and leaned forward to kiss his cheek lightly. O’Donnell had a sudden impulse to take her into his arms, but restrained it.

She was even more beautiful than he remembered, with a smiling radiance that left him breathless. She had on a short, full-skirted evening gown of jet-black lace over a strapless sheath of black silk, the lace about her shoulders accenting the filmy vision of white flesh beneath. At her waist was a single red rose.

She released one of his hands and with the other led him to the terrace. The manservant had preceded them, carrying a silver tray with glasses and a cocktail shaker. Now he withdrew discreetly.

“The martinis are already mixed.” Denise looked at O’Donnell inquiringly. “Or if you like I can get you something else.”

“Martini is fine.”

Denise poured two drinks and handed him one. She was smiling, her eyes warm. Her lips said softly, “Welcome to New York from a committee of one.”

He sipped the martini; it was cool and dry. He said lightly, “Please thank the committee.”

For a brief moment her eyes caught his. Then, taking his arm, she moved across the terrace toward the low, pillared balustrade which marked its end.

O’Donnell asked, “How is your father, Denise?”

“He’s well, thank you. Entrenched like a true die-hard, of course, but in good health. Sometimes I think he’ll outlive us all.” She added, “I’m very fond of him.”

They had stopped and stood looking down. It was dusk now, the warm, mellow dusk of late summer, and the lights of New York were flickering on. From the streets below the throb of evening traffic was steady and insistent, punctuated by the peaklike whine of diesel buses and the full points of impatient horns. Across the way, its outline blurring into shadow, was Central Park, only scattered street lamps marking the roadways through. Beyond, the west-side streets dimmed darkly into the Hudson River; and on the river the pinpoint lamps of shipping were a link between the blackness and the distant glimmering New Jersey shore. Uptown, O’Donnell could see the George Washington Bridge, its highstrung floodlights a chain of white, bright beads, and, below, the headlights of cars, multi-laned, streaming across the bridge, away from the city. O’Donnell thought: People going home.

A warm, soft breeze stirred around them, and he was conscious of Denise’s closeness. Her voice said softly, “It’s beautiful, isn’t it? Even though you know that under the lights there are things that are wrong and hateful, it’s still beautiful. I love it all, especially at this time of evening.”

He said, “Have you ever considered going back—to Burlington, I mean?”

“To live?”

“Yes.”

“You can never go back,” Denise said quietly. “It’s one of the few things I’ve learned. Oh, I don’t mean just Burlington, but everything else—time, people, places. You can revisit, or renew acquaintance, but it’s never really the same; you’re detached; you’re passing through; you don’t belong because you’ve moved on.” She paused. “I belong here now. I don’t believe I could ever leave New York. Do I sound terribly unrealistic?”

“No,” he said. “You sound terribly wise.”

He felt her hand on his arm. “Let’s have one more cocktail,” she said, “then you may take me to dinner.”

Afterward they had gone to the Maisonette, a discreet and pleasantly appointed night club on Fifth Avenue. They had dined and danced, and now they had come back to their table. “How long have you in New York?” Denise asked.

“I go back in three more days,” he answered.

She inclined her head. “Why so soon?”

“I’m a workingman.” He smiled. “My patients expect me to be around and there’s a lot of hospital business too.”

Denise said, “I rather think I shall miss you.”

He thought for a moment, then turned to face her. Without preliminary he said, “You know that I’ve never been married.”

“Yes.” She nodded gravely.

“I’m forty-two,” he said. “In that time, living alone, one forms habits and patterns of life that might be hard to change or for someone else to accept.” He paused. “What I’m trying to say, I suppose, is that I might be difficult to live with.”

Denise reached out and covered his hand with her own. “Kent, darling, may I be clear about something?” She had the slightest of smiles. “Is this by any chance a proposal of marriage?”

O’Donnell was grinning broadly; he felt absurdly, exuberantly, boyish. “Now that you mention it,” he said, “I rather think it is.”

There was a moment’s silence before Denise answered, and when she spoke he sensed that she was maneuvering for time. “I’m very flattered, but aren’t you being a little rash? After all, we scarcely know one another.”

“I love you, Denise,” he said simply.

He felt her regarding him searchingly. “I could love you too,” she said. Then she added, speaking slowly and choosing her words, “At this moment everything in me tells me to say yes and to grab you, dearest, with two eager hands. But there’s a whisper of caution. When you’ve made one mistake you feel the need to be careful about committing yourself again.”

“Yes,” he said, “I can understand that.”

“I’ve never fallen in,” she said, “with the popular idea that one can shed partners quickly and afterward get over it, rather like taking an indigestion tablet. That’s one of the reasons, I suppose, why I’ve never got a divorce.”

“The divorce wouldn’t be difficult?”

“Not really. I imagine I could go to Nevada to arrange it, or some such place. But there’s the other thing—you’re in Burlington; I’m in New York.”

He said carefully, “You really meant what you said, Denise—about not living in Burlington?”

She thought before answering. “Yes. I’m afraid I do. I couldn’t live there—ever. There’s no use pretending, Kent; I know myself too well.”

A waiter appeared with coffee and replenished then: cups. O’Donnell said, “I feel a sudden compulsion for the two of us to be alone.”

Denise said softly, “Why don’t we go?”

He called for the check and paid it, helping Denise on with her wrap. Outside a doorman summoned a cab and O’Donnell gave the address of the Fifth Avenue apartment. When they had settled back, Denise said, “This is a very selfish question, but have you ever considered moving your practice to New York?”

“Yes,” he answered, “I’m thinking about it now.”

He was still thinking when they entered the apartment block and rode up in the elevator. Ever since Denise’s question he had been asking himself: Why shouldn’t I go to New York? There are fine hospitals; this is a medical city. It would not be difficult to get on staff somewhere. Setting up practice would be comparatively easy; his own record, as well as the friends he had in New York, would bring him referrals. He reasoned: What really keeps me tied to Burlington? Does my life belong there—now and for always? Isn’t it time, perhaps, for a change, a new environment? I’m not married to Three Counties Hospital, nor am I indispensable. There are things I’d miss, it’s true; the sense of building and creation, and the people I’ve worked with. But I’ve accomplished a great deal; no one can ever deny that. And New York means Denise. Wouldn’t it be worth it—all?

At the twentieth floor Denise used her own key to let them in; there was no sign of the manservant O’Donnell had seen earlier.

As if by consent they moved to the terrace. Denise asked, “Kent, would you like a drink?”

“Perhaps later,” he said, and reached out toward her. She came to him easily and their lips met. It was a lingering kiss. His arms tightened around her and he felt her body respond to his own. Then gently she disengaged herself.

Half turned away, she said, “There are so many things to think of.” Her voice was troubled.

“Are there?” The tone of voice was disbelieving.

“There’s a great deal you don’t know about me,” Denise said. “For one thing, I’m terribly possessive. Did you know that?”

He answered, “It doesn’t sound very terrible.”

“If we were married,” she said, “I’d have to have all of you, not just a part. I couldn’t help myself. And I couldn’t share you—not even with a hospital.”

He laughed. “I imagine we could work out a compromise. Other people do.”

She turned back toward him. “When you say it like that I almost believe you.” Denise paused. “Will you come back to New York again—soon?”

“Yes.”

“How soon?”

He answered, “Whenever you call me.”

As if by instinct, she moved toward him and they kissed again, this time with growing passion. Then there was a sound behind them and a shaft of light from a door opening to the living room. Denise pushed herself gently away and a moment later a small figure in pajamas came onto the terrace. A voice said, “I thought I heard someone talking.”

“I imagined you were sleeping,” Denise said. “This is Dr. O’Donnell.” Then to O’Donnell, “This is my daughter Philippa.” She added affectionately, “One half of my impossible twins.”

The girl looked at O’Donnell with frank curiosity. “Hullo,” she said, “I’ve heard about you.”

O’Donnell remembered Denise telling him that both her children were seventeen. The girl seemed small for her age, her body only just beginning to fill out. But she moved with a grace and posture uncannily similar to her mother.

“Hullo, Philippa,” he said. “I’m sorry if we disturbed you.”

“I couldn’t sleep, so I was reading.” The girl glanced down at a book in her hand. “It’s Herrick. Did you ever read it?”

“I don’t think so,” O’Donnell said. “As a matter of fact, there wasn’t much time for poetry in medical school and I’ve never really got around to it since.”

Philippa picked up the book and opened it. “There’s something here for you, Mother.” She read attractively with a feeling for words and balance and with a touch of lightness.

“That age is best, which is the first,

When youth and blood are warmer;

But being spent, the worse, and worst

Time, still succeed the former.

Then be not coy, but use your time;

Date: 2014-12-21; view: 1044