Miracle Cure (3 page)

No job, no license. No license, no job. Catch-22.

Now, for the past month, he had simply stopped trying. He had stepped back and begun to mull over other directions in which his life might be ready to go. The process hadn’t been easy, but there was one saving grace. Rarely, in all these frustrating months of rejection and disappointment, had he thought about drinking or taking pills.

“You ready, Pop?”

“You go on and get that top down. I’ll be right there.”

Jack Holbrook headed slowly toward the bathroom. When he heard the front door open and close, he quickly braced himself against the wall, fighting to slow his breathing as a skewer of pain bored up to his jaws from beneath his breastbone. He fumbled the vial of nitroglycerin from his shirt pocket and dissolved one under his tongue. Half a minute later, the pain began to subside. He wiped beaded sweat from his upper lip and took a long, grateful breath.

“Jack, everything okay?” Brian called from the front steps.

“Yeah, fine, Brian. Everything’s fine.”

The Towne Deli was a trendy little place on Boylston with a fine salad bar and nine-dollar sandwiches. Brian dropped his father off in front and spent ten minutes finding a parking space. Jack’s condo was in Reading, a working-class suburb that straddled Route 128 northwest of the city. The ride in, beneath brilliant late-afternoon sun, was as much of a joy on Sunday as it was a nightmare during the typical morning commute. And Brian’s three-year-old red LeBaron, by far the best thing he retained after the divorce, was the perfect car for the day.

During the drive, Brian knew that Jack wanted information. Any job prospects? Any new word from the board? Any interesting women? But perhaps in honor of the warmth of the day and the peace between them, his dad kept his thoughts to himself. Brian, too, avoided the inflammatory topic of his father’s health. Instead, they alternated between sports and silence.

Brian entered the Towne Deli and spotted his father at a small table in the corner. For a few seconds, he stood by the front door, studying what remained of the man who
had so dominated the first two decades of his life. From almost the day Brian took his first step, Coach was there, monitoring his diet, social life, and workouts, creating what he believed would be one of the great quarterbacks. And save for one play, he might have succeeded.

Jack sat motionless, staring down at the menu. Then, almost subconsciously, he began rubbing at his chest and up toward his neck. Brian hurried across to him. Beneath his tan, Jack was ashen. His eyes were glazed.

“Jack, what’s going on? Are you having pain?”

Jack Holbrook took a breath through his nose and nodded.

“Some,” he managed in a half-grunt.

Brian checked the carotid pulses on either side of Jack’s neck. They were regular, but thready. A sheen of sweat had formed across his forehead.

“Jesus,” Brian whispered. “Jack, do you have your nitro?”

Jack produced the bottle from his shirt pocket.

“Shouldn’t have come into Boston,” he said hoarsely.

“Nonsense,” Brian said, sensing the strange, paradoxical calmness that for many years now had been his response to a medical crisis. “It wouldn’t have made any difference. Come on, Pop. I’m going to sit you over here on the floor and give you one of your nitros. Do you still have that aspirin I put in your wallet? Good. Let me get it out.”

Either Jack was having a bad angina attack—not enough blood flow to a portion of his heart—or he was having a full-blown coronary: a myocardial infarction in which the heart segment was getting no blood at all. If the problem was an artery obstructed by a clot, the extra aspirin might help dissolve the blockage before there was permanent damage.

“Is there a problem, sir?”

Brian looked up at the balding restaurant manager.
Of course not, I always put my father on the floor in restaurants
.

“He’s a heart patient and he’s having chest pain,” Brian said instead.

“Should … should I call an ambulance? Ask if there’s a doctor here?”

“I
am
a doctor,” Brian said, for the first time in a year and a half. “And I think an ambulance would be an excellent idea.”

Silently, Brian cursed himself for giving in to the Boston trip. Jack’s internist, cardiologist, surgeon, and all his records were at Suburban Hospital, way on the other side of Route 128. It was an excellent hospital, well known for its orthopedics, rehabilitation medicine, and in some circles, for a former chief of cardiology named Brian Holbrook.

He checked Jack’s pulses once again and mopped his brow.

“How’s your pain, Jack? One to ten.”

“Six. The nitro’s helping. What are the odds it’s a coronary?”

“Fifty-fifty.”

“Bad odds.”

“Just hang in there. The EMTs’ll get a little oxygen going and give you some pain medicine, and you’ll feel much better.”

“Ten bucks says one of the EMTs in the ambulance is a woman. Deal?”

“Deal. Just stay cool. Do you want to lie down flat?”

“I couldn’t.”

In the distance, they could hear an approaching siren. Brian kept a constant check of the pulse at Jack’s wrist. The perspiration, so typical of a cardiac event, seemed less heavy.

“Everything’s fine, Pop. How’s the pain now?”

“Ten.”

“The pain is up to a ten?”

“No, you owe me ten.”

Jack nodded toward the door, where a young brunette in blue EMT coveralls was on the pulling end of a stretcher. Brian introduced his father and gave a capsule summary of the situation and the limited treatment he had instituted.

“You a doctor?” The young woman asked immediately.

“A cardiologist. Brian Holbrook.”

“Well, we got no pride on this team, Dr. Holbrook,” she said, doing, it seemed, a dozen things at once, and doing them all well. “If there’s anything we overlook, just call it out.”

“Thanks. Jack’s a patient at Suburban Hospital.”

“Well, in a few minutes he’s going to be a patient at White Memorial. That okay with you?”

White Memorial was not only the best hospital in the city, it was the home of Boston Heart Institute, one of the foremost centers of its kind. Brian flashed on the interview he had blown when applying for cardiology training there. The subsequent rejection letter was hardly a surprise. Given all that had happened to him since then, he mused, it seemed the interviewer had shown pretty good judgment.

Brian noted Jack’s immediate improvement with a bit of IV morphine and some oxygen.

“Actually,” he said to the young EMT, “Boston Heart is precisely where I was going to ask to have him taken.”

B
RIAN SQUEEZED INTO THE AMBULANCE FOR THE SHORT
ride from Back Bay to White Memorial. His father’s pain was down to a two or three by the time they left the Towne Deli. Still, throughout the ride Brian kept a watchful eye on the monitor. The absence of extra beats was a good sign, but the shape of the cardiogram wave pattern strongly suggested an acute coronary.

Jack’s cardiologist at Suburban was Gary Gold, one of Brian’s former partners—the only one of the four partners who had believed that Brian was recovering from an illness and should be readmitted to the practice as soon as he was ready. Silently, Brian cursed himself for not insisting that Gary be more aggressive with Jack in pushing for a repeat cardiac catheterization and surgical evaluation. But then again, with Jack so adamantly against repeat surgery, what was there to do?

White Memorial was an architectural polyglot of a
dozen or more buildings crowding four square blocks along the Charles River. All around, as with most large hospitals, there was construction in progress. Earth movers and other heavy equipment were as much a part of the scene as were ambulances, and two towering cranes rose above all but the tallest building. A new ambulatory care center, one sign proclaimed. The twenty-story future home of the Hellman Research Building, boasted another. Like the patients within, the hospital itself was in a constant cycle of disease and healing, decay and repair, death and birth.

The vast ER was in noisy but controlled disarray. The two triage nurses were backed up, and the waiting room was full. Brian took in the scene as they rushed Jack to a monitor bed in the back. The drama and energy of the place were palpable to him—his element. Merely walking into the ER made him feel as if he had been breathing oxygen under water and had suddenly popped through the surface. He had anticipated heightened emotions at reentering this world, but he was still surprised by the fullness in his chest and throat, and the sudden increased moisture in his eyes. Not that long ago he had been part of all this and his own actions had caused it to be taken away. Now, there was no telling when, or even
if
, he would ever get it back again.

“How’re you doing, Jack?” Brian asked, taking his father’s hand as they waited for a clean sheet to be thrown over the narrow gurney in room 6.

“Been better. The pain’s gone, though.”

“Great.”

“Two bucks says I don’t get dinner.”

Brian glanced at the monitor. The elevation in the ST segment of the cardiographic tracing was less striking—definitely a good omen.

“If this place serves typical hospital food,” he said, “you stand to win twice.”

He helped the team transfer Jack to his bed, then stood off to one side as a resident named Ethan Prince began his rapid preliminary evaluation. Brian grudgingly gave the young man high marks for speed and thoroughness. Then he remembered where he was. Suburban was a decent enough hospital, but not one of the interns or residents there would ever get a call-back interview at White Memorial. Slip below the top ten percent of your medical school class and you didn’t even bother applying.

“You know anybody here?” Jack asked Brian.

The resident, listening through his stethoscope, shushed him.

I hope not
, Brian thought.

“I don’t think so,” he whispered.

As if on cue, he heard his name being called and looked over at the doorway. Standing there, hands on hips, was Sherry Gordon, not much older than Brian, but a grandmother several times over. She was right up there with the sharpest ER nurses Brian had ever worked with.

“Hey, you’re a Suburban girl,” he said, crossing to her and accepting a warm hug and kiss on the cheek. “What’re you doing here?”

“Cream rises to the top. They’d had my application on file for years. Openings don’t come too frequently in this place.”

“You like it?”

She gestured to the chaos and smiled.

“What do you think?” She studied him intently. “So, how about you? Are you okay?”

Brian held her gaze.

“It took three months in a rehab,” he replied, softly enough that only she could hear, “and about a billion AA and NA meetings, but yeah, I’m okay.”

“I’m happy to hear that, Brian. Real happy. That’s your dad, right? I remember that nightmare he went through at Suburban.”

“Six years ago. He had an MI four years before that, then gradually his angina became too severe to bear and we went for the surgery. And you’re right. It was a nightmare. And to make matters worse, the bypass wasn’t even that successful. He’s probably having a small MI now.”

“Well, he’s got a crackerjack resident going over him. Kid reminds me of you.”

“I wish.”

“Tell him to look into getting your dad put on Vasclear. Everyone around here has started talking about it. Listen, I’ve got to get back to help Dr. Gianatasio. He’s got a real sick lady down the hall.”

“Phil Gianatasio?”

“That’s right. You know him?”

“From years ago, when we were interns, then residents, together. I had no idea he was even in Boston. This is like old home week for me. Please tell him I’m here, Sherry. I’ll stop by when I’m certain my pop’s stable. Would that be okay?”

“I don’t see why not. Got to run. Good luck with your dad.”

Vasclear
. Brian knew next to nothing about the drug, and most of what he did know he had learned from the newspapers. He wasn’t as medically current as in the days when he was attending cardiology rounds twice a week and reading or skimming a dozen different journals. But he had kept up fairly well through tapes and two courses, and Vasclear, the latest in a long line of experimental drugs aimed at reducing arteriosclerosis, simply hadn’t been written about widely.

Ethan Prince freed his stethoscope from his ears, reviewed Jack’s EKG again, then passed it over to Brian.
Brian accepted it calmly, consciously trying to keep his eagerness and gratitude hidden from the younger physician. There was still a persistent two-millimeter elevation in the ST segment in several of the twelve standard views in the tracing.

“Looks like some persistent anterior injury,” Brian said.

“I agree. I’ll get the wheels in motion for his admission. Meanwhile, we’ve got to decide whether to attempt to melt the blockage. Before we do that, I’ll try and get him a cardiologist. Dr. Gianatasio is on first backup, but he’s got all he can handle with a very sick woman in four. I’ll have to find out who’s on second call.” He turned to Jack, whose color had improved significantly. “Mr. Holbrook, it appears you’re having a very small blockage, and as a result a part of your heart is not getting enough blood.”

“A heart attack,” Jack said. “It’s okay. You can say it.”

“Actually, we won’t be certain it’s a full heart attack until we see some blood tests and another cardiogram.”

“Two bucks says it is.”

“Pardon?”

“Never mind him,” Brian said, taking Jack’s hand again. “He was a football lineman in school—offense
and
defense. Too many blows to the helmet.”

“I see.… Well, I’d better get going. I need to find out who’s on cardiology backup and I need to get back in with Dr. Gianatasio.”

“Just one quick thing. Sherry Gordon said I should look into Vasclear.”

The resident shrugged. “You probably know as much about it as I do. It’s a Boston Heart research drug. Rumor has it the results have been really promising.”