A Case of Need: A Novel (13 page)

The doctor figured this was what was wrong with his patient—he had suppressed his own white cells, and now he was infecting himself. The treatment was simple: take him off the drug, do nothing, and wait for his marrow to recover.

I told the doctor that the marrow didn’t look so bad on the slide. We went to see the patient and found he was still sick. He had ulcers in his mouth, and staph infections on his legs and back. He had a high fever, was lethargic, and answered questions slowly.

We couldn’t understand why his marrow should seem so basically normal when he was so damned sick; we puzzled over this for most of the afternoon. Finally, about four, I asked the doctor if there had been any infection at the site of biopsy, where they had made the puncture to draw marrow. The doctor said he hadn’t checked. We went to the patient and examined his chest.

Surprise: unpunctured. The marrow biopsy hadn’t been taken from this patient. One of the nurses or residents had screwed up the tags, mislabeling a marrow sample from a man with suspected leukemia. We immediately drew a sample from our patient and found a very suppressed marrow indeed.

The patient later recovered, but I would never forget our puzzling over the lab results.

I
HAD THE SAME FEELING NOW
—something was wrong, something was out of place. I couldn’t put my finger on it, but I had the suspicion that people were working at cross-purposes, almost as if we were talking about different things. My own position was clear: Art was innocent until proven guilty, and that wasn’t proven yet.

Nobody else seemed to care whether Art was guilty or not. The issue that was crucial to me was irrelevant to them.

Now why was that?

¹
Normal white count is 4-9,000 cells/cubic centimeter. With infection, this may double or triple.

²
Breastbone.

W
HEN I AWOKE IT FELT LIKE A NORMAL DAY.
I was exhausted and it was drizzling outside, cold, gray, and uninviting. I pulled off my pajamas and took a hot shower. While I was shaving, Judith came in and kissed me, then went to the kitchen to make breakfast. I smiled into the mirror and caught myself wondering what the surgical schedule would be like.

Then I remembered: I wasn’t going to the hospital today. The whole business came back to me.

It was not a normal day.

I went to the window and stared at the drizzle on the glass. I wondered then for the first time whether I ought to drop everything and go back to work. The prospect of driving to the lab, parking in the lot, hanging up my coat, and putting on my apron and gloves—all the familiar details of routine—seemed suddenly very appealing, almost enticing. It was my job; I was comfortable at it; there were no stresses or strains; it was what I was trained to do. I had no business playing amateur detective. In the cold morning light, the idea seemed ludicrous.

Then I began to remember the faces I had seen. Art’s face, and the face of J. D. Randall, and Bradford’s smug confidence. And I knew that if I didn’t help Art, nobody would.

In one sense, it was a frightening, almost terrifying thought.

JUDITH SAT WITH ME AT BREAKFAST
. The kids were still asleep; we were alone.

“What are you planning today?” she said.

“I’m not sure.”

I had been asking myself that very question. I had to find out more, lots more. About Karen, and Mrs. Randall particularly. I still didn’t know very much about either of them.

“I’ll start with the girl,” I said.

“Why?”

“From what I’ve been told, she was all sweetness and light. Everybody loved her; she was a wonderful girl.”

“Maybe she was.”

“Yes,” I said, “but it might be good to get the opinion of someone besides her brother and her father.”

“How?”

“I’ll begin,” I said, “with Smith College.”

SMITH COLLEGE
, Northampton, Massachusetts, 2,200 girls getting an exclusive education in the middle of nowhere. It was two hours on the turnpike to the Holyoke exit; another half-hour on small roads until I passed under the train tracks and came into the town. I’ve never liked Northampton. It has a peculiarly repressed atmosphere for a college town; you can almost smell irritation and frustration in the air, the heavy combined frustration of 2,200 pretty girls consigned to the wilderness for four years, and the combined irritation of the natives who are forced to put up with them for that time.

The campus is beautiful, particularly in autumn, when the leaves are turning. Even in the rain, it’s beautiful. I went directly to the college information office and looked up Karen Randall in the paperback directory of students and faculty. I was given a map of the campus and set out for her dorm, Henley Hall.

It turned out to be a white frame house on Wilbur Street. There were forty girls living inside. On the ground floor was a living room done in bright, small-print fabric, rather foolishly feminine. Girls wandered around in dungarees and long, ironed hair. There was a bell desk by the door.

“I’d like to see Karen Randall,” I said to the girl.

She gave me a startled look, as if she thought I might be a middle-aged rapist.

“I’m her uncle,” I said. “Dr. Berry.”

“I’ve been away all weekend,” the girl said. “I haven’t seen Karen since I got back. She went to Boston this weekend.”

I was in luck: this girl apparently didn’t know. I wondered whether the other girls did; it was impossible to tell. It seemed likely that her housemother would know, or would find out soon. I wanted to avoid the housemother.

“Oh,” said the girl behind the desk. “There’s Ginnie. Ginnie’s her roommate.”

A dark-haired girl was walking out the door. She wore tight dungarees and a tight poor-boy sweater, but the overall effect remained oddly prim. Something about her face disowned the rest of her body.

The desk girl waved Ginnie over and said, “This is Dr. Berry. He’s looking for Karen.”

Ginnie gave me a shocked look. She knew. I quickly took her and steered her to the living room, and sat her down.

“But Karen’s—”

“I know,” I said. “But I want to talk to you.”

“I think I’d better check with Miss Peters,” Ginnie said. She started to get up. I pushed her gently back down.

“Before you do,” I said, “I’d better tell you that I attended Karen’s autopsy yesterday.”

Her hand went to her mouth.

“I’m sorry to be so blunt, but there are serious questions that only you can answer. We both know what Miss Peters would say.”

“She’d say I can’t talk to you,” Ginnie said. She was looking at me suspiciously, but I could see I had caught her curiosity.

“Let’s go someplace private,” I said.

“I don’t know …”

“I’ll only keep you a few minutes.”

She got up and nodded toward the hall. “Men aren’t normally allowed in our rooms,” she said, “but you’re a relative, aren’t you?”

“Yes,” I said.

Ginnie and Karen shared a room on the ground floor, at the back of the building. It was small and cramped, cluttered with feminine mementos—pictures of boys, letters, joke birthday cards, programs from Ivy football games, bits of ribbon, schedules of classes, bottles of perfume, stuffed toy animals. Ginnie sat on one bed and waved me to a desk chair.

“Miss Peters told me last night,” Ginnie said, “that Karen had … died in an accident. She asked me not to mention it to anyone for a while. It’s funny. I never knew anybody who died—I mean, my age, that kind of thing—and it’s funny. I mean peculiar, I didn’t feel anything, I couldn’t get very worked up. I guess I don’t really believe it yet.”

“Did you know Karen before you were roommates?”

“No. The college assigned us.”

“Did you get along?”

She shrugged. Somehow, she had learned to make every bodily gesture a wiggle. But it was unreal, like a practiced gesture perfected before the mirror.

“I guess we got along. Karen wasn’t your typical freshman. She wasn’t scared of the place, and she was always going away for a day or the weekend. She practically never went to class, and she always talked about how she hated it here. That’s the thing to say, you know, but she meant it, she really did. I think she really
did
hate it.”

“Why do you think so?”

“Because of the way she acted. Not going to class, always leaving campus. She’d sign out for weekends, saying she was going to visit her parents. But she never did, she told me. She hated her parents.”

Ginnie got up and opened a closet door. Inside, tacked to the door, was a large glossy photograph of J. D. Randall. The picture was covered with minute punctures.

“You know what she used to do? She used to throw darts at this picture. That’s her father, he’s a surgeon or something; she threw darts at him every night, before going to sleep.”

Ginnie closed the door.

“What about her mother?”

“Oh, she liked her mother. Her real mother; she died. There’s a stepmother now. Karen never liked her very much.”

“What else did Karen talk about?”

“Boys,” Ginnie said, sitting on the bed again. “That’s all any of us talk about. Boys. Karen went to private school around here someplace, and she knew a lot of boys. Yalies were always coming to see her.”

“Did she date anyone in particular?”

“I don’t think so. She had lots of guys. They were all chasing her.”

“Popular?”

“Or something,” Ginnie said, wrinkling her nose. “Listen, it isn’t nice to say things about her now, you know? And I have no reason to think it’s true. Maybe it’s all a big story.”

“What’s that?”

“Well, you get here as a freshman and nobody knows you, nobody’s ever
heard
of you before, and you can tell people anything you like and get away with it. I used to tell people I was a high-school cheerleader, just for the fun of it. Actually I went to private school, but I always wanted to be a high-school cheerleader.”

“I see.”

“They’re so wholesome, you know?”

“What kind of stories did Karen tell you?”

“I don’t know. They weren’t exactly stories. Just sort of implications. She liked people to believe that she was wild, and all her friends were wild. Actually, that was her favorite word:
wild.
And she knew how to make something sound real. She never just told you straight out, in a whole long thing. It was little comments here and there. About her abortions and all.”

“Her abortions?”

“She said she had had two before she ever got to college. Now that’s pretty incredible, don’t you think? Two abortions? She was only seventeen, after all. I told her I didn’t believe it, so she went into this explanation of how it was done, the complete explanation. Then I wasn’t so sure.”

A girl from a medical family could easily acquire a knowledge of the mechanics of a D & C. That didn’t prove she’d had an abortion herself.

“Did she tell you anything specific about them? Where they were done?”

“No. She just said she’d had them. And she kept saying things like that. She wanted to shock me, I know that, but she could be pretty crude when she wanted. I remember the first—no, the second weekend we were here, she went out Saturday night, and she got back late. I went to a mixer. Karen came in all a mess, crawled into bed with the lights out, and said, ‘Jesus, I love black meat.’ Just like that. I didn’t know what to say, I mean, I didn’t know her well then, so I didn’t say anything. I just thought she was trying to shock me.”

“What else did she say to you?”

Ginnie shrugged. “I can’t remember. It was always little things. One night, as she’s getting ready to go out for the weekend, and she’s whistling in front of the mirror, she says to me, ‘I’m really going to get it this weekend.’ Or something like that, I don’t remember the exact words.”

“And what did you say?”

“I said, ‘Enjoy yourself.’ What
can
you say when you get out of the shower and somebody says that to you? So she said, ‘I will, I will.’ She was always coming up with shocking little comments.”

“Did you ever believe her?”

“After a couple of months, I was beginning to.”

“Did you ever have reason to think she was pregnant?”

“While she was here? At school? No.”

“You’re sure?”

“She never said anything. Besides, she was on the pill.”

“Are you certain of that?”

“Yeah, I think so. At least, she made this big ceremony of it every morning. The pills are right there.”

“Where?”

Ginnie pointed. “Right there on her desk. In that little bottle.”

I got up and went to the desk, and picked up the plastic bottle. The label was from Beacon Pharmacy; there were no typed directions. I took out my notebook and wrote down the prescription number and the name of the doctor. Then I opened the bottle and shook out a pill. There were four left.

“She took these every day?”

“Every single day,” Ginnie said.

I was no gynecologist and no pharmacologist, but I knew several things. First, that most birth-control pills were now sold in a dispenser to help a woman keep track of the days. Second, that the initial hormone dosage had been cut from ten milligrams a day to two milligrams. That meant the pills were small.

These pills were huge in comparison. There were no surface markings of any kind; they were chalky white and rather crumbly to the touch. I slipped one into my pocket and replaced the others in the bottle. Even without checking, I had a pretty good idea what the pills were.

“Did you ever meet any of Karen’s boyfriends?” I asked.

Ginnie shook her head.

“Did Karen ever talk about them? Talk about her dates?”

“Not really. Not personally, if you know what I mean. She’d talk about how they’d been in bed, but it was usually just gross stuff. She was always trying to gross you out. You know, the earthy bit. Wait a minute.”

She got up and went to Karen’s dresser. There was a mirror over the dresser; stuck into the frame were several pictures of boys. She plucked out two and handed them to me.

“This guy was one she talked about, but I don’t think she was seeing him anymore. She used to date him over the summer or something. He goes to Harvard.”