Authors: Douglas Carlton Abrams
“Is this a joke?” Frank said.
Tom shook his head.
“What is it—some kind of cloning experiment gone wrong?”
“No,” Tom said. “It’s a video of a sperm sample from a man in Denmark. A colleague sent it to me for a second opinion. They’ve been seeing lots of cases like this.” Frank knew Tom was an expert in “dysfunctional” sperm. He examined the image again closely. The sperm had two heads and were swimming erratically in a circle.
“What’s the diagnosis?”
“No one knows, but this man is not alone. I just read a review study that said sperm counts are down fifty percent in the last sixty years.”
“Fifty percent?”
“I guess it’s good for my fertility clinic. I’m in a growth business.”
“Never thought of it that way. But if it continues at this rate, our whole species could…”
“Ironic, isn’t it? We could go from a population explosion to zero population.”
Frank sat thinking about this possibility for a second before his thoughts were interrupted by the hospital loudspeaker. “Dr. Lombardi, please report to the reception desk.”
“W
HAT THE HELL
do you want?” Frank demanded when he saw who it was.
Teo held up Elizabeth’s wedding ring, the large square-cut diamond sparkling under the fluorescent light. “I found it on the kitchen floor under the fridge.”
“You stole her ring?”
“I never going to keep it. I was thinking I could get her to love me, but now that I meet you and know that she pregnant, it just don’t seem right.”
Despite his dislike of Teo, Frank’s shoulders started to relax. “Thanks,” he said, taking the ring.
“I came here as a test, and Liza—your Elizabeth—pass. Or maybe I fail. Hold on to her. Strong ones always get away if you don’t hold them fast.” Teo turned to leave.
“What happened to your head?” Frank asked. Teo’s hair was matted with blood. Nilsen had knocked him out, no doubt with the butt of his gun.
“Is nothing. Just a farewell present.”
“Let me have a look. It might need stitches.”
SIXTY-FOUR
5:00
P.M.
Davis
E
LIZABETH WAS TIRED
and glad to be home. She was also glad to have the whale sample in the hands of a toxicologist. Outside in her small courtyard, the wind made the rosebush sway. The pink of the flowers was washed out by the gathering night, but their fragrance filled her nose. She took a deep breath and willed her body to relax.
The rosebush was desperately in need of pruning, or any attention at all. One of the branches snagged her jacket. Why hadn’t she asked her mother to show her how to garden? As a girl, she had always felt like there would be more time. She pulled off the branch, careful to avoid the thorns crowding up the stem. She looked at their shape, interested in them because her mother had been. The spikes reminded her of tiny shark’s teeth. Always the biologist, Elizabeth marveled at the limited number of shapes in the natural world. The very laws of physics, she knew, dictated this fact.
Once inside the house, she noticed a pile of mail that Teo must have gathered from where it had fallen through the door slot. The bills could wait. First she needed a shower.
The hot water felt sublime, and she closed her eyes as she remembered the events of the last several weeks. Elizabeth heard a noise. Maybe it was her neighbors getting home. She peeked out of the translucent shower curtain, hearing the music from the movie
Psycho
in her head. How many showers had that movie ruined? She
rolled her eyes at her imagination and picked up the shampoo. Then she remembered what Dr. Ginsburg had said about the toxic chemicals in ordinary household products. The ingredients list was an inch and a half long. Even with her chemistry classes, she couldn’t pronounce half of the names and certainly didn’t know what they were. The shampoo bottle thudded as it hit the plastic trash can next to the sink.
After the shower, Elizabeth put on a terry-cloth robe and wrapped her hair in a blue towel. Absentmindedly, she picked up the mail and began to flip through it. Bills, bills, junk. Then she saw something strange.
There was a letter with no stamp or return address. She pulled it out and looked at her name, handwritten on the envelope. The writing was precise, like that of an engineer or architect: E
LIZABETH MCKAY
. There was no address. It must have been dropped off.
She ripped it open.
The envelope’s only contents was a folded piece of newspaper, which she opened. Her chest seized with terror, and her fingertips went numb as she dropped it on the counter.
It was her graduate school head shot that had been printed in one of the newspaper articles. Someone had burned out her eyes with a cigarette.
SIXTY-FIVE
5:30
P.M.
Sacramento
F
RANK WALKED QUICKLY
toward the exam room where the family was waiting. He took some deep breaths and tried to stay hopeful. He had not seen the test yet and was worried. This girl had found her way into his heart, had cracked open his shell of detachment. What had begun simply as professional concern about Justine’s condition was now real and unavoidable human compassion.
During residency, they had tried to beat this out of him under the banner of scientific objectivity. Frank had sworn to himself that he would not get numb, would not stop caring, but that was before the endless hours, the countless patients. It had happened without his even knowing. The truth was that most of the doctors who cared about their patients eventually experienced emotional burnout. Distancing oneself was a necessary part of survival in a field with a staggering amount of unexplainable and incomprehensible suffering. It was one thing for an adult who had smoked all his life to be diagnosed with lung cancer, but for a kid to get cancer…It was the kind of thing that made you shake your fist at the sky and doubt the existence of God. Frank had done both.
As Frank hurried down the hall, he recalled Professor Ginsburg’s lecture. Maybe the cases of childhood cancer had less to do with God and more to do with humanity. Frank glanced at the dark glass door of the Epidemiological Research Unit as he walked quickly down the
hall. He noticed the words written in cheerful white letters:
SPONSORED BY THE ENVIRONMENTAL STEWARDSHIP CONSORTIUM.
When he arrived at the exam room, Frank felt flushed as he took the chart from the door and flipped through it. The results of the biopsy were not there.
“Kim,” Frank said, then hesitated as he recalled their failed date. “Can you please call pathology and have them fax over the test results for the Gates baby, stat?”
“Yes, Doctor.” Her tone was professional. Thank God she wasn’t going to hold it against him. Frank turned back to the exam room and took a deep breath. It would be awkward to be in the room without the results, but Frank did not want to keep the family waiting any longer. He opened the door.
Justine, once again on her mother’s lap, was smiling as she pointed at a picture in a board book. In quick diagnostic observation, Frank noticed the bags under Delores Gates’s eye makeup as well as how her husband played nervously with his black watch.
“Not a lot of sleep last night?” Frank asked, knowing that much suffering could be relieved just by its acknowledgment.
“No, not much,” she said.
Frank sat down on a rolling stool and approached slowly, not wanting to scare Justine. “Now, let’s have a look at the surgeon’s handiwork.”
Frank gently pulled back the dressing tape and gauze bandage on the girl’s neck. When she flinched, he stopped and waited. Then he finished removing the gauze so slowly the girl did not even seem to notice. He stared at the centimeter-long incision where the pediatric surgeon had removed a lymph node. A red line showed where she had been cut, and across it were the sutures of black nylon thread. They looked like fishing line knotted on one side, straight as the rungs on a ship’s ladder. The incision was healing fine, and any redness was hidden by the girl’s beautiful coffee-colored skin.
“The lab test should be here any minute,” he said, looking back at the parents. The mother’s hands were clenched, and the father was tapping one of his black leather shoes. Frank reminded himself to breathe. If he calmed himself, it helped his patients and their families stay calm as well.
“What would it mean,” Gates asked, “if our baby has this disease?”
“Lymphoma,” Frank said, “is a cancer of the lymph system, of the immune system.”
“Will our baby die?” Ms. Gates asked.
“We’ll know more once we get the tests back,” Frank said. “Let’s wait—”
“Doctor, if my baby’s going to die, I want to know.” Gates was speaking with executive authority. He was a man who clearly felt most comfortable with the hard truth of numbers, but there was no certainty on the profit and loss of life, only probabilities. Frank knew that many people took a prognosis as prophecy and died on the exact day predicted. He refused to give a death sentence to anyone, regardless of the “facts.”
“I understand, Mr. Gates. We all want to know what might happen to Justine, but much depends on the kind of lymphoma, its severity, where it is in the body, and how far it has spread. And much depends on her.”
“Last time I was here,” Gates said, “you asked me about my job at the chemical company and how far we live from the plant. Does this have something to do with our baby being sick? Because we don’t live near the plant—we live in
Blackhawk.”
He said the name of the most exclusive town in the Bay Area with hard-earned pride. Frank noticed Gates glance at his wife, who was scowling but said nothing.
“It may not be the result of exposure, but that is one of the risk factors,” Frank said.
“Dr. Lombardi, I spoke to a friend of mine,” Ms. Gates said. “She has a toddler who was diagnosed with this same disease a year ago.”
“A neighbor?” Frank asked.
“Used to be,” Gates said.
There was a knock at the door. Kim handed him the lab results.
“Thank you.” Frank was still trying to be hopeful. The blood test was often a false positive. The biopsy would tell them for sure. “Now let’s see,” he said, and then began to review the tissue diagnosis on the first page, outlining everything that the pathologist had found. Then he flipped to the conclusion on the second page. He felt his face fall.
Lymphoblastic lymphoma/acute lymphoblastic leukemia.
“The test was positive,” Frank said as he looked down, unable to face the parents.
“Positive—that’s good, right?” Ms. Gates said, forcing a smile.
Frank looked into her worried brown eyes. “I’m afraid not. I’m very sorry.”
Ms. Gates burst into tears, which caused Justine to start crying, too. She pulled her child against her, trying to comfort them both as she rocked back and forth. “My baby, oh, my baby, my baby…”
SIXTY-SIX
5:15
A.M.
Next day
Thursday
Alameda, California
L
IEUTENANT
J
AMES
poured himself a cup of coffee from the glass pot. The steam felt damp against his tired face. The kitchen was still dark except for the light from the streetlamp outside and the orange glowing light on the coffeemaker. His wife was still asleep, as were his twin daughters. He had gotten home late the night before, too late to read them a book or say good night, but they always wanted him to kiss them, even if they were asleep. He had walked into their bedroom, pulled up their covers, and kissed their warm cheeks. They smelled like baking loaves of bread.
The phone rang, and Lieutenant James jumped to the counter to answer it, hoping it wouldn’t wake up his wife or his girls.
Who is calling at this hour?
“Isaac, it’s Commander Swift.”
“Sir.”
“The facts on the ground are changing. We’ve got to get that whale out of there by tomorrow, or we’re going to have to euthanize it.”
“Sir, I thought we had at least until the end of the week. As I’m sure you know, Humphrey was upriver for twenty days before he was rescued.”
“This operation is costing the state much more than Humphrey ever did, and money is only one of the factors.”
“Factors, sir?”
There was an awkward silence. “Isaac, your order is to get that whale out today or kill it tomorrow.”
“I don’t know how to get it out, Commander.”
“Well, find out how, or we have no other choice. I want to hear back from you by 1400. Understood?”
“Yes, sir.”
As Lieutenant James hung up, he heard little feet on the stairs. His brown-haired daughters came running at him with big smiles, and each hugged a leg as he turned around. His girls were getting so tall they now came up to his waist. Kayla was in her pajamas and held a book in her hand. Eliana was already dressed and held her blue sneakers against her chest.
“I can do it, Daddy. I can do it myself.” Eliana had been trying to learn to tie her shoes for months. The fact that she was already six and her twin sister knew how to do it was a source of serious embarrassment. Lieutenant James squatted down as she slipped her sneakers on over her frilly white socks. She picked up the laces of her left sneaker and wrapped them around each other, her face in deep concentration. But she got lost in the twisting and threw her laces down in defeat, all the more frustrated because she had thought she could do it.
“Remember the rabbit ears,” Lieutenant James said as he took the laces and looped each one. “Wind one ear around the other and come through the rabbit hole like this. Now you try with the other foot.”
“No, I can’t do it.” Eliana was frowning, and her arms were crossed over her chest.
“You can do it, Elly,” her sister said as she sat down to read.
Lieutenant James held up his pointer finger like the number one. “One more try? Just one more try?” He smiled, found her downcast eyes, and spoke in a playful voice. “Just one more little try.”