Miracle Cure (11 page)

“I love you, too, babe,” Brian said, swallowing against the baseball that had suddenly materialized in his throat.

“Knock knock,” Becky chirped without bothering with a greeting.

Nearly seven, she was radiant, high-energy, athletic, and as down-to-earth as Caitlin was ethereal. Brian had once asked the girls if they ever agreed on anything. Not surprisingly, one replied yes, and the other, no.

“Who’s there?” he responded.

“Ivan.”

“Ivan who?

“Ivan workin’ on the railroad. Here’s Mommy. Bye.”

“Becky!” Phoebe called out. “Come back here and talk some more with your father.… Gone.”

“That’s okay. I got a knock-knock joke out of her that was actually a knock-knock joke. I’ll settle for that.”

“She’s doing great.”

“I know. They both are.… So, I’m officially on board.”

“Congratulations. You should be very proud of yourself.”

“I get paid next week. Postdocs don’t earn too much more than fellows, but the check I’ll be able to send you will be increased by almost fifty percent.”

“Good for all of us,” Phoebe said, out front as always. “My bank account echoes when I deposit money in it. If what you say is true, pretty soon I might be able to cut back a couple of hours a week at work—maybe get involved in Brownies.”

“Good idea,” he replied, carefully avoiding any reaction to her not-so-subtle reminder of his years of broken promises.

There was silence, during which Brian knew she was waiting for his retort.

“You know,” she said finally, “as angry and frustrated as I was with you, I always sensed you could make it through this thing.”

It’s still a day at a time
, Brian wanted to warn her. Instead, he thanked her. The sentiment was one she had never expressed before.

The ER was in a rainstorm-induced lull. Brian crossed the muddied reception area and caught up with Gianatasio in the hallway just outside room 4. Phil was hunched over a man in a wheelchair, listening with his
stethoscope inside the man’s unbuttoned shirt. His patient, who looked every bit of seventy-four years, had his left wrist in a cast and his arm in a sling. His unruly hair was a pile of silver straw. His thick-featured, deeply etched face had a pleasing quality to it, although at the moment he appeared anxious. A man who had endured hard times and prevailed, Brian thought.

Phil worked the stethoscope from his ears and straightened up.

“Wilhelm Elovitz, meet Dr. Brian Holbrook.”

“Bill. Everyone calls me Bill,” Elovitz replied with a totally engaging smile and a modest Jewish accent. He gestured to the middle-aged woman pushing his chair. “This is my neighbor, Mrs. Levine. She’s here to take me home.”

“Bill is going to be on the ten o’clock news,” Phil said. “Maybe even on CNN, and possibly in
Ripley’s Believe It or Not
. The MBTA platform at Downtown Crossing was so crowded, he got shoved off in front of an oncoming train. The conductor managed to stop just in time, but then Bill stumbled trying to get up and fell right on the third rail. This rubber raincoat kept him from becoming a crispy critter, and all he ended up with was a broken wrist.”

“You
can say ‘all he ended up with’ because it is not your wrist,” Elovitz remarked dryly.

“Why did the ER people ask for a cardiac consult?” Brian asked.

“Oh, partly because they just thought that anyone who fell on ten trillion volts ought to be checked over by us whether he conducted the electricity or not, and partly because he’s a Vasclear patient. One of the first, as a matter of fact.”

Brian’s interest perked up immediately.

“And you’re doing okay?” he asked.

“I don’t know about
your
okay,” Elovitz said, “but by
my
okay I’m okay. Now please. My wife is not well and she’s very worried about me. I’ve got to get home.”

Brian noted that the man took an extra breath or two during each sentence.

“Dyspnea?” he asked Phil.

“He’s in some early CHF,” Gianatasio replied, using the abbreviation for congestive heart failure—fluid building up in the lungs because of a weakened heart. “Listen, Bill. You’re a little short of breath. I don’t work in the Vasclear clinic anymore, but Dr. Holbrook does, and he would like to check you out. Could you call the clinic tomorrow and make an appointment to see him?”

Elovitz cocked his head and looked up at Brian.

“You’re a good doctor?” he asked.

“Pretty good,” Brian said. “Yes.”

“In that case, I’ll call. Thank you, Dr. Phil. Let’s go, dear.”

Before either physician could say a word, Mrs. Levine had wheeled her charge down the hall and around the corner.

“He’s cute,” Brian said. “How’s his ticker?”

“It needs some buffing up. I don’t do really good exams in the hallway on patients who are fully dressed and squirming to get out the door. That’s why I told him to arrange to see you. You might want to check with the Vasclear secretary in two days. If he hasn’t made an appointment, maybe we should call him. Now, let’s repair to the residents’ room. I want to know if Juicy Lucy came on to you or not.”

Twenty minutes later, Brian walked Phil out of the hospital and then returned to continue his orientation tour. Gianatasio was in no position to determine whether
Wilhelm Elovitz was a treatment failure on Vasclear or whether his symptoms were due to factors other than hardening of the arteries. But he did make the point that Brian already knew well—while the drug had so far proved to be wildly successful by any standards, twenty-five percent of patients receiving it did not respond.

Brian wandered back to Boston Heart and made his way past the third-floor operating suite and the second-floor laboratories. Patient registration and the administrative offices were on the main floor, along with the regular cardiac clinic. The basement level housed the cardiac cath lab on one end and the animal maintenance facility on the other. In between them was a mechanized canteen. Brian suddenly realized he hadn’t eaten anything since breakfast except Phil’s cake.

He picked the stairs nearest the cath lab and descended to the basement. Tomorrow morning he would be taking the same stairway down to scrub in on a cath case for the first time in a year and a half, and with Carolyn Jessup no less. The cath lab and the film library next door to it were locked, and the basement corridor was totally deserted, although there were lights on beyond the twin glass doors of the animal facility. He was approaching the small canteen when a man emerged carrying a small cardboard box with two coffees and some sandwiches. He was Brian’s height, or even a bit taller, but with a linebacker’s broad shoulders and narrow waist; small, dark eyes; high cheekbones; and acne-scarred skin. He was wearing jeans and a blue button-down dress shirt, and was so startled at seeing Brian that he nearly dropped his food.

For the briefest moment, their eyes met. Brian saw only hostility and not a spark of intelligence. The man grunted a greeting, missed badly at an attempt to smile, and backed away several steps before turning. He then
hesitated once more before entering the stairway across from the one Brian had used—the stairs down to the subbasement. Brian checked his map. The floors depicted on the sheet ended with the basement. He tried to place the man into some hospital niche based on his dress, impressive size, and connection with the subbasement. Maintenance? Security? Laundry? Heating plant?

A few moments later, Brian was microwaving a breaded chicken-breast sandwich and sipping from a paper cup of scalding coffee as bad as any he had ever tasted. The strange, moose-in-the-headlights expression on the man’s pockmarked face refused to fade from his thoughts. But what could the guy have been doing? Stealing food from the vending machines?

Brian’s reflections were cut short by his beeper. The number in the display was his home phone. He checked around for a phone, and then carried what remained of his sandwich and coffee down the glimmering linoleum to the lights at the end of the hall, where Animal Maintenance Facility was painted in gold across the first of two pairs of glass doors. It wasn’t until he was inside the outer set that Brian smelled and heard the animals. Through the inner doors, the odor and racket were a lot stronger.

“Help you?”

The man, his feet up on an old, scarred desk, was gaunt and ill-kempt. Brian took in the gray stubble, scraggly gray-black hair, jeans, and stained knee-length lab coat. An empty pen holder/nameplate on the desk identified him simply as Earl.

“My name’s Holbrook, Dr. Brian Holbrook. Today’s my first day at BHI, so I’m kind of orienting myself. I also wanted to use your phone if I could.”

“Phone’s all yours,” Earl said with an Appalachian twang. “I heard you was comin’ today. Gonna be helpin’ with the Vasclear study, right?”

Brian was surprised that this basement dweller knew of him.
People may be talking about you, but so far, I haven’t heard anything
. Isn’t that what Phil had just said?

The man’s teeth were nicotine-stained and in dreadful condition, and he was contributing, not insignificantly, to the odor of the place. But there was a smell other than filth that Brian detected coming off him as well—a smell he had become sensitized to over the last eighteen months—alcohol.

“That’s right,” Brian said. “I’ll be working on the ward and covering the Vasclear clinic some evenings. Were you involved in the animal studies?”

“’Course.”

Brian picked up the receiver, at the same time nonchalantly dropping his half-eaten sandwich into the trash. The man’s body odor, plus the alcohol fumes, had killed his appetite. Jack’s line was busy. Just a few hours ago, the visiting nurse had reported him stable and in decent spirits. Brian checked the coverage list. Sally was supposed to be there with him. It was most likely something minor, he decided.

“Busy,” he said. “Okay if I look around for a few minutes before I call again?”

“Suit yerself. I’ll be right here.”

“What animal did they use for the preliminary Vasclear studies?”

“Oh, a little of everything,” Earl replied. “That’s the way they usually do it. First the rats ’n rabbits, then a whole bunch of pigs, a few sheep, some dogs, an’ finally some monkeys. They like to work with them pig hearts most of the time. Somethin’ about them bein’ a lot like human hearts. Doesn’t surprise me none. I can show you a lot of humans who are just plain pigs.”

His mucousy laugh at his own humor terminated in a spasm of coughing. Brian glanced down at his newly
placed TB skin test and made a mental note to have a follow-up done in a few months.

“Any problems arise with the testing?” he asked.

Earl looked at him queerly.

“Why no,” he said finally. “Why would you ask somethin’ like that?”

Brian grinned, trying to dispel the sudden change in mood.

“Just wantin’ to learn about the drug I’m going to be workin’ with is all,” he said, consciously adding the slight twang to his voice.

“Well, for your information, the animal testing was perfect.”

“That’s great to hear. I’ll be back in a minute to try that call again.”

Brian turned quickly and headed through the glass-paneled door to the right of Earl’s desk, and down one of the rows of cages.

Earl’s territory was actually quite large—and much better maintained than the man himself. From the left side of the facility to the right, the cages and the animals increased in size. Mice, hamsters, rats, rabbits, even some small dogs. Brian had never had pets when growing up and perhaps for that reason didn’t feel passionately against animal testing of pharmaceuticals, so long as the animals themselves were well cared for. But looking at them now, in row after row of cages, did affect him.

To the far right, separated from the rest of the facility by a glass wall, was a series of larger cages. Several of them were empty at the moment; two held sheep; two others large dogs; and eight of them housed primates—six wiry gibbons and two chimpanzees.

The primate cages were four feet wide by eight feet deep—tall enough for a man to stand. Brian was pleased to see the swinging bars and children’s toys—touches of
caring. Several of the monkeys seemed as curious about him as he was about them. Then, one of the chimps caught his eye. It was the smaller of the two, although it was still as large as a six-year-old child. It was slumped against the near corner of the cage, apparently asleep. But its breathing was sonorous and labored, and its abdomen seemed markedly distended. In addition, its hind paws were strikingly swollen.

To Brian’s eye, the somnolent animal seemed to be experiencing fairly severe fluid retention. Lungs, kidneys, liver, heart—instinctively, Brian thought through the various system failures that could be causing such a condition, acknowledging that certain hormonal imbalances could produce the same picture as well.

There was a mop resting against the wall nearby. Brian held it at the business end, slipped the pole between the steel mesh, and gently prodded the animal. Nothing. No reaction at all. He repeated the maneuver a little more firmly, touching the end of the pole against the side of the chimp’s distended belly. A rheumy eye opened and slowly looked down at the spot. But there was no reaction besides that. The animal was ill, almost moribund. Brian noted down the number in the card affixed to the cage—4386. Then he returned to the desk, where Earl was reading the comics in the
Herald
.

Before mentioning the animal, Brian called Jack once more. His father answered on the first ring.

“Brian?”

“Yeah, Pop. You okay?”

“Of course. I was just calling to see when you were coming home.”

Brian winced. Once one of the most fiercely self-reliant men he had ever known, his father was becoming more and more dependent as his illness progressed. Brian had encountered the syndrome in many of his patients,
but Jack was only sixty-three. It was as if his natural aging was accelerating. And without any siblings, Brian knew there was nowhere for him to displace the consequences. The coach was rapidly becoming his third child.

“I was going to wait until the traffic let up some,” Brian replied. “Seven-thirty, eight, maybe. Can I bring you anything?”