Why wouldn’t she let him help? He almost resented those friends of hers. Without them, she might turn to him, which she should do anyway. This was his child, too.
Would it be a boy or girl? he wondered. Would it have his mother’s nose or his father’s eyes? Maybe it would be a little girl with Stacy’s curly hair and elfin chin. If he saw her on the street someday, would he recognize her? And all this had started with one overachieving cell shaped like a tadpole and only a fraction the size of the period he’d just made in his notes.
Cole had two offices, one in the medical building, where he saw private patients, and the other designated for the head of the men’s fertility program, in a ground-floor suite at the hospital. In his hospital office, he found a sports jacket on a peg and carried it to the doctors’ lounge, which had a full-length mirror. Putting it on, Cole examined his reflection. Too casual? He replaced it with a white coat. Too pretentious? He felt ridiculous spending so much time deciding what to wear, yet he rarely appeared before the general public and wanted to make a good impression.
“I’d stick with the white coat.” From across the lounge, Owen Tartikoff regarded Cole with amusement. Where had he come from? Whatever. On this occasion, Cole could use a second opinion.
“You think?” He frowned at his image. “I don’t want to come across like some TV doctor.”
“Image counts,” the fertility chief observed. “But only if you get moving.”
Cole checked the clock. Ten minutes to two. “Damn. I’m running late.”
“Never thought I’d see you flustered about giving a little speech,” Owen said.
Instead of dignifying that remark with a response, Cole asked, “Are you introducing me?”
“Got to babysit the twins.” The surgeon rolled his shoulders. He’d been operating this morning, too. “Bailey has a rehearsal with the church choir. Don’t worry. Jennifer Martin will warm them up for you.”
“Does she know any male fertility jokes?” Cole asked.
“Those might play better at a urology conference.”
“Good point.” Cole returned to his office, rehung his sports jacket on its peg and hurried toward the auditorium. There were a lot of men milling around in the corridor, and a couple scowled at him when he angled between them. One large fellow made a move to block his path until he noticed the white coat.
“Are you the speaker?” the man asked.
“That’s right.” Cole indicated the congestion. “What’s the holdup?”
“No seats.”
No seats? The steeply tiered auditorium had permanently installed, well-upholstered chairs. He didn’t see how anyone could have removed them.
A pretty, dark-haired woman peered anxiously from inside the double doors. “Cole!” It was Jennifer.
“Is something wrong with the chairs?” he asked as the man got out of his way.
“They’re filled.” She gestured for him to enter, and raised her voice to the men waiting in the hall. “If you don’t mind sitting on the carpet, you can use the side aisles. For safety reasons, you have to leave space for at least one person to pass. Also, please avoid the area around the TV cameras.”
The what?
“This way.” The public relations director guided Cole down a side aisle, ahead of the sea of latecomers. How many people did this auditorium hold? he wondered, as heads turned to follow their progress.
Most of the crowd was male, with a sprinkling of women among them, Cole observed as he took a seat on the stage. As Jennifer had indicated, a camera crew occupied a post at the rear, which, given the steep slope of the room, put them at his eye level. A man with a couple of cameras dangling from his neck stood near the front, presumably also from the press. Who’d have thought the subject would attract so much attention?
When Jennifer reached the lectern, a profound stillness gripped the audience. No papers rustled. These weren’t academics. They were people who cared.
“We are fortunate to have one of the nation’s foremost urologists with us today,” Jennifer began. “Dr. Cole Rattigan is the innovator of surgical techniques that have become standard...”
His mind drifted as she summarized his education: University of Minnesota Medical School, Residency at Yale... The audience members leaned forward, listening intently. A few gripped tablet computers. Others held up cameras, presumably recording video. Everything he said was likely to be tweeted and blogged and posted online within seconds. How strange. That never happened at urology conferences.
“Without further ado, I give you Dr. Cole Rattigan,” Jennifer finished.
Applause accompanied Cole to the microphone. Several microphones, in fact.
He got straight to the point. “Increasingly, or perhaps I should say decreasingly, we hear reports from around the globe that sperm counts are dropping to historic lows,” he said. “How do we compare to our ancestors? That’s debatable. It’s not as if anyone ran around in ancient times testing sperm samples from the Visigoths.”
Laughter rippled through the assembly. It felt good.
“However, there is evidence that during the past few decades, sperm counts have indeed decreased.” He cited a few statistics. “It isn’t only the number of sperm that affect fertility. There’s also motility—the ability to swim—along with speed, concentration and morphology, which means shape and size.”
The only noise came from fingers tapping on laptop keys and the scratch of pens on paper. Cole hadn’t said anything interesting yet, just provided some basic background.
“What’s causing this?” he asked rhetorically. At the back of the auditorium, a few more latecomers slipped in and stood against the wall.
“The easy answer is to blame the environment.” Cole didn’t bother reading his notes. Everyone knew this stuff—well, everyone in his field. “Toxins in our food, our air and our water. But it isn’t that simple. Our genetic programming and our social mores have an impact, too.”
He explained that since sperm-producing genes exist only on the Y, or male, chromosome, there was no way for the body to compensate for a degraded gene with a healthy one from the X chromosome. In time, this situation could cause birth rates to dwindle. Most species compensated with promiscuity.
“It may not seem very nice,” he said, “but the result is that the guy with the healthiest sperm sires a lot of children, while the guy with weak sperm doesn’t reproduce. That might sound like we’d lose a lot of Einsteins and gain a lot of action heroes, but we shouldn’t equate rough-and-ready sperm with rough-and-ready physiques.”
A few chuckles greeted this remark. Well, Cole had never claimed to be a stand-up comic.
“Sad to say, the use of anabolic steroids to increase muscle mass and improve athletic ability is widespread. These steroids may be male hormones, but ironically, they suppress a man’s ability to manufacture testosterone. Some of the side effects can persist across one’s lifetime,” he added.
“Our personal medical histories and lifestyles also affect fertility.” Among the harmful factors, Cole listed infections, smoking, obesity, poor diet, too much or too little exercise, illegal drugs, and both prescription and over-the-counter medications.
Okay, he’d scared them enough. “On the plus side, many of the conditions killing or impeding sperm can be fixed. Sometimes weight loss, improved diet, vitamin supplements and a healthier lifestyle will do the trick. Other times, surgery or advanced fertility techniques can help a man to father children.”
He described some of the newer treatments, and concluded, “There’s research under way that may allow even men with no sperm to become fathers by using their stem cells. So far, it’s only been tested on mice, but then, it’s a mere thirty-five years since the first test tube baby was born, and more than four million infants have been born in vitro since then. Yesterday’s miracle is today’s standard course of treatment.”
Cole expected the usual smattering of applause. Instead, a swell swept through the auditorium as the listeners rose
to their feet. What had he said? He’d just reiterated facts known by everyone in his profession.
Finally, the ovation ebbed and people sat down. “Any questions?” Cole asked.
Hands flew up. He pointed to a husky fellow in the center.
“This was interesting, but when a couple can’t have a baby, isn’t that mainly the wife’s problem?”
A woman in the audience hissed. Cole figured she’d like his response. “Quite the opposite. In about sixty percent of infertility cases, the man’s condition is involved. Twenty percent involve both the man and the woman, and forty percent are mostly him. Since running a sperm analysis is relatively simple, that should be one of the first tests to consider.”
More hands went up. Before Cole could choose from among them, a tall man with abundant wavy hair shouted from near the cameras, “So are you saying there’s a danger of the human race fading away?”
Normally, Cole would have laughed off such a ridiculous question, but he knew enough not to dismiss the press. “Well, if we relied on technology to reproduce for a few millennia, and then an asteroid knocked us back to the Stone Age without modern medicine, we could be in trouble.” He had to smile at such an unlikely scenario. “But—”
“So you’re saying we may be evolving into a species unable to survive without doctors?” interrupted a heavily made-up woman in a power suit.
Cole decided to provide a bit of perspective. “In a similar vein, one could argue that vaccines and antibiotics interfere with our developing genetic immunities. Should we let millions of people die from treatable or preventable diseases, and let the survivors and a few naturally immune individuals repopulate the planet?”
Jennifer scooted to the microphone, which Cole gladly relinquished. “I see we have a lot of questions.” Deftly, she began calling on ordinary folks who wanted to know about testing, surgery and outcomes.
Fifteen minutes later, although there were still hands waving, Jennifer apologetically ended the session. “I’m afraid we can’t get to everyone. If you’ll email your questions to the public relations office, I’ll forward them to Dr. Rattigan. Thank you all for coming.”
“I wouldn’t mind answering their questions,” Cole told her as she led him off the stage. “I’m in no hurry.”
“We have security personnel whose shifts are ending,” she explained. “And I promised Ian I’d relieve him of babysitting duties so he can conduct an interview.”
Cole recalled that her husband, a journalist and author, hosted an online news focus show.
“I see,” Cole said. “Thanks for your help.”
“I didn’t expect this big a turnout,” she admitted. “You handled the press well.”
“They tend to ask silly questions.” He had received his share of accolades and awards over the years, but he’d never before had an experience like this with the media.
“They aren’t all so superficial,” Jennifer said as they skirted the remnants of the crowd. “Ian explores serious issues on his show. Still, he couldn’t earn a living doing that. Serious journalism rarely goes viral.”
Cole held a side door for her. “I don’t understand why anyone would want to be famous,” he said, right before he stepped out into the glare of camera flashes.
Chapter Seven
With microphones in his face and questions flying, Cole did his best to answer the barrage of increasingly ridiculous questions. Should schools teach teenage boys to preserve the health of their sperm? Should the federal government create an office to combat the decline in male fertility? Should there be a law against tight-fitting men’s underpants, since these could raise the temperature enough to damage sperm?
His struggles to keep a straight face soon gave way to frustration. A handful of men were waiting to one side, clearly eager to ask about their personal situations, while the reporters ignored Jennifer’s attempts to wrap up the impromptu press conference. A security guard hovered, held in check by the PR director’s warning frown. You didn’t manhandle the press.
All the same, Cole feared that if this went on much longer, he might lose his temper and become sarcastic. His tongue had sliced and diced more than a few bullies in his early years, but those individuals hadn’t had the power to edit his comments and make him look like a bad-tempered idiot on the air.
“As a fertility doctor, aren’t you adding to the crisis of unwanted babies?” demanded a man whose T-shirt bore the call letters of a Los Angeles radio station.
Cole hardly knew where to start. “Men who undergo treatment aren’t likely to abandon their children. And if there’s a crisis of unwanted babies, why are so many couples adopting overseas?”
“Isn’t the whole infertility field just a racket to make doctors rich?” the reporter persisted.
Cole found himself at a rare loss for words. Mercifully, a series of loud claps cut off the other reporters’ attempts to leap into the breach.
From among the men waiting at the side, a blond fellow built like a wrestler stalked in front of the reporters. “You folks have had your turn,” he boomed. “Now mind your manners and give the rest of us a chance.”
“Who are you?” someone demanded.
“I’m a high school biology teacher used to setting boundaries for adolescents.” The statement drew muffled laughter.
“The public has a right to know,” a female journalist snapped.
“Yeah, you’re not in charge here,” a radio reporter interjected.
“Ever heard of showing respect for others?” the teacher responded. “If you were my students, I’d send you all to the principal’s office.”
Seizing his chance, the security guard moved in. “Folks, fire regulations require me to clear the corridor. If you’ll just head toward the exits...”
“Thank you for coming,” Jennifer called, and grabbed Cole’s elbow. “Quick! Hide!”
Most of the waiting men scattered, along with the press. Spurred by a sense of fair play, Cole waved to the teacher to come with them.
They ducked into the fertility program suite. It being a Saturday, there was no one else around.
“Thanks, Jennifer,” Cole told the PR director as he unlocked his private office. “You’ve been great.”
“You sure you’re all right?” She seemed uncertain about their guest.
“Go home to your family.” Speaking those words gave Cole a twinge. Until recently, families had belonged to other people, not to him. Now his thoughts flew to Stacy and the baby she carried.
She’d told him to mind his own business. Yet wasn’t it his business, too?
To the teacher, Jennifer said, “I’m Jennifer Martin, by the way, and you did a great job of running interference.”
“Peter Gladstone. My motives were purely self-serving.” They shook hands. After she departed, he accepted a seat. “I appreciate your sparing me a few minutes, Dr. Rattigan.”
Behind his desk, Cole shifted into doctor mode. “What can I do for you?”
“I’m trying to find out if there’s any point in my even making an appointment. My case might be hopeless.”
“What seems to be the problem?” Normally, Cole would have insisted they continue this discussion during an office visit, since he couldn’t assess the situation without a medical history or an examination. However, in view of Peter’s help earlier, he felt the guy deserved more than a quick dismissal.
The man folded his muscular arms. “I have a low sperm count. My previous doctor ruled out a number of factors, but he couldn’t find a cause.”
Mentally, Cole struck off the man’s age—early thirties—and apparently good health as possible causes. “He didn’t give you a referral?”
“He never got the chance. My wife...” The teacher’s voice broke.
Cole refrained from offering sympathy. In his experience, guys who got emotional preferred to pretend you hadn’t noticed.
Peter swallowed and went on. “During the fertility workup, we discovered my wife had ovarian cancer. She died
a year and a half ago.”
“I’m sorry.” He was confused. “Why are you concerned about your sperm count now?”
“Having children has always been my dream,” the teacher said. “I can’t believe I’ll ever find anyone I could love as much as Angela, but even if I do, how could I ask her to marry me if I can’t father children?”
He could find someone who loved him enough to adopt or to use artificial insemination, but this wasn’t a counseling session, and Peter was smart enough to have considered those ideas on his own. Obviously, he wanted his own flesh-and-blood children. “Do you remember what tests have been run?”
Peter’s expression cleared at the straightforward question. “Yes, I do.” He read off a list of tests and results from his cell phone. The previous physician, a local urologist, had done a thorough job.
Although they’d exhausted the obvious possibilities, that wasn’t the end of the story. “I’d like to review your case in more depth,” Cole told Peter. “If you have any trouble getting an appointment, ask for my nurse, Luke Mendez.” Cole typed on the computer as he spoke. “I’m sending him an email right now. We’ll schedule you in.”
Gratitude suffused the man’s face. “I can’t tell you how much this means to me.”
“I’m glad to help.”
After his visitor left, Cole made a few notes while the discussion was fresh in his mind. Peter’s determination to have children underscored the irony of Cole’s own impending fatherhood.
What was he going to do about it? The prospect of standing aside, preserving his anonymity and watching Stacy take the heat as she grew ever larger struck him as unacceptable. And what about their baby?
Working in a hospital, he saw babies all the time. Their presence barely registered, though. Taking a closer look might help guide his reaction.
After locking his office, Cole climbed to the third floor. While most of the hospital lay quiet on a Saturday afternoon, there was plenty of activity around Labor and Delivery. During his internship, that hadn’t been one of his favorite rotations. Too much noise, too many hard-to-control factors and too many relatives swamping the waiting rooms and demanding updates.
The Baby Jackpot Page 6