Embryo 1: Embryo

by JA Schneider

  Damn! Jill thought. That long?

  Using a micropipette, Gregson explained how he was now teasing out some of the cells into discrete particles. “Nice crop,” he murmured. “Very nice.”

  Jill watched as he transplanted the separated cells from the slide onto a Petri dish, its amber culture medium loaded with nutrients and antibiotics to suppress bacterial growth. The Petri dish disappeared into a nearby incubator, and Gregson slammed its door.

  “Want to do the next one?” he asked.

  “Goddammit!” Tom Ganon bellowed. “Where’s Raney?”

  Tension was always high in the GYN clinic when he was there, but this outburst sent nurses scurrying. Someone dropped a tray of instruments, and a resident calmed a patient he’d been wheeling.

  Tricia Donovan poked her head out of one of the examining rooms.

  “Jill’s coming,” she said nervously, not wanting to further enrage the chief resident.

  Ganon held a schedule practically in her face and pointed back to the crowded first floor waiting room. “We’ve got patients lined up to the door out there. Raney’s twenty minutes late. Now just where in hell - ”

  “I said, she’s coming.” Tricia floundered for a better answer, and came up with the worst.

  “As a matter of fact, I think she’s involved in a follow up.”

  Ganon’s eyes narrowed. His arm slowly lowered the schedule. “What follow up?”

  Tricia’s lips parted. Oh Jill, I’m sorry.

  Reddening, he stepped into the flimsy-curtained cubicle. Tricia had to back up to where a patient, naked except for a flimsy paper gown, looked mortified. Ganon ignored her. “What follow up,” he repeated in a threatening voice.

  Then Tricia remembered she wasn’t that dumb. “Dolan,” she said brightly. “Dolan lost a lot of blood, and this morning her hematocrit – ”

  He turned and left.

  In the office behind the nurses’ station, he closed the door, picked up a phone and punched numbers.

  The idea of doing “cell autopsies” had first occurred to Jill during her phone call to the morgue.

  She still found it mind-boggling that specimens from cadavers could be grown out, multiplied, and studied as if they had come from living patients. The cells, Jill thought, might have something to say about what had gone wrong with each pregnancy. And more compelling – although this was farfetched – the cells might reveal if these two vastly dissimilar cases were somehow related.

  She was frowning as she left Pathology and walked to the elevators. Husband indeed. Someone certainly seemed to want Mary Jo Sayers out of the way, and no one had called about her infant. If that nice young man had been Sayers’ husband or ex or even friend, wouldn’t he have at least asked about the baby?

  Three med students were waiting by the elevator; Jill barely noticed them. Christopher Sayers, she thought, would be easier; his problem had doubtless been genetic.

  But what about Moran?

  The elevator arrived, and Jill followed the med students in. Moran’s family had forbidden an autopsy or removal of the unborn fetus for examination. Ironic, that the nature of the woman’s death made all that unnecessary. She had died of abruptio placentae. This meant that, after the initial catastrophic rupture, amniotic fluid containing fetal cells had surged through the maternal circulation via the large uterine vessels, then had “seeded out” everywhere throughout the mother’s body. Moran’s skin cells had stayed alive, and plenty of those cells, Jill suspected, would carry a dose of fetal hemoglobin “marker.”

  So there it was. The clue – if there was one – would be found in two tiny skin tabs.

  On the first floor she got off and turned down the wide gray corridor. She passed crowds of indigents, milling about or waiting in passive lines. Her mind was in a fit of abstraction.

  Turning into the waiting area of the GYN clinic she thought: Sayers and Moran were both here at ovulation time.

  No connection, said the experts.

  She stopped suddenly, heedless of people around her, and looked at the ceiling as if she could see through it all the way to Obstetrics. She wondered if anything else had gone wrong there: before her internship began; last month; last year. Mishaps perhaps not so rare and dramatic as those of Sayers and Moran…but still, trouble…some of it so subtle as to be missed by anyone not looking for it, not suspecting connections…

  The two little jars now sitting in Pathology’s incubator would have answers.

  Her watch read 11:25. Great, and Ganon was clinic head for today. Brace yourself.

  She pushed through the automatic doors, and entered that tumult.

  “Hold it.”

  He caught her by the wrist as she was rushing from her sixth to seventh patient. By skipping lunch she had whipped through routine exams, no frills, little conversation, just do it right and catch up. Others had been busy and thank goodness there’d been no sign of Tom Ganon. It was now 1:09. What luck.

  Until there stood David Levine suddenly blocking the way.

  “Let go,” she complained. “What are you doing?”

  “Have to talk to you.”

  “I’ve got more patients!”

  “Woody’ll do them. Won’t you, Woody?”

  Woody Greenberg came up, carrying a pile of charts.

  “Sure,” he said. “Hey Jill, Tricia says she got you a sandwich, right? You shouldn’t skip lunch!” He turned into a cubicle and chirped a greeting to the patient.

  Jill turned irritably back to Levine. “What’s going on?”

  He pulled her into a free cubicle and yanked the curtain closed. “Funny,” he said. “I was about to ask you the same. Do you have any idea of how much hot water you’re in? Stryker’s office has been getting angry calls. You shook up the Psych floor. You were late here. Ganon went personally to Stryker to complain about you. What could have possessed you to go off the rails like that?”

  She regarded him stonily. “Go off the rails?”

  “You heard me. Is this about what you wanted to tell me this morning?”

  He looked more troubled than angry. She relaxed somewhat and drew a deep breath.

  She sat and started slowly: the uneasy feeling that persisted after yesterday’s OB casualties; the charts in Emergency where she’d found a link between the Sayers and Moran tragedies…

  “This was after I saw you last night?”

  “Yes.” She began to speak more rapidly. “Bizarre, isn’t it? Both women here for routine exams right at their ovulation time? Neither exam signed, which is unusual – ”

  “Not as unusual as you think. People get crazy busy, absentminded – ”

  “But both? Some coincidence!”

  Levine looked at her. He dropped tiredly into the chair next to her. “Yeah, some coincidence. But I’ve seen stranger things in this place. You learn not to react every time the impossible happens.”

  “And what about the Sayers kidnapping?” she challenged.

  “Kidnapping?” His tone was ironic. “I called Psych back after their complaint. Her husband came and discharged her.”

  “He wasn’t her husband.”

  “I saw the chart. Yeah, Sayers told the admissions clerk she was divorced. So maybe the guy was her ex. The nurse in Psych said he looked really concerned, so he was somebody who cared.”

  “He left the baby,” Jill said tonelessly. “Didn’t even inquire. Nothing about funeral or some kind of arrangement. No calls to the morgue.”

  There was a long silence. In a low, stifled voice David said, “The fetus was just 21 weeks old. Women miscarry plenty and do you hear of them having funerals? People have different ways of dealing with things.” His head dropped down. “God knows, most of us never get used to the things we see. But we don’t turn the place into total chaos either.”

  Jill rose stiffly. “You don’t have the slightest feeling that anything peculiar is going on?”

  He gave her an exasperated look. “Notions like that are the exclusive domain of new i
nterns.”

  Jill had had enough and tensely headed out. He reached and pulled her back. “Listen,” he said, his face coloring. “Please play it cool from now on. Don’t buck the hierarchy! Later you can be Joan of Arc. When you’re higher up the totem pole!”

  “You’re mixing metaphors,” she said drily. But smiled a little in spite of herself. Why, she thought, he’s funny when he’s upset.

  He rose to look at her, surprised at the delight he felt in seeing her smile. “Hey,” he said. “That’s more like it.” For an instant he glanced down at the gentle rise and fall of her breasts under her scrubs.

  “Ahem,” he coughed. “Do we still have a date for tonight?”

  She hesitated, then nodded. “Provided I’m not thrown out by then.”

  “You won’t be. You haven’t received any blistering phone calls?”

  “No. I’m still waiting for the ax to fall.”

  “Maybe it won’t. They complained to me.” He paused. “Is seven okay? I’ll stop by your on-call room?”

  She said yes. He pulled aside the curtain and they went out to the busy gray room.

  “David, I appreciate your trying to help,” she said.

  He shrugged. “I’m not sure if I have yet.”

  She touched his arm affectionately and walked away. Levine stared after her, looking troubled again.

  16

  She was not surprised to receive the summons.

  At 5:20 she’d been returning from the X-ray department when Stryker’s secretary called her. Repocketing her phone, Jill realized she’d been rehearsing all afternoon what she was going to say. She would be cool and professional. She would present her convictions about the actions she had taken. She was still feeling resolute until the moment she entered the conference room – and saw the expressions on the four white-coated men who awaited her.

  “Have a seat,” said William Stryker coldly, indicating the chair at the end of the long table.

  It looked like Siberia down there. Clearly, that was the point. Jill walked to the chair and sat. From her end to the middle was all empty seats. Eight, four on each side. There were that many assistant researchers?

  The White-Coated Tribunal watched her gravely. Stryker, Arnett, Simpson and Rosenberg.

  She put both elbows on the table and folded her hands - not too tight so the knuckles would turn white. Her heart speeded up.

  Stryker leaned forward, his expression solemn. “Dr. Raney, I’m going to make this brief and to the point. The list of your infractions today is very serious. You have jeopardized the smooth functioning of the obstetrical department, and you have disrupted other parts of the hospital.” His pale eyes bored into her. “I have called this meeting to discuss the feasibility of retaining your tenure. Do you have anything to say?”

  Anger welled up. All Jill could think was, where is Mary Jo? Carefully she said, “I was acting in the best interest of the patient.”

  “And not of the hospital,” said Willard Simpson, heavy-jowled with little piggy eyes. His thin lips pressed tight.

  Jill looked hard at him. She squared her shoulders and struggled to keep her voice steady. “In my judgment, the Sayers patient was perfectly sane and lucid. There was no reason for the medications ordered for her, and the mere fact that the transfer order wasn’t signed – ”

  “The matter is under investigation,” Stryker snapped. “And by the correct authorities, which you certainly are not.” He pointed his finger at her. “You had no right to leave your floor and act as you did.”

  Her heart thudded but Jill eyed him levelly. “An innocent woman was cruelly manhandled, and you talk about rights?”

  Stryker’s spectacles reflected the glare from fluorescents. “You are very foolish, Dr. Raney. You were given the opportunity to work under the most eminent teachers of human genetics in the country. You are ruining your career before it has begun, and worse, you are ruining the chances of others. Are you aware of that?”

  Ruining the chances of others? Jill’s lips parted.

  Willard Simpson said curtly, “You have spoken with Dr. Levine?”

  Swallowing, she nodded.

  “Then I’m sure he’s told you,” said Stryker, “that he’s being held responsible for today’s troubles. A senior resident loses control of his floor, and the blame is on him.” He paused to let that sink in. “A pity, since Levine had been first choice for Tom Ganon’s position next year. Levine knows this. Your sabotage” – his voice roughened – “could severely undermine his chances.”

  Jill was dumbstruck. David had said nothing about this.

  “I had no idea…my…concerns would involve Dr. Levine.” Her voice faltered. “He never said …” David’s “Please play it cool from now on” came back to her. Guilt flooded in.

  Clifford Arnett broke the silence. “Well now, hang on a second. Can we explain our issues more clearly to Dr. Raney?” He glanced from Stryker to Rosenberg, a slender, studious-looking man who nodded imperceptibly.

  “Dr. Raney,” said Rosenberg. “Surely you realize where our concern is coming from. For months our work has been bogged down by so-called ethical controversy. We cure birth defects – in utero yet - but there are still people who don’t understand and call it tampering with nature.”

  Arnett said, “And our advanced in vitro program has attracted picket signs, ridiculous stories in tabloids.” He shook his head. “Now, something like the Sayers case is an isolated tragedy of unknown causes. But the fact that it occurred here, well, people seize on this sort of thing.”

  “And we don’t need you,” snorted Simpson, “running around calling attention to the problem. More qualified – and if I may say – more loyal people than you are already studying the Sayers case.”

  “Quietly,” snapped Stryker.

  Jill frowned, and said slowly, “I understand. The reputation of the hospital is at stake.”

  “Exactly,” said Simpson.

  She watched them, studying their faces, feeling her guilt turn back into boiling resentment. She stopped struggling to keep calm, and leaned forward. “If it’s true that the Sayers case is already under investigation, don’t you want to examine the patient? Question her about any drugs she may have taken in addition to examining the infant, who hasn’t been gone near in the morgue! Have you called Sayers’ place of employment? The Madison Museum, which you know, of course – it’s on her admission sheet. Ask them where she is and if she was married. And if she wasn’t, dear God! You can add kidnapping to your stillbirths, fetal abnormalities, bizarre maternal death – ”

  Stryker banged his fist on the table. “That’s it!” he shouted. “She’s out. This is intolerable.”

  The others reacted similarly until Arnett held his hands up to get a word in. “I just want to remind you that Dr. Raney is a person of extraordinary research potential.” He glanced subtly at Stryker. “Not to mention, a dismissed intern becomes an adversary, and what we need at this time is support, isn’t that right?”

  He looked back at Jill. “This only happened yesterday,” he said reasonably.

  Moments passed. Glances were traded. Oddly quiet, Stryker seemed to be pondering something, peering through his spectacles as though from a place far away.

  His gaze swiveled to Jill. “You will be watched very carefully.” His voice was deadly calm. “Every move you make will be scrutinized, and will reflect directly on Dr. Levine.”

  Blackmail, in other words. Stryker glared at Jill. “I have another stipulation to retaining you as an intern. Sometime tomorrow, I want you to visit the Infant School.”

  She stared. “The Infant School?”

  “You are familiar with it?”

  “Heard of it. It’s on the third floor. I’ve seen mothers bringing their babies – ”

  “The infants you will see there,” interrupted Stryker, “are the children of habitual aborters; of couples pronounced elsewhere as incurably infertile. They are children who would have had birth defects, were it not for the p
renatal diagnosis and treatment received at this hospital.”

  “Yes but – ”

  “When you see those children, I want you to remember that they represent medical advances unthinkable even five years ago.” His voice rose. “Perhaps then you will exhibit the respect which is due this institution!”

  His words stung. “I’ll go,” she said heavily. Thoughts collided and her head throbbed.

  She rose. The White Tribunal’s faces relaxed somewhat. Nothing was said as she gathered her things.

  At the door she wrestled again between impulse and restraint.

  “If that man wasn’t Sayers’ husband, will you call the police?”

  Four guarded masks went back on. No one answered.

  She stood watching them for a moment, then opened the door and went out.

  17

  Ruining the chances of others…

  At a wall phone on the OB floor, Jill removed the receiver and looked bleakly at her watch.

  Six-fourteen. Time enough to cut my throat.

  The operator answered. With an ache, Jill slowly said, “Please tell Dr. David Levine that Dr. Raney will be unable to keep tonight’s appointment.” She inhaled. “Tell him I’m sorry.” She signed out for the night and hung up. Made sure her cell phone was off too.

  The elevator arrived, and some happy husbands rushed out carrying flowers. Jill entered, staring miserably down until the car reached the main floor.

  She looked straight ahead as she weaved through the throng. Overhead, the page come alive to call Dr. David Levine. That was her call, she realized, and her heart turned over.

  “Sabotage,” she muttered bitterly, pushing through the entrance door. Walking down the driveway she kicked savagely at a Starbucks cup. At Second Avenue she began to cross.

  She had caused David enough trouble. If word got out that they were dating, it would be worse for him. Jill tugged uncomfortably at her scrub top. The evening was sticky, the setting sun blinding. She swiped at tears.

  A truck honked and brakes squealed.