The Killing Harvest

by Don Donaldson

  Raymond and Regina Stanhill were names she’d never heard before. She navigated back to the original message with the Stanhills’ number and reached for the phone.

  While it rang in Clinton Corners, she tried to figure out what she was going to say. As it turned out, she didn’t have to worry about that, because she got only their answering machine.

  If she hadn’t been going out for the evening, and it wouldn’t have required the Stanhills to make a long distance call, she would have left her name and number. Instead, she simply hung up.

  Usually, when she soaked in the tub, Sarchi made a point of allowing her mind to dwell on nothing but the sensation of soothing hot water against her skin. But tonight she might as well have been dressed and sitting at the kitchen table, because she couldn’t stop thinking about that enigmatic message: “All is not as it appears . . .”

  What could that mean? Did this person know Latham had accidentally hit Drew’s caudate nucleus during his operation? Had he made the same mistake on the Stanhills’ child? And what if he had? What would she do about it? What could she do about it? Why had this landed in her lap?

  The questions just kept coming. At dinner she tried to hold up her end of the conversation, but the evening was punctuated by many awkward periods of silence.

  The first thing she did when she got home was to check her hospital e-mail account to see if there was a reply from her mystery correspondent. She discovered that the message she had sent back to that person had not been delivered due to “host or domain name not found.” Big surprise.

  She then picked up the phone and tried the Stanhills again. This time a man answered.

  “Is this Raymond Stanhill?”

  “Yes,” he said, warily.

  She still hadn’t planned what she was going to say, so what came out was entirely extemporaneous. “I’m Doctor Seminoux, a pediatrician in Memphis. One of my patients is a boy who was treated for a paralytic disorder by Doctor Latham in New Orleans.” At this point, it seemed unwise to reveal her suspicions that Latham had botched Drew’s operation. Instead, she said, “It was such a puzzling disorder and so new to me I’m trying to learn more about it.”

  “Doctor, you don’t know how good it is to hear from you,” Stanhill said, his voice now friendly. “Our daughter, Stephanie, was treated by Doctor Latham a month ago, and what he did for her was absolutely incredible. When she went to him, she was almost totally paralyzed. Now, she’s nearly back to normal.”

  Nearly back to normal. Had Latham inadvertently damaged their daughter’s caudate nuclei too? “Are you saying your daughter has residual effects?”

  “Yes. Latham said it would probably clear up eventually, but after a month there’s been no improvement. Latham is a fine man and a great doctor, but frankly, we’re becoming concerned about this and have been wanting to talk to other parents with children who have had the treatment to see what their experiences have been. We asked Latham for some names, but he said it would be a violation of doctor-patient confidentiality to give them to us. We asked him to pass our name along to some of the other parents with an invitation to contact us, and he agreed. But so far, we haven’t heard from anyone until now. Did he give you our name?”

  “Not exactly.” Afraid he might follow up on that point, Sarchi quickly changed the subject. “This residual effect—it makes Stephanie appear to be yawning?”

  “No. It’s an involuntary movement of her right shoulder, sort of like she’s shrugging. It goes on fairly constantly. Then sometimes her whole arm will lash out.”

  Sarchi was shocked. Since Pierce had identified Drew’s tic as a characteristic symptom of Huntington’s disease, she had been reading up on the disease in any spare moment she could find. In that reading, she’d encountered a discussion of how HD tics differed from other movement disorders. One point that had stuck in her mind was how HD tics of the limbs generally involved the hands and fingers and the forearm. Stephanie’s movements sounded more like those seen in a condition known as ballismus, a disorder not generally associated with damage to the caudate.

  “Tell me about your daughter’s symptoms when she was sick.”

  Though he was probably only a layman, Raymond provided her with a surprisingly detailed account of Stephanie’s condition, even down to the absence of tendon reflexes below the neck. In all respects, her condition mirrored Drew’s.

  “The boy you mentioned,” Stanhill said, “he came out of his operation with a yawning disorder?”

  Without thinking, Sarchi blurted out, “Mr. Stanhill, I’d like very much to see your daughter.”

  “We’d like to talk to you as well. But how?”

  Sarchi’s mind grappled with the same question. How? Her day off was near. “I’ll come to Clinton Corners the day after tomorrow. When could we all get together?”

  “Since you’re the one who’s traveling, we’ll do it at your convenience.”

  “Let me check on flights and get back to you. But just exactly where is Clinton Corners?”

  Stanhill told her they lived about two hours north of New York City. Sarchi called Delta Airlines and made reservations for an early morning flight two days hence that would put her into Kennedy around ten a.m. To be sure her day wouldn’t be rushed, she booked the latest possible flight home. She then called Raymond Stanhill back and set up a one thirty meeting. Afterward, she sat by the phone for a long time, worried about where this was headed.

  The next day, she went to her attending’s office to let her know she’d be gone. “Kate, I need to be away tomorrow. Jim Hartley will cover for me.”

  “Nothing wrong I hope.”

  Given that opening, Sarchi laid the story out for Kate. When she finished, Kate looked concerned. “Just what do you predict will be the outcome of all this?”

  “I haven’t thought that far ahead. But it looks like this guy Latham may be making a lot of mistakes during his operations. He certainly did with Drew and maybe with this girl in New York. That’s probably what the anonymous e-mail I got was trying to tell me.”

  “What makes you think mistakes were made?”

  “Pierce said he didn’t have to go through the caudate to get to the site he was going to lesion.”

  “Maybe Latham didn’t tell you everything. A caudate lesion might be part of the treatment.”

  “That’s not what he said. And Stephanie, the girl in New York, has what sounds like a fundamentally different kind of tic than Drew has. If damage to the caudate is part of the treatment, why is her tic different?”

  “Let’s assume you’re right and Latham has made mistakes. What would you do about it?”

  “I don’t know.”

  Kate looked hard at Sarchi. “You should think very carefully about this. You’re a fine doctor, one of the best I’ve seen at this stage of your career. I’d hate to see you jeopardize your future.

  “If you were to initiate an action against Latham, there are many in our profession who would view that as an act of treason. Don’t misunderstand me, I’m not saying that’s my opinion. It’s merely something you need to consider. There was a time when you could practice medicine alone, but now, with the cost of malpractice insurance so high, a young person can’t do it by themselves. You’ll need a group behind you. And they’ll all want a team player. It may not seem like it, but medicine is a small community. Cross the brotherhood, and you’re marked.”

  These were chilling words, but certainly nothing new to Sarchi. For years she’d avoided any confrontation with her superiors that would label her a troublemaker. As a medical student, she’d heard one particular resident make so many crude comments about his patients she couldn’t count them, but she’d done nothing about it. And she’d ignored every personally demeaning insult that came her way, including that horrible day in her medicine clerkship.

  She’d requested clar
ification on a question the attending had asked her on morning rounds, and he’d ridiculed her in front of everyone, wondering aloud if she’d gotten into medical school by sleeping with the admissions committee.

  Burning with embarrassment and anger, she’d held her tongue, telling herself over and over: “Do not respond.”

  And she hadn’t.

  She’d believed she was simply being smart. But with all that had happened recently, her behavior now just seemed like a character flaw.

  “Team player . . .” Sarchi said in a small voice. “This isn’t a football game. We’re talking about people’s lives.”

  “Suppose he did make a mistake. Who hasn’t? In addition to what I’ve already said, consider the good Latham does. If it weren’t for him, Drew would likely still be paralyzed, because we sure as hell didn’t know what to do for him. And there’s also the Stanhills’ child and who knows how many others he’s helped. Just think ahead before you react.”

  Sarchi left Kate’s office unsure of what to do. Something was wrong at Latham’s clinic. Could she ignore that and look the other way just to avoid personal risk?

  It was true though, Latham had done a remarkable amount of good in treating Drew and Stephanie. And probably a lot of other kids. But was the problem just mistakes? That anonymous message had said all is not as it appears at the clinic. She hadn’t mentioned it to Kate, but that sounded like more was involved than mistakes. In any event, her travel arrangements were made, and she’d already talked Hartley into covering for her. What harm could come from simply visiting the Stanhills?

  SHE HADN’T COUNTED on snow. It had been falling heavily in New York since early morning, a heavy white cascade that reduced visibility to fifteen yards at best. And traffic was crawling, so the hour and twenty minutes she’d added to Raymond Stanhill’s estimate of the time it would take to reach their home from the airport was quickly consumed.

  Should she call and let them know she’d be late? She certainly couldn’t do that while driving, and there wasn’t a good place to pull off the road. Believing that when she didn’t show, the Stanhills would surely realize she’d been delayed by the weather, she decided to just forget the call.

  A half mile farther on, the brake lights of the car immediately ahead of her flared, and its back wheels fishtailed. Sarchi tapped her brakes and came to a safe stop. Taken by surprise, the guy behind her hit his brakes hard and went into a slide. Through the back window she could see wide-eyed fear on his face and his hands spinning the steering wheel. She braced for a hit, but at the last minute he navigated to her right, sliding past on the shoulder. Five cars up the road, the one who’d caused all this completed a left turn, and the procession once more got under way.

  It took a lot of concentration to drive in this kind of weather. But a part of her mind still wandered, fancifully imagining that the snow was a plot to keep her from reaching the Stanhills. Despite the hallucinatory nature of this thought, the weather increased her determination to examine their daughter.

  Fifteen minutes later, the snowfall lessened, and she found herself in a region that hadn’t been hit as heavily as the area around the city. The flow of traffic gradually picked up speed, and she began to make much better time. For all the difficulties she’d encountered, she arrived at the Stanhills’ driveway only forty-five minutes late.

  They lived in a wonderful two-story house of classic Georgian design with so many multipaned windows that if the mullions weren’t snap-ins, they’d take a month to wash. Judging from all the fresh tire tracks in the driveway, the snow hadn’t kept the Stanhills from getting out. She pulled up behind a silver Lincoln Town Car, killed the engine, and stepped into air sharp as a knife’s edge.

  The industrial-strength snowstorm that had hindered her earlier had faded to a few drifting crystals glinting in the bright afternoon sun. Except for a well-trod path on the sidewalk leading to the porch, the yard was covered in an unblemished white quilt that made Sarchi think of Latham and how the good he did seemed to be covering something bad. When she stepped up on the porch, a man in a gray suit opened the door before she even rang the bell.

  “Doctor Seminoux?”

  “Sorry I’m so late . . .”

  “Yes, yes, the weather. We heard it’s been horrible south of here. Come in, come in.”

  Sarchi stepped inside.

  “We never have snow this early,” the man said, shutting the door behind her.

  “It’s been that kind of year in Memphis, too. Not snowy, but cold.”

  “My wife and Stephanie are in the back. May I take your coat?”

  With his large glasses and pronounced chin, Raymond Stanhill reminded her of Garrison Keillor of Prairie Home Companion fame. While he put her coat in the hall closet, her attention wandered to a small oil painting of two rabbits chewing a lettuce leaf. Under it was a long table bearing dozens of flower pots holding the most realistic fake vegetable collection she’d ever seen—carrots and asparagus spears standing upright, a cauliflower, a big artichoke, snap beans, red peppers, all highly original. If Regina Stanhill was responsible for this whimsical scene, Sarchi liked her already.

  “Come on back,” Raymond said, leading the way.

  She followed him down the hall and past a room in which she caught a glimpse of the mounted head of a buck deer with a shotgun displayed across its antlers. Hanging from the fireplace mantel like Christmas stockings were several stringers of carved fish. Had to be Raymond’s study. He hadn’t struck her at all as an outdoorsman, just another example of things not being what they seem.

  They emerged from the hall into a large, high-ceilinged room where snow-reflected light pouring in from multiple sets of French doors and tall windows was warmed by rugs and walls of summer yellow. A woman in a yellow skirt and pale yellow blouse was standing with her hands on the shoulders of a beautiful little girl whose long blond hair was held back from her face with a barrette. The girl was wearing a purple polka-dot skirt and white blouse under a green sweater vest decorated with colorful ladies’ hats. The only discord in this harmonious scene was the girl’s right shoulder, which was in constant motion.

  The woman stepped toward Sarchi and offered her hand. “Doctor Seminoux, I’m Regina Stanhill. We’re so glad you’ve arrived safely.”

  Tall and blond, Regina was a woman who by careful attention to her hair, makeup, and clothing maximized her assets.

  “And this is Stephanie.” Regina turned and held her hand out to the child, who eagerly came over and looked up at Sarchi. “I’m five. I’ll be six in . . .” She looked at Regina.

  “Three months,” Regina said. “Doctor, can I get you anything? Coffee, tea? Are you hungry?”

  “I ate at the airport.”

  “Let’s sit down,” Raymond suggested.

  After Sarchi had taken a seat, Stephanie came over to her and perched on the edge of a small leather trunk that served as an end table.

  “Where do you live?” Stephanie asked. She had lovely gray eyes and only the barest indication above her brows where the stereotaxic device had been screwed to her skull.

  “I live in Memphis, Tennessee. Do you know where that is?”

  Stephanie put her hands on her hips, leaned forward, and smiled, showing her little teeth. “No.”

  Sarchi held her palm up and pointed to the tip of her middle finger. “This is where you live. And I live way down here.” She pointed at the end of her life line.

  Stephanie looked into Sarchi’s eyes, then postured again. “That’s ridiculous. People can’t live on other people’s hands.” Her shoulder shrugged again, but this time her entire arm danced to the side.

  “That’s what I was telling you about on the phone,” Raymond said. “It happens about once every twenty minutes.”

  “Do any of these movements occur while she’s asleep?”

  �
��I’m sure they don’t,” Regina said. “I know, because sometimes I just watch her sleep, wishing she was the way she . . .” Regina’s eyes misted, and she bit her lip.

  “Stephanie, can you touch your nose with this hand?” Sarchi pointed to the child’s affected arm.

  “Anybody can do that,” Stephanie said.

  “Some can’t.”

  Stephanie brought her hand up and touched her nose with ease. “I told you.”

  “Can you do it with your eyes closed?”

  Stephanie repeated the maneuver, hitting the target with precision. This showed that she not only retained voluntary control over the affected limb, but the circuits for sensing position of the arm and hand in space were intact.

  Sarchi reached out and gently stroked Stephanie’s affected limb below the sleeve of her blouse.

  Stephanie giggled. “That tickles.”

  Sarchi stroked the girl’s forearm near the wrist. “Can you feel it here, too?”

  “Yes. Can I tickle you now?”

  “If you like.” Sarchi unbuttoned the sleeve of her blouse and pushed it up her arm. Grinning, Stephanie ran her little finger lightly down Sarchi’s skin. Sarchi gave an exaggerated shiver. “Please, no more.”

  “Don’t you want to see me do this?” Stephanie raised her affected hand and touched her thumb with each of the fingers on that hand, another standard neurological test.

  “Where did you learn that?”

  “From the doctors who made me better when I was sick. I couldn’t move. It was terrible. They shaved some spots on my head while I was asleep. Want to see?”

  “Could I?”

  Stephanie removed her barrette, tilted her head toward Sarchi, and parted her hair. “Can you see the spots? They’ll grow in eventually.”

  Sarchi did indeed see the two shaved areas, directly opposite each other, and in a distinctly different place than they were on Drew’s head.

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