The small assembled group was listening intently, although in truth there was very little the director was saying that was new. The director sat at the head of the table, next to the ICU fellow—an ICU specialist in training. Ukrit Wattana was a tall man, for a Thai. With sharp cheekbones and square black glasses, he looked like an awkward adolescent who hadn’t quite grown up. But he was very intense and respectful. And people said he was very smart. That he would take over as the ICU Director one day.
The tough head nurse came next, across from the ICU administrator, who was a nice woman, and pleasantly competent, but who was unlikely to have any opinion whatsoever.
They were all quiet, showing respect by listening. Not like the Americans she met in Chicago. To show respect and agreement, they talked, generally saying the same thing that the most senior person has said, but in a different way. In the United States, an important person’s opinion is like a stone dropped into a small pool—it creates waves that echo back and forth endlessly. Such a noisy waste of time.
In Thai culture, we show respect by listening. By being quiet. That’s not better, really. But Thai meetings are generally much more peaceful. And shorter.
Next to Ladarat, Sisithorn was sitting quietly, taking notes. She had taken extra time with her appearance this morning, hadn’t she? More than usual perhaps. And today her hair had been brushed out instead of corralled in a bun, the way Ladarat wore hers.
For a moment, Ladarat was just a little offended that her assistant should find her own style. But, of course, that was silly. Especially since Ladarat would be the first to admit that no one with any sense whatsoever should emulate her style. That road to fashion led nowhere.
It took a moment for Ladarat to notice the other difference. Her glasses. Sisithorn wasn’t wearing her glasses. Had she gotten contacts? She would find a way to ask carefully. Surreptitiously. As a detective would.
“It has been six days since his accident, and there is no meaningful sign of recovery.” The director paused, and his right hand juggling his pen picked up its tempo.
“We’ve tried to reduce his sedation every day for the last two days in hopes of improving his level of consciousness, but without effect.”
Now the pen was flipping over his hand like that migrating fish—a salmon?—leaping out of the water of a river again and again to swim upstream.
“And the brain scan of yesterday shows no significant swelling that could be the cause of his lack of responsiveness,” he continued. “So… are there any questions?”
Here the pen escaped gravity entirely, whirring through the air to land in the lap of the ICU administrator, who, smiling and blushing, delicately placed the pen in front of the director without shifting her attention. Everyone around the table laughed.
“Thank you, Khun.” He smiled at the table in embarrassment and picked up the pen. But when the administrator edged backward in her chair, the director covered the pen with his hands, making a little tent. He seemed almost relieved that his migrating pen had been trapped.
“So it’s my recommendation that we tell his parents and his wife that there is nothing else we can do to prolong his life.” Then, to Ladarat’s considerable surprise, he turned to her.
“What sort of reaction do you think we can expect, Khun Ladarat? You have lived in America. You have seen these sorts of discussions before. You are more American than we are. What do you think they might say?”
More American? Odd that she’d never thought of herself as American at all. But the director meant it as a compliment. Didn’t he?
Ladarat thought for a moment. What indeed? They would not be pleased, she knew that much. And they would be reluctant to agree to stop treatment. But the reason was difficult to put into words that would not cause offense.
“This will be a shock to them, of course,” she said hesitantly. “A very great shock.”
“But it is obvious that he is dying,” Dr. Wattana said. He turned first to the director, and then back to Ladarat. “Isn’t it?”
“Yes,” she agreed. “It’s obvious enough to us. But sometimes… it takes some time for your heart to catch up with what your head knows to be true.”
As Professor Dalrymple said, we use our heads to make decisions for ourselves, but we use our hearts to make decisions for our loved ones.
Dr. Wattana seemed as though he was ready to argue, but the director laid a restraining hand on his shoulder.
“I see. So you think they may need more time to… come to terms?”
Did they? That was part of it. But not all of it.
“They may need more time, it’s true. But…”
“But they may not trust our opinion,” the director said, finishing her thought for her.
“Exactly so,” she said, relieved that it she did not need to say what they all knew.
Dr. Wattana looked as though he was going to argue, but again the director laid a hand on the young man’s shoulder.
“Of course they may not trust that he will get the best care here. Why would they? This is a small city in a small country, halfway around the world from the United States. How could he know that he will get the finest care here?”
Everyone around the table thought about that for a moment.
“Well, we cannot convince them that we provide excellent care. They will need to see that for themselves. And then perhaps their experts back in the U.S. will review our records and will agree.
“But,” he continued, “perhaps you could meet with the wife this afternoon? Just to see what she is thinking?”
The director was looking at Ladarat with eyes that flicked back and forth in an unbecoming way over a fixed, wooden yim haeng smile. It was the dry, slightly apologetic smile that you would offer when you are asking someone to do something that you know is not right. Or, say, when you are asking for a loan of baht that you know you cannot pay back.
She nodded. “Of course I will.”
She sighed. Of course. This case was full of all the kinds of discomfort and awkwardness that Thais hated. But if she could act like an American and put those anxieties about conflict behind her for a few minutes, then of course she was the right person to talk to the Americans. Besides, who else would?
The director smiled a genuine smile. A true smile of relief as if a weight had been removed from his shoulders. As indeed it had.
And Ladarat smiled, too. It was good to be an ethicist again. Just an ethicist.
“Then it is agreed that you will talk to the wife.” He looked at his watch. “It is two P.M. She is in the ICU and should be leaving soon. Perhaps you could talk to her in the waiting room as she leaves? Perhaps… perhaps you could help her to trust us, just a little more?”
Ladarat agreed that she would, but she knew that more trust wasn’t the only answer. It was true that the Fullers had no reason to trust Thai medicine, but even if they did, they would not give up so easily on a young man. All the trust in the world wouldn’t induce people like this American family to make that decision before they had to.
But she couldn’t explain this easily to her colleagues around the table. They were being logical and reasonable, she knew. It’s just that this wasn’t a situation in which logic and reason were likely to be particularly helpful. They were thinking with their heads, as Professor Dalrymple would have said, but the Fullers were thinking with their hearts. So instead she nodded and said that she would do her best.
Trust. Ladarat pondered that as the meeting adjourned. No, the Americans would most certainly not trust Thai doctors, just as she’d said. And that made her think of something else… but no sooner had her brain registered the presence of another thought waiting in the wings than that thought vanished. But she felt that there was something, somewhere, that she was missing.
THE NATIONAL THAI SLOGAN
The meeting had officially ended, but Ladarat knew with the certainty of experience that there would be chatting and gossiping. Especially if there was tea left. She’d seen meetings
like this trail off over an hour. Call it traditional Thai laziness, and to a farang that’s what it would look like.
But it was deeper than that. Thai culture was not well suited to modern medicine, with its rules and requirements. And, above all, its demanding pace. Everything else about the Western world—law, tourism, even business—could be made to fit the relaxed, easygoing Thai view of life. But medicine wouldn’t fit.
Especially when people work together for the benefit of others, as in medicine, relationships matter. You cannot be in a hurry. You cannot rush past the formalities of greeting and inquiring after another’s health. If you hurry past those niceties, you pass by the structure that allows us to work together.
But after ten minutes of such conversation, Ladarat decided that she needed to leave. She touched Sisithorn’s elbow and steered her quietly out of the room and down the hall. They didn’t have time for endless discussion today. Sisithorn apparently was thinking the same thing, and she turned to the right as they left the conference room, heading toward the ICU.
“So I talked with the young Mrs. Fuller, as you suggested, Khun.” Sisithorn was nodding as she spoke, but she seemed puzzled about where to start.
“And so what did you talk about?” They’d reached the elevator, and this one was usually very slow. So they had some time. But not much.
“Well, she was born in Ann Arbor? Ann Arbor. Yes. It is in…”
“Michigan,” Ladarat suggested.
“Yes, Khun. I believe that is correct. Michigan. She grew up there, and her parents had both taught at the university there. That is where she and her husband met. They were both graduate students there.”
“And what else did you learn about her family?”
“His studies focused on business. Business administration, I think she said? And she studied international relations. Diplomacy? Yes, diplomacy, I think that was it.”
“But what of her family? Surely there is someone?” A good thing the elevator was so slow. It would take hours for Sisithorn to get to the point.
“Ah, but that is difficult.”
That was when she knew why Sisithorn had hesitated. It wasn’t that she didn’t know what was important. It was that she’d stumbled on an awkward topic. But what?
Ladarat had only a moment to wonder about what might be causing her assistant such distress before she was distracted by the sight of a flowering bush that materialized next to them. The bush was not really a bush, of course. It was an enormous bouquet. The biggest Ladarat had ever seen—so tall that the crowning orchid brushed the ceiling. And so wide that its bulk completely hid the person carrying it. Ladarat glimpsed only a pair of thin, pale forearms grasping the basket, the left one of which was adorned by an enormous gold watch.
The mobile bouquet hovered there, just to Sisithorn’s left, as if it, too, were waiting for the elevator. But Ladarat was almost certain that this bouquet was not interested in taking the elevator.
Ladarat wasn’t sure why she felt uneasy, but that young man’s reappearances were strange. Very strange. This was a large hospital, and to encounter the same person so many times was not consistent with chance. Then she thought of the note on her car, and the durian. She thought of those things and she became very worried.
Was this young man working with Peaflower? Was he here to threaten her?
Her mind entertained other, wilder possibilities, too. Like perhaps this young man was an advance spy sent by the Royal Hospital Inspection Committee. She’d heard of such things. And indeed, that would be a relief. At least that was something that she was familiar with. But Ladarat knew that a far likelier explanation was that this man was an accomplice of Peaflower’s.
Ladarat peered around the shrubbery to confirm that this was indeed the young man she’d encountered several times before. She nodded, satisfied, just as Sisithorn opened her mouth to ask what on earth she was doing.
“Come this way,” she told Sisithorn.
“But the elevator will come if we wait,” Sisithorn said, confused.
Of course she would say that. That could be the national Thai slogan.
“The stairs are faster,” Ladarat said simply as she marched farther down the hallway.
Sisithorn was lagging behind and Ladarat was pretty sure she’d stopped in her tracks. She couldn’t hear the click of Sisithorn’s heels on the tile floor behind her, but she smiled and marched on.
“Come along,” she said over her shoulder. “We have work to do.”
As she’d expected, Sisithorn caught up with her, click-click-clicking in her hurry not to be left behind. The only force in Thailand stronger than a benign laziness was the intense and all-encompassing fear of missing something. So they pushed through the door to the stairwell together.
Sisithorn looked at her for a split second as Ladarat held the door open for her.
“Is this a habit you learned in Chicago, Khun?” she asked.
Ladarat smiled. Perhaps she was more American than she’d thought. Maybe the director had been right. Maybe she was at least a little bit American. And was that such a bad thing? Well, yes. It probably was.
“It’s only two flights,” Ladarat pointed out. “And we can talk as we go.” She waved her hand at the empty space around them. “And we have complete privacy,” she pointed out.
Sisithorn seemed to be thinking as they climbed in silence up half a flight of stairs and then they reached the fifth-floor landing. Ladarat was perhaps breathing a little heavily. Not that she was short of breath, of course. But a little faster than usual. Just a little.
Actually, she checked the pulse in her wrist surreptitiously, holding both hands in front of her so Sisithorn could not see. One hundred and ten. Well, maybe that was a little high, but surely some elevation could be attributed to the excitement of going to see a patient, could it not? Of course it could. But they should stop to rest at the second landing. It wouldn’t do to walk out into a busy hallway looking as though they’d just run a race across Chiang Mai.
“This is not difficult, is it?” Ladarat asked over her shoulder.
“No, Khun,” Sisithorn gasped. “Not at all.”
Ladarat smiled. Still, she slowed her pace so they would not embarrass each other by gasping like beached carp when they arrived. Slowly, one step at a time, they ascended the next flight and came to a stop at the landing. Sisithorn was breathing a little rapidly, too, Ladarat was pleased to note. In fact, she’d say they were about even, despite the fact that Ladarat was older by twenty years. So there.
“Now,” she said as soon as she was breathing a little easier. “What is it that is difficult about the young American’s family?”
“Ah, well you see, Khun, it seems as though she doesn’t… have any family.”
“No family? You said that she was put in foster care when her parents died. But surely she is close to them. And perhaps there are other family members?”
Sisithorn shook her head sadly. “Her foster parents died when she was in college. An auto accident, I believe.”
“Aunts and uncles? Foster brothers and sisters?”
Again Sisithorn shook her head. “She said that she was… alone in the foster family. So her parents were the only family she had. And now…”
“Her husband’s family is her family. Ah, that is difficult. So she has no one to support her. And no one to take her side if she disagrees with her husband’s… family.”
She almost said “her husband’s father” since that was where the trouble was likely to be. But that wouldn’t do. There was nothing to be gained by assigning blame. The members of that American family were all grieving in their own ways.
And yet, the father had a very strong personality. Perhaps in some ways a replacement father for her. As the boy’s mother was certainly filling that role. That would make things more difficult. But there was something even more important.
“Then she will need your support more than ever,” Ladarat pointed out.
Sisithorn nodded. �
��I had the same thought. I will try to visit her every day, just to give her someone to talk with.”
Ladarat nodded. They were both breathing more or less normally now. And she opened the door to the hallway that would take them to the ICU waiting room, ushering Sisithorn ahead of her.
That was done, then. And her assistant ethicist had done excellent work. But there was just one more question.
“Your hair, Khun… it looks nice. What made you decide to change it? Not that change is bad, of course—change is good. Or it can be good…” Oh dear. In that moment, Ladarat vowed that she would steer clear of discussions about fashion in the future.
“I always used to wear it like this,” Sisithorn said. “Don’t you remember?”
Ladarat didn’t.
“But not since I’ve known you?”
“That’s true, Khun,” Sisithorn admitted. “I wanted… to be like you.”
Imagine that. Her assistant had redone her hair when she took this position because she wanted to emulate her. Ladarat supposed she should feel offended that her assistant had now embraced a new style, but she was too overwhelmed by pleasant surprise to harbor any negative feelings. She never would have imagined that anyone would emulate her, and now this bright, energetic nurse ethicist had been doing so all along.
A VERY SAD SITUATION
Still deep in thought about the implications of her assistant’s new hairstyle, Ladarat didn’t notice the strange man until they’d almost reached the sliding doors to the ICU. He was crouched against his familiar wall, again with a view of Doi Suthep mountain. He smiled at them a little uncertainly and gave a deep wai, which they both returned. Ladarat pointed at the doors.
“Perhaps you can go ahead,” she said softly to Sisithorn. “You could bring the wife out here and we could talk in more quiet circumstances?” Sisithorn nodded, and then she disappeared into the ICU and the doors hissed closed behind her.
The man was looking at her strangely, with a mix of fear and respect that mystified her. Surely he recognized her? But then she realized that she’d put on her white coat for the meeting they’d just come from. Seeing her now in her professional outfit, the man was probably surprised. Perhaps he was intimidated, too. If he truly came from the hills, his experience with medical people would be very limited.
Murder at the House of Rooster Happiness Page 16