by Robin Cook
“What happens?” asked Cassi.
“I always get propositioned. It never fails. Some dude sees me and guesses I’m a stud, so he comes over and starts to talk to me. I end up beating the guy to a pulp. It’s one thing the army taught me. How to fight with my hands.”
Cassi remembered reading that both borderline personalities and narcissists wanted to protect themselves from homosexual impulses. Homosexuality could be a potentially fertile area for future sessions, but for the moment she didn’t want to push into areas that were too sensitive.
“What about your work?” asked Cassi to change the subject.
“If you want to know the truth, I’m tired of being in the army. I liked the early competition. But now that I’m a colonel, that’s over. I’ve arrived. And I’m not going to make general because too many people envy me. There is no more challenge. Every time I go into the office I get this empty feeling-like what’s the use.”
“An empty feeling?” echoed Cassi.
“Yeah, empty. I feel the same after I’ve been living with a woman for a couple of months. At first it’s intense and exciting, but it always goes sour. It gets empty. I don’t know how else to explain it.”
Cassi bit her lip.
“The ideal relationship with a woman,” said Bentworth, “would be one month long. Then, puff, she’d disappear and another one would take her place. That would be perfect.”
“But you were married.”
“Yeah, I was married. Only lasted a year. I just about killed the broad. All she did was complain.”
“Are you living with someone now?”
“No. That’s why I’m here. The day before they picked me up, she walked out. I’d only known her for a couple of weeks, but she met some other guy and took off. That’s why I want to get out of here for the weekend. She’s still got a key to my apartment. I’m afraid she might clean me out.”
“Why not call a friend and have him change the lock?” said Cassi.
“There’s nobody I can trust,” said Bentworth, standing up. “Look, are you going to give me a weekend pass or is all this bull for nothing?”
“I’ll bring it up at the next team meeting,” said Cassi. “We’ll discuss it.”
Bentworth leaned over the desk. “The only thing I’ve learned in all my time in the hospital is that I hate psychiatrists. They think they’re so goddamned smart, but they’re not. They’re a hell of a lot crazier than I am.”
Cassi returned his stare, noticing how cold his eyes had become. The thought went thought her mind that Colonel Bentworth should be committed. Then she remembered he was.
Cassi knocked on the doorjamb of Robert’s tiny office. As he looked up from his binocular scope, his face broke into a broad and infectious smile. He jumped up so quickly to hug Cassi that his chair sped back on its wheels to the opposite wall.
“You look down,” said Robert examining her. “What’s wrong?”
Cassi looked away. She had had enough talk in the past few hours. “I’m just exhausted. I thought psychiatry was going to be so easy.”
“Then maybe you should transfer back to pathology,” said Robert as he pulled out a chair for Cassi. Leaning forward, he rested his hands on her knees. If any other man had done so, Cassi would have been annoyed, but she was comforted by Robert’s gesture.
“What can I get for you? Coffee? Orange juice? Anything?”
Cassi shook her head. “I wish you could give me a good night’s sleep. I’m beat, and I have to go to a party tonight at Doctor Ballantine’s home in Manchester.”
“Wonderful,” cooed Robert. “What are you going to wear?”
Cassi rolled her eyes in disbelief, saying she hadn’t given it a moment’s thought, at which point Robert, who had some knowledge of Cassi’s wardrobe, made several suggestions. Cassi interrupted to say that she’d come to hear about the autopsy, not for his fashion advice.
Robert made an exaggerated expression of being hurt and said, “The only thing that you come up here for is business. I can remember when we used to be friends.”
Cassi reached out to give Robert a friendly shake, but he eluded her by pushing back on his chair, which glided smoothly out of the way. They both laughed. Cassi sighed and realized she felt better than she had all day. Robert was like a tonic.
“Did your husband tell you he saved me at the last surgical death conference?”
“No,” said Cassi, surprised. She’d never mentioned Thomas’s antipathy to Robert, but it was all too obvious the few times they’d met.
“I made a big mistake. I got this crazy notion that the cardiac surgeons would be overjoyed to hear about SSD, and I decided to make a preliminary presentation at yesterday’s conference. It turned out to be the worst thing I could have done. I suppose I should have realized their egos are such that they’d consider the study a form of criticism. Anyway, when I finished talking, Ballantine started to chew me out until Thomas interrupted with an intelligent question. That sparked a few more questions, and what could have been a total disaster was averted. I did get a lot of heat this morning from the chief of pathology. It seems George Sherman had asked him to muzzle me in the future.”
Cassi was impressed and grateful for her husband’s intervention. She wondered why he hadn’t mentioned it to her until she remembered that she hadn’t given Thomas a chance. She’d brought up her eye surgery the second she’d seen him.
“Maybe I’ll have to take back some of the nasty things I’ve said about your husband,” added Robert.
There was an awkward silence. Cassi did not want to get into a discussion of her own feelings just then.
“Well,” said Robert, rubbing his hands together enthusiastically. “To work! As I said on the phone, I think I found a new SSD case.”
“Cyanotic like the last?” asked Cassi, eager to change the subject.
“Nope,” said Robert. “Come on, I want to show you.”
He leaped to his feet and dragged Cassi out of his office and into one of the autopsy rooms. A young, light-skinned black was laid out on the stainless steel table. The standard Y autopsy incision had been closed with heavy sutures and clumsy bites of tissue.
“I asked them to leave the body so you could see something,” said Robert, his voice echoing in the tiled room.
He let go of Cassi and inserted his thumb into Jeoffry Washington’s mouth, pulling down the lower jaw. “Look in here.”
With her hands behind her back, Cassi bent over and looked into the patient’s mouth. The tongue was a mangled piece of meat.
“Chewed hell out of it,” said Robert. “Obviously had one hell of a grand mal seizure.”
Cassi straightened up, a little sickened by what she’d seen. If this was an SSD case, he was the youngest yet.
“I think this one died of an arrhythmia,” said Robert, “but I won’t know for sure until the brain is fixed. You know, seeing this kind of case doesn’t help my anxiety about my own surgery.” Robert glanced over at Cassi.
“When are you going to have it?” she asked. Robert’s statement sounded definitive.
Robert smiled. “I told you, but you wouldn’t believe that I was going to get it over with. I’m being admitted tomorrow. What about yours?”
Cassi shook her head. “It’s not definite yet.”
“You chicken,” accused Robert with an air of superiority. “Why don’t you schedule yours for the day after tomorrow, too, so we can visit together in the recovery room.”
Cassi didn’t want to tell Robert about her difficulties talking the matter over with Thomas. Reluctantly her eyes went back to the corpse.
“How old?” asked Cassi, motioning toward Jeoffry Washington.
“Twenty-eight,” said Robert.
“God, that’s young,” said Cassi. “And it’s only been two weeks since the last case.”
“That’s a fact,” said Robert.
“You know, the more I think about it, the more disturbing these cases are.”
“Why do
you think I’ve persisted?” said Robert.
“With the number you have now and the apparent increase in frequency, it’s getting harder and harder to ascribe the deaths to chance.”
“I agree,” said Robert. “Ever since the last, I’ve had the nagging suspicion that these deaths are more closely related than we suspect. The only trouble with that idea is that it suggests a specific agent, and as your husband pointed out, the deaths are physiologically different. The facts don’t fit the theory.”
Cassi walked around the table to Jeoffry’s right side. “Does this look swollen to you?” she said, reaching out and running her hand up the body’s forearm.
Robert bent down to look. “I don’t know. Where?”
Cassi pointed. “Was the patient on IV?”
“I think so,” said Robert. “I think he was on antibiotics for phlebitis.”
Cassi picked up Jeoffry’s left arm and looked at the IV site. It was red and puffy. “Just for interest’s sake, how about getting some sections of the vein where the IV was?”
“Anything if it will get you to come up and visit.”
Cassi replaced Jeoffry’s arm as carefully as if it were still sensate. “Do you happen to know if all the SSD cases were on IVs?” asked Cassi.
“I don’t know, but I can find out,” said Robert. “I have an idea what you’re thinking, and I don’t like it.”
“The other suggestion I have,” said Cassi, “is to collate the supposed physiological mechanisms of death and see if there is any pattern. You know what I mean.”
“I know what you mean,” said Robert. “I can probably do that today. And I’ll get the sections of the vein, but you have to promise to come up and look at them. Agreed?”
“Agreed,” said Cassi.
As Cassi pressed the elevator button in the corridor outside the pathology department, she was aware she was dreading her upcoming session with Maureen Kavenaugh. Without doubt, Maureen’s depression exacerbated Cassi’s own. The fact that Cassi had reason to be depressed, as Joan had pointed out, did not make the symptoms easier to live with.
Dreading the meeting with Maureen bothered Cassi because it forced her to admit that as a psychiatrist she was going to have to deal with her own value judgments. In other areas of medicine, if you were forced together with a patient you disliked, you concentrated on the pathology and cut the personal contact to a minimum. In psychiatry that was not possible.
Happily, when she entered her office, Maureen still was nowhere to be seen. Cassi knew she was going to have difficulty concentrating on what Maureen had to say because Robert’s decision to have his surgery brought up the issue of her own. She knew Robert was right. After a moment’s indecision, she dialed Thomas’s office.
Unfortunately, he was still in surgery.
“I don’t know when he will be out,” said Doris. “But I know it will be late because he called me and told me to cancel his afternoon office hours.”
Cassi thanked her and hung up. Blankly she stared at her Monet print. Joan’s comment about the “impaired physician” disrupting his appointment schedule flashed into her mind. Then she dismissed the thought. Thomas had obviously canceled his office hours because he was stuck in surgery.
A knock interrupted her thoughts. Maureen’s listless face appeared in the doorway.
“Come in,” said Cassi as cheerfully as she could. She suspected that the next fifty minutes were going to be a good example of the blind leading the blind.
It was Doris, not Thomas, who called Cassi in the middle of the afternoon to say that Dr. Kingsley would meet her at the front entrance to the hospital at six o’clock sharp. She insisted Cassi be on time because of the party that night. Cassi was in the lobby promptly, but when the clock over the information booth showed twenty after six, she worried that she may have gotten the message wrong.
The entrance of the hospital was crowded with waves of people coming and going. The people leaving were primarily employees, and they chattered and laughed, glad to see the workday come to an end. Those arriving were mostly visitors who seemed subdued and intimidated as they lined up in front of the information booth to get directions from the volunteers in their green smocks.
Watching the crowds made time pass, and when Cassi looked back at the clock, it was almost six-thirty. Finally she decided to call Thomas’s office, but as she moved toward the phone, she caught a glimpse of his head above the crowd. He looked as tired as Cassi felt. His face was shadowed, which turned out to be an irregular growth of beard as if he’d not shaved carefully that morning. As he came closer, Cassi could see that his eyes were red-rimmed.
Unsure of her reception, Cassi held her tongue. When she realized that Thomas had no intention of talking or even stopping, she hooked her arm in his and was carried toward the rapidly revolving door.
Outside Cassi was confronted by a mixture of rain and snow, which melted the instant the flakes touched the ground. Hefting her bag onto her shoulder, she shielded her face and stumbled behind Thomas toward the parking garage.
Once inside the garage, he stopped and, finally turning to Cassi, said, “Awful weather.”
“We’re paying for such a nice fall,” said Cassi, encouraged that Thomas did not seem to be in a bad mood. Maybe Patricia would not tell him of the visit to his study.
The engine of the Porsche reverberated like thunder in the garage. As he watched the dials and gauges, Cassi carefully did up her seat belt. It took a conscious effort for her not to tell Thomas to do his, especially given the bad weather, but remembering his previous response, Cassi remained silent.
Whenever it snowed, traffic in Boston slowed to a frustrating stop-and-go mess. As Thomas and Cassi proceeded east on Storrow Drive, it was mostly stop. Although Cassi wanted to talk, she was afraid to break the silence.
“Did you hear from Robert Seibert today?” Thomas finally asked.
Cassi swung her head around. Thomas still had his eyes on the road despite the fact that the car was immobilized in a sea of red taillights. He seemed hypnotized by the rhythmic click-clack of the windshield wipers.
“I did speak to Robert today,” admitted Cassi, surprised at the question. “How did you know?”
“I’d heard that one of George Sherman’s patients had died. Apparently it wasn’t expected, and I wondered if your friend Robert was still interested in that series of his.”
“Absolutely,” said Cassi. “I went up after the autopsy. And when I did, Robert told me how you rescued him at death conference. I think that was very nice of you, Thomas.”
“I wasn’t trying to be nice,” said Thomas. “I was interested in what he had to say. But he was a fool to do what he did, and I still think he should get his butt kicked.”
“I think he did get his butt kicked,” said Cassi.
With a faint smile Thomas took advantage of the thin-ning traffic and goosed his car up the grade to the expressway.
“Was this last death another suspicious one?” he asked as the car accelerated to seventy. He drove with both hands on the wheel, blinking his high beams furiously as he came up behind people traveling more slowly.
“Robert thinks so,” said Cassi, her hands involuntarily gripping each other. Thomas’s driving always scared her. “But he hasn’t done the brain yet. He thinks the patient convulsed prior to death.”
“So it wasn’t like the last case?” asked Thomas.
“No,” said Cassi. “But Robert thinks the situations are related.” Purposely she kept her own role in the discussion secret. “Most of the patients, particularly over the last several years, have died after their acute postoperative course was over. One point that occurred to Robert today was that all the patients may have been on IV when they died. He’s checking on that now. It could be significant.”
“Why? Does Robert think these deaths could be suspicious?” asked Thomas with shock.
“I guess it’s occurred to him,” said Cassi. “After all, there was a case in New Jersey where a seri
es of patients were given something like curare.”
“That’s true, but they all died with the same symptoms.”
“Well,” said Cassi. “I guess Robert feels that he has to consider all possibilities. I know it sounds awful and it certainly accentuates any insecurities Robert has about his own imminent surgery.” Cassi was hoping to shift the topic to her own operation.
“What kind of surgery is Robert going to have?”
“He’s finally having his impacted wisdom teeth removed. Since he had rheumatic heart disease as a child, he has to be treated with prophylactic antibiotics.”
“He’d be a fool not to,” agreed Thomas. “Although he must have suicidal tendencies. That’s the only way I can explain his behavior at that death conference. Cassi, I want you to be sure to stay away from this so-called SSD study, especially if there are going to be ludicrous accusations. With everything else going on, I certainly don’t need that kind of grief.”
Cassi watched the cars in front as the Porsche relentlessly passed them. The monotonous movement of the windshield wipers mesmerized her as she tried to find the courage to broach her own operation. She’d promised herself she’d start speaking as soon as they came abreast of that yellow car. But the yellow car soon dropped behind them. Then it was the bus. But they’d passed that, too, and still Cassi remained silent. She gave up in despair, hoping that Thomas would bring up the subject himself.
The tension exhausted her. The idea of Ballantine’s party seemed less and less attractive. She had trouble understanding why Thomas, of all people, wanted to go. He hated hospital affairs. The idea occurred to Cassi that maybe he was going for her benefit. If that were the case, it was ridiculous. All Cassi could think about was clean sheets and their comfortable bed. She decided she’d say something when they got to the next overpass.
“Do you really want to go to this party tonight?” asked Cassi hesitantly as an overpass flashed above them.
“Why do you ask?” Thomas pulled the car sharply to the right, then gunned the engine to pass a car that had ignored his blinking high beam.