Deficiency

by Andrew Neiderman

  There was never enough money when Curt's father, uncles, and aunt were growing up. His father had to take on odd jobs and when he was old enough, work in the Catskill resorts as a busboy and finally as a waiter to earn his college tuition. But he never gave up and when he did get into law school, he graduated at the top of his class. Only after he had landed a good job with a New York City law firm did he marry Curt's mother, Marion Steele. Shortly afterward, when the opportunity presented itself, he went into his own practice, developed real estate deals in the Catskills and became one of the most respected and successful attorneys here.

  There wasn't time in those days to worry about whether or not he was stepping on his wife Marion's own career goals, he once told Curt whenever they discussed Curt and Terri's long engagement. "Your mother knew that from the start. She once had some ambition to become a magazine editor and work in New York City, but she never really pursued it. Oh, she tried some freelance writing, but that didn't lead anywhere, and soon she was happy just being Mrs. William Levitt. I never heard her complain about the decisions she made. Of course, that was before all this women's liberation business, before women began to wonder why they couldn't have flies on their pants, too," he joked, half joked, actually. Curt knew his father was too much of a male chauvinist. However, Curt's father loved and respected Terri, even though he teased her whenever he had an opportunity to do so. Curt was also aware that his father was a flirt and suspected that he might have had an extramarital affair here and there, but Curt would rather not think about it. He was like that when it came to his father -- deliberately blind to any of his faults or willing to easily excuse and rationalize them away.

  Yet Curt supposed, or rather hoped, he was like his father in many ways. After all, his father was a self-made man. Curt looked more like him than any of his siblings. His younger brother Neil, who worked with Uncle Frank on Wall Street, looked more like their mother, and his younger sister Michele, who was married to a dentist in Boston, was so much a cross between their mother and father that she had a totally different look.

  He had his father's six feet two inch height and the same broad shoulders, but he had his mother's smaller facial features, her slightly turned up nose and soft mouth. His father didn't have the narrow waist he once had. However, he still had a rough and ruddy complexion, a farmer boy's forearms and hands. "Just shake hands with Bill Levitt and you know you've been shook," people would say. His father and he had glimmering rust brown eyes and reddish brown hair. Both had a splatter of freckles along their foreheads, too.

  His habitual gestures, holding his chin between his thumb and forefinger whenever he paused to think, or nodding softly when he was in deep thought were gestures borrowed from his father. They had the same deeply resonant voice, good for trial work, and like his father, he was impatient with small talk and bureaucracy.

  Right now, he tightened his robe around his waist and stared incredulously at Terri.

  "Jesus, you know what time it is?"

  "I'm sorry. I just got off my turn at the hospital."

  "I'm glad I don't have to keep doctor's hours." He wiped his eyes and looked at her more closely.

  "What... what's wrong?" he asked.

  "Oh Curt, just hold me. Please," Terri said, a little surprised herself at how vulnerable and feminine she sounded. Curt pulled her to him and pressed her against him.

  "What?" He closed the door behind her quickly.

  "A terrible night in the emergency room," she said. "Two deaths, one right before my eyes."

  "Really? What happened?" He wiped the sleep from his eyes when she stepped back.

  "One was a car fatality, but the other, the first one... Paige Thorndyke. You remember the Thorndykes. Her father is an airline pilot."

  "Sure. Paige's brother Phil Thorndyke was on the varsity basketball team with me. What about Paige?"

  "She's dead."

  "Oh no. Also a car?"

  "No." Terri shivered. He put his arm around her again.

  "Easy. Want some coffee?"

  "No. Let's just crawl back into your bed," she said. He looked surprised.

  "Sure, but... so what killed her?"

  "I'm not certain," she said as they walked toward his bedroom together. "It seems ridiculous in fact. I'll have to wait on the lab tests and speak with Hyman."

  "Well, what were her symptoms?"

  "Curt," she said stopping and turning so abruptly to him in the doorway, his eyebrows lifted. "If I believed her symptoms, she died of scurvy."

  "Scurvy? You mean... like sailors used to get because they didn't have enough vitamin C?"

  Terri nodded.

  "Only, taken to a bizarre extreme." She shook her head again, this time to shake the images out of her mind.

  "What the hell... can't be, can't it?"

  "I don't see how," she said and began to take off her clothes. "I don't want to think about it right now. I don't want to think at all. I just want to feel." He nodded. He understood and he was glad she had come to him. He would make love to her as gently and as lovingly as he could. In bed together there were no careers to consider, no egos to stroke. There was just honest and sincere passion.

  Terri was eager to lose herself in it. She drew Curt to her as she would draw a warm blanket over her body, and as she had hoped, she forgot the dead.

  TWO

  Dr. Hyman Templeman pressed his lips together and squinted at Terri as if the sunlight coming through the opened pale blue Venetian blinds in his private office reflected too brightly off her face. Templeman's medical practice was located in his large home on Main Street, Centerville. It was a Queen Anne --

  style Victorian house with a steeply pitched irregularly shaped roof, a dominant front-facing gable, and one side-facing gable. It had patterned white shingles and cutaway bay windows with Wedgwood blue shutters. The asymmetrical facade had a full-width, one-story-high porch that extended along both side walls. In its day it was one of the most expensive homes in the area. Now it was a remarkably well-kept historic whose spindle work detailing drew appreciative eyes.

  "They just don't make houses like this anymore," people would say. And patients would add, "Nor do they make doctors like Hyman Templeman." The two-story building contained fourteen rooms. Hyman and his wife Estelle utilized the rear and the upstairs for living quarters, which was far more space than the two of them now needed. Their three children were all married and gone, two living in California and one in Westchester. The front five rooms, including a relatively recently built waiting room, were dedicated to Hyman's medical practice. He had an X-ray room, three examination rooms, and a small lab.

  The structure didn't have much land around it, but it did have a long front lawn that unfolded smoothly toward the street. There was never enough parking space around or near his offices, but the village police had an unwritten understanding that they wouldn't ticket the cars of patients parked at expired meters. Parking was enforced only during the summer months anyway, and just as in most small resort communities, the recognizable cars belonging to residents enjoyed a special dispensation.

  "I haven't seen a case of Frank scurvy since I served in the army medical corps," Hyman remarked. "And that was in the South Pacific. Never seen one around here. Why even the occasional stump jumpers and rednecks who come down from the hills don't have symptoms that bad. Frank scurvy is rare in the modern world, but the occurrence of petechiae, spongy gums, and tendency to bleed, usually with other evidences of nutritional deficiencies, suggests the possibility of scorbutic purpura."

  "I know how unusual all this is, Hyman, but if you saw her..."

  "Of course, I've heard of women who have gone on one or another of these fad diets denying themselves necessary nutrition. And you are aware, of course, that patients with gastrointestinal disease, especially those on an ulcer diet consisting chiefly of milk, cream, cereals, and eggs, develop secondary deficiencies. Infections increase the physiologic requirements for vitamin C and people with poor dietary
habits are likely to precipitate the appearance of symptoms."

  "I don't know whether or not she was on some fad diet, of course," Terri said,

  "or if she was suffering from an ulcer..."

  "Well, the Thorndykes have been my patients for years. I never treated Paige for anything like that." He shook his head. "We'll have to wait for the autopsy report to confirm it all," Hyman said sitting back in his high back, dark brown, wide-lapped leather chair. The mahogany arms were worn where he would run his palms up and down while he thought deeply or spoke intensely. It was a nervous habit Terri had noticed. What she didn't know was that it, along with some other chronic gestures, was growing more and more pronounced as Hyman approached his mid-seventies.

  He was a tall, lean man with dark eyes and a dark complexion that made his crown of white hair that much more distinct. He had a long, thin nose, but a strong mouth with full lips and a hard, sharp jaw. Patients were usually set at immediate ease by his fatherly smile, a soft movement in his cheeks, and a radiant light around his eyes. They felt his compassion and concern and were reassured by his confidence and wisdom.

  Terri knew it took years to develop the physician's demeanor, especially the demeanor of a man like Hyman Templeman. She longed for the time when she would finally not have to wonder if the patient had any faith in her diagnosis and prognosis. No one need be arrogant and overconfident, but a doctor had to emit assurance and firm purposes.

  "I saw a lot of scurvy in infants while I was stationed in the Philippines." He shook his head. "Such an unnecessary thing and the poor little things -- you know," he said lifting his long right hand with its puffy fingers, "angular enlargements of the costochondral junctions of the ribs, swelling of the extremities over the ends of the long bones, swollen hemorrhagic gums surrounding erupting teeth..." His body shook as if an ice cube had been dropped down the back of his neck.

  "You know there are things that deplete vitamins -- alcohol, of course, antibiotics, anticonvulsants, antihistamines, even aspirin -- but can you imagine the intake of one or more of these substances one would have to undergo to achieve this serious a condition?" he muttered.

  She shook her head.

  "In any case, what I really don't understand," Terri said, "is she not realizing she was this sick. Manifest scorbutic symptoms are almost always preceded by weakness, irritability, muscle aches and pains, and weight loss." Hyman shrugged.

  "She might have attributed all that to her fad diet," he suggested.

  "Um. But you would think bleeding gums, gingivitis, loose teeth would have frightened her into stopping it."

  Hyman shook his head.

  "I've seen a lot of craziness lately. Just last week, they rushed Mrs. Menkos in with a palpitating heart. She had been living on celery stalks and diet pills. She was losing hair, too. What about anorexia?" Hyman asked.

  "That's the thing, Hyman. Paige Thorndyke didn't look anorexic to me. She was undernourished, but not really underweight."

  He shook his head and then looked at his watch.

  "Let's call," he said. "If Julie's on duty, he'll skip the protocol and give us the findings."

  He leaned forward and lifted the receiver of the brass phone. Terri remembered sitting in this office nearly ten years ago to talk to Hyman Templeman about her ambitions. He still had that wonderful painting hanging behind his desk. It was a picture of a doctor making a house call and putting the stethoscope on his own chest to show the frightened child it was nothing. Terri had accompanied her grandmother, who had to have a routine examination, and while they waited for the nurse to help her get dressed, Hyman had invited her in to discuss her plans. He knew she wanted to be a doctor. In Centerville, everyone knew everyone else's business; sometimes before he or she knew it. Of course, Terri's parents had been bragging about her and, on more than one occasion, had told Hyman about her ambitions.

  Funny, she thought, how everything looked so much bigger to her in those days. Hyman's dark oak desk had seemed enormous, as well as the office itself. Even the examination rooms were bigger in her eyes. Or was it that she was so much smaller? Regardless of her accomplishments and her association with Hyman Templeman, he still loomed larger than life in so many ways. The family doctor remained an icon in America, she thought, whether he or she deserved the reverence or not. She wondered, especially at this moment, if that veneration wasn't as much a liability as it was an asset. They expect miracles, and all we can offer is scientific knowledge and some medical skill. There certainly wasn't very much she could do for Paige Thorndyke last night, she concluded sadly.

  "Julie," Hyman said when he had reached the morgue, "Hyman." Only someone with Hyman Templeman's standing in the medical community could slip past the hospital bureaucracy so smoothly, Terri thought enviously.

  "My young assistant was on duty last night when they brought in Paige Thorndyke. Yes, yes, tragic. Have you had an opportunity for any preliminary findings?" He listened. "Really?" he said after one point, his eyebrows rising.

  "That's amazing. Negligible, you say? I know, I know." He listened some more.

  "It sounds like someone kept in solitary confinement for months." He listened and then looked at Terri while he asked the next question. "Any chemical substances, antibiotics, barbiturates...

  "Okay. Appreciate it. Talk to you soon," he added and returned the receiver to its cradle slowly. Then he lifted his eyes toward Terri again.

  "Normal plasma ascorbic acid level, as you know, is about 1.5 mg. per 100 cc. He couldn't get any reading... nothing."

  "Low levels may sometimes be found in nonscorbutic patients," Terri said softly. "But nothing?"

  "Right, and she had no reading in the white cell-platelet layer. She had epistaxis, conjunctival, retinal, cerebral, gastrointestinal, and genitourinary bleeding... all of it," he emphasized. "There's no doubt; this was a severe case of scurvy. It's actually one for the record books."

  "What a freaky death for a young, affluent woman in the twenty-first century," Terri said, more to herself than to Hyman.

  "She had sexual intercourse right before she was brought in," he added. Terri raised her eyebrows just as Hyman's intercom buzzed.

  "Yes, Elaine?"

  "Mr. and Mrs. Thorndyke are here to see Dr. Barnard," the receptionist said, her voice cracking with emotion. Elaine Wolf had been with Dr. Templeman nearly as long as he had been practicing. Some older patients considered her evaluation of their condition as good as a preliminary examination. She was a fountain of information when it came to knowledge about families in the community. She asked questions with the forcefulness of a homicide detective and knew if someone came in with bad bronchitis, there were good chances this or that close relative wouldn't be far behind.

  "Show them in," Hyman said. He sat back.

  "What am I going to tell them?" Terri asked, not disguising the panic in her voice.

  "All you know. What else?"

  There was a knock at the office door, and Terri rose reluctantly to greet the Thorndykes.

  Bradley Thorndyke was still in his pilot's uniform. He was a tall, handsome man in his early fifties with light brown hair and a light complexion that usually gave him a youthful appearance. Now, the weight of mourning and the personal tragedy had added years quickly. His eyes were dark; his skin pale, his shoulders slumped.

  Geena Thorndyke was nearly her husband's height. She was an attractive, longlegged, slim woman with ebony hair and dark brown eyes. She clung to her husband for veritable support, her eyes bloodshot, her lips trembling.

  "Bradley... Geena," Hyman Templeman said, rising. He went to them quickly and shook Bradley's hand and then put his arm around Geena Thorndyke's shoulders and guided her to the brown leather settee. "I'm so sorry," he said.

  "Can you believe this?" Bradley asked. "It makes no sense to us and we couldn't sit at home and wait for something sensible, so we decided to come see the doctor who examined her," he said looking at Terri.

  "We were just discussing it," Hy
man said stepping back. "Needless to say, it's one of the most unusual things I've seen or heard since I began practicing medicine."

  Bradley Thorndyke's gaze swung quickly to Terri again. She felt his sorrow, but she also felt his anger. There was accusation in those eyes. She quickly realized that in their need to understand what had happened to their daughter, the Thorndyke's were searching for a scapegoat, someone to blame so it would make some sense.

  "You were on duty when they brought her into the emergency room, right?" he said in an accusing tone.

  "Yes. I was with a patient and I heard the STAT and rushed right down. I had just gotten my stethoscope on her chest when she expired," Terri explained. Geena Thorndyke groaned and began to sob.

  "They're telling us it looks like she died of acute scurvy," Bradley said, his disdain and disbelief quite evident in his voice.

  "Yes, Mr. Thorndyke. It's just about certain that will be the diagnosis."

  "That's just ridiculous. She was found unconscious on the floor of a cheap, onenight motel room. She must have been drugged," Bradley insisted. "Someone picked her up and slipped her one of those Ecstasy things or something, an overdose, right?"