Miracle Cure

by Michael Palmer

  Bouncer … car-rental gofer … supervised visitations with his daughters … living with Dad … Brian knew that after eighteen months of hard work—counseling, Narcotics Anonymous meetings, and endless hours with his NA sponsor, Freeman Sharpe, a building maintenance man with twenty years of recovery from heroin addiction—his internal demons were pretty much under control. But his external life still left a lot to be desired.

  Brian’s Saturday-night stint at Aphrodite had ended after three, so it wasn’t until ten that he had gotten up. He had planned to go for a run, and then maybe hook up with some of the kids playing touch football in the park. They loved having him in their game, especially when he sent one of them deep and threw a fifty- or sixty-yard bullet spiral to him. But one glance at Jack had changed his mind. The man who had been Brian’s football coach from Pop Warner to high school and on to college was wrapped in an afghan in his favorite chair, where he had been sitting up for most of the night. On the table next to him were several cardiac medications and others for pain. He looked drawn and in need of a shave.

  “Got any plans for the day, Coach?” Brian asked.

  “Yeah. The sultan of Brunei is supposed to stop by with his harem. I told him just three for me, though.”

  “How about I make you some breakfast?”

  Jack’s gray crew cut, chiseled features, and lingering summer tan helped him look younger, and healthier, than he was. But Brian knew that his cardiac condition was worsening. Portions of his six-year-old quintuple bypass were almost certainly closing. Brian picked up the small vial of nitroglycerin tablets and checked inside. More than half were gone.

  “How many of these did you take yesterday?” he asked.

  Jack snatched the vial away and put it into his shirt pocket.

  “To tell you the truth, I don’t remember taking any.”

  “Jack, come on.”

  “Look, I’m fine. You just tend to your business and let me tend to mine.”

  “You are my business, Jack. I’m your son and I’m a cardiologist, remember?”

  “No. You’re a bouncer in a bar. That and a car salesman.”

  Brian started to react to the barb, then caught himself. Jack was probably operating on even less sleep than he was.

  “You’re right, Coach,” Brian responded, willing his jaw to unclench. “When I’m back to being a cardiologist again, then I can give advice. Not before. Let me toast you a bagel.”

  The living room of the first-story flat that Jack had owned for the ten years since his heart attack was, like the rest of the place, devoid of a woman’s touch. There were sports photos on the walls and trophies on almost every surface that would hold one. Most of the awards had Brian’s name on them. They were the trappings of a man who needed gleaming hardware and laminated certificates to pump up his self-esteem. When Brian had first moved in, being surrounded by all those trophies had been something of a problem for him. But Freeman Sharpe had helped him deal with his issues. Remember, your dad loves you and he always wanted more for you than he ever wanted for himself. And if he pushes your buttons, just tell yourself that he’s a master at doing that because he’s the one who installed them in the first place. And in the end, as with so many other things that had seemed like a big deal, the trophies meant nothing more than Brian chose to make them.

  As he headed into the small kitchen, he glanced at one of the photographs on the wall by the doorway. It was the official photo of the UMass team taken just before the start of his fateful junior season. He was in the middle of the next-to-last row. Number 11. Then, for the first time that he could remember, his eyes were drawn to a face at the right-hand end of the very last row. Dr. Linus King, the team orthopedist. Brian had looked at the photo any number of times before—where it hung, he had no real choice. It was curious that he had never noticed the man until now. Over countless therapy sessions and countless recovery meetings, Brian had come to accept responsibility for his addiction to prescription painkillers. But if there was anyone else who bore accountability, it was King.

  Brian repressed the sudden urge to slam his fist into the photo. Over the year following his reconstruction of Brian’s knee, Linus King, a sports-medicine deity, was always too busy to conduct a thorough reevaluation of his work, to say nothing of sitting down to talk with his patient about persistent discomfort in the joint. Instead, he had preached patience and rehabilitation, and had prescribed hundreds of Percocets and other painkillers. Finally, a repeat MRI had disclosed a previously undiagnosed fracture. A cast and three months of rest took care of the cracked bone, but by then Brian had acquired a string of harried doctors, each willing to dash off a prescription in exchange for not having to listen. His addiction was full-blown and well-fed years before he violated the law and his own principles by writing the first prescription for himself.

  “Jack, do you really think you’re up for a trip into the city?” Brian asked now.

  “I don’t know. I think so. I’m going slightly stir-crazy, son. And beating you at gin isn’t what I’d call the most challenging activity in the world.”

  “I’ll tell you what. I’ll cut cards with you. You win, it’s Jean-Claude and the restaurant of your choice.”

  “And if I lose?”

  Brian could tell his father knew what was coming.

  “You lose and we still go into Boston. But you’ve got to promise me you’ll go back and see Dr. Clarkin.”

  “I’m fine.”

  “You’re not fine. It’s been six years since your operation. Clarkin can revise those grafts or replace them.”

  “No more Clarkin, no more surgery. I’ve told you that a thousand times. I’ve had my last catheter and my last tube.”

  As often seemed to be the case with a physician or a physician’s kin, everything that could have gone wrong postoperatively for Jack did. Heart failure, infection, graft revision, reinfection. A total of eight miserable weeks in the hospital which, in the era of managed care, spoke volumes as to how spectacularly ill he was. For many of those weeks, he literally begged to die. True, Black Jack was more stubborn than most. But having seen the man every one of those fifty-six days, Brian could hardly blame him for taking such a hard line against any return to the OR.

  “All right,” Brian said. “But I’ve never seen you chicken out of a friendly wager before.”

  “That’s because I have a reputation for always paying up on my losses. And I know I’d end up welshing on this one. Tell you what. How about one cut: the seventy-one bucks you owe me versus you treating for dinner and the movies.”

  “Deal.” Brian turned over the queen of clubs. “Hey, maybe my luck is changing.”

  Jack cut the three of diamonds. He stared at the card for a few protracted seconds.

  “Maybe mine is, too,” he said.

  He pulled on his favorite sweater, a frayed orange cardigan Brian’s mother had given him just before her death nearly thirteen years ago.

  “You gonna be warm enough if I put the top down?” Brian asked.

  “Sure.… Um … son, there’s something I gotta get off my chest before we leave.”

  “Go ahead.”

  “I … I was out of line saying what I did this morning about you not being a cardiologist.”

  “Don’t worry about it. Besides, I never paid any attention to anything you ever said before. Why should I start now?”

  “I’m frustrated, that’s all. And I don’t understand how you could have let this happen.”

  “I know, Pop. I know. Sometimes we have to hit bottom before we figure out how to really enjoy life.”

  “I’m sure something will come along.”

  Brian looked away.

  “I’m sure it will,” he said.

  Actually, he was reasonably certain it wouldn’t. The Board of Registration in Medicine had determined six months ago that he was in good recovery and ready to resume practice, but it was their policy in drug and alcohol cases to insist on a physician having a work situation in pla
ce with tight on-the-job monitoring and random urine testing before a license would be issued. No job, no license. It was the board’s immutable law. Brian had argued that in Boston, with three medical schools and a plethora of teaching hospitals, cardiologists were more plentiful than cod. Why would anyone take a chance on hiring someone without an active license?

  Two children and Jack’s shaky medical situation made a move too far away from eastern Massachusetts out of the question. So Brian had done what he could, responding to ads in the cardiology press and the New England Journal of Medicine and sending out at least two dozen resumés. He had networked until he had absorbed more than his quota of rejections, and had seen colleagues he thought were his friends turn away. He had even placed an ad himself.

  Former chief of cardiology and cath-lab director at Boston-area hospital seeks group practice in eastern Mass, Rhode Island, southern New Hampshire.

  No job, no license. No license, no job. Catch-22.

  Now, for the past month, he had simply stopped trying. He had stepped back and begun to mull over other directions in which his life might be ready to go. The process hadn’t been easy, but there was one saving grace. Rarely, in all these frustrating months of rejection and disappointment, had he thought about drinking or taking pills.

  “You ready, Pop?”

  “You go on and get that top down. I’ll be right there.”

  Jack Holbrook headed slowly toward the bathroom. When he heard the front door open and close, he quickly braced himself against the wall, fighting to slow his breathing as a skewer of pain bored up to his jaws from beneath his breastbone. He fumbled the vial of nitroglycerin from his shirt pocket and dissolved one under his tongue. Half a minute later, the pain began to subside. He wiped beaded sweat from his upper lip and took a long, grateful breath.

  “Jack, everything okay?” Brian called from the front steps.

  “Yeah, fine, Brian. Everything’s fine.”

  The Towne Deli was a trendy little place on Boylston with a fine salad bar and nine-dollar sandwiches. Brian dropped his father off in front and spent ten minutes finding a parking space. Jack’s condo was in Reading, a working-class suburb that straddled Route 128 northwest of the city. The ride in, beneath brilliant late-afternoon sun, was as much of a joy on Sunday as it was a nightmare during the typical morning commute. And Brian’s three-year-old red LeBaron, by far the best thing he retained after the divorce, was the perfect car for the day.

  During the drive, Brian knew that Jack wanted information. Any job prospects? Any new word from the board? Any interesting women? But perhaps in honor of the warmth of the day and the peace between them, his dad kept his thoughts to himself. Brian, too, avoided the inflammatory topic of his father’s health. Instead, they alternated between sports and silence.

  Brian entered the Towne Deli and spotted his father at a small table in the corner. For a few seconds, he stood by the front door, studying what remained of the man who had so dominated the first two decades of his life. From almost the day Brian took his first step, Coach was there, monitoring his diet, social life, and workouts, creating what he believed would be one of the great quarterbacks. And save for one play, he might have succeeded.

  Jack sat motionless, staring down at the menu. Then, almost subconsciously, he began rubbing at his chest and up toward his neck. Brian hurried across to him. Beneath his tan, Jack was ashen. His eyes were glazed.

  “Jack, what’s going on? Are you having pain?”

  Jack Holbrook took a breath through his nose and nodded.

  “Some,” he managed in a half-grunt.

  Brian checked the carotid pulses on either side of Jack’s neck. They were regular, but thready. A sheen of sweat had formed across his forehead.

  “Jesus,” Brian whispered. “Jack, do you have your nitro?”

  Jack produced the bottle from his shirt pocket.

  “Shouldn’t have come into Boston,” he said hoarsely.

  “Nonsense,” Brian said, sensing the strange, paradoxical calmness that for many years now had been his response to a medical crisis. “It wouldn’t have made any difference. Come on, Pop. I’m going to sit you over here on the floor and give you one of your nitros. Do you still have that aspirin I put in your wallet? Good. Let me get it out.”

  Either Jack was having a bad angina attack—not enough blood flow to a portion of his heart—or he was having a full-blown coronary: a myocardial infarction in which the heart segment was getting no blood at all. If the problem was an artery obstructed by a clot, the extra aspirin might help dissolve the blockage before there was permanent damage.

  “Is there a problem, sir?”

  Brian looked up at the balding restaurant manager. Of course not, I always put my father on the floor in restaurants.

  “He’s a heart patient and he’s having chest pain,” Brian said instead.

  “Should … should I call an ambulance? Ask if there’s a doctor here?”

  “I am a doctor,” Brian said, for the first time in a year and a half. “And I think an ambulance would be an excellent idea.”

  Silently, Brian cursed himself for giving in to the Boston trip. Jack’s internist, cardiologist, surgeon, and all his records were at Suburban Hospital, way on the other side of Route 128. It was an excellent hospital, well known for its orthopedics, rehabilitation medicine, and in some circles, for a former chief of cardiology named Brian Holbrook.

  He checked Jack’s pulses once again and mopped his brow.

  “How’s your pain, Jack? One to ten.”

  “Six. The nitro’s helping. What are the odds it’s a coronary?”

  “Fifty-fifty.”

  “Bad odds.”

  “Just hang in there. The EMTs’ll get a little oxygen going and give you some pain medicine, and you’ll feel much better.”

  “Ten bucks says one of the EMTs in the ambulance is a woman. Deal?”

  “Deal. Just stay cool. Do you want to lie down flat?”

  “I couldn’t.”

  In the distance, they could hear an approaching siren. Brian kept a constant check of the pulse at Jack’s wrist. The perspiration, so typical of a cardiac event, seemed less heavy.

  “Everything’s fine, Pop. How’s the pain now?”

  “Ten.”

  “The pain is up to a ten?”

  “No, you owe me ten.”

  Jack nodded toward the door, where a young brunette in blue EMT coveralls was on the pulling end of a stretcher. Brian introduced his father and gave a capsule summary of the situation and the limited treatment he had instituted.

  “You a doctor?” The young woman asked immediately.

  “A cardiologist. Brian Holbrook.”

  “Well, we got no pride on this team, Dr. Holbrook,” she said, doing, it seemed, a dozen things at once, and doing them all well. “If there’s anything we overlook, just call it out.”

  “Thanks. Jack’s a patient at Suburban Hospital.”

  “Well, in a few minutes he’s going to be a patient at White Memorial. That okay with you?”

  White Memorial was not only the best hospital in the city, it was the home of Boston Heart Institute, one of the foremost centers of its kind. Brian flashed on the interview he had blown when applying for cardiology training there. The subsequent rejection letter was hardly a surprise. Given all that had happened to him since then, he mused, it seemed the interviewer had shown pretty good judgment.

  Brian noted Jack’s immediate improvement with a bit of IV morphine and some oxygen.

  “Actually,” he said to the young EMT, “Boston Heart is precisely where I was going to ask to have him taken.”

  CHAPTER TWO

  BRIAN SQUEEZED INTO THE AMBULANCE FOR THE SHORT ride from Back Bay to White Memorial. His father’s pain was down to a two or three by the time they left the Towne Deli. Still, throughout the ride Brian kept a watchful eye on the monitor. The absence of extra beats was a good sign, but the shape of the cardiogram wave pattern strongly suggested an ac
ute coronary.

  Jack’s cardiologist at Suburban was Gary Gold, one of Brian’s former partners—the only one of the four partners who had believed that Brian was recovering from an illness and should be readmitted to the practice as soon as he was ready. Silently, Brian cursed himself for not insisting that Gary be more aggressive with Jack in pushing for a repeat cardiac catheterization and surgical evaluation. But then again, with Jack so adamantly against repeat surgery, what was there to do?

  White Memorial was an architectural polyglot of a dozen or more buildings crowding four square blocks along the Charles River. All around, as with most large hospitals, there was construction in progress. Earth movers and other heavy equipment were as much a part of the scene as were ambulances, and two towering cranes rose above all but the tallest building. A new ambulatory care center, one sign proclaimed. The twenty-story future home of the Hellman Research Building, boasted another. Like the patients within, the hospital itself was in a constant cycle of disease and healing, decay and repair, death and birth.

  The vast ER was in noisy but controlled disarray. The two triage nurses were backed up, and the waiting room was full. Brian took in the scene as they rushed Jack to a monitor bed in the back. The drama and energy of the place were palpable to him—his element. Merely walking into the ER made him feel as if he had been breathing oxygen under water and had suddenly popped through the surface. He had anticipated heightened emotions at reentering this world, but he was still surprised by the fullness in his chest and throat, and the sudden increased moisture in his eyes. Not that long ago he had been part of all this and his own actions had caused it to be taken away. Now, there was no telling when, or even if, he would ever get it back again.

  “How’re you doing, Jack?” Brian asked, taking his father’s hand as they waited for a clean sheet to be thrown over the narrow gurney in room 6.

  “Been better. The pain’s gone, though.”

  “Great.”

  “Two bucks says I don’t get dinner.”