A Perilous Conception

by Larry Karp

  “But you and Dr. Hearn have been working pretty closely for a while, haven’t you? You were getting her human eggs to work on in that private alcove of hers.”

  Just for an instant, his body went stiff, and the hint of a glow spread over his cheekbones. He swallowed, then had to clear his throat before he could say, “Who told you that?”

  “Doesn’t matter,” I said. “It’s true, isn’t it?”

  He shrugged. “Yes, it’s true. So what? Every now and then, I retrieved some human eggs for her to do experiments on. I guess if you want to look at it that way, those ovum retrievals were my quid for her quo of doing an occasional clinical procedure for one of my patients. As I said, that’s why the Medical Center operates the way it does. It works to everyone’s benefit.”

  “And ‘every now and then’ was how often?”

  “I didn’t keep count. When I was doing a laparoscopy, say, to cut adhesions or to tie tubes for birth control, I’d also retrieve some eggs from the ovaries.”

  I filed that in the back of my mind, right next to what I’d read the day before about the way Dr. Steptoe went about retrieving eggs. “Did you get permission from the women to do that?”

  “I could hardly do it without their consent. I gave them injections of hormones for a couple of weeks beforehand, to ripen the eggs so some would be ready to ovulate at the time of the procedure. Ova that haven’t gone through that development can’t be fertilized. Then I got sperm samples from medical students, and Dr. Hearn did her studies.”

  “Which were what?”

  “She was interested in conditions that might cause abnormal chromosome behavior at fertilization. I can’t tell you more than that. I’m not a geneticist.”

  “But what you are saying is that she worked on human embryos. Live human embryos that could’ve developed into—”

  “If they’d been able to implant in a uterine wall, yes. But there’s nothing illegal about this research. It’s being done all over the world.”

  “Isn’t there some sort of Ethics Board in your hospital that’s supposed to review procedures like that?”

  “No. We’re a clinical, community hospital. We have a Practice Standards Committee that reviews cases where treatment may have been inappropriate or inadequate, but if a doctor wants to help further medical research and the patient has no problem with it, we don’t see any need to tie our own hands with bureaucratic red tape.”

  “How about at the University? Don’t they have an Ethics Board or Committee that researchers are supposed to go to for approval of research on human tissue? Especially on human embryos?”

  “Yes. There is an Ethics Committee at the U.”

  “Did Dr. Hearn present her work to that board?”

  “I don’t…no, she didn’t, and I’ll tell you why. Even if the Committee had given unanimous approval to that sort of project, Gerry Camnitz still wouldn’t have permitted it to be done in his department.”

  “Why not?”

  Sanford looked like he’d swallowed a mouthful of sour milk. “Because Camnitz has six inches of moss growing on his back. God forbid that some religious nut or conservative ethicist might get on TV or in the newspapers, and accuse Dr. L. Gerald Camnitz of permitting experiments in his department that Dr. Mengele would have loved.”

  “Could that have gotten you into any trouble, too?”

  Sanford shrugged. “I only supplied her ova and sperm samples. What she did and how she did it wasn’t my concern.”

  I broke out laughing. “Come on, Dr. Sanford. First you talk about Dr. Mengele, then you say you were only providing Dr. Hearn what she needed to do verboten experiments?”

  “Nothing she did was ‘verboten,’ except according to Dr. Camnitz. I told you before, work on human embryos is not in any way illegal.” He made a show of glancing at his watch. “What are you getting at?”

  “I’m wondering whether Dr. Hearn did any work on Joyce Kennett’s eggs.”

  “I told you, she did Density Gradient Separation on James’ sperm.”

  “Yes, I remember you said that. But what I asked you was whether she also did any experimental work on Ms. Kennett’s eggs?”

  “No,” Sanford said. “Is that clear enough?”

  I got up, walked to the window, stared at the city twelve stories below, then turned to stand over Sanford. “Wasn’t there a problem with one of your…Dr. Hearn’s experiments a while ago? Something about a tube that she dropped on the floor and broke?”

  He got to his feet, but still had to look up to talk to me. “I don’t recall anything of that sort.”

  I held up a hand. “Before you perjure yourself—”

  “We’re not in court, Mr. Baumgartner.”

  “No, we’re not. But we may well be headed that way. And if you repeat in court what you’ve just told me, you’ll be perjuring yourself. Before we go any further, I’m going to tell you there were witnesses who do recall that accident, very clearly, in fact. They say right after the accident, Dr. Hearn called you, and practically before she hung up, you were over there. You both went into her office, then came out a few minutes later, and hustled off down the hall. Does that help you remember?”

  Sanford walked a few steps off, studied the ceiling. “Yes…I’d forgotten. It was some time ago, and it wasn’t important. Giselle had a little bout of the clumsies, dropped an experiment and ruined it. She was a very serious woman, totally dedicated to her work, and she was worried I’d be angry at her for wasting the tissue I’d retrieved. I told her not to worry, accidents happen, and I wasn’t the least bit sore. She went back to work, I came back to my patients, and that was that. She just needed to vent.”

  “What was it she dropped that got her so upset?”

  “I told you, I don’t know exactly what she did. It was one of her experiments in progress, studying chromosomes at fertilization. She dropped a specimen, and that was the end of the experiment. That’s all I can tell you.” He glanced at his wrist again. “I really would like to grab a sandwich before my afternoon patients.”

  He stepped to the side; I matched him. We must have looked like two tomcats circling each other, looking for an opening. “Dr. Sanford, I don’t want to inconvenience you. Could we please take a quick look at Ms. Kennett’s chart? Then I’ll get out of your hair.”

  “We couldn’t find that chart on Friday. What makes you think—”

  “I think a doctor who pays so much attention to his patients’ well-being isn’t going to settle to have a chart vanish permanently.”

  Sanford made a disgusted face, then marched to the door. I rode his wake into the waiting room, behind the reception counter, and up to the chart storage rack. He worked his fingers into the row of hanging charts. “K…K-E…N-N…damn, still not here. Sorry.”

  “Think one of your office workers could find it?”

  “They’re on their lunch break in the staff room.”

  “Can you get one of them out?”

  He tapped a well-manicured nail on the counter. “Mr. Baumgartner, my staff works hard. Barring emergencies—and this really isn’t one—my receptionist is supposed to have an hour free to eat lunch and relax. She’s still got twenty minutes. Come on, let’s go down to the cafeteria and have a sandwich. Then we’ll see if she can find the chart. I have nothing to hide.”

  ***

  Twenty minutes later, Sanford and I marched up to the reception counter. Sally flashed just the right smile to her boss and his cop guest. Sanford cleared his throat. “Mr. Baumgartner and I want to look at Ms. Kennett’s chart, but I can’t find it in the rack.”

  Sally jumped to her feet. “Bet I can find it for you.” She turned to the chart rack, then started to paw through it. After a few seconds, she cried, “Ah,” and pulled a folder from the rack. “Here it is, Doctor. It was misfiled by a few names.”r />
  Sanford took the chart from her. “Thank you, Sally.”

  The young woman grinned at me. “This happens a lot. We’ve all learned, if you can’t find a chart, don’t give up till you’ve checked at least ten names on either side of where it should be. Usually, it’s off by only one or two.”

  I tipped an imaginary hat to her. “Good work, young lady. Dr. Sanford’s lucky to have such great help.” I crooked a finger toward the office. “Let’s have a look.”

  Back in Sanford’s inner sanctum, I asked if it was okay for me to sit at the desk to look through the chart. He told me to be his guest. I flipped pages to the last entry. “‘Prenatal visit, thirty-nine weeks,’” I read out loud. “Looks like everything was hunky-dory.” I paged back past the first prenatal visit on September 26, to a one-line confirmation of pregnancy on September 8, then to a handwritten operative summary from August 6. “’Post-Pergonal and HCG regimen. Laparoscopy, lysis of adhesions…pre-ovulatory ovaries, tubes, uterus, all normal, save for small number of adhesions at right and left tubo-ovarian junctions, which were easily lysed.’” I looked up at Sanford. “Would you mind translating for me?”

  “Sure. It means she’d gotten hormone shots to time ovulation to the procedure, and the ovaries were on the point of releasing eggs, perfect timing. And she had a little scar tissue around the ends of the fallopian tubes, where they come up to the ovary to receive eggs at ovulation. That scar tissue can block an egg from getting into the tube and being fertilized. So I lysed—cut—it away.”

  “Where’s it come from, the scar tissue?”

  Sanford shrugged. “Could’ve been an old inflammation, say from a mild case of gonorrhea. Or appendicitis. Or a condition called endometriosis, though I didn’t see any specific evidence of that. Sometimes, we just don’t have any idea. Whatever caused it, it’s not an unusual condition.”

  “But she had a long history of infertility, and got workups by you and the University doctors. Didn’t anyone ever look for scar tissue before?”

  “That’s a yes-but. She had a radio-opaque dye injected up through the uterus and into the tubes, to see if it spilled out the far ends. But that’s not awfully precise, especially if the adhesions are mild, which hers were. An open operation to look for adhesions would be excessive, but laparoscopy has reached the point of being useful for that.”

  “Laparoscopy…that’s that new ‘Band-Aid’ surgery, right?”

  He chuckled. “You’ve got it.”

  “And you can do it?”

  “No one else in Emerald, including the University faculty, has my background or experience.”

  “What? You mean to tell me you’re the only doctor in town who can do laparoscopy? That nobody at the U—”

  “Oh, they can do it.” Sanford practically drooled contempt. “Talk to people at the U, they’ll tell you they’re the last word. But I learned the technique from Guiseppe Allegri, who happens to be the world’s authority. If a woman in this city needs laparoscopy and goes to anyone but me, frankly, she’s out of her mind.”

  Amazing, the load of brass this guy schlepped around between his legs. “You told me before that you used laparoscopy to get eggs for Dr. Hearn when you were cutting adhesions on patients. But you didn’t take any eggs from Ms. Kennett, is that right?”

  “The chart doesn’t say I did, does it?”

  I took a deep breath. “Dr. Sanford, it’s a bad idea to crack wise to a cop who’s looking into a homicide. I take my work as seriously as you take yours. Now, the chart says you gave Ms. Kennett the same hormone shots Dr. Edwards and Dr. Steptoe use in their experiments, and I’m betting if I check back, I’ll find out they were also the same shots you used in your experimental women before you took their eggs. So, did you or didn’t you take eggs from Ms. Kennett at this procedure?”

  He put on his best thinking cap. “To the best of my recollection, no. If I had, it would’ve been in her chart. In her case, I was timing ovulation to give the treated sperm the best chance to fertilize eggs in her body. It would’ve been silly to inseminate her if she wasn’t going to have eggs ready to be fertilized.”

  “Okay. Thank you. Now, if this procedure took place on August 6, and Ms. Kennett had her baby April 28, unless that baby was premature, she must have conceived right then. Your sperm treatment must have worked.”

  He made no secret of how pleased he was with himself. “I like to think so, but it really could have been any number of things, or even a combination. Maybe cutting away the adhesions freed up the tubes to let an egg enter from the ovary. But I’ve got to admit, there’s a joker in that deck. Almost any infertility treatment, even the crackpot stuff, has a decent conception rate right after it’s done. Some people think it’s psychological, but no one really knows. Whatever, Joyce did conceive in that cycle. Sure, I’m curious about what actually did the job, but I don’t think Joyce or her husband cared.”

  “Was there anything else you did? To help her get pregnant?”

  “Like what?”

  “Like anything. Anything else either you or Dr. Hearn did that you haven’t told me about.”

  Sanford shook his head slowly. “No…there was nothing else.” He gave his watch a long look.

  “Dr. Sanford…”

  He waited.

  “Did you know a woman named Alma Wanego?”

  “Wanego? That name’s not familiar.”

  “She was the supervisor in Dr. Hearn’s lab until she disappeared one day last September. You never heard anything about that?”

  He made such a production of thinking, I wanted to tell him to go down to the Rep and see if he could get a part in their next play. “Yes…yes…I do remember something about a supervisor who vanished, and they had to replace her. But I have nothing to do with the running of that lab, and it made no impression on me.

  “All the times you took eggs over there for Dr. Hearn, you never met Alma Wanego?”

  “I didn’t take eggs over there. Dr. Hearn came to the operating room so she could get the eggs as soon as I’d recovered them from the ovary. I did take sperm samples from the medical students over to her, and from time to time we’d get together to talk about how things were going, and whether we needed to make any changes in the clinical protocol.”

  “Dr. Hearn was never busy doing something else, so you had to deal with another lab person?”

  “No. We planned our meetings for when she’d be free.”

  “And she never sent anyone else to the operating room to pick up the eggs?”

  Sanford’s laugh had a sharp edge. “And take a chance someone might leak information that could get to Dr. Camnitz?” He shook his head. “Besides, the first steps for culture after retrieval are critical, and Dr. Hearn was as compulsive as they come. I don’t think she’d ever have trusted anyone else to do that work.”

  “Doctor, how far along in pregnancy does a woman have to be before her pregnancy test turns positive?”

  “There are blood tests and urine tests. Blood tests can be suggestive very early on, but the gold standard for both tests is six weeks after the last menstrual period. That’s four weeks after conception.”

  “Six weeks, four weeks…okay, then. Dr. Hearn’s botched experiment happened right about the time your patient, Ms. Kennett, got pregnant, thanks to the sperm preparation, the lysed adhesions, psychological reasons, whatever. Cut to four weeks later, early September. Ms. Kennett’s pregnancy test turns positive, and the supervisor in the laboratory vanishes.”

  Sanford shrugged extravagantly. “So?”

  “So, you think it’s just a coincidence that strange things happened at two key points in Ms. Kennett’s pregnancy?”

  “I’d say you’re reaching, Mr. Baumgartner. Sorry.”

  I slammed the chart shut. “Okay, Doctor, thanks. I appreciate the time you’ve given me.�
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  “I hope I’ve been able to help.”

  “Oh, yes.” I extended a hand, we shook, then Sanford led me to the door. As he reached for the knob, I stopped. “Shoot, I forgot. One last thing. I hear you had a press conference scheduled last Friday, but you canceled it.”

  Sanford frowned. “Where did you hear that?”

  “From a reliable source.”

  Actually, I’d heard it while I was waiting for Sanford to finish his morning appointments. A woman was dropping a load on Ms. New York, the receptionist, about how her weekend had been ruined by the vaginal bleeding that was supposed to have been taken care of on Friday, but they’d had to re-schedule her because of a press conference Dr. Sanford had set up. Yes, the receptionist said, she was awfully sorry, and on top of everything, Dr. Sanford had had to cancel the conference.

  “So, what was that conference all about?” I asked.

  Sanford turned on the sad-eye. “I guess it really doesn’t matter now. It was going to be for Dr. Hearn to announce something she’d discovered in her work. She thought she’d made a major breakthrough.”

  “And you’ve got no idea what this major breakthrough was?”

  “Only in a general way. Something to do with the cause of Down Syndrome. That’s all I know.”

  “Isn’t there a record of the work Dr. Hearn did in that alcove. Don’t scientists keep notes? Details of their experiments as they go along?”

  “Sure they do. I saw the log Dr. Hearn kept on our collaborative work, but I never looked over the data.”

  “And you have no idea where it might be.”

  Sanford shrugged. “My best guess would be that she kept it in her desk.”

  “You’re saying the press conference was to announce Dr. Hearn’s work, which you only knew about in a general kind of way, but it was going to take place in your office. Why didn’t Dr. Hearn schedule it at her office?”

  “Two reasons. For one thing, Dr. Hearn didn’t want to have Gerry Camnitz playing bull in her china shop. Camnitz has no control over what I do in my office. And for another, bringing reporters and photographers into my office does wonders for my patient lists. Get it?”