“Uh-oh,” said Gwen. “They haven’t even started drinking yet.”
Peering down the rickety wooden stairway at the chief’s house, Rick said, “This is your new boss’s house? It looks like something from The Hobbit.”
“Or Hansel and Gretel,” said Gwen, gripping his arm.
“What’s a hobbit?” Marco asked.
As Kevin was about to answer, the front door creaked open. All four stepped back.
Herb peeked out and waved at them.
“Come on in,” he called merrily. “Ray won’t bite.”
Kevin and Gwen glanced at each other. Neither had ever seen Herb in such an expansive mood. Taking the initiative, Kevin led the way down the stairs.
Herb showed them into a living room crowded with shelves of books on Native American art and handicrafts. Bright Huichol yarn paintings from northwest Mexico hung on the walls. Cecilia Wu, Ray, and Ray’s wife were chatting by the fireplace. The new chief, a portly man with a salt and pepper goatee, was delighted to see them, especially Gwen.
“I hope more house staff are coming,” said Ray.
“Don’t worry,” said Gwen. “They’ll all be here. No one I’ve worked with at City Hospital would miss a free meal.”
The doorbell rang, and Ray let in six interns. Marco walked around the room examining the yarn paintings.
“Who’s the collector?” he asked.
“Ray,” said the chief’s wife.
Marco began another question but Herb interrupted, insisting, “Let me get you some wine. You have to catch up with us.”
He led the two couples to the kitchen. An array of bottles and long stemmed glasses covered several marble counters.
“I brought this one,” said Herb as he opened a magnum and poured five generous servings. “It’s from Oregon, the new frontier for boutique Pinot Noirs.”
Their conversation moved from wine to geopolitics—the rise of Solidarity in Poland and the Ayatollah in Iran. After a few minutes, Marco wandered back to the living room where he found an encyclopedic collection of world music to explore. A new group of boisterous interns came into the kitchen for wine. Rick drifted away with them.
Herb could knock off a half-liter of wine and hardly feel it. He had already passed that benchmark and noticed Kevin and Gwen were matching him ounce for ounce. Curious about a Zinfandel on the counter from a winery he didn’t know, Herb opened the bottle. He filled Kevin’s and Gwen’s glasses, then his own. They stared at him in surprise.
“It’s a party,” Herb said with an authority that quickly disintegrated into silly laughter.
“All right!” shouted Kevin, raising his glass.
“This’ll be a first,” he said in a stage whisper to Gwen. “I don’t know anyone who can say they’ve seen Herb Wu drunk.”
Kevin and Herb took long sips then eyed Gwen’s full glass. Smiling serenely, she downed a larger amount, then held it up for their inspection. Herb and Kevin took even larger swallows. Herb immediately topped off all three.
Kevin shook his head in wonder.
“You have to be able to drink seriously to make it in academic medicine,” Herb pronounced.
“It’s a requirement?” asked Gwen.
“It is.”
“Perhaps I should reconsider my career plans. I was going to look for a clinic job after residency.”
“You should reconsider that,” said Herb, no longer facetious. “GRID is going to be the next big thing. Not just because of the epidemic we’re dealing with here. Understanding what causes this immune deficiency could revolutionize transplant medicine. Think about it. You could get in on the ground floor.”
Kevin nodded in agreement.
“It’s a great career opportunity,” Herb added mischievously, “for someone with your clinical skills.”
Kevin wagged his finger at Herb and said accusingly, “Herb, you are such a slut. First you hit on me. Now you’re hitting on Gwen?”
Gwen’s laughter was loud and shrill. Herb’s face reddened, but he was tickled by Kevin’s absurdity.
“Very clever.”
“Wait,” Gwen interjected. “What’ll happen to poor Kevin? You’ve seduced and abandoned him.”
Herb rose to the occasion with faux lugubrious sympathy.
“I feel bad for him. He’s hooked now. He’ll never be able to stop working. I guess by default he’ll end up becoming an academic superstar.”
Gwen whooped and clapped. It was Kevin’s turn to be embarrassed. He bore it good naturedly until realizing what game they were playing.
“Herb, what you said about Gwen’s skills is right on. What do you see in her future?”
Herb put his thumb under his chin and studied Gwen.
“I think Gwen could be more than a master clinician,” he said with no mockery. “This disease is eventually going to affect a lot of people. How the country deals with it will be controversial at best. Gwen has the even temper and maturity to communicate to the public about it very effectively.”
Gwen’s face was crimson, which caused Herb and Kevin to laugh. They slapped each other’s backs.
Kevin suddenly wondered where Marco was. He went to the living room and found Marco talking excitedly with Ray in Spanish. Gwen and Herb had followed Kevin, and the three could see Rick through French doors outside on the deck, huddled in a circle of house staff passing a joint. Rick caught Marco’s eye and motioned him to join them. Marco glanced around the room. He noticed two young women taking off their coats in the foyer.
Pointing to them, he asked Ray, “Interns or residents?”
Ray went to greet them, and Marco slipped out onto the deck.
“Different strokes,” Herb chuckled.
Gwen laughed, but Kevin was no longer paying attention. After four glasses of wine, his mood was swinging down the register to sad reflection.
“Herb,” Kevin said. “Remember last summer when you told me about working with doomed young people. I don’t get how it doesn’t depress you. Unless it actually does and you’re incredibly good at hiding it.”
“Doomed young people?” Herb echoed blankly.
Once he grasped Kevin wasn’t referring to the pot-smoking interns on the deck but was back to GRID again, he said, “It makes me feel…privileged. Don’t you, both of you, feel that way?”
Kevin and Gwen hesitated.
“You should. The bad things you see happen to these patients aren’t your fault. You have every right to feel good about helping them. There aren’t many jobs in the world that are this ethically unambiguous. That’s reason enough to be grateful. Hell, this would be God’s work, if any of us believed in God.”
Kevin and Gwen stared at Herb, their mouths open.
“Sorry for the sermon,” said Herb, briskly shaking his head to clear away the fog inside. “I guess it was an anti-sermon.”
Before Kevin or Gwen could respond, Herb shepherded them back to the kitchen for refills. He began praising Oregon wines again. But Kevin, intrigued by what Herb had just said, pursued it.
“Herb, why do you assume we don’t believe in God?”
“Ha! That’s my little secret. I have a sixth sense for it. I’m right aren’t I?”
“Yeah,” Kevin answered then looked at Gwen.
“How did you know?” she asked.
“It’s not magic. I’ve done my own local survey.”
“You survey people about whether they believe in God?” said Kevin, flabbergasted.
“I ask my patients, colleagues too. I’m more curious about that than how they experience physical attraction or jealousy or other transparent emotions. Anyway, I lack the courage to question people I don’t know intimately about things you two are probably very comfortable talking about with strangers. I kind of missed out on the ‘60s.”
“Why do you do it?”
“Because I’m fascinated by faith and the lack of it. And most people don’t seem to feel that asking about their religious beliefs is intrusive.”
�
�So what have you discovered?”
“Among doctors in the Bay Area, the ones I know, the vast majority don’t believe in God. So maybe I was guessing about you and Gwen. The odds were in my favor.”
“Herb,” Gwen objected,. “from what I’ve seen, you lead with knowing, not guessing.”
“Aha! That’s why it’s a fascinating question. The state of another’s faith isn’t knowable. There’s no blood test, no radiographic image to confirm its presence or absence. There’s just subjective report.”
“I beg to differ,” said Kevin, his speech now slurred. “Saints are the gold standard for having faith, aren’t they? The Catholic Church has objective criteria for sainthood. To be a saint, you can’t just say you believe. There has to be evidence, like a miracle others have witnessed.”
‘Fair enough,” Herb agreed, “But only a tiny fraction of people who profess faith in God are saints. Sainthood is a very, very rare condition. You can’t generalize from that.”
“Good one, Herb,” Kevin laughed. “Did you go to a Jesuit college?”
“Wait a second, Herb.” Gwen interrupted. “You didn’t answer Kevin’s question. How did you know neither of us believes in God?”
“I didn’t know. I guessed. There’s no tell, like in poker. But what’s odd is I’m virtually always right. I certainly have a better batting average for that than for making the right diagnosis in the ICU.”
“That would be batting a thousand,” Kevin protested.
“OK, I’ll show you. I’ll putting my nickel down that you both believed in God as children and were done with faith by the time you graduated from high school.”
Kevin and Gwen’s mouths dropped open again.
“Herb,” said Gwen. “That’s an eerie talent.”
Herb had a self-satisfied smile.
“Did you believe in God as kid?” asked Kevin.
“Nope. I come from a long line of atheists. Superstitious ones, but atheists at the core.”
“I’m missing something,” said Gwen.
“Let me refill your glass,” offered Herb.
“No. I’ve had enough to drink. I meant this conversation is getting too deep for me. I stopped thinking about big ideas when I quit the Socialist Worker’s Party in the early seventies. I’m just a simple Valley Girl from Pasadena.”
“Oh, right,” snorted Kevin.
“You were in the sectarian left?” Herb asked, amused.
“For a few years,” Gwen replied airily. “I was horizontally recruited.”
Kevin snorted again.
“By my future husband,” she said with indignation.
Gwen looked suspiciously at Herb.
“Were you…?”
“No, no,” Herb cut her off. “Attempts were made, but they failed.”
Kevin snorted again.
“Vertical attempts, Kevin. Dogma has never appealed to me.”
“You’re over my head now,” confessed Kevin as he held out his glass for more wine.
Herb started talking about northern California Zinfandels.
When the three returned to the living room, Rick and Marco were entering through the French doors, followed by Ray.
“You’ve got to hear this,” Ray said to them.
He knelt in front of a shelf of record albums. His eyes, usually at raptor-like attention, were unfocused. On finding the album he wanted, Ray delicately removed a vinyl disc. He showed it to Marco and Rick who both nodded in beatific approval. Kevin snuck behind Marco, peered over his shoulder, and scurried back to Gwen and Herb.
“Ravi Shankar,” he tittered.
Ray ceremoniously set the record on a turntable and gently set the needle down. Rick and Marco appeared to be meditating on the spinning disc.
Gwen covered her mouth to muffle her laughter.
The three men stood in a small circle, swaying to the sitar’s melody and the tabla’s rhythm.
Kevin began guffawing through his clenched teeth.
“I’m leaving,” he said. “Ray deserves more respect than this.”
“Me too,” said Gwen.
But they couldn’t move, paralyzed by the sight of their lovers in a stoned séance with their boss.
“Time for coffee,” said Herb.
He steered them toward the kitchen.
XVI
HERB FINISHED ICU SIGN-OUT rounds early on Monday, picked up Martin at school, ran soccer practice at Dolores Park, then circled back to the hospital. When he arrived at his office, there was an urgent message posted on the door from a name he didn’t recognize, an Elliot Reed from the local blood bank. It was almost six o’clock. He dialed the number anyway.
A gravelly voice answered, “Elliot Reed.”
“This is Herb Wu from City Hospital returning your call.”
“Thanks for getting back to me so quickly. I need to locate the doctor of a patient named Anna Polchevek. Would that be you?”
Herb’s heart sank. Sister Anna was a nun in her mid-sixties, a heavy smoker with chronic bronchitis whom Herb had been seeing in lung clinic for the last ten years. She had a ruddy complexion, wore an Isadora Duncan scarf over her habit, and made airy gestures while speaking. She mixed quaint phrases such as “Dear me” or “My goodness” with four letter words for various bodily functions. At her appointments, Sister Anna always inquired about his family.
“Yes,” Herb replied, his mouth dry as he recalled an episode of pneumonia she had a year ago. She was severely anemic at the time, and he had ordered a blood transfusion for her.
“Someone from the CDC is tracking GRID cases. He asked me to check if any of the names and birth dates on their list of cases match any of our blood donors.”
Reed paused.
What’s he waiting for, Herb fumed. Am I supposed to connect the dots so he won’t have to say anything else?
“There was one match,” Reed said evenly. “Two units of packed red cells from that donor were given to your patient Polchevek last January, apparently before the donor got sick.”
Herb expected to hear more. Then he understood Reed was only remaining on the line to verify Herb had received the information.
“So what am I supposed to tell her?”
“You’ll have to talk to the CDC and find out what they recommend.”
“Shit!” hissed Herb.
“Sorry, I don’t know anything about GRID. Obviously, this can’t be good, but I can’t advise you on what to tell her. Try the CDC.”
“Thanks,” Herb said icily and hung up the phone.
He paced inside his office until he was calm enough to call the convent. When Sister Anna came to the phone, he apologized for bothering her and asked if she would come to clinic tomorrow. His excuse was to explain the results of her recent x-rays. She agreed and had no questions.
XVII
KEVIN SPENT ALL MONDAY in clinic. At dusk, he went across the street to see inpatients where he ran into Gwen. She had been on call since Sunday morning.
“Last progress note,” she said, closing a chart. “I’m out of here.”
“Get any sleep?”
“I did! A whole, uninterrupted hour.”
She didn’t seem in a rush, so he brought up her post-residency plans, urging her again to apply for a general internal medicine attending position at City Hospital. Gwen said she had submitted the application and had also scheduled interviews at several public health clinics around the Bay Area.
“Stay here,” he pleaded. “The residents take care of the scut, and you’ll get to teach them. You might get woken by a phone call in the middle of night once a month, if that. It’ll be more fun than working in a public health clinic and way less time away from your family than this is.”
“Any job will be easier than this, Kevin. You know I’d love to be hired here. But they’re not making any promises. I need other options.”
He put a hand to his forehead and gnashed his teeth in an operatic imitation of despair. Gwen’s laughter stopped when her pager sounded.
“Damn!” she cried on seeing the number. “The ICU. Five more minutes, and I would have been signed out.”
“I’ll be there in a bit,” he said as she hurried off. “If it’s about Miller, I can take care of it.”
“You’re sweet,” she called back to him.
Miller’s sedation had been temporarily lightened that afternoon to look for signs of recovery. He became agitated and yanked out his intravenous line. A nurse attempted to re-insert a new one but had no success. Per hospital policy, a medicine resident had to take the next try. If that failed, a surgeon could be called in to dissect down to a vein.
Gwen found Miller motionless except for the periodic rise and fall of his chest each time the ventilator pumped air into his lungs. She scrubbed his forearm with iodine and alcohol, tied a rubber tourniquet above his elbow, opened an intravenous catheter kit, and donned a pair of sterile gloves. Using the tip of her gloved finger, Gwen stroked Miller’s skin, hunting for an engorged vein. Finding a promising bulge, she drove in a needle encased inside a white Teflon tube. Blood appeared. Satisfied she was in the right place, Gwen slid the white catheter off the needle into his vein. She was reaching backward to drop the needle in a sharps container when she felt wetness on her ankle. Turning her head, she saw blood dripping from the catheter onto her leg. Reaching back to pick up a piece of tubing, Gwen impaled the fleshy part of her left palm on the needle she was still gripping with her right hand.
Gwen stared at the needle for a numb moment before pulling it out. Eva crossed her mind. She’s only twelve years old, Gwen thought. Then all thinking was submerged by a flood of nausea and disbelief.
As Kevin entered the ICU, he saw Gwen leave Miller’s room. Her eyes were oddly glazed. She was wandering, not walking purposefully. This was beyond any post-call torpor. She passed him with no sign of recognition. Kevin followed her out the rear door into a resident sleeping room. She collapsed on a bed.
“What’s wrong?”
“Unbelievably stupid!” she sobbed. “I stuck myself.”
“When?…Miller?”
She nodded yes and began shaking. Kevin sat next to her.
“Let me see.”
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