Noah expected to be chastised for his tardiness by an angry and imperious mother. Instead, Mrs. Anschutz seemed surprisingly at ease.
“Come in, doctor.” She even smiled at him.
“Willard is well?” Perhaps the boy had been so exhausted by his symptoms that he remained quiescent.
“He’s still sleeping. Quite peacefully,” Mrs. Anschutz replied. “When I looked in on him a few minutes ago, he did not even notice when I felt his forehead.”
“I am pleased to hear that, Mrs. Anschutz. Perhaps his crisis is past.” Could it be? So soon? Had his diagnosis been incorrect after all? “I should look in on him for a moment in any event.”
“Of course, doctor. Whatever you say.”
As they mounted the stairs, Mrs. Anschutz cast Noah an abashed glance. She paused on the second step. “You know, Dr. Whitestone, I must confess that I came to you with some trepidation. Dr. Frias has cared for this family since Aldridge was born. He often says that experience makes the best doctors. But I can now see that some of our younger physicians are more than competent.”
Despite himself, Noah was flattered. “Thank you for saying so, Mrs. Anschutz. I was gratified to be able to bring Willard some relief. I am very fond of him. He reminds me of . . . myself, when I was a boy.”
“Well, you should visit then. Willard is a great joy. Such spirit.”
“Thank you. I will.”
They made their way up the stairs. This time, Noah modulated his pace to allow Mrs. Anschutz to keep up with him. When they reached the landing, Noah didn’t wait, but moved to the door of Willard’s bedroom.
He turned the switch to the electric light. Willard was under the covers, lying on his back, mouth agape. His skin was sallow and pasty and his breathing labored and shallow.
Noah ran to the bed. He had only moments, perhaps seconds. Noah grabbed him by both arms and shook him, first gently, then with ferocity. The child didn’t rouse. Noah threw back the covers, pulled up the boy’s nightshirt, and dug the knuckle of his middle finger into his solar plexus. There was no effect.
Noah lifted Willard’s eyelid. Acute miosis—constriction of the pupil.
“Get me cold water!” he yelled to the boy’s mother, who stood stunned in the doorway. Willard’s breathing had almost ceased. If Noah could not induce its return, the boy’s brain would begin to asphyxiate—if it had not done so already.
Mrs. Anschutz stuck her head into the hall and screamed for Molly to bring water. Noah continued to shake Willard, tried to stand him up, slap him on the cheeks, anything to induce motor function. Finally, Molly appeared with a pitcher of cold water and a cloth. Eschewing the cloth, Noah began to douse the boy’s face. No response. He poured some on the child’s privates. Nothing.
Don’t die, he thought. Don’t die. A vision flashed before him. Another occasion on which he had been helpless. A woman. In childbirth. Hemorrhaging. In shock. Don’t die. Beautiful. Fading. The baby, Oliver, already dead. Don’t die. Don’t die.
Isobel. His wife. Don’t die.
But she had.
And so did Willard Anschutz.
THREE
DAY 2. THURSDAY, 9/21—3 A.M.
It wasn’t possible. Noah had never been more certain of anything. He could not have been responsible for the boy’s death. Willard Anschutz could not have perished from two drops of laudanum. Not after three hours. Not at all. Two drops of laudanum would not have killed a one-year-old let alone a five-year-old. There were any number of cases, certainly, of children dying from laudanum poisoning, but the doses had been exponentially greater.
Noah stared up at the ceiling over his bed. Over and over, he considered every moment he had spent with the child, reviewed each symptom. Had he blundered, misinterpreted some sign, failed to note an item of significance, made a hasty assumption? He could think of nothing. He had taken every precaution, followed proper procedure to the letter.
Why then could he not escape the face of the dead child dancing against the plaster? There were moments that the shimmering image was so real, it seemed the boy was about to speak. As the night had lengthened but stubbornly refused to yield to morning, Willard’s features had begun to meld into Isobel’s.
Two sets of dark eyes, one holding the innocence of youth, the other the innocence of trust. Whose were which? He had fixed Isobel’s face in his memory, immutable and eternal, yet suddenly he could not seem to remember her. Was this to be his punishment for the dead child?
Noah rose from the bed, his joints stiff, his eyelids aching. For a moment, he was light-headed, forced to grasp the bedpost until the feeling passed. When he regained his equilibrium, he walked to the door and turned the switch. The lightbulbs in the ceiling fixture glowed dimly, suffusing the bedroom in artificial twilight. The clock on the side table showed 4 o’clock. Noah padded to the chest of drawers at the wall opposite his bed and removed the framed photograph that sat alone on a lace doily. The photograph that would be guiltily consigned to a drawer, secreted under a sheaf of papers or a stack of appointment books after he was married to Maribeth.
He held the pewter frame delicately in his hands, as if too tight a grip might cause the memories that it held to slip away. Yes, of course. There she was. Isobel. He had not forgotten at all. Beautiful, ethereal, in her high lace collar, her rich chestnut hair piled full and luxurious, framing the face that he would love forever. The face that would no longer age.
One day, he would hold this photograph and be an old man looking at a young woman. Wondering how she would have looked had she lived. Was Mildred Anschutz at that moment staring at a photograph of her son, wondering the same? Would she spend her remaining days seeing a boy perpetually five years old? Had he created that grisly bond between them when he allowed Willard to die?
But he had not allowed Willard to die.
Had he?
Mrs. Anschutz knew that her son was lost even as Noah did. She had gone ashen, and for a moment, he thought she would faint. But Pug Anschutz’s wife does not swoon. Instead, she rushed to the bed, leaned down, and held one hand to either side of her son’s face. Then she began to rock slowly. A low moan escaped her, eerie, as if it emanated from all corners of the room at once.
Noah had stepped away, but he wanted to examine the boy, even then, to try to determine what had caused his death. He ached to request permission for an autopsy but knew that was out of the question. When Mrs. Anschutz finally looked up, he had instead said how sorry he was. He offered to summon a clergyman, notify the authorities, or see to the arrangements of having Willard’s body removed to a mortician’s. Anything that Mrs. Anschutz thought might be of help.
But she had just shaken her head, slowly, mechanically, as if physical movement had become disengaged from her core. She would see to everything, she said in a monotone. She had then softly asked Noah to leave.
He walked past Willard’s siblings and Molly, the maid, without a word. She was distraught, sobbing into a crumpled handkerchief. Noah considered for a moment whether to try to comfort the wretched young woman, but unwelcome as he now was, he simply had left her in the hall.
Noah replaced the picture frame on his dresser and picked up the envelope that was laying next it. He removed the blue pill and held it between his thumb and forefinger. Could this possibly have any bearing on the boy’s death? It seemed impossible. He wasn’t even certain why he’d asked for it. Some perverse curiosity about Frias, most likely. But Mildred Anschutz hadn’t been deceiving him when she claimed that her son had not taken the medication for two weeks. Of that Noah was convinced. Some people could lie and some could not. After a lifetime of feeling license to say what she pleased to whom she pleased, Mildred Anschutz would never have had need to cultivate such as subtle skill as mendacity.
Yet, something had killed Willard Anschutz. He replaced the tablet in the envelope and left it on the dresser. He padded back across the room and once more lay in bed. He would rest. Sleep was a lost cause.
FOUR
> DAY 2. THURSDAY, 9/21—7:30 A.M.
Father, a patient died in my care last night. A child. His mother believes I am responsible for his death.”
Abel Whitestone ran his forefinger around the diaphragm of his stethoscope, then placed the end in his vest pocket. He was a large man with small, delicate hands. Lines had given way to pouches along his jaw and under his eyes. He reached up and patted Noah softly on the cheek. “Come into the office.”
It was just after seven. Even at fifty-five, Abel arrived early every morning to tidy up, complete leftover paperwork, read medical journals, and prepare the office for the daily onslaught. Noah had tried to persuade his father to sleep an extra hour, but Abel would have none of it. Noah had encountered him in one of the examining rooms, setting bandages, sheets, and instruments in their proper places.
Father and son made their way to the rear. The practice had been here on Adams Street for two decades. Abel had leased office space on the first floor until nine years ago, when Noah announced his intention to enter medical school at New York University in Manhattan. Abel then scraped together the money to purchase the two-story building. Abel, Elspeth, and Noah’s sister, Agnes, had moved into the top floor and bottom floor rear, leaving the offices on the street level front. By the time Noah finished school, Agnes had married and moved to Milwaukee. Abel then expanded the offices to the entire first floor. When he extended an invitation to join the practice, Noah had accepted instantly.
Where Noah’s private office was bright and modern, Abel’s was wood-paneled and dark. It was filled with photographs, letters of appreciation, and plaques from religious and civic organizations, expressing gratitude for some service that Dr. Whitestone had performed in the community. Nothing was more revealing of a doctor’s character than his reputation among his patients. Any greed, incompetence, lack of commitment, or professional vanity will soon surface in one who treats his fellows when they are afraid and vulnerable. Abel Whitestone was adored; invited to innumerable weddings and christenings, he had been made godfather to more neighborhood children than Noah could count.
Noah sat in a leather chair opposite the desk, a location from which countless patients over the years had heard that they were pregnant, or tubercular, or in fine health, or dying. Here they had confided, asked favors, or requested an extension on their arrears. This chair had held millionaires, community leaders, the indigent, and thieves. Many had sat and merely sought advice. As now Noah did.
Abel walked in a moment later, letting his hand linger on his son’s shoulder as he passed. He settled heavily into the wing chair behind the desk and polished his spectacles with a small handkerchief he removed from a vest pocket. With his glasses off, Abel’s eyes appeared sleepy, slightly lacking in focus. Old.
“All right, son. Tell me about your patient.”
Noah recited the case history in full, from the first summons by Mildred Anschutz to Willard’s death. He restricted himself to a recitation of the symptoms and did not propose a diagnosis. As he spoke, his father sat leaned against one arm of the chair, tugging at his lower lip, looking off to the side. When Noah had finished, Abel sat back in his chair. He never spoke in haste, appearing to give due consideration to even the most obvious question.
“A tragedy,” Abel said with a deep sigh. “There is nothing worse than the death of a child.” He paused to once again polish his spectacles. “What will you enter on the death certificate?”
“Respiratory failure.”
“Seems vague.” Abel leaned even farther back, but eyed Noah in a way that had made him uncomfortable since he was eight.
“Should I enter something specific, even if I’m not totally certain?”
“You’re not totally certain?”
“How could I be?”
Abel nodded slowly, as if reviewing the diagnosis, but instead he said, “The boy’s mother blames you for his death . . .”
“She was distraught. It’s natural.”
“Perhaps. But do you share her assessment?”
“No. I don’t think so.” Noah rubbed his forefinger across his thumb. “I’m not sure.”
“Not sure if he died from the laudanum or not sure if you are responsible?”
“I can’t see how he could have died from the laudanum.”
“Then you don’t. It was something out of your control. What more do you believe you could have done?”
“Saved him.”
“Ah, yes. And how could you have done that?”
“I’m not sure of that either.”
“Most men, Noah, if they’re worth anything, are responsible for something in their lives. We doctors happen to be responsible for something precious. We are responsible for people’s lives. And their health. But the nature of the responsibility doesn’t mean we cease being human. We all have our failures. It’s painful. And inevitable. Only God is omnipotent. But you know all this. You’ve lost patients before.”
“This seems different.”
“Why? Because the Anschutz boy was five?”
Noah didn’t reply. From anyone else, he would have been furious.
“Willard Anschutz was not your son, Noah.”
His son. For five years, the most bleak of phrases.
Abel heaved out a breath. “Noah, you were not to blame for Isobel’s death. Or the baby’s. Isobel hemorrhaged. Thousands of women each year die in childbirth. Dear Isobel was one of them. And you were only assisting. Not even the primary physician. A tragedy. A horrible tragedy. But tragedy does not mean culpability.”
“I was too slow.” The words came out in a whisper.
“You could have been Mercury himself and still not have stopped the bleeding.”
“I was too slow,” Noah repeated. “Isobel’s parents were correct.”
“How? How could they have been correct? They aren’t doctors. They weren’t even in the room. Nor, I might add, was Mildred Anschutz.”
“It doesn’t matter. They believe my negligence contributed to the death of their daughter. That I shouldn’t have even been in the room. And they were correct.”
Abel shook his head. They had been over this hundreds of times. There were no words left.
“How is Clement Van Meter?” he asked instead.
“He continues to hang on. The man has astounding will. If only he had come to us sooner.”
“He’s been stubborn for thirty years. Whenever I knew he was in port, I tried to get him to let me take a look at him. Went to his house any number of times. He laughed at me. Thought planning for old age was a joke. ‘Aw, doc,’ he’d say, ‘I’m gonna die at sea. Eaten by sharks, most likely. Or washed overboard in a storm. Ain’t no cure for that.’ Then he’d throw his arm around my shoulders . . . strong as a plow horse . . . and lead me out the door. ‘Now you go and tend to all the shore folk who’re gonna die in their beds.’ The last thing he figured was that he would be one of them, rotting away, dying by inches.”
“I never knew him like that.”
“A person just couldn’t help liking Clement.” Abel paused. “So, Noah? Should I feel guilt? For not convincing Clement to take better care of himself.”
“Of course not. Clement Van Meter was a grown man. There was nothing more you could have done.”
“I don’t see the difference.”
“Maybe there isn’t any. I don’t know,” Noah exclaimed. “Don’t you feel guilt anyway, father? See their faces? The patients who have died in your care?”
Abel looked off over Noah’s shoulder. “Do you remember Rosemary Mangino?”
“From Henry Street? The funny old woman who talked to herself? Of course.”
“She had a daughter. Born almost a year to the day after you.”
“I didn’t even know she ever had a husband.”
“Oh yes. A drunk. Ran off after the little girl was born. In any event, the doctor who delivered Rosemary’s daughter botched the job. Forceps delivery. He was young and made a mistake. The little girl’s skull was compr
essed. Viola they called her. Grew up to be an idiot, poor thing. Could barely feed or dress herself. But a sweeter or more gentle child never graced God’s earth. Viola was always laughing and making other people laugh. Not in a bad way, mind you. It was simply that she was so happy, so easy to please, that people could not help but be happy around her.
“But she was always sickly, of course. Seemed not a month went by when either her breathing or her digestion or something else wasn’t out of whack. One day, her respiration went bad. Non-tubercular but clearly degenerative. Everyone knew she was going to die, even her mother. Everyone except me, that is. I decided I was going to save her. I tried everything. Medication, inhalers . . . I read that a tribe in the Amazon ate some mixture of ground-up plants to cure respiratory ailments, so I even tried that. She steadily worsened, of course. I became more determined. At the end, I was spending more time at Viola’s house than here. None of it mattered. The little girl died. Six years old.”
“I’m so sorry, father. Why did you never tell me this before?”
“Why would I?” Abel heaved a sigh. “I was disconsolate. I even considered giving up medicine. Thought I could never treat patients in the same way again.”
“But you did.”
“Yes. It took three months, but I did. As will you. And, yes, I still see Viola Mangino’s face. Every day.”
Abel placed his elbows on the arms of his chair, letting his fingertips fall together just under his chin. “So what will you do now?”
“I thought I might speak with Alan.”
“If that will make you feel better. You’re seeing him at dinner tonight, are you not?”
“I thought perhaps I would see him this morning. At the hospital.”
Abel sat straighter in his chair. “You suspect Arnold had some role in the boy’s death?”
Deadly Cure Page 3