“If you came here to ask me for the money so you could go to a different program, I couldn’t help you if I wanted to. I’m still paying off my student loans and had to hock my soul to buy into this practice.” Even as she spoke, Chris became upset with herself for going into such details with him about her finances.
“No, I didn’t think you’d be able to do that,” Wayne said. He paused, apparently searching for words.
Suddenly, Chris got an ugly premonition. Surely he wasn’t going to ask her . . .
“I know I have no right to expect you to help me,” Wayne said. “And I wouldn’t have come, except I don’t want to die with the sorry legacy I’ve built for myself. I need time to balance the scales, to find some way to make up for a lifetime of self-absorption that did nothing for anyone else. So forgive me for what I’m about to say, but I read somewhere that it’s possible for a living person to give a part of their liver to another, and within a few months the part the donor contributed grows back, so they’re as good as new, except for maybe a little scar.”
Oh my God, Chris thought. That is why he came. He wants a piece of my liver. This is just a visit to his parts warehouse. Her anger toward him surged to new levels for putting her in this position.
“Of course the blood type of the donor and the recipient have to be appropriate,” her father said. “I’m type O, and I remember that you are, too.”
“After your history with me, you have the nerve to ask for this?”
“Believe me, I didn’t want to come. But I couldn’t think of any other solution.”
“What about the woman you left us for? What’s her blood type?”
“That only lasted a few years. I don’t even know where she is.”
Chris was so filled with disgust she couldn’t stand to look at him another second. “I’ve got a very busy day scheduled, and I’m already running late. I can’t talk any more just now.” She pulled a sheet of paper from the box on her desk, wrote her address and phone number on it, and got up and handed it to him. “Come to my apartment tonight at seven o’clock. And don’t expect dinner.”
He rose, took the paper, and put it in an inside pocket of his jacket. “I’m sorry for doing this to you.” Then he left.
With him gone, Chris wondered why the hell she’d given him her address and agreed to meet with him again. There was no way she was giving him part of her liver. Undergo major surgery and let somebody hack out a piece of her so a louse of a man could . . .
Live.
Damn it. That’s what we’re talking about here. The man’s life is at stake. How could she just ignore that?
Feeling the needle on her stress gauge creeping into the red zone, she closed her eyes and began the meditation exercise she learned from a Chinese classmate when she was a medical student. Within a few seconds, her pulse and respiration slowed, and her blood pressure edged downward. In just a few minutes she was once again fit for duty.
On the way out she stopped at the secretary’s desk.
“Hope I’m not being out of line,” Paula said, “but your father doesn’t look well.”
“Just one of his many problems. I need to talk with Tom Doyle, the cardiovascular surgeon, ASAP. When you get him on the line, page me, would you please? I’ll be making rounds.”
Ten minutes later, in the ICU, Chris was writing an order for fluconazole to combat a cryptococcal lung infection in a woman who’d caught the bug from the droppings of her newly purchased parrot. Just as Chris scribbled her name on the order and closed the chart, her pager sent her again to a house phone, where she learned that Paula had Doyle on the line.
“I’m at six-eight-two-three,” Chris said. “Ask him to call me here.”
In seconds, he did.
“Tom, thanks for getting back to me so quickly. Would you have a few minutes today to talk about those two patients of yours with strep infections?”
“Are you free now?” Doyle asked.
“Yes. Where are you?”
“The CCU.”
“Let’s meet in my office in five minutes.”
If Chris had merely wanted to discuss her management of one of Doyle’s patients in her role as a private infectious disease consultant on a case, she would have just met him in the coronary care unit. But implicating him as a strep carrier was not something to do publicly.
Five minutes gave her time to check on one more patient, a retired fireman whose respiratory infection was so extensive his ventilator had blown a hole in one of his weakened lungs. She found his chart in the hands of Charles Hickman, an effusive young pulmonary physician who hadn’t lost enough patients yet to whittle away at his boundless optimism and good humor.
When he saw her, he grinned and showed her the plot of the fireman’s temperature since Chris had added amphotericin B to the antibiotics he was being given.
“You could ski down that slope,” Hickman said, referring to the plot’s precipitous drop to normal. He pointed at Chris. “You da man.”
With more important things on her mind, she let the opportunity pass to remind Hickman that she was actually the other sex sometimes found in the practice of medicine. Instead, she just said, “Keep that up, and I’m going to think you’re surprised. How’s he sound?”
“Better,” Hickman said. “See for yourself.”
She slipped on a gown and mask and donned gloves from the isolation cart outside the fireman’s room. Listening to his lungs with the isolation stethoscope, she noted a distinct improvement in the man’s chest sounds. Returning to the hall, she wrote a short note to that effect in his chart.
“Well, it’s been real,” she said to Hickman.
“Going so soon? What is it—my breath, my personality, my wife?”
“All of the above,” Chris said, wiggling her fingers over her shoulder at him.
On the way back to her office, a small voice began telling Chris that any woman who would refuse to help her dying father, regardless of what he had done to her, was cold and callous and possibly deserved being abandoned when she was a child. She had always been impressed by the enormity of death. The passing of life from any creature was not a casual event, no matter how many times it had occurred in the history of the earth, for the aggregate passing of billions in the past didn’t lessen the impact on the next one to die. And wouldn’t her refusal to help him be doing the same thing to him he had done to her?
Worse, the voice said. You lived.
And she was a doctor, for God’s sake . . . Her whole life was dedicated to helping the sick.
WITH ALL THE weight he carried, Tom Doyle looked as though he’d soon be needing a bypass himself. Whenever Chris saw him, she was reminded that every pound of fat needs two hundred miles of blood vessels to support it. It was no wonder he had the flushed complexion of a hypertensive.
“Hello, Tom. Let’s go in the conference room.”
“It’s my understanding that there have been three cases of strep infection. And only two of those are mine,” Doyle said, following her. “So who’s the common denominator?”
“Have a seat. Can I get you some coffee?”
“I’m fine,” Doyle said, sitting at one of the wooden chairs around the mahogany conference table.
Chris sat opposite him. “Tom, how have you been feeling lately?”
“Overworked and fat,” he replied, scratching his head. “You know who I think it is . . . Bill Gooch, the anesthesiologist. He’s always farting in the OR. And I once heard of a guy who had a rectal strep colonization contaminating his OR by farting them into the air.”
“My question about how you’ve been feeling wasn’t a social inquiry. Have you or anyone in your family had a sore throat lately?”
“Wait a minute,” Doyle said, catching on. “You think it’s me?”
“The strep case t
hat isn’t yours . . . you went in that OR while the surgery was taking place to speak to Dale Blake about a fishing trip. Do you remember that?”
“Who said so?”
Not wanting to create any trouble for Jamie Mallon, Chris said, “Then you didn’t go in there?”
“I might have.”
“Tom, you’re the common denominator. Have you had a fever lately, or any little skin eruptions?”
Doyle scratched his head. “No, nothing like that.”
It actually wasn’t necessary for a strep carrier to exhibit any symptoms, so Doyle could have harbored a colony in his nose or his rectum without any signs. On the other hand . . . “Would you wait here for just a sec? I’ll be right back.”
Chris made a quick trip to her office and returned with a pair of rubber gloves and a swab and saline kit. “Would you mind if I took a sample from your scalp?”
“Of course not. But it’s not me. You’re mistaken.”
Chris donned the gloves and swabbed a scaly patch on Doyle’s scalp. “I’ll send this right down to the lab. We should have the results by late tomorrow. In the meantime, you don’t have a case scheduled today or tomorrow, do you?”
“I have one early in the morning.”
It was within Chris’s authority to suspend Doyle’s OR privileges until the strep problem was solved. But without the lab results for confirmation of her hunch, she was reluctant to play that card.
“Under the circumstances, do you feel comfortable operating?’
“It’s not me,” Doyle said. His hand headed for his scalp, but he caught himself and put it back on the table. “You’ll see. It’s somebody else.”
“But what if it is you?”
There was a brief trapped-animal look in his eyes, then the fight went out of him, and he flipped his hand in the air. “All right. I’ll postpone my next case until we hear from the lab.”
When he left, Chris sat at the big table all by herself and wrestled once more with the problem of her father. Finally, needing to get moving, she roused herself and headed back to the hospital to drop off the swab and continue her rounds.
She returned to her office a little after four o’clock, having considered and reconsidered all the arguments in favor of giving her father what he wanted. But she just couldn’t do it. If that meant she was cold and heartless, that’s what she’d have to be.
A few minutes later, while perusing the weekly morbidity and mortality report from the CDC, where, before her infectious disease fellowship, she’d spent two years as an Epidemic Intelligence Service (EIS) officer, she was struck by a sudden thought. Maybe there was something she could do for her father.
She flipped through her Rolodex, found the number for Michael Boyer, and called it.
“This is Dr. Collins at Good Samaritan. Is Dr. Boyer available? No? Would you page him please and have him call me? It’s very important that I speak to him today.”
Boyer quickly returned her call, and they spoke for nearly ten minutes. Hearing her suggestion, he expressed strong interest in the idea and then made a proposal himself that took her by surprise. By the end of the conversation, she had set up an interview for her father which, if it went well, would not only give him a chance to live, but would make him famous.
Chapter 2
CHRIS PICKED UP the hardcover novel and looked at the author’s name: Wayne Collins. The only book her father had ever published. His picture on the back was the head shot she’d mentally referenced when he’d shown up in her office. She’d found the book by accident many years ago while browsing in a secondhand bookshop in Boston.
It was a rags-to-riches story, set during the Depression about a boy growing up in rural Kansas in a family so poor their suffering drove the father to commit suicide. Possessed of a gritty determination and unschooled intelligence, the oldest son became the family breadwinner, supporting them with money he made running a street-corner shell game in Kansas City. With what little he could put aside, he bought a calf and raised it on land the family didn’t own. From the sale of that animal, he’d earned enough to buy two more calves. Eventually, the boy became head of the biggest meat-packing operation in the state.
Chris had read the book a dozen times, looking for clues about why her father had abandoned her. So that the book, which looked practically new when she’d bought it, was now battered and worn from being thrown across the room in anger on many occasions.
The buzzer at the front entrance sounded. She carried the book to the intercom and asked who it was.
“Wayne Collins.”
The formal way he identified himself struck Chris as odd. But then what could he have said . . . It’s Daddy?
She pressed the button that released the security door in the lobby and hastened to her study, where she dropped the book behind a row of novels with medical themes. She returned to the living room and waited for her father to arrive.
After what seemed like an inordinately long time, she heard three light taps on the door. She opened it, and there he was, wearing the same clothes as before. There was an awkward moment as they sized each other up, Chris wondering how he was going to greet her and how she should respond. Finally she just stepped back and said, “Come in,” not calling him by name because it seemed odd to do so.
“Hello, Chris,” Wayne said, stepping in. “Hope my visit earlier, at your office, didn’t upset your routine.”
“Why should it?” she said, shutting the door. “I don’t see or hear from you for nearly three decades, and then you just show up one day and tell me you’re dying . . . Sure, that’s an event that wouldn’t affect anyone’s day.”
“I’ll just put that on the list of everything else I’m sorry for.”
There he goes again, Chris thought, the old self-deprecation ploy.
“I brought you something.” He raised his right hand and offered her a small flat package in a floral gift wrapping.
Chris took it without enthusiasm and appraised him with cool detachment.
“Open it.”
Chris removed the paper and discovered a spanking-new copy of Billy Runyan, Wayne’s only published novel.
“There’s a dedication inside,” he urged.
Chris turned to the title page and read in a neat hand:
To Chrissy,
Who, like Billy Runyan, became a success despite the actions of a spineless father. Whatever else you might think of me, please believe that I do love you.
Your wayward father,
Wayne Collins
Well, there was the thread she’d been looking for in the book and missed—the spineless father. Pretty obvious now. But did he really expect her to believe he loved her? And what was with the date after his signature? “Why is this inscription dated seven years ago?”
“I wrote it the day before you graduated and had it with me at the ceremony. I was going to give it to you then, but I lost my nerve.”
Chris was taken aback by this. So her father had expressed his love for her in this dedication long before he knew he needed a new liver. If he was telling the truth, which she greatly doubted. She looked at the dedication again, as though she could somehow detect the age of the ink. Then, feeling extremely suspicious of him, she closed the book and mumbled her thanks.
More as a gambit to delay their coming conversation than out of any wish to be a good host, she said, “Could I get you something to drink?” She was about to offer him a glass of wine but caught herself. “I can make coffee, or there’s Coke or tea . . .”
“I just ate, so I don’t need anything.”
After another awkward pause, Chris gestured self-consciously to a pair of overstuffed chairs by the fireplace. “Let’s sit over there.”
“Your apartment is nice,” Wayne said. “You have good taste.”
Chris im
mediately wondered what he meant by that. Was he suggesting that if she could afford this place, she could find the money to help him? “Everything was chosen carefully,” she said. “With an eye toward economy.”
Well, for the love of— She’d done it again. Defended herself to him. What was wrong with her?
When they were seated, Wayne said, “You have your mother’s red hair and green eyes, and you’re petite like she was.”
Chris fumbled through her mind for a response.
Not getting one, Wayne went on. “Have you ever worn your hair long, or has it always been short like that?”
“Mostly short.”
“It suits you.”
An ice age followed, during which neither of them knew what to say. The tension for Chris was unbearable, and her hands became so cold they hurt. She felt a frigid drop of perspiration fall from her right armpit and hit her side under her blouse. Then, suddenly, she became angry at being nervous. This was her home. He had no right to come in here and cause her this kind of discomfort. And there was no need to feel guilty about her decision. She should just tell him and get it over with.
“I can’t be a donor for you,” she blurted out. “I’ve thought about it, and I can’t.”
A tide of hopelessness moved across Wayne’s jaundiced eyes. “Well,” he said, “I don’t blame you. It was a lot to ask.”
Affected by his obvious disappointment, Chris quickly moved on to tell him the rest of what she’d planned to say. “But I made a phone call today, and you may have another option.”
Wayne moved to the front of his chair. “What would that be?”
“You’ll have to pass an interview. It’s not a sure thing that you’ll be accepted.”
“Into what? Some kind of clinical trial for a new drug?”
“A different kind of transplant.” She hesitated, looking for a way to phrase it that wouldn’t make the whole idea sound so desperate. But there was no other way to put it. “There’s a group at Monteagle Hospital, who are looking for the right candidate to receive a liver from a genetically altered strain of pigs they’ve developed.”
The Judas Virus Page 2