Alex Glauberman Mysteries Vol 1-3

by Dick Cluster

  “But you’re not sure?”

  “Somebody sent me that letter, whether it was Foster himself or maybe somebody he might have told about me. Possibly I scared him off, them off, or possibly it was all somebody’s idea of a practical joke. But I find myself still waiting for the other shoe to drop. I want you to find Foster for me. Maybe he really needs help and I can help him. Or maybe he’s gone paranoid schizo, and I’m his idee fixe, and someday in a year or two, he’ll walk in here with a sawed-off shotgun and open up. Besides, I’ve got a responsibility to protect the work I’m involved in and to protect my patients. So I want to know about Foster, what the story is. You sound like you could find out in a delicate way. Are you interested?”

  “I’m interested. And curious. You say he hasn’t got anything to blackmail you with. I’d need to know what you were into, besides hitchhiking, around May of 1971. You didn’t seem to have any trouble coming up with that date.”

  “I know where I was coming from, I was coming from the Mayday antiwar demonstrations in D.C. Ten thousand people got busted in two days, if I remember the numbers right. It was just after the Vietnam Veterans Against the War camped on the Mall and threw their medals back up the Capitol steps. I got out of jail after a night and got my act together and started hitching up this way.”

  “And ended up going to California. With Foster and his girlfriend, the letter says. So, it’s safe to say you weren’t just hitting the books and getting ready to be a doctor in those days?”

  “Nope. I’m a little less boring than that. But it’s a long way from what I was into then, to anything that qualifies as a ten-thousand-dollar secret. On my resume, it’s just three years missing between college and medical school. There ought to be a couple of misdemeanors in my police record or my FBI file, and a couple subversive collectives I belonged to. Since I got the letter I’ve been over all this ground myself, and I’ve come up with zero every time. We’re talking the medical, scientific, grant-getting world here. There’s lots of internal politics to it, and it’s very old-boy, but nobody gives much of a damn about your opinions or private life. Nobody cares what the hell your political activities might have been twenty years ago. All they care about is that I went to the right schools and impressed the right people, for better or for worse.”

  Harrison ran his hands through his hair and then tried to pat it back into place. Alex had to admit that he looked truly confused. “Not even in George Bush’s Washington?” Alex pressed. “Not even in the AMA?”

  “We’re talking medicine,” Harrison answered. “We’re not talking arts funding or what’s allowed or not allowed in the schools. The medical world is conservative on doctors’ salaries, on taxes, on national health service, and they like to keep the pharmaceutical companies happy too. But beyond that, most of them don’t even know what laypeople fight about, then or now. The worst thing I did— from a right-winger’s viewpoint, I mean— is that I helped active-duty GIs get to Canada. Out in California I worked on a kind of underground railway thing. Number one, the line today is that we’ve put those divisions behind us, right? Number two, I can’t believe Foster would be holding that over me, because he was AWOL himself. That’s what got me into aiding antiwar soldiers, meeting him.… So look, before we get any further into this, do you want this job?”

  “I want the job,” Alex said.

  “Good.” Harrison stood up and reached out to shake hands again. “Please call me Jay,” he said. “Titles don’t gratify my ego, you’ll find.”

  “Alex,” Alex said. “So how I am going to start looking for him? If that travel agency’s a dead end, I mean.”

  “I’ve got other things you could go on. I know a little about his background. In prying data out of record keepers you’ll have use of the sanctified Dennison Center name. But I need to be up on the unit in fifteen minutes, so we’ll get into that later. If you want a tour, though, you can come up with me. We’d just have time for a look at the cryopreservation facilities on the way. If you want to, I mean. I just thought that, considering…”

  “Sure,” Alex said. He wanted to understand about marrow transplants. He wanted to see what it would be like to go through this, to see what the journal articles left out. And besides, showing off the process he was pioneering did gratify Jay Harrison’s ego, if Alex understood him right.

  4. Balancing Act

  Somewhere in his subconscious Alex had formed an image of what a quart of bone marrow would be. He’d pictured a narrow-neck opaque white plastic jar, heavy with unseen contents. If you shook it, you’d hear a slushy primeval ooze rocking around. You wouldn’t shake it, though, you’d just place it in a deep-freeze cabinet as solid as a vault.

  What Alex held in his hands in a back room of the Dennison Center’s blood bank wasn’t anything like that. He held a pouch of thin, transparent plastic, maybe four inches by seven. This one was empty, but it wouldn’t be more than half an inch thick even when filled. The pouch had no neck, no mouth, no screw cap, only a pair of built-in flexible plastic tubes. To Alex it looked and felt like the seventy-nine-cent pencil cases his daughter Maria bought to slip into her three-ring loose-leaf binder each fall. Alex didn’t like the idea of his or anyone else’s bone marrow being stored in such a container. Even if it might be strong, space-age plastic, it still left the marrow so— well, indecently exposed.

  Nor was the blood bank anything like the kind of bank with armed guards and vaults. The rooms through which he’d come had been a confusing clutter of machines, computer terminals, beakers and test tubes, file cabinets, and rows of silvery refrigerated cabinets that seemed to belong in the hospital’s kitchen more than anyplace else. All this hodgepodge had been tended by a bevy of white women in white coats.

  “What color would the stuff be?” Alex asked as he turned the plastic pouch over and looked at it some more. Purified, he assumed, marrow would be a kind of ghostly white. He hoped his voice sounded steadier than it felt.

  “Oh, reddish. It looks like pale blood. Most of what we’re freezing is blood serum, just a little of it is really the marrow itself. From the marrow, we separate out just the nucleated— that is, pretty much just the cells I was talking about, the ones that can multiply and differentiate into blood components. We separate and concentrate those, using a cell washer, one of those dozen machines we went by on the way in. Then what we’ve got is, oh, say a half cup of the primo, high-grade stuff, but that half cup contains billions of cells. We wipe out any cancerous ones with monoclonal antibodies— I can explain that later if you want— and then we stir the good stuff into a mixture that’s derived from the patient’s blood plus a preservative chemical we use. That’s what we put in the pouch. Then we freeze it down to nearly two hundred below. When we’ve finished treating the patient, we thaw the mixture in lukewarm water and then reinfuse it through a vein. The DMSO— that’s the preservative— has a kind of garlicky odor. Patients say they can smell the garlic from inside.”

  “Uh-huh,” Alex said. He was remembering a science teacher’s demonstration of how cold liquefied gases were. The teacher had poured liquid air, mostly nitrogen, into a Styrofoam bowl and dropped a rubber ball in. He’d fished the ball out with a pair of tongs and dropped it on the floor. The superfrozen ball had shattered like glass. Alex concentrated on that problem, if only to avoid the notion of smelling garlic from inside.

  “What happens if somebody drops the bag of marrow, say?” he asked.

  “Well, we do our best to protect it,” Jay said with a short laugh. “When the sample comes out of the programmable freezing unit here, the pouch goes inside one of these aluminum cases, and that case fits into a rack in the storage freezer over there.”

  The case looked like a metallic VCR cartridge, only thinner. The freezing unit looked like a cross between a photocopier and a microwave oven. The storage unit was just a wide top-loading barrel, joined by a thick flexible metal hose to a tall gleaming tank.

  The barrel reminded Alex of an immense thermos, and
the tank brought back faint images of the equipment at a dairy farm he’d visited as a kid. He felt flushed and weak-kneed, like a child that needed to get out of an overwhelming place into the fresh air. The feeling didn’t improve as he watched the doctor slide his hands into a pair of heavy gloves and raise the hinged top of the barrel. A swirl of what looked like smoke emerged, the kind that usually precedes the genie out of the bottle. Jay reached into the smoke with a long pair of tongs, lifting up a rack with slots for those metallic VCR cases. Most of the slots were empty, but not all. Now Alex felt a wave of cold whiteness go through him, felt his blood drain right out of his face.

  “That was the specimen rack,” Jay said once he’d closed the top of the storage unit. “That mist is water vapor condensing from the cold. The bottom third of the thing is full of liquid N-two, liquid nitrogen, and that’s where the specimens sit. An automatic sensor monitors the N-two level, and an automatic draw device keeps adding more from that Dewar, that shiny supply tank on the other end of the hose. The only time the specimens are out of the cases is when it’s time to thaw them. During the thawing the pouch sits in an outer plastic bag, and we keep changing that outer bag about once a minute just to be sure it’s intact. I don’t know of anybody spilling a specimen, ever, but we always extract enough marrow so we can keep an extra sample frozen, just in case.… You’re looking kind of pale— why don’t we get the hell out of here, okay? I guess I sound pretty matter-of-fact about all this.”

  “Well,” Alex said weakly. “Usually I’m pretty good about seeing the body as a mechanism, but…” He didn’t elaborate, just followed Harrison out a back door into the corridor of the basement level, where the blood bank had been installed. He felt ridiculous, like the patient he’d always prided himself on not being. That quivering mass of fear and doubt.

  “Did you ever do any acid?” Jay Harrison asked suddenly.

  He asked about LSD the same way he’d asked about hitchhiking earlier. A little wistful, and a little defiant of convention.

  “Well, yeah.” Alex took some deep breaths and let his muscles get themselves together. He told himself what his t’ai chi teacher said: whatever you’re doing, remember to breathe. He stood up straighter and felt the cold sweat evaporating off his skin.

  “Then maybe you’ve had the experience where the parts of everything solid dissolve into atoms, and you’re conscious that it’s all a balancing act, that everything is suspended in so much empty space? That same thing happens when people see their blood, or the insides of bodies— when they really see all the components that make them up. We like to think of ourselves as solid, unitary, no matter how much we intellectually understand that we’re not. Come on, let’s get you some caffeine or fat or sugar or whatever your poison is. Then we’ll get up to the unit. There’s only whole people up there.”

  Jay put a fatherly hand on Alex’s shoulder, the way Alex might with Maria after telling her something she wasn’t allowed to do even though she was almost twelve. Go to boy-girl get-togethers without a parent present, for instance, or ride the subway without a friend. Wait’ll she wants to smoke dope and hitch across the country and drop acid if there is any, he told himself sternly, if only to distract himself from the out-of-body bone marrow again.

  There had been a time when Alex had told himself not to count on living through Maria’s teenage years, but now those years were beginning and Alex found himself feeling very much alive. Not that he didn’t get danger signals— there was the tinge of double vision that had been bothering him for the past few weeks. It was just that looking forward, he tended to see at least as many dangers for Maria as for himself. She was going to be coming of age in an era that Alex, perhaps like all parents, saw as more dangerous than his own. Wrenching as the sixties had been, that era had been fueled by hope as well as fear and anger, because it had seemed there might be a new world to gain.

  He let Jay steer him toward the cafeteria. Jay was saying, “Only whole bodies, I promise, though some of them may be hooked up to a lot of tubes.”

  “Rounds on the unit,” seemed to mean something different than the “attending rounds” Deborah had spoken of before. Alex had expected Jay to make some kind of presentation, but in fact he was going from patient to patient, looking at charts and talking with medical staff. He’d let Alex follow him into the “anteroom,” as this long lobby or buffer zone was called, introduced him to one of the nurses, and told her to show him around.

  Inside the anteroom everybody else was in scrubs, hospital green pajama things like surgeons on TV shows wore. Alex didn’t have to wash or change clothes, the nurse Yvonne Price told him, but he had to be careful not to touch anything, and of course he couldn’t be allowed into any of the patients’ rooms. The guts of the transplant unit consisted of ten patient rooms arranged off two buffer zones, the one he was in and another identical one off the main corridor farther down. Not that Alex was comfortable calling the patients’ quarters “rooms.” To him a room was a place you could shut yourself up in when you chose, and leave when you chose, too. Here you had neither of those privileges. Alex tried to understand what it would be like to live here. He was standing in front of a temporarily empty room that belonged to Yvonne’s patient.

  The wall closest to Alex was clear plastic. It looked like a heavy shower curtain, except it had arm-length gloves built in so that objects could be manipulated from outside if the need arose, and at one end was a three-foot gap where the “wall” was nothing but a current of air. For a month, the patient didn’t walk out through that doorway, because out here, even in the buffer zone, lay a world of bugs and bacteria in which the patient couldn’t yet survive.

  Were there such things as jails without cruelty? Alex wondered— institutions that rehabilitated you to the point where you really could make it with your newfound strengths and skills? If so, that’s the way he’d have to describe this place. A place where you were always watched, and which you couldn’t leave. It gave him the creeps. Yet his heart went out right away to the invisible occupant of this room. “She’s down getting TBI,” Yvonne had said. Alex managed to translate that to total body irradiation. The patient was a woman, just now getting the treatment that would kill off her cancer, everyone hoped, and would kill off her remaining bone marrow too.

  “Remember not to touch the wall,” the nurse said again. Alex stopped a good foot away from the plastic curtain but leaned forward to peer through. He noted the room’s right-hand wall, which was all air vents, and the phone and TV and VCR that provided contact with the world outside. He noted the pillar adorned with tubes and probes and gadgets, sort of like a glorified dentist’s rig, and also, taking up about a quarter of the space, one of those pretend-you’re-climbing kind of exercise machines. “The air in the room is as sterile as we can get it,” Yvonne explained, “and it changes over at a rate of sixty times a minute. Filtered air comes in through all those vents, and the old air flows out into the anteroom here. Nobody goes in without a surgical scrub first thing in the morning, and another wash each time. You don’t notice the air flow except in the doorway, where there’s kind of a breeze. The blower makes a lot of noise, but it’s constant and after a while the mind tunes that out. Like a lot of worse things,” she said, smiling, “that your mind has to tune out, too.”

  “I guess so,” Alex replied, guessing at all the things a person with her job might mean by that. Yvonne Price looked as if she smiled easily and often. She had that kind of face that seemed to be mostly cheeks, cheeks that worked hard at pulling genuine smiles out of her eyes and mouth. Alex had never been able to imagine what it would be like to have that kind of face, though he’d learned after some years of suspicion to be grateful for many of the people who did. Yvonne’s face was a pale brown that suggested she breathed a lot of filtered air but not much fresh. She was probably about twenty-five, but she lacked the healthy outdoor glow a young African-American in a soda or cigarette ad would have. Of course, it was still only the end of April. Maybe she�
�d get out more once Boston’s always tentative spring got more of a grip.

  “Somebody else can show you the kitchen and stuff if you want, but you’ll have to get out of my way now, because my patient is coming back up,” she said by way of dismissal. This time she didn’t smile, possibly because she was saving that reassuring energy for her patient. “Just tell them at the desk that I was showing you around for Dr. Harrison, and ask them whatever else you want to know.”

  Alex left the anteroom and turned right. He stood for a minute near the central desk looking for Jay Harrison, but he didn’t see him. They had a new appointment for “around three,” back down in Jay’s office. Alex noticed a man with a stethoscope dangling from his pocket, who was giving him a curious glance. The man wore green scrubs under a long yellow thing, partly open in back, that Yvonne had referred to as a “gown.” For patients especially at risk, she’d said, the medical staff had to go into the room gloved and capped and gowned.

  “Excuse me,” the man said. “I’m Dr. Kramer, the senior resident. You look a little lost.” Kramer also had on a round paper cap, a flimsy thing that covered his hair and ears. The whole getup reminded Alex of the habits nuns used to wear. He remembered how they’d seemed like mannequins, not real people, when he passed them in the street.

  “Oh,” Alex said. “No, I’m not lost. Yvonne was showing me around, for Dr. Harrison. But her patient is coming up from radiology now.”