Side Effects

by Michael Palmer

  Originally, they had tried to eschew traditional roles in setting up and maintaining their household, but both rapidly realized that their traditional upbringings made that arrangement impractical if not impossible. The shopping and food preparation had reverted to her, the maintenance of their physical plant to Jared. Day-to-day finances, they agreed, were beyond either of their abilities and therefore to be shared. Again she checked out the window. Then after a final hesitation, a final thought about calling home and leaving a message on their machine that she was going to work late, she pushed herself away from the desk. As she stood up, she decided, if it was going to be dinner, then dammit, it was going to be a special dinner. In medical school and residency, she had always been able to find an extra gear, a reserve jet of energy, when she needed it. Perhaps tonight her marriage could use a romantic, gourmet dinner more than it could her moaning about the exhausting day she had endured. Spinach salad, shrimp curry, candles, Grgich Hills Chardonnay, maybe even a chocolate souffle. She ticked off a mental shopping list as she slipped a few scientific reprints into her briefcase, bundled herself against the rush-hour snow, and hurried from her office, pleased to sense the beginnings of a surge. It was good to know she still had one. + In the quiet of his windowless office, Carl Horner spoke through his fingertips to the information storage and retrieval system in the next room. He had implicit faith in his machines, in their perfection.

  If there was a problem, as it now seemed there was, the source, he felt certain, was human-either himself or someone at the company. Again and again his fingers asked. Again and again the answers were the same.

  Finally, he turned from his console to one of two black phones on his desk. A series of seven numbers opened a connection in Buffalo, New York, four numbers more activated the line to a "dead box" in Atlanta, and a final three completed an untraceable connection to Darlington, Kentucky. Cyrus Redding answered on the first ring. "Carl?"

  "Orange red, Cyrus." Had the colors been reversed, Redding would have been warned either that someone was monitoring Horner's call or that the possibility of a tap existed. "I can talk, " Redding said. "Cyrus, a woman named Kate Bennett, a pathologist at Metro, just called asking for information on two women who died from the same unusual bleeding disorder."

  "Patients of ours?"

  "That is affirmative, although Dr. Bennett is only aware that one of them is. Both women had autopsies that showed, in addition to the blood problems, a rare condition of their ovaries."

  "Have you asked the Monkeys about them?"

  "Affirmative. The Monkeys say there is no connection here."

  "Does that make sense to you, Carl?"

  "Negative."

  "Keep looking into matters. I want a sheet about this Doctor Bennett "I'll learn what I can and teletype it tomorrow."

  "Tonight."

  "Tonight, then."

  "Be well, old friend."

  "And you, Cyrus. You'll hear from me later."

  Wednesday 12 December

  Coronary strikes out Bobby. Kate cringed at the Boston Herald headline on her office desk. The story was one of the rare events that managed to make the front page in both that paper and the Boston Globe. Though the Globe's treatment was more detailed, the lead and side articles said essentially the same thing in the two papers.

  Bobby Geary, beloved son of Albert and Maureen Geary, son of the city itself, had been taken without warning by a clot as thin as the stitching on a baseball. The stories, many of them by sportswriters, were the heart-rending stuff of which Pulitzers are made, the only problem being that they weren't true. The storm, which had begun the evening before, had dumped a quick eight inches of snow on the city before skulking off over the North Atlantic. However, neither the columns of journalistic half-truths. nor the painful drive into the city could dampen the warmth left by the C talking and the sharing that had followed the candlelight meal Kate had i prepared for her husband.

  For the first time in years, Jared had talked about his disastrous first marriage and the daughter he would, in all likelihood, never see again.

  "Gone to find something better" was all the note from his wife had said.

  The trail of the woman and her daughter had grown cold in New York and finally vanished in a morass of evanescent religious cults throughout southern and central California. "Gone, to find something better."

  Jared had cried as he spoke of the Vermont years, of his need then to break clear of his father's expectations and build a life for himself.

  Kate had dried his tears with her lips and listened to the confusion and pain of a marriage that was far more an act of rebellion than one of love. Kate was finishing the last of the Globe stories when, with a soft knock, a ponderous woman entered carrying a paper bag. The woman's overcoat was unbuttoned, exposing a nurse's uniform, pin, and name tag.

  Kate read the name as the woman spoke it. "Dr. Bennett, I'm Sandra Tucker. Ginger Rittenhouse was my roommate."

  "Of course. Please sit down. Coffee?"

  "No, thank you. I'm doing private-duty work, and I'm expected at my patient's house in Weston in half an hour. Dr. Engleson said that if I remembered anything or found anything that might help you understand Ginger's death I could bring it to you."

  "Yes, that's true. I'm sorry about Ginger."

  "Did you know her?"

  "No. No, I didn't."

  "We had shared the house only for a few months."

  "I know."

  "A week after she moved in, Ginger baked a cake and cooked up a lasagna for my birthday."

  "That was very nice, " Kate said, wishing she had thought twice about engaging the woman in small talk. There was a sad aura about her-a loneliness that made Kate suspect she would talk on indefinitely if given the chance, patient or no patient. "We went to the movies together twice, and to the Pops, but we were only just getting to be friends and …"

  "It's good of you to come all the way down here in the snow, " Kate said in as gentle an interruption as she could manage. "Oh, well, it's the least I could do. Ginger was a very nice person. Very quiet and very nice. She was thinking about trying for the marathon next spring."

  "What do you have in the bag? Is that something of hers? " A frontal assault seemed the only way. "Bag? Oh, yes. I'm sorry. Dr. Engleson, what a nice man he is, asked me to go through her things looking for medicines or letters or doctors' appointments or anything that might give you a clue about why she… why she…"

  "I know it was a hard thing for you to do, Miss Tucker, and I'm grateful for any help."

  "It's Mrs. Tucker. I'm divorced."

  Kate nodded. "The bag?"

  "My God, I apologize again." She passed her parcel across the desk.

  "Sometimes I talk too much, I'm afraid."

  "Sometimes I do, too." Kate's voice trailed away as she stared at the contents of the bag. "I found them in the top of Ginger's bureau. It's the strangest way to package pills I've ever seen. On that one sheet are nearly two months worth of them, packaged individually and labeled by day and date when to take each one. Looks sort of like it was put together by a computer."

  "It was, " Kate said, her thoughts swirling. "Pardon?"

  "I said it was put together by a computer." Her eyes came up slowly and turned toward the window. Across the street, its glass and steel facade jewellike, was the pride of Metropolitan Hospital of Boston. "The pharmacy-dispensing computer of the Omnicenter. The Omnicenter where Ginger Rittenhouse never went."

  "I don't understand."

  Kate rose. "Mrs. Tucker, you've been a tremendous help. I'll call if we need any further information or if we learn something that might help explain your friend's death. If you'll excuse me, there are some phone calls I must make."

  The woman took Kate's hand. "Think nothing of it, " she said. "Oh, I felt uncomfortable at first, rifling through her drawers, but then I said to myself, If you're not going to do it, then…"

  "Mrs. Tucker, thank you very much." One hand still locked in Sandra Tu
cker's, Kate used her other to take the woman by the elbow and guide her out the door. The tablets were a medium-strength estrogen-progesterone combination, a generic birth control pill. Kate wondered if Ginger Rittenhouse had been too shy to mention to her roommate that she took them. Computer printed along the top margin of the sheet were Ginger's name, the date six weeks before when the prescription had been filled, and instructions to take one tablet daily.

  Also printed was advice on what to do if one dose was missed, as well as if two doses were missed. Common side effects were listed, with an asterisk beside those that should be reported immediately to Ginger's Omnicenter physician. Perforations, vertical and horizontal, enabled the patient to tear off as many pills as might be needed for time away. The setup, like everything at the Omnicenter, was slick-thoughtfully designed, and practical-further showing why there was a long list of women from every economic level waiting to become patients of the facility. Kate ran through half a dozen possible explanations of why she had been told Ginger Rittenhouse was not a patient at the Omnicenter, then she accepted that there was only one way to find out. She answered,

  "Doctor Bennett, " when the Omnicenter operator asked who was calling, emphasizing ever so slightly her title. Immediately, she was patched through to Dr. William Zimmermann, the director. "Kate, this is a coincidence. I was just about to call you. How are you? " It was typical of the man, a dynamo sometimes called Rocket Bill, to forgo the redundancy of saying hello. "I'm fine, Bill, thanks. What do you mean coincidence'?"

  "Well, I've got a note here from our statistician, Carl Horner, along with a file on someone named Rittenhouse. Carl says he originally sent word to you that we had no such patient."

  "That's right."

  "Well, we do. Apparently there was a coding mistake or spelling mistake or something."

  "Did he tell you why I wanted to know?"

  "Only that this woman had died."

  "That's right. Does your Carl Horner make mistakes often? " The idea of an error didn't jibe with Marco Sebastian's description of the man.

  "Once every century or so as far as I can tell. I've been here four years now, and this is the first time I've encountered any screw up by his machines. Do you want me to send this chart over to you?"

  "Can I pick it up in person, Bill? There are some other things I want to talk with you about."

  "One o'clock okay with you?"

  "Fine. And Bill, could you order a printout of the record of a Beverly Vitale."

  "The woman who bled out on the inpatient service?"

  "Yes."

  "I've already reviewed it. A copy's right here on my desk."

  "Excellent. One last thing."

  "Yes?"

  "I'd like to meet Carl Horner. Is that possible?"

  "Old Carl's a bit cantankerous, but I suspect it would be okay."

  "One o'clock, then?"

  "One o'clock." + Ellen Sandler clutched her housecoat about her and sat on the edge of her bed staring blankly at a disheveled blackbird foraging for a bit of food on the frozen snow beyond her window. She was expected at the office in less than an hour. The house was woefully low on staples. Betsy's math teacher had set up a noontime conference to investigate her falling interest and grade in the subject. Eve needed help shopping for a dress for her piano recital. Darcy had come home an hour after weekday curfew, her clothes tinged with a musty odor that Ellen suspected was marijuana. So much to do. So much had changed, yet so little. The silence in the house was stifling. Gradually, she focused on a few ongoing sounds, the hum of the refrigerator, the drone of the blower on the heating and air conditioning system Sandy had installed to celebrate their last anniversary, the sigh that was her own breathing.

  "Get up, " she told herself. "Goddamn it, get up and do what you have to do." Still, she did not move. The hurt, the oppressive, constricting ache in her chest seemed to make movement impossible. It wasn't the loneliness that pained so, although certainly that was torture. It wasn't the empty bed or the silent telephone or the lifeless eyes that stared at her from the mirror. It wasn't even the other woman, whoever she was. It was the lies-the dozens upon dozens of lies from the one person in the world she needed to trust. It was the realization that while the anguish and hurt of the broken marriage might, in time, subside, the inability to trust would likely remain part of her forever.

  "Get up, dammit. Get up, get dressed, and get going."

  With what seemed a major effort, she broke through the inertia of her spirit and the aching stiffness in her limbs, and stood up. The room, the house, the job, the girls-so much had changed, yet so little. She walked to the closet, wondering if perhaps something silkier and more feminine than what she usually wore to the office would buoy her. The burgundy dress she had bought for London caught her eye. Two men had made advances toward her the first day she wore it, and there had been any number of compliments on it since. As she crossed the room, Ellen felt the morning discomforts in her joints diminish-all, that is, except a throbbing in her left thigh that seemed to worsen with each step. She slipped off her housecoat, hung it up, and pulled her flannel nightgown off over her head. Covering much of the front of her thigh was the largest bruise she had ever seen.

  Gingerly, she explored it with her fingers. It was somewhat tender, but not unbearably so. She did not know how she had gotten it. She had sustained no injury that she could remember. It must, she decided, have been the way she slept on it. She selected a blue, thin wool jumpsuit in place of the dress, which, it seemed, might not cover the bruise in every situation. She dressed, still unable to take her eyes off the grotesque discoloration. Her legs had always been one of her best features. Even after three children, she took pride that there were only a few threadlike veins visible behind her knees. Now this. For a moment, she thought about calling Kate for advice on whether or not to have a doctor check things out, but she decided that a bruise was a bruise.

  Besides, she had simply too much else to do. A bit of makeup and some work on her hair, and Ellen felt as ready as she ever would to tackle the day. The face in her mirror, thin and fine featured, would probably turn some heads, but the eyes were still lifeless. She was leaving the room when she noticed the note tacked to the doorjamb. Each day it happened like this, and each day it was like seeing the note for the first time, despite the fact that she had tacked it there more than a year before. "Take Vit, " was all it said. Ellen went to the medicine cabinet, took the sheet of multivitamins plus iron from the shelf, punched one out, and swallowed it without water. Half consciously, she noticed that there was only a four-week supply remaining, and she made a mental note to set up an appointment with her physician at the Omnicenter. Although she was limping slightly as she left the house, Ellen found the tightness in her thigh bearable. In fact, compared to the other agonies in her life at the moment, the sensation was almost pleasant. The sign, a discreet bronze plate by the electronically controlled glass doors, said, "Metropolitan Hospital of Boston, Ashburton Women's Health Omnicenter, 1975." Kate had been one of the first patients to enroll and had never regretted her decision.

  Gynecological care, hardly a pleasant experience, had become at least tolerable for her, as it had for the several thousand other women who were accepted before a waiting list was introduced. The inscription above the receptionist's desk said it all. "Complete Patient Care with Complete Caring Patience."

  Kate stopped at the small coatroom to one side of the brightly lit foyer, and checked her parka with a blue-smocked volunteer. She could have used the tunnel from the main hospital, but she had been drawn outdoors by the prospect of a few minutes of fresh air and a fluffy western omelet sandwich, spetcialite' de la maison at Maury's Diner. The receptionist signaled Kate's arrival by telephone and then directed her to Dr. Zimmermann's office on the third floor. The directions were not necessary. Zimmermann had been Kate's Omnicenter physician for four years, since the accidental drowning death of Dr. Harold French, his predecessor and the first head of the Omnicenter. Alt
hough she saw Zimmermann infrequently-three times a year was mandatory for women on birth control pills-Kate had developed a comfortable patient-physician relationship with him, as well as an embryonic friendship. He was waiting by his office door as she stepped from the elevator.

  Even after four years, the sight of the man triggered the same impresi sions as had their first meeting. He was dashing. Corny as the word was, Kate could think of no better one to describe him. In his late thirties or early forties Zimmermann had a classic, chiseled handsomeness, along with an urbanity and ease of motion that Kate had originally felt might be a liability to a physician in his medical specialty. Time and the man had proven her concerns groundless. He was polite and totally professional. In a hospital rife with rumors, few had ever been circulated regarding him. Those that had gone around dealt with the usual speculations about an attractive man of his age who was not married. Active on hospital and civic committees, giving of his time to his patients and of his knowledge to his students, William Zimmermann's was a star justifiably on the rise. "Dr. Kate." Zimmermann took both her hands in his and pumped them warmly. "Come in, come in. I have fresh coffee and… Have you had lunch? I could send out for something."

  "I stopped at Maury's on the way over. I'm sorry for being so thoughtless. I should have brought you something."

  "Nonsense. I only asked about lunch for your benefit. I have been skipping the meal altogether-part of a weight loss bet with my secretary."

  Even if the bet were concocted on the spot, and considering the man's trim frame that was quite possible, his words were the perfect breeze to dispel Kate's embarrassment. Zimmermann's office was the den of a scholar. Texts and bound journals filled three walls of floor-to-ceiling bookcases, and opened or marked volumes covered much of a reading table at one end of the room. On the wall behind his desk, framed photographs of European castles were interspersed with elegantly matted sayings, quotations, and homilies. "The downfall of any magician is belief in his own magic."