“Yes, well—” he was interrupted by the phone. He answered it, barked orders into the receiver, and hung up.
“That was Beverly Lucas, the social worker. She’ll be here shortly to fill you in.”
“I know Bev. She was a student here when I was an intern.”
He held out his hand palm down and moved it side to side. “Soso, eh?”
“I always thought she was pretty sharp.”
“If you say so.” He looked doubtful. “She wasn’t much use with this family.”
“That may be true of me as well, Raoul.”
“You’re different, Alex. You think like a scientist but can relate to patients like a humanist. It’s a rare combination. That’s why I chose you, my friend.”
He’d never chosen me but I didn’t argue. Maybe he’d forgotten the way it really started.
Several years back, he was awarded a government grant to study the medical value of isolating children with cancer in germ-free environments. The “environments” came from NASA—plastic modules used to prevent returned astronauts from infecting the rest of us with cosmic pathogens. The modules were filtered continuously and flooded with air blown out rapidly and smoothly in laminar flow. Such smooth flow was important because it prevented pockets of turbulence where germs collected and bred.
The value of an effective way to protect cancer patients from microbes was obvious if you understood a little about chemotherapy. Many of the drugs used to kill tumors also knock out the body’s immune system. It was as common for patients to die of infection brought about by treatment as to perish from the disease itself.
Raoul’s reputation as a researcher was impeccable and the government sent him four modules and lots of money to play with. He constructed a randomized study, dividing the children into experimental and control groups, the latter treated in regular hospital rooms using conventional isolation procedures such as masks and gowns. He hired microbiologists to monitor the germ count. He gained access to a computer at Cal Tech to analyze the data. He was ready to go.
Then someone raised the issue of psychological damage.
Raoul pooh-poohed the risk, but others weren’t convinced. After all, they reasoned, the plans were to subject children as young as two to what could only be termed sensory deprivation—months in a plastic room, no skin to skin contact with other human beings, segregation from normal life activities. A protective environment, to be sure, but one that could be harmful. It needed to be looked into.
At the time I was a junior level psychologist and was offered the job because none of the other therapists wanted anything to do with cancer. And none of them wanted to work with Raoul Melendez-Lynch.
I saw it as an opportunity to do some fascinating research and prevent emotional catastrophe. The first time I met Raoul and tried to tell him about my ideas, he gave me a cursory glance, returned his attention to the New England Journal, and nodded absently.
When I finished my pitch he looked up and said, “I suppose you’ll be needing an office.”
It wasn’t an auspicious beginning, but gradually his eyes were opened to the value of psychological consultation. I badgered him into building the unit so that each module had access to a window and a clock. I nagged him until he obtained funds for a full-time play therapist and a social worker for the families. I cadged a healthy chunk of computer time for psychological data. In the end it paid off. Other hospitals were having to release patients from isolation because of psychological problems but our children adjusted well. I collected mountains of data and published several articles and a monograph with Raoul as co-author. The psychological findings received more scientific attention than the medical articles, and by the end of three years he was an enthusiastic supporter of psychosocial care and somewhat humanized.
We grew friendly, though on a relatively superficial level. Sometimes he talked about his childhood. His family, originally Argentinian, had escaped from Havana in a fishing boat after Castro nationalized their plantation and most of their wealth. He was proud of a family tradition of physician-businessmen. All of his uncles and most of his cousins, he explained, were doctors, many of them professors of medicine. (All were fine gentlemen except Cousin Ernesto, who was a scum-sucking Communist pig. Ernesto had been a doctor, too, but he’d abandoned his family and his profession for the life of a radical murderer. No matter that thousands of fools worshipped him as Ché Guevara. To Raoul he’d always be despicable Cousin Ernesto, the black sheep of the family.)
As successful as he was in medicine, his personal life was a disaster. Women were fascinated by him but ultimately repelled by his obsessive character. Four of them endured marriage with him and he sired eleven children, most of whom he never saw.
A complex and difficult man.
Now he sat in a plastic chair in a drab little office and tried to be macho about the buzz saw ripping through his skull.
“I’d like to meet the boy,” I said.
“Of course. I can introduce you now, if you’d like.”
Beverly Lucas came in just as he was about to get up.
“Good morning, gentlemen,” she said. “Alex—how nice to see you.”
“Hi, Bev.”
I rose and we embraced briefly.
She looked good, though considerably thinner than I remembered. Years ago, she’d been a cheerful, rather innocent trainee, full of enthusiasm. The kind voted Miss Bubbly in high school. She had to be thirty by now, and some of the pixie cuteness had turned to womanly determination. She was petite and fair, with rosy cheeks and straw-colored hair worn in a long soft perm. Her round open face was dominated by hazel saucer eyes and untouched by makeup. She wore no jewelry and her clothes were simple—knee-length navy skirt, short-sleeved blue-and-red plaid blouse, penny loafers. She carried an oversized purse, which she swung up on the desk.
“You look svelte,” I said.
“Running. I’m doing long distance, now.” She flexed a muscle and laughed.
“Very impressive.”
“It helps center me.” She sat on the edge of the desk. “What brings you around here after all this time?”
“Raoul wants me to help out with the Swopes.”
Her expression changed without warning, the features hardening and gaining a few years. With forced amiability she said, “Good luck.”
Raoul stood up and started to lecture.
“Alex Delaware is an expert in the psychosocial care of children with malignant—”
“Raoul,” I interrupted, “why don’t you let Beverly fill me in on the case. There’s no need for you to spend any more time at this point.”
He looked at his watch.
“Yes. Of course.” To Beverly: “You’ll give him a comprehensive rundown?”
“Of course, Dr. Melendez-Lynch,” she said sweetly.
“You want me to introduce you to Woody?”
“Don’t bother. Bev will handle it.”
His eyes darted from me to her and then back to his watch.
“All right. I’m off. Call if you need me.”
He removed the stethoscope from around his neck and swung it at his side as he left.
“I’m sorry,” I said to her when we were alone.
“Forget it, it’s not your fault. He’s such an asshole.”
“You’re the second person he’s riled this morning.”
“There’ll be plenty of others before the day’s up. Who was the first?”
“Nona Swope.”
“Oh. Her. She’s angry at the world.”
“It must be rough for her,” I said.
“I’m sure,” she agreed, “but I think she was an angry young lady long before her brother got cancer. I tried to develop a rapport with her—with all of them—but they shut me out. Of course,” she added, bitterly, “you may do much better.”
“Bev, I’ve got no stake in being a miracle worker. Raoul called me in a panic, gave me no background, and I tried to do a friend a favor, okay?”
; “You should pick your friends with greater care.”
I said nothing, just let her listen to the echoes of her own words.
It worked.
“Okay, Alex, I’m sorry for being such a bitch. It’s just that he’s impossible to work for, gives no credit when you do a good job, and throws these incredible tantrums when things go wrong. I’ve put in for a transfer, but until they find a sucker to replace me, I’m stuck.”
“No one can do this type of work for very long,” I said.
“Don’t I know it! Life’s too short. That’s why I got into running—I come home all burnt out and after a couple of hours of pushing my body to the limit I’m renewed.”
“You look great.”
“Do I? I was starting to worry about getting too thin. Lately I’ve been losing my appetite—oh, hell, I must sound like a real egomaniac, griping like this when I’m surrounded by people in real crises.”
“Griping is a God-given right.”
“I’ll try to look at it that way.” She smiled and pulled out a notebook. “I suppose you want a psychosocial rundown on the Swopes.”
“It would help.”
“The name of the game is weird —these are strange people, Alex. The mother never talks, the father talks all the time, and the sister can’t stand either of them.”
“Why do you say that?”
“The way she looks at them. And the fact that she’s never around when they are. It’s like she feels out of place. She doesn’t pay much attention to Woody when she’s here, keeps strange hours—shows up late at night, or really early in the morning. The night staff says she mostly sits and stares at him—usually he’s asleep, anyway. Once in a while she’ll go in the unit and read him a book, but that’s about it. The father doesn’t do much in the way of stimulation, either. He likes to flirt with the nurses, acts like he knows it all.”
“Raoul told me the same thing.”
“Raoul’s not totally incapable of insight.” She laughed maliciously. “Seriously, Mr. Swope is a different kind of guy. Big fellow, gray-haired with a beer gut and a little goatee. Kind of like Buffalo Bill without the long hair. He’s really cut off from his feelings—I know it’s denial and I know it’s not unheard of, but he goes beyond what we normally see. His son’s diagnosed with cancer and he’s laughing and joking with the nurses, trying to be one of the gang, talking about his orchard and his precious plants, throwing around horticultural jargon. You know what can happen to guys like that.”
“Sudden breakdown.”
“Exactly. All at once it hits them and pow! Pathological grief reaction.”
“Doesn’t sound like the boy has much support.”
“The mother. She’s got to be the most unliberated thing I’ve ever seen—Garland Swope is the king of his castle—but she does seem to be a good mother—nurturant, gives lots of hugs and kisses, goes into the unit a lot, and without any hesitation. You know how scary the spacesuit can be for lots of parents. She jumped right in. The nurses see her go off into the corner and cry when she thinks no one’s looking, but when Garland comes around she puts on a great big smile, lots of ‘Yes, Dears’ and ‘No, Dears.’ It’s really sad.”
“Why do you think they want to pull the kid out?” I asked.
“I know Raoul believes it was those people from the Touch—he’s so paranoid about anything holistic—but how can he be so sure? Could be he’s to blame for the whole thing. Maybe he screwed up communication with them—he’s very aggressive when he describes the treatment protocols and lots of people are put off.”
“He seemed to think the Fellow was at fault.”
“Augie Valcroix? Augie marches to his own drummer but he’s a good guy. One of the few docs who actually takes time to sit down with the families and act like a human being. He and Raoul hate each other’s guts, which makes sense if you know them. Augie thinks Raoul’s a fascist and Raoul sees him as a subversive influence. It’s been great fun working in this department, Alex.”
“What about those cultists?”
She shrugged.
“What can I say? Another group of lost souls. I don’t know much about them—there are so many fringe groups it would take a specialist to understand all of them. Two of them showed up a couple of days ago. The guy looked like a teacher—glasses, scuzzy beard, wimpy manner, brown oxfords. The lady was older, in her forties or fifties, the kind who was probably a hot number when she was younger but lost it. Both of them had that glazed look in their eyes—the I-know-the-secret-of-the-universe-but-I-won’t-tell-you trance. Moonies, Krishnas, esties, Touchers, they’re all the same.”
“You don’t think they turned the Swopes around?”
“They may have been the straw that broke it,” she conceded, “but I don’t see how they could be entirely responsible. Raoul’s looking for a scapegoat, for easy answers. That’s his style. Most of the docs are like that. Instant fix-its for complex issues.”
She looked away and folded her arms across her chest.
“I’m really tired of all of it,” she said softly.
I steered her back to the Swopes.
“Raoul wondered if the parents’ being older had anything to do with it. You pick up any hints the boy was an unwanted accident?”
“I didn’t get close enough to even touch on stuff like that. I was lucky to get enough for a bare-bones intake. The father smiled and called me “dear” and made sure I never got enough time alone with his wife to develop a relationship. This family’s armored. Maybe they’ve got lots of secrets they don’t want coming out.”
Maybe. Or maybe they’re terrified at being in a strange environment so far from home with a gravely ill child and don’t want to strip themselves bare in front of strangers. Maybe they don’t like social workers. Maybe they’re simply private people. Lots of maybes...
“What about Woody?”
“A cutie pie. He’s been sick since he got here, so it’s hard to judge what kind of kid he really is. Seems like a little sweetie—isn’t it always the sweet ones who suffer?” She took out a tissue and blew her nose. “Can’t stand the air in here. Woody’s a nice little boy who’s agreeable and kind of passive. A people pleaser. He cries during procedures—the spinal tap really hurt him—but he holds still and gives no serious problems.” She stopped for a moment and fought tears.
“It’s a goddamn crime, their pulling him out of treatment. I don’t like Melendez-Lynch, but goddamn it, he’s right this time! They’re going to kill that little boy because somehow we screwed up, and it’s driving me nuts.”
She pounded a small fist on the desk, snapped herself to a standing position, and paced the cramped office. Her lower lip quivered.
I stood up and put my arms around her and she buried her head in the warmth of my jacket.
“I feel like such a fool!”
“You’re not.” I held her tightly. “None if it is your fault.”
She pulled away and dabbed at her eyes. When she seemed composed I said, “I’d like to meet Woody.”
She nodded and led me to the Laminar Airflow Unit.
There were four modules, placed in series, like rooms in a railroad flat, and shielded from one another by a wall of curtain that could be opened or drawn by pushing buttons inside each room. The walls of the units were transparent plastic and each room resembled an oversized ice cube, eight feet square.
Three of the cubes were occupied. The fourth was filled with supplies—toys, cots, bags of clothing. The interior side of the curtained wall in each room was a perforated gray panel—the filter through which air blew audibly. The doors of the modules were segmented, the bottom half metal and closed, the top plastic, and left ajar. Microbes were kept out of the opening by the high speed at which the air was expelled. Running parallel to all four units were corridors on both sides, the rear passage for visitors, the front for the medical staff.
Two feet in front of the doorway to each module was a no-entry area marked off by red tape on the vinyl floor. I
stood just outside the tape at the entrance of Module Two and looked at Woody Swope.
He lay on the bed, under the covers, facing away from us. There were plastic gloves attached to the front wall of the module, which permitted manual entry into the germ-free environment. Beverly put her hands inside them and patted him on the head gently.
“Good morning, sweetie.”
Slowly and with seeming effort, he rolled over and stared at us.
“Hi.”
A week before Robin left for Japan, she and I went to an exhibition of photographs by Roman Vishniac. The pictures had been a chronicle of the Jewish ghettos of Eastern Europe just before the Holocaust. Many of the portraits were of children, and the photographer’s lens had caught their small faces unaware, flash-freezing the confusion and terror it found there. The images were haunting, and afterward we cried.
Blood Test Page 5