Marker

by Robin Cook

  Laurie mentioned that she was leaving early to visit her mom in the hospital. Calvin waved her away without a question. Laurie didn’t have to clear such a thing with him, but she had been trying of late to be a little more politically sensitive herself, at least on a personal level.

  Outside, the rain had finally stopped, making it easier to hail a taxi. The ride uptown went quickly, and in less than a half hour she was deposited at the front steps of the University Hospital. During the drive, she had tried to imagine what her father had meant by “an associated aspect” of her mother’s illness that he wished to discuss. She truly had no idea. It was such an oblique statement, but she assumed he meant some limitations of her mother’s activity.

  The hospital’s lobby was in its usual afternoon uproar with visiting hours in full swing. Laurie had to wait in line at the information booth to find out her mother’s room number, castigating herself for failing to get it earlier. Armed with the information, she took the proper elevators up to the proper floor and walked past the nurses’ station, where a number of people were busy at work. No one looked up at her. It was the VIP wing, which meant the corridor was carpeted and the walls were hung with original, donated oil paintings. Laurie found herself glancing into the rooms as she passed like a voyeur, reminding her of her first year of clinical residency.

  Her mother’s door was ajar like most of the others, and Laurie walked right in. Her mother was in a typical hospital bed with the guardrails up, an intravenous running slowly into her left arm. Instead of the usual hospital garb, she was wearing a pink silk robe. She was sitting up with a number of pillows behind her. Her medium-length, silver-gray hair, which normally billowed on top of her head, was pressed down like an old-fashioned bathing cap. Her color was gray without her makeup, and her skin seemed to be pulled tighter than usual over her facial bones, and her eyes had retracted as if she was slightly dehydrated. She appeared fragile and vulnerable, and although Laurie knew she was petite, she looked particularly tiny in the large bed. She also looked older than she did less than a week before, when Laurie had seen her for lunch. There had been no conversation about cancer or imminent hospitalization.

  “Come in, my dear,” Dorothy said, waving with her free hand. “Pull a chair over. Sheldon told me he had called you. I wasn’t going to bother you until I was home. This is all very silly. It’s just not worth getting all upset over.”

  Laurie glanced over at her father, who was reading The Wall Street Journal in a club chair by the window. He glanced up, gave a little wave and a wan smile, and then went back to his paper.

  Advancing to the side of the bed, Laurie took her mother’s free hand and gave it a squeeze. The bones felt delicate and the skin cool. “How are you, Mother?”

  “I’m just fine. Give me a kiss and then sit down.”

  Laurie touched her cheek to her mother’s. Then she pulled a chair over to the side of the bed. With the hospital bed raised, she had to look up at her mother. “I’m so sorry this has happened to you.”

  “It’s nothing. The doctor has already been in, and he said things are just fine, which is more than I can say about your hair.”

  Laurie had to suppress a smile. Her mother’s ploy was transparent. Whenever she didn’t want to talk about herself, she went on the offensive. Laurie used both hands to sweep her highlighted auburn hair back away from her face. It was shoulder-length, and although she usually wore it up with a clip or a comb, she’d taken it down to brush it out after her morning’s stint in the “moon suit” and hadn’t put it back up. Unfortunately, her hair had been a frequent target for her mother ever since Laurie’s teenage years.

  After the conversation about her hair and a short pause in which Laurie tried to ask a question about her mother’s surgery, Dorothy switched to another convenient target by saying that Laurie’s outfit was much too feminine for working in a morgue. With some difficulty, Laurie restrained herself in response to this new criticism. She made it a point to wear such clothing. It was part of her identity, and she saw no conflict with her place of employment. Laurie also knew that part of her mother’s response was derived from her distaste for Laurie’s career choice. Although both her parents had mellowed to a degree and had even grudgingly come to recognize the merits of forensics subsequent to Laurie’s work, they had been disappointed from the moment she had announced her decision to become a medical examiner. At one point, Dorothy had actually told Laurie that she had no idea what to say when her friends asked what kind of a doctor Laurie was.

  “And how is Jack?” Dorothy inquired.

  “He’s just fine,” Laurie said, not wishing to open that can of worms.

  Dorothy then went on to describe some upcoming social events that she hoped Laurie and Jack would attend.

  Laurie listened with half an ear while glancing over at her father, who’d finished with The Wall Street Journal. He had a large stack of newspapers and magazines. He stood up and stretched. Although he was in his eighties, he was still a commanding figure, well over six feet tall with an acquired aristocratic air. His silver hair knew its place. As usual, he had on a carefully pressed, conservatively cut, glen plaid suit with matching tie and pocket square. He walked over to the opposite side of the bed from Laurie and waited for Dorothy to pause.

  “Laurie, would you mind if we stepped out in the hall for a moment?”

  “Not at all,” Laurie said. She stood and gave her mother’s hand a squeeze through the bed’s guardrail. “I’ll be right back.”

  “Now don’t you go worrying her about me,” Dorothy scolded her husband.

  Sheldon didn’t respond but rather pointed with an open palm toward the door.

  Outside in the hall, Laurie had to step out of the way of a passing gurney carrying a postoperative patient back to her room. Her father came up behind her. Since he was almost a foot taller, she had to look up into his face. His skin was tan from a January trip to the Caribbean and surprisingly devoid of wrinkles, considering his age. Laurie didn’t harbor any ill feelings toward the man, since she had long ago overcome her anger and frustration about his emotional distance. Her eventual maturation had made her realize that it was his problem, not hers. At the same time, there was no sense of love. It was as if he were someone else’s father.

  “Thank you for coming over so quickly,” Sheldon said.

  “There’s no need to thank me. There’s no question I’d come over immediately.”

  “I was afraid you might be more upset with the news coming out of the blue. I want to assure you that it was your mother’s insistence that you not be informed of her condition.”

  “I gathered that from what you said on the phone,” Laurie said. She was tempted to say how ridiculous it was to keep such information from her, but she didn’t. There wasn’t any point. Her mother and father were not going to change.

  “She didn’t even want me to call you this afternoon, wishing to wait until she got home either tomorrow or the next day, but I had to insist. I had respected her wishes up until today, but I didn’t feel comfortable putting it off any longer.”

  “Putting off what? What are you talking about?” Laurie couldn’t help but notice her father looking up and down the hall as if concerned that they might be overheard.

  “I’m sorry to have to tell you this, but your mother has a marker for a specific mutation of the BRCA1 gene.”

  Laurie felt her face flush with heat. Although she knew people were supposed to blanch with disturbing news, she always did the opposite. As a physician, Laurie was aware of the BRCA1 gene, which in its mutated form was associated with breast cancer. More disturbing, she knew that such mutations were inherited in a dominant fashion with high penetrance, meaning there was probably a fifty percent chance that she carried the same genotype!

  “It is important for you to have this information, for obvious reasons,” Sheldon continued. “If I had thought the three-week delay would have had any significance for you, I would have told you immediately. Now that
you know, I must say that my professional opinion is that you should be tested. The presence of such a mutation raises the probability of developing breast cancer sometime prior to your eightieth year.” Sheldon paused and again glanced up and down the corridor. He seemed to be genuinely uncomfortable about revealing a family secret in public.

  Laurie touched her cheek with the back of her hand. As she feared, her skin was hot to the touch. With her father showing no emotion as usual, she was embarrassed that she was being so demonstrative.

  “Of course, it is up to you,” Sheldon recommenced. “But I should remind you that if you are found to be positive, there are things you can do to lower probabilities of developing a tumor as much as ninety percent, such as prophylactic bilateral mastectomies. Thankfully, the implications of a BRCA1 mutation are not the same as with Huntington’s chorea gene or some other untreatable illness.”

  Despite her obvious embarrassment, Laurie stared back into the dark eyes of her father. She even found herself imperceptively shaking her head. Even if their relationship was strained, particularly after her brother’s death, even if he didn’t act like her father, she couldn’t believe he could be saying what he was saying without more human warmth. In the past, she’d attributed his general detachment to a need for a defense mechanism against the stress of literally holding his patients’ beating hearts, and hence their lives, in his hands on a daily basis. Having assisted at surgery as a first-year resident, she knew something of what such stress was like. She also was aware that his patients had ostensibly appreciated his detachment, seemingly interpreting it as supreme confidence rather than a narcissistic personality flaw. But Laurie hated it.

  “Thank you for this most helpful sidewalk consult,” Laurie managed, unable to keep the sarcasm from her voice. She forced herself to smile before breaking off from her father and returning back to claim her seat at her mother’s bedside.

  “Has he upset you, dear?” Dorothy questioned after taking one look at Laurie. “Your face is as red as a beet.”

  Laurie didn’t answer for a moment. She had her mouth clamped shut to stop her lower jaw from quivering. Her emotions were threatening to surface, a weakness she had always despised, especially in the presence of her emotionless father.

  “Sheldon!” Dorothy called out as he reclaimed his chair by the window. “What did you say to Laurie? I told you not to upset her about me.”

  “I wasn’t talking to her about you,” Sheldon said as he picked up The New York Times. “I was talking about her.”

  Jack put down his pen and turned to look at Chet McGovern’s back hunched over his desk. Chet was a medical examiner colleague and Jack’s officemate. Although he was five years Jack’s junior, they had started at the OCME at almost the same time and got along famously. Although Jack appreciated sharing space with Chet for the companionship, he still thought it was ridiculous that the city didn’t provide them with private offices. The problem was a continuous budgetary constraint that precluded updating the facility; the OCME was an easy target for politicians in a city strapped for funds. The building had been adequate when it had opened almost a half a century ago but was now something of a dinosaur, with space at a premium. Since Jack was aware that dinosaurs had lived on Earth for some hundred and sixty million years, he hoped the building in its present configuration wasn’t expected to last quite that long.

  “I can’t believe it,” Jack called out. “I’m finished. I’ve never been finished.”

  Chet swung around. He had a boyish face capped by a shock of blond hair that was considerably longer than Jack’s but worn in a similar unkempt style. Like Jack, he also gave the impression of being athletic, but it was from almost daily visits to the gym, not from street basketball. He was in his mid-forties but looked considerably younger.

  “What do you mean you’re finished? Finished what?”

  With his hands clasped into fists, Jack stretched his arms over his head. “All my cases. I’m completely caught up.”

  “Then what are all those folders doing in your inbox?” Chet used his index finger to point at the sizable stack threatening to spill out.

  “Those are just the cases waiting for material to come back from the lab.”

  “Big deal!” Chet scoffed with a dismissive laugh before returning to his work.

  “Hey, it’s big for me,” Jack said. He stood up and touched his palms to the floor and held them there for a beat. After the unaccustomed bike ride to work that morning, his hamstrings felt tight. After straightening back up, he glanced at his watch. “Good grief! It’s only three-thirty. Will wonders never cease? I might make it for the first run on the court.”

  “If it’s dry,” Chet said without looking up. “Why don’t you come over to Sports Club L.A. The court will be dry there. If you were smart, you’d tag along with me to body-sculpting class. I tried it last Friday, and I’m telling you, the chicks are incredible. There was this one that was something else. She had on a full-body, black, skintight bodysuit that left nothing to the imagination.”

  “Ogling chicks!” Jack mocked. “One of these days, you’ll wake up and be able to look back on these difficult years of puberty and laugh at yourself.”

  “The day I stop checking out the women will be when I’m ready for one of those pine boxes downstairs.”

  “I’ve never been much for spectator sports,” Jack quipped. “I’ll leave that up to you wimps.”

  Jack took his jacket from the back of the chair and headed out of the office, whistling as he went. It had been an interesting and stimulating day. When he reached Laurie’s office, he poked his head in, wondering if she was inclined to change her mind about not coming back to his place that evening. The office was empty, though he noticed an open folder on Laurie’s desk.

  Jack sauntered in and checked the name. As he’d guessed, it was Sean McGillin. He was curious why Laurie and Janice seemed so engrossed in what sounded to him like a routine case. Generally, he wasn’t one to stereotype women, but he thought it odd that they had both displayed what he thought was rather unprofessional emotion. He flipped open the folder and shuffled through it until he found Janice’s report. He read it quickly. Nothing jumped out. Other than the victim being only twenty-eight, the circumstances weren’t particularly noteworthy. It might have been sad and a tragedy for the victim’s family and friends, but it wasn’t sad for mankind or the city or even the borough, for that matter. There were a lot of individual tragedies in a metropolis the size of New York.

  Jack quickly closed the folder and beat it out of the office as if he’d been engaged in something surreptitious and was fearful about being caught. All at once, he was less inclined to see if Laurie wanted to reconsider her decision to move back to her own apartment for fear of having to deal with too much emotion. Thinking about family tragedies was not a pastime he wanted to indulge in. He’d had too much personal experience.

  Down on the first level, Jack retrieved his biking paraphernalia as well as the bike itself. He waved to the evening security man, Mike Laster, as he carried his bicycle out onto the receiving dock and then down onto the pavement. The rain had stopped, and it was significantly colder than it had been when he’d arrived that morning. He was thankful for his gloves as he climbed on the bike and pedaled across 30th Street to First Avenue.

  In contrast to his morning ride, Jack enjoyed the afternoon slalom among the cars, taxicabs, and buses as he streaked northward, racing the traffic in daredevil fashion. Eventually, he cut over to Madison Avenue, using the brief crosstown traverse as a time to allow his circulation to relieve his aching quadriceps. Heading north again, he regained his speed. At the rare times he had to stop for traffic lights, he briefly questioned between breaths why he was enjoying challenging the traffic when he hadn’t that morning. Sensing it had something to do with things he didn’t want to think about, he gave up trying to understand and just savored the experience.

  At the Grand Army Plaza, with the Plaza Hotel on one side and the She
rry-Netherland Hotel on the other, Jack entered Central Park. This was always his favorite part of his commute. With the temperature continuing to plummet, it was now cold enough for his breath to form a cloud of vapor with each exhale. Overhead, the sky had darkened into a deep purple, except to his left, in the direction of the setting sun. There it was still a rich but rapidly fading scarlet that formed a striking, blood-red backdrop for the sawtoothed spires of the buildings lining Central Park West.

  The street lamps had come on in the park, and Jack rode between spheres of light and their intersecting penumbras. There were more joggers than there had been in the morning, and Jack kept his speed down. Above 80th Street, the number of joggers began to fall precipitously. By then, night had taken full command of the sky. To make things worse, it seemed to Jack that the distance between the street lamps had grown. As dark as it was, he occasionally had to slow down to walking speed between illuminated areas, since he could not see the ground and had to proceed on faith that there were no obstacles in his path.

  When he passed 90th Street, it got even darker, particularly in the hilly section where he had felt such exhilaration that morning. In contrast, now he felt the stirrings of foreboding. The leafless trees crowded the pathway. He could no longer see the buildings along Central Park West, and except for an occasional distant beep of a taxi horn, he could have been biking out in some vast, isolated forest. When he did approach a street lamp, it made the intervening, leafless branches appear like giant spider webs.

  Exiting the park at 106th Street, Jack felt relief. As he hit the button for the traffic light, he had to laugh at his imagination and wonder what had stimulated it. Although he had not been riding in the park at night for months, he’d done it a considerable number of times over the years. He could not remember it having affected him in such a fashion. Even he recognized the absurdity of his having had no fear earlier in traffic, where it was truly dangerous, while getting the heebie-jeebies riding through the deserted park. He felt like an impressionable ten-year-old walking through a cemetery on Halloween.