Guarded Prognosis

by Richard L. Mabry MD

  “I sort of let it hang there. I . . . I had something else on my mind, but I promised him we’d talk again soon.”

  The buzzer on the oven went off. Beth got up but put her hand on Caden’s shoulder to keep him sitting. “Let me turn the heat down to warm. I think you’d better tell me what else happened today to divert your attention. Be right back.”

  Caden half-rose when Beth hurried back into the room, wiping her hands on a kitchen towel.

  She resumed her seat on the sofa. “Now tell me what else happened today.”

  He took a deep breath. He didn’t want her worrying about the office, but this was too big not to share. “Two men came by to see me—agents from the Drug Enforcement Agency . . . ”

  He told it all. Beth didn’t say anything, but Caden could almost see the wheels turning as he spoke. Beth had never encountered any problem for which she didn’t have a solution, and when he finished speaking, he was certain she’d tell him how she’d handle this. He was used to this, but he didn’t mind, because she was right most of the time.

  Beth waited until he was through before she spoke. “It sounds like they’re not so much after you as interested in your office routine. It appears you’re probably not the one under the gun.”

  “I hope you’re right, although if I’m not the one they’re interested in, someone in that office has been doing this stuff. I just can’t believe it.”

  “Think you should consult an attorney?” Beth asked.

  “I thought about it, but I don’t know one—certainly not well enough to trust him with something like this. It’s . . . It’s kind of embarrassing. Then one of the agents suggested I keep it simple and let them look around. So that’s what I decided to do.” Caden ran his fingers through his hair. “I haven’t figured out how I’ll let the agents ask questions without the nurses and other doctors knowing the DEA is snooping around.”

  “I think maybe what I’d do is say they’re doctors who wanted to look at your office’s operation. That should cover it.”

  Caden nodded. “I suppose I can do that. I can introduce Neilson as a doctor who’s been in academia in another state. He’s thinking of setting up private practice here, and he wants to see how ours functions. Harwell might move here and go in with him, but he’d like to see how things are done in Freeman.”

  “Now back to the other problem,” Beth said. “When are we going to drive to Dallas to see your father?”

  Caden had been turning that over, but his plans had never gotten very far. “With this DEA thing, I don’t know about leaving.”

  “We have every reason to go, and this weekend is a good time. By the way, and this really isn’t off-topic, I talked with my mother today.”

  “Anything important, or just the usual complaining?”

  “Caden, I realize you and Mother don’t see eye to eye, but she’s really got a good heart.”

  He realized that was probably true. Maybe he should be kinder in his remarks about her mother. But right now, he didn’t feel like dealing with one of his wife’s sermons. “What did you all talk about? Did her conversation cover all the points in the Beverly Cummings trifecta—you’re wasting your nurses’ training, why haven’t we given her a grandchild, and when are we coming to see them?”

  “As a matter of fact, she mentioned all three. I didn’t respond to the first two, but I told her we’d try to get to south Texas to see them soon—this weekend if possible.”

  “But—”

  Beth raised a finger to stop her husband. “Hear me out. Tomorrow is Friday. Is the DEA going to start then?”

  “No. They decided next Monday would be soon enough. They’ll start looking then.”

  “You’re not on call this weekend. I think we should go to Dallas on Saturday to see your father. It’s just an hour’s drive, and I’m embarrassed you haven’t seen him in so long. We need to go there, offer support, do what families do.”

  Caden thought back on the times he’d have appreciated a visit—or even a call—from his father. But he realized that just because Henry Taggart hadn’t done what he should was no reason for his son to repeat the behavior. “I suppose you’re right.”

  “Is there any reason you can’t be gone this weekend?”

  Caden thought about it. His colleague, Dr. Ann Russell, was on call this weekend, but there was nothing special to tell her. “I think it will be fine. Do you want me to call Dad to tell him to expect us?”

  “That would be nice. And I’ll phone Mother and explain why we won’t be coming to see them this weekend. I’ll tell her your dad has some problems but won’t get specific. Not yet.” Beth stood. “Now, let’s have some of that casserole I cooked before it’s too dry to enjoy.”

  Caden didn’t feel very hungry, but the food Beth prepared did smell good. And he had to admit that he felt better now that he’d shared his problems with her. Wasn’t there something in the Bible about sharing bad things? He’d have to ask Beth about it. That was her thing, not his.

  Beth watched her husband load the suitcases into his SUV on Saturday morning. She wasn’t concerned about whether the DEA agents would find any irregularities involving her husband. That was one of the things she found endearing about him—he was definitely what used to be called a “straight arrow.” No, her mind was on this trip to Dallas.

  She waited until they had left the city limits of Freeman before she started the conversation. “It will be good to see Henry. He needs his family around him at a time like this.” Beth took a deep breath. “And I think we should see your mother while we’re there as well.”

  Her husband’s face flinched when she mentioned visiting his mother. “I’m going. Will you go with me?”

  Ever since Nancy’s stroke about two years ago, when the neurologist told Henry his wife would never be a sentient human again, she had lived in Sunset Rest to receive the constant nursing care she needed. Beth had visited her every month. And each time, when Beth asked him if he’d like to accompany her, Caden had said, “I don’t want to see my mother looking like that. Can’t you go by yourself?”

  Of course, she’d also suggested they take a weekend to visit Caden’s father as well. But her husband always found some excuse for not going. Well, this time they were both traveling to Dallas, and she was determined Caden would see both his father and his mother.

  If he went with her to Sunset Rest to see his mom, Beth knew this would be one small victory in her battle. She considered taking the conversation further, trying to convince Caden that God would see him through these crises—his father’s diagnosis, his mother’s status, the DEA agents looking around his office. But she decided not to go there right now. She was aware that her husband wasn’t on speaking terms with God. She wasn’t sure how to get Caden to take the first step toward repairing that breach. But she’d continue to work on it.

  “I’m in. We’re going back on Monday to look around the office.”

  “How did he take it?”

  “Surprised and a little scared, just as you predicted. We’ll be there for several days, and I’m going to make certain there’s nothing that points to the racket we have going on.”

  “How are you going to wind this up? What’s your end game?”

  “I’d like to go through the investigation and say that any fake prescribing of narcotics has stopped. That would let the higher-ups direct their attention to another area. After all, their assets are stretched pretty thin. We’re just unlucky they chose this one to look into.”

  “But if you can’t give the practice a clean bill of health—”

  “The alternative plan is to have Dr. Taggart tragically die, preferably by his own hand, leaving behind a note taking responsibility for the prescriptions coming from his office.”

  “I’d hate for it to come to that.”

  “Because it would mean his death?”

  “No. Because it’s so much simpler the other way.”

  “We’ll call the second scenario Plan B. I’m prepared to pu
t either one in motion. It just depends on how this plays out.”

  As Caden pulled into the driveway of his childhood home in the University Park section of Dallas, memories came flooding back. The neighborhood was upscale, and the house was as nice as those of the neighbors, but Caden never thought of it in those terms. To him the house and its location weren’t important. What made it home to Caden was the presence of his mother, the woman who always seemed to be around when he needed her.

  He guessed what he remembered most was how his mom never missed one of his activities, especially the baseball games. Sure, his father had tried—even made it to one or two of the games—but a lot of the time he’d been too busy with his practice.

  Henry Taggart always had an apology ready for his son after he failed to show up, and Caden had tried to shrug off these absences. He knew that most fathers couldn’t get away from work to be at the high school games, which most often were held right after school. But deep in his heart, Caden always wished his father could be there. He would have given anything for his dad’s praise, but the opportunity never came.

  There’d been the time his high school coach told him he’d be the starting pitcher in the district playoff game. That was an important contest, one that would decide the championship. Caden hurried home to give both parents the news, and Henry Taggart assured his son he wouldn’t miss the game. But he did.

  “Sorry, Caden. An emergency came up,” he explained. “I’m sure you understand.”

  Caden had pushed back the tears forming in his eyes. “That’s okay, Dad.” Then he couldn’t help adding, “Mom was there.” She had always been there.

  Thinking about his childhood made Caden renew his resolve not to be like his father. He’d pay attention to his family. There was only Beth right now, but there’d be children as soon as he got his practice established.

  Beth put her hand on Caden’s arm, bringing him back to the present. “Ready for this?”

  “I’m as ready as I’ll ever be,” he said.

  As they approached the front door, Caden’s memory flashed back to the first time he came home from college. His mother had met him at the door with open arms. How he wished she could be there again. He stepped onto the porch, but before he could touch the knob a woman opened the door of the house in which Caden had lived for so many years. But it wasn’t his mother.

  3

  The Nancy Taggart that Caden remembered was a petite lady, with hair the shade of red-brown most people called auburn. She smiled often, not only with her face, but with her sparkling green eyes. The woman who opened the door for Caden was about the same age as his mother, but the resemblance stopped there. She was a bit taller than Mom. Her hair was dark blonde and cut short. Rimless glasses partially hid gray eyes. And her voice was a soft contralto, not the lilting soprano he remembered as his mother’s.

  The woman who opened the door was no stranger to Caden, but in his mind she only represented a name that occasionally came up, a voice on the phone, a presence in his dad’s office. She shouldn’t be the person who welcomed him to this house.

  “Caden,” she said as she stepped forward to give him a hug. “It’s good to see you.” She turned to Beth, who waited a step behind her husband. “And Beth. I’m glad you both could come.”

  It took Caden a moment to react. “Sorry, Jean. You took me by surprise.” He turned to Beth. “You remember Jean Kirkpatrick—Dad’s nurse.” He bore down on the last word, as though by doing so he could emphasize how out of place she seemed here in his father’s home.

  “Of course. You were at our wedding.” The two women exchanged hugs.

  “Is that Caden?” Henry Taggart called from deeper in the house.

  Jean followed Caden and Beth into the study where his dad sat by the window in the armchair that had always been off limits to the younger Taggart. “Don’t sit there. That’s your father’s chair,” his mother had said repeatedly.

  His father stood—were his movements a bit slower than usual?—and moved toward his son and daughter-in-law.

  “I was surprised to get your call last night,” Henry said. “There was no need for you to come. But I’m glad you did.”

  The doctor and the son within Caden fought, and the son won. He didn’t look for a yellow cast in the whites of his dad’s eyes. Caden didn’t scan for early signs of weight loss in the man’s arms or an increase in his abdominal girth. No, he was just glad to see his dad. He wondered how many more times he’d be able to see him, talk with him.

  His father’s dark hair was wavy like his son’s, but his hairline had receded a bit and there was some gray at the temples, something that Caden didn’t recall from his last visit. Had his father shrunk since their last meeting, or was it only Caden’s imagination at work? Was the change due to aging or to cancer?

  Caden stepped forward and hugged his father. “Dad, we’re here for you.”

  His father nodded at Caden’s words, then moved to embrace Beth. “It’s so good to see you both.” He waved them to chairs.

  “Let me get lunch on the table,” Jean said from her position on the periphery of the group. She turned to the visitors. “You haven’t eaten yet, have you?”

  “No, we came straight here.” Beth didn’t bother sitting down. Instead, she turned toward Jean. “Let me help you with lunch.” Both women left the room without a glance behind them.

  Caden sat down and leaned forward, his elbows on his knees. “Dad, you’re looking good. I’m glad to see that. Now that we’re here, tell me what you know about your diagnosis.”

  “Get right down to it, do you? That’s the surgeon in you, I guess,” his dad said. “Next week I’ll see one of the specialists at the medical center here in Dallas. Dr. Geist and I think they’ll do a CAT scan first to confirm what the GI series showed.”

  “But—”

  “Yes.” His father nodded. “You and I both know a biopsy and tissue exam is the gold standard. That will answer the question once and for all of whether I have pancreatic ca.”

  “But not an open biopsy—no surgery. Right?”

  “Right.” The smile that accompanied his dad’s response was minimal—more of a grimace. “The oncologist will probably do an endoscopic ultrasound and needle biopsy.” He placed his hand before his mouth and mimed swallowing. “I just swallow a long tube, they use an ultrasound probe at the end of it to look around, get a few needle biopsy specimens, and it’s over. No general anesthetic. No surgical procedure.”

  “I suppose you’ll be sedated for the procedure, which means you’ll need someone to drive you home,” Caden said. He pulled out his smart phone. “Tell me when it’s scheduled. Beth or I can come back here then.”

  “No need. Jean will drive me to and from the testing, and I can call you after we get the results.”

  Part of Caden realized it might not be practical for him to cancel his schedule and help his father. But the other part was a little upset, not just that someone else was doing what he wished he was able to do, but because Jean was playing a more important role in his father’s life than just being his office nurse. It was bad enough that his mother was in a coma. A thought that had festered in Caden’s mind since they’d arrived now began to bloom. Was his dad planning for Jean to take Nancy Taggart’s place in other ways?

  Beth saw that Jean didn’t really need any assistance as she moved confidently around the kitchen putting the finishing touches on lunch.

  “I suppose you’ll eat at the kitchen table,” Jean said. “Henry hates to use the dining room. Says it’s too formal.”

  “Fine.” Beth took the folded napkins Jean had set down on the far end of the table and began to lay places.

  “I imagine this was a shock,” Jean said over her shoulder as she ladled soup into bowls. She pointed to a drawer. “You’ll find silverware in there.”

  It took Beth a moment to realize Jean was talking about learning Henry’s probable diagnosis, not his relationship with his nurse. “It was. We’re all anxious
to see what the work-up shows.”

  “Henry might fuss and say there’s no need for Caden and you to come here, but I know he’s glad you did.” Jean inclined her head toward the now-filled soup bowls. “Want to put those on the table? I have some cornbread coming out of the oven in a minute.”

  Jean had set out three napkins and dished up three bowls of soup. “Aren’t you eating with us?” Beth asked her.

  “No. I’m happy to fix you all some lunch, but this is family time. I’ll leave you to talk.”

  Jean put a trivet in the center of the table and set a pan of cornbread on it. “The butter is in the refrigerator. I’ll pour the drinks. Henry will want iced tea. How about you and Caden?”

  Beth set the butter on the table next to the cornbread. “Tea will be fine.”

  “I’ll tell the men lunch is ready, then I’ll be on my way,” Jean said. “It was good to see you again, although not under these circumstances.”

  As she waited in the kitchen, Beth wondered if there were other surprises ahead for Caden . . . and for her.

  Caden looked around when he sensed someone entering the room.

  “Beth is putting lunch on the table,” Jean said. “I’ll be going now. Leave the dishes when you’ve finished. I’ll come back later to clean up.”

  Caden noted that she didn’t hug or kiss Henry, but the look they shared told him there was something there. Before Jean could leave the room, Caden said, “Dad, while we’re here, I think Beth and I will go see Mother at the nursing home. Want to come?”

  “I go every week, Son. But I’m glad you’ll be going.”

  As soon as Jean left the room, Caden moved into a part of the discussion he’d thus far avoided. He hadn’t yet touched on the question of Henry ending his own life—and Caden’s role in it. Was his father serious when he talked about suicide if it came to that? For a fleeting moment, Caden thought maybe if he didn’t mention it, the subject would fade away. Yeah, right.