by Harry Kraus
“Don’t you see, Doc? The Stoney Creek curse may be nothing but an undiagnosed pocket of Huntington’s disease.”
“Claire, I’ve been the health care in this valley for over thirty years. There is no rare genetic illness stalking these hills.”
“But how can you be so sure? Steve Hudson’s mother may have had it, too. Grandma said she died at Steve’s birth, so she could have carried the gene. And her father was none other than Harold Morris, the still owner who spawned the whole Stoney Creek curse legend.”
“He was an alcoholic, too, Claire. He was addicted to the corn liquor he sold to half the men in this valley.”
“How can you be so sure? My future is resting on this knowledge.”
“You’re being melodramatic, Claire. And may I suggest something else?”
“Well, I—”
“You’re falling into a trap that many young physicians fall prey to. I call it ivory-toweritis. You go up to the big university medical center and see all the rare and unique cases, and have access to all the latest medical miracle machinery, and think that’s the way medicine is practiced out here in the real world. Well, it just ain’t so. Your attendings in the university may be able to look down from their ivory towers on the rest of us, but this is where most of the people in this county go for their care.”
“No one’s looking down on you, Doc—”
“Let me finish. We had a saying in my day. ‘When you hear hoofbeats, think horses, not zebras.’ So while you might see the rare diagnosis at the big referral centers, we go right on treating the bread-and-butter illnesses of the world. So when I see someone who loves the bottle stumbling around town, losing their temper, and slurring their speech, what do I think? Huntington’s disease? No. I don’t think zebras, I think horses. Your father is an alcoholic, Claire. And from the sounds of your grandmother’s confession, his real father may have been, too.”
Claire sighed. “I was hoping I could talk you into getting his blood screened for the HD gene.”
“Well, I’m afraid I can’t help you. Number one, your dad hasn’t come into my office for care in a long time. And number two, even if he did, I’d be way out on shaky ground ordering a test like that. His insurance plan may never allow it, unless I could demonstrate a positive family history.”
“That would be difficult to do.”
He huffed. “Claire, you’re a smart young woman. But my advice to you is to drop this search right now before you get yourself in the middle of a huge family tangle. You bailed out of your family at a young age, and for good reason, as I recall. Why do you want to go stirring things up so?”
“I just can’t stop thinking about the patient I saw with HD. He looked just like my dad. What if we’ve been blaming him and his drink for his actions all this time, and it’s really been out of his control all along?”
“Tell me the truth, Claire. You’re not suddenly concerned about your father, are you? You stopped worrying about him years ago. You moved on. You made your own life. Why act as if you’re so concerned about him now?
His words stung. There was truth in them, Claire knew. She hesitated, then admitted softly, “Because now the issue is my life, my future.”
“Stop worrying, Claire. You’ve got enough to do up there without obsessing over some rare genetic disease.”
“You’re right about that.”
“I know I am. Drop this, Claire. I’m the one paid to worry about the people in this valley, not you.”
“But I keep thinking that—”
“Claire. Listen to me. I’ve been a friend of your family’s for a long time. Don’t bring these kind of secrets out into the open with your curiosity. People could be hurt by this stuff.”
“Maybe you’re right.” She yawned. “Ivory-toweritis, huh?”
“Exactly. Now follow my advice and I won’t tell my old buddy Dr. Rogers that he’s not giving you enough to do.”
“You know better.”
“You do too.”
“Okay, Doc, I give. I’m gonna crash early tonight. I’ve got call tomorrow ‘cause it’s an odd day, the thirty-first. And unfortunately, when I switch services for August, I’ve been assigned the odd-day calls there too.”
“So you’ve got two call nights in a row?”
“I told you medical school was kindergarten.”
“So this is how they create surgeons. No wonder most of them are jerks.”
“Doctor Jenkins!”
“Just a lifetime observation. Don’t let ‘em change you.”
“I’ll try not. Bye.”
“Good night, doll.”
Claire hung up the phone and collapsed on her bed. I may have ivory-toweritis, but at least I have an open mind. Blindness is worse.
Far worse.
I just want to be sure. Is that so bad? Why are there so many roadblocks to the truth?
Dr. Jimmy Jenkins set down the phone in its cradle and tried to quell a rising tide of panic in his gut. He walked to a large closet in the back hall of his office and opened the door. The shelves were lined with pharmaceutical samples, each arranged in neat rows according to alphabetical order. He reached for Valium and pressed two tablets from a bubble pack into his hand. He swallowed them dry and shuffled through the medicines to locate the Pepcid. He took forty milligrams, four times the over-the-counter dose, and returned to the phone, glancing first to be sure the door leading to his house was closed.
He called Della McCall. She answered after six rings.
“Hello.” Her voice was cheerful, something that had always endeared her to him, but irritated him in his present mood.
“Della.”
Her voice became immediately softer, stiff, and formal. “Yes?”
She must be with Wally. “Claire just called.”
“And?”
“Della, I thought I told you to tell her to forget about this Huntington’s disease notion.”
“I did. I told her exactly what you told me. That you’d never seen the disease in this valley, so she shouldn’t give it another thought. Why, what’s the deal?”
“She talked to Wally’s mother—”
“She didn’t! I told her specifically not to do that! The last thing my family needs is to alienate Elizabeth with suggestions that she—”
“Della, calm down. She didn’t accuse Elizabeth of anything. But Elizabeth confided in her that she’d been raped, and that she wasn’t sure that Wally is really John’s son.”
“W—what? She never said anything to us!”
“She never told anyone, Della. She must have been too ashamed. But now, with Claire questioning the family tree, Elizabeth must have felt obligated to tell her. In fact, Claire said her grandmother wanted to warn her that she might be in the bloodline to inherit the Stoney Creek curse.”
Jimmy heard the sound of a squeaky hinge and the slam of a screen door. He could imagine Della walking into the backyard.
“This is crazy. Did she say who did this to her? If John McCall wasn’t Wally’s father, who was?”
“She thinks it may have been a man by the name of Steve Hudson. Do you remember him?”
“Yes, but I didn’t really know him. I was a teenager when he died.”
“He killed himself, Della.”
“I know. Everyone in Stoney Creek talked about it for weeks. He shot himself in the barn that belonged to Elizabeth’s parents.”
“I hadn’t remembered that. I knew he committed suicide, and that rumor had it that he was lovesick over Elizabeth, but I didn’t know he had killed himself at her home place.”
“Right in the hayloft.”
He shook his head to erase the mental image of Steve Hudson’s corpse. “Anyway, Steve’s grandfather was Harold Morris. Elizabeth evidently worries that some curse placed on him might be passing through the generations. And Claire has it in her mind that this might be Huntington’s disease.”
“And what do you think?”
“I think she’s in left field, worrying a
bout something so rare, when the real problem is staring her in the face. These men have all been alcoholics. The curse is nothing but the ravages of alcohol abuse.”
“So why did Claire call you?”
“She wanted to talk me into having Wally tested. She wants to look for a faulty gene to blame for his behavior.”
“What would be wrong with that?”
“Della, the last thing I want is to focus attention on Claire’s gene pool.”
“You’re afraid for your own reputation, aren’t you?”
“And what about you? You’ve been consumed with your own secrets, afraid that Elizabeth wouldn’t keep the children in the will if she suspected—”
“I’m concerned about my children, yes, but also about how all this would affect Wally. He’s a proud man, Jimmy. He wouldn’t take this news quietly. He forgave me, but he never suspected that the children—”
“We don’t know about the children,” he interrupted. “It’s never been proven for sure that—”
“You told me yourself that you knew. As soon as you saw Clay’s hair, you felt it.”
“It was only a stupid emotion, Della. We don’t know. We never have. And we don’t have any reason to suspect it now.”
“Why are you so afraid? It was a long time ago.”
“That’s right. It was a long time ago. There’s no benefit in bringing this up now.”
“You’re avoiding my question. Why are you so afraid?” Della asked.
“And you’re not?”
“Maybe I am, but I asked you.”
Jimmy looked at the closed door leading to his house. His wife, Fiona, was there preparing supper, soup or a fruit plate perhaps, just as she had for every Sunday evening as long as he could remember. “I’ve never shared this with Fiona. This would devastate her.” He sighed deeply, exhaling into the phone. “Look, Della, I’m about to retire. News like this would taint my career. I’ve given my life to this town. Rumors spread like fire in this valley. I’d be ruined.”
“And what about Wally? Aren’t you concerned about him?”
“Sure, I am. But there’s little I can do. The man won’t see a doctor. And we know what his problem is. He’s fried his brain on the same liquor that has been the undoing of too many men around here.”
“So why did you tell me this? What can I do?”
“Talk some sense into Claire. Convince her to stop her crazy search.”
“She won’t listen to me. That should be obvious by now. I told her not to talk to Elizabeth, and she went right on. The girl has a mind of her own.”
He cursed. “You can try.”
“It won’t do any good. And what am I to do with this information about Steve Hudson? I can’t tell this to Wally. He’s in no condition to deal with news like this. Yesterday he went to get the mail without his trousers on. And he peed all over the carpet this morning. I don’t know what I’m going to do with him.”
“He’s going to need a nursing home.”
Della started to cry. “He won’t go. And how can I afford that?”
This conversation wasn’t going the way he’d planned. “Della. Something will work out. Certainly Elizabeth would care for her own son, wouldn’t she?”
“I—I hope.”
“Don’t cry, Della. Something always works out. I didn’t call to upset you. I just, well, I just hoped we could keep Claire from asking so many questions.”
“Claire’s my daughter. And she’s smart. Smarter than I ever was. Hopefully she’ll avoid the mistakes I made.” She sniffed. “If Claire has a medical explanation for this stupid town curse, maybe we should listen.”
“Let her keep talking then, Della. People are going to get hurt. And not just in your family. These things have a way of ripping communities apart.” He paced to the phone cord’s limit, looking first into an exam room, and then back toward his desk. “And I don’t need to remind you how jealous Leon McCall is over the McCall fortune. His lawyers would certainly find a way to keep the money away from anyone who isn’t a blood McCall. And it sounds like Wally’s going to need that money. He’s gonna need that money soon.”
There was an uncomfortable pause. “I’ll talk to Claire, Jimmy. But I can’t promise anything.”
He heard a click. He laid the phone down and put his head in his hands before heading to the medicine closet again.
Chapter Eighteen
Sierra Jones was hit by a drunk driver while riding on her new bicycle on Claire’s last night of trauma call. It was Sierra’s seventh birthday. The bicycle was a gift from her father.
At eight-thirty, Claire stood anxiously awaiting the patient’s arrival. The team had gathered after receiving notification by the Lafayette paramedics that an unstable patient was en route.
She glanced at the other members of the team. Nervous laughter punctuated their conversation. Everyone was pacing, milling around the empty stretcher, unable to still the anxiety that accompanied the knowledge that soon, very soon, a child’s life would be in their hands. Claire sensed an unspoken heaviness that seemed to hover each time they cared for one so young. Adults, she supposed, mostly were in trouble because of their own choices. They drank. They took chances.
But children were different, at least for Claire. Their innocence captured her. Their cries, which rose from their ignorance and the fear of events unfolding around them, tugged on her heart like an adult’s never could. And worst of all, there was little margin for error. Children bled to death quicker, occluded their small airways faster, and coded sooner than their adult counterparts.
As Sierra arrived, the team began a symphony of critical care. The paramedics had been unable to start an IV, and a quick assessment revealed her peripheral veins were flat.
“Should we do a cutdown?” Claire pulled a flexible plastic tourniquet off of the patient’s arm. “There are no IV sites available.”
“I’ll do a central line,” Basil offered. “I’ll use the ultrasound.”
Claire leaned over the little girl and smiled. “Hi, Sierra. I’m Dr. McCall. We’re going to help you. Do you hurt anywhere?”
“My tummy hurts. And my arm.”
Claire carefully explained everything that was happening to her young patient. “Don’t try to move, Sierra. You’re neck is in a brace until we know it’s okay.”
Basil inserted a large-bore central venous line while the O-man did a primary survey. “Her lungs are clear. Her heart is tachycardic. Her abdomen is distended and tender throughout. Pelvis is stable. Left arm is abraised, tender above the elbow. Knees are abraded. No malangulation of the legs.”
Deb Parrish called out the vital signs. “B.P. sixty systolic. Heart rate 170.”
Dr. Overby gave the orders. “Let’s get a hematocrit, amylase, liver functions, and urinalysis. Type and cross for six units and give five hundred cc’s of lactated ringers stat!” He looked at Claire. “She’s going to need a CT of the abdomen. I want you to stay with her. Go over the scan with the radiology resident and call me. And arrange an ICU bed. She probably has a ruptured spleen, maybe a liver crack.” He looked at an X-ray technician. “Get a portable chest and c-spine film before she goes to the scanner.”
The team responded. Claire squeezed the IV bag and watched the heart monitor. Sierra’s blood pressure came up to eighty-five after the IV bolus.
“Careful,” the O-man cautioned. “Let’s not overdo it. Her normal blood pressure may not be much more than that.”
Claire put her face close to the patient’s. “Can you tell us what happened?”
“I was riding my bike on the sidewalk. A man in a red car ran into me.” Her chin quivered. “He smashed my new bike.”
“I’m sure it can be replaced, honey.”
“It was my favorite color. Purple. And it had a bell and a handlebar bag.”
“It sounds wonderful.”
“I got it for my birthday.”
“How old are you?”
“Seven.”
“Happy bir
thday, Sierra.”
“How did you know it was my birthday?”
“The men on the rescue squad radioed ahead, and told us about you. They said it was your birthday.” Claire looked up to see Cliff, the ward secretary, standing at the foot of the bed.
“Her family is in the waiting room. Can you talk to them, Dr. McCall?”
Claire looked at Basil. He nodded. “You talk to the parents. I’ll set up the CT scan.”
She walked into a crowded waiting room where she met Roger and Celia Jones. Mr. Jones was wearing a blue workman’s jumpsuit with his name embroidered on the breast pocket. His hair was blond, and he had black grease on his hands. He put his arm around his wife, and his other around two boys, who looked to be preschoolers.
Mr. Jones looked at Cliff, who had escorted Claire to the waiting room. “I thought you said you would bring out the doctor.”
Claire ignored his comment. “I’m Dr. McCall. I’m helping take care of Sierra.”
“You’re a doctor?”
She nodded. “An intern.” Claire watched as the parents exchanged glances.
The father spoke again. “How is she?”
“She seems to have stabilized. We need to do some tests.”
Mrs. Jones frowned. “Tests?”
Claire nodded. “A CT scan of her abdomen. We want to check for internal injuries.”
“I want to see her.” The father stepped up, breathing down into Claire’s face. “Now.”
She stepped back. “Why don’t you come back with me, and you can see her for a few minutes until she goes to get her CT scan.”
Claire led the family back into the first trauma bay just as they were hooking Sierra up to a portable monitor for her trip to the scanner. Mrs. Jones rushed to her daughter’s side. “Sierra, we’re here, honey. Everything’s gonna be all right.”
Mr. Jones took his daughter’s hand.
Basil Roberts, the second-year resident, spoke. “They’re ready in the scanner, Claire. Josef will help you with transport.”
Claire nodded. Baby-sitting trauma patients in the CT scanner was old hat to her by now. “Let’s move.” She spoke to the parents. “You can come as far as the radiology waiting area, then you’ll have to leave her with us.”