“Melissa.”
“Listen to me. When I was in college, a woman I knew started the same way as you are now. I think she had numbness in her arms and her face. Gradually, she lost everything.”
“You always get crazy over these rare cases,” said Bill. “I know a dozen people who had numbness for a day or two and then were fine.” He paused. “I’ve got to get to the office tomorrow.”
“Numbness can turn into paralysis.” Melissa’s fingers began fluttering, as if on a keyboard. “If you aren’t concerned for yourself, you should at least be concerned for your family. For Alex and me.”
He cupped his hand over her shoulder and leaned around to kiss her.
“No, don’t look at me. I look awful.” She slowly stood up and caught a glimpse of herself reflected from the rim of the silver coffee service. “I’m going to bed.”
A fine mist of water drifted into the porch as the automatic sprinklers started their evening program.
WAITING ROOM
It was with a sense of extreme frustration that Bill parked his car at the Alewife Station the next morning, on his way to the Massachusetts General Hospital instead of his office in the Marbleworth Building. Only minutes earlier, Jenkins had called with an urgent message relating to the appointments rescheduled once again. “If you’re not going to be at your terminal this morning, at least stay near your phone. I’m doing everything I can for you here.” Bill smacked his dashboard, feeling no sensation but minutely relieved to have expressed something.
He had arrived at the Alewife well after rush hour. Nevertheless, out of habit he ran from his car for the elevators. His recovered briefcase bulged with the entirety of the Trag.dat1 file, which to the best of anyone’s knowledge had never before been printed out in hard copy. Of far less weight was the slim new cellular phone in his pocket.
The train was half empty. Taking a seat, Bill found himself trembling. The last time he had boarded the subway, the world had collapsed. With some difficulty, he wrote down “MGH, Petrov at 10:30” on three pieces of paper and put one in his briefcase, placed one in his shirt pocket, and held one tightly in his hand. This safety measure brought him a small modicum of comfort, although he was still much too anxious to work. He was also exhausted. Melissa had sat up most of the night at her vanity, sleepless, a silent silhouette every time he opened his eyes in the dim light of the room.
His gaze wandered around the train, eventually fastening on the man sitting across from him. Unexpectedly, Bill felt an odd connection to this man. He appeared to be about forty, Bill’s own age, with quiet blue eyes. His skin was delicate and white, even at this time of year, as if he had affairs too important to leave for a holiday in the sun. His brown hair was neither so short as to make him seem obsessively neat nor long enough to suggest someone caught up with fashion. The subtly patterned suit that he wore, probably bought at Louis, was more expensive than Bill would ever have purchased for himself, and his shoes had those little tassels that Bill despised. Those shoes alone boasted to the world that this man had already won the Big Race, had so conquered the vicissitudes of life that he could glide to his office at 10:00 or 10:30 in the morning, and he did not want to be reminded of other people’s strivings and sufferings as he now read his Wall Street Journal with magnificent serenity.
Bill couldn’t help comparing himself to this fellow. There might he be, with a different toss of the dice. He both detested this man and wanted what he had. He knew him well, had known several men like him in school. They were the ones to whom everything came easily. They were the ones who finished their homework in half the time and then set to polishing the valves of their immaculate second-hand Porsches. This fellow, Bill felt certain, had always appeared as he did now, oblivious to the storms of the world, sailing through his professional life, marriage, and family without a ruffle in his sails. Undoubtedly, he was current on all that he needed to know, he absorbed information without effort through the pores of his pale skin. If Bill’s better self, sitting there six feet away, had ever momentarily fallen behind, there was no sign of it now. If he had ever slipped or been ill, no one had known. Indeed, despite the pale white of his finely chiseled face, he seemed to exude an undeniable fitness and well-being, with a stomach considerably less prominent than Bill’s. He was the best modern man, always in step with the world, the embodiment of progress.
At that moment, Bill felt an impulse to fling himself from his seat and punch the other man in the nose. The fellow deserved a good vicious wallop. Maybe after being struck he would stand up and begin shouting, his delicate white skin turning pink. Then he would drop his newspaper to the dirty floor. That would be a satisfying spectacle. Bill’s impulse electrified his body and stiffened his muscles, but he remained quietly in his seat, merely staring at his alter self, twisting the universe around in his mind until the train reached his stop and he had to disembark.
With a last glance over his shoulder, thinking again that he should have walloped the other man on the train, he hurried down the hot metal stairs to the street and toward the Ambulatory Care Building, which housed the offices of his physician, Dr. Armand Petrov. At 10:28, two minutes ahead of schedule, he arrived in the waiting room.
It was the same dull and miserable little room that he remembered from his visit two years ago. Saccharine arrangements of Beatles songs dripped from the corner speakers, a Xerox machine hummed behind the receptionist’s desk. Only the wallpaper had changed, from a faded pale orange to a thicket of blue and green triangles. He presented his hospital card to the receptionist, who hardly glanced up from her keyboard, and claimed the one empty seat.
Bill made a quick examination of his fellow patients. One typed nervously at her laptop, another two scribbled on documents in manila folders, a man in the corner leaned over some massive report and muttered into his cell phone. Aside from one young woman, flushed and feverish, no one appeared clearly ill. However, none seemed altogether well, either, and a vague unwholesomeness hung in the air. There were half a dozen people in the room. At fifteen minutes each, that would total up to an hour and a half! Was it conceivable that they were all ahead of him? No, that couldn’t be possible. In any event, he could not afford to lose time. He emptied his briefcase and began arranging his material in two piles on the floor. A woman glanced at him disapprovingly, then returned to her magazine. Most likely she was the one who stank of the acrid musk perfume. Bill pinched his nose and inspected his watch. It was 10:33.
Despite the aggressive air conditioning, the room felt stuffy and tense. At 10:35, a man leaped out of his chair and advanced upon the receptionist. “I can’t wait any longer,” he said. “It’s ten thirty-five. I’ve been waiting since ten. My appointment was at ten.” The receptionist nodded implacably. “I can show you,” he said. With that, he yanked the appointment book away from her and stabbed his pen on the line with his name. “Does Petrov think he is the only one whose time is valuable? I’ve got crucial other business this morning. I want to see Dr. Petrov immediately.”
The receptionist retreated a few paces and whispered something to an assistant behind her. “I’m sorry,” she said, returning to the front desk. “Dr. Petrov is busy with another patient at the moment. We’ll call you when it’s your turn. Would you like me to reschedule your appointment?”
“Reschedule!” the man shrieked. “So that I can waste another half-day waiting?” He studied his watch. “I’ll tell you what. I’m going outside in the corridor to make some telephone calls. I want to be notified when Petrov is ready for me.” He strode to the door, rotated around as if recalculating his strategies, then vacated the room. His announcements created a certain added distress in the rest of Dr. Petrov’s patients, who fidgeted with their papers and consulted their own timepieces.
“My appointment was also ten,” ventured the woman with the laptop. She half rose from her chair, seemingly unsure about whether to press her case forward or return to her work, and she cast a quick look toward Bill as if pleading fo
r his moral support.
“I’m sorry,” said the receptionist. “Dr. Petrov is running behind this morning.”
“I will have to leave at 10:45,” said the woman, again examining her watch. She was dressed stylishly in a beige silk blouse, black pants, and black heels. “Can I receive a fax here while I’m waiting?”
“I’m sorry,” said the receptionist. “We don’t have fax service for our patients.” From somewhere behind her, the assistant whispered something and the receptionist stifled a laugh.
“You are mocking me,” said the woman with the laptop, and she glanced again at Bill, who could only shrug his shoulders helplessly. Why was she asking for his assistance? The fax machine was not his problem. People en route should not be dependent on fax machines. He tried to ignore her and looked down at his papers, but her outburst had upset him, and she continued talking to the receptionist, this time in a more uncertain voice. “It would not at all be unreasonable for you to offer fax service to your patients,” she said, “especially when you keep us waiting so long. I happen to need some important information to continue what I am doing. Everyone else offers fax service. Hotels offer fax service.”
“Maybe you should walk over to the Holiday Inn across the street,” blurted the invisible assistant, and she released a loud guffaw. The receptionist was dying to laugh. Instead, she turned around and whispered a few words of admonition to the assistant.
“I know that you have a fax machine,” said the woman with the laptop. “I saw it when I came in. It’s on the desk of that woman behind you.”
“That machine is for the private use of the office,” said the receptionist. Immediately, she walked back to the assistant’s desk and turned off the fax machine.
A nurse appeared in the reception area with a handful of glass tubes. She whispered something to the receptionist, who let out a small cry and began typing rapidly on her keyboard. “What in the world! He can’t really want that.” “That’s what I thought, but what do we know.” “This is a pain.” “You’re telling me.” The two of them stood at the receptionist’s terminal, shaking their heads with annoyance. Then the nurse dashed off. A back door slammed. Abruptly, she returned and began hunting around the reception area, feeling around in drawers with her hands as if she had misplaced some small object. Again, she vanished.
“I’ll be back,” said the woman with the laptop, and she hurried out of the office, scowling a last time at Bill. How could he possibly work with so much commotion? He hated doctors’ offices. How much time had he wasted so far? It was 10:45. He stared at his papers on the floor, dismayed to see that they’d gotten out of order, and spent several minutes rearranging the correspondence by date before beginning to read.
“Is this your first visit?” suddenly asked a short, balding man in the next seat. His blue blazer strained at its brass buttons. “I haven’t seen you here before.” Bill tried to ignore him, but the man seemed unusually agitated, continually adjusting his glasses and rubbing his head.
“A real operation they have here,” continued the man in the blue blazer, raising his voice just enough so that everyone could overhear him. “Someone should call the AMA, or maybe the Better Business Bureau. If I were you, I’d change physicians.” At that moment his telephone rang. For several minutes, he gave instructions to some subordinate on the other end of the line, repeatedly referring to his watch, then shoved the instrument into his coat pocket as if it caused him great suffering. He leaned closer, so close that Bill could smell a trace of cleaning detergent in his shirt. “So what’s wrong with you?”
“I’d rather not say,” said Bill. People were so pushy and obnoxious in doctors’ offices, he thought to himself.
“Well, I will tell you something, my friend. A word from the wise. Today is my sixth visit in three months, and Herr Doctor Petrov still hasn’t offered me any diagnosis. Do you have time for that? I certainly do not.”
Bill put down his papers with alarm. In fact, he knew very little about Petrov. He saw the physician once every few years, and on those occasions only for brief routine checkups. How had he been recommended to Petrov in the first place? he suddenly wondered. It struck him that he should have thoroughly investigated Petrov’s credentials long ago. Bill guardedly introduced himself.
The other man’s hand was swollen and clammy. “Morton Bineas,” he said. “Let me not pry, Mr. Chalmers. Keep your illness to yourself.” Bill shifted uncomfortably in his chair, again cursing himself for waiting so long to investigate Petrov. Bineas smiled, observing that he had found an appreciative audience, and continued. “On my last visit, a month ago Tuesday, Dr. Petrov hinted to me that he might be ready to proceed to a provisional diagnosis, also called the diagnosis pro tem. But then, just when I was leaving his office, he ordered another group of tests.” Bineas began coughing strenuously, to the uneasy glances of the other patients, and the receptionist’s assistant brought him a tiny paper cup of water. He tossed it down with a look of embarrassment and asked for two more. After a few moments, he continued, hoarsely. “I once heard that when Petrov was a young physician, years ago, he occasionally made definite diagnoses, and these were often quite correct. But with the vast increase in medical technology, and with it so many new considerations to take into account, he’s limited himself to what I’ve mentioned.”
“I’ve got to be treated right away,” said Bill, becoming angry. “I was actually hoping to be treated today. I’ve already lost two days of work.”
“Two days? Two days?” said Bineas in mock sympathy. “You should complain. I’ve lost two weeks. And I’m vice president of accounting at Boston Chowder.” He let out a long breath and sank back into his chair. His face softened. “Since Christmas, I’ve been tired all the time. It has something to do with my illness. And this terrible cough.”
Bill glanced gloomily around the room, wondering about the various stages of diagnoses of Dr. Petrov’s other patients. Bineas seemed to read his mind, for he said, with a wave of his hand, “No one in this room has advanced to a diagnosis pro tem, let alone a final diagnosis, I can assure you. However, I have heard that some of Petrov’s patients have indeed been treated, and some fraction of those have recovered completely.”
At that moment, the door to the back rooms was flung open and a patient emerged, appearing forlorn. He hesitated in front of the receptionist, as if trying to remember something, and then hurried out the front door. For a second, Bill caught a brief glimpse down the inner hall. Dr. Petrov, a small man with a small red beard, could be seen dashing from the examination room to his private office, with a nurse running after him and another patient standing half-dressed and confused in the hall. Petrov’s door slammed shut, answered by the door to the waiting room.
At the departure of the last patient, the receptionist sang out the name of the woman in the musk perfume, who hurled down her magazine with a loud “Finally” and followed a nurse. It was 11:09.
“That woman,” said Bineas, nodding his head knowledgably, “I’ve seen her here before. She believes that she has intermittent cystitis, so she’s been drinking gallons of cranberry juice. But she could equally well have a small bladder tumor, or possibly inflammation of the kidneys. I happen to know that she was in line for a diagnosis pro tem three weeks ago, but Petrov was unwilling to write it down on her chart. Have you ever heard of such a crock of baloney!”
“But why do you put up with all this, Mr. Bineas?”
“Good question,” said Bineas, rubbing his head. “I would have kissed Petrov goodbye long ago, but my insurance would stop covering me.”
“Yes, I understand,” said Bill. “The insurance companies have us over a barrel.” He looked again at his watch to discover that he had already invested three-quarters of an hour waiting for Dr. Petrov.
One of the nurses who had appeared earlier entered the waiting room. However, she no longer wore her white nurse’s uniform but was dressed in a smart pair of khaki pants and a blue cotton blouse. “That’s Geneviev
e,” whispered Bineas. “She won’t be back until after lunch. Genevieve is quite competent, but she wants to work at the Colonial Theatre. Am I boring you, Mr. Chalmers? I must be interrupting your work. I saw you working there a few minutes ago. I should be working too, I have many phone calls to make.”
“No, please,” said Bill. “I’m grateful for everything you’ve told me. I want to know what to expect. I gather that you must have a provisional diagnosis at this time?”
Bineas rolled his eyes. “That’s confidential,” he muttered and turned away in his chair without further comment. He took out a pen and began writing in a crimson notebook.
“I’m sorry,” said Bill to the other man’s back. “I shouldn’t have asked.” Bineas made no reply.
After a few minutes, Bineas put away his book and turned back to face Bill. “Okay,” he said in a resigned voice. “I could have lupus. It’s very rare in men. So far, Dr. Petrov has been willing to rule out arthritis, fibromyalgia, and polymyositis. Chronic fatigue syndrome is another possibility.”
“You seem to have learned a fair amount about your illness,” said Bill.
“I have, I have,” said Bineas. “But not all thanks to Petrov. I’ve also been getting tips from another physician who I’ve been visiting on the side and paying out of my own pocket. He charges much less than Petrov. There’s a possibility that he might see you as well. He takes calls after eight in the evening.”
“Has he diagnosed you?” asked Bill.
“Twice. Neither of the diagnoses was of much help, but he’s provided me with some insight, as well as with several articles to read. Here, I’ll give you his name and address.” Bineas scribbled down a name and telephone number on a little white slip.
“Oh,” said Bineas, after noticing Chalmers’s clumsiness in grasping the scrap of paper. “I see that you’re having trouble with your fine motor coordination.”
“My fingers are numb,” Bill said. He slapped his hands viciously against the center table.
Diagnosis Page 10