Michael Palmer - Natural Causes

Later that evening they made love-consuming, passionate love, the way it had been in the beginning.

Peter had come through-for her and their sputtering relationship. She knew it wasn't easy for him. He honestly believed that, on balance, traditional western medicine had become so lost in science, competitive pharmacology, and dehumanizing technology that it now did more harm than good. In fact, above his desk was a placard engraved:

IATROGENIC: ILLNESS OR INJURY CAUSED BY THE WORDS OR ACTIONS OF A PHYSICIAN

Now the chance was right there for him to belittle her judgment-to once again force his famous views on M.D.s and their methods down her throat. But he hadn't taken it.

Like Peter, she understood the miraculous potential in the relationship between healer and patient. She had great faith in the power of holistic methods to diagnose and treat. But unlike him, she had never viewed traditional medicine as a court of last-or no-resort. After all, she had once survived a nearly fatal ruptured appendix by getting airlifted to a U.S. military hospital and having emergency surgery.

Peter was forty-a dozen years older than she. That age difference, along with his imposing size-he was six feet four-his immense drive and material successes made holding her own in their relationship a challenge and asserting herself in it almost a pipe dream. But at last Peter had chosen to listen rather than to react: to understand that his way of doing things might not be the only way.

They took the following morning off from work and spent a good deal of it making love. By the time Sarah arrived at the institute to begin seeing a full afternoon of appointments, she was feeling more centered and positive about her life than she had in some time.

By three o'clock, though, she began wondering why she hadn't heard from the neurologist at White Memorial. At least some of his evaluation of Henry McAllister should have been completed by then. If her observations of the artist's motor problems were correct, an emergency CT scan and several other tests were in order. The physician had promised to call Sarah at her office as soon as he had anything to report.

Three-thirty… four… four-thirty…

She checked the time again and again as she worked her way through her clients. Finally, after the last of them had left, she called White Memorial.

"Miss Baldwin, I assumed you knew," the neurologist said.

"Knew what?" She felt a sudden, unpleasant tightness in her throat.

"When I arrived at the office this morning, there was a message waiting with my answering service from your Mr. McAllister. He called at, oh, ten o'clock last night to say that he had spoken with his own medical advisor and would not be keeping his appointment with me. I thought that by medical advisor he meant you."

"No," she said. "No, I'm afraid he meant someone else. Thank you, Doctor."

"Well, I'm sorry I couldn't have been of more-"

She was already lowering the receiver to its cradle. She stalked down the hall to Peter's office. He was leaning back in his chair, his feet up on the corner of his desk.

"Peter, why didn't you tell me last night that you called Henry McAllister?"

"I didn't think it was that important."

"Important? I probably gave myself an ulcer agonizing over the decision to refer him."

"Well, now you don't have to worry about it anymore." He lowered his feet to the floor.

"But you said I did the right thing."

"And you did. The right thing for you. But not necessarily the right thing for Henry."

"But how do you know? How could you tell him to cancel that appointment without even seeing him?"

"First of all, I don't believe there's much an M.D. can do that our people can't do as well or better. You know that. And second, I didn't tell him to cancel his appointment. I told him that he should use his judgment, and that no matter what he decided, I would be available to see him all day today. He need only call and set up a time to come in."

"And did he call?" She felt her pulse begin pounding in her temples. Her cheeks were burning. She wanted to leap over the man's desk and pummel the self-assuredness off his face. "Well, did he!"

Peter's expression tightened.

"I–I guess in all the excitement going on here today I forgot to check." He glanced at his message spindle and then called the receptionist. "It seems he didn't feel the need to call," he said as he hung up.

"Peter, you are really a son of a bitch. Do you know that?"

She whirled and hurried back into her office.

"Hey, easy does it, babe," he called after her. "Easy does it."

Henry McAllister's clinic record was on her desk. She dialed his number and let the phone ring a dozen or more times. Then she dialed 911. If she was wrong, she'd look like a fool. But there was no way she could let matters drop. For the first time in three years, she felt as if she were reacting to a challenging situation like Sarah Baldwin, and not like Peter Ettinger's flunky.

Peter was just coming out of his office as she raced past him, down the stairs, and out of the institute. He called to her, but she never even looked back.

McAllister lived in a South End loft about ten blocks away. She thought briefly about looking for a cab. Then she just gritted her teeth, clenched her fists, and sprinted off…

"So?" Alma Young asked.

"Pardon?"

"So what happened to the sculptor? You can't leave me hanging like that!"

"Oh, sorry," Sarah said, uncertain of precisely how much of her thoughts she had actually shared. "Well, in that particular situation, if I had accepted that what I had already done was everything I could do, the man would probably have died. The police ended up breaking into his apartment. We found him unconscious on the floor. Two hours later he was in the operating room at White Memorial. He had a slowly growing malignancy-a meningioma, actually-on the right side of his brain. And as sometimes happens, he had begun bleeding into the tumor. Pressure was building inside his skull."

"Thank God you reached him in time." Alma gasped, genuinely relieved at the fate of a man whose crisis had occurred seven years before.

Sarah smiled at the nurse's reaction.

"I was allowed into the operating room to watch them take the tumor out. It was really incredible. That's when I decided I wanted to be a surgeon of some sort. Eventually I settled on OB/Gyn."

"And the other man? Your… um… friend?"

Sarah shrugged. "I moved out the next day, and we haven't spoken since."

"That's quite a story."

"And part of the reason that I'm never comfortable accepting that I've done all I can for a patient."

"Maybe. But I still say you'll be better off when you admit you're only human. Doctors today have remarkable capabilities, but they still aren't God. Never were, never will be. If you can't come to grips with the fact that in spite of your best efforts, some of your patients are going to lose their baby, or lose their arm, or both, or worse, then sooner or later this racket's going to eat you alive."

"I understand."

"Do you?"

"Yes. Yes, I do."

Alma Young reached over and gave Sarah a reassuring hug. "In that case, Dr. Baldwin, I don't want to see you beating up on yourself because a horrible condition you had nothing to do with took that girl's baby and arm. I want to hear you bragging from the rooftops about what you did yesterday to help save her life. It was big, big stuff for this hospital. And everyone who cares about MCB will be crowing right alongside of you. Got that?"

Sarah managed a smile.

"Cock-a-doodle doo," she said.

The doors to the SICU glided open, and Lisa was wheeled in by a transportation worker and a nurse. Andrew Truscott followed moments later. The night he had just spent in the OR showed in the faint shadows enveloping his eyes, but no one would have guessed that he was into his second straight day without sleep. It was a phenomenon Sarah had noticed in herself as well. With each passing year of surgical training, sleep deprivation had fewer biologic effects-as far as she could tell.