Michael Palmer - Side Effects

Kate continued staring through the glass as the gargoylelike child-no, woman, for she had to be in her thirties-lumbered aimlessly about the playroom. Reflected in the window, Kate saw the faces of Sally Bicknell and her father-in-law, watching for her reaction. You are the monster, Win Samuels, not that poor thing, her thoughts screamed. What do you think I am, a piece worker in a factory? Did you think this… this demonstration would frighten me? Do you think I know nothing of amniocentesis and prenatal diagnosis and counseling?

Did you think I would just brush off the enormous lie you have been telling my husband for the past thirty years? Why? Why have you brought me here? Why haven't you included Jared?

"Take me home, " she ordered softly. "Take me home now." The antique clock on Win Samuels's huge desk said two-fifty. It had been nearly two hours since Kate had abandoned her efforts to sleep and wandered into the study searching for reading matter distracting enough to close her mind to the events of the evening. Something was wrong. Something did not sit right in the bizarre scenario to which her father-in-law had treated her. But what?

On the ride home from Stonefield, Samuels had quietly assailed her with statistics relating maternal age to infertility, fetal death, chromosome abnormalities, genetic mutation, spontaneous abortions, and mental retardation. He had, over many years apparently, done his homework well.

The few arguments she had managed to give him on the accuracy of intrauterine diagnosis were countered with more facts and more statistics. Still, nothing the man said could dispel her gut feeling that something was not right. At one time during his presentation-for that is what it was-she came close to crying out that their whole discussion was quite possibly a futile exercise, because a production error at Redding Pharmaceuticals might have already cost her any chance of seeing her forties, let alone conceiving in them. From the direction of Samuels's room on the second floor, she heard a door open and then close softly. Seconds later, the sound was repeated further down the hall. Jocelyn Trent had returned to her room. The study, now divested of its fire, was chilly and damp. Kate shuddered and tightened the robe Jocelyn had given her. It was only around midnight in San Diego. Jared wouldn't mind a call, she thought, before realizing that she had forgotten to ask Win at which hotel he was staying. As she reached for a pad and pen to write herself a reminder, she noticed Samuels's Rolodex file. She spun it to "A." The man was right about having a card for the Ashburton Foundation. On it were an address and a number that had been crossed out. A second, apparently newer, address and number were written in below. Kate copied the new address and added a note to check in the morning on Jared's hotel. She glanced at the clock. Three-fifteen. How many surgicals were scheduled for the day? Five? Six? Too many.

Desperate for sleep, she took her note and an anthology of Emily Dickinson and padded up two flights of stairs to her room. Forty-five minutes of reading were necessary before Kate trusted the heaviness in her eyes and the impotence in her concentration enough to flip off the light. The realization that her drowsiness was continuing to deepen brought a relieved, contented smile. Then, in her final moments of consciousness, she sensed a troublesome notion. It appeared, then vanished, then appeared again like a faint neon sign. It was not the trip or the school or even the girl. No, it was the address-the address of the Ashburton Foundation, not the newer Washington, DC, address, but the one that was crossed out. With each flash, the neon grew dimmer, the thoughts less distinct. There was something, she thought at the moment of darkness, something special about Darlington, Kentucky. Something…

Soundlessly, Kate unlocked the heavy oak door and slipped out of her father-in-law's home into the gray glare of morning.

The deserted streets, sidewalks, and stone steps were covered with an immaculate dusting of white. Over the three days past, a blizzard had crushed the midwest and moved, unabated, into the midatlantic states.

Stepping gingerly down Beacon Hill toward Charles Street, Kate wondered if the feathery snow was, perhaps, the harbinger of that storm. She had slept far too little. Her eyes were dry and irritated, her temples constricted by the ache of exhaustion-an ache she had not experienced so acutely since her days as a medical student and intern. She thought about the surgicals scheduled to begin at ten o'clock and run through most of the rest of the day. With tensions thrusting at her life from one direction after another like the spears in some medieval torture, she debated asking one of the others to take over for her. No way, she decided quickly. As it was, the members of her department were stretched beyond their limits. Stan Willoughby's repeated requests for an additional pathologist had been laughed at. No, she was expected to do her part, and she would find whatever concentration it took to do it right. As she made her way toward the cab stand near White Memorial, Kate began her morning ritual of mentally ticking off the events and responsibilities of her day. The cab was halfway to Metro when she ended the ritual, as she inevitably did, by scrambling through her purse for her daily calendar, certain that she had forgotten something crucial.

Her schedule was abbreviated, due largely to a block of time marked simply "surgicals." Penciled in at the bottom was the one item she had forgotten, "Drinks with Tom." The three words triggered a surprising rush of feelings, beginning with the reflex notion to call and cancel, and ending with the sense of what her return home to an empty house would be like. Scattered in between were any number of images of the intense, gangly resident who had been her staunchest supporter during the difficult days that had followed the biopsy of Beverly Vitale. Tom Engleson was a man and a youth, enthusiastic at times even to exuberance, yet sensitive about people, about medicine, and especially about what her career involved and meant to her. The prospect of an hour or two together in the corner of some dark, leather and wood lounge might be just the carrot to get her through the day. "Dammit, Jared, " she muttered as the cab rolled to a stop in front of her hospital. "I need you."

She began her day as she had each of the last several working days, with a visit to Room 421 of the Berenson Building. Ellen was lying on her back, staring at the wall. Her breakfast was untouched on the formica stand by her bed. Suspended from a ceiling hook, a plastic bag drained saline into her arm. "Hi, " Kate said. "Hi, yourself." Ellen's eyes were shadowed. Her skin seemed lacking in color and turgor. Bruises, large and small, lined both arms. There was packing in one side of her nose.

Kate set the Cosmopolitan and morning Globe she had brought on the stand next to the breakfast tray. "Something new's been added, huh? " She nodded toward the IV. "Last night. A little while after you left."

Kate raised Ellen to a sitting position and then settled onto the bed by her knee. "They say why?"

"All they'll tell me is that it's a precautionary measure-"X "Have you had some new bleeding?"

"In my bowel movements, and I guess in my urine, too." She took a glass of orange juice from her tray and sipped at it absently that's probably why the IV, " Kate said. "In case they have to inject any X-ray dye or give you any blood." How much do you want to hear, El? Give me a sign.

Do you want to know about sudden massive hemorrhage? About circulatory collapse sudden and severe enough to make emergency insertion of an intravenous line extremely difficult? Do you want to know about Beverly Vitale. "Listen, Kate. As long as you're on top of what's going on, I'm satisfied."