Robin Cook - Death Benefit

“I’m so sorry to hear about your boys,” Pia offered.

“I’m not telling you this to elicit any sympathy. I’m telling you this so that you understand me better. I have never ever agreed to mentor anyone, and it is not just because my Asperger’s puts me at a social disadvantage. I feel I don’t have the time for other people’s nonsense, and this includes Ph.D. students as well as medical students. You were a first. I thought your foster care experience would make you thrive in the lonely pursuit of science and that you should have been given a chance.”

“I think you’re right,” Pia said. “I know I struggle with social issues as well.”

“Pia, commitment to research has to be total. Two days ago you came in here and told me that, yes, you were going to take me up on my offer to do your Ph.D. here in my lab. At the same time you told me you were going to do a simultaneous residency in internal medicine. And then you expected me to be pleased. Pia, that old myth of the doctor doing both clinical medicine and research at the same time is totally passe. It wasn’t even true when it was current. Research is more than a full-time job.”

For one of the first times in their three and a half years of knowing each other, Pia and Rothman held each other’s eyes. It was a kind of Mexican standoff. Both were conflicted. Pia had struggled hard and surmounted considerable obstacles in her drive to become a doctor. And now she was so close. In months she would be getting her M.D. degree. The problem was she wouldn’t yet be a doctor, one that can get a license from the state. A resident was on his or her way to becoming a real doctor. If she didn’t take a residency, she’d always be a medical student with an M.D.

Both individuals looked away.

“I realize that I’m hard to read,” Rothman said, breaking a short silence, “or at least my wife tells me so. She advised me to have a conversation with you.”

“She knows about me?”

“She knows about everything in my life. It is the only way we could have survived as a couple. I’m not easy to live with.”

Rothman had been rehearsing this speech for days so he was relatively comfortable once he had started talking.

“What I seek in a colleague is commitment. A med school graduate knows nothing. No offense. But if they’re able to pass through medical school it means they have the basic intellectual wherewithal to do research. After the initial flash of inspiration that tells you what to look for, most of the success in research lies in doggedness. In covering every angle, tracking down every lead. I’m mixing metaphors but you know what I mean. Dr. Yamamoto was in fact a rather mediocre student, but he exhibited more application than ten other men who had better grades. I can already tell what kind of doctors your colleagues will be. Ms. Wong is desperate to help sick people, and she’ll be very good at it. Mr. McKinley will probably end up doing something flashy but unchallenging, like surgery, and worse yet, plastic surgery.”

Pia didn’t know what to say.

“I’m pleased you made the right decision about the nuns. It shows me that you’re orienting yourself in the direction of research, but I don’t want you to make the same mistakes I made. For me, doing a residency in internal medicine was a big waste of time.”

Rothman paused.

“I think we’re similar in a number of ways.”

Pia’s eyes opened wide, and she flushed and looked down at her feet. She didn’t share Rothman’s newfound comfort in discussing such personal matters.

“I need more help here. Dr. Yamamoto can’t do everything, and I can’t rely on med students rotating in and out of the lab. No offense. The two of us are spread thin, working on salmonella and organogenesis at the same time. But the university is committed to helping us, and I hope we’ll be able to add laboratory staff and take over more lab space to ramp up our organogenesis work. We need at least another researcher. Which is why I’m talking to you about commitment. Although I usually have no time for excuses, tell me why you were late the last couple of days.”

“There’s no excuse, really,” Pia admitted. “But I’ve been having trouble sleeping.” Silently she cursed George for her getting accustomed to him waking her up even though she knew it was totally unfair.

“Why have you been having trouble sleeping? Anxiety?”

“Nightmares.”

“About what, if I may ask?”

“Childhood memories. Ancient history.”

“Pia, I think I need to know more about you. You’ve told me little about yourself even though I’ve tried to be open with you about me.”

“What do you want to know?”

“Everything!”

Pia took a deep breath. Occasionally in life there is a key crossroads moment that can be identified as such even as it’s taking place. Pia understood she couldn’t hide or keep quiet. The time to talk was now. Except with her caseworker, Sheila Brown, she’d never talked about her childhood. She took another breath. She felt as if the room were closing in on her. The only light in the room was a small library light on the desk, which put Rothman’s face in shadowy relief.

“I do remember my mother-not much, just little things. She was also a Pia. My first name is actually Afrodita, but we were both called Pia. Sometimes out of the blue, a scent on someone or a gesture will make me think of her. But she died when I was little. I don’t know how, and I don’t even know how I know she died, but I do. I lived somewhere in the city with my father, Burim, and his older brother, Drilon, who stayed with us. They were Albanians, real Albanians, just off the boat, very rough around the edges. My father was away a lot, and I had to spend time with my uncle, who was a real creep. Have you got any water or anything?” Pia’s throat was dry.

Rothman got out a bottle from a small fridge under the Nespresso machine. He pushed it and a cup across the desk’s leather surface.

“He hit me a couple of times, my uncle. He used to touch me, never when my father was around, he was very careful. He made me touch him inappropriately, to say the least. He took pictures of me, you know, and developed them himself, and I think he used to sell them to other creeps like him. It developed into a side business for him. One night I had enough, and I went for him.”

“What did you do?”

“I tried to stab him in the penis with a pair of scissors. Unfortunately I missed the target. It bled a lot. I remember later during first-year anatomy when the professor was talking about the femoral artery and joked about how you should avoid puncture wounds there. I suppose that’s where I must have stabbed my uncle.

“When he got out of the hospital, he beat me up pretty well, and I guess someone called nine-one-one about a little girl with a bruised face because the police came and grabbed me. My uncle and my dad both got arrested. So I became the property of New York City Child Protective Services.”

Pia took another drink of water.

“And your father?”

“He vanished. Years later I made Sheila Brown, my final and best caseworker, tell me what happened. She managed to find out that the two of them made bail and disappeared into the city. I’ve no idea where he is, if he’s even alive. I guess I convinced myself that my father wasn’t to blame for what his brother did to me. When I was in foster care, I used to fantasize that he would suddenly appear and rescue me from those places I was in, but he never did. I gave up hoping after a few of years.”

“How old were you when you were taken into care?”

“Six. I was a problem for the foster care people from the get-go. My father hadn’t officially given up his parental rights, so I couldn’t be adopted. He had to register with Child Services before-I wasn’t in school, I guess-and genius that he was, he said I was a Muslim, which, as an Albanian, he may have been. Sheila said he must have thought I’d get better treatment if I was a minority, but it just meant none of the religious agencies wanted me. Back then the system was dominated by Catholic, Protestant, and Jewish organizations. So instead of having a chance at some reasonably appropriate placement, I was put in a kind of temporary group home, and a janitor there tried to abuse me like my uncle did, but I fought him off. I complained about it, and I guess that marked me down as a troublemaker.