Robin Cook - Fever

“Are you talking about whether Michelle should be told she has leukemia?” asked Cathryn.

“That’s part of it,” agreed Dr. Keitzman.

Cathryn looked at Charles, but he had his eyes closed again. Dr. Wiley returned her gaze with a sympathetic expression that made Cathryn feel a modicum of reassurance.

“Well,” said Dr. Keitzman, “it is an issue that demands thought. No decision has to be made now. For the time being, Michelle can be told that we are trying to figure out what’s wrong with her. Before we go, does Michelle have any siblings?”

“Yes,” said Cathryn. “Two brothers.”

“Good,” said Dr. Keitzman. “They should be typed to see if they match Michelle’s HLA and ABO loci. We’re probably going to need platelets, granulocytes, and maybe even marrow, so I hope one of them matches.”

Cathryn looked at Charles for support but his eyes were still closed. She had no idea what Dr. Keitzman was talking about but she assumed Charles did. But Charles seemed to be having more trouble than she was with the news.

On the way up in the elevator, Charles fought to control himself. He’d never before experienced such painfully conflicting emotions. On the one hand he could not wait to see his daughter, to hold her and protect her; on the other he dreaded seeing her because he was going to have to come to terms with her diagnosis. And in that sense he knew too much. She would see it in his face.

The elevator stopped. The doors opened. Ahead stretched a pale blue hall with pictures of animals affixed like decals directly on the paint. It was busy with pajama-clad children of a variety of ages, nurses, parents, even hospital maintenance men grouped about a stepladder fixing the lights.

Dr. Wiley led them down the hall, skirting the ladder and passing the busy nurses’ station. The charge nurse, seeing Dr. Wiley from behind the chart racks, scurried out and caught up with them. Charles glanced down at the floor and watched his feet. It was as if he were looking at someone else. Cathryn was beside him with her arm thrust under his.

Michelle had a single room, painted the same shade of pastel blue as the hallway. On the left wall beside the door to the lavatory was a large, dancing hippopotamus. At the end of the room was a shaded window. To the right was a closet, a bureau, a night table, and a standard hospital bed. At the head of the bed was a stainless steel pole supporting a small plastic bag as well as an IV bottle. The plastic tubing snaked down and entered Michelle’s arm. She turned from looking out the window when she heard the group enter.

“Hello, peanuts,” said Dr. Wiley brightly. “Look who I brought to see you.”

At the first glimpse of his daughter, Charles’s dread of seeing her vanished in a wave of affection and concern. He rushed up to her and scooped her head in his arms, pressing her face against his. She responded by throwing her free arm around his neck and squeezing.

Cathryn stepped around the bed to the opposite side. She caught Charles’s eye and saw that he was struggling to hold back tears. After a few minutes, he reluctantly released his hold, lowering Michelle’s head to the pillow, and smoothing out her rich, dark hair to form a fan about her pale face. Michelle reached out for Cathryn’s hand and grasped it tightly.

“How are you?” asked Charles. He was afraid that his precarious emotional state was apparent to Michelle.

“I feel fine now,” said Michelle, obviously overjoyed to see her parents. But then her face clouded and turning to Charles, she asked: “Is it true, Daddy?”

Charles’s heart leaped in his chest. She knows, he thought with alarm. He glanced at Dr. Keitzman and tried to remember what he had said about the proper psychological approach.

“Is what true?” asked Dr. Wiley casually, coming to the foot of the bed.

“Daddy?” pleaded Michelle. “Is it true I have to stay overnight?”

Charles blinked, at first unwilling to believe that Michelle wasn’t asking him to confirm the diagnosis. Then when he was sure she didn’t know she had leukemia, he smiled with relief. “Just for a few nights,” he said.

“But I don’t want to miss school,” said Michelle.

“Don’t you worry about school,” said Charles with a nervous laugh. He eyed Cathryn for a moment who also laughed in the same hollow fashion. “It’s important that you stay here for some tests so that we can find out what’s causing your fever.”

“I don’t want any more tests,” said Michelle, her eyes widening in fright. She’d had enough pain.

Charles was struck by how tiny her body was in the hospital bed. Her narrow arms looked incredibly frail as they poked out of the sleeves of the hospital gown. Her neck, which had always seemed substantial, now looked about the size of his forearm; she had the appearance of a delicate and vulnerable bird. Charles knew that somewhere in the heart of her bone marrow was a group of her own cells waging war against her body. And there was nothing he could do to help her—absolutely nothing.

“Dr. Wiley and Dr. Keitzman will only do the tests they absolutely need,” said Cathryn, stroking Michelle’s hair. “You’re going to have to be a big girl.”

Cathryn’s comment awakened a sense of protectiveness in Charles. He recognized he couldn’t do anything for Michelle, but at least he could protect her from unnecessary trauma. He knew too well that patients with rare diseases were often subjected to all sorts of physical harassment at the whim of the attending physician. With his right hand, Charles twisted the soft plastic bottle so he could see the label. Platelets. With his hand still holding the bottle, he turned to Dr. Wiley.

“We felt she needed platelets immediately,” said Dr. Wiley. “Hers were only about twenty thousand.”

Charles nodded.

“Well, I’ve got to be going,” said Dr. Keitzman. Grasping one of Michelle’s feet through the covers he said, “I’ll be seeing you later, Miss Martel. Also there will be a few other doctors coming in to talk to you sometime today. We’ll be giving you some medicine in that tube, so keep your arm nice and still.”

Charles peered at the plastic tube: Daunorubicin! A fresh wave of fear washed over him, accompanied by a new urge to reach down and snatch his beloved daughter from the clutches of the hospital. An irrational thought passed through his mind: maybe the whole nightmare would disappear if he got Michelle away from all these people.

“I’m available anytime at all if you’d like to speak to me,” said Dr. Keitzman as he moved to the door.

Cathryn acknowledged the offer with a smile and a nod. She noticed that Charles didn’t look up from Michelle. Instead he sat on the edge of the bed and whispered something in her ear. Cathryn hoped his silence would not further antagonize the oncologist.

“I’ll be right outside,” said Dr. Wiley, following Dr. Keitzman. The charge nurse who hadn’t spoken left, too.

In the hall Dr. Keitzman slowed his steps, giving Dr. Wiley a chance to catch up. Together they walked toward the nurses’ station.

“I think Charles Martel is going to make this a very difficult case,” said Dr. Keitzman.

“I’m afraid you’re right,” agreed Dr. Wiley.

“If it weren’t for that poor sick child, I’d tell Martel to stuff it,” said Dr. Keitzman. “Could you believe that bullshit about withholding chemotherapy? God! You’d think that someone in his position would know about the advances we’ve made with chemotherapy, especially in lymphocytic leukemia and Hodgkin’s.”

“He knows,” said Dr. Wiley. “He’s just angry. It’s understandable, particularly when you know he’s been through all this when his wife died.”

“I still resent his behavior. He is a physician.”