Robin Cook: Fever

“I just feel a little weak, that’s all. I can go to school. Really I can.”

“Sore throat?”

“A little. Not much. Cathryn said I couldn’t go to school.”

“Anything else? Headache?”

“A little but it’s better.”

“Ears?”

“Fine.”

“Stomach?”

“Maybe a little sore.”

Charles depressed Michelle’s lower lids. The conjunctiva was pale. In fact, her whole face was pale. “Let me see your tongue.” Charles realized how long it had been since he’d done clinical medicine. Michelle stuck out her tongue and watched her father’s eyes for the slightest sign of concern. Charles felt under the angle of her jaw and she pulled her tongue back in. “Tender?” asked Charles as his fingers felt some small lymph nodes.

“No,” said Michelle.

Charles had her sit on the edge of the bed, facing away from him, and he began to draw up her nightgown. Jean Paul’s head came into the room from the connecting bathroom to tell her the shower was free.

“Get out of here,” yelled Michelle. “Dad, tell Jean Paul to get out.”

“Out!” said Charles. Jean Paul disappeared. He could be heard laughing with Chuck.

Charles percussed Michelle’s back somewhat clumsily but well enough to be convinced that her lungs were clear. Then he had her lie back on her bed, and he drew her nightgown up to just below her nascent breasts. Her thin abdomen rose and fell rhythmically. She was thin enough for him to see the recoil of her heart after each beat. With his right hand, Charles began to palpate her abdomen. “Try to relax. If I hurt you, just say so.”

Michelle attempted to remain still but she squirmed beneath Charles’s cold hand. Then it hurt.

“Where?” asked Charles. Michelle pointed and Charles felt very carefully, determining that Michelle’s abdomen was tender at the midline. Putting his fingers just beneath the right ribs he asked her to breathe in. When she did, he could feel the blunt edge of her liver pass under his fingers. She said that hurt a little. Then with his left hand under her for support, he felt for her spleen. To his surprise he had no trouble palpating it. He’d always had trouble with that maneuver when he was in practice and he wondered if Michelle’s spleen wasn’t enlarged.

Standing up, he looked at Michelle. She seemed thin, but she’d always been slender. Charles started to run his hand down her legs to feel the muscle tone, then stopped, noticing a series of bruises. “Where’d you get all these black-and-blue marks?”

Michelle shrugged.

“Do your legs bother you?”

“A little. Mostly my knees and ankles after gym. But I don’t have to go to gym if I have a note.”

Straightening up again, Charles surveyed his daughter. She was pale, had minor aches and pains, a few lymph nodes, and a fever. That could be just about any minor viral illness. But four weeks! Maybe Cathryn was right. Maybe she should be seen by a “real” doctor.

“Please, Dad,” said Michelle. “I can’t miss any more school if I’m going to be a research doctor like you.”

Charles smiled. Michelle had always been a precocious child and this indirect flattery was a good example. “Missing a few days of school in the sixth grade is not going to hurt your career,” said Charles. “Cathryn is going to take you to Pediatric Hospital today to see Dr. Wiley.”

“He’s a baby doctor!” said Michelle defiantly.

“He’s a pediatrician and he sees patients up to eighteen, smarty pants.”

“I want you to take me.”

“I can’t, dear. I’ve got to go to the lab. Why don’t you get dressed and come down for some breakfast?”

“I’m not hungry.”

“Michelle, don’t be difficult.”

“I’m not being difficult. I’m just not hungry.”

“Then come down for some juice.” Charles lightly pinched Michelle’s cheek.

Michelle watched her father leave her room. Her tears welled up anew. She felt horrid and did not want to go to the hospital but worst of all, she felt lonely. She wanted her father to love her more than anything in the world and she knew that Charles was impatient when any of the kids got sick. She struggled up to a sitting position and braced herself against a wave of dizziness.

“My God, Chuck,” said Charles with disgust. “You look like a pig.”

Chuck ignored his father. He got some cold cereal, poured milk over it, then sat down to eat. The rule for breakfast was that everyone fended for themselves, except for the orange juice which Michelle usually made. Cathryn had made it this morning.

Chuck was wearing a stained sweater and dirty jeans, which he wore so long that he walked on the frayed bottoms. His hair was uncombed and the fact that he hadn’t shaved was painfully apparent.

“Do you really have to be so sloppy?” continued Charles. “I thought that the hippie look was passé now and that college kids were becoming respectable again.”

“You’re right. Hippie is out,” said Jean Paul, coming into the kitchen and pouring orange juice. “Punk is in now.”

“Punk?” questioned Charles. “Is Chuck punk?”

“No,” laughed Jean Paul. “Chuck is just Chuck.”

Chuck looked up from his cereal box to mouth some obscenities at his younger brother. Jean Paul ignored him and opened his physics book. It occurred to him that his father never noticed what he wore. It was always Chuck.

“Really, Chuck,” Charles was saying. “Do you honestly feel you have to look that bad?” Chuck ignored the question. Charles watched the boy eat with growing exasperation. “Chuck, I’m speaking to you.”

Cathryn reached over and put her hand on Charles’s arm. “Let’s not get into this discussion at breakfast. You know how college kids are. Leave him be.”

“I think I at least deserve an answer,” persisted Charles.

Taking in a deep breath and blowing it out noisily through his nose to punctuate his annoyance, Chuck looked into his father’s face. “I’m not a doctor,” he said. “I don’t have to adhere to a dress code.”

The eyes of the father and the older son met. Chuck said to himself: “Take that, you smart-ass son-of-a-bitch, just because you got good grades in chemistry you think you know everything, but you don’t.” Charles examined the face of this son of his, marveling how much arrogance the boy could manufacture with so little basis. He was intelligent enough but hopelessly lazy. His performance in high school had been such that Harvard had rejected him, and Charles had a feeling that he wasn’t doing well at Northeastern. Charles wondered where he, as a father, might have gone wrong. But such musing was made difficult by the personality of Jean Paul. Charles glanced at his other son: neat, easygoing, studious. It was hard to believe that both boys had sprung from the same genetic pool and grown up together. Charles’s attention returned to Chuck. The boy’s defiance had not altered, but Charles felt his interest in the issue wane. He had more important things to think about.

“I hope,” said Charles evenly, “your appearance and your grades have nothing in common. I trust you are doing all right at college. We haven’t heard much about that.”

“I’m doing all right,” said Chuck, finally dropping his eyes back to his cereal. Standing up to his father was something new for Chuck. Before he’d gone to college, he had avoided any confrontation. Now he looked forward to it. Chuck was sure that Cathryn noticed and approved. After all, Charles was a tyrant with Cathryn as well.

“If I’m going to drive the station wagon into Boston, I’m going to need some extra cash,” said Cathryn, hoping to change the subject. “And speaking of money, the oil people called and said they won’t deliver until the account is settled.”