Robin Cook - Mindbend

A woman entered the office and came up to the reception desk, and Adam stepped out of the way, thinking that Smyth’s problem was similar to the case of tardive dyskinesia that he had discussed in his presentation at the medical school. In that case the cause was an unexpected reaction to tranquilizers.

“Do you know if Dr. Smyth had any psychiatric problems?” Adam asked once the patient was seated.

“I don’t think so,” said Christine. “He was one of the nicest young men. Looks a little bit like you. Dark, curly hair.”

“What hospital is he in?” asked Adam.

“He was admitted to University, but I heard one of the nurses say that he was going to be transferred to the Julian Clinic.”

The phone rang again, and Christine reached for it.

“One last question,” said Adam. “Did Foley or Smyth go on a Conference Cruise like Dr. Vandermer?”

“I think they both did,” said Christine, lifting the phone. “GYN Associates, could you please hold?” Turning back to Adam, she asked, “Would you like to see either Dr. Stens or Dr. Baumgarten?”

“Not today,” said Adam. “Another time, when things aren’t quite so hectic. Give my best to DJ.”

Christine gave Adam a thumbs-up sign and pushed the blinking button on the telephone.

Leaving the office, Adam felt he could no longer ignore the strange coincidences relating to the Julian Clinic. Why had so many doctors abruptly left their practices to work there? And why, after doing so, had Vandermer suddenly decided to prescribe pregdolen to Jennifer? As unpleasant as this last interview would be, Adam felt he had no choice but to confront the obstetrician. He had to convince him either to treat Jennifer without medication or to relinquish her as a patient. Adam knew he couldn’t persuade his wife to change physicians on his own.

As he approached the southern limits of Harlem, he saw the clinic towering over the surrounding tenements. Admiring its mirrored surface, Adam realized that it must have been designed by the same architects who had built Arolen headquarters. The office building was better suited to its surroundings. The clinic struck Adam as a twenty-first-century vision flung into a two-hundred-year-old setting.

A half block away Adam found a parking spot and backed into it. Taking his briefcase in case he needed to disguise his visit as a sales call, he jogged up the broad steps to the clinic’s entrance.

The moment he walked inside his suspicions dissipated. He had intended to march through the lobby to the OB-GYN section as if he were a member of the staff. From his experience as a medical student he knew that if someone acted as if he belonged, he could go anywhere in a hospital. But the relaxed atmosphere of the Julian changed his mind. He walked directly up to the large information booth and said he wished to speak with Dr. Vandermer.

“Certainly,” said the receptionist. She picked up a phone and relayed Adam’s request. “The doctor is in,” she said, smiling broadly. “Do you know how to get to the GYN clinic?”

“Maybe I should ask the doctor if he has time to see me. I want to talk to him about my wife.”

“Of course he’ll see you,” she said, as if Adam had lost his senses. “Let me call one of the orderlies.” She pressed a small bell on the counter and a young man in blue shirt and white chino pants appeared. The receptionist gave him instructions.

He led Adam down a long central hallway, past a flower shop, a bookstore, a pleasant-looking cafeteria.

“This is an impressive place,” said Adam.

“Yes,” said the young man mechanically.

Adam glanced at him as they walked. He had a broad, expressionless face. Looking more carefully, Adam thought he seemed drugged; he was probably a psychiatric case. A lot of the chronic patients worked in hospitals. It made them feel more confident.

The man left Adam in a lounge that resembled a private living room rather than a hospital waiting room. There was a couch, two chairs, and a small desk. Strange clinic, thought Adam as he walked to the window. The darkened glass gave a peculiar cast to the row houses across the street. He felt as if he were looking at an old photograph.

He wandered back to the couch and began leafing through one of the magazines. A few minutes later the door opened and Dr. Vandermer came in. Adam got hastily to his feet.

The man was imposing, especially in his starched white coat. But he seemed less hostile than at their first meeting.

“Adam Schonberg, welcome to the Julian,” he said.

“Thank you,” said Adam, relieved and at the same time taken aback by Vandermer’s cordiality. “I’m surprised to find you here. I thought you were very happy in your practice.”

“I was at one time,” said Dr. Vandermer. “But fee-for-service medicine is a thing of the past. Here we try to keep people well, instead of just trying to cure them when they are sick.”

Adam noticed that Vandermer’s voice had an oddly flat inflection, as if he were reciting from memory. “I wanted to talk about Jennifer,” he said.

“I assumed as much,” said Dr. Vandermer. “I asked the geneticist to come by.”

“Fine. But first I want to discuss the pregdolen.”

“Has it helped your wife’s nausea?” asked Dr. Vandermer.

“She thinks so,” said Adam. “But I suspect it is simply a placebo effect. What surprises me is that you gave it to her.”

“There are a number of drugs on the market,” said Dr. Vandermer, “but I think pregdolen is the best. Normally, I don’t like to use drugs for morning sickness, but your wife’s had gone on too long.”

“But why pregdolen?” said Adam tactfully. “Especially after the negative report in the New England Journal. ”

“That was a poorly designed study,” said Dr. Vandermer. “They didn’t use the proper controls.”

Unwilling to confront Vandermer directly, Adam finally said, “But you told me the last time we spoke that pregdolen was dangerous. What’s made you change your mind?”

Dr. Vandermer shook his head, puzzled. “I’ve never said the drug was dangerous. I’ve been using it for years.”

“I distinctly remember…” began Adam as two other doctors entered the lounge. One was a tall, thin man with gray hair. He was introduced as Dr. Benjamin Starr, the Julian Clinic’s geneticist.

“Dr. Starr and I were just discussing your wife’s case this morning,” said Dr. Vandermer.

“Indeed,” said Dr. Starr, launching into a detailed description of the case. His voice had the same flat inflection as Vandermer’s, making Adam wonder if all the doctors at the Julian Clinic worked themselves to death.

Adam tried to understand what Starr was saying, but the man seemed to be speaking deliberately over Adam’s head. After trying to make sense out of the reasons given for Jennifer’s amniocentesis, Adam decided he was wasting his time. It was as if both Vandermer and Starr were trying to confuse him. As soon as he could, Adam said he had to leave. Dr. Vandermer offered to buy him lunch in the cafeteria, but Adam insisted he had to go.

Walking down the hall, he decided Jennifer was right. Dr. Vandermer was a changed man, and it made Adam nervous. In fact, the whole clinic struck a false note. Looking at the beautifully decorated rooms, he could understand why the Julian had such appeal. It seemed the ideal hospital environment. At the same time, it was almost too nice and, to Adam’s mind, slightly sinister.

Back in the car, Adam hesitated before turning on the ignition. There was no doubt in his mind that Vandermer had originally proclaimed pregdolen dangerous and all that super-scientific rhetoric about Jennifer needing amniocentesis alarmed him. With his wife sequestered at her parents’, his hands were tied. The only thing he was sure of was that he did not want Jennifer taking pregdolen, which meant that he didn’t want her to keep seeing Vandermer. The problem was that she obviously trusted Vandermer and didn’t want to change doctors.