Robin Cook - Mindbend

When he reached the apartment, he was surprised to find the police lock unengaged. He pushed open the door and saw Jennifer and her mother.

“Hi,” he said, quite amazed. “This is a nice surprise.”

“I was hoping to catch you before you went to Puerto Rico,” said Jennifer.

“I’m not going to Puerto Rico,” said Adam.

“I don’t think you should be going anyplace,” said Mrs. Carson. “Jennifer has had a shock and she needs your support.”

Adam put his things on the desk and turned to Jennifer. She did look pale.

“What’s the matter?” asked Adam.

“Dr. Vandermer gave her some bad news,” replied Mrs. Carson.

Adam did not take his eyes from Jennifer’s face. He wanted to tell Mrs. Carson to shut up, but instead he stood directly in front of his wife. “What did Dr. Vandermer say?” he asked gently.

“The amniocentesis was positive. He said our baby is severely deformed. I’m so sorry, Adam. I think I’ll have to have an abortion.”

“That’s impossible,” said Adam, slamming his fist into his palm. “It takes weeks to do the tissue cultures after an amniocentesis. What the hell is wrong with this Vandermer?”

Adam strode to the phone.

Jennifer burst into tears. “It’s not Dr. Vandermer’s fault,” she sobbed, explaining that the abnormality was so severe that tissue cultures weren’t needed.

Adam hesitated, trying to remember what he’d read. He couldn’t recall any cases where tissue culture wasn’t needed.

“That’s not good enough for me,” he said, putting through a call to the Julian Clinic. When he asked for Dr. Vandermer, he was put on hold.

Mrs. Carson cleared her throat. “Adam, I think that you should be more concerned about Jennifer’s feelings than about Dr. Vandermer.”

Adam ignored her. The Julian Clinic operator came back on the line and told Adam that Dr. Vandermer was doing a procedure but would call back. Adam gave his name and number and then dropped the receiver into its cradle.

“This is crazy,” he mumbled. “I had a strange feeling about the Julian Clinic. And Vandermer…” He didn’t finish the sentence.

“I think the Julian Clinic is one of the finest hospitals I’ve ever been in,” said Mrs. Carson. “And except for my own doctor, I’ve never met a more caring man than Dr. Vandermer.”

“I’m going over there,” said Adam, ignoring his mother-in-law. “I want to talk to him in person.” Picking up his keys, Adam strode toward the door.

“What about your wife?” demanded Mrs. Carson.

“I’ll be back.” Then he left, slamming the door behind him.

Mrs. Carson was furious. She couldn’t believe that she had originally favored the marriage. Hearing Jennifer weep, she decided it was better not to say anything. She went over to her daughter, murmuring, “We’ll go home. Daddy will take care of everything.”

Jennifer didn’t object, but when she got to the door, she said, “I want to leave Adam a note.”

Mrs. Carson nodded and watched Jennifer write a short note at Adam’s desk, then put it on the floor by the door. It said simply: “Gone home. Jennifer.”

Adam drove uptown like an aggressive New York City cabbie, pulled directly in front of the Julian Clinic, and jumped out of the car. A uniformed security guard tried to stop him, but Adam merely called over his shoulder that he was Dr. Schonberg and it was an emergency.

When he reached Gynecology, the receptionist acted as if he were expected.

“Adam Schonberg,” she said. “Dr. Vandermer said for you to wait in his office.” She pointed down another corridor. “It’s the third door on the left.”

Adam thanked the girl and went to the office she’d indicated. The room was impressive, the shelves filled with books and medical journals. Adam glanced at a row of model fetuses, feeling an uncharacteristic urge to vandalize the place. He wandered over to the desk. It was a large, inlaid affair with claw feet. On top was a pile of typed operative notes awaiting signatures.

Dr. Vandermer came in almost immediately. He was carrying a manila folder under his arm.

“Won’t you sit down?” he suggested.

“No, thank you,” said Adam. “This won’t take long. I just wanted to confirm my wife’s diagnosis. I understand you believe she’s carrying a chromosomally defective child.”

“I’m afraid so,” said Dr. Vandermer.

“I thought it took weeks to do tissue cultures,” said Adam.

Dr. Vandermer looked Adam directly in the eye. “Normally, that is true,” he said. “But in your wife’s case there were plenty of cells for us to examine directly in the amniotic fluid. Adam, as a medical student, I’m sure you understand these things happen. But as I told your wife, you’re both young. You can have other babies.”

“I want to see the slides,” said Adam, preparing himself for an argument. But Vandermer just nodded and said, “Why don’t you follow me?”

Adam began to wonder if he’d been too hasty in his judgment. The man seemed genuinely sorry to be the bearer of such bad news.

On the fourth floor Vandermer led Adam to the cytology lab. Adam blinked as they went through the door. Everything was white: walls, floor, ceiling, and countertops. At the back of the room was a lab bench with four microscopes. Only one was in use, and a middle-aged brunette woman looked up as Dr. Vandermer approached.

“Cora,” he asked, “I hate to bother you, but could you get us the slides on Jennifer Schonberg?”

Cora nodded and Vandermer motioned for Adam to sit down at a teaching microscope with dual viewing heads.

“I don’t know if you wanted to see the B scan ultrasonography or not,” said Dr. Vandermer, “but I brought it anyway.” He opened the folder he’d been carrying and handed the images to Adam.

As a medical student, Adam had not had any experience with ultrasonography, and the pictures looked like inkblots to him. Dr. Vandermer took the photo that Adam was examining, turned it over, and outlined the developing fetus with the tip of his finger. “The technique is getting better and better,” he said. “Here you can plainly see testicles. A lot of times at this age you can’t tell the sex by ultrasound. Perhaps this little guy takes after his father.”

Adam realized Vandermer was doing his best to be friendly.

The door swung open and Cora reappeared with a tray of slides. Each had a tiny cover glass over its center. Dr. Vandermer selected one that had been labeled with a grease pencil. He placed it under the optical head of the microscope, put a drop of oil on it, and lowered the oil-immersion lens. Adam sat up and looked through the eyepiece.

Dr. Vandermer explained that the specimens had been specially stained to make viewing of the chromatin material as easy as possible. He said they had to find a cell in the process of division. Finally, he gave up and asked for Cora’s assistance.

“I should have let you do this in the first place,” he said, changing seats with the woman.

It took Cora about thirty seconds to find an appropriate cell. By manipulating the hairline pointer, she showed Adam the chromosomal abnormality.

Adam was crushed. He had hoped the results would be ambiguous, but even to his inexperienced eye, the problem was clear. Cora continued pointing out other minor problems that had been noticed, including the fact that one of the X chromosomes also appeared slightly abnormal.

Finally, Cora asked if he would like to see another case that demonstrated a more common type of Down’s syndrome.

Adam shook his head. “No, but thanks for your time.” He put both hands on the lab bench and started to rise. Halfway up he stopped. Something was wrong. He leaned forward and peered into the microscope. “Show me that X chromosome abnormality again,” said Adam.