Michael Crichton - A Case of Need

“How long have you been doing this work?”

“Seven years now. I started very slowly, half a day a week. Then it got to be every Tuesday. Pretty soon it was Tuesdays and Thursdays. Then it was all weekend as well. I’ve cut down my practice as much as I can. This work is really addicting.”

“You like it?”

“I adore it. It’s a game, a big wonderful game. A puzzle where nobody knows the answer. If you’re not careful, though, you can become obsessed with the answer. Some people in the biochem department work longer hours than any practicing doctor. They drive themselves. But I won’t let that happen to me.”

“How do you know?”

“Because whenever I feel the symptoms coming on—the urge to work round the clock, to keep going until midnight, or to come in at five in the morning—I say to myself, it’s just a game. I repeat that over and over. And it works: I settle down.”

The cleaver finished the third rat.

“Ah,” Peter said, “halfway there.” He scratched his stomach reflectively. “But enough about me. What about you?”

“I’m just interested in Karen.”

“Ummm. And you wanted to know about an accident? There was none, that I recall.”

“Why were skull films taken last summer?”

“Oh that.” He stroked the fourth victim soothingly and set it on the block. “That was typical Karen.”

“What do you mean?”

“She came into my office and said, ‘I’m going blind.’ She was very concerned, in her own breathless way. You know how sixteen-year-old girls can be: she was losing her vision, and her tennis game was suffering. She wanted me to do something. So I drew some blood and ordered a few tests. Drawing blood always impresses them. And I checked her blood pressure and listened to her and generally gave the impression I was being very thorough.”

“And you ordered skull films.”

“Yes. That was part of the cure.”

“I don’t follow you.”

“Karen’s problems were purely psychosomatic,” he said. “She’s like ninety percent of the women I see. Some little thing goes wrong—like your tennis game—and bang! you have a medical problem. You go to see your doctor. He can find nothing physically wrong with you. But does this satisfy you? No: on to another doctor, and still another, until you find one who will pat your hand and say, ‘Yes, you’re a very sick woman.’” He laughed.

“So you ordered all these tests as a diversion?”

“Largely,” he said. “Not entirely. I believe in caution, and when one hears a complaint as serious as vision loss, one must investigate. I checked her fundi. Normal. I did a visual fields. Normal, but she said it came and went. So I took a blood sample and ordered tests of thyroid function and hormone levels. Normal. And the skull films. They were normal, too, or have you already seen them?”

“I saw them,” I said. I lit a cigarette as the next rat died. “But I’m still not sure why—”

“Well, put it together. She’s young, but it’s still possible—vision and headache, slight weight gain, lethargy. That could be pan hypopituitarism with optic nerve involvement.”

“You mean a pituitary tumor?”

“It’s possible, just possible. I figured the tests would show if she was pan hypopit. The skull films might show something if she was really badly off. But everything came back negative. It was all in her mind.”

“Are you sure?”

“Yes.”

“The labs might have made a mistake.”

“That’s true. I would have run a second test, just to be sure.”

“Why didn’t you?”

“Because she never came back,” Peter said. “That’s the key to it all. One day she comes in near hysteria because she’s going blind. I say come back in a week, and my nurse makes the appointment. A week later, no show. She’s out playing tennis, having a fine time. It was all in her mind.”

“Was she menstruating when you saw her?”

“She said her periods were normal,” he said. “Of course, if she were four months’ pregnant at the time of her death, she would just have conceived when I saw her.”

“But she never came back to you?”

“No. She was rather scatterbrained, actually.” He killed the last rat. All the girls were now busily working. Peter collected the carcasses and put them into the paper bag, then dropped the bag into a wastebasket. “Ah,” he said, “at last.” He washed his hands vigorously.

“Well,” I said, “thanks for your time.”

“Not at all.” He dried his hands on a paper towel, then stopped. “I suppose I ought to make some sort of official statement,” he said, “since I’m the uncle and so forth.” I waited.

“J. D. would never speak to me again if he knew I’d had this conversation with you. Try to keep that in mind if you talk to anybody else.”

“O.K.,” I said.

“I don’t know what you’re doing,” Peter said, “and I don’t want to know. You’ve always struck me as pretty level and sensible, and I assume you’re not wasting your time.”

I didn’t know what to say. I couldn’t see what he was leading up to, but I knew he was leading up to something.

“My brother, at this moment, is neither level nor sensible. He’s paranoid; you can’t get anything out of him. But I understand that you were present at the autopsy.”

“That’s right.”

“What’s the dx [36] See Appendix IV: Abbreviations. there?”

“It’s uncertain on the basis of the gross,” I said. “Nothing clear at all.”

“And the slides?”

“I haven’t seen them yet.”

“What was your impression at autopsy?”

I hesitated, then made my decision. He had been honest with me; I’d be honest with him.

“Not pregnant,” I said.

“Hmmm,” he said. “Hmmmm.”

He scratched his stomach again, then held out his hand.

“That’s very interesting,” he said.

We shook hands.

WHEN I GOT HOME, a big squad car with a flashing light was waiting at the curb. Captain Peterson, still crew-cut and tough-looking, leaned against the fender and stared at me as I pulled into my driveway.

I got out of my car and looked at the nearby houses. People had noticed the flasher and were staring out of their windows.

“I hope,” I said, “that I didn’t keep you waiting.”

“No,” Peterson said with a little smile. “Just arrived. I knocked at the door and your wife said you weren’t back yet, so I waited out here.”

I could see his bland, smug expression in the alternating flashes of red from the light. I knew he had kept the light on to irritate me.

“Something on your mind?”

He shifted his position on the car. “Well, yes, actually. We’ve had a complaint about you, Dr. Berry.”

“Oh?”

“Yes.”

“From whom?”

“Dr. Randall.”

I said innocently, “What kind of complaint?”

“Apparently you have been harassing members of his family. His son, his wife, even his daughter’s college friends.”

“Harassing?”

“That,” said Peterson carefully, “was what he said.”

“And what did you say?”

“I said I’d see what could be done.”

“So here you are.”

He nodded and smiled slowly.

The flasher was beginning to get on my nerves. Down the block, one or two kids were standing in the street, watching in silence.

I said, “Have I broken any law?”

“That hasn’t been determined yet.”

“If I have broken a law,” I said, “then Dr. Randall may go to court about it. Or he may go to court if he feels he can show material damage as a result of my alleged actions. He knows that, and so do you.” I smiled at him, giving him some of his own. “And so do I.”