Michael Crichton - A Case of Need

I went into the drugstore, bought two packs of cigarettes, and made some phone calls from a pay phone. First I called my lab and told them I’d be gone the rest of the day. Then I called Judith and asked her to go over to the Lees’ house and stay with Betty. She wanted to know if I’d seen Art, and I said I had. She asked if he was all right, and I said everything was fine, that he’d be out in an hour or so.

I don’t usually keep things from my wife. Just one or two small things, like what Cameron Jackson did at the conference of the American Society of Surgeons a few years back. I knew she’d be upset for Cameron’s wife, as she was when they got divorced last spring. The divorce was what is known locally as an MD, a medical divorce, and it had nothing to do with conventions. Cameron is a busy and dedicated orthopedist, and he began missing meals at home, spending his life in the hospital. His wife couldn’t take it after a while. She began by resenting orthopedics and ended by resenting Cameron. She got the two kids and three hundred dollars a week, but she’s not happy. What she really wants is Cameron—without medicine.

Cameron’s not very happy, either. I saw him last week and he spoke vaguely of marrying a nurse he’d met. He knew people would talk if he did, but you could see he was thinking, “At least this one will understand—”

I often think of Cameron Jackson and the dozen people I know like him. Usually, I think of him late at night, when I’ve been held up at the lab or when I’ve been so busy I haven’t had time to call home and say I’ll be late.

Art Lee and I once talked about it, and he had the last word, in his own cynical way. “I’m beginning to understand,” he said, “why priests don’t marry.”

Art’s own marriage has an almost stifling sort of stability. I suppose it comes from his being Chinese, though that can’t be the whole answer. Both Art and his wife are highly educated, and not visibly tied to tradition, but I think they have both found it difficult to shake off. Art is always guilt ridden about the little time he spends with his family, and lavishes gifts on his three children; they are all spoiled silly. He adores them, and it’s often hard to stop him once he begins talking about them. His attitude toward his wife is more complex and ambiguous. At times he seems to expect her to revolve around him like a trusting dog, and at times she seems to want this as much as he does. At other times she is more independent.

Betty Lee is one of the most beautiful women I’ve ever seen. She is soft-spoken, gracious, and slender; next to her Judith seems big, loud, and almost masculine.

Judith and I have been married eight years. We met while I was in medical school and she was a senior at Smith. Judith was raised on a farm in Vermont, and is hardheaded, as pretty girls go.

I said, “Take care of Betty.”

“I will.”

“Keep her calm.”

“All right.”

“And keep the reporters away.”

“Will there be reporters?”

“I don’t know. But if there are, keep them away.”

She said she would and hung up.

I then called George Bradford, Art’s lawyer. Bradford was a solid lawyer and a man with the proper connections; he was senior partner of Bradford, Stone and Whitlaw. He wasn’t in the office when I called, so I left a message.

Finally I called Lewis Carr, who was clinical professor of medicine at the Boston Memorial Hospital. It took a while for the switchboard to page him, and as usual he came on briskly.

“Carr speaking.”

“Lew, this is John Berry.”

“Hi, John. What’s on your mind?”

That was typical of Carr. Most doctors, when they receive calls from other doctors, follow a kind of ritual pattern: first they ask how you are, then how your work is, then how your family is. But Carr had broken this pattern, as he had broken other patterns.

I said, “I’m calling about Karen Randall.”

“What about her?” His voice turned cautious. Obviously it was a hot potato at the Mem these days.

“Anything you can tell me. Anything you’ve heard.”

“Listen, John,” he said, “her father is a big man in this hospital. I’ve heard everything and I’ve heard nothing. Who wants to know?”

“I do.”

“Personally?”

“That’s right.”

“Why?”

“I’m a friend of Art Lee.”

“They got him on this? I heard that, but I didn’t believe it. I always thought Lee was too smart—”

“Lew, what happened last night?”

Carr sighed. “Christ, it’s a mess. A real stinking hell of a mess. They blew it in outpatient.”

“What do you mean?”

“I can’t talk about this now,” Carr said. “You’d better come over and see me.”

“All right,” I said. “Where is the body now? Do your people have it?”

“No, it’s gone to the City.”

“Have they performed the post yet?”

“I haven’t any idea.”

“O.K.,” I said. “I’ll stop by in a few hours. Any chance of getting her chart?”

“I doubt it,” Carr said. “The old man has it now.”

“Can’t spring it free?”

“I doubt it,” he said.

“O.K.,” I said, “I’ll see you later.”

I hung up, put in another dime, and called the morgue at the City. The secretary confirmed that they had received the body. The secretary, Alice, was a hypothyroid; she had a voice as if she had swallowed a bass fiddle.

“Done the post yet?” I said.

“They’re just starting.”

“Will they hold it? I’d like to be there.”

“I don’t think it’s possible,” Alice said, in her rumbling voice. “We have an eager beaver from the Mem.”

She advised me to hurry down. I said I would.

IT IS WIDELY BELIEVED IN BOSTON that the best medical care in the world is found here. It is so universally acknowledged among the citizens of the city that there is hardly any debate.

The best hospital in Boston is, however, a question subject to hot and passionate debate. There are three major contenders: the General, the Brigham, and the Mem. Defenders of the Mem will tell you that the General is too large and the Brigham too small; and the General is too coldly clinical and the Brigham too coldly scientific; that the General neglects surgery at the expense of medicine and the Brigham the reverse. And finally, you will be told solemnly that the house staffs of the General and the Brigham are simply inferior in training and intelligence to those of the Mem.

But on anybody’s list of hospitals, the Boston City comes near the bottom. I drove toward it, passing the Prudential Center, the proudest monument to what the politicians call the New Boston. It is a vast complex of skyscrapers, hotels, shops, and plazas, with lots of fountains and wasted space, giving it a modern look. It stands within a few minutes’ lustful walk of the red-light district, which is neither modern nor new, but like the Prudential Center, functional in its way.

The red-light district lies on the outskirts of the Negro slums of Roxbury, as does the Boston City. I bounced along from one pothole to another and thought that I was far from Randall territory.

It was natural that the Randalls would practice at the Mem. In Boston the Randalls were known as an old family, which meant that they could claim at least one seasick Pilgrim, straight off the Mayflower, contributing to the gene pool. They had been a family of doctors for hundreds of years: in 1776, Wilson Randall had died on Bunker Hill.

In more recent history, they had produced a long line of eminent physicians. Joshua Randall had been a famous brain surgeon early in the century, a man who had done as much as anyone, even Gushing, to advance neurosurgery in America. He was a stern, dogmatic man; a famous, though apocryphal, story had passed into medical tradition.