Jodi Picoult - Handle with Care

The next day, Amelia came to the courthouse. I saw her walking with Sean down the corridor to the room that he’d hidden in before. I wondered if you were still in the hospital, if-given the situation-that might not be a blessing.

I knew I was the witness the jury had been waiting for-either to vilify or to vindicate. Guy Booker had begun his defense by putting the other two OBs who had bought into my practice on the stand as character references: Yes, I was an excellent physician. No, I’d never been sued before. In fact, I’d been named the New Hampshire Obstetrician of the Year by a regional magazine. Malpractice, they said, was a ridiculous charge.

Then it was my turn. Guy had been asking me questions for three-quarters of an hour: about my training, my role in the community, my family. But when he asked me the first question about Charlotte, I could feel the atmosphere in the room change. “The plaintiff testified that you two were friends,” Guy said. “Is that true?”

“We were best friends,” I said, and very slowly, she lifted her head. “I met her nine years ago. In fact, I was the one who introduced her to her husband.”

“Were you aware of the fact that the O’Keefes were trying to conceive a child?”

“Yes. To be honest, I think I wanted them to get pregnant just as much as they wanted it. After Charlotte asked me to be her doctor, we spent months looking at her ovulation cycle and doing everything short of fertility treatments to enhance conception-which is why it was such a thrill when we found out she was going to have a baby.”

Booker entered some papers into evidence and handed them to me. “Dr. Reece, are you familiar with these pages?”

“Yes, they’re notes I made in Charlotte O’Keefe’s medical file.”

“Do you remember them?”

“Not really. I’ve gone back and reviewed my notes, obviously, to prepare for this trial, but there wasn’t something so extraordinary that I remembered it immediately.”

“What do the notes say?” Booker asked.

I read from the pages. “Femur length measuring short at sixth percentile, within the curve of normality. Near field of fetal brain particularly clear.”

“Did that strike you as unusual?”

“Unusual,” I said, “but not abnormal. It was a new machine, and everything else on the fetus looked great. At eighteen weeks, based on that ultrasound, I fully expected the baby to be born healthy.”

“Were you disturbed by the fact that you could see the intracranial contents so well?”

“No,” I said. “We’re trained to see something that looks wrong, not something that looks too right.”

“Did you ever see something that looked wrong on Charlotte O’Keefe’s sonogram?”

“Yes, when we did one at twenty-seven weeks.” I glanced at Charlotte and remembered that moment when I first looked at the screen and tried to make the image into something it wasn’t, the sinking feeling in my stomach when I realized that I would have to be the one to tell her. “There were healing fractures of the femur and tibia, as well as several beaded ribs.”

“What did you do?”

“I told her that she needed to see another doctor, someone in maternal-fetal medicine who was better equipped to deal with a high-risk pregnancy.”

“Was that twenty-seven-week ultrasound the first indication you had that there might be something wrong with the plaintiff’s baby?”

“Yes.”

“Dr. Reece, have you had other patients who were diagnosed with abnormal fetuses in utero?”

“Several,” I said.

“Have you ever advised a couple to terminate the pregnancy?”

“I’ve presented that option to numerous families when malformations are diagnosed that aren’t compatible with life.”

Once, I had a case where a thirty-two-week fetus had hydrocephaly-so much fluid on the brain that I knew the baby couldn’t be born vaginally, much less survive. The only way to deliver would have been C-section, but the fetal head was so large that the incision would have destroyed the mother’s uterus. She was young, it was her first pregnancy. I offered her the options, and eventually we drained the fluid from the head by piercing it with a needle, causing a cranial hemorrhage. The baby was then delivered vaginally, and died within minutes. I remembered showing up at Charlotte’s house that night with a bottle of wine, and telling her I had to drink the day away. I’d slept on her couch afterward, and had awakened to find her standing over me with a steaming mug of coffee and two Tylenol for my throbbing head. “Poor Piper,” she had said. “You can’t save them all.”

Two years later, that same couple came back to me when they were having another baby-who was born, thank goodness, perfectly healthy.

“Why didn’t you counsel termination for the O’Keefes?” Guy Booker asked.

“There was no definitive reason to believe the baby would be born impaired,” I said, “but even beyond that, I never thought termination would be an option for Charlotte.”

“Why not?”

I looked up at Charlotte. Forgive me, I thought.

“For the same reason she didn’t agree to amniocentesis when we thought there was a risk of Down syndrome,” I said. “She’d already told me she wanted this baby, no matter what.”

It was hard to sit here and listen to Piper giving a chronicle of our friendship. I imagine it had been just as hard for her when I had been the witness. “Were you close to the plaintiff after she gave birth?” Guy Booker asked.

“Yes. We’d see each other once or twice a week, and we talked every day. Our kids would play together.”

“What sorts of things did you do together?”

God, what had we done? It didn’t really matter. Piper had been the kind of friend with whom I didn’t have to fill in the spaces with random conversation. It was okay to just be with her. She knew that sometimes I needed that-to not have to take care of anyone or anything, to simply exist in my own space, adjacent to hers. Once, I remembered, we told Sean and Rob that Piper had a conference in Boston at the Westin Copley Place, and that I was going along to talk about having a baby with OI. In reality, there had been no conference. We checked in to the Westin and ordered room service and watched three sappy movies in a row, until we could not keep our eyes open.

Piper had paid. She always paid-treating me to lunch out, or coffee, or drinks at Maxie’s Pad. When I tried to go dutch, she’d make me put my wallet away. I’m lucky enough to be able to afford it, she said, and we both knew that I wasn’t.

“Did the plaintiff ever have a conversation with you where she blamed you for her daughter’s birth?”

“No,” Piper said. “In fact, the week before I was served, we went shopping together.”

Piper and I had tried on the same red blouse in between Emma’s and Amelia’s buying fits, and to my shock, it had looked fantastic on both of us. Let’s both get one, Piper had said. We can wear them home and see if our husbands can tell us apart .

“Dr. Reece,” Booker asked, “how has this lawsuit affected your life?”

She sat up a little straighter in the chair. It wasn’t very comfortable; it hurt your back, made you wish you were somewhere else. “I’ve never been sued before,” Piper said. “This was the first time. It’s made me doubt myself, even though I know I didn’t do anything wrong. I haven’t practiced since. Every time I try to get back on that horse…well, it starts moving away from me. I suppose I understand that, even if you’re a good physician, bad things sometimes happen. Bad things that nobody wishes for, and that nobody can explain.” She looked directly at me, so intently that a shiver went down my spine. “I miss being a doctor,” Piper said, “but nowhere near as much as I miss my best friend.”