Jodi Picoult - Handle with Care

“Marin,” I whispered suddenly, and my lawyer bent her head toward mine. “Don’t.”

“Don’t what?”

“Don’t…just don’t make it worse for her.”

Marin raised her eyebrow. “You have got to be kidding,” she murmured.

“Your witness,” Booker said, and she rose to her feet.

“Isn’t it a violation of medical ethics to treat someone you know well on a personal level?” Marin asked.

“Not in a small town like Bankton,” Piper said. “If that was the case, I wouldn’t have any patients. As soon as I realized there was a complication, I stepped down.”

“Because you knew you were going to be blamed?”

“No. Because it was the right thing to do.”

Marin shrugged. “If it was the right thing to do, why didn’t you call in a specialist as soon as you saw complications during the eighteen-week ultrasound?”

“There weren’t complications during that ultrasound,” Piper said.

“That’s not what the experts have said. You heard Dr. Thurber say that the standard of care, after an ultrasound reading like Charlotte’s, would have been a follow-up ultrasound, at the very least.”

“That’s Dr. Thurber’s opinion. I respectfully disagree.”

“Hm. I wonder whom a patient would rather listen to: a doctor who’s established in his field, with numerous awards and citations…or a small-town OB who hasn’t been near a patient in over a year.”

“Objection, Your Honor,” Guy Booker said. “Not only was that not a question but my witness doesn’t need to be vilified.”

“Withdrawn.” Marin walked toward Piper, tapping a pen against her open palm. “You were best friends with Charlotte, right?”

“Yes.”

“What did you talk about?”

Piper smiled a little. “Everything. Anything. Our kids, our pipe dreams. How we sometimes wanted to kill our husbands.”

“But you never bothered to have a conversation about terminating this pregnancy, did you?”

During interrogatories I had told Marin that Piper had not discussed aborting the baby with me. And the way I had remembered it up to this point, that’s exactly the way it was. But memory is like plaster: peel it back and you just might find a completely different picture.

“Actually,” Piper said, “we did.”

Although Piper and I were best friends, we didn’t touch very often. A quick hug sometimes, a pat on the back. But we weren’t like teenage girls, who walk with their arms twined around each other. Which was why it felt so strange to be sitting beside her on a couch, her arm wrapped around me while I cried against her shoulder. She was bony, birdlike, when I would have expected her to be strong and fierce.

I had held my hands over the bowl of my belly. “I don’t want her to suffer.”

Piper sighed. “I don’t want you to suffer.”

I thought of the conversation Sean and I had had after we left the geneticist’s office the day before, after being told you had-at worst-lethal OI and-at best-severe OI. I had found him in the garage, sanding the rails of the cradle he’d been making in anticipation of your arrival. It’s like butter, he said, holding out the narrow piece of wood. Feel it . But to me, it looked like a bone, and I couldn’t bring myself to touch it. “Sean doesn’t want to do it,” I said.

“Sean isn’t pregnant.”

I asked you how an abortion was performed, and I asked you to be honest. I had pictured being on the plane, having flight attendants ask me when I was due, whether it was a boy or a girl, those same flight attendants not making eye contact on the flight home. “What would you do?” I asked her.

She hesitated. “I’d ask myself what scares me the most.”

That’s when I looked up at her, the one question on my lips that I had not been brave enough to ask Sean, or Dr. Del Sol, or even myself. “What if I can’t love her?” I whispered.

Piper smiled at me, then. “Oh, Charlotte,” she said. “You already do.”

The defense called Dr. Gianna Del Sol to the stand, to establish that there was nothing she would have done differently if she’d been the primary physician to treat Charlotte instead of the referral. But when they called Dr. R. Romulus Wyndham, an OB and bioethicist with a list of credentials that took a half hour to run through, I started to worry. Not only was Wyndham smart but he was movie-star pretty, and he had the jury eating out of his hand. “Some tests that flag abnormality early are false positives,” he said. “In 2005, for example, a team from Reprogenetics kept growing fifty-five embryos that were diagnosed as abnormal during preimplantation genetic diagnosis. After a few days, they were shocked to find out that forty-eight percent of them-nearly half-were normal. Which means there’s evidence that embryos with genetically flawed cells might heal themselves.”

“Why might that be medically important to a physician like Piper Reece?” Booker asked.

“Because it’s proof that termination decisions made too early might not be prudent.”

As Booker took his seat, I rose in one smooth motion. “Dr. Wyndham, that study you just cited-how many of those embryos had osteogenesis imperfecta?”

“I…I don’t know that any of them did.”

“What was the nature of the abnormality, then?”

“I can’t say, precisely-”

“Were they major abnormalities?”

“Again, I’m not-”

“Isn’t it true, Dr. Wyndham, the study could have been showing embryos with very minor abnormalities that corrected themselves?”

“I suppose so.”

“There’s also a difference between waiting to see what happens to a days-old embryo and a weeks-old fetus, isn’t there, in terms of the point when you can safely and legally terminate a pregnancy?”

“Objection,” Guy Booker said. “If I can’t run a pro-life rally in court, she can’t run a pro-choice rally.”

“Sustained,” the judge said.

“Isn’t it true that if doctors followed your wait-and-see approach and withheld information about fetal conditions, it might make it harder to terminate a pregnancy-logistically, physically, and emotionally?”

“Objection!” Guy Booker called out again.

I walked toward the bench. “Please, Your Honor, this isn’t about abortion rights. It’s about the standard of care that my client should have received.”

The judge pursed his lips. “All right, Ms. Gates. But make your point fast.”

Wyndham shrugged. “Any obstetrician knows how hard it is to counsel patients with fetal abnormalities to terminate pregnancies when, in one’s medical opinion, the baby won’t survive. But it’s part of the job.”

“It might be part of Piper Reece’s job,” I said. “But that doesn’t mean she did it.”

We had a two-hour recess for lunch, because Judge Gellar had to go to the DMV to apply for a motorcycle license. Apparently, according to the clerk of the court, he planned to take a Harley cross-country next summer during his month off the bench. I wondered if that was what had made him dye his hair: black went better with leather.

Charlotte left the minute court was recessed, so that she could visit you at the hospital. I hadn’t seen Sean or Amelia since this morning, so I stepped out onto the janitor’s loading dock, a door most reporters didn’t know existed.

It was one of those late September days that felt like the long fingers of winter tugging the hem of New Hampshire-cold, bitter, with a biting wind. And yet, there still seemed to be a big crowd gathered on the front steps, which I could only just make out from where I was standing. A custodian pushed out the door and stood beside me to light up a cigarette. “What’s going on up there?”