Дуглас Кеннеди - Five Days

The patient was a woman who was exactly my age. Born three months after me. A native Mainer, she told me. ‘Not from away’, but someone who went away to a ‘pretty good college’ in the Pacific northwest and ‘an even better’ law school in Boston, and was groomed for big things in a big ‘white shoe’ Beacon Hill law firm. She married a hotshot financial whizz kid and they lived far too well. ‘Life in the fast lane.’ Then he got caught on an insider trading scam, and his legal fees wiped them out, and she never made it beyond associate in that ultra-prestigious, ultra-WASP law firm (where she was just one of three lawyers without an Ivy League degree) because of her husband’s conviction and seven years in a Club Fed sentence. After all that, she had nine months where she was out of work. Then a friend of her dad’s found her a job in one of the bigger law firms here in Portland. Coming back to Maine wasn’t what she really wanted. But having a soon-to-be ex-husband in prison for financial fraud wasn’t helping her employment prospects, and it was a prestigious outfit ‘as Maine firms go’. Even though she was finding a lot of the contractual work she’d been given to do this side of boring (‘Hell, I’m a born litigator’), she was making enough to live in that condo development off the Old Port, and—

‘By the way, my name is Caroline and I’m nervous as shit.’

I told her my name and explained, in my usual professionally calm voice, the scanning procedure and how, outside of the needle in her arm—

‘I hate needles.’

‘A small momentary prick and then it’s done.’

‘And I’m not ten years old and you don’t have to promise me a lollipop at the end.’

‘We do have them if you really want one.’

‘That’s your way of telling me I’m a bitch, right? Paul always says that. Says when I get into one of these manic moods I am fucking impossible.’

‘A scan is always stressful.’

‘And you are Miss Zen-o-rama.’

If only you knew, if only you knew.

‘I know how worried you must be now,’ I continued. ‘But—’

‘But what? I have a lump in my left breast, a very big lump near a very important lymph node. And though my doctor wanted me to have a mammogram I insisted on a CT scan — because with a CT scan you can see how seriously the cancer has metastasized. So you’re now telling me what? To try to stay calm and focussed and centered and all that New Age shit? Did my doctor tell you I’m four months’ pregnant?’

‘It’s there on your chart, yes.’

‘But what she didn’t tell you is that this is the first pregnancy that I have been able to carry beyond the initial trimester. I fell pregnant twice while married. Boom. Two miscarriages at eight and eleven weeks respectively. Now I’m pregnant again — at forty-three. An unmarried mother. Not that my firm knows anything about this yet. If I can hold onto the baby — if my body shows me a little grace this time — I am going to probably find myself professionally demoted. Especially if the father of the baby — who happens to be a partner in the same firm — leaves his wife for me. Which I don’t think he’ll do. Which is pulling him apart and pulling me apart. Because we love each other. Because we’re so right for each other. And because I feel that, yet again, life has dealt me the shittiest hand imaginable, even though I know it was my choice to get involved with him, my choice to fall in love with him, my choice to get pregnant by him — a very deliberate choice, I should add, but you probably figured that out by now. And I bet all this is being taken down on a hidden microphone and is going to be used against me.’

‘Fear not,’ I said, helping her onto the bier and strapping her down. ‘Anything you say here stays here.’

‘So you’re my father confessor, right?’

I swabbed her arm with an antiseptic wipe.

‘Here comes the needle.’

Her entire body stiffened — always a sign in my professional experience of someone who expects the pain to be deservedly painful. The needle slipped in. I taped it down. I explained that the whole procedure would last ten, fifteen minutes at most.

‘I know it’s cancer,’ she said. ‘I’ve been on the Internet. Crawling all over the Mayo Clinic’s website. From non-stop self-examination I know that it has all the telltale signs of a malignant tumor.’

‘As I’ve often told so many people I see here, stay off the Internet when it comes to lumps and growths and blood being passed.’

‘But you’ve got to understand — my entire adult life has been about things being taken away from me. My husband. Our home. Two wonderful babies. And now, given how the cards keep falling for me, at best I am going to lose a breast and probably the child when they put me on a huge course of chemotherapy. Given my age this will be the last time I ever get pregnant. And—’

‘Aren’t we getting a little ahead of ourselves here?’

‘I’m going to die.’

‘Did your doctor indicate that?’

‘She did what all you people in the medical world do — commit to nothing until you have the actual death warrant in your hand.’

‘And your boyfriend — Paul, right? What does he say about all this?’

‘He came with me today.’

‘That’s good.’

‘Before I came in here he told me how much he loved me.’

‘That’s even better.’

‘The thing is, he’ll never leave his wife. He’s told me recently that, yes, he would move in with me when the pregnancy started to show. But he knows what that will do to his standing at the firm. And his wife is the niece of the senior partner.’

‘But it is, nonetheless, love?’

I could see she was crying.

‘Yes,’ she said. ‘It is love.’

‘That, in itself, is wonderful.’

‘I keep telling myself that. But. ’

I wanted to say: I know all about that ‘but’. Instead I squeezed her shoulder and said:

‘Let’s get this behind you.’

I left the scan room as quietly and quickly as I could, moving into the technical booth. As I programed in the necessary data I felt the usual moment of tension that still accompanies the start of each of these procedures. The realization that, from the moment I shoot 80 milligrams of high-contrast iodine into Caroline’s veins, I will then have less than fifty seconds to start the scan. Begin the scan a few critical seconds ahead of the Venus phase — when all the veins are freshly enhanced with the iodine — and you will be scanning ahead of the contrast, which means you will not get the images that the radiologist needs to make a thorough and accurate diagnosis. Scan too late and the contrast might be too great.

Timing.

It really is everything.

I leaned in to the microphone on the control panel and flipped a switch.

‘Caroline?’

My voice boomed out on the speaker within the scan room. She shifted her gaze to the technical booth window, her eyes flooded with fear. I followed the script I always use when it is clear a patient is terrified.

‘Now I know this is all very spooky and strange. But I promise you that it will all be over in just a few minutes. OK?’

I hit the button that detonated the automatic injection system. As I did so a timer appeared on one of the screens. I turned my vision immediately to Caroline, her cheeks suddenly very red as the iodine contrast hit her bloodstream and raised her body temperature by two degrees. The scan program now kicked in, as the bed was mechanically raised upwards. Like almost every other patient Caroline shuddered. I grabbed the microphone:

‘Nothing to worry about, Caroline. Just please keep very still.’

To my immense relief she did absolutely as instructed. The bed reached a level position with the circular hoop. Twenty-eight seconds had elapsed. The bed began to shift backwards into the hoop. Thirty-six seconds when it halted, the hoop encircling her head. Forty-four seconds. Forty-six. My finger was on the scan button. I noticed it trembling. Forty-nine. And.