Robin Cook - Foreign Body

“Thank you. It was about my grandmother.” Jennifer pulled her arm free and reached across Neil’s desk to grab a tissue.

“I remember. Maria, right?”

“Yes. She died just a few hours ago. It was even announced, believe it or not, on CNN.”

“Oh, no! Gosh, I’m truly sorry. I know what she meant to you. What happened?”

“I’m told a heart attack, which definitely surprises me.”

“I can understand why. Didn’t the medical department here recently give her a remarkably clean bill of health?”

“They absolutely did. They even gave her a stress test.”

“Are you going to head home, or is that a problem? I mean, didn’t you start your new surgery rotation today?”

“No and yes,” Jennifer said cryptically. “The situation is a bit more complicated.” She then went on to tell Neil the whole story about India, about being needled concerning cremation or embalming, about getting the dean to grant a week’s leave, about a medical-service company paying her expenses, and about leaving in just a few hours.

“Wow,” Neil said. “You’ve had quite a morning. I’m sorry you are going to India for such a sad reason. As I told you last May when I came back, it’s a fascinating country, full of unbelievable contrasts. But I guess this won’t be a pleasure trip.” Neil had been to India five months before to speak at a medical conference in New Delhi.

“I can’t imagine anything about this trip being pleasurable, which brings me to the issue of malaria. What do you think I should do?”

“Ouch,” Neil said, wincing. “I’m sorry to say you should have started something a week ago.”

“Well, there’s no way I could have anticipated this. I’m okay on everything else, even typhoid, from the scare last year with my patient in internal medicine.”

Neil grabbed a prescription pad from his drawer and rapidly wrote one out. He handed it to Jennifer, who looked it over.

“Doxycycline?” Jennifer read out loud.

“It’s not the number-one choice, but the coverage starts immediately. The best part is you probably don’t need it. It’s the south of India where malaria is a true problem.”

Jennifer nodded and put the scrip into her shoulder bag.

“Why did your grandmother go to India for her surgery?”

“Purely cost, I assume. She didn’t have health insurance. And I’m sure my bastard of a father encouraged it big-time.”

“I’ve read about medical tourism to India, but I’ve never known someone who actually did it.”

“I wasn’t even aware of it.”

“Where are they putting you up?”

“A hotel called the Amal Palace.”

“Wow!” Neil said. “That’s supposed to be five-star.” He chuckled, then added, “You’d better be careful; they must be trying to buy you off. Of course I’m kidding. They don’t need to buy you off. One of the negatives about medical tourism is you have no recourse. There’s no such thing as malpractice. Even if they screw up big-time, like taking out the wrong eye or killing someone by mistake or incompetence, there’s not a thing you can do.”

“It’s my guess they’ve negotiated some kind of deal with the Amal Palace. It’s just where they put people up. I mean, it’s not like I’m getting a special deal. Apparently, they pay airfare and hotel for one relative. That’s why I’m getting the trip. My lazy father claimed he couldn’t go.”

“Well, I hope something positive comes out of this journey,” Neil said. He gave Jennifer’s wrist one last squeeze. “And keep me informed. Call me anytime: morning, noon, or night. I’m so sorry about your grandmother.” He picked up the pen as a signal he had to get back to work.

“I have a couple of requests,” Jennifer said, maintaining her seat.

“Sure. What’s on your mind?”

“Would you consider coming with me? I think I need you. I mean, I’m going to be completely out of my element. Except for a trip to Colombia when I was nine, I’ve never been out of the country, much less to some exotic place like India. Since you were just there, you already have a visa. I can’t tell you how much more comfortable I’d feel. I know it is asking a lot, but I feel so provincial; even going to New Jersey used to make me anxious. I’m kidding, but I’m not a traveler by any stretch of the imagination. And I know that one of the benefits of emergency-room medicine is that you can take time off, especially since you covered for Clarence a couple of weeks ago, and he owes you.”

With a sigh, Neil shook his head. The last thing he wanted to do was wing off to India, even if he could get time off. In truth, it had been part of his initial motivation for the specialty, and he’d specifically set up a twenty-four-hours on, twenty-four-hours off schedule for himself so that when his workweek started seven a.m. Monday it was essentially over seven a.m. Thursday, unless he wanted overtime. The four remaining days of the week were available for his true love, surfing. At that very moment he was looking forward to a surfing meet over the weekend in San Diego. It was also true that his friend, colleague, and fellow surfer Clarence Hodges did owe him for a Hawaiian trip he’d made. But all that didn’t matter. Neil did not want to go to India because of a dead grandmother. If it had been Jennifer’s mother who had passed away maybe, but not her grandmother.

“I can’t,” Neil said, after a pause, as if he’d given the idea true consideration. “I’m sorry, but I can’t go. Not now, anyway. If you can wait a week, maybe, but it’s not a good time.” He spread his hands awkwardly in the air over the schedule he was working on as if it was the problem.

Jennifer was taken aback and disappointed. She’d given a lot of thought about whether to ask him or not and if she truly needed him. What had tipped the balance was the realistic question in her mind whether she could actually handle the situation once she got to India. What was clear to her was that after the initial shock of learning about Maria’s death, she’d marshaled significant defenses, including all the rushing around, making the plans to take the trip, and what psychiatrists called “blocking.” So far things had worked reasonably well and she was functioning. But as close as her grandmother had been to her, she feared there would be problems when the reality of the loss set in. She truly feared she could get to India and be an emotional train wreck.

Jennifer stared daggers at Neil. Surprise and disappointment had instantly metamorphosed into anger. Jennifer had been so confident that if she asked him directly and admitted she needed him, which she felt she had done, he would surely acquiesce as a direct spin-off of the confidences they shared. The fact that he was turning her down so promptly and with a flimsy, ridiculous explanation, something she never would have done had the situation been reversed, could mean only that their relationship was not what she thought it was. In short, like men in general, in her mind he was demonstrating he couldn’t be counted on.

Jennifer stood abruptly and without saying anything walked out of the tiny office and back into the crowded emergency room. She could hear Neil call her name, but she didn’t stop or respond. It tormented her that she knew now that it had been a mistake to confide in him. As for asking to borrow some cash, at this point she wouldn’t even consider it.

October 16, 2007

Tuesday 6:30 a.m.

New Delhi, India

Cal Morgan was a deep sleeper and needed a powerful alarm to wake up. What he employed was a clock radio with a CD player, and the CD he used was martial music. At three-quarter volume the player was capable of vibrating the night table enough to move itself and other objects on its crowded surface. Even Petra in the neighboring master suite could hear it as if it were in her room. So when it sounded, Cal made an effort to turn it off the moment he became adequately conscious. Even so, he occasionally fell back into deep sleep.