{"id":3316,"date":"2026-01-03T23:18:54","date_gmt":"2026-01-03T23:18:54","guid":{"rendered":"https:\/\/epub-book.com\/download\/a-case-of-need-crichton-michael\/"},"modified":"2026-01-03T23:18:54","modified_gmt":"2026-01-03T23:18:54","slug":"a-case-of-need-crichton-michael","status":"publish","type":"post","link":"https:\/\/epub-book.com\/download\/a-case-of-need-crichton-michael\/","title":{"rendered":"A Case Of Need – Crichton, Michael"},"content":{"rendered":"
\n

Book Preview<\/h3>\n
\n

\nI will prescribe regimen for the good of my pa<\/span>
\ntients, according to my judgment and ability, and <\/span>
\nnever do harm to anyone. To please no one will I <\/span>
\nprescribe a deadly drug, nor give advice which may <\/span>
\ncause his death. Nor will I give a woman a pessary <\/span>
\nto procure abortion. But I will preserve the purity of my life and my art. . . .<\/span>
\n<\/span>\n<\/p>\n

\n-FROM THE HIPPOCRATIC OATH <\/span>
\nDEMANDED OF THE YOUNG PHYSICIAN <\/span>
\nABOUT TO ENTER UPON THE PRACTICE <\/span>
\nOF HIS PROFESSION.<\/span>
\n<\/span>\n<\/p>\n

\nThere is no moral obligation to conserve DNA.<\/span>
\n<\/span>\n<\/p>\n

\n\u2014Garrett Hardin<\/span><\/span>
\n<\/span>\n<\/p>\n

\u00a0<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\n
\n
\nMONDAY<\/span>
\n<\/i>
\n<\/b>
\n<\/span>\n<\/p>\n

\n
\n
\nOCTOBER 10<\/span>
\n<\/i>
\n<\/b>
\n<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\n
\n
\nONE<\/span>
\n<\/i>
\n<\/b>
\n<\/span>\n<\/p>\n

\nALL HEART SURGEONS ARE BASTARDS, and Conway is<\/span>
\n<\/span>\n<\/p>\n

\nno exception. He came storming into the path lab <\/span>
\nat 8:30 in the morning, still wearing his green surgical gown and cap, and he was furious. When <\/span>Conway is mad he clenches his teeth and speaks through them in a flat monotone. His face turns red, with purple blotches at the temples.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Morons,” Conway hissed, “goddamned morons.” <\/span>
\nHe pounded the wall with his fist; bottles in the cabinets rattled.<\/span>
\n<\/span>\n<\/p>\n

\nWe all knew what was happening. Conway does two open-heart procedures a day, beginning the first <\/span>at 6:30. When he shows up in the path lab two <\/span>hours later, there’s only one reason.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Stupid clumsy bastard,” Conway said. He kicked <\/span>
\nover a wastebasket. It rolled noisily across the floor.<\/span>
\n<\/span>\n<\/p>\n

\n“Beat his brains in, his goddamned brains,” <\/span>
\nConway said, grimacing and staring up at the ceil<\/span>
\ning as if addressing God. God, like the rest of us,<\/span>
\n<\/span>\n<\/p>\n

\nhad heard it before. The same anger, the same <\/span>
\nclenched teeth and pounding and profanity. <\/span>
\nConway always ran true to form, like the rerun of<\/span>
\n<\/span>\n<\/p>\n

\na movie.<\/span>
\n<\/span>\n<\/p>\n

\nSometimes his anger was directed against the <\/span>
\nthoracic man, sometimes against the nurses, sometimes against the pump technicians. But oddly <\/span>enough, never against Conway.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“If I live to be a hundred,” Conway hissed <\/span>
\nthrough his teeth, “I’ll never find a decent anes <\/span>
\nman. Never. They don’t exist. Stupid, shit-eating bastards, all of them.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nWe glanced at each other:\u00a0 <\/span>this time\u00a0 <\/span>it was<\/span>
\nHerbie. About four times a year the blame fell on<\/span>
\n <\/span>
\nHerbie. The rest of the time he and Conway were<\/span>
\n <\/span>
\ngood friends. Conway would praise him to the sky,<\/span>
\n <\/span>
\ncall him the finest anesthesiologist in the country,<\/span>
\n <\/span>
\nbetter than Sonderick at the Brigham, better than<\/span>
\n <\/span>
\nLewis at the Mayo, better than anyone.<\/span>
\n<\/span>\n<\/p>\n

\nBut four times a year, Herbert Landsman was re<\/span>
\nsponsible for a DOT, the surgical slang for a death <\/span>
\non the table. In cardiac surgery, it happened a lot: <\/span>
\nfifteen percent for most surgeons, eight percent for a man like Conway.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nBecause Frank Conway was good, because he <\/span>
\nwas an eight-percenter, a man with lucky hands, a man with the touch, everyone put up with his temper tantrums, his moments of anger and destructiveness<\/span>
\n. Once he kicked over a path microscope <\/span>
\nand did a hundred dollars’ worth of damage. No-<\/span>
\n<\/span>\n<\/p>\n

\nbody blinked, because Conway was an eight-<\/span>
\npercenter.<\/span>
\n<\/span>\n<\/p>\n

\nOf course, there was scuttlebutt in Boston about <\/span>
\nhow he kept his percentage, known privately among <\/span>
\nsurgeons as the “Kill rate,” down. They said <\/span>
\nConway avoided cases with complications. They <\/span>
\nsaid Conway avoided jerry cases.1<\/sup> They said <\/span>
\nConway never innovated, never tried a new and dangerous procedure. The arguments were, of <\/span>course, wholly untrue. Conway kept his kill rate <\/span>low because he was a superb surgeon. It was as simple as that.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe fact that he was also a miserable person was <\/span>
\nconsidered superfluous.<\/span>
\n<\/span>\n<\/p>\n

\n“Stupid, stinking bastard,” Conway said. He <\/span>
\nlooked angrily about the room. “Who’s on today?”<\/span>
\n<\/span>\n<\/p>\n

\n“I am,” I said. I was the senior pathology staff member in charge for the day. Everything had to be <\/span>cleared through me. “You want a table?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Yeah. Shit.”<\/span>
\n<\/span>\n<\/p>\n

\n“When?”<\/span>
\n<\/span>\n<\/p>\n

\n“Tonight.”<\/span>
\n<\/span>\n<\/p>\n

\nIt was a habit of Conway’s. He always did his <\/span>
\nautopsies on the dead cases in the evening, often <\/span>
\ngoing long into the night. It was as if he wanted to <\/span>
\npunish himself. He never allowed anyone, not even his residents, to be present. Some said he cried <\/span>while he did them. Others said he giggled. The fact <\/span>was that nobody really knew. Except Conway.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n‘ Geriatrics.<\/span>
\n<\/span>\n<\/p>\n

\n“I’ll tell the desk,” I said. “They’ll hold a locker <\/span>
\nfor you.”<\/span>
\n<\/span>\n<\/p>\n

\n“Yeah. Shit.” He pounded the table. “Mother of <\/span>
\nfour, that’s what she was.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’ll tell the desk to arrange everything.” “Arrested before we got into the ventricle. Cold. We massaged for thirty-five minutes, but nothing. <\/span>
\n
\nNothing.”<\/span>
\n<\/i>
\n<\/span>\n<\/p>\n

\n“What’s the name?” I said. The desk would need <\/span>
\nthe name.<\/span>
\n<\/span>\n<\/p>\n

\n“McPherson,” Conway said, “Mrs. McPherson.” <\/span>
\nHe turned to go and paused by the door. He <\/span>
\nseemed to falter, his body sagging, his shoulders <\/span>
\nslumping.<\/span>
\n<\/span>\n<\/p>\n

\n“Jesus,” he said, “a mother of four. What the hell <\/span>
\nam I going to tell him?”<\/span>
\n<\/span>\n<\/p>\n

\nHe held his hands up, surgeon-style, palms facing him, and stared at his fingers accusingly, as if <\/span>
\nthey had betrayed him. I suppose in a sense they <\/span>
\nhad.<\/span>
\n<\/span>\n<\/p>\n

\n“Jesus,” Conway said. “I should have been a dermatologist. Nobody ever dies on a dermatologist.” Then he kicked the door open and left the lab.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nwhen we were alone, <\/span>
\none of the first-year resi<\/span>
\ndents, looking very pale, said to me, “Is he always like that?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” I said. “Always.”<\/span>
\n<\/span>\n<\/p>\n

\nI turned away, looking out at the rush-hour traffic moving slowly through the October drizzle. It would <\/span>
\nhave been easier to feel sympathy for Conway if I<\/span>
\n<\/span>\n<\/p>\n

\ndidn’t know that his act was purely for himself, a kind <\/span>
\nof ritual angry deceleration that he went through ev<\/span>
\nery time he lost a patient. I guess he needed it, but <\/span>
\nstill most of us in the lab wished he could be like Delong in Dallas, who did crossword puzzles in <\/span>French, or Archer in Chicago, who went out and had <\/span>a haircut whenever he lost someone.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nNot only did Conway disrupt the lab, he put us behind. In the mornings, that was particularly bad, <\/span>because we had to do the surgical specimens and <\/span>we were usually behind schedule anyway.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI turned my back to the window and picked up <\/span>
\nthe next specimen. We have a high-speed tech<\/span>
\nnique in the lab: the pathologists stand before <\/span>
\nwaist-high benches and examine the biopsies. A mi<\/span>
\ncrophone hangs from the ceiling before each of us, and it’s controlled by a foot pedal. This leaves your <\/span>hands free; whenever you have something to say, <\/span>you step on the pedal and speak into the mike, recording your comments on tape. The secretaries type it up later for the charts.2<\/sup><\/span><\/span>
\n<\/span>\n<\/p>\n

\nI’ve been trying to stop smoking for the past <\/span>
\nweek, and this specimen helped me: it was a white lump imbedded in a slice of lung. The pink tag at<\/span>
\ntached gave the name of the patient; he was down in the OR now with his chest cut open. The sur<\/span>
\ngeons were waiting for the path dx3<\/sup> before proceed-<\/span>
\n<\/span>\n<\/p>\n

\n
\n2 <\/span><\/span>
\n<\/sup>
\nThe files containing the history of treatment of patients in the hospital.
<\/span>
\nCalled a “chart” because the bulk of the file consists of daily charts of tem
<\/span>
\nperature, blood pressure, pulse and respiration, the so-called “vital signs.”<\/span>
\n<\/span>\n<\/p>\n

\n
\n3\u00a0 <\/span><\/span>
\n<\/sup>
\nDiagnosis.<\/span>
\n<\/span>\n<\/p>\n

\ning further with the operation. If this was a benign tumor, they’d simply remove one lobe of his lung. If it was malignant, they’d take the whole lung and all <\/span>
\nhis lymph nodes.<\/span>
\n<\/span>\n<\/p>\n

\n1 stepped on the floor pedal. “Patient AO\u2014four-five-two-three-three-six. Jo<\/span>seph Magnuson, The specimen is a section of right <\/span>lung, upper lobe, measuring”\u2014I took my foot off the pedal and measured it\u2014”five centimeters by <\/span>seven point five centimeters. The lung tissue is pale <\/span>pink in color and crepitant.4<\/sup> The pleural surface is smooth and glistening, with no evidence of fibrous <\/span>material or adhesions. There is some hemorrhage. Within the parenchyma is an irregular mass, white <\/span>in color, measuring”\u2014<\/span>
\n<\/span>\n<\/p>\n

\nI measured the lump\u2014”approximately two centimeters in diameter. On cut surface, it appears whit<\/span>
\nish and hard. There is no apparent fibrous capsule, and there is some distortion of surrounding tissue structure. Gross impression . . . cancer of the lung, <\/span>suggestive of malignancy, question mark metastatic. <\/span>Period, signed, John Berry.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI cut a slice of the white lump and quick-froze it. <\/span>
\nThere was only one way to be certain if the mass <\/span>
\nwas benign or malignant, and that was to check it <\/span>
\nunder the microscope. Quick-freezing the tissue allowed a thin section to be rapidly prepared. Nor<\/span>mally, to make a microscope slide, you had to dunk<\/span>
\n<\/span>\n<\/p>\n

\n
\n4<\/span>
\n<\/sup>
\n Crepitant means it is crackly and filled with air. This is normal.<\/span>
\n<\/span>\n<\/p>\n

\nyour stuff into six or seven baths; it took at least six <\/span>
\nhours, sometimes days. The surgeons couldn’t wait. <\/span>
\nWhen the tissue was frozen hard, I cranked out a <\/span>
\nsection with the microtome, stained the slice, and <\/span>
\ntook it to the microscope. I didn’t even need to go to high dry: under the low-power objective, I could see <\/span>
\nthe lacy network of lung tissue formed into delicate <\/span>
\nalveolar sacs for exchange of gas between blood and <\/span>
\nair. The white mass was something else again. I stepped on the floor button. “Micro examination, frozen section. The whitish mass appears composed of undifferentiated parenchyma cells which have invaded the normal sur<\/span>rounding tissue. The cells show many irregular, hyperchromatic nuclei and large numbers of mi<\/span>toses. There are some multinucleate giant cells. <\/span>There is no clearly defined capsule. Impression is primary malignant cancer of the lung. Note marked <\/span>degree of anthracosis in surrounding tissue.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nAnthracosis is accumulation of carbon particles <\/span>
\nin the lung. Once you gulp carbon down, either as cigarette smoke or city dirt, your body never gets rid <\/span>of it. It just stays in your lungs.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe telephone rang. I knew it would be Scanlon <\/span>
\ndown in the OR, wetting his pants because we <\/span>
\nhadn’t gotten back to him in thirty seconds flat. <\/span>
\nScanlon is like all surgeons. If he’s not cutting, he’s <\/span>
\nnot happy. He hates to stand around and look at the big hole he’s chopped in the guy while he waits for the report. He never stops to think that after he <\/span>takes a biopsy and drops it into a steel dish, an or-<\/span><\/span>
\n<\/span>\n<\/p>\n

\nderly has to bring it all the way from the surgical <\/span>
\nwing to the path labs before we can look at it. <\/span>
\nScanlon also doesn’t figure that there are eleven <\/span>
\nother operating rooms in the hospital, all going like hell between seven and eleven in the morning. We have four residents and pathologists at work during those hours, but biopsies get backed up. There’s <\/span>nothing we can do about it\u2014unless they want to <\/span>risk a misdiagnosis by us.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nAnd they don’t. They just want to bitch, like <\/span>
\nConway. It gives them something to do. All sur<\/span>
\ngeons have persecution complexes anyway. Ask the<\/span>
\n<\/span>\n<\/p>\n

\npsychiatrists.<\/span>
\n<\/span>\n<\/p>\n

\nAs I went to the phone, I stripped off one rubber <\/span>
\nglove. My hand was sweaty; I wiped it on the seat of <\/span>
\nmy pants, then picked up the receiver. We are careful <\/span>
\nabout the phone, but just to be safe it gets swabbed <\/span>
\nwith alcohol and Formalin at the end of each day. “Berry speaking.”<\/span>
\n<\/span>\n<\/p>\n

\n“Berry, what’s going on up there”?” <\/span>
\nAfter Conway, 1 felt like taking him on, but I <\/span>
\ndidn’t. I just said, “You’ve got a malignancy.”<\/span>
\n<\/span>\n<\/p>\n

\n“I thought so,” Scanlon said as if the whole path <\/span>
\nwork-up had been a waste of time. <\/span>
\n“Yeah,” I said and hung up. I wanted a cigarette badly. I’d only had one at <\/span>breakfast, and I usually have two.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nReturning to my table, I saw three specimens <\/span>
\nwere waiting: a kidney, a gallbladder, and an appendix. I started to pull my glove back on when the in<\/span>
\ntercom clicked.<\/span>
\n<\/span>\n<\/p>\n

\n“Dr. Berry?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes?”<\/span>
\n<\/span>\n<\/p>\n

\nThe intercom has a high pickup. You can speak <\/span>
\nin a normal voice anywhere in the room, and the <\/span>
\ngirl will hear you. They mount the microphone high <\/span>
\nup, near the ceiling, because the new residents usually rush over and shout into it, not knowing <\/span>
\nhow sensitive it is. That blasts the ears off the girl <\/span>
\nat the other end.<\/span>
\n<\/span>\n<\/p>\n

\n“Dr. Berry, your wife is on the telephone.”<\/span>
\n<\/span>\n<\/p>\n

\nI paused. Judith and I have an understanding: no calls in the morning. I’m always busy from seven to <\/span>eleven, six days a week, sometimes seven if one of the staff gets sick. She’s usually very good about it. She didn’t even call when Johnny drove his tricycle <\/span>into the back of a truck and had to have fifteen stitches in his forehead.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“All right,” I said, “I’ll take it.” I looked down at my hand. The glove was half on. I stripped it off <\/span>and went back to the phone.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Hello?”<\/span>
\n<\/span>\n<\/p>\n

\n“John?” Her voice was trembling. I hadn’t heard <\/span>
\nher sound that way in years. Not since her father <\/span>
\ndied.<\/span>
\n<\/span>\n<\/p>\n

\n“What is it?”<\/span>
\n<\/span>\n<\/p>\n

\n“John, Arthur Lee just called.”<\/span>
\n<\/span>\n<\/p>\n

\nArt Lee was an obstetrician friend of ours; he had been best man at our wedding.<\/span>
\n<\/span>\n<\/p>\n

\n“What’s the problem?”<\/span>
\n<\/span>\n<\/p>\n

\n“He called here asking for you. He’s in trouble.”<\/span>
\n<\/span>\n<\/p>\n

\n“What kind of trouble?” As I spoke, I waved to a<\/span>
\n<\/span>\n<\/p>\n

\nresident to take my place at the table. We had to<\/span>
\n<\/span>\n<\/p>\n

\nkeep those surgical specimens moving.<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t know,” Judith said, “but he’s in jail.” <\/span>
\nMy first thought was that it was some kind of<\/span>
\n<\/span>\n<\/p>\n

\nmistake. “Are you sure?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes.\u00a0\u00a0 <\/span>He just\u00a0 <\/span>called.\u00a0 <\/span>John,\u00a0 <\/span>is\u00a0 <\/span>it\u00a0 <\/span>something<\/span>
\n<\/span>\n<\/p>\n

\nabout<\/span>
\n
\n—– <\/span>
\n?”<\/span>
\n<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t know,” I said. “I don’t know any more than you do.” I cradled the phone in my shoulder <\/span>
\nand stripped away my other glove. I threw them <\/span>
\nboth in the vinyl-lined wastebasket. “I’ll go see him <\/span>
\nnow,” I said. “You sit tight and don’t worry. It’s prob<\/span>
\nably a minor thing. Maybe he was drinking again.” <\/span>
\n“All right,” she said in a low voice. <\/span>
\n“Don’t worry,” I repeated. <\/span>
\n“All right.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’ll speak to you soon.”<\/span>
\n<\/span>\n<\/p>\n

\nI hung up, untied my apron, and placed it on the<\/span>
\n <\/span>
\npeg by the door. Then I went down the hall to<\/span>
\n <\/span>
\nSanderson’s office. Sanderson was chief of the path<\/span>
\n <\/span>
\nlabs. He was very dignified looking; at forty-eight,<\/span>
\n <\/span>
\nhis hair was just turning gray at the temples. He<\/span>
\n <\/span>
\nhad a jowly, thoughtful face. He also had as much<\/span>
\n <\/span>
\nto fear as I did.<\/span>
\n<\/span>\n<\/p>\n

\n“Art’s in jail,” I said.<\/span>
\n<\/span>\n<\/p>\n

\nHe was in the middle of reviewing an autopsy <\/span>
\ncase. He shut the file. “Why?”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t know. I’m going to see him.” “Do you want me to come with you?” “No,” I said. “It’s better if I go alone.”<\/span>
\n<\/span>\n<\/p>\n

\nCall me, Sanderson said, peering over his half <\/span>
\nframes, “when you know.”<\/span>
\n<\/span>\n<\/p>\n

\n“I will.”<\/span>
\n<\/span>\n<\/p>\n

\nHe nodded. When I left him, he had opened the <\/span>
\nfile again, and was reading the case. If he had been upset by the news, he wasn’t showing it. But then <\/span>
\nSanderson never did.<\/span>
\n<\/span>\n<\/p>\n

\nIn the hospital lobby I reached into my pocket <\/span>
\nfor my car keys, then realized I didn’t know where they were holding Art, so I went to the information <\/span>desk to call Judith and ask her. The girl at the desk <\/span>was Sally Planck, a good-natured blonde whose <\/span>name was the subject of endless jokes among the residents. I phoned Judith and asked where Art <\/span>was; she didn’t know. It hadn’t occurred to her to <\/span>ask. So I called Arthur’s wife, Betty, a beautiful and <\/span>efficient girl with a Ph.D. in biochem from <\/span>Stanford. Until a few years ago, Betty had done re<\/span>search at Harvard, but she stopped when she had <\/span>her third child. She was usually very calm. The only time I had seen her upset was when George Kovacs <\/span>had gotten drunk and urinated all over her patio.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nBetty answered the phone in a state of stony <\/span>
\nshock. She told me they had Arthur downtown, on <\/span>
\nCharles Street. He had been arrested in his home <\/span>
\nthat morning, just as he was leaving for the office. The kids were very upset, and she had kept them home from school that day, and now what did she <\/span>do with them? What was she supposed to tell <\/span>them, for Pete’s sake?<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI told her to say it was all a mistake and hung up.<\/span>
\n<\/span>\n<\/p>\n

\nI drove my Volkswagen <\/span>
\nout of the doctors’ parking <\/span>
\nlot, past all the shiny Cadillacs. The big cars are <\/span>
\nall owned by practicing physicians; pathologists <\/span>
\nare paid by the hospital and can’t afford all those<\/span>
\n<\/span>\n<\/p>\n

\nglistening horses.<\/span>
\n<\/span>\n<\/p>\n

\nIt was 8:45, right in the middle of rush-hour traffic, which in Boston means a life-and-death propo<\/span>
\nsition. Boston has the highest accident rate in the <\/span>
\nU.S., even higher than Los Angeles, as any EW5<\/sup> intern can tell you. Or pathologists: we see a lot of <\/span>automobile trauma at autopsy. They drive like mani<\/span>acs; like sitting in the EW as the bodies come in, <\/span>you think there’s a war going on. Judith says it’s be<\/span>cause they’re repressed. Art has always said it was <\/span>because they’re Catholic and think God will look <\/span>after them as they wander across the double stripe, <\/span>but Art is a cynic. Once, at a medical party, a sur<\/span>geon explained how many eye injuries occur from <\/span>plastic dashboard figurines. People get into acci<\/span>dents, pitch forward, and have their eyes put out by the six-inch Madonna. It happens a lot; Art thought <\/span>it was the funniest thing he had ever heard.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nHe laughed until he was crying. “Blinded by reli<\/span>
\ngion,” he kept saying, doubled over in laughter. “Blinded by religion.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe surgeon did plastic stuff, and he didn’t see <\/span>
\nthe humor. 1 guess because he’d repaired too many <\/span>
\npunched-out eyesockets. But Art was convulsed.<\/span>
\n<\/span>\n<\/p>\n

\n
\n5<\/span>
\n<\/sup>
\n <\/span>
\n\u00a0<\/span>Emergency ward.<\/span>
\n<\/span>\n<\/p>\n

\nMost people at the party were surprised by his <\/span>
\nlaughter; they thought it was excessive and in <\/span>
\nrather poor taste. I suppose of all the people there <\/span>
\nI was the only one who understood the significance of this joke to Art. I was also the only one who knew the great strains under which he worked.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nArt is my friend, and he has been ever since we went to medical school together. He’s a bright guy and a skilled doctor, and he believes in what he’s <\/span>doing. Like most practicing doctors, he tends to be <\/span>a little too authoritarian, a little too autocratic. He thinks he knows what’s best, and nobody can know <\/span>that all the time. Maybe he goes overboard, but I <\/span>can’t really knock him. He serves a very important <\/span>function. After all, somebody around here has to do <\/span>the abortions.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI don’t know exactly when he started. I guess it <\/span>
\nwas right after he finished his gynecology residency. <\/span>
\nIt’s not a particularly difficult operation\u2014a well-trained nurse can do it with no problem. There’s <\/span>only one small catch.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nIt’s illegal.<\/span>
\n<\/span>\n<\/p>\n

\nI remember very well when I first found out <\/span>
\nabout it. There was some talk among some of the path residents about Lee; they were getting a lot of <\/span>
\nD & C’s that were positive. The D & C’s had been ordered for a variety of complaints\u2014menstrual ir<\/span>
\nregularity, pain, mid-period bleeding\u2014but quite a <\/span>
\nfew were showing evidence of pregnancy in the scrapings. I got concerned because the residents <\/span>were young and loose-mouthed. I told them right<\/span><\/span>
\n<\/span>\n<\/p>\n

\nthere in the lab that it wasn’t funny, that they could <\/span>
\nseriously damage a doctor’s reputation by such <\/span>
\njokes. They sobered up quickly. Then I went to see <\/span>
\nArthur. I found him in the hospital cafeteria. <\/span>
\n“Art,” I said, “something’s bothering me.” <\/span>
\nHe was in a jovial mood, eating a doughnut and <\/span>
\ncoffee. “Not a gynecological problem, I hope.” He<\/span>
\n<\/span>\n<\/p>\n

\nlaughed.<\/span>
\n<\/span>\n<\/p>\n

\n“Not exactly. I overheard some of the residents <\/span>
\nsay that you had a half-dozen pregnancy-positive <\/span>
\nscrapings in the last month. Have you been noti<\/span>
\nfied?”<\/span>
\n<\/span>\n<\/p>\n

\nImmediately, the hearty manner was gone. “Yes,”<\/span>
\n<\/span>\n<\/p>\n

\nhe said, “I have.”<\/span>
\n<\/span>\n<\/p>\n

\n“I just wanted you to know. There might be trou<\/span>
\nble in the tissue committee when these things<\/span>
\n<\/span>\n<\/p>\n

\ncome up, and<\/span>
\n\u2014”<\/span>
\n<\/span>\n<\/p>\n

\nHe shook his head. “No trouble.” <\/span>
\n“Well, you know how it looks.” “Yes,” he said. “It looks like I’m performing abortions.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nHis voice was low, almost dead calm. He was <\/span>
\nlooking directly at me. It gave me a strange feeling. <\/span>
\n“We’d better have a talk,” he said. “Are you free <\/span>
\nfor a drink about six tonight?” <\/span>
\n“I guess so.”<\/span>
\n<\/span>\n<\/p>\n

\n“Then meet me in the parking lot. And if you get <\/span>
\nsome free time this afternoon, why don’t you have <\/span>
\na look at a case of mine?” <\/span>
\n“All right,” I said, frowning.<\/span>
\n<\/span>\n<\/p>\n

\n“The name is Suzanne Black. The number is <\/span>
\nAO\u2014two-two-one-three-six-five.”<\/span>
\n<\/span>\n<\/p>\n

\nI scribbled the number on a napkin, wondering <\/span>
\nwhy he should have remembered it. Doctors re<\/span>
\nmember a lot about their patients, but rarely the <\/span>
\nhospital number.<\/span>
\n<\/span>\n<\/p>\n

\n“Take a good look at this case,” Art said, “and <\/span>
\ndon’t mention it to anyone until you talk to me.”<\/span>
\n<\/span>\n<\/p>\n

\nPuzzled, I went back to work in the lab. I was up for an autopsy that day, so I wasn’t free until four in <\/span>
\nthe afternoon. Then I went to the record room and pulled the chart for Suzanne Black. I read it right <\/span>there\u2014it wasn’t very long. She was Dr. Lee’s pa<\/span>tient, first admitted at age twenty. She was a junior <\/span>at a local Boston college. Her CC6<\/sup> was menstrual <\/span>irregularity. Upon questioning, it was revealed that she had recently suffered a bout of German mea<\/span>sles, had been very tired afterward, and had been <\/span>examined by her college doctor for possible mononucleosis<\/span>. She reported irregular spotting approxi<\/span>mately every seven to ten days, but no normal flow. <\/span>This had been going on for the last two months. <\/span>She was still tired and lethargic.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nPhysical examination was essentially normal, ex<\/span>
\ncept that she had a mild fever. Blood tests were <\/span>
\nnormal, though hematocrit7<\/sup> was somewhat low.<\/span>
\n<\/span>\n<\/p>\n

\nDr. Lee ordered a D & C to correct her irregularity. This was in 1956, before the advent of estrogen<\/span>
\n<\/span>\n<\/p>\n

\n
\n6\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>
\n<\/sup>
\nChief complaint, the term for the medical disorder that brings the pa
tient to seek treatment.<\/span>
\n<\/span>\n<\/p>\n

\n
\n7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>
\n<\/sup>
\nA test of the amount of hemoglobin, or red cells, in the blood.<\/span>
\n<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\ntherapy. The D & C was normal; no evidence of tu<\/span>
\nmors or pregnancy. The girl seemed to respond well <\/span>
\nto this treatment. She was followed for the next three months and had normal periods.<\/span>
\n<\/span>\n<\/p>\n

\nIt looked like a straightforward case. Illness or <\/span>
\nemotional stress can disrupt a woman’s biological clock, and throw off her menses; the D & C reset <\/span>that clock. I couldn’t understand why Art had <\/span>wanted me to look at it. I checked the path report <\/span>on the tissue. It had been done by Dr. Sanderson. The write-up was brief and simple: gross appear<\/span>ance normal, micro examination normal.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI returned the chart and went back to the lab. <\/span>
\nWhen I got there, I still couldn’t imagine what the point of the case was. I wandered around, doing <\/span>odds and ends, and finally began the work-up on<\/span><\/span>
\n<\/span>\n<\/p>\n

\nmy autopsy.<\/span>
\n<\/span>\n<\/p>\n

\nI don’t know what made me think of the slide. <\/span>
\nLike most hospitals, the Lincoln keeps path <\/span>
\nslides on file. We save them all; it is possible to go back twenty or thirty years and reexamine the mi<\/span>
\ncroscopic slides from a patient. They’re stored in <\/span>
\nlong boxes arranged like card catalogs in a library. <\/span>
\nWe had a whole room full of such boxes.<\/span>
\n<\/span>\n<\/p>\n

\nI went to the appropriate box and found slide <\/span>
\n1365. The label gave the case number and Dr. <\/span>
\nSanderson’s initials. It also said in large letters,<\/span>
\n<\/span>\n<\/p>\n

\n“D & C.”<\/span>
\n<\/span>\n<\/p>\n

\nI took the slide back to the micro room, where <\/span>
\nwe have ten microscopes in a long row. One was<\/span>
\n<\/span>\n<\/p>\n

\nfree; I slipped the slide onto the stage and had a <\/span>
\nlook.<\/span>
\n<\/span>\n<\/p>\n

\nI saw it immediately.<\/span>
\n<\/span>\n<\/p>\n

\nThe tissue was a uterine scraping, all right. It <\/span>
\nshowed a rather normal endometrium in the proliferative<\/span>
\n phase, but the stain stopped me. This slide <\/span>
\nhad been stained with Zenker-Formalin stain, giving <\/span>
\neverything a brilliant blue or green color. It was a rather unusual stain, employed for special diagnostic problems.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nFor routine work, the Hematoxylin-Eosin stain is <\/span>
\nused, producing pink and purple colors. Almost ev<\/span>
\nery tissue slice is stained with H & E, and if this is not the case, the reasons for the unusual stain are <\/span>
\nnoted in the pathological summary.<\/span>
\n<\/span>\n<\/p>\n

\nBut Dr. Sanderson had not mentioned that the <\/span>
\nslide was Zenker-Formalin.<\/span>
\n<\/span>\n<\/p>\n

\nThe obvious conclusion was that the slides had been switched. I looked at the handwriting on the <\/span>
\nlabel. It was Sanderson’s, no doubt about it. What <\/span>
\nhad happened?<\/span>
\n<\/span>\n<\/p>\n

\nAlmost immediately, other possibilities came to mind. Sanderson had forgotten to note in his report <\/span>
\nthat an unusual stain was used. Or two sections <\/span>
\nwere made, one H & E, the other Zenker-Formalin, <\/span>
\nand only the Zenker was saved. Or that there had been some legitimate mixup.<\/span>
\n<\/span>\n<\/p>\n

\nNone of these alternatives was particularly con<\/span>
\nvincing. I thought about it and waited impatiently <\/span>
\nuntil six that evening, when I met Art in the parking lot and got into his car. He wanted to go some-<\/span>
\n<\/span>\n<\/p>\n

\nplace away from the hospital to talk. As he drove, he said, “Read the case?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” I said. “Very interesting.”<\/span>
\n<\/span>\n<\/p>\n

\n“You checked the section?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes. Was it the original?”<\/span>
\n<\/span>\n<\/p>\n

\n“You mean, was it a scraping from Suzanne<\/span>
\n<\/span>\n<\/p>\n

\nBlack? No.”<\/span>
\n<\/span>\n<\/p>\n

\n“You should have been more careful. The stain <\/span>
\nwas different. That kind of thing can get you into <\/span>
\ntrouble. Where did the slide come from?”<\/span>
\n<\/span>\n<\/p>\n

\nArt smiled thinly. “A biological supply house. <\/span>
\n‘Slide of normal endometrial scraping.’ “<\/span>
\n<\/span>\n<\/p>\n

\n“And who made the switch?”<\/span>
\n<\/span>\n<\/p>\n

\n“Sanderson. We were new to the game, in those days. It was his idea to put in a phony slide and <\/span>write it up as normal. Now, of course, we’re much more refined. Every time Sanderson gets a normal <\/span>scraping, he makes up a few extra slides and keeps them around.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I\u00a0\u00a0 <\/span>don’t\u00a0\u00a0 <\/span>understand,”\u00a0\u00a0 <\/span>I\u00a0\u00a0\u00a0 <\/span>said.\u00a0\u00a0 <\/span>“You\u00a0\u00a0 <\/span>mean Sanderson is in this with you?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” Art said. “He has been for several years.” <\/span>
\nSanderson was a very wise, very kind, and very<\/span>
\n<\/span>\n<\/p>\n

\nproper man.<\/span>
\n<\/span>\n<\/p>\n

\n“You see,” Art said, “that whole chart is a lie. The <\/span>
\ngirl was twenty, all right. And she had German measles. And she had menstrual irregularity, too, <\/span>
\nbut the reason was she was pregnant. She had been <\/span>
\nknocked up on a football weekend by a guy she said <\/span>
\nshe loved and was going to marry, but she wanted <\/span>
\nto finish college first, and a baby would get in the<\/span>
\n<\/span>\n<\/p>\n

\nway. Furthermore, she managed to get measles dur<\/span>
\ning the first trimester. She wasn’t a terribly bright <\/span>
\ngirl, but she was bright enough to know what it <\/span>
\nmeant when you got measles. She was very worried <\/span>
\nwhen she came to see me. She hemmed and hawed for a while, and then blurted it all out and asked for an abortion.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I was pretty horrified. I was fresh from my res<\/span>
\nidency, and I still had a little starry idealism in me. <\/span>
\nShe was in a terrible fix; she was a wreck and acted as if the world had collapsed around her. I guess <\/span>in a way it had. All she could see was her problem <\/span>as a college dropout, the unwed mother of a possi<\/span>bly deformed child. She was a nice enough girl, and I felt sorry for her, but I said no. I sympathized with <\/span>her, feeling rotten inside, but I explained that my <\/span>hands were tied.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“So then she asked me if it was a dangerous op<\/span>
\neration, to have an abortion. At first I thought she was planning to try it on herself, so I said it was. <\/span>
\nThen she said she knew of a man in the North End who would do it for two hundred dollars. He had <\/span>been a medical orderly in the Marines, or some<\/span>thing. And she said that if I wouldn’t do it for her, she’d go to this man. And she walked out of my of<\/span>fice.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nHe sighed and shook his head as he drove.<\/span>
\n<\/span>\n<\/p>\n

\n“I went home that night feeling like hell. I hated her: I hated her for intruding on my new practice, <\/span>for intruding on my neatly planned life. I hated her for the pressure she was putting on me. I couldn’t<\/span><\/span>
\n<\/span>\n<\/p>\n

\nsleep; I kept thinking all night. I had a vision of her <\/span>
\ngoing to\u00a0 <\/span>a\u00a0 <\/span>smelly back room\u00a0 <\/span>somewhere\u00a0 <\/span>and <\/span>
\nmeeting a leering little guy who would letch her <\/span>
\nand maybe even manage to kill her. I thought about <\/span>
\nmy own wife and our year-old baby, and how happy it could all be. I thought about the amateur abor<\/span>tions I’d seen as an intern, when the girls came in <\/span>bleeding and foaming at three in the morning. And <\/span>let’s face it, I thought about the sweats I’d had in <\/span>college. Once with Betty, we sat around for six <\/span>weeks waiting for her period. I knew perfectly well <\/span>that anybody can get pregnant by accident. It’s not <\/span>hard, and it shouldn’t be a crime.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI smoked a cigarette and said nothing. <\/span>
\n“So I got up in the middle of the night and <\/span>
\nfought it out with six cups of coffee, staring at the <\/span>
\nkitchen wall. By morning I had decided that the <\/span>
\nlaw was unfair. I had decided that a doctor could <\/span>
\nplay God in a lot of crappy ways, but this was a <\/span>
\ngood way. I had seen a patient in trouble and I had <\/span>
\nrefused to help her when it was within my power. <\/span>
\nThat was what bothered me\u2014I had denied her <\/span>
\ntreatment. It was just as bad as denying penicillin <\/span>
\nto a sick man, just as cruel and just as foolish. The <\/span>
\nnext morning, I went to see Sanderson. I knew he had liberal ideas about a lot of things. I explained <\/span>
\nthe whole situation and told him I wanted to do a <\/span>
\nD & C. He said he would arrange to do the path <\/span>
\nexamination himself, and he did. That was how it<\/span>
\n<\/span>\n<\/p>\n

\nall started.”<\/span>
\n<\/span>\n<\/p>\n

\n“And you’ve been doing abortions ever since?”<\/span>
\n<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\n“Yes,” Art said. “When I’ve felt that they were warranted.”<\/span>
\n<\/span>\n<\/p>\n

\nAfter that, we went to a bar in the North End, a simple place, filled with Italian and German laborers. Art was in a talkative, almost confessional <\/span>mood.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I often wonder,” he said, “about what medicine would be like if the predominant religious feeling in <\/span>this country were Christian Scientist. For most of history, of course, it wouldn’t have mattered; medicine was pretty primitive and ineffective. But supposing Christian Science was strong in the age of <\/span>penicillin and antibiotics. Suppose there were pressure groups militating against the administration of <\/span>these drugs. Suppose there were sick people in <\/span>such a society who knew <\/i>perfectly well that they didn’t have to die from their illness, that a simple <\/span>drug existed which would cure them. Wouldn’t <\/span>there be a roaring black market in these drugs? <\/span>Wouldn’t people die from home administration of <\/span>overdoses, from impure, smuggled drugs? Wouldn’t <\/span>everything be an unholy mess?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I see your analogy,” I said, “but I don’t buy it.”<\/span>
\n<\/span>\n<\/p>\n

\n“Listen,” he said. “Morality must keep up with <\/span>
\ntechnology, because if a person is faced with the <\/span>
\nchoice of being moral and dead or immoral and <\/span>
\nalive, they’ll choose life every time. People today <\/span>
\nknow that abortions are safe and easy. They know it <\/span>
\nisn’t a long, tedious, dangerous operation. They <\/span>
\nknow it’s simple and they want the personal happi<\/span>
\nness it can give them. They demand it. And one<\/span>
\n<\/span>\n<\/p>\n

\nway or another they get it. If they’re rich, they go to Japan or Puerto Rico; if they’re poor, they go to the <\/span>
\nMarine orderly. But one way or another, they get <\/span>
\nthat abortion.”<\/span>
\n<\/span>\n<\/p>\n

\n“Art,” I said. “It’s illegal.”<\/span>
\n<\/span>\n<\/p>\n

\nHe smiled. “I never thought you had so much re<\/span>
\nspect for the law.”<\/span>
\n<\/span>\n<\/p>\n

\nThat was a reference to my career. After college, <\/span>
\nI entered law school and stuck it out for a year and <\/span>
\na half. Then I decided I hated it and quit to try <\/span>
\nmedicine. In between, I did some army time.<\/span>
\n<\/span>\n<\/p>\n

\n“But this is different,” I said. “If they catch you, they’ll toss you in the clink and take away your li<\/span>
\ncense. You know that.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m doing what I have to do.” “Don’t be an ass.”<\/span>
\n<\/span>\n<\/p>\n

\n“I believe,” he said, “that what I’m doing is right.” <\/span>
\nLooking at his face, I saw he meant it. And as <\/span>
\ntime went on, I personally encountered several <\/span>
\ncases where an abortion was the obvious, humane <\/span>
\nanswer. Art handled them. I joined Dr. Sanderson <\/span>
\nin covering up in the path department. We fixed <\/span>
\nthings so that the tissue committee never knew. That was necessary because the tissue committee <\/span>
\nof the Lincoln was composed of all the chiefs of service, as well as a rotating group of six doctors. <\/span>The average age of the men on the tissue commit<\/span>tee was sixty-one, and, at any given time, at least a <\/span>third were Catholic.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nOf course it was not a well-kept secret. Many of the younger doctors knew what Art was doing, and<\/span>
\n<\/span>\n<\/p>\n

\nmost agreed with him, because he exercised careful <\/span>
\njudgment in deciding his cases. Most would have <\/span>
\nperformed abortions too, if they had dared.<\/span>
\n<\/span>\n<\/p>\n

\nA few didn’t agree with Art and would have been <\/span>
\ntempted to turn him in if they’d had the guts. Anal retentives like Whipple and Gluck, men whose re<\/span>
\nligion precluded compassion and common sense.<\/span>
\n<\/span>\n<\/p>\n

\nFor a long time, I worried about the Whipples <\/span>
\nand the Glucks. Later on I ignored them, turning <\/span>
\naway from their nasty knowing glances and <\/span>
\npinched, disapproving faces. Perhaps that was a <\/span>
\nmistake.<\/span>
\n<\/span>\n<\/p>\n

\nBecause now Art was down, and if his head <\/span>
\nrolled, so would Sanderson’s. And so would mine.<\/span>
\n<\/span>\n<\/p>\n

\nthere was no place to park <\/span>
\nnear the police station. Finally I came to a lot four blocks away and <\/span>
\nwalked quickly back to find out why Arthur Lee <\/span>
\nwas in jail.<\/span>
\n<\/span>\n<\/p>\n

\n
\nTWO<\/span>
\n<\/i>
\n<\/span>\n<\/p>\n

\nwhen I<\/span>
\n was in the army <\/span>a few years back, I served <\/span>
\nas an MP in Tokyo, and the experience taught me <\/span>
\na lot. MP’s were the most unpopular people in the <\/span>
\ncity in those days, during the last phases of the oc<\/span>
\ncupation. In our white helmets and uniforms, we<\/span>
\n<\/span>\n<\/p>\n

\nrepresented the final reminders of a tiresome mili<\/span>
\ntary authority to the Japanese. To the Americans on the Ginza, drunk with sake or whiskey if they could <\/span>
\nafford it, we represented all that was frustrating or <\/span>
\nconstricting about rigid military life. We were therefore a challenge to anyone who saw us, and more <\/span>than one of my friends ran into trouble. One was <\/span>blinded by a knife in the eye. Another was killed. <\/span>Of course, we were armed. I remember when we <\/span>were first issued our guns, a hard-nosed captain <\/span>said to us: “You have your weapons, now take my <\/span>advice: never use the gun. You shoot a rowdy drunk, <\/span>even in self-defense, and you’ll find out later his <\/span>uncle is a congressman or a general. Keep the gun <\/span>in sight, but keep it in your holster. Period.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nIn effect we were ordered to bluff our way <\/span>
\nthrough everything. We learned to do it. All cops<\/span>
\n<\/span>\n<\/p>\n

\nlearn to do it.<\/span>
\n<\/span>\n<\/p>\n

\nI remembered this as I faced the surly police ser<\/span>
\ngeant in the Charles Street Station. He looked up at me as if he’d enjoy breaking my skull.<\/span>
\n<\/span>\n<\/p>\n

\n“Yeah? What is it?”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m here to see Dr. Lee,” I said.<\/span>
\n<\/span>\n<\/p>\n

\nHe smiled. “The little chink’s uptight, is he? Too<\/span>
\n<\/span>\n<\/p>\n

\nbad.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m here to see him,” I repeated.<\/span>
\n<\/span>\n<\/p>\n

\n“Can’t.”<\/span>
\n<\/span>\n<\/p>\n

\nHe looked back at his desk and shuffled the papers on it in a busy, irritable dismissal. <\/span>
\n“Would you care to explain that?” <\/span>
\n“No,” he said. “I wouldn’t care to explain that.”<\/span>
\n<\/span>\n<\/p>\n

\nI took out my pen and notebook. “I’d like your badge number, please.”<\/span>
\n<\/span>\n<\/p>\n

\n“What are you, a funny guy? Beat it. You can’t <\/span>
\nsee him.”<\/span>
\n<\/span>\n<\/p>\n

\n“You are required by law to give your badge <\/span>
\nnumber upon request.”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s nice.”<\/span>
\n<\/span>\n<\/p>\n

\nI looked at his shirt and pretended to write down the number. Then I started for the door.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nHe said casually, “Going somewhere?”<\/span>
\n<\/span>\n<\/p>\n

\n“There’s a phone booth right outside.” <\/span>
\nSo?<\/span>
\n<\/span>\n<\/p>\n

\n“It’s a shame. I’ll bet your wife spent hours sew<\/span>
\ning those stripes on your shoulder. It takes them <\/span>
\nten seconds to get them off. They use a razor blade: <\/span>
\ndoesn’t even damage the uniform.”<\/span>
\n<\/span>\n<\/p>\n

\nHe stood up heavily behind the desk. “What’s <\/span>
\nyour business here?”<\/span>
\n<\/span>\n<\/p>\n

\n“I’ve come to see Dr. Lee.”<\/span>
\n<\/span>\n<\/p>\n

\nHe looked at me evenly. He didn’t know if I <\/span>
\ncould have him busted, but he knew it could be <\/span>
\ndone.<\/span>
\n<\/span>\n<\/p>\n

\n“You his lawyer?”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s right.”<\/span>
\n<\/span>\n<\/p>\n

\n“Well, for Christ’s sake, you should have said so <\/span>
\nbefore.” He took a set of keys from his desk drawer. <\/span>
\n“Come on.” He smiled at me, but his eyes were still <\/span>
\nhostile.<\/span>
\n<\/span>\n<\/p>\n

\nI followed him back through the station. He said <\/span>
\nnothing, but grunted a couple of times. Finally he<\/span>
\n<\/span>\n<\/p>\n

\nsaid over his shoulder, “You can’t blame me for be<\/span>
\ning careful. Murder is murder, you know.” <\/span>
\n“Yes,” I said.<\/span>
\n<\/span>\n<\/p>\n

\nart was locked in a nice cell. <\/span>
\nIt was tidy and didn’t smell much. Actually, Boston has some of the <\/span>nicest cells in America. They have to: lots of fa<\/span>mous people have spent time in those cells. May<\/span>ors, public officials, people like that. You can’t <\/span>expect a man to run a decent campaign for reelec<\/span>tion if he’s in a lousy cell, can you? It just wouldn’t look right.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nArt was sitting on his bed, staring at a cigarette between his fingers. The stone floor was littered <\/span>with butts and ash. He looked up as we came down the hallway.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“John!”<\/span>
\n<\/span>\n<\/p>\n

\n“You have him for ten minutes,” the sergeant<\/span>
\n<\/span>\n<\/p>\n

\nsaid.<\/span>
\n<\/span>\n<\/p>\n

\nI entered the cell. The sergeant locked the door <\/span>
\nbehind me and stood there, leaning against the<\/span>
\n<\/span>\n<\/p>\n

\nbars.<\/span>
\n<\/span>\n<\/p>\n

\n“Thank you,” I said. “You can go now.” <\/span>
\nHe gave me a mean look and sauntered off, rat<\/span>
\ntling the keys.<\/span>
\n<\/span>\n<\/p>\n

\nWhen we were alone, I said to Art, “You all<\/span>
\n<\/span>\n<\/p>\n

\nright?”<\/span>
\n<\/span>\n<\/p>\n

\n“I think so.”<\/span>
\n<\/span>\n<\/p>\n

\nArt is a small, precise man, a fastidious dresser. <\/span>
\nOriginally he’s from San Francisco from a large <\/span>
\nfamily of doctors\u00a0 <\/span>and lawyers.\u00a0 <\/span>Apparently his<\/span>
\n<\/span>\n<\/p>\n

\nnese. His skin is more olive than yellow, his eyes <\/span>
\nlack epicanthic folds, and his hair is light brown. <\/span>
\nHe is very nervous, constantly moving his hands in <\/span>
\nfluttering movements, and the total effect is more <\/span>
\nLatin than anything else.<\/span>
\n<\/span>\n<\/p>\n

\nHe was pale now and tense. When he got up to <\/span>
\npace the cell, his movements were quick and ab<\/span>
\nrupt.<\/span>
\n<\/span>\n<\/p>\n

\n“It was good of you to come.”<\/span>
\n<\/span>\n<\/p>\n

\n“In case there’s any question, I’m the representative of your lawyer. That’s how I got in here.” I took <\/span>out my notebook. “Have you called your lawyer?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“No, not yet.”<\/span>
\n<\/span>\n<\/p>\n

\n“Why not?”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t know.” He rubbed his forehead and mas<\/span>
\nsaged his eyes with his fingers. “I’m not thinking straight. Nothing seems to make sense. . . .”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Tell me your lawyer’s name.”<\/span>
\n<\/span>\n<\/p>\n

\nHe told me, and I wrote it in the notebook. Art <\/span>
\nhad a good lawyer. I guess he figured he’d need <\/span>
\none, sometime.<\/span>
\n<\/span>\n<\/p>\n

\n“Okay,” I said. “I’ll call him when I leave. Now what’s going on?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I’ve been arrested,” Art said. “For murder.”<\/span>
\n<\/span>\n<\/p>\n

\n“So I gathered. Why did you call me?”<\/span>
\n<\/span>\n<\/p>\n

\n“Because you know about these things.”<\/span>
\n<\/span>\n<\/p>\n

\n“About murder? I don’t know anything.”<\/span>
\n<\/span>\n<\/p>\n

\n“You went to law school.”<\/span>
\n<\/span>\n<\/p>\n

\n“For a year,” I said. “That was ten years ago. I al-<\/span>
\n<\/span>\n<\/p>\n

\nmost flunked out, and I don’t remember a thing I <\/span>
\nlearned.”<\/span>
\n<\/span>\n<\/p>\n

\n“John,” he said, “this is a medical problem and a legal problem. Both. I need your help.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“You’d better start from the beginning.”<\/span>
\n<\/span>\n<\/p>\n

\n“John, I didn’t do it. I swear I didn’t. I never <\/span>
\ntouched that girl.”<\/span>
\n<\/span>\n<\/p>\n

\nHe was pacing faster and faster. I gripped his <\/span>
\narm and stopped him. “Sit down,” I said, “and start from the beginning. Very slowly.”<\/span>
\n<\/span>\n<\/p>\n

\nHe shook his head and stubbed out his cigarette. <\/span>
\nImmediately he lit another, then said, “They picked me up at home this morning, about seven. Brought me in and started questioning me. At first they said <\/span>it was routine, whatever that means. Then they <\/span>turned nasty.”<\/span>
\n<\/span>\n<\/p>\n

\n“How many were there?”<\/span>
\n<\/span>\n<\/p>\n

\n“Two. Sometimes three.”<\/span>
\n<\/span>\n<\/p>\n

\n“Did they get rough? Slap you around? Bright <\/span>
\nlights?”<\/span>
\n<\/span>\n<\/p>\n

\n“No, nothing like that.”<\/span>
\n<\/span>\n<\/p>\n

\n“Did they say you could call a lawyer?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes. But that was later. When they advised me of my constitutional rights.” He smiled that sad, <\/span>
\ncynical smile of his. “At first, you see, it was just for <\/span>
\nroutine questioning, so it never occurred to me to <\/span>
\ncall one. I had done nothing wrong. They talked to <\/span>
\nme for an hour before they even mentioned the <\/span>
\ngirl.”<\/span>
\n<\/span>\n<\/p>\n

\n“What girl?”<\/span>
\n<\/span>\n<\/p>\n

\n“Karen Randall.”<\/span>
\n<\/span>\n<\/p>\n

\n“You don’t mean the <\/i>Karen\u2014”<\/span>
\n<\/span>\n<\/p>\n

\nHe nodded. “J. D. Randall’s daughter.”<\/span>
\n<\/span>\n<\/p>\n

\n“Jesus.”<\/span>
\n<\/span>\n<\/p>\n

\n“They began by asking me what 1 knew about <\/span>
\nher, and whether I’d ever seen her as a patient. Things like that. I said yes, that she had come to <\/span>
\nme a week ago for consultation. Chief complaint of amenorrhea.”<\/span>
\n<\/span>\n<\/p>\n

\n“What duration?”<\/span>
\n<\/span>\n<\/p>\n

\n“Four months.”<\/span>
\n<\/span>\n<\/p>\n

\n“Did you tell them the duration?”<\/span>
\n<\/span>\n<\/p>\n

\n“No, they didn’t ask me.”<\/span>
\n<\/span>\n<\/p>\n

\n“Good,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“They wanted to know other details about her <\/span>
\nvisit. They wanted to know if that was her only <\/span>
\nproblem, they wanted to know how she had acted. <\/span>
\nI wouldn’t tell them. I said that the patient had spoken in confidence. So then they switched tacks: <\/span>they wanted to know where I was last night. I told them I had made evening rounds at the Lincoln <\/span>and then taken a walk in the park. They asked me <\/span>if I had gone back to my office. I said no. They <\/span>asked me if anyone had seen me in the park that <\/span>night. I said I couldn’t remember anyone, certainly <\/span>nobody I knew.”<\/span>
\n<\/span>\n<\/p>\n

\nArt sucked deeply on his cigarette. His hands <\/span>
\nwere trembling. “Then they started to hammer at <\/span>
\nme. Was 1 sure I hadn’t returned to my office? <\/span>
\nWhat had I done after making rounds? Was I sure <\/span>
\nI hadn’t seen Karen since last week? I didn’t under<\/span>
\nstand the point of the questions.”<\/span>
\n<\/span>\n<\/p>\n

\n“And what was the point?”<\/span>
\n<\/span>\n<\/p>\n

\n“Karen Randall was brought to the Mem EW at <\/span>
\nfour this morning by her mother. She was bleeding profusely\u2014exsanguinating actually\u2014and was in a <\/span>
\nstate of hemorrhagic shock when she arrived. I <\/span>
\ndon’t know what treatment they gave her, but any<\/span>
\nway she died. The police think I aborted her last <\/span>
\nnight.”<\/span>
\n<\/span>\n<\/p>\n

\nI frowned. It just didn’t make sense. “How can <\/span>
\nthey be so sure?”<\/span>
\n<\/span>\n<\/p>\n

\n“They wouldn’t say. I kept asking. Maybe the kid <\/span>
\nwas delirious and mentioned my name at the Mem. <\/span>
\nI don’t know.”<\/span>
\n<\/span>\n<\/p>\n

\nI shook my head. “Art, cops fear false arrest like <\/span>
\nthey fear the plague. If they arrest you and can’t <\/span>
\nmake it stick, a lot of people are going to lose their <\/span>
\njobs. You’re a respected member of the professional <\/span>
\ncommunity, not some drunken bum without a <\/span>
\npenny or a friend in the world. You have recourse to good legal advice, and they know you’ll get it. They <\/span>
\nwouldn’t dare charge you unless they had a strong case.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nArt waved his hand irritably. “Maybe they’re just <\/span>
\nstupid.”<\/span>
\n<\/span>\n<\/p>\n

\n“Of course they’re stupid, but not that stupid.”<\/span>
\n<\/span>\n<\/p>\n

\n“Well,” he said, “I don’t know what they’ve got on <\/span>
\nme.”<\/span>
\n<\/span>\n<\/p>\n

\n“You must know.”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t,” he said, resuming his pacing. “I can’t <\/span>
\neven begin to guess.”<\/span>
\n<\/span>\n<\/p>\n

\nI watched him for a moment, wondering when to<\/span>
\n<\/span>\n<\/p>\n

\nask the question, knowing that I would have to, <\/span>
\nsooner or later. He noticed I was staring.<\/span>
\n<\/span>\n<\/p>\n

\n“No,” he said.<\/span>
\n<\/span>\n<\/p>\n

\n“No what?”<\/span>
\n<\/span>\n<\/p>\n

\n“No, I didn’t do it. And stop looking at me that way.” He sat down again and drummed his fingers <\/span>
\non the bunk. “Christ, I wish I had a drink.”<\/span>
\n<\/span>\n<\/p>\n

\n“You’d better forget that,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“Oh, for Christ’s sake\u2014”<\/span>
\n<\/span>\n<\/p>\n

\n“You only drink socially,” I said, “and in modera<\/span>
\ntion.”<\/span>
\n<\/span>\n<\/p>\n

\n“Am I on trial for my character and personal hab<\/span>
\nits, or for\u2014”<\/span>
\n<\/span>\n<\/p>\n

\n“You’re not on trial at all,” I said, “and you don’t <\/span>
\nwant to be.”<\/span>
\n<\/span>\n<\/p>\n

\nHe snorted.<\/span>
\n<\/span>\n<\/p>\n

\n“Tell me about Karen’s visit,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“There’s nothing much to tell. She came asking <\/span>
\nfor an abortion, but I wouldn’t do it because she <\/span>
\nwas four months’ pregnant. I explained to her why <\/span>
\nI couldn’t do it, that she was too far along, and that an abortion would now require abdominal section.”<\/span>
\n<\/span>\n<\/p>\n

\n“And she accepted that?”<\/span>
\n<\/span>\n<\/p>\n

\n“She seemed to.”<\/span>
\n<\/span>\n<\/p>\n

\n“What did you put in your records?”<\/span>
\n<\/span>\n<\/p>\n

\n“Nothing. I didn’t open a file on her.”<\/span>
\n<\/span>\n<\/p>\n

\nI sighed. “That,” I said, “could be bad. Why <\/span>
\ndidn’t you?”<\/span>
\n<\/span>\n<\/p>\n

\n“Because she wasn’t coming to me for treatment, she wasn’t becoming my patient. I knew I’d never <\/span>see her again, so I didn’t open a file.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“How are you going to explain that to the police?”<\/span>
\n<\/span>\n<\/p>\n

\n”Look,” he said, “if I’d known that she was going to get me arrested, I might have done lots of things <\/span>differently.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI lit a cigarette and leaned back, feeling the cold stone against my neck. I could already see that it <\/span>was a messy situation. And the small details, inno<\/span>cent in another context, could now assume great <\/span>weight and importance.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Who referred her to you?”<\/span>
\n<\/span>\n<\/p>\n

\n“Karen? I assumed Peter.”<\/span>
\n<\/span>\n<\/p>\n

\n“Peter Randall?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes. He was her personal physician.”<\/span>
\n<\/span>\n<\/p>\n

\n“You didn’t ask her who referred her?” Art was <\/span>
\nusually careful about that.<\/span>
\n<\/span>\n<\/p>\n

\n“No. She arrived late in the day, and I was tired. <\/span>
\nBesides, she came right to the point; she was a very <\/span>
\ndirect young lady, no foolishness about her. When I <\/span>
\nheard the story, I assumed Peter had sent her to me to explain the situation, since it was obviously too <\/span>
\nlate to arrange an abortion.”<\/span>
\n<\/span>\n<\/p>\n

\n“Why did you assume that?”<\/span>
\n<\/span>\n<\/p>\n

\nHe shrugged. “I just did.”<\/span>
\n<\/span>\n<\/p>\n

\nIt wasn’t making sense. I was sure he wasn’t telling me everything. “Have other members of the Randall family been referred to you?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“What do you mean?”<\/span>
\n<\/span>\n<\/p>\n

\n“Just what I said.”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t think it’s relevant,” he said.<\/span>
\n<\/span>\n<\/p>\n

\n“It might be.”<\/span>
\n<\/span>\n<\/p>\n

\n“I assure you,” he said, “it’s not.”<\/span>
\n<\/span>\n<\/p>\n

\nI sighed and smoked the cigarette. I knew Art <\/span>
\ncould be stubborn when he wanted to. “O.K.,” I said. “Then tell me more about the girl.”<\/span>
\n<\/span>\n<\/p>\n

\n“What do you want to know?”<\/span>
\n<\/span>\n<\/p>\n

\n“Had you ever seen her before?”<\/span>
\n<\/span>\n<\/p>\n

\n“No.”‘<\/span>
\n<\/span>\n<\/p>\n

\n“Ever met her socially?”<\/span>
\n<\/span>\n<\/p>\n

\n“No.”<\/span>
\n<\/span>\n<\/p>\n

\n“Ever helped any of her friends?”<\/span>
\n<\/span>\n<\/p>\n

\n“No.”<\/span>
\n<\/span>\n<\/p>\n

\n“How can you be sure?”<\/span>
\n<\/span>\n<\/p>\n

\n“Oh, hell,” he said, “I can’t be sure, but I doubt <\/span>
\nit very much. She was only eighteen.”<\/span>
\n<\/span>\n<\/p>\n

\n“O.K.,” I said. Art was probably right. I knew he <\/span>
\nusually aborted only married women, in their late <\/span>
\ntwenties and thirties. He had often said he didn’t <\/span>
\nwant to get involved with the younger ones, though he did on occasion. Older women and married <\/span>women were much safer, more closemouthed and realistic. But I also knew that he had recently been <\/span>doing more young girls, calling them “teeny-bopper <\/span>scrapes,” because he said to do only married <\/span>women was discrimination. He meant that partly as <\/span>a joke, and partly not.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“How was she,” I said, “when she came to your <\/span>
\noffice? How would you describe her?”<\/span>
\n<\/span>\n<\/p>\n

\n“She seemed like a nice girl,” Art said. “She’s <\/span>
\npretty and intelligent and well poised. Very direct, <\/span>
\nas I said before. She came into my office, sat <\/span>
\ndown, folded her hands in her lap, and reeled it all off. She used medical terms too, like amenorrhea. I<\/span>
\n<\/span>\n<\/p>\n

\nsuppose that comes from being in a family of doc<\/span>
\ntors.”<\/span>
\n<\/span>\n<\/p>\n

\n“Was she nervous?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” he said, “but they all are. That’s why the <\/span>
\ndifferential is so hard.”<\/span>
\n<\/span>\n<\/p>\n

\nThe differential diagnosis of amenorrhea, partic<\/span>
\nularly in young girls, must consider nervousness as <\/span>
\na strong etiologic possibility. Women often delay or <\/span>
\nmiss their menstrual periods for psychological rea<\/span>
\nsons.<\/span>
\n<\/span>\n<\/p>\n

\n“But four months?”<\/span>
\n<\/span>\n<\/p>\n

\n“Well, not likely. And she’d also had a weight <\/span>
\ngain.”<\/span>
\n<\/span>\n<\/p>\n

\n“How much?”<\/span>
\n<\/span>\n<\/p>\n

\n“Fifteen pounds.”<\/span>
\n<\/span>\n<\/p>\n

\n“Not diagnostic,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“No,” he said, “but suggestive.”<\/span>
\n<\/span>\n<\/p>\n

\n“Did you examine her?”<\/span>
\n<\/span>\n<\/p>\n

\n“No. I offered to, but she refused. She had come <\/span>
\nto me for an abortion, and when I said no, she left.”<\/span>
\n<\/span>\n<\/p>\n

\n“Did she say what her plans were?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” Art said. “She gave a little shrug and said, <\/span>
\n‘Well, I guess I’ll just have to tell them and have the <\/span>
\nkid.'”<\/span>
\n<\/span>\n<\/p>\n

\n“So you thought she would not seek an abortion <\/span>
\nelsewhere?”<\/span>
\n<\/span>\n<\/p>\n

\n“Exactly. She seemed very intelligent and percep<\/span>
\ntive, and she seemed to follow my explanation of <\/span>
\nthe situation. That’s what I try to do in these <\/span>
\ncases\u2014explain to a woman why it is impossible for<\/span>
\n<\/span>\n<\/p>\n

\nher to have a safe abortion, and why she must rec<\/span>
\noncile herself to having the child.”<\/span>
\n<\/span>\n<\/p>\n

\n“Obviously she changed her mind.”<\/span>
\n<\/span>\n<\/p>\n

\n“Obviously.”<\/span>
\n<\/span>\n<\/p>\n

\n“I wonder why.”<\/span>
\n<\/span>\n<\/p>\n

\nHe laughed. “Ever meet her parents?”<\/span>
\n<\/span>\n<\/p>\n

\n“No,” I said, and then seeing my chance, “have <\/span>
\nyou?”<\/span>
\n<\/span>\n<\/p>\n

\nBut Art was quick. He gave me a slow, apprecia<\/span>
\ntive grin, a kind of subtle salute, and said, “No. <\/span>
\nNever. But I’ve heard about them.”<\/span>
\n<\/span>\n<\/p>\n

\n“What have you heard?”<\/span>
\n<\/span>\n<\/p>\n

\nAt that moment, the sergeant came back and be<\/span>
\ngan clanking the key into the lock.<\/span>
\n<\/span>\n<\/p>\n

\n“Time’s up,’ he said.<\/span>
\n<\/span>\n<\/p>\n

\n“Five more minutes,” I said, <\/span>
\nlimes up.<\/span>
\n<\/span>\n<\/p>\n

\nArt said, “Have you spoken to Betty?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” I said. “She’s fine. I’ll call her when I leave <\/span>
\nhere and tell her you’re all right.”<\/span>
\n<\/span>\n<\/p>\n

\n“She’s going to be worried,” Art said.<\/span>
\n<\/span>\n<\/p>\n

\n“Judith will stay with her. It’ll be O.K.”<\/span>
\n<\/span>\n<\/p>\n

\nArt grinned ruefully. “Sorry to cause all this trou<\/span>
\nble.”<\/span>
\n<\/span>\n<\/p>\n

\n“No trouble.” I glanced at the sergeant, standing with the door open, waiting. “The police can’t hold <\/span>you. You’ll be out by the afternoon.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe sergeant spit on the floor.<\/span>
\n<\/span>\n<\/p>\n

\nI shook hands with Art. “By the way,” I said, <\/span>
\n“where’s the body now?”<\/span>
\n<\/span>\n<\/p>\n

\n“Perhaps at the Mem. But it’s probably gone to <\/span>
\nthe City by now.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’ll check,” I said. “Don’t worry about a thing.” I <\/span>
\nstepped out of the cell and the sergeant locked up behind me. He said nothing as he led me out, but <\/span>
\nwhen we reached the lobby, he said, “Captain <\/span>
\nwants to see you.”<\/span>
\n<\/span>\n<\/p>\n

\n“All right.”<\/span>
\n<\/span>\n<\/p>\n

\n“Captain’s very interested in having a little talk.”<\/span>
\n<\/span>\n<\/p>\n

\n“Just lead the way,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n
\nTHREE<\/span>
\n<\/i>
\n<\/span>\n<\/p>\n

\nTHE SIGN ON THE FLAKING GREEN DOOR SAID HOMI<\/span>
\nCIDE, and underneath, on a hand-printed name <\/span>
\ncard, “Captain Peterson.” He turned out to be a <\/span>
\nstiff, burly man with close-cropped gray hair and a <\/span>
\nterse manner. He came around the desk to shake hands with me, and I noticed he had a limp in his right leg. He made no effort to hide it; if anything, <\/span>
\nhe exaggerated it, allowing his toe to scrape loudly <\/span>
\nover the floor. Cops, like soldiers, can be proud of their infirmities. You knew Peterson hadn’t received <\/span>his in an auto accident.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nI was trying to determine the cause of Peterson’s injury and had decided that it was probably a bullet <\/span>
\nwound\u2014rarely does anyone get cut with a knife in<\/span>
\n<\/span>\n<\/p>\n

\nthe calf\u2014when he stuck out his hand and said, <\/span>
\n“I’m Captain Peterson.”<\/span>
\n<\/span>\n<\/p>\n

\n“John Berry.”<\/span>
\n<\/span>\n<\/p>\n

\nHis handshake was hearty, but his eyes were cold <\/span>
\nand inquiring. He waved me to a chair.<\/span>
\n<\/span>\n<\/p>\n

\n“The sergeant said he hadn’t seen you around before and I thought I ought to meet you. We know <\/span>most of the criminal lawyers in Boston.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Don’t you mean trial lawyers?”<\/span>
\n<\/span>\n<\/p>\n

\n“Of course,” he said easily. “Trial lawyers.” He <\/span>
\nlooked at me expectantly.<\/span>
\n<\/span>\n<\/p>\n

\nI said nothing at all. A short silence passed, then Peterson said, “Which firm do you represent?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Firm?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m not a lawyer,” I said, “and I don’t know what <\/span>
\nmakes you think I am.”<\/span>
\n<\/span>\n<\/p>\n

\nHe pretended to be surprised. “That’s not the im<\/span>
\npression you gave the sergeant.”<\/span>
\n<\/span>\n<\/p>\n

\n“No?”<\/span>
\n<\/span>\n<\/p>\n

\n“No. You told him you were a lawyer.”<\/span>
\n<\/span>\n<\/p>\n

\n“I did?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” Peterson said, placing his hands flat on his <\/span>
\ndesk.<\/span>
\n<\/span>\n<\/p>\n

\n“Who says so?”<\/span>
\n<\/span>\n<\/p>\n

\nHe says so.<\/span>
\n<\/span>\n<\/p>\n

\n“Then he’s wrong.”<\/span>
\n<\/span>\n<\/p>\n

\nPeterson leaned back in his chair and smiled at <\/span>
\nme, a very pleasant, let’s-not-get-all-excited smile.<\/span>
\n<\/span>\n<\/p>\n

\n“If we had known you weren’t a lawyer, you’d <\/span>
\nnever have been allowed to see Lee.”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s possible. On the other hand, I was not asked for my name or my occupation. Nor was I <\/span>
\nasked to sign in as a visitor.”<\/span>
\n<\/span>\n<\/p>\n

\n“The sergeant was probably confused.”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s logical,” I said, “considering the sergeant.”<\/span>
\n<\/span>\n<\/p>\n

\nPeterson smiled blankly. I recognized his type: he <\/span>
\nwas a successful cop, a guy who had learned when <\/span>
\nto take it and when to dish it out. A very diplomatic <\/span>
\nand polite cop, until he got the upper hand.<\/span>
\n<\/span>\n<\/p>\n

\n“Well?” he said at last.<\/span>
\n<\/span>\n<\/p>\n

\n“I’m a colleague of Dr. Lee.”<\/span>
\n<\/span>\n<\/p>\n

\nIf he was surprised, he didn’t show it. “A doctor?”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s right.”<\/span>
\n<\/span>\n<\/p>\n

\n“You doctors certainly stick together,” he said, still smiling. He had probably smiled more in the last two minutes than he had in the last two years.<\/span>
\n<\/span>\n<\/p>\n

\n“Not really,” I said.<\/span>
\n<\/span>\n<\/p>\n

\nThe smile began to fall, probably from fatigue <\/span>
\nand unused muscles. “If you are a doctor,” Peterson <\/span>
\nsaid, “my advice to you is to stay the hell away from <\/span>
\nLee. The publicity could kill your practice.”<\/span>
\n<\/span>\n<\/p>\n

\n“What publicity?”<\/span>
\n<\/span>\n<\/p>\n

\n“The publicity from the trial.”<\/span>
\n<\/span>\n<\/p>\n

\n“There’s going to be a trial?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” Peterson said. “And the publicity could kill <\/span>
\nyour practice.”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t have a practice,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“You’re in research?”<\/span>
\n<\/span>\n<\/p>\n

\n“No,” I said. “I’m a pathologist.”<\/span>
\n<\/span>\n<\/p>\n

\nHe reacted to that. He started to sit forward,<\/span>
\n<\/span>\n<\/p>\n

\ncaught himself, and leaned back again. “A patholo<\/span>
\ngist,” he repeated.<\/span>
\n<\/span>\n<\/p>\n

\n“That’s right. I work in hospitals, doing autopsies <\/span>
\nand things.”<\/span>
\n<\/span>\n<\/p>\n

\nPeterson was silent for some time. He frowned, <\/span>
\nscratched the back of his hand, and looked at his <\/span>
\ndesk. Finally he said, “I don’t know what you’re try<\/span>
\ning to prove, Doctor. But we don’t need your help, <\/span>
\nand Lee is too far gone to<\/span>
\n\u2014”<\/span>
\n<\/span>\n<\/p>\n

\n“That remains to be seen.”<\/span>
\n<\/span>\n<\/p>\n

\nPeterson shook his head. “You know better than <\/span>
\nthat.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m not sure I do.”<\/span>
\n<\/span>\n<\/p>\n

\n“Do you know,” Peterson said, “what a doctor could claim in a false-arrest suit?”<\/span>
\n<\/span>\n<\/p>\n

\n“A million dollars,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“Well, let’s say five hundred thousand. It doesn’t <\/span>
\nmatter much. The point is essentially the same.”<\/span>
\n<\/span>\n<\/p>\n

\n“You think you have a case.”<\/span>
\n<\/span>\n<\/p>\n

\n“We have a case.” Peterson smiled again. “Oh, <\/span>
\nDr. Lee can call you as a witness. We know <\/span>
\nthat. And you can talk up a storm using the big <\/span>
\nwords, trying to fool the jury, to impress them with <\/span>
\nyour weighty scientific evidence. But you can’t get past the central fact. You just can’t get past it.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“And what fact is that?”<\/span>
\n<\/span>\n<\/p>\n

\n“A young girl bled to death in the Boston Memo<\/span>
\nrial Hospital this morning, from an illegal abortion. <\/span>
\nThat fact, straight and simple.”<\/span>
\n<\/span>\n<\/p>\n

\n“And you allege Dr. Lee did it?”<\/span>
\n<\/span>\n<\/p>\n

\n“There is some evidence,” Peterson said mildly.<\/span>
\n<\/span>\n<\/p>\n

\n“It had better be good,” I said, “because Dr. Lee <\/span>
\nis an established and respected<\/span>
\n\u2014”<\/span>
\n<\/span>\n<\/p>\n

\n“Listen,” Peterson said, showing impatience for <\/span>
\nthe first time, “what do you think this girl was, a <\/span>
\nten-dollar doxy? This was a nice girl, a hell of a nice <\/span>
\ngirl, from a good family. She was young and pretty <\/span>
\nand sweet, and she got butchered. But she didn’t go <\/span>
\nto some Roxbury midwife or some North End <\/span>
\nquack. She had too much sense and too much <\/span>
\nmoney for that.”<\/span>
\n<\/span>\n<\/p>\n

\n“What makes you think Dr. Lee did it?”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s none of your business.”<\/span>
\n<\/span>\n<\/p>\n

\nI shrugged. “Dr. Lee’s lawyer will ask the same <\/span>
\nquestion, and then it will be his business. And if <\/span>
\nyou don’t have an answer<\/span>
\n\u2014”<\/span>
\n<\/span>\n<\/p>\n

\n“We have an answer.”<\/span>
\n<\/span>\n<\/p>\n

\nI waited. In a sense, I was curious to see just <\/span>
\nhow good, just how diplomatic Peterson was. He <\/span>
\ndidn’t have to tell me anything; he didn’t have to <\/span>
\nsay another word. If he did say more, it would be a <\/span>
\nmistake.<\/span>
\n<\/span>\n<\/p>\n

\nPeterson said, “We have a witness who heard the <\/span>
\ngirl implicate Dr. Lee.”<\/span>
\n<\/span>\n<\/p>\n

\n“The girl arrived at the hospital in a state of <\/span>
\nshock, delirious and precomatose. Anything she <\/span>
\nsaid will constitute weak evidence.”<\/span>
\n<\/span>\n<\/p>\n

\n“At the time she said it, she wasn’t in a state of <\/span>
\nshock. She said it much earlier.”<\/span>
\n<\/span>\n<\/p>\n

\n“To whom?”<\/span>
\n<\/span>\n<\/p>\n

\n“To her mother,” Peterson said, with a grin of sat<\/span>
\nisfaction. “She told her mother that Lee did it. As<\/span>
\n<\/span>\n<\/p>\n

\nthey were leaving for the hospital. And her mother <\/span>
\nwill swear to that.”<\/span>
\n<\/span>\n<\/p>\n

\n
\n
\nFOUR<\/span>
\n<\/i>
\n<\/b>
\n<\/span>\n<\/p>\n

\nI tried to play it Peterson’s way. <\/span>I tried to keep my <\/span>
\nface blank. Fortunately you have a lot of practice at <\/span>
\nthat in medicine; you are trained to show no sur<\/span>
\nprise if a patient tells you they make love ten times <\/span>
\na night, or have dreams of stabbing their children, <\/span>
\nor drink a gallon of vodka daily. It is part of the <\/span>
\nmystique of the doctor that nothing surprises him. <\/span>
\n“I see,” I said.<\/span>
\n<\/span>\n<\/p>\n

\nPeterson nodded. “‘A reliable witness,” he said. <\/span>
\n“A mature woman, stable, careful in her judg<\/span>
\nments. And very attractive. She will make an excellent impression on the jury.” <\/span>“Perhaps.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“And now that I have been so frank,” Peterson <\/span>
\nsaid, “perhaps you would tell me your special inter<\/span>
\nest in Dr. Lee.”<\/span>
\n<\/span>\n<\/p>\n

\n“I have no special interest. He is my friend.” <\/span>
\n“He called you before he called his lawyer.” “He is allowed two telephone calls.” “Yes,” Peterson said, “but most people use them <\/span>
\nto call their lawyer and their wife.” <\/span>
\n“He wanted to talk to me.”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes,” he said. “But the question is why.”<\/span>
\n<\/span>\n<\/p>\n

\n“I have had some legal training,” I said, “as well as my medical experience.”<\/span>
\n<\/span>\n<\/p>\n

\n“You have an L.L.B.?”<\/span>
\n<\/span>\n<\/p>\n

\n“No,” I said.<\/span>
\n<\/span>\n<\/p>\n

\nPeterson ran his fingers across the edge of his <\/span>
\ndesk. “I don’t think I understand.”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m not convinced,” I said, “that it is important <\/span>
\nthat you do.”<\/span>
\n<\/span>\n<\/p>\n

\n“Could it be you are involved in this business in <\/span>
\nsome way?”<\/span>
\n<\/span>\n<\/p>\n

\n“Anything is possible,” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“Does that mean yes?”<\/span>
\n<\/span>\n<\/p>\n

\n“That means anything is possible.”<\/span>
\n<\/span>\n<\/p>\n

\nHe regarded me for a moment. “You take a very <\/span>
\ntough line, Dr. Berry.”<\/span>
\n<\/span>\n<\/p>\n

\n“Skeptical.”<\/span>
\n<\/span>\n<\/p>\n

\n“If you are so skeptical, why are you convinced <\/span>
\nDr. Lee didn’t do it?”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m not the defense attorney.”<\/span>
\n<\/span>\n<\/p>\n

\n“You know,” Peterson said, “anyone can make a <\/span>
\nmistake. Even a doctor.”<\/span>
\n<\/span>\n<\/p>\n

\nwhen I<\/span>
\n got outside <\/span>into the October drizzle, I de<\/span>
\ncided this was a hell of a time to quit smoking. <\/span>
\nPeterson had unnerved me; I smoked two cigarettes as I walked to the drugstore to buy another pack. I <\/span>had expected him to be stupid and pointlessly <\/span>tough. He was neither of those things. If what he <\/span>had said was true, then he had a case. It might not work, but it was strong enough to protect his job.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nPeterson was caught in a quandary. On the one <\/span>
\nhand, it was dangerous to arrest Dr. Lee; on the <\/span>
\nother, it was dangerous not to arrest him, if the <\/span>
\ncase seemed strong enough. Peterson was forced <\/span>
\ninto a decision, and he had made it. Now he would <\/span>
\nstick by it as long as he could. And he had an es<\/span>
\ncape: if things began to go bad, he could blame it <\/span>
\nall on Mrs. Randall. He could use the familiar line <\/span>
\nso famous among surgeons and internists that it <\/span>
\nwas abbreviated DHJ: doing his job. That meant <\/span>
\nthat if the evidence was strong enough, you acted <\/span>
\nand did not care whether you were right or not; you <\/span>
\nwere justified in acting on the evidence.1<\/sup> In that <\/span>
\nsense, Peterson’s position was strengthened. He was taking no gambles: if Art was convicted, <\/span>
\nPeterson would receive no accolades. But if Art was <\/span>
\nacquitted, Peterson was covered. Because he was doing his job.<\/span>
\n<\/span>\n<\/p>\n

\nI went into the drugstore, bought two packs of cigarettes, and made some phone calls from a pay <\/span>
\nphone. First I called my lab and told them I’d be <\/span>
\ngone the rest of the day. Then I called Judith and <\/span>
\nasked her to go over to the Lees’ house and stay <\/span>
\nwith Betty. She wanted to know if I’d seen Art, and <\/span>
\nI said I had. She asked if he was all right, and I said<\/span>
\n<\/span>\n<\/p>\n

\n\u00a0 <\/span>This happens a lot in medicine. For example, a patient presents with fe<\/span>
\nver, leukocytosis\u2014increased numbers of white cells\u2014and pain in the <\/span>
\nright-lower quadrant of the abdomen. The obvious diagnosis is appendici<\/span>
\ntis. The surgeon may perform an appendectomy only to find that the ap<\/span>
\npendix is normal. But he is vindicated, so long as he is not overhasty, because the evidence is consistent with appendicitis, and delay may be fa<\/span>tal.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\neverything was fine, that he’d be out in an hour or<\/span>
\n <\/span>
\nso.<\/span>
\n<\/span>\n<\/p>\n

\nI don’t usually keep things from my wife. Just <\/span>
\none or two small things, like what Cameron Jack<\/span>
\nson did at the conference of the American Society <\/span>
\nof Surgeons a few years back. I knew she’d be up<\/span>
\nset for Cameron’s wife, as she was when they got <\/span>
\ndivorced last spring. The divorce was what is <\/span>
\nknown locally as an MD, a medical divorce, and it had nothing to do with conventions. Cameron is a <\/span>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 <\/span>resenting orthopedics and ended by resenting <\/span>Cameron. She got the two kids and three hundred <\/span>dollars a week, but she’s not happy. What she really <\/span>wants is Cameron\u2014without medicine.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nCameron’s not very happy, either. I saw him last week and he spoke vaguely of marrying a nurse he’d <\/span>met. He knew people would talk if he did, but you could see he was thinking, “At least this one will <\/span>understand\u2014”<\/span>
\n<\/span>\n<\/p>\n

\nI often think of Cameron Jackson and the dozen <\/span>
\npeople I know like him. Usually, I think of him late at night, when I’ve been held up at the lab or when <\/span>I’ve been so busy I haven’t had time to call home <\/span>and say I’ll be late.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nArt Lee and I once talked about it, and he had <\/span>
\nthe last word, in his own cynical way.\u00a0 <\/span>“I’m begin<\/span>
\nning to understand,” he said, “why priests don’t <\/span>
\nmarry.”<\/span>
\n<\/span>\n<\/p>\n

\nArt’s own marriage has an almost stifling sort of <\/span>
\nstability. I suppose it comes from his being Chinese, though that can’t be the whole answer. Both <\/span>
\nArt and his wife are highly educated, and not visi<\/span>
\nbly tied to tradition, but I think they have both <\/span>
\nfound it difficult to shake off. Art is always guilt <\/span>
\nridden 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 am<\/span>biguous. At times he seems to expect her to revolve <\/span>around him like a trusting dog, and at times she seems to want this as much as he does. At other <\/span>times she is more independent.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nBetty Lee is one of the most beautiful women <\/span>
\nI’ve ever seen. She is soft-spoken, gracious, and slender; next to her Judith seems big, loud, and al<\/span>
\nmost masculine.<\/span>
\n<\/span>\n<\/p>\n

\nJudith and I have been married eight years. We met while I was in medical school and she was a <\/span>
\nsenior at Smith. Judith was raised on a farm in Ver<\/span>
\nmont, and is hardheaded, as pretty girls go.<\/span>
\n<\/span>\n<\/p>\n

\nI said, “Take care of Betty.”<\/span>
\n<\/span>\n<\/p>\n

\n“I will.”<\/span>
\n<\/span>\n<\/p>\n

\n“Keep her calm.”<\/span>
\n<\/span>\n<\/p>\n

\n“All right.”<\/span>
\n<\/span>\n<\/p>\n

\n“And keep the reporters away.”<\/span>
\n<\/span>\n<\/p>\n

\n“Will there be reporters?”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t know. But if there are, keep them away.”<\/span>
\n<\/span>\n<\/p>\n

\nShe said she would and hung up.<\/span>
\n<\/span>\n<\/p>\n

\nI then called George Bradford, Art’s lawyer. Brad<\/span>
\nford was a solid lawyer and a man with the proper <\/span>
\nconnections; he was senior partner of Bradford, <\/span>
\nStone and Whitlaw. He wasn’t in the office when I called, so I left a message.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nFinally I called Lewis Carr, who was clinical pro<\/span>
\nfessor of medicine at the Boston Memorial Hospi<\/span>
\ntal. It took a while for the switchboard to page him, <\/span>
\nand as usual he came on briskly.<\/span>
\n<\/span>\n<\/p>\n

\n“Carr speaking.”<\/span>
\n<\/span>\n<\/p>\n

\n“Lew, this is John Berry.”<\/span>
\n<\/span>\n<\/p>\n

\n“Hi, John. What’s on your mind?”<\/span>
\n<\/span>\n<\/p>\n

\nThat was typical of Carr. Most doctors, when <\/span>
\nthey receive calls from other doctors, follow a kind <\/span>
\nof ritual pattern: first they ask how you are, then <\/span>
\nhow your work is, then how your family is. But Carr <\/span>
\nhad broken this pattern, as he had broken other <\/span>
\npatterns.<\/span>
\n<\/span>\n<\/p>\n

\nI said, “I’m calling about Karen Randall.”<\/span>
\n<\/span>\n<\/p>\n

\n“What about her?” His voice turned cautious. Ob<\/span>
\nviously it was a hot potato at the Mem these days.<\/span>
\n<\/span>\n<\/p>\n

\n“Anything you can tell me. Anything you’ve <\/span>
\nheard.”<\/span>
\n<\/span>\n<\/p>\n

\n“Listen, John,” he said, “her father is a big man <\/span>
\nin this hospital. I’ve heard everything and I’ve heard <\/span>
\nnothing. Who wants to know?”<\/span>
\n<\/span>\n<\/p>\n

\n“I do.”<\/span>
\n<\/span>\n<\/p>\n

\n“Personally?”<\/span>
\n<\/span>\n<\/p>\n

\n“That’s right.”<\/span>
\n<\/span>\n<\/p>\n

\n“Why?”<\/span>
\n<\/span>\n<\/p>\n

\n“I’m a friend of Art Lee.”<\/span>
\n<\/span>\n<\/p>\n

\n“They got him on this? I heard that, but I didn’t <\/span>
\nbelieve it. I always thought Lee was too smart\u2014”<\/span>
\n<\/span>\n<\/p>\n

\n“Lew, what happened last night?”<\/span>
\n<\/span>\n<\/p>\n

\nCarr sighed. “Christ, it’s a mess. A real stinking <\/span>
\nhell of a mess. They blew it in outpatient.”<\/span>
\n<\/span>\n<\/p>\n

\n“What do you mean?”<\/span>
\n<\/span>\n<\/p>\n

\n“I can’t talk about this now,” Carr said. “You’d <\/span>
\nbetter come over and see me.”<\/span>
\n<\/span>\n<\/p>\n

\n“All right,” I said. “Where is the body now? Do <\/span>
\nyour people have it?”<\/span>
\n<\/span>\n<\/p>\n

\n“No, it’s gone to the City.”<\/span>
\n<\/span>\n<\/p>\n

\n“Have they performed the post yet?”<\/span>
\n<\/span>\n<\/p>\n

\n“I haven’t any idea.”<\/span>
\n<\/span>\n<\/p>\n

\n“O.K.,” I said. “I’ll stop by in a few hours. Any chance of getting her chart?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I doubt it,” Carr said. “The old man has it now.”<\/span>
\n<\/span>\n<\/p>\n

\n“Can’t spring it free?”<\/span>
\n<\/span>\n<\/p>\n

\n“I doubt it,” he said.<\/span>
\n<\/span>\n<\/p>\n

\n“O.K.,” I said, “I’ll see you later.”<\/span>
\n<\/span>\n<\/p>\n

\nI hung up, put in another dime, and called the <\/span>
\nmorgue at the City. The secretary confirmed that they had received the body. The secretary, Alice, <\/span>
\nwas a hypothyroid; she had a voice as if she had <\/span>
\nswallowed a bass fiddle.<\/span>
\n<\/span>\n<\/p>\n

\n“Done the post yet?” I said.<\/span>
\n<\/span>\n<\/p>\n

\n“They’re just starting.”<\/span>
\n<\/span>\n<\/p>\n

\n“Will they hold it? I’d like to be there.”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t think it’s possible,” Alice said, in her <\/span>
\nrumbling voice. “We have an eager beaver from the <\/span>
\nMem.”<\/span>
\n<\/span>\n<\/p>\n

\nShe advised me to hurry down. I said I would.<\/span>
\n<\/span>\n<\/p>\n

\n
\nFIVE<\/span>
\n<\/i>
\n<\/span>\n<\/p>\n

\nIT IS widely believed in boston <\/span>that the best medical<\/span>
\n care in the world is found here. It is so universally acknowledged among the citizens of the city <\/span>that there is hardly any debate.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe 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 <\/span>small; and the General is too coldly clinical and the Brigham too coldly scientific; that the General neg<\/span>lects surgery at the expense of medicine and the Brigham the reverse. And finally, you will be told <\/span>solemnly that the house staffs of the General and <\/span>the Brigham are simply inferior in training and in<\/span>telligence to those of the Mem.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nBut on anybody’s list of hospitals, the Boston <\/span>
\nCity comes near the bottom. I drove toward it, <\/span>
\npassing the Prudential Center, the proudest monu<\/span>
\nment to what the politicians call the New Boston. <\/span>
\nIt is a vast complex of skyscrapers, hotels, shops, <\/span>
\nand plazas, with lots of fountains and wasted <\/span>
\nspace, giving it a modern look. It stands within a <\/span>
\nfew minutes’ lustful walk of the red-light district,<\/span>
\n<\/span>\n<\/p>\n

\nwhich is neither modern nor new, but like the Pru<\/span>
\ndential Center, functional in its way.<\/span>
\n<\/span>\n<\/p>\n

\nThe red-light district lies on the outskirts of the Negro slums of Roxbury, as does the Boston City. I <\/span>bounced along from one pothole to another and <\/span>thought that I was far from Randall territory.<\/span><\/span>
\n<\/span>\n<\/p>\n

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

\nIn more recent history, they had produced a long <\/span>
\nline of eminent physicians. Joshua Randall had <\/span>
\nbeen a famous brain surgeon early in the century, a <\/span>
\nman who had done as much as anyone, even <\/span>
\nGushing, to advance neurosurgery in America. He <\/span>
\nwas a stern, dogmatic man; a famous, though apoc<\/span>
\nryphal, story had passed into medical tradition.<\/span>
\n<\/span>\n<\/p>\n

\nJoshua Randall, like many surgeons of his period, <\/span>
\nhad a rule that no resident working under him <\/span>
\ncould marry. One resident sneaked off and did; a <\/span>
\nfew months later, Randall discovered what had hap<\/span>
\npened and called a meeting of all his residents. He lined them up in a row and said, “Dr. Jones, please take one step forward.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe guilty doctor did, trembling slightly.<\/span>
\n<\/span>\n<\/p>\n

\nRandall said, “I understand you have gotten mar<\/span>
\nried.” He made it sound like a disease.<\/span>
\n<\/span>\n<\/p>\n

\n“Yes, sir.”<\/span>
\n<\/span>\n<\/p>\n

\n“Before I discharge you from the staff, do you have anything to say in your defense?”<\/span>
\n<\/span>\n<\/p>\n

\nThe young doctor thought for a moment, then <\/span>
\nsaid, “Yes, sir. I promise I’ll never do it again.”<\/span>
\n<\/span>\n<\/p>\n

\nRandall, according to the story, was so amused by <\/span>
\nthis reply that he kept the resident after all.<\/span>
\n<\/span>\n<\/p>\n

\nAfter Joshua Randall came Winthrop Randall, <\/span>
\nthe thoracic surgeon. J. D. Randall, Karen’s father, was a heart surgeon, specializing in valvular replacements. I had never met him, but I’d seen him <\/span>once or twice\u2014a fierce, patriarchal man, with thick <\/span>white hair and a commanding manner. He was the terror of the surgical residents, who flocked to him <\/span>for training, but hated him.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nHis brother, Peter, was an internist with his of<\/span>
\nfices just off the Commons. He was very fashion<\/span>
\nable, very exclusive, and supposedly quite good, though I had no way of knowing.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nJ. D. had a son, Karen’s brother, who was in med<\/span>
\nical school at Harvard. A year ago there was a ru<\/span>
\nmor that the kid was practically flunking out, but <\/span>
\nnothing recently.<\/span>
\n<\/span>\n<\/p>\n

\nIn another town, at another time, it might seem <\/span>
\nodd that a young boy with such a distinguished medical tradition would choose to try and live it <\/span>
\ndown. But not Boston: in Boston the wealthy old <\/span>
\nfamilies had long felt only two professions were <\/span>
\nworthy of one’s attention. One was medicine and <\/span>
\nthe other was law; exceptions were made for the ac<\/span>
\nademic life, which was honorable enough so long as <\/span>
\none became a professor at Harvard.<\/span>
\n<\/span>\n<\/p>\n

\nBut the Randalls were not an academic family, or a legal family. They were a medical family, and any <\/span>Randall who could, contrived to get himself <\/span>through medical school and into a house officer-<\/span>ship1<\/sup> at the Mem. Both the medical school and the Mem had, in the past, made allowances for poor <\/span>grades when it came to the Randalls, but over the <\/span>years, the family had more than repaid the trust. In <\/span>medicine, a Randall was a good gamble.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nAnd that was about all I knew about the family, <\/span>
\nexcept that they were very wealthy, firmly Episcopal, determinedly public spirited, widely respected, <\/span>and very powerful.<\/span>
\n<\/span>\n<\/p>\n

\nI would have to find out more.<\/span>
\n<\/span>\n<\/p>\n

\nTHREE BLOCKS FROM THE HOSPITAL, I passed through<\/span>
\n<\/span>\n<\/p>\n

\nthe Combat Zone at the corner of Mass and Co<\/span>
\nlumbus avenues. At night it teems with whores, <\/span>
\npimps, addicts, and pushers; it got its name be<\/span>
\ncause doctors at the City see so many stabbings <\/span>
\nand shootings from this area they regard it as the location of a limited war.2<\/sup><\/span><\/span>
\n<\/span>\n<\/p>\n

\nThe Boston City itself is an immense complex of <\/span>
\nbuildings sprawling over three city blocks. It has <\/span>
\nmore than 1,350 beds, mostly filled with alcoholics <\/span>
\nand derelicts. Within the Boston medical establish-<\/span>
\n<\/span>\n<\/p>\n

\n
\n1 <\/span><\/span>
\n<\/sup>
\nPosition as an intern or resident, where one is an M.D. but not licensed
<\/span>
\nto practice, and still completing education.<\/span>
\n<\/span>\n<\/p>\n

\n
\n2 <\/span><\/span>
\n<\/sup>
\nFormerly the most violent area in Boston was Scollay Square, but it was
<\/span>
\ndemolished five years ago to make way for government buildings. Some
<\/span>
\nconsider that an improvement; some a step backward.<\/span>
\n<\/span>\n<\/p>\n

\nment, the City is known as the Boston Shitty be<\/span>
\ncause of its clientele. But it is considered a good teaching hospital for residents and interns, because <\/span>one sees there many medical problems one would never see in a more affluent hospital. A good exam<\/span>ple is scurvy. Few people in modern America contract scurvy. To do so requires general malnutrition <\/span>and a complete abstinence from fruit for five <\/span>months. This is so rare that most hospitals see a <\/span>case every three years; at the Boston City there are <\/span>a half-dozen each year, usually in the spring <\/span>months, the “scurvy season.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nThere are other examples: severe tuberculosis, <\/span>
\ntertiary syphilis, gunshot wounds, stabbings, accidents, self-abuse, and personal misfortune. What<\/span>ever the category, the City sees more of it, in a <\/span>more advanced state, than any other hospital in <\/span>Boston.3<\/sup><\/span><\/span>
\n<\/span>\n<\/p>\n

\nTHE INTERIOR OF THE CITY HOSPITAL is a maze built<\/span>
\n <\/span>
\nby a madman. Endless corridors, above ground and <\/span>
\nbelow, connect the dozen separate buildings of the hospital. At every corner, there are large green signs<\/span><\/span>
\n<\/span>\n<\/p>\n

\n
\n3<\/span>
\n<\/sup>
\n The frequently bizarre cases mean that every doctor and surgeon has a backlog of strange stories. One surgeon is fond of telling how he was on the Accident Floor\u2014the City’s EW\u2014when two victims of an auto acci<\/span>
\ndent were brought in. One man had lost his leg at the knee. The other had massive crush injury to the chest, so bad that the degree of damage could <\/span>
\nnot at first be ascertained from the heavy bleeding. On an X ray of the <\/span>
\nchest, however, it was seen that one man’s foot and lower leg had been rammed into the second man’s chest, where it was lodged at the time of admission.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\npointing directions, but they don’t help much; it is <\/span>
\nstill hopelessly confusing.<\/span>
\n<\/span>\n<\/p>\n

\nAs I cut through the corridors and buildings, I remembered my rotation through the hospital as a <\/span>
\nresident. Small details came back. The soap: a <\/span>
\nstrange, cheap, peculiar-smelling soap that was used everywhere. The paper bags hung by each sink, one for paper towels, the other for rectal <\/span>
\ngloves. As an economy, the hospital saved used <\/span>
\ngloves, cleaned them, and used them again. The little plastic name tags edged in black, blue, and red <\/span>depending on your service. I had spent a year in <\/span>this hospital, and during that time I had done sev<\/span>eral autopsies for the medical examiner.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nTHERE ARE FOUR MEDICAL SITUATIONS in which the<\/span>
\n <\/span>
\ncoroner claims jurisdiction and an autopsy is re<\/span>
\nquired by law. Every pathology resident knows the list cold:<\/span><\/span>
\n<\/span>\n<\/p>\n

\nIf the patient dies under violent or unusual circumstances.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nIf the patient is DOA.4<\/sup><\/span>
\n<\/span>\n<\/p>\n

\nIf he dies within twenty-four hours of admission.<\/span>
\n<\/span>\n<\/p>\n

\nIf a patient dies outside the hospital while not <\/span>
\nunder a doctor’s care.<\/span>
\n<\/span>\n<\/p>\n

\nUnder any of these circumstances, an autopsy is performed at the City. Like many cities, Boston has no separate police morgue. The second floor of the <\/span>Mallory Building, the pathology section of the hos-<\/span>
\n<\/span>\n<\/p>\n

\n
\n4<\/span>
\n<\/sup>
\n Dead on arrival at hospital.<\/span>
\n<\/span>\n<\/p>\n

\npital, is given over to the medical examiner’s offices. <\/span>
\nIn routine cases, most of the autopsies are per<\/span>
\nformed by first-year residents from the hospital in <\/span>
\nwhich the patient died. For the residents, new to <\/span>
\nthe game and still nervous, a coroner’s autopsy can <\/span>
\nbe a tense business.<\/span>
\n<\/span>\n<\/p>\n

\nYou don’t know what poisoning or electrocution <\/span>
\nlooks like, for instance, and you’re worried about <\/span>
\nmissing something important. The solution, passed down from resident to resident, is to do a meticu<\/span>lous PM, to take lots of pictures and notes as you <\/span>go, and to “save everything,” meaning to keep <\/span>pieces of tissue from all the gross organs in case there is a court action that requires reexamination <\/span>of the autopsy findings. Saving everything is, of <\/span>course, an expensive business. It requires extra jars, extra preservative, and more storage space in the <\/span>freezers. But it is done without question in police cases.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nYet even with the precautions, you worry. As you <\/span>
\ndo the post, there is always that fear, that dreadful <\/span>
\nthought at the back of your mind that the prosecution or the defense will demand some piece of in<\/span>formation, some crucial bit of evidence either <\/span>positive or negative, that you cannot supply because <\/span>you did not consider all the possibilities, all the var<\/span>iables, all the differentials.<\/span>for some long-forgotten reason, <\/span>there are two <\/span>small stone sphinxes just inside the doors of Mallory. Each time I see them, they bother me;<\/span><\/span>
\n<\/span>\n<\/p>\n

\nsomehow sphinxes in a pathology building smack of <\/span>
\nEgyptian embalming chambers. Or something.<\/span>
\n<\/span>\n<\/p>\n

\nI went up to the second floor to talk to Alice. <\/span>
\nShe was grumpy; the post hadn’t been started be<\/span>
\ncause of some delay; everything was going to hell in <\/span>
\na wheelbarrow these days; did I know that a flu ep<\/span>
\nidemic was expected this winter?<\/span>
\n<\/span>\n<\/p>\n

\nI said 1 did, and then asked, “Who’s doing the <\/span>
\npost on Karen Randall?”<\/span>
\n<\/span>\n<\/p>\n

\nAlice gave a disapproving frown. “They sent someone over from the Mem. His name, I believe, <\/span>
\nis Hendricks.”<\/span>
\n<\/span>\n<\/p>\n

\nI was surprised. I had expected someone big to do this case.<\/span>
\n<\/span>\n<\/p>\n

\n“He inside?” I asked, nodding toward the end of <\/span>
\nthe hall.<\/span>
\n<\/span>\n<\/p>\n

\n“Umm,” Alice said.<\/span>
\n<\/span>\n<\/p>\n

\nI walked down toward the two swinging doors, <\/span>
\npast the freezers on the right which stored the bodies, and past the neatly labeled sign: authorized<\/span><\/span><\/span>
\n<\/span>\n<\/p>\n

\nPERSONNEL\u00a0 <\/span>ONLY\u00a0 <\/span>BEYOND\u00a0 <\/span>THIS\u00a0 <\/span>POINT.\u00a0 <\/span>The\u00a0\u00a0 <\/span>doors<\/span>
\n<\/span>\n<\/p>\n

\nwere wood, without windows, marked in <\/span>and out. <\/span><\/span>
\nI pushed through into the autopsy room. Two men <\/span>
\nwere talking in a far corner.<\/span>
\n<\/span>\n<\/p>\n

\nThe room was large, painted a dull, institutional green. The ceiling was low, the floor was concrete, <\/span>and the pipes overhead were exposed; they don’t <\/span>spend much on interior decoration here. In a neat <\/span>row were five stainless-steel tables, each six feet <\/span>long. They were tilted slightly and made with a lip. <\/span>Water flowed constantly down the table in a thin<\/span><\/span>
\n<\/span>\n<\/p>\n

\nsheet and emptied into a sink at the lower end. The <\/span>
\nwater was kept running all during the autopsy, to carry away blood and bits of organic matter. The <\/span>
\nhuge exhaust fan, three feet across and built into <\/span>
\none frosted-glass window, was also kept on. So was <\/span>
\nthe small chemical unit that blew scented ersatz <\/span>
\nair-freshener into the room, giving it a phony pine-<\/span>
\nwoods odor.<\/span>
\n<\/span>\n<\/p>\n

\nOff to one side was a changing room where pathologists could remove their street clothes and put on surgical greens and an apron. There were four <\/span>large sinks in a row, the farthest with a sign that <\/span>said this sink for washing hands only. <\/span>The others <\/span>were used to clean instruments and specimens. <\/span>Along one wall was a row of simple cabinets con<\/span>taining gloves, bottles for specimens, preservatives, <\/span>reagents, and a camera. Unusual specimens were <\/span>often photographed in place before removal.<\/span><\/span>
\n<\/span>\n<\/p>\n

\nAs I entered the room, the two men looked over <\/span>
\nat me. They had been discussing a case, a body on <\/span>
\nthe far table. I recognized one of the men, a resi<\/span>
\ndent named Gaffen. I knew him slightly. He was very clever and rather mean. The other man I did <\/span>
\nnot know at all; I assumed he was Hendricks.<\/span>
\n<\/span>\n<\/p>\n

\n“Hello, John,” Gaffen said. “What brings you <\/span>
\nhere?”<\/span>
\n<\/span>\n<\/p>\n

\n“Post on Karen Randall.”<\/span>
\n<\/span>\n<\/p>\n

\n“They’ll start in a minute. Want to change?”<\/span>
\n<\/span>\n<\/p>\n

\n“No, thanks,” I said. “I’ll just watch.”<\/span>
\n<\/span>\n<\/p>\n

\nActually I would have liked to change, but it <\/span>
\nseemed like a bad idea. The only way I could be<\/span>
\n<\/span>\n<\/p>\n

\ncertain of preserving my observer’s role would be to <\/span>
\nremain in street clothes. The last thing I wanted to <\/span>
\ndo was to be considered an active participant in the autopsy, and therefore possibly influencing the find<\/span>
\nings.<\/span>
\n<\/span>\n<\/p>\n

\nI said to Hendricks, “I don’t think we’ve met. I’m <\/span>
\nJohn Berry.”<\/span>
\n<\/span>\n<\/p>\n

\n“Jack Hendricks.” He smiled, but did not offer to <\/span>
\nshake hands. He was wearing gloves, and had been touching the autopsy body before them.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“I’ve just been showing Hendricks a few physical <\/span>
\nfindings,” Gaffen said, nodding to the body. He <\/span>
\nstepped back so I could see. It was a young Negro <\/span>
\ngirl. She had been an attractive girl before somebody put three round holes in her chest and stom<\/span>
\nach.<\/span>
\n<\/span>\n<\/p>\n

\n“Hendricks here has been spending all his time <\/span>
\nat the Mem,” Gaffen said. “He hasn’t seen much of this sort of thing. For instance, we were just dis<\/span>cussing what these little marks might represent.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nGaffen pointed to several flesh tears on the body. <\/span>
\nThey were on the arms and lower legs.<\/span>
\n<\/span>\n<\/p>\n

\nHendricks said, “I thought perhaps they were <\/span>
\nscratches from barbed wire.”<\/span>
\n<\/span>\n<\/p>\n

\nGaffen smiled sadly. “Barbed wire,” he repeated.<\/span>
\n<\/span>\n<\/p>\n

\nI said nothing. I knew what they were, but I also <\/span>
\nknew that an inexperienced man would never be <\/span>
\nable to guess.<\/span>
\n<\/span>\n<\/p>\n

\n“When was she brought in?” I said.<\/span>
\n<\/span>\n<\/p>\n

\nGaffen glanced at Hendricks, then said, “Five <\/span>
\na.m. <\/span>
\nBut the time of death seems to be around midnight.” To Hendricks he said, “Does that suggest <\/span>anything?”<\/span><\/span>
\n<\/span>\n<\/p>\n

\nHendricks shook his head and bit his lip. Gaffen was giving him the business. I would have objected but this was standard procedure. Browbeating often <\/span>passes for teaching in medicine. Hendricks knew it. <\/span>I knew it. Gaffen knew it.<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Where,” Gaffen said, “do you suppose she was <\/span>
\nfor those five hours after death?”<\/span>
\n<\/span>\n<\/p>\n

\n“I don’t know,” Hendricks said miserably.<\/span>
\n<\/span>\n<\/p>\n

\n“Guess.”<\/span>
\n<\/span>\n<\/p>\n

\n“Lying in bed.”<\/span>
\n<\/span>\n<\/p>\n

\n“Impossible. Look at the lividity.5<\/sup> She wasn’t ly<\/span>
\ning flat <\/i>anywhere. She was half seated, half rolled <\/span>
\nover on her side.”<\/span>
\n<\/span>\n<\/p>\n

\nHendricks looked at the body again, then shook <\/span>
\nhis head again.<\/span>
\n<\/span>\n<\/p>\n

\n“They found her in the gutter,” Gaffen said. “On Charleston Street, two blocks from the Combat <\/span>Zone. In the gutter.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Oh.”<\/span>
\n<\/span>\n<\/p>\n

\n“So,” Gaffen said, “what would you call those <\/span>
\nmarks now?”<\/span>
\n<\/span>\n<\/p>\n

\nHendricks shook his head. I knew this could go <\/span>
\non forever; Gaffen could play it for all it was worth. I cleared my throat and said, “Actually, Hendricks, they’re rat bites. Very characteristic: an initial punc<\/span>ture, and then a wedge-shaped tear.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n
\n5<\/span>
\n<\/sup>
\n The seeping of blood to the lowest portions of the body after death. It of<\/span>
\nten helps establish the position of the body.<\/span>
\n<\/span>\n<\/p>\n

\n\u00a0<\/span>\n<\/p>\n

\n“Rat bites,” he said in a low voice.<\/span>
\n<\/span>\n<\/p>\n

\n“Live and learn,” Gaffen said. He checked his <\/span>
\nwatch. “I have a CPC now. Good to see you again, <\/span>
\nJohn.” He stripped off his gloves and washed his <\/span>
\nhands, then came back to Hendricks.<\/span>
\n<\/span>\n<\/p>\n

\nHendricks was still looking at the bullet holes <\/span>
\nand the bites.<\/span>
\n<\/span>\n<\/p>\n

\n“She was in the gutter for five hours?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes.”<\/span>
\n<\/span>\n<\/p>\n

\n“Didn’t the police find her?”<\/span>
\n<\/span>\n<\/p>\n

\n“Yes, eventually.”<\/span>
\n<\/span>\n<\/p>\n

\n“Who did it to her?”<\/span>
\n<\/span>\n<\/p>\n

\nGaffen snorted. “You tell me. She has a history of <\/span>
\na primary luetic oral lesion, treated at this hospital, and five episodes of hot tubes, treated at this hospital.”<\/span><\/span>
\n<\/span>\n<\/p>\n

\n“Hot tubes?”<\/span>
\n<\/span>\n<\/p>\n

\n“P.I.D.”6<\/sup><\/span>
\n<\/span>\n<\/p>\n

\n“When they found her,” Gaffen said, “she had forty dollars in cash in her bra.”<\/span>
\n<\/span>\n<\/p>\n<\/div>\n<\/div>\n

\n

Read the full book by downloading it below.<\/p>\n

DOWNLOAD EPUB<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Book Preview I will prescribe regimen for the good of my pa tients, according to my judgment and ability, and never do harm to anyone. To please no one will I prescribe a deadly drug, nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion. But … Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":3315,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[180],"class_list":["post-3316","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-michael-crichton"],"_links":{"self":[{"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/posts\/3316","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/comments?post=3316"}],"version-history":[{"count":0,"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/posts\/3316\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/media\/3315"}],"wp:attachment":[{"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/media?parent=3316"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/categories?post=3316"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/epub-book.com\/download\/wp-json\/wp\/v2\/tags?post=3316"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}