The Cole Trilogy: The Physician, Shaman And Matters Of Choice Part 153

R.J. told them about the town and the people. They talked about influenza in Ma.s.sachusetts and in Florida and compared their problem cases-shop talk, doctor talk. Susan said she had been in Lauderdale ever since finishing her internship at Michael Riis Medical Center in Chicago. She had gone to medical school at the University of Michigan. R.J. was drawn to her open manner and easy friendliness.

Just as their shrimp dinners were being served, Susan's pager beeped. "Uh-oh," she said, and excused herself and went off to find a telephone.

"Well?" R.J.'s father said a few moments later, and she realized this woman was important to him.

"You were right. I really like her."

"I'm glad."

He had known Susan for three years, he said. They had met when she came to Boston to attend a conference at the medical school.

"After that, we saw each other occasionally, sometimes in Miami, sometimes in Boston. But we couldn't meet often enough, because both of us have crowded schedules. So before I retired in Boston, I contacted colleagues at the university here and was happy to get an offer."

"Then this is a serious relationship."

He smiled at her. "Yes, we're becoming serious about one another."

"Dad, I'm so happy for you," R.J. said, taking his hands in hers.

For a moment she was conscious only that his fingers had become more gnarled with arthritis. Then she was aware of a descending, a gradual loss of energy even as she leaned toward him, smiling.

Susan was returning to the table. "I took care of it by phone," she said.

"Dad, are you feeling all right?"

Her father was pale, but his eyes were alert as he looked at her. "Yes. Shouldn't I be?"

"Something is going on," R.J. said.

Susan Dolby regarded her. "What do you mean?"

"I think he's having a heart attack."

"Robert," Susan said steadily, "are you experiencing chest pains? Shortness of breath?"

"No."

"You don't seem to be sweating. Do you have muscular pain?"

"No."

"Listen. Is this some kind of family joke?"

R.J. felt a sinking, the falling of an internal barometer. "Where's the nearest hospital?"

Her father was watching her with interest. "I think we'd better listen to R.J., Susan," he said.

Puzzled, Susan made up her mind, nodded. "Cedars Medical Center is only minutes away. The restaurant has a wheelchair. We can call the emergency room on my car phone. It will take less time to drive him than to wait for an ambulance to get here."

Her father began to gasp with his first pains just as they turned into the medical center drive. Nurses and a resident were waiting in front of the door with a gurney and oxygen. They gave him a shot of streptokinase, hustled him into an examining room, and wheeled up the portable EKG.

R.J. stood to one side. She was listening hard, watching ferociously, but these people were good, and it was best to leave them alone so they could do their jobs. Susan Dolby was at her father's side, holding his hand. R.J. was a bystander.

It was late evening. Her father was resting comfortably in an oxygen tent in the intensive care unit, hooked up to beeping monitors. The hospital cafeteria was closed, so R.J. and Susan went to a small restaurant nearby and ate black bean soup and Cuban bread.

Then they returned to the hospital and sat alone in a small waiting room.

"He's doing very well, I think," Susan said. "They got the anticoagulants into him so quickly, one-point-five million units of streptokinase, aspirin, five thousand units of heparin. We're lucky."

"Thank G.o.d."

"Now. How did you know?"

As sparely and factually as possible, R.J. told her.

Susan Dolby shook her head. "I would say it's your imagination, a fairy tale. Except that I saw it happen."

"My father calls it the Gift. ... There have been times when I've thought it was a burden. But I'm learning to live with it, learning to use it. Tonight, I'm so grateful for it," R.J. said. She hesitated. "I don't talk about this to other physicians, as you can understand. I would appreciate it if you wouldn't ..."

"No. Who would believe me? But why did you tell me the truth? Weren't you tempted to make up a story?"

R.J. leaned over and kissed the tanned cheek. "I knew we would keep it in the family," she said.

Her father was in pain, and sublingual nitroglycerine didn't do much good, so they gave him morphine. It made him sleep a lot. After the second day she could go away from the hospital for an hour or two at a time. She drove his car. Susan had patients to see but she pointed out the best beach, and R.J. swam. She slopped on sunscreen like a good doctor, but it felt good to have sea salt dry on her skin again, and for a few minutes she lay on her back with an orange glow above her closed eyes and nursed hurtful regrets about David. She prayed for her father and then for Greg Hinton, as promised.

That evening she asked for a conference with her father's cardiologist, Dr. Sumner Kellicker, and was glad when Susan wanted to join them. Kellicker was a red-faced, fussy man who wore gorgeous suits and obviously didn't relish patients with physicians in the family.

"I'm apprehensive about the morphine, Dr. Kellicker."

"Why is that, Dr. Cole?"

"It has a vagotonic effect. It can cause bradycardia or advanced degrees of heart block, no?"

"Well, yes, that happens. But everything we do has risks, a down side. You know that."

"How about giving him a beta-blocker instead of morphine?"

"Beta-blockers don't always work. Then he's back with the pain."

"But it would be worth a try, wouldn't it?"

Dr. Kellicker glanced at Susan Dolby, who had been listening intently, watching R.J. "I agree," she said.

"If that's what the two of you want, I have no objection," Dr. Kellicker said sourly. He nodded and walked away.

Susan stepped close to R.J. She looked into R.J.'s eyes and put her arms around her. They stood there, swaying, and R.J. hugged her back.

She made several telephone calls. "On your first day there, he had the attack?" Peter Gerome said. "What a way to begin your vacation!" Everything was in complete control, he a.s.sured her. People told him they missed her. People sent love. He didn't mention David.

Toby was terribly concerned, first for R.J.'s father and then for R.J. When R.J. asked her how she was, Toby said dolefully that her back hurt constantly and she felt she had been pregnant all her life.

Gwen made her go over every detail of her father's case history, and said R.J. had been wise to request the beta-blocker instead of continued use of morphine.

She was right. The beta-blocker was successful in keeping away the pain, and after two days R.J.'s father was allowed to leave the bed and sit in a chair twice a day for half an hour. Like many physicians, he was a terrible patient. He asked a lot of questions about his own condition and demanded the results of his angiography, as well as a complete report from Kellicker.

His mood vacillated wildly, from euphoria to severe pessimism, and back again. "I'd like you to take Rob J.'s scalpel with you when you leave," he told his daughter during a depressed moment.

"Why?"

He shrugged. "It will be yours someday. Why not have it now?"

Her eyes locked his. "Because it's going to continue to be yours for many years," she said, and firmly closed the subject.

He made progress. On the third day he began standing next to his bed for short intervals, and the day after that he began to walk in the corridor. R.J. knew that the first six days after an attack were the most dangerous, and when a week had pa.s.sed without mishap, she began to breathe easier.

On R.J.'s eighth morning in Miami, she met Susan at a hotel for breakfast. They sat on the terrace overlooking the beach and the sea, and R.J. breathed in the soft salt air. "I could become accustomed to this."

"Could you, R.J.? Do you like Florida?"

Her remark had been a joke, an appreciation of unaccustomed luxury. "Florida's very nice. ... I don't really enjoy extreme heat."

"One becomes acclimated, though we Floridians do love our air conditioners.

"R.J., I'm planning to retire next year. My practice is established, and the income from it is very good. I wonder if you would be interested in taking it over?"

Oh.

"I'm so flattered, Susan. And I thank you. But I've sunk roots in Woodfield. It's important to me that I practice medicine there."

"Are you certain you don't want to think it over? I could give you lots of details to consider. I could work alongside you for a year. ..."

R.J. smiled, shook her head.

Susan made a quick chagrined face at her and smiled back. "Your father has become so important to me. I liked you at once. You're smart and caring, and obviously you're a very good doctor-the kind of doctor I admire, the kind my patients deserve. So I thought, here is a perfect way in which to serve everyone-my patients, R.J., Robert ... and myself-all in one neat package. I don't have family. You will forgive someone who should know better, but I allowed myself to fantasize about being a family. I should have realized that there never are perfect solutions that answer everyone's needs."

R.J. admired Susan's frankness. She didn't know whether to laugh or cry; a little more than a year before, she had spun the same fantasy for herself.

"I like you too, Susan, and I hope you and my father do end up together. If you do, we'll get together regularly and often," R.J. said.

That noon when she came into her father's room, he put aside his crossword puzzle. "Hi."

"Hi."

"What's new?"

"New? Nothing much."

"Did you meet Susan this morning and have a talk?"

Ah. They had discussed it before Susan had talked with her. "Yes, I did. I told her she's a dear, but I have a practice of my own."

"For Pete's sake, R.J. ... It's a terrific opportunity," he said crankily.

It occurred to R.J. that perhaps there was something about her personal chemistry that made people suggest how and where she should live. "You have to learn to let me say no, Dad," she said quietly. "I'm forty-four years old, and capable of making personal decisions."

He turned away. But in a little while, he turned back to her. "You know something?"

"What, Dad?"

"You're absolutely right."

They played gin rummy, and he won two dollars and forty-five cents from her and then took a nap.

When he woke, she told him about her practice. He was pleased that it had grown so quickly and approved that she had closed the practice at fifteen hundred patients. But it worried him when she told him she was getting ready to pay the remaining debt on the bank note he had co-signed.

"You don't have to wipe away the debt in two years, you know. You shouldn't do without things you may need."

"I don't do without anything," she said, and held his hand.

Calmly and deliberately, he placed his other hand in hers.

It was a frightening moment for her, but the message she received from his hands placed a smile on her face as she bent to kiss him, and his relief could be seen in his own quick smile.

On Thanksgiving Day, she and Susan arranged to have hospital trays with him in his room.

"I ran into Sumner Kellicker this morning when I made rounds," Susan said. "He's very pleased with your condition and said he hopes to release you in another two or three days."

R.J. knew she had to return to her patients. "We'll have to get somebody to stay at the apartment with you for a while."

"Nonsense. He's coming to stay at my house. Aren't you, Robert?"

"I don't know, Susan. A patient is not the way I want you to think of me."

"I think it's time we thought of each other in every possible way," she said. In the end, he agreed to go to her house.

"I have a good cook who comes weekdays to prepare dinner. We'll watch Robert's diet and see that he gets just the right amount of exercise. You're not to worry about this man," she said, and R.J. promised that she wouldn't.

She took the 6:20 P.M. plane for Hartford the next day. As they circled Bradley Airport, the pilot announced: "The temperature on the ground is twenty-two degrees. Welcome to the real world."

The night air was sharp and rough to breathe, New England air in late autumn. She drove home slowly, into Ma.s.sachusetts and up into the hills.

When she turned into her driveway, she sensed that something was different. She braked the car for a moment and studied the dark house that hugged the verge, but nothing seemed changed. It wasn't until the next morning that she glanced through the window at her shingle hung by the road at the end of the driveway, and saw that the hooks below it were empty.