Bitter Harvest: A Woman's Fury, a Mother's Sacrifice (5 page)

Timothy Farrar, born on January 20, 1982, was all those things. Debora had asked to have an epidural anesthetic, but her labor was overdue and had to be induced. Once the contractions started, Debora’s cervix dilated so rapidly that there was no time to inject the numbing anesthetic—so Tim was born, perforce, by natural childbirth. Mike was in the delivery room and remembers being thrilled to have a son. Debora would also recall that her husband was beside himself with happiness at Tim’s birth. The baby boy would have “Farrar” for his last name, as would all their children.

Debora was a good mother; she nursed her son and took a six-week maternity leave so that she could stay with him for the first month of his life. But she never intended to be a stay-at-home mother. She had worked right up to the end of her pregnancy and, having hired a warm-hearted Jamaican nanny to take care of Tim, she went back to school. She had received a fellowship to study hematology and oncology at the University of Cincinnati.

Tim’s birth was unplanned, but welcome. Both Mike and Debora decided that they should have a second child within three years, so Debora’s next pregnancy was a mutual decision. Lissa was born two days after Christmas, 1984. Once again, Debora had requested an epidural; but this time the anesthesiologists mistakenly gave her a spinal anesthetic, which often leaves the patient with a severe headache. Nevertheless, Debora was out of bed the next day and walked down to the nursery with two-year-old Tim so he could look at his new baby sister.

Tim would always be the child who most resembled Debora physically. He had her coloring, her features, her sturdy, square body. He was blond (his hair would later turn russet) and brown-eyed, full of beans and very masculine, but Lissa was a delicate elfin baby, dark-haired and petite, with her father’s rounded forehead and fine features. Debora and Mike now had the perfect family: a little boy and a baby girl.

Again Debora went back to work almost immediately. Although she and Mike both had fellowships in internal medicine and were supposedly working the same hours, she was usually back at their apartment by four in the afternoon, while he worked three or four hours later. “She used to tell me that was because I was inefficient and I spent too much time stopping to talk to people,” Mike recalled. “And part of that was true—but I just don’t think she ever had a burning desire to excel. She never really wanted to be an excellent or outstanding doctor. Interestingly enough, here is a woman who is brilliant—and she had to take her oncology boards
twice
. Both times, she failed. She barely passed the internal medicine boards. Those
were
difficult tests, but if you’re an American who goes to a university training program, who works hard and does a reasonable amount of study, you
should
be able to pass those…. She was just ill-prepared.”

Mike rarely saw Debora studying medical books; she read only for pleasure. She went to classes and on rounds, and her keen mind made it possible for her to retain far more than most students—but it was not enough to pass her board exams.

The day the test results arrived was not a good one. Mike’s letter said, “Congratulations! You have passed the boards for cardiovascular disease,” while Debora’s began, “We regret to inform you …”

Debora opened both envelopes and phoned Mike. She was angry and crying—in hysterics—and accused him of caring only about his own test scores. She blamed him for her failure: she’d had to take care of Tim and Lissa, she said, and hadn’t had enough time to study. The truth was that both of them had cared for the babies until they were put down for the night, and that Mike then read medical books while Debora went upstairs with a novel.

Debora never passed either her hematology or oncology board examinations. That would not bar her from practicing in those specialties, but if patients checked, they would find she was not “board-certified.” She seldom read literature on medical advances in her field, and she rarely attended seminars and conventions. Apparently she had no desire to mingle with her fellow oncologists.

In 1985, Mike had one more year of his cardiology fellowship in Cincinnati to complete, but Debora was finished. With their dependable nanny caring for Tim and Lissa, she started a private practice in oncology and hematology. Dealing with cancer patients requires both compassion and acceptance of what is often tragic beyond words. Most oncologists manage to maintain enough emotional distance to protect themselves, while still evincing true concern for their patients. Although Debora insisted that she chose her specialty because she loved people so much, both her husband and her co-workers were appalled at her indifferent approach to patients.

Again, Mike wondered why. “She had trouble dealing with patients,” he recalled. “I can remember listening to her talking to a patient one night when she was on call. It was clear that the patient needed to go into the emergency room and that she would have to go in and check on her. Debora was very passive-aggressive with the patient—angry about the whole thing.” Nurses, too, were puzzled by her behavior toward patients. One commented, “She was the strangest doctor I’ve ever worked with in my life.” Another found her “cold” and “unfeeling.”

Mike, however, was emerging as a “real superstar,” according to a physician who worked with him in Cincinnati. “He was so good at everything. He showed unusual maturity. He related extremely well and had extremely good judgment, all of which marked him as someone who would be a superior cardiologist.”

In the spring of 1986, he completed his fellowship and agreed to stay at the University of Cincinnati as an assistant professor at the medical school; he would also serve as medical director of the heart transplant unit. “But the chairman of cardiology resigned and they were bringing in new people,” Mike said. “I wasn’t sure what my future would be there.” A physician friend in Kansas City, Missouri, invited Mike to join his partnership, so he and Debora decided to move back there rather than wait to see how things would shake out with the new regime at the university.

It was July 1, 1986, when they settled in Kansas City. Twelve twenty-four West Sixty-first Terrace, in an older, upscale neighborhood near the Country Club Church, was a beautiful house with stucco walls crisscrossed with heavy beams, and a brick façade with arched passageways that led into a side garden. After so many years of studying and deprivation, Debora and Mike brought their children home to the area where they had met and been married—the Kansas-Missouri border, where the wind blew all the time, a steady, almost comforting sound in the trees. It was, really, a whole new start. They both looked forward to their careers and to raising their two children. On West Sixty-first Terrace, children abounded and the neighbors were friendly. But the move meant leaving behind their nanny, who had been with Tim for four years and Lissa for two. Debora and Mike would have to interview applicants for child care in their home, and Debora did not go back to work until they found a new nanny.

Mike went into private practice with the group in KCMO, and Debora soon joined another group of physicians. They were on staff at many of the same hospitals and occasionally ran into each other during the day. Debora was thirty-five that summer, and Mike was thirty-one.

Mike’s practice did very well, although he ultimately moved on to join another group of doctors. At the end of Debora’s first year in her group, both she and Mike expected that she would be offered a partnership. That was medical protocol—but the offer didn’t come. Such a slight is almost unheard-of.

“I knew what the reason was.” Mike sighed. “She could not get along with patients—she drove them away. So she left that first practice in Kansas City at the end of the year, and went into private practice on her own.”

But the doctors in her group practice may have had more serious reasons for not offering Debora a partnership. An old bugaboo raised its head soon after they moved to Kansas City. Mike noticed that once again Debora’s gait was off-balance enough to make her stagger slightly, and her speech was sometimes slurred. And, though she had always written with flowing cursive letters so perfect they could have been used in a penmanship manual, Debora now began to scribble. A doctor she worked for called Mike and said, “Hey, what’s wrong with our Debora? She’s not being as attentive to details, and her writing has really deteriorated. What’s going on?”

There were other signs. Mike’s sister Karen was getting married and his whole family was thrilled with the new son-in-law. Debora had not been welcomed into his family with open arms and she began to complain that she was sick of hearing about Karen’s wedding. “One night,” Mike said, “she actually called my sister up and told her that we weren’t coming … for the wedding, and she was pretty insulting and her speech was slurred and almost incoherent.”

Debora had physical problems besides her wrist injury. Some years earlier, she had fallen while climbing stairs at the University of Cincinnati and somehow gotten a puncture wound in her knee. A stubborn infection developed; extremely painful, it required a ten-day hospitalization. Much like her wrist injury, the mysterious infection required draining by syringe several times a day. Antibiotics finally cured it, but Debora had had chronic pain in her knee ever since.

Now, with Debora behaving so bizarrely, Mike deduced what the problem was. His heart sank. She was using drags again. He searched their house and found a drawer jammed with sleeping pills and painkillers—potent narcotics, including Tylox.

Mike told Debora that he had to talk to her alone. With the bedroom door closed so that neither Tim, Lissa, nor their nanny could hear, he silently lined up the narcotics vials on the dresser. For once, she did not shout at him. There was no way she could explain having so many bottles of Tylox, prescribed to different names, none of them hers.

“My knee has been bothering me,” she said weakly. “It’s hard to keep on my feet without something to ease the pain.”

“Debora, you can’t
do
this,” Mike said softly. “These prescriptions aren’t for you—these are for your
patients
. They have bone pain, and you have a minor knee injury. I don’t believe you’re taking Tylox for pain—I’m afraid you’re in trouble again.”

After a long silence, Debora lifted her head. “You’re right,” she agreed. “I know I have to stop. And I will. I promise you.”

“Are there any more of these?” Mike asked. Debora shook her head. He stared at her, drew a deep breath, and began to gather up the vials of pills and capsules. “I’m going to throw them out,” he said. “I’m going to believe you when you say it won’t happen again.”

As far as Mike could tell, Debora kept her promise. Things got better for them after that, and he didn’t notice any suspicious signs that Debora was using narcotics.

Rather than apply to join another group practice in Kansas City, Debora opened her own office, and having a one-woman practice seemed to work for her. She was on staff at St. Mary’s Hospital. It wasn’t a really busy hospital, and there weren’t many doctors there covering oncology. For the first time since she had gotten her M.D., Debora didn’t have other physicians looking over her shoulder or second-guessing how she treated her patients. Her quick temper and her confrontational behavior when she was questioned were, for a time, not an issue. She employed an answering service and hired a woman to do her billing.

“It really went pretty well for her,” Mike said of Debora’s solo practice, which lasted a little less than a year. “The problem was that St. Mary’s closed. And then Debora got pregnant with Kelly. She was pretty upset about that.”

Although Debora was thirty-seven, which is no longer considered unusually late for childbearing, she and Mike had assumed that there would be no more children. She was shocked when, in May of 1988, she recognized the unmistakable symptoms of pregnancy. This, added to the closing of the only hospital where she had felt comfortable, effectively ended her attempt to establish a private practice in Kansas City.

Kelly was born almost exactly four years after Lissa—on December 13, 1988. This time Debora got the epidural anesthetic she had chosen for each of her deliveries. All through the labor, Mike stood beside Debora’s bed, trying to comfort her. He fed her ice chips, rubbed her back, and reached out to hold her hand. But she brushed him away impatiently; she didn’t want him to touch her at all. They had been married nine years and this was their third baby, but Debora seemed to resent Mike because she was delivering a child she didn’t want, a child who had interfered with the first successful practice she had ever had.

“She clearly didn’t care if I was there or not,” Mike said. “It was kind of upsetting to me, because I thought that this was something that we would always go through together.”

Kelly turned out to be a special child, an unexpected gift, a curly-haired blond pixie of a baby. And there was something more: she exuded love and seemed to have the somber wisdom of an old soul. She was, her father would judge, the most intelligent of the three children born to him and Debora. Of course, it wasn’t long before everyone forgot she had begun as an unwelcome surprise. Both her mother and her father adored her, and Tim and Lissa welcomed their baby sister.

Debora had always been an excellent mother to newborns and toddlers. Mike was proud of her for that. She seemed to enjoy them tremendously—and they her. There were always special birthday cakes and parties. Debora taught them to swim and saw that they had tennis lessons and dancing lessons and that Tim started in sports early. She had great ambition for her children.

If only their marriage could have grown as naturally as their children. But it didn’t. Debora suspected that Mike was looking at other women, a concern that may not have been unfounded. One nurse who worked with Mike later recalled that Debora seemed obsessed with him and would follow him around to see what he was doing when he was away from her.

Even so, nothing changed at home. Debora either would not or could not control the tantrums brought on by frustration at delays and small annoyances. She had never been a homemaker and she was clearly not about to change. She and Mike had the children in common, but the physical side of their marriage, the intimate man-and-wife side, scarcely existed.