Confucius Jane (4 page)

“Sort of. Only it wasn't fun.”

She held back a smile at the forlorn note in his voice. “All right. Anything else?”

“I can't see the damn TV,” he groused. “Did they move my bed? I could see it fine yesterday.”

“I don't think so. It's difficult to move your bed because of all the machinery. Does your vision seem blurry, or just worse?”

“I don't know! I just want to watch
SportsCenter,
damn it!”

Sutton made another note. “Who's your team, Mr. Bartlett?”

“The Rangers! Who else?”

“Did you play hockey, ever?”

He didn't answer right away, and Sutton glanced up to find him looking out the window. The desolate expression on his face was a reminder that, for him, the hospital felt more like a prison. As she waited for him to speak, she smoothed the hem of his thin blanket, wishing futilely that there was more she could do. It was a silly reaction—as useless as regret.

“All the neighborhood kids used to play on the pond at the bottom of the hill.”

“Where did you grow up?”

“Flushing.” His mouth tightened into a thin line. “That pond is a goddamn McDonald's now.”

“I'm sorry. We don't need any more of those, do we? Is there anything else you'd like me to know?”

His scowl grew deeper. “The food here has no taste. None.”

Sutton laughed. “I can empathize. It's not any better in the cafeteria, I promise.” She wrote a few shorthand notes into her book and snapped it shut. “Your incision site is healing well, and you have a CT scan scheduled for tomorrow. Any questions for me?”

“If that scan-thing is clear, I can go home?”

For the first time, a note of vulnerability crept into his voice, and Sutton felt a rush of sympathy. “I can't promise you that, but it seems likely to me.”

He sighed and closed his eyes. Sutton wished him a good night and left, releasing her breath on a slow exhale as the door shut behind her. That had gone pretty well. The question was, did Mr. Bartlett's symptoms amount to anything, or was he just complaining because he was lonely and uncomfortable? The strange sensation he'd felt might have been a reaction to his medication, but the loss of eyesight was more difficult to explain. Sutton had a niggling suspicion that something was going on, but she knew better than to take her hunch to the residents without any corroborating proof. That meant she had to stop at the nurses' station.

“Hi, Diana,” she greeted the head nurse. “Do you have a sec to answer a few questions for me?”

From the moment she'd begun her clinical rotations, Sutton had worked hard to establish a strong rapport with as many of the nurses as possible. They were the true eyes and ears of the wards, and the glue that held the hospital together. And as a student, much further down on the totem pole than even the youngest resident, she was especially careful to tread lightly.

“No, but ask anyway,” Diana said, never taking her eyes off her computer screen.

“I'm wondering if you can tell me what Mr. Bartlett said each time he buzzed today.”

“Can't wait to be rid of that one.” Diana stopped typing and gave Sutton her full attention. “In the morning, he told me he felt ‘off.' When I pressed him for details, he said he felt like he was ‘floating.' When I started asking more questions, he started yelling.”

“And in the afternoon?”

“He was more focused then, but he kept insisting we'd moved his bed away from the television. When I told him we hadn't, all I got was more verbal abuse.”

“Was he this cantankerous before the surgery?”

“You know,” Diana said slowly, “I remember him being gruff, but not nearly this much of a pain in the ass.” She met Sutton's eyes. “What are you thinking?”

“I'm not sure yet. I need to consult with one of the residents. But if he buzzes again, will you page me?”

“Sure.”

“Thanks.” With a wave, Sutton headed for the elevator, writing down a few additional notes as she walked. The sensation of floating. Eyesight problems. A change in mood. Instinct told her they were puzzle pieces waiting to be put together, if only she could make the connections. As she pressed the button for the third floor, her eyes skimmed over the word
cafeteria
and she smiled to herself at the memory of Mr. Bartlett's complaints. She didn't know anyone—physician or patient—who had ever praised the taste of hospital food. But Mr. Bartlett hadn't complained about how bad the food was—he'd complained that it had no taste at all.

Epiphany flared, burning away her fatigue. “That's it,” she said aloud, startling the other person in the elevator—an orderly with a dolly full of boxes.

Sutton squeezed between the doors as soon as they opened. As she hurried down the corridor, she greeted everyone she recognized but didn't slow until she swerved into the residents' lounge. Tom wasn't seated on either of the couches, and she was about to turn toward the row of computers in the back when the image of her father on the television in the far corner paralyzed her. A quick glance at the bottom corner of the screen confirmed that it was just past two o'clock in the afternoon, which meant that Dr. America's daily show had just begun.

“Today, we'll be discussing one of the most hot-button contemporary issues in the medical community: stem-cell research. I'll define what stem cells are, how some scientists intend to use them, and the moral and ethical issues involved.”

Her father might sound reasonable and objective now, but Sutton would have wagered everything in her wallet that, within minutes, he would invoke the notion of “playing God.” Smothering an urge to march across the room and yank the cord out of its socket, Sutton instead turned her back on her father's glossy image and found Tom seated at one of the computers, tapping away industriously.

“Hi again, Tom.”

“Hey, Sutton. How were rounds?”

“Stem cells are special because when they divide, they can ‘differentiate' into anything—heart cells, muscle cells, nerve cells. There are two different kinds of stem cells, embryonic and adult.”

Momentarily distracted by her father's voice, Sutton tried to relegate him to background noise. She had to focus. A man's life might be in the balance. “I need to talk to you about a case. You assisted on the brain tumor resection three days ago, right? For Mr. Bartlett?”

“That's right.”

“Adult stem cells are most frequently harvested from bone marrow, and they are used in the treatment of several illnesses, including cancer and spinal-cord trauma. However, adult stem cells are limited in terms of the kinds of cells they can differentiate into.”

She took a deep breath. “I think he's having TIAs.” Transient Ischemic Attacks were known colloquially as
mini-strokes,
in which the blood supply to part of the brain was temporarily blocked before resolving without medical intervention. They were often the harbingers of more serious and potentially debilitating strokes.

“Evidence?”

“He's reported loss of taste, loss of vision, and feeling light-headed. The nurses have also witnessed a noticeable change in mood since he was admitted. There's been nothing abnormal on the patient monitor, but that's not inconsistent with a TIA that's not originating in the heart.”

Tom laced his hands behind his head, which meant he was going into teacher mode. As she waited for him to speak, her father's words filled the silence.

“Embryonic stem cells, on the other hand, are harvested only five days after conception. These stem cells can, under the right conditions, divide into any kind of cell in the body. However, when these stem cells are harvested, the embryo is completely destroyed.”

Without looking at the television, Sutton could tell that her father had his audience spellbound. His “preacher's voice” was in full effect—inherited, so he claimed, from his Baptist minister father. By the end of the hour, stem-cell research would probably have thousands more opponents.

“Let's say you were me,” Tom said, drawing her attention back to the important matter at hand. “What would you do?”

“He's scheduled for a CT scan tomorrow, but I'd have that done now. And I'd order a carotid ultrasound, just to rule out narrow blood vessels in his neck as the cause.”

“And for treatment?”

“He's allergic to aspirin, and he's already taking an anticoagulant. I'd prescribe an antiplatelet medication, and frequent liver function tests to make sure his body can handle the combination.”

“Sounds good, Dr. St. James. Get on it.” The barest hint of a smile appeared at his lips. “I'll take this to Buehler and have him call in the CT scan, though, so it's sure to happen right away.”

She nodded. The hospital hierarchy permeated every aspect of the institution, and seniority made everything easier. “Thanks. I'll take care of the rest.”

“… and even the production of adult stem cells is controversial, because it relies on cloning techniques. Is it ethical to ‘play God' in this way?”

Sutton couldn't leave the lounge fast enough. As she walked down the hall toward the tiny, cramped computer lab reserved for medical students doing their clerkships, she forced her thoughts away from her father's fearmongering and focused instead on her to-do list. After placing the order for the ultrasound, she would write up her notes and send them to both Tom and Dr. Buehler. Then, she would return to the nurses' station and fill them in while waiting for the results of the CT scan. If the tests came back clear, she would look foolish and overeager.

“But better wrong than uncertain, right?” she muttered under her breath.

Regardless of the outcome, she knew exactly what she wanted once this day was over: a large plate of dumplings and a hot bowl of soup from the one place in the city where she could relax.

*   *   *

HEAD BOWED AGAINST THE
biting wind, Sutton quickly navigated the ten-block walk to her apartment building. A converted warehouse, its high ceilings and exposed wooden beams lent a spacious feeling to her living space that was missing from many other places in the city. The only downside was the poor insulation. Sutton shivered as she stepped into her room but made no move to turn on the space heater. As much as she wanted to spend the rest of this day curled under the covers with a good detective story, she had to make some additional progress on the article for Buehler. That meant going back out into the frigid wasteland. This apartment was her sanctuary, and she refused to bring work home to it.

Mindful of the chill, she hastily stripped off her scrubs and threw on a white cable-knit sweater and jeans. After pulling her hair back in a ponytail and switching out her contacts for glasses, she grabbed her heaviest coat. Her messenger bag was waiting by the door, already packed with her laptop and lab notebook. Within five minutes, she was back in the street and headed toward Chinatown.

Until this past fall, she had done her studying and writing on the top floor of the Ehrman Medical Library, in a carrel with a view of the East River. But in the hubbub surrounding residency applications, the library had transformed from a refuge to a gigantic watercooler. Her so-called friends had sought her out at every opportunity, first asking about her plans and then asking for advice. No matter how many times Sutton tried to convince them otherwise, they assumed she had special insights into the process. Finally, she had abandoned the library as a viable place to do her work. After a few aborted attempts at coffee shops where the conversations around her had been utterly distracting, Sutton had stumbled across a solution one overcast day while seeking out an inexpensive lunch. The brightly painted façade of a small Chinese restaurant called Noodle Treasure had caught her eye, and the mouth-watering scent of frying dumplings had lured her inside. A stout Chinese man had greeted her, his warm smile immediately putting her at ease. The food was hearty and satisfying, the tea fragrant and strong. Her fortune cookie read:
Find a place to shelter from the storm.
By the time she had finished her meal, the skies had opened in an autumnal downpour. Sutton had laughed at the coincidence and opted to do some reading while waiting out the rain.

Noodle Treasure, it turned out, was the perfect place for her to work. Most of the patrons were Chinese, and the cadence of their conversations washed over Sutton without interrupting her concentration. By some mystical process, a petite woman with twinkling eyes and salt-and-pepper hair appeared to refill her teacup whenever it was nearly empty. For once, she'd been able to focus on her work without any interruption except her own tendency to procrastinate whenever she had to do any kind of writing.

The next day, Sutton had brought her laptop and asked to sit at the far corner of the faux-marble bar set against the front window. Instead of dumplings, she ordered soup and noodles. They, too, were delicious. Her fortune cookie read:
Stop and be quiet today.
Sutton had smiled, thinking that perhaps she'd finally found the perfect spot to do just that.

Since then, she had spent many an afternoon in Noodle Treasure. Now, as she pushed open the door and stepped into the warmth, she immediately felt herself relax. When a white-haired gentleman wearing a chef's jacket smiled at her from a table near the back, Sutton gave him a little wave. Giancarlo Bugiardini had been a regular much longer than she. He owned Ciao Bella, one of the nearby Italian restaurants, but ate lunch in Noodle Treasure most days. He had once told Sutton that his sister thought it heretical that he dined elsewhere than his own restaurant, but that “man cannot subsist on Italian fare alone.”

“Hello, Dr. Sutton, hello!” Benny's familiar voice rang out over the scrape of chopsticks and murmur of conversation. Sutton smiled at the nickname. Over time, she had become friendly with Benny, who owned the restaurant with his wife, Mei. Once they had found out about her dual degrees, they had insisted upon using her title at every opportunity.