Die Once Live Twice (36 page)

Fredrick nodded and worked his tired jaws again. “I’m thirsty.” A weak grin crept over his weary lips as tears flowed from Helene’s aching eyes.

“Oh...yes... of course. Here, my love, drink this.” She held a small glass of water to his cracking lips as she supported his head, easing a few droplets into his mouth. Each successful swallow gained him a few drops more until his head fell back onto his pillow, exhausted by the effort. Helene couldn’t bear to let him drift off again without making sure he was still conscious. Clasping his hand in hers she asked him to squeeze it and shivered as he pumped it twice and opened his eyes once more.

“I’m fine,” he said with greater strength before he drifted back to sleep. The emotions of the week finally surfaced as Helene held his hand in hers and cried steadily.

“Helene, what’s happened?” Jackson said, panicking, as he entered the room. Seeing Helene grasping Frederick’s hand in a fit of tears stirred his worst fears. He leaned towards the bed with a sinking feeling. “Doctor Specht?”

Helene quickly reached over to stop Jackson. “No, it’s fine. These are tears of joy. Frederick woke up and asked for water. He said he feels fine.”

Jackson reached for the doctor’s wrist to check his pulse. “Ninety-five. The first time in two days it’s under a hundred.” Grabbing the thermometer off the bed stand, Jackson anxiously tapped his foot while he watched the thermometer in Frederick’s axilla. “One hundred. Good Lord, I can’t believe it,” he said dropping into the chair next to the bed. Staring at Helene’s wide-eyed joy, he shook his head. “I just can’t believe it. I think this damn drug is actually working.”

Jackson remained in the room, thinking of his mother’s relapse. Helene tidied up Fredrick’s bed, touching him gently at every tuck of the sheet. His hand responded to her soft squeeze. Pulling her small wooden chair closer to the bed, Helene rested her head upon her arms on the edge of his mattress. A few deep relieved sighs later, Helene drifted into a peaceful slumber as the final movement of Beethoven’s 9th,
Ode to Joy
, crescendoed on the radio. Frederick’s hand lay gently on her head.

When Jonathan arrived in the morning, Helene and Jackson were there talking with Frederick, who was propped up on pillows. Jonathan saw the IV drip in Fredrick’s arm and said a silent prayer of gratitude for the genius of Florey and Chain.

“Dad,” Jackson said, “what about this! This drug is a miracle. It will change medicine forever. This is the most exciting thing I’ve ever seen. Even beating Yale is a distant second.”

“I see the miracle, son. But make sure that he continues to get the drug on schedule and keep an eye on him. Florey told me the second patient he treated did not get enough drug and relapsed. Let’s not touch the money just yet.”

Helene walked over to Jonathan and hugged him, asking, “Jonathan, can you help me get a telegram to Sebastian that his father is out of danger?”

“I’ll contact the Defense Department this morning, Helene.”

Jackson came into the room later in the morning and brought the leaders of the internal medicine department with him. The whitehaired Chief of Medicine looked at Frederick, sipping water from a cup, with astonishment in his eyes. Neither he nor his senior colleagues had seen a pneumonia patient so sick survive. His wide-eyed stare quickly became a grin of radiant joy, and he clapped one of his senior staff on the back. “By God, I never thought I’d see it! We just whipped that ol’ Captain’s ass! Today, Life triumphed over Death.”

Frederick continued to improve. His temperature was normal and the crackling in his lungs diminished. After three days, Jonathan said to Jackson, “I think we can touch the money. We have a drug with curative powers never before seen by man. Three hundred years of doctors who watched pneumonia steal away their patients would love to be here today.” Jackson wanted to celebrate Frederick’s recovery on September 15, when he had finished the entire course of the drug. “Just a couple of swallows of champagne won’t hurt you, Doctor Specht. We’ll all drink the rest!”

Ten days after the first dose of penicillin, Frederick was cured. His chest x-ray was clear, his breath sounds were normal, and he was actively exercising his new hip. But the hospital room was still filled with tension. Jonathan had told Frederick and Helene there was another battle in Guadalcanal. Waves of Japanese were attacking a ridge behind the Marine base. If the ridge was lost, the airfield and base were lost. The silver ice bucket Jackson had brought sat empty on the floor in a corner of the room.

Late in the afternoon, Jonathan bounced into Frederick’s room as lightly as a seventy-six-year-old man could bounce. A wide smile shone on his face in stark contrast to the glum look on Helene’s, and Frederick’s hopes rose as he asked, “Do you have news of Sebastian?”

“It’s good. It’s all good. A group of Marines called Edson’s Raiders protected the ridge and won the day! But listen to this. Behind Edson, the next biggest hero among the Marines is Sebastian. He saved a Marine with shrapnel in his heart. He operated on a heart! A heart! The forbidden organ. The seat of the soul. That’s the second medical frontier crossed in one week.”

“I can’t believe my snot-nosed friend had the guts to do that,” Jackson grinned. “How dare he become a hero before me!”

“I’ve got the champagne for your party,” Jonathan said as he raised the bottle high. “It’s even cold. The nurse is rounding up Jimmy because I wanted him here too.”

“I wish I had my violin here, Jonathan,” Helene said. “I would serenade you. You brought the penicillin that saved my Frederick and today you brought good news of Sebastian. Your family was our first friends in this country. We had you in our home in Iowa. Jackson—you were your parents’ dream. For thirty years your family has remained our dear friends. May my God of Abraham bestow grace on you for the rest of your life.”

Jimmy burst into the room. “Helene, did you hear what your kid did in Guadalcanal? I can’t help but wonder what Freud would say about that—operating on the heart. Probably ‘his Zuperego vas shtruggling mit some unbearable tenzhun.’”

“Ach,” said Frederick, “that’s not all that’s unbearable around here.”

Amidst the howling, Jackson took the champagne from Jonathan and popped the cork. “Damn, I forgot glasses,” Jonathan said.

Jackson turned out and hurried out of the room. He returned with six plastic hospital glasses. “Nothing but the finest!”

Jackson filled the cups, except for Frederick’s, which was given only a swallow. “Your alcohol is rationed, doctor,” Jackson said as he raised his glass. “To penicillin, the wonder drug that every doctor has dreamed of. If Pasteur could only be here to witness the mountain climbed. Man’s conquest over bacteria. And Frederick’s.”

After his toast, Jackson retrieved the silver ice bucket from its corner. Instead of filling it with ice, he reached into his pocket and transferred a glass vial with yellow powder into the silver bucket. Jackson stepped over to stand next to his father. “I think all of you know the story of my family’s legacy. My grandmother Katherine sent my father and my uncle to the medical world to discover new cures and save lives. My dad has always called this the road to Jerusalem. Uncle Jeffrey contributed by his development of medical education, and my dad by his dedication to research.”

“Ultimately, Grandmother wanted them to find the Holy Grail—the curative power to forestall death. I realized this week that the journey was over. Dad returned to us with the Holy Grail. He brought us the magic potion that stops death and lets us live twice. So Dad, here’s the long-sought silver chalice with the power of life inside it—a vial of penicillin.” Jackson’s eyes were full of pride as he handed the icebucket to his father. The room erupted with applause.

Jonathan hugged Jackson, then stood cradling the chalice in one arm, the other draped around his son’s shoulders. “This has been, I think, the most momentous week of my life. As I stand here I can see little Angelo in his mother’s arms as Park injects him with the diphtheria vaccine. I remember my thrill at the first pasteurized milk—sanitation of water and milk enabled the children of New York to survive. Life expectancy is now sixty years—I’m way overdue! —because we saved half of our infants from dying in the first year. How could I forget little Anna, who taught me that penicillin was a possibility. Or the Great Flu, which was so horrible it made me rededicate myself for the rest of my life, to this day. Medicine allowed you to survive World War I, Jimmy. You were so excited with the new hip nail, Frederick. And my Marion proved you don’t need to be a doctor to doctor patients.”

“Forgive me for my memories, but they have given value to my life. This week is the culmination of all I’ve dreamed about in medicine. Pneumonia cured and a heart repaired. Fifty years ago doctors could do little and sickness or injury was a death warrant. Now medicine has surgical and medicinal powers to cure those killer diseases and give people a second chance at life. The gates to Katherine’s Jerusalem are open forever. Richard the Lionheart never saw Jerusalem and I will not either. He left for England after insuring access and now I leave medicine fully fulfilled. Jackson, you and Sebastian have a whole new world in front of you with unlimited possibilities of medical miracles. Medicine will explode after this war as never before seen by man.”

“My incredible journey is over,” he said, looking into Jackson’s eyes and seeing the future. “Yours has begun.”

Becoming skilled as a surgeon requires persistence, patience, and time. I needed all three of these qualities to complete this novel about the transformation of medicine from a craft that could offer little more than solace to a profession that could restore life to a dying patient. I teach surgeons that they will learn four things while they are in medicine, as I did: the thrill of victory, the agony of defeat, that there is a God but they are not Him, and to give back better than they take.
Die Once, Live Twice
is a testament to the suffering and exhilaration that accompanied the arduous and dangerous research that advanced medicine. It is the story of the maturation of the profession of medicine, which serves us all so well now and which has given me a magnificent life of serving others.

Surgery is a creative profession, but I have also always been interested in writing, from my time at Cornell College in Mt. Vernon, Iowa, where an English professor, Winifred Van Etten, sparked in me a desire to write. I even wrote a few chapters of a book with her before I left for medical school at the University of Iowa, but for the next thirty years, scientific writing crowded out any other form: 300 journal and book articles, a book on hip surgery, and editing two other medical books.

My conversion from lifelong scientific writer to novelist was a demanding journey, both for the traveler, his companions, and his guides. My faithful companion has been my wife Marilyn. Familiar as she is with my obsessive-compulsive personality, at times even she questioned my sanity in taking on this project in combination with my medical practice and my other responsibilities to medicine. Her love allowed me to pursue this dream.

My guides have been Margaret Leslie Davis, known as Marnie, and Walter Bode. I was introduced to Marnie by Uri Herscher, the chief executive officer of the Skirball Cultural Center, and in referring me to Marnie, he was a rabbi from Heaven. Without her, this book would not be a worthy novel nor would the business of getting it published have been successfully negotiated. Walter Bode is an editor whose blunt honesty and patience with my naivety made my writing readable. No one could be better at refining a scene and skillfully manipulating dialogue than Walt. The publication of this book is my public thankyou to both Marnie and Walt.

Marnie and Walt led me to my publisher, Paul Chutkow, who saw immediately my vision of what this book could be and has worked tirelessly to bring it to completion, for which I offer my sincere gratitude.

In 2007 I employed Leigh-Ellen Sirianni to help me begin work on a novel based on the history of medicine from the years 1800 to 2000. She enthusiastically and capably collected information and wrote it up for me, and I appreciated her high-quality work, some of which is still in evidence, especially in the chapters on cancer, because she was in cancer treatment.

I must also thank Patricia J. Paul for transcribing my oral drafts; my brother David, an award-winning journalist, for his advice; and my dog Split, for his company in the early morning hours when I wrote.

Historical fiction has special demands of research to verify events and dates. My sources for medical events were medical journals, medical friends who advised me in areas outside my expertise, and a number of books of special note.
Vaccine
by Arthur Allen (Norton and Company, 2007) is a comprehensive history of the development of vaccines.
The Social Transformation of American Medicine
by Paul Starr (Basic Books, 1982) provides insight about the social and political changes in medicine that influenced its transformation, particularly the effect of the Flexner Report.
The Great Influenza
by John M. Barry (Penguin, 2005) provides both a history of the beginning of modern medical education and research, especially the contributions of William Welch to American medicine, and a compelling description of the course of the disease and the frustrations of the doctors searching for a solution to this epidemic.
Polio
by David M. Oshinsky (Oxford University Press, 2005) tells, in a most interesting style, the entire history of polio and its effects within medicine and on society.
In Search of Penicillin
by David Wilson (Knopf, 1976) tells the fascinating story of how penicillin was developed from an unstable chemical to become the most important discovery in medicine. This book describes the research into the development of antibiotics during the early 1900s and the methods of research which initially inhibited, and then enhanced, the discovery of these life-saving chemotherapeutic drugs. Typhoid is a disease seldom seen by doctors today, but vividly described in the Thomas Mann’s
Buddenbrooks: The Decline of a Family
(Vintage, 1994).