Hold Tight (5 page)

Spencer hadn’t been alone, after all.

AS he had nearly every weekday for the past decade, Mike woke up at five in the morning. He worked out for exactly one hour. He drove into New York City over the George Washington Bridge and arrived at NewYork-Presbyterian’s transplant center by seven A.M.

He threw on the white coat and rounded on patients. There were times when this threatened to become routine. It didn’t vary much, but Mike liked to remind himself of how important this was to that person lying in the bed. You are in a hospital. That alone made you feel vulnerable and scared. You are ill. You may very well be dying and it seems to you that the person who stands in the way between you and greater suffering, between you and death, is your doctor.

How does your doctor not develop a bit of a God complex?

More than that, sometimes Mike thought it was healthy to have that complex, albeit benevolently. You mean a lot to your patient. You should act like it.

There were doctors who rushed through it. There were times Mike wanted to do that too. But the truth is, if you give your all, it only takes an extra minute or two per patient. So he listened and held a hand if that was required or stayed a little aloof-depending on the patient and how he read them.

He was at his desk by nine A.M. The first patient had already arrived. Lucille, his RN, would be working them up. That gave him maybe ten minutes to review the charts and overnight test results. He remembered his neighbor and quickly searched for the Loriman results in the computer.

Nothing posted yet.

That was odd.

A strip of pink drew Mike’s eye. Someone had stuck a Post-it note onto his phone.

See me

– Ilene

Ilene Goldfarb was his practice partner and head of transplant surgery at NewYork-Presbyterian. They had met during their residency in transplant surgery and now lived in the same town. He and Ilene were friends, Mike guessed, but not close ones, which made the partnership work well. They lived maybe two miles apart, had kids who attended the same schools, but other than that, they had few mutual interests, didn’t need to socialize, and totally trusted and respected the other’s work.

Do you want to test your doctor friend on his medical recommendation? Ask him this: If your kid was sick, what doctor would you send him to?

Mike’s answer was Ilene Goldfarb. And that told you everything you needed to know about her competence as a physician.

He headed down the corridor. His feet padded silently on the industrial-gray wall-to-wall. The prints lining the off-white hallway were gentle on the eyes, simple and with about as much personality as the artwork you’d find in a mid-scale motel chain. He and Ilene had wanted the entire office to whisper, “This is about the patient and the patient only.” In the offices, they displayed only professional diplomas and citations because that seemed to comfort. They did not keep anything personal-no pencil holder made by a child, no family photographs, nothing like that.

Your child often came here to die. You don’t want to see the image of someone else’s smiling, healthy children. You just don’t.

“Hey, Doc Mike.”

He turned. It was Hal Goldfarb, Ilene’s son. He was a high school senior, two years older than Adam. He’d made Princeton early decision and planned to go in premed. He’d managed to get school credit to spend three mornings a week interning for them.

“Hey, Hal. How’s school?”

He gave Mike a big smile. “Coasting.”

“Senior year after you’ve already been admitted to college-the dictionary definition of coasting.”

“You got it.”

Hal was dressed in khakis and a blue dress shirt and Mike couldn’t help but notice the contrast with Adam’s goth black and feel a pang of envy. As if reading his mind, Hal said, “How’s Adam?”

“Okay.”

“I haven’t seen him in a while.”

“Maybe you should give him a call,” Mike said.

“Yeah, I should. It’d be great to hang out.”

Silence.

“Mom in her office?” Mike asked.

“Yes. Go right in.”

Ilene sat behind her desk. She was a slight woman, small-boned except for her talonlike fingers. She wore her brown hair pulled back in a severe ponytail and had horn-rimmed glasses that nicely straddled the border between looking bookish and in vogue.

“Hey,” Mike said.

“Hey.”

Mike held up the pink Post-it note. “What’s up?”

Ilene let loose a long breath. “We got a big problem.”

Mike sat. “With?”

“Your neighbor.”

“Loriman?”

Ilene nodded.

“Bad tissue test result?”

“Weird test result,” she said. “But it had to happen sooner or later. I’m surprised this is our first.”

“Do you want to clue me in?”

Ilene Goldfarb took off the glasses. She put one of the earpieces in her mouth and chewed on it. “How well do you know the family?”

“They live next door.”

“You close?”

“No. Why, what’s that got to do with anything?”

“We may have,” Ilene said, “something of an ethical dilemma.”

“How so?”

“Dilemma might be the wrong word.” Ilene looked off, talking more to herself than Mike right now. “More like a blurry ethical line.”

“Ilene?”

“Hmm.”

“What are you talking about?”

“Lucas Loriman’s mother will be here in half an hour,” she said.

“I saw her yesterday.”

“Where?”

“In her yard. She’s doing a lot of pretend gardening.”

“I bet.”

“Why do you say that?”

“Do you know her husband?”

“Dante? Yes.”

“And?”

Mike shrugged. “What’s going on, Ilene?”

“It’s about Dante,” she said.

“What about him?”

“He’s not the boy’s biological father.”

Just like that. Mike sat there for a moment.

“You’re kidding me.”

“Yeah, that’s what I’m doing. You know me-Dr. Kidder. Good one, right?”

Mike let it sink in. He didn’t ask if she was sure or wanted to take more tests. She would have thought of all those angles. Ilene was right too-the bigger surprise was that they hadn’t run into this before. Two floors below them were the geneticists. One of them told Mike that in random population tests, more than ten percent of men were raising children that, unbeknownst to them, weren’t biologically theirs.

“Any reaction to this news?” Ilene said.

“Wow?”

Ilene nodded. “I wanted you to be my medical partner,” she said, “because I love your way with words.”

“Dante Loriman is not a nice man, Ilene.”

“That was my vibe.”

“This is bad,” Mike said.

“So is his son’s condition.”

They sat there and let that sit in the room, heavy.

The intercom buzzed. “Dr. Goldfarb?”

“Yes.”

“Susan Loriman is here. She’s early.”

“Is she here with her son?”

“No,” the nurse said. “Oh, but her husband is with her.”

“ WHAT the hell are you doing here?”

County Chief Investigator Loren Muse ignored him and headed over to the corpse.

“Sweet Lord,” one of the uniforms said in a hushed voice, “look what he did to her face.”

The four of them stood now in silence. Two were first-on-the-scene uniforms. The third was the homicide detective who’d technically be in charge of the case, a lazy lifer with a potbelly and world-weary manner named Frank Tremont. Loren Muse, the lead investigator for Essex County and the lone woman, was the shortest of the group by nearly a foot.

“DH,” Tremont pronounced. “And I’m not talking baseball terminology.”

Muse looked a question at him.

“DH, as in Dead Hooker.”

She frowned at his chuckle. Flies buzzed about the pulpy mess that at one time had been a human face. There was no nose or eye sockets or even much of a mouth anymore.

One of the uniforms said, “It’s like someone shoved her face into a meat grinder.”

Loren Muse looked down at the body. She let the two uniforms jabber. Some people jabber to ward off the nerves. Muse wasn’t one of them. They ignored her. So did Tremont. She was his immediate superior, all their superiors really, and she could feel the resentment coming off them like humidity from the sidewalk.

“Yo, Muse.”

It was Tremont. She looked at him in that brown suit with the belly from too many nights of beer and too many days of doughnuts. He was trouble. There had been complaints leaked to the media since she’d been promoted to chief investigator of Essex County. Most came from a reporter named Tom Gaughan, who just so happened to be married to Tremont’s sister.

“What is it, Frank?”

“Like I asked you before-what the hell are you doing here?”

“I need to explain myself to you?”

“I caught this one.”

“So you did.”

“And I don’t need you looking over my shoulder.”

Frank Tremont was an incompetent ass but because of his personal connections and years of “service,” fairly untouchable. Muse ignored him. She bent down, still staring at the raw meat that had once been a face.

“You get an ID yet?” she asked.

“No. No wallet, no purse.”

“Probably stolen,” one of the uniforms volunteered.

Lots of male head-nodding.

“Gang got her,” Tremont said. “Look at that.”

He pointed to a green bandana still clutched in her hand. “Could be that new gang, bunch of black guys who call themselves Al Qaeda,” one of the uniforms said. “They wear green.”

Muse stood and started circling the corpse. The ME van arrived. Someone had police-taped the scene. A dozen hookers, maybe more, stood behind the line, each stretching her neck for a better view.

“Have the uniforms start talking to the working girls,” Muse said. “Get a street name at least.”

“Gee, really?” Frank Tremont sighed dramatically. “You don’t think I already thought of that?”

Loren Muse said nothing.

"Hey, Muse.”

“What, Frank?”

“I don’t like you being here.”

“And I don’t like that brown belt with black shoes. But we both have to live with it.”

“This isn’t right.”

Muse knew that he had a point. The truth is, she loved her prestigious new position as chief investigator. Muse, still in her thirties, was the first female to hold that title. She was proud. But she missed the actual work. She missed homicide. So she got involved when she could, especially when a seasoned jackass like Frank Tremont was on the job.

The medical examiner, Tara O’Neill, came over and shooed the uniforms away.

“Holy crap,” O’Neill whispered.

“Nice reaction, Doc,” Tremont said. “I need prints right away so I can run her through the system.”

The ME nodded.

“I’m going to help question the hookers, round up some of the leading gang scumbags,” Tremont said. “If that’s okay with you, boss.”

Muse didn’t respond.

“Dead hooker, Muse. There isn’t really enough of a headline for you here. Hardly a priority.”

“Why isn’t she a priority?”

“Huh?”

“You said not a headline for me here. I get that. And then you added, ‘hardly a priority.’ Why not?”

Tremont smirked. “Oh, right, my bad. A dead hooker is priority number one. We treat her like the governor’s wife was just whacked.”

“That attitude, Frank. It’s why I’m here.”

“Right, sure, that’s why. Let me tell you how people look at dead hookers.”

“Don’t tell me-like they’re asking for it?”

“No. But listen and you might learn: If you don’t want to end up dead by a Dumpster, don’t turn tricks in the Fifth Ward.”

“You ought to make that your epitaph,” Muse said.

“Don’t get me wrong. I will get this sicko. But let’s not play games about priorities and headlines.” Tremont moved a little closer, so that his belly was almost pressing against her. Muse did not back up. “This is my case. Go back to your desk and leave the work to the grown-ups.”

“Or?”

Tremont smiled. “You don’t want that kind of trouble, little lady. Believe me.”

He stormed off. Muse turned back around. The ME was concentrating very hard on opening her work case, pretending not to have heard.

Muse shook it off and studied the body. She tried to be the clinical investigator. The facts: The victim was a Caucasian female. Judging by the skin and general frame she looked to be about forty, but the streets had a way of aging you. No visible tattoos.

No face.

Muse had only seen something this destructive once before. When she was twenty-three, she spent six weeks with state troopers on the New Jersey Turnpike. A truck crossed a divider and smashed head-on into a Toyota Celica. The Toyota driver had been a nineteen-year-old girl coming home from college break.

The destruction had been mind-blowing.

When they finally pried the metal off, that nineteen-year-old girl had no face either. Like this.

“Cause of death?” Muse asked.

“Not sure yet. But man, this perp is one sick son of a bitch. The bones aren’t just broken. It’s almost like they were ground into small chunks.”

“How long ago?”

“I would guess ten, twelve hours. She wasn’t killed here. Not enough blood.”

Muse already knew that. She examined the hooker’s clothes-her pink bra top, her tight leather skirt, the stiletto heels.

She shook her head.

“What?”

“This is all wrong,” Muse said.

“How’s that?”

Her phone vibrated. She checked the caller ID. It was her boss, County Prosecutor Paul Copeland. She looked over at Frank Tremont. He gave her a five-finger wave and grinned.

She answered. “Hey, Cope.”

“What are you doing?”

“Working a crime scene.”

“And pissing off a colleague.”

“A subordinate.”

“A pain-in-the-ass subordinate.”

“But I’m in charge of him, right?”

“Frank Tremont is going to make a lot of noise. Get that media on us, rile up his fellow investigators. Do we really need the aggravation?”

“I think we do, Cope.”

“What makes you say that?”

“Because he has this case all wrong.”

DANTE Loriman came into Ilene Goldfarb’s office first. He gave Mike a little too firm a handshake. Susan came in behind him. Ilene Goldfarb stood and waited behind her desk. She had the glasses back on now. She reached across and gave them both quick handshakes. Then she sat down and opened the manila folder in front of her.

Dante sat next. He never looked at his wife. Susan took the chair next to him. Mike stayed in the back of the room, out of sight. He folded his arms and leaned against the wall. Dante Loriman began carefully to roll up his sleeves. First the right sleeve, then the left. He placed his elbows on his thighs and seemed to beckon Ilene Goldfarb to hit him with the worst.

“So?” Dante said.

Mike watched Susan Loriman. Her head was up. She sat hold-your-breath still. Too still. As if feeling his gaze, Susan turned her lovely face toward him. Mike aimed for neutral. This was Ilene’s show. He was just a spectator.

Ilene continued to read the file, though that seemed more for show. When she was done, she folded her hands on the desk and looked somewhere between the two parents.

“We ran the necessary tissue typing tests,” she began.

Dante interrupted. “I want to be the one.”

“Excuse me?”

“I want to give Lucas a kidney.”

“You’re not a match, Mr. Loriman.”

Just like that.

Mike kept his eyes on Susan Loriman. Now it was her turn to play neutral.

“Oh,” Dante said. “I thought the father…”

“It varies,” Ilene said. “There are many factors, as I think I explained to Mrs. Loriman during her previous visit. Ideally we want the HLA typing to have a six antigen match. Based on the HLA typing, you wouldn’t be a good candidate, Mr. Loriman.”

“How about me?” Susan asked.

“You’re better. You’re not perfect. But you’re a better match. Normally your best chance is a sibling. Each child inherits half his antigens from each parent and there are four combinations of inherited antigens possible. Put simply, a sibling has a twenty-five percent chance of being an identical match, a fifty percent chance of being a half match-a three antigen-and a twenty-five percent chance of not being a match at all.”

“And which is Tom?”

Tom was Lucas’s younger brother.

“Unfortunately, the news is bad there. Your wife is the best match we have so far. We will also put your son on the cadaver kidney transplant bank, see if we can find a better candidate, but I would call that unlikely. Mrs. Loriman might be considered good enough, but frankly she is not an ideal donor.”

“Why not?”

“Her match is a two. The closer we are to a six, the more likely your son’s body will not reject the new kidney. You see, the better the antigen match, the less likely he will have to spend his life taking medications and doing constant dialysis.”

Dante ran his hand through his hair. “So what do we do now?”

“We have a little time maybe. Like I said, we can put his name on the list. We search and keep working with dialysis. If nothing better comes along, we use Mrs. Loriman.”

“But you’d like to find better,” Dante said.

“Yes.”

“We have some other relatives who said they’d donate to Lucas if they could,” Dante said. “Maybe you could test them.”

Ilene nodded. “Make up a list-names, addresses, and exactly how they are blood related.”

Silence.

“How sick is he, Doc?” Dante spun around and looked behind. “Mike? Be straight with us. How bad is this?”

Mike looked at Ilene. Ilene gave a little go-ahead nod.

“Bad,” Mike said.

He looked at Susan Loriman when he said it. Susan looked away. They discussed options for another ten minutes or so and then the Lorimans left. When Mike and Ilene were alone, Mike took the chair Dante had been in and raised his palms to the sky. Ilene pretended to be busy putting files away.

“What gives?” Mike said.

“You thought I should tell them?”

Mike didn’t reply.

“My job is to treat their son. He is my patient. The father isn’t.”

“So the father has no rights here?”

“I didn’t say that.”

“You took medical tests. You learned something from them that you kept from a patient.”

“Not my patient,” Ilene countered. “My patient is Lucas Loriman, the son.”

“So we bury what we know?”

“Let me ask you this. Suppose I found out from some test that Mrs. Loriman was cheating on Mr. Loriman, would I be obligated to tell him?”

“No.”

“How about if I found out that she was dealing drugs or stealing money?”

“You’re reaching, Ilene.”

“Am I?”

“This isn’t about drugs or money.”

“I know, but in both cases it is irrelevant to the health of my patient.”

Mike thought about that. “Suppose you found a medical problem in Dante Loriman’s test. Suppose you found out that he had a lymphoma. Would you tell him?”

“Of course.”

“But why? As you just pointed out, he’s not your patient. He’s not your concern.”

“Come on, Mike. That’s different. My job is to help my patient- Lucas Loriman-get better. Mental health is part of that. Before we do a transplant, we make our patients go through psychiatric counseling, right? Why? Because we worry about their mental health in these situations. Causing tremendous upheaval in the Loriman household will not benefit my patient’s health. Period, end of story.”

They both took a second.

“It’s not that easy,” Mike said.

“I know.”

“This secret will weigh heavy on us.”

“That’s why I shared it with you.” Ilene spread her arms and smiled. “Why should I be the only one with sleepless nights?”

“You’re a great partner.”

“Mike?”

“Yes?”

“If it was you, if I ran a test like this and found out that Adam wasn’t your biological son, would you want to know?”

“Adam not my son? Have you seen the size of his ears?”

She smiled. “I’m trying to make a point. Would you want to know?”

“Yes.”

“Just like that?”

“I’m a control freak. You know that. I need to know everything.”

Mike stopped.

“What?” she said.

He sat back, crossed his legs. “Are we going to keep avoiding the elephant in the room?”

“That was my plan, yes.”

Mike waited.

Ilene Goldfarb sighed. “Go ahead, say it.”

“If our first credo is indeed ‘First do no harm’…”

She closed her eyes. “Yeah, yeah.”

“We don’t have a good donor for Lucas Loriman,” Mike said. “We’re still trying to find one.”

“I know.” Ilene closed her eyes and said, “And the most obvious candidate would be the biological father.”

“Right. He’s our best chance now for a solid match.”

“We need to test him. That’s priority one.”

“We can’t bury it,” Mike said. “Even if we want to.”

They took that in.

“So now what do we do?” Ilene asked.

“I’m not sure we have much of a choice.”

BETSY Hill waited to confront Adam in the high school parking lot.

She looked behind her at “Mom Row,” the curb along Maple Avenue where the moms-yes, there was the occasional dad but that was more the exception that proved the rule-sat in idling cars or gathered to chat with other moms, waiting for school to let out so they could shepherd their offspring to the violin lesson or the orthodontist appointment or the karate class.

Betsy Hill used to be one of those mothers.

She had started as one of those mothers at the kindergarten drop-off at Hillside Elementary and then middle school at Mount Pleasant and finally here, just twenty yards from where she now stood. She remembered waiting for her beautiful Spencer, hearing the bell, peering out the windshield, watching the kids erupt-exit like ants scattering after a human boot toes their hill. She’d smile when she first laid eyes on him and most of the time, especially in the early days, Spencer would smile back.

She missed being that young mother, the naïveté you are granted with your firstborn. It was different now, with the twins, even before Spencer’s death. She looked back at those mothers, at the way they did it without a care or thought or fear, and she wanted to hate them.

The bell sounded. The doors opened. The students made their way out in giant waves.

And Betsy almost started looking for Spencer.

It was one of those brief moments when your brain just can’t go there anymore, and you forget how horrible everything is now, and you think, for just a brief second, that it was all a bad dream. Spencer would walk out, his backpack on one shoulder, his posture in teenage stoop, and Betsy would see him and think that he needed a hair-cut and looked pale.

People talk about the stages of grief-denial, anger, bargaining, depression, acceptance-but those stages tend to blend more in tragedy. You never stop denying. Part of you is always angry. And the whole idea of “acceptance” is obscene. Some shrinks prefer the word “resolution.” Semantically the notion was better, but it still made her want to scream.

What exactly was she doing here?

Her son was dead. Confronting one of his friends would not change that.

But for some reason it felt like it might.

So maybe Spencer hadn’t been alone that whole night. What did that change? Cliché, yes, but it wouldn’t bring him back. What was she hoping to find here?

Resolution?

And then she spotted Adam.

He was walking alone, the backpack weighing him down-weigh- ing them all down, when she thought about it. Betsy kept her eyes on Adam and moved right so that she would be in his path. Like most kids, Adam walked with his eyes down. She waited, adjusting her stance a little left or right, making sure that she stayed in front of him.

Finally, when he got close enough, she said, “Hi, Adam.”

He stopped and looked up. He was a nice-looking boy, she thought. They all were at this age. But Adam too had changed. They had all crossed some adolescent line. He was big now, tall with muscles, much more a man than a boy. She could still see the child in his face, but she could also see something like a challenge too.

“Oh,” he said. “Hi, Mrs. Hill.”

Adam started to walk away, now veering toward his left.

“Can I talk to you a moment?” Betsy called out.

He glided to a stop. “Uh, sure. Of course.”

Adam jogged toward her with athletic ease. Adam had always been a good athlete. Not Spencer. Had that been part of it? Life is so much easier in towns like this when you’re a good athlete.

He stopped maybe six feet in front of her. He couldn’t meet her eye, but few high school boys could. For a few seconds she did not say anything. She just looked at him.

“You wanted to talk to me?” Adam said.

“Yes.”

More silence. More staring. He squirmed.

“I’m really sorry,” he said.

“About?”

That answer surprised him.

“About Spencer.”

“Why?”

He didn’t reply, his eyes everywhere but on her.

“Adam, look at me.”

She was still the adult; he was still the kid. He obeyed.

“What happened that night?”

He swallowed and said, “Happened?”

“You were with Spencer.”

He shook his head. His face drained of color.

“What happened, Adam?”

“I wasn’t there.”

She held up the picture from the MySpace page, but his eyes were back on the ground.

“Adam.”

He looked up. She thrust the picture toward his face.

“That’s you, isn’t it?”

“I don’t know, it might be.”

“This was taken the night he died.”

He shook his head.

"Adam?”

“I don’t know what you’re talking about, Mrs. Hill. I didn’t see Spencer that night.”

“Look again-”

“I have to go.”

“Adam, please-”

“I’m sorry, Mrs. Hill.”

He ran away then. He ran back toward the brick edifice and around the back and out of sight.