Pascal's Wager (7 page)

I'm just going to see that she gets some professional help
, I told myself as I pushed the speed limit on Campus Drive toward Stanford Hospital.
Then it's up to her what she does with it
.

The corridor leading to the hematology lab was bustling with its usual atmosphere of urgency when I got there. No one wearing a white coat ever
walked
anywhere; these people seemed to think that if they didn't run where they were headed, something catastrophic was going to happen. But I was oblivious to it, since I
was busy considering the possibility that I was now trying to control my mother's life the way she'd always controlled mine. But I dismissed that the minute I got to her office door. It was cracked slightly, and somebody inside was doing the controlling for me.

“Liz, you aren't hearing me,” he was saying. It was Ted Lyons, head of hematology. “I am not going to attribute this to an oversight on the part of one of the techs. This is your signature, your recommendation.”

“Made on the basis of test results,” I heard my mother say.

She didn't sound the least bit shaken. At the tone of Ted's voice, even I would have been. Every word was being punched at her like she was a leather bag. I leaned against the door jamb and waited for her to throw her next punch. I'd watched her many times discover a weakness in an opponent's case and magnify it to the point of ridicule. I glanced at my watch. I'd give it five minutes before poor Ted would be slinking out of there.

“The patient's first test for rubella was negative,” Ted said. “So she didn't receive the vaccine.”

“You've said that four times now,” Liz said.

“But a subsequent test showed her to be rubella-positive.”

“How many times are you going to go over this?”

Ted plowed on, his voice rising with each punch. “When you saw that, why didn't it occur to you that it was going to create a cascade of concerns for the fetus? The possibility of cerebral palsy alone is—”

“The sample was repeated—on my orders. It came up positive again. That is defini—defini—”

“Definitive,” I whispered.

“It is
not
definitive!” Ted said. “It was completely uncharacteristic for you not to recommend a referral to the Infectious Disease people. Or at least to consider a false positive. You advised on the basis of low probability of the infection.”

“I didn't want to put off the inevitable.”

“Inevitable? That couple had a decision to make. Only
because the ID docs saw inconsistencies—inconsistencies you should have caught—did they send a sample to another lab.”

“I know. It came back negative. Bravo for the couple.”

“Why did another lab beyond Stanford have to find our mistake, Liz? It's unconscionable. What if that couple had elected to terminate the pregnancy? They would have done it on the basis of your report. We'd be responsible for the abortion of a perfectly normal baby.”

Here we go
, I thought.
She's going to get him on improper terminology or something—

I waited. It didn't happen. There was a killing silence in the office.

“It's not the first major mistake that has come out of this office in the last two months, Liz,” Ted said finally. “My question is this: Is it going to be the
last?”

“You'll have to answer that one,” Liz said. “I'm going to lunch.”

I didn't even have a chance to back away from the door before she pushed it open. She didn't look at all as if she'd just lost an argument—probably the first one in her professional life. She just appeared puzzled to see me there.

“Oh,” she said. “Oh, yes. We're having lunch.”

She headed off down the hall at a stiff march, and her petite form was immediately lost in the sea of white coats. I got to her just as she was about to step into the line in the cafeteria. I looked at the myriad of shoulders in surgical scrubs and shook my head.

“Come on—let's get out of here,” I said. “It's way too crowded.” And too public. What I had to say, she wasn't going to want to hear amid her colleagues.

I had to move at a dead run to keep up with her as she turned abruptly and headed for the front entrance, lab coat flying out behind her. Was it me, I thought, or was she becoming more unkempt every time I saw her? She was wearing a pair of black slacks and the brown loafers she normally only put on to go out
and get the newspaper off the front lawn.

Her Mercedes wasn't in much better shape. It was a cream-colored '85 she'd bought from one of the doctors when he retired. He reminded her of my grandfather or something; it was one of the few sentimental things I'd ever known her to do—that and the way she normally had the thing groomed every week. There was no evidence of that now. I had to move a pair of shoes and several empty Burger King cups before I could sit in the passenger seat.

Since when did you start drinking soda?
I wanted to say. I managed to withhold comment, though. I had to stay in the right compartment—and that one was going to be hard enough. I'd be lucky if she didn't shove me out of the car the minute I started talking about it.

I tried for about the umpteenth time since last night to get my words organized, but it was pointless. The scene I'd overheard between her and Ted Lyons had given the thing a whole new twist. Other people
were
noticing—people who had a real impact on her career.

“Look, Mother,” I said finally, “I heard what happened with Ted. The door was open, and, to be honest, I listened.”

She looked at me vaguely and pulled the Mercedes out of the parking lot and onto Pasteur Drive. She didn't pick up any of the CDs in the console and stick them in the player as she was wont to do.

“And your point is?” she said.

“My point is, it sounds like things aren't going particularly well.”

“Things are going perfectly fine. What are you talking about?”

I watched her closely. Her square face was as untroubled as ever.

“Ted doesn't seem to think they're ‘fine,'” I said. “From the way he sounded, you could have caused somebody a personal disaster, not to mention the hospital a lawsuit.”

“Ted Lyons has a strong sense of the—of the—the thing they do on stage, the theater—”

“The dramatic?” I said.

“He always imagines the worst possible impresario.”

She must have meant scenario, but I didn't have the nerve to correct her. I just tried not to stare.

“Blood tests have a 99.9 percent accuracy rate,” she went on, “but some of them are so sensational—no—so—you know, they detect every little—they're so—well, they're that way, and they can pick up a false positive.”

She closed her mouth firmly, as if that should explain it all. I was groping.

“Yeah, but what does that prove?” I said.

She glanced at me coldly, which didn't surprise me, but I saw that she had a white-knuckled grip on the steering wheel. Maybe I should wait until we got to the restaurant to pursue this further.

“Where are we going, anyway?” I said. “You didn't like the food at Marie Callendar's.”

“I liked it fine. I did a second test—”

At Marie Callendar's? No, she was back to the lab thing.

“The first one was just a—uh—you know, a test that rules things out.”

“Screening test?”

“Screening test. The second one was to conform it.”

She cocked her head slightly to the side.
She knows that wasn't the right word
, I thought. I was still considering whether to supply a quick “you mean
confirm”
when she continued.

“The second test was not as sensible but it was highly pacific. The first test was designated—determined—designed—
whatever
. It was supposed to pick up all cases but not all the people it would pick up would have the thing—the sickness—the—”

The skin between her eyebrows puckered, and she gave the steering wheel a soft pound with her fist. She had to suddenly slam on the brakes to keep from plowing into the back of the
BMW in front of us. I could see the driver staring into her rearview mirror.

“It's supposed to filter the false positives out. I guess it didn't.”

Mother shrugged, but as we moved forward again she was still holding onto the wheel as if it were threatening to take on a life of its own.

“You guess?” I said. “I didn't think you ever
guessed.”

“When did you get your medical degree, Jill?” she said.

“Mother, come on. You have always prided yourself on—”

“Ted goes off about the consolation—no, the comput—what the devil is the
word?”

I never got the chance to answer. Nor did I have the opportunity to scream, “Mom! Stop!” I just saw the stop sign she was ignoring and heard the sickening squeal of brakes and screeching tires. The blue Jeep Grand Cherokee was just beginning its plow into my mother's side of the Mercedes as I was snapping my head toward her. The last look I saw on her face was one of complete bewilderment—before we were smashed into the street sign and came to a lurching halt.

T
he next few minutes were a smear of Mrs. BMW peering into the Mercedes while chattering incoherently into her cell phone, and the driver of the Cherokee shouting over and over, “Didn't you see the stop sign, lady? Didn't you see it?” When the paramedics arrived, they added to it with a chain of increasingly pointless questions.

The only thing I remembered clearly—once I was piled into an ambulance I didn't need, ensconced in a neck brace I needed even less—was that my mother hadn't answered a single one of their queries. She'd just lain there in the front seat and then on the stretcher, blinking at them as they asked her to say her name and tell them if she knew where she was.

I slanted my eyes toward the paramedic in my ambulance, though I could only see half of him. The stupid neck brace prevented me from doing anything except stare at the ceiling. As far as I could tell, I had a lump on the side of my head and a gash on my right forearm. Why this necessitated traction was beyond me.

“Do you think my mother is in shock?” I said.

“Hard to tell.”

“Hard to tell? Three paramedics and several thousand dollars' worth of medical equipment and you can't detect a simple thing like shock? Was her breathing shallow, pupils dilated? Isn't that basic First Aid?”

“Whoa, girl,” the paramedic said. “Look at your blood pressure go up. She's getting good care. They'll fill you in at the hospital.”

I gave the ceiling my blackest look. “No wonder you put people in these straitjackets—it's to keep us from smacking you when you make idiotic statements like that. My mother should have been telling
you
characters what her injuries were. Now, do you think she's in shock or has there been brain damage?”

“Brain damage? Now that's hard to say.”

“Forget it,” I said. “Just forget it.”

“You need to try to stay calm. You've just been involved in a serious accident—”

“Ya think? What was your first clue?”

“She's a little cranky” he said to his partner as they were unloading me in front of the emergency room.

I wasn't any more cheerful in the ER when no less than sixteen people surrounded my gurney in the trauma room. I told them all in no uncertain terms that I had never lost consciousness and that I could have
walked
to the hospital if they hadn't strapped me to the stretcher like a mental patient.

“All I want to do is see my mother and have somebody tell me what injuries she sustained. I don't want stitches—I don't want a CAT scan—I don't want an MRI, for Pete's sake. I just want to know about my mother!”

I didn't calm down, despite the eye-rolling that was going on above me, until Ted Lyons came in. By then they'd determined that I had one subdural hematoma on my head—in other words, a bruise—and one laceration on my forearm that would require a few stitches.

“We'll get somebody in here to suture that up,” a nurse said to Ted—not to me.

“I don't want sutures,” I said through clenched teeth. “I want to see my mother, and if I don't, somebody's head is going to roll.”

“She's already on her way to surgery,” Ted said. He put a freckled hand on my shoulder and guided me firmly back onto the gurney.

There wasn't an inch on Ted Lyons that hadn't been liberally sprinkled with freckles. You could even see them up into the scalp of his thinning red hair. Though balding, he still had a boyish face that grinned down at me.

“You McGavock women are mean as snakes,” he said. “Stay put and I'll tell you what's going on with your mom.”

“And could you please take this thing off my neck before I go into some kind of meltdown?”

“No. I'm liable to get slugged by a nurse. They'll take it off. Just relax.” Then Ted perched himself on a stainless steel stool beside my gurney. “Your mother has an open fracture of the femoral diaphysis—the large bone in the thigh—and the protective musculature is also displaced, which all means there's been significant bleeding and the potential for infection. Typically, patients with that type of injury heal well. These days they get them right up on their feet so they don't risk the complications associated with prolonged bed rest.”

“So they're doing surgery just to set the bone?” I didn't even attempt to compete with the jargon he was throwing at me.

He nodded. “They're doing some intramedullary nailing—putting in pins.”

“Ouch.”

“She'll get plenty of pain meds, and they'll probably give her a sedative hypnotic, too, for the anxiety. That's pretty common. But there didn't appear to be any injuries to internal organs, no head trauma. The paramedics reported that she was verbally unresponsive, but apparently she was just stunned.”

Ted stuffed his hands into the pockets of his lab coat and stared at the wall above me.

“What?” I said.

“The police officer told me the accident was Liz's fault, that she ran a stop sign.”

I tried to nod and frowned as my chin collided with the overgrown collar.

“You don't have to answer this if you're not comfortable,” Ted said, “but did she seem upset when she got in the car? I mean, upset enough to be driving erratically?”

“You mean upset over your conversation about the rubella test?”

“You heard.”

“Yes. And, no, she didn't seem upset over
that
. I was more upset than she was because she
wasn't
upset. I am making no sense.”

“You're making perfect sense. I had the same reaction.”

He stared at the wall again, freckles folding around his eyes and mouth. “Do you mind if I speak frankly?” he said. “If you're not comfortable, I won't—”

“Say it already!” I said. “Just tell me what the
heck
is wrong with my mother.”

He pressed his lips together. “You've obviously picked up on it—the language aphasia, the slurred speech, the errors in judgment.”

“Just recently,” I said. “But then, she's been avoiding me for the last six months. You're obviously way ahead of me.”

“This whole thing with the pregnant patient and the rubella test—Liz knows that no diagnosis hinges on just one test. You use a constellation of findings. And this isn't the first time she's made that mistake in the last couple of months.”

“I gathered that.”

“About a month ago, apparently two patients' blood samples were switched in the lab. It happens once in about ten thousand lifetimes with the system we have, and that wasn't her fault—it was the technicians'. Anyway, the reports were given backward, and the doctor of the patient who received the positive result called Liz because the abnormal value didn't make sense with what he was seeing in the patient.” Ted shook his head. “Liz didn't even look into it. She just told him the tests didn't lie—they were 99.9 percent accurate. She recommended the patient
start treatment immediately. She said nothing about it to the techs, who then routinely disposed of the samples. The doctor had the patient retested and then called
me
to tell me the follow-up test was negative, which means we now have another patient out there who thinks he's disease-free because his results were negative. That shouldn't have happened, Jill. That and about a half-dozen other occurrences I could recount for you.”

I closed my eyes and tried to compartmentalize. I couldn't. I didn't have a compartment for craziness.

“One of her friends thinks it's depression,” I said.

“Could be. Depression presents itself in a number of different ways.” Ted arched an eyebrow at me. “You're not buying that.”

“I don't know. This is all so…weird. I don't have a scientific name for it.”

“I don't either,” Ted said. “But I think maybe somebody ought to find one.”

I could feel my eyes sharpening. “What are you saying?”

“Why don't you see if you can talk her into submitting to a psychiatric evaluation while she's in here?”

“Sure. And while I'm at it, I'll also shoot myself with a large assault weapon.”

Ted grinned. “I know she can be difficult.”

“No, you haven't seen difficult until you see my mother's reaction to the suggestion that she go into therapy. I was just going to drop the hint today that maybe she ought to see a counselor, and I was sweating bullets over that. You'd better have those paramedics standing by when I drop this on her.”

“Would you rather I did it?” Ted said.

“Yes,” I said.

“Even though it would be in an official capacity?”

“As in, it would go in her file? You'd have to write her up?”

He nodded.

“If you'd suggested this to me a month ago, I'd have said
you
were the one who needed the psychiatrist.”

He stood up. “Look, if you want to talk this through with me before you approach her, you have my number. Just call me—have my answering service page me if you need to. And you might want to wait until her orthopedic doc gives you the okay. We'll want to make sure she's strong enough.”

Liz McGavock not strong enough for something?
I thought when he was gone. Could the things I was now having to consider get any more outlandish?

It was another forty-five minutes before a resident who looked as if she ought to be skipping off to her Girl Scout meeting came in to stitch up my arm. When I was finally released to go to the OR waiting room, Max was there, pacing a path in the carpet.

When he saw me, he took the hall in two bounding leaps like he was going to scoop me up into his arms.

“Look at you,” he said. “You're white as a sheet! Should you be here? Aren't they going to admit you?”

“They're going to have to admit
you
if you don't calm down.”

“Where do you want to go? The recliner? The couch? Yes, lie here on the couch.”

I sat down on a vinyl sofa, then Max took off his ankle-length black raincoat, rolled it into a ball, and put it behind my head.

“You need something to eat. The food here is for nothing. I could probably doctor up some soup for you—what can they do to soup?”

“Max, I'm fine. Stop it. Just sit here. You're going to drive me up the wall.”

I patted the seat next to me and he sank into it.

“Have they told you anything about Mother?” I said.

“They put her under,” Max said. He rubbed his hand over his face and looked at me, red-eyed. “They called down and said they were starting the operation. God forbid anything should happen to her.”

“Something did happen to her,” I reminded him. “She may never walk again.”

I snapped my head toward him. “They told you that?”

“No. But you know me, I always think the worst.”

I sighed. “You don't have to think the worst, Max. The worst may already be happening.”

I told him about my conversation with Ted Lyons. If anybody should be made aware of it, Max should. For reasons I could never understand, he was as loyal to my mother as a St. Bernard.

I could recall when Mother had first met him at some kind of university social soiree, though my memory was a little hazy. I'd only been about six. I knew I'd been smitten with him, though, probably because he came to the house every night after that for a while, bringing me a book or a puzzle for every bouquet of flowers or box of imported chocolates he brought my mother. Then there had been the period of time when we hadn't seen him at all. I remembered asking Mother why “Uncle Max,” as he'd asked me to call him, didn't come anymore.

She'd been characteristically clinical about it. “He wanted to be my boyfriend,” she had explained. “I don't want a boyfriend, or a husband, which boyfriends usually lead to. One husband was enough, thank you very much.”

I'd known enough to realize she was referring to my father, whom I hadn't seen since I was eighteen months old and obviously didn't remember. Even by age six, she had told me that my father was a wealthy player who had preferred another woman to her, so they had divorced. We had left Virginia and never looked back. I didn't need a father anyway, she told me. I was doing just fine with her as my parent. I argued with her even less at age six than I did now.

But a few months after that conversation, Uncle Max had reappeared. He didn't bring flowers and candy and toys anymore. He just brought food and cooked it in our kitchen, at least once a week. And whenever there was a social event for which either of them needed an escort, they went together. We could expect Max for Thanksgiving and Christmas dinner, for birthdays and backyard
barbecues, and as I'd grown older I'd just assumed that Max had decided friendship was good enough for him, too.

Now as I finished filling him in on Ted's recommendation, his soft eyes were troubled.

“This is going to hurt her—knowing we think she's cracking up.”

“We don't think she's ‘cracking up'!” I said. “We're not considering having her committed, for Pete's sake. Max, what?”

He was suddenly looking wilted, as if the St. Bernard had been caught with one of Liz's slippers.

I leaned closer. “You know something you aren't saying. What is it?”

“Nothing. I'm just so sad. How could it come to this?”

“Would you stop playing King Lear and tell me what you know! I can see it all over your face.”

When he shook his head, I grabbed him by both lapels.

“This is not the time to be protecting Liz's dignity!” I said. “The woman is in trouble. I need every piece of information I can get before I go in there and tell her I want her to see a shrink so she won't screw up her whole life! Now talk to me!”

Across the room at the phone desk, a volunteer in a pink jacket cleared her throat. The other people waiting for word about loved ones were peering curiously over the tops of their magazines. I lowered my voice.