Private Practices (15 page)

Ben nodded and Neville went on, “But she insisted. Said she'd heard the baby was going to turn out bad. I asked her who'd told her such a thing and she said she'd been to the obeah-woman.” He laughed. “The fortune-teller! Still, it's her own choice to make.”

The woman on the table was eyeing Ben and Neville nervously. Now Neville turned back to her and peeled off the sheet. Ben, looking at her, realized the woman was a housekeeper he had seen at the hotel.

“All the others this morning are early ones. Easy ones,” Neville said, reaching for a sponge. With it, he began to color the woman's belly with red antiseptic, then he covered the painted area with a sterile sheet with an opening in its middle. The woman bit her lower lip and Neville said “It's nothing. Not nearly so bad as a cactus prick.” He had soothed her and now he inserted a tiny syringe into the midline of her belly, just below the graceful, mounded curve. On the woman's skin a small, white, foaming bubble erupted and she clenched her teeth.

“That's it. It's over,” Neville said, patting her arm. “There's no more pain at all. Just some cramps later when you expel the fetus.”

He moved quickly afterward, inserting a longer syringe straight into her stomach. The needle point disappeared and he pushed down on the syringe saying, “There. It's home.” The housekeeper, already anesthetized, was gazing at the ceiling. But Ben was staring at her belly. For a moment, his eyes intent, he thought he saw it shudder as if to expel the needle. Yet the woman's eyes were still placidly examining the ceiling. Now the needle heaved from side to side as if pushed by an unseen hand. He looked away. He had seen it all innumerable times before but he had never grown used to it, never stopped marveling at that one strange moment when, always, despite all rationality, it occurred to him that the fetus knew of and was struggling against its imminent death.

Neville now attached a thin, plastic tube to the syringe and began feeding through it the small drops of fluid that would, many hours later, force the fetus to emerge. “That's it,” he said to the woman, patting her again.

She was lying back, her eyes closed.

Neville did sixteen other abortions that morning but they went quickly. They were early ones, done by suction, and none of them involved women who had been using Sidney's pill. Sixteen fetuses were suctioned out into several huge glass jars, Neville listening intently as he finished with each woman for what some French doctor had named, inadvisably Ben thought, the cry of the uterus. The dry sound of an emptied womb. For the first time, it occurred to him that, given his dislike of abortions, he ought himself one day to work on birth control techniques. What would Sidney say? Would he laugh if he told him that he was no longer content with being a clinician alone, but wanted to do research.

Afterward, the two doctors went into Neville's office and Neville handed Ben his folders and notebooks, plus a stack of X rays and a box of transparencies. “How much time were you planning on spending?” he asked.

“Four or five hours. How long do you think it'll take to go through all this?”

Neville didn't answer him directly. Instead, he said, “Suppose I asked you to stay into the evening? Could you do it?”

“I could, but I was hoping to get done early. Go snorkeling. Or sailing.”

“Please,” Neville said, suddenly insistent. “I'd like you to be here when she's ready.” He gestured upward with his chin toward the floor above where the housekeeper had been put to bed to wait out the effects of the prostaglandin with which she had been injected. “After all, she'll be Case Number 81. You can examine the fetus afterward, if you wish.”

“All right,” he agreed, sorry to give up his recreational plans but flattered by Neville's wish to involve him in his research. “Okay. I'll just call down to the hotel and let them know I may not be there 'til late.”

Naomi was uncomplaining. “Fine. Maybe I'll take Petey into town. Show him the way the rest of the world down here lives. Not just the tourist scene.”

After Ben hung up, Neville's nurse brought him a tray of deviled land crab and some unfamiliar, profoundly sweet fruits. Nibbling, he settled himself as comfortably as he could in the straight-backed wooden desk chair, reached for Neville's notes and began reading.

The material surprised him by its thoroughness. Neville had kept remarkable records, managing to follow his sample of eighty women even though some of them had moved to different parts of the mountainous island and, in several instances, even to other islands in the region. He had tracked down each of the women, had examined their infants and the women themselves, had gotten detailed information on the women's medical histories and the course of their pregnancies, and, notoriously difficult in the islands, located and taken family histories from the fathers of a majority of the defective children. When the subjects of his study would not or could not come to him, he had himself traveled, and at his own expense, to examine and question them in their home villages.

Neville's records were painstaking, the work of a man devoted to research. Like Sidney himself, Ben thought, and imagined for a moment that Sidney would be pleased to learn he had hired, in Neville, a scientist with standards as rigorous as his own. Then he read on, although after a while his eyes and even his forehead began to ache. The birth defects Neville had found had occurred, for the most part, in the hearts, tracheae and esophagi of the infants he had examined. But there were also two cases of limblessness. Reading, he rubbed at his temples. They were throbbing. Still, he went on and, concentrating, paid careful attention to the questions Neville had asked in his lengthy interviews.

His argument against the pill rested on the fact that the defective children had consistently been born into families with normal parents and siblings and that, in every case, the mothers of the afflicted infants had reported that they had taken no other drug but Sidney's prior to their pregnancies. At least superficially, Ben thought, it looked as if Neville's suspicion of the Zauber pill was based on sound theory. But he was sure he would find a question Neville hadn't asked, a line of reasoning he hadn't pursued. He didn't believe it was possible that the Zauber pill could in actual fact be harmful. Neville simply didn't know Sidney and his renowned infallibility.

Reading, he began to take copious notes, and all the while he wondered to himself at the audacity of a provincial doctor like Neville trying to play David to Sidney's Goliath.

It had grown dark by the time Neville swung open the door to the big, steamy office and shouted, “Come on. She's started!” Ben, poring over his notes, sprang upright and ran after Neville, who was himself racing up the central staircase behind the miniskirted nurse. “I was just about to invite you for some dinner,” Neville called out. “I was afraid it might be several hours more.”

“I
was
just getting hungry,” Ben admitted, his long legs carrying him rapidly up the stairs so that he was right behind Neville. The nurse, already inside, held the door open for them and Neville spoke soothingly to the hotel housekeeper, whose face was strained now, her hands on her belly. And then, so quickly it was almost instantaneous, the fetus slipped from between her quivering legs into Neville's palms.

It was a tiny, kitten-sized creature that cried as soon as Neville caught it. Ben averted his eyes. He disliked prostaglandin abortions with their all-too-frequent record of producing live fetuses incapable of sustaining life. Too bad he couldn't shield his ears. Neville had placed the fetus on a wheeled instrument cart the nurse had rolled to the side of the bed and from its direction he could hear it as it continued to moan, its cry a shallow, muted, barely human lament.

It would die within minutes, he knew, and waited, still not looking at it, concentrating instead on Neville's swift movements as he delivered the placenta. Then at last, the fetus ceased crying and Ben turned to look at it.

Its chest was heaving mercilessly, its skinny legs were raised skyward, and it had no arms. Beneath miniature, beautifully formed shoulders jutted knobs of bulging, twisted flesh. He reached out a hand to explore them but as he did, a revulsion he thought he had conquered years ago in medical school swept over him, making him gag. By the time he had gained control over himself, the fetus had given one last, tortured pant and, legs no longer twitching, was lying absolutely still.

“Take it to the lab,” Ben heard himself commanding the nurse. “Don't let the mother see it!”

Later that night, after examining the fetus with Neville, he got into his car and drove thoughtfully back down the twisting mountain road. He had been deeply affected by the sight of the armless fetus and in view of it, and in view of Neville's undeniably excellent research, it seemed to him now that there was indeed a strong likelihood that the Zauber pill was fallible. Of course, whether it was or wasn't, only further study would tell. But in the meantime Sidney ought to cancel all further testing of the pill until the dropouts from the other island clinics could be located and questioned. Of course, he'd be devastated. Poor Sidney. For a moment he experienced the unfamiliar emotion, a feeling of pity for Sidney. But to go ahead with further testing of the pill was out of the question. Driving through a field of tall trees whose bulbous roots stood sculpturelike above the earth, he stepped on the gas pedal and began to speed.

It was after midnight when he reached the hotel and Naomi, sun reddened, let him quietly into their cottage. He embraced her and then moved immediately to the telephone. He'd best call Sidney at once. Most likely he would be asleep, worn out from his hectic one-day excursion to Chicago and an afternoon of exhausting meetings and panels. The phone would wake him, scattering his dreams, shattering them. Dialing the hotel operator and asking her to connect him with Sidney's number in New York, he resolved to break his news as gently as possible.

Naomi, hovering over him, asked him what happened and while he waited to be connected he told her a little of the day's revelations. “That goddamn Sidney,” Naomi exclaimed, outraged by his brief account. He looked at her reprovingly and said, “Ssh.” The phone was already ringing on the other end of the wire and Sidney was picking it up.

“Ben? Yeah. G'head.”

Sidney answered so promptly that Ben realized he hadn't been asleep at all, but must have been sitting right beside the phone, awake and anxious. “G'head. What'd you find?” Despite its staccato, Sidney's voice sounded tired, slurred, and once again Ben resolved to be as considerate as he could.

“Well, Neville's an interesting fellow,” he began. “Runs the only women's clinic this side of the island. Works incredibly hard.”

“I know all about his clinic,” Sidney broke in. “What about his stuff?” Ben could hear impatience make Sidney begin to speak more loudly.

“He runs the clinic with government money. I guess that's common down here.”

“For Christ's sake, Ben,” Sidney exploded. “Just tell me whether the pill is sour or not.”

He hesitated a moment longer and then he said, “Yeah. It's sour. Really sour.”

Sidney was silent. Alarmed, Ben nevertheless launched into a summary of Neville's findings, mentioning that Neville had until tonight spotted only eight problematic births but that the figure had just gone up to nine. Still, Sidney kept quiet. Ben talked on, and was about to tell Sidney that in his considered opinion it was essential that further research on the pill be suspended until the drop outs on all the islands could be investigated, when he suddenly realized that he had been talking into a dead phone. Sidney had hung up so silently that he hadn't even heard the click.

CHAPTER FIVE

MAY

Emily, struggling back into glen-plaid maternity slacks after her monthly examination by Ben Zauber, looked into the dressing-cubicle mirror, pulled the drawstring of the baggy pants disdainfully, and decided that she would, after all, use the rest of her time off from work this morning to buy herself a few maternity clothes of her own. The slacks had been given to her by her cousin Dorothy, along with a bulging cartonful of ill-fitting polyester blouses and skirts that Dorothy had worn while carrying her own child several years before. Emily had accepted the hand-me-downs eagerly, telling Philip she really didn't want to buy her own things because she didn't think it wise to spend money on so transitory a need as maternity clothes.

But there was more to her refusal to go shopping than mere thriftiness. She had been feeling unattractive lately, feeling so heavy and unfashionable in figure that she had hated the prospect of seeing herself in the impertinent lights and revealing three-way mirrors of department stores. But she had discussed her feelings with Dr. Zauber during her checkup and, as always, he had made her feel better about herself.

“I don't find you unattractive,” he had said. And then he had mused, “There's no intrinsic reason to associate pregnancy with loss of sexual appeal. There are lots of cultures that idealize the pregnant woman.” He had gestured to an African wood carving that had newly appeared on his wall and added, “You have to fight the culture.”

“How?” she had asked. “I don't think you can.” Their conversations these days always excited her, made her remember how she had felt in college when her professors spurred her to be thoughtful and to question.

“Act
as if you feel attractive,” he had said. “Sometimes acting as if we feel something
makes
us feel it.”

Emily had been cheered by his challenge, even though she didn't quite believe she could effect the change in herself he was urging on her. But she had promised to try to listen to him and to come in for her next appointment looking more attractive even if she didn't quite feel it. Remembering, she slipped Dorothy's blouse over her hair, which had long since outgrown the chic trim her hairdresser had given her in February, stepped into her flat-heeled shoes, and started down the corridor to the receptionist's desk to make her next appointment. If she skipped lunch, she'd have plenty of time for a long look in Bloomingdale's before she was due at the neighborhood center.