Sandrine's Case (9780802193520) (11 page)

Sandrine had been in relatively good spirits the morning she left for Dr. Ortins's office, though she'd still been unsure she had made the right call in Dr. Ortins herself. Because of privacy issues, I'd warned her to stay clear of any physicians associated with Coburn College.

“You can bet they chatter like magpies about what professor has herpes or AIDS or who takes Viagra,” I told her over breakfast one morning. “They're like old ladies at a quilting party. They couldn't keep a secret in a jar.”

For her part, Sandrine had already decided to avoid any doctor whose practice smacked of a “holistic” approach.

“I don't want some vegan doctor telling me about the benevolence of nature,” she said, “or that a tumor is okay as long as it's growing.”

I'd laughed out loud at that one but Sandrine had only smiled.

Only smiled, yes, but tensely, because by then she must have been quite frightened of the possibility that something was seriously wrong with her.

The first signs were not much different from the usual changes that occur as one gets older, and since Sandrine was forty-six she'd dismissed them at first. It was several weeks before she'd even mentioned them to me, though I later learned she must have been asking herself why she should have such mysterious weakness in her muscles.

Then, out of nowhere, her speech began to slur occasionally, and for Sandrine this must surely have sent a cold dread through her soul.

She was born of parents already rather old, and who'd died in their late seventies, a few years before, and so she had little reason to fear an early death. And yet, for all that, I'd seen that fear in her eyes the morning she was to see Dr. Ortins, and which I'd tried unsuccessfully to quell.

“You're fine, I'm sure,” I told her.

She nodded crisply. “Probably,” she said cheerily, then rose from the table and gathered up her things. “Back soon,” she said.

I'd assumed that she was headed immediately for Dr. Ortins's office, but that had turned out not to be the case, a fact I learned only later from the tightly drawn lips of Detective Alabrandi.

She'd returned at just after six. I'd noticed very little change in her demeanor, a fact that now struck me as rather odd in light of what was presently being said on the witness stand.

“Mrs. Madison was quite alarmed,” Dr. Ortins told the court. “She had been experiencing certain disturbing physical changes for a long time.”

“How long?”

“Over a year.”

Over a year, and yet, as I thought at that moment, she'd mentioned nothing of these changes to me, not one hint of what must have been a steadily growing dread.

“What kind of problems?” Mr. Singleton asked.

Serious problems, as I finally learned, and of whose dire nature the jury was now to hear.

“Mrs. Madison had noticed what she called a ‘constellation of effects,'” Dr. Ortins answered. “I know she used that term because I wrote it down in my notes.”

“Why did you write it down, Dr. Ortins?”

“Because it suggested to me that Mrs. Madison had been doing her own medical research,” Dr. Ortins answered. “And frankly, when I know a patient is doing that, I'm a little more careful in how I approach things with them because they may have gathered some quite incorrect information, usually from the Internet.”

“But that was not the case with Mrs. Madison, was it?” Mr. Singleton asked.

“No,” Dr. Ortins answered. “Mrs. Madison had done quite good research.”

“And had she come to any determination with regard to her research?”

“If you mean by way of self-diagnosis, then yes, as it turned out, she had,” Dr. Ortins answered. “Of course, I didn't know that her research had generated a correct diagnosis. You need several tests to determine that.”

“And did you order those tests?”

“Yes. I did an electrodiagnostic, which included electromyography and a nerve conduction velocity test. Also the usual blood and urine tests, including high-resolution serum protein electrophoresis, thyroid and parathyroid hormone levels . . .”

She seemed suddenly to realize that her answer had overshot the question by half and she quickly brought her answer to a halt. “Along with other tests, of course,” she added.

“All right, so what was the diagnosis that resulted from those tests, doctor?”

“Amyotrophic lateral sclerosis.”

“That disease has a more common name, doesn't it, Dr. Ortins?”

“Yes,” Dr. Ortins answered. “It's more commonly referred to as ALS or Lou Gehrig's disease.”

Hearing those words again, I couldn't imagine that for weeks before seeing Dr. Ortins Sandrine must have had them fluttering like bats in her mind. Even so, she'd certainly given no indication of so dark a suspicion. Not even the afternoon she'd returned from her first visit to Dr. Ortins. Of course, there'd been a reason for that, as the doctor made clear.

“But on her first visit to my office, I assured Mrs. Madison that it was quite unlikely that she had ALS,” Dr. Ortins told the jury. “There are many reasons why a person can feel muscle weakness, and as for the occasional slurring she'd noticed, that is sometimes the result of fatigue. Although Mrs. Madison didn't appear tired in that way, she did seem . . .”

Here Dr. Ortins stopped, a pause that focused my attention because she was clearly searching for the right word.

“Sad,” she said, when she found it.

And so my wife, so lovely, so brilliant, still quite young and probably healthy, with a marriage that was by all outside appearances quite happy, had seemed “sad” to Dr. Ortins. How in all the months and weeks and days before she appeared in the good doctor's office, I asked myself suddenly, had I not seen that?

And what, I further asked myself at that moment, would have made Sandrine sad?

Mr. Singleton did not ask Dr. Ortins this question, because he knew that it would be leading the witness or calling for a conclusion, and Morty would no doubt object, and his objection would certainly be sustained.

For the next few minutes, Dr. Ortins reviewed the results of the tests she'd ordered, along with her analysis of the test results, and finally the awesome certainty to which she'd come and of which she'd informed Sandrine on the afternoon of April 12.

“I told her that her initial self-diagnosis was unfortunately the correct one,” Dr. Ortins said. “She, of course, already knew the prognosis. Even so, as I would with any patient, I detailed the likely progress of the disease and how Mrs. Madison might prepare for it.”

“Did Mrs. Madison appear to be interested in how she might prepare?”

“Yes,” Dr. Ortins answered. “She asked quite a few questions. And, of course, she was interested in just how long she had to live. I told her that she might well live another ten years, and that during that time there might be some breakthrough in medical research. She asked about this research, and I went into some of the work that was being done.”

“Did Mrs. Madison say anything else to you at that point, Doctor?” Mr. Singleton asked.

“Only one thing,” Dr. Ortins answered.

“And what was that?”

“She said she didn't want to die,” Dr. Ortins told the jury. “And that she intended to live as fully as she could to the last breath.”

Mr. Singleton was still watching the jury when he very pointedly asked Dr. Ortins his next question.

“To the last breath. Those were Mrs. Madison's exact words?”

Nor did he turn from them when she gave her answer.

“Her exact words, yes.”

Only two hours or so after Sandrine had said this to Dr. Ortins, I'd returned from my classes to find her in the bedroom in the darkness:
Come back later, Sam.

Which I had done, though by then she'd left the bedroom, so that I'd found her in the scriptorium, sipping a glass of red wine, reading a biography of Cleopatra.

“What would make a woman a true queen of the Nile, Sam?” she asked as she closed the book.

“Courage, I suppose,” I said. “Daring. What do you think would make a woman a true queen of the Nile?”

“The ability to face the truth,” Sandrine answered. “To try to change what there's still time to change and accept what you can't.”

I laughed. “That's from the serenity prayer, isn't it?” I asked. “Have you been going to AA meetings?”

She watched me silently, and her expression told me everything.

“It was something bad, wasn't it?” I asked. “From the doctor.”

She nodded.

“What is it?”

“I have Lou Gehrig's disease,” she said flatly.

With this news, I'd experienced that famous cliché, the sense of being hit very hard in the stomach. But was it at that very moment, I asked myself now, as Dr. Ortins continued her matter-of-fact testimony, that I'd begun to run the awful scenario of what was to come, the profound changes that lay ahead, all of them quite dreadful?

“Are you sure?” I asked her. “Is the doctor certain about the diagnosis?”

“Yes.”

I offered no response to this, and during the following silence I saw something in Sandrine's eyes change, and with that change a terrible sadness settled over her, one so profound she seemed physically to deflate, as if all the light and air had suddenly left her soul.

“I have to think things through,” she said in a voice that struck me as suddenly very distant, something said to herself and whose meaning she alone understood, so that she looked as if she'd just received a blow somehow deeper and more wounding than her diagnosis, something that smelled even more of death.

“Think what through?” I asked.

Rather than answer, she glanced down at the book she'd been reading, let her gaze linger there for a moment, then looked up at me and said, “I wish I had something to leave you, Sam.” She watched me closely, as if she were looking for some small light in a steadily darkening room. When that light failed to appear, she said, “I was thinking of
Who's Afraid of Virginia Woolf?
The way George stares off into infinity and says, ‘Sunday. Tomorrow. All day.'”

“Why that of all things?” I asked.

“Because when he says that, he's really lost hope that anything can change,” Sandrine answered. “That's the hope I don't want to lose.”

When I reached over to touch her hand, she drew it back quickly and reflexively, as she might have drawn it back from a wasp or a spider.

“You won't lose hope,” I assured her.

Something very strange had come into her eyes at that moment, I recalled now, a look I'd never seen before, half fear, half care. Then, just as suddenly, her gaze had hardened into determination. “No,” she'd said firmly, “I won't lose hope.”

Dr. Ortins was closing in upon the last of her testimony by the time this memory played out, but what lingered in my mind was the fact that I'd been certain Sandrine had been speaking about her illness at that point, the fact that she hadn't wanted to lose hope that Dr. Ortins might be right in telling her about the research going on, the possibility that there might, indeed, be a breakthrough.

My question now was simple. Was that what she'd meant or had she been speaking of some different hope she'd feared to lose? Hope for herself? For Alexandria? Or had it been some unspoken hope she'd had for me?

I thought suddenly of the candle from Albi, how Sandrine had asked me to place it exactly on the spot where its light would play directly on the glass jars and bottles she'd later put on the table beside her bed. Why had she done that?

So many odd questions were emerging now, a debris washed up by my trial, questions that were subtle and unfathomable and which in some way were beyond my guilt or innocence of the crime for which I was charged.

Mr. Singleton, however, had a very different question on his mind.

“When did you next see Mrs. Madison?” he asked Dr. Ortins.

“She came to my office with her husband,” Dr. Ortins said. “I went over what would be expected in the coming years, the work of the caregiver in a case like this.”

“And that's a lot of work, isn't it?”

“Yes.”

“Why is it a lot of work, doctor?”

“Because a person suffering from ALS becomes increasingly unable to care for herself.”

“And so Mrs. Madison would become more and more difficult to manage, isn't that true, Doctor? On a day-to-day basis, I mean.”

“Yes,” Dr. Ortins answered. “I explained to Mr. Madison that his wife would begin to lose her ability to use her muscles.”

“In the end her muscles would entirely desert her, correct?” Mr. Singleton asked.

“With a few exceptions like blinking her eyes, that's true.”

For the benefit of the jury and to emphasize this dreadful point, Mr. Singleton now took Dr. Ortins through the grim steps of Sandrine's horrifying decline.

“So, in the end, Mr. Madison would have to feed his wife?” he asked.

“Yes.”

“Bathe her?”

“Yes?”

“Even take her to the toilet?”

With this question, I noticed several members of the jury turn to look at me, a grim surmise already in their minds, I felt certain, the grave possibility that I'd plotted then carried out the selfish opposite of euthanasia, a murder motivated by my simple desire to rid myself of the loathsome tasks that would soon be mine.

“Yes,” Dr. Ortins answered.