"You were on duty when they brought her into the emergency room, right?" he said in an accusing tone.
"Yes. I was with a patient and I heard the STAT and rushed right down. I had just gotten my stethoscope on her chest when she expired," Terri explained. Geena Thorndyke groaned and began to sob.
"They're telling us it looks like she died of acute scurvy," Bradley said, his disdain and disbelief quite evident in his voice.
"Yes, Mr. Thorndyke. It's just about certain that will be the diagnosis."
"That's just ridiculous. She was found unconscious on the floor of a cheap, onenight motel room. She must have been drugged," Bradley insisted. "Someone picked her up and slipped her one of those Ecstasy things or something, an overdose, right?"
"The autopsy doesn't show that, Bradley," Hyman said softly. "There was some alcohol in her blood stream, but no chemical substances."
"Well let them do another autopsy, for Christ sakes! My daughter had to have been murdered. Murdered!"
Hyman Templeman shifted his gaze quickly to Terri and then nodded sympathetically at Bradley Thorndyke.
"I can understand why you would feel this way, Bradley. We're stumped."
"Someone had to have at least hit her or..." He turned to Terri, his hands out,
"Or done something violent to her."
"Every hemorrhage on her body appears to have been caused by fragile capillaries, a classic symptom of scurvy. The autopsy reveals large muscle hemorrhages and petechial and purpuric skin manifestations," Hyman explained, when Terri hesitated.
Bradley shook his head.
"It's not the sort of thing that happens overnight," Terri added. "Not this severe, this quickly. Did either of you notice her becoming weak, irritable? Did she become black and blue at the slightest touch? And her gums... rapidly developing gingival hemorrhages give the appearance of bags of blood," Terri continued. Wide-eyed, both Bradley and Geena looked at her. It was as if she were from another planet.
Geena finally shook her head.
"No, nothing like that," she muttered.
"She wasn't being treated for peptic ulcers, was she?" Hyman asked.
"Ulcers? No," Bradley said. "Besides, you would know. You were her doctor, Hyman."
Doctor Templeman nodded.
"It's been a while since I've seen her," he remarked softly.
"That's because she was as healthy as a horse. You know she was into all that aerobics and exercise. Christ, she ate like someone in training. She was always complaining about our fatty diets, the chemicals in our food. We never ate the right cereals and she would go into tirades over the cholesterol we consumed, right, Geena?"
"What? Oh, yes, yes," she said smiling and wiping her cheeks. "She made me promise to buy this butter substitute because Bradley eats so badly when he's traveling." Her voice trailed off. She caught herself as if she realized she was adding the most inane details to the discussion.
"When did you see your daughter last, Mrs. Thorndyke?" Terri asked softly.
"Two days ago... we had lunch." She started to bury her face in her hands again.
"So what were Paige's dietary habits?" Terri pursued. "I mean, was she following any fads? I know that some people get caught up in these meditation cults and make radical changes in their food habits."
"Meditation cults?" Bradley cried. "This is ridiculous," he said turning back to Hyman. "Scurvy? That comes from a lack of vitamin C, right? A sailor's disease before they knew about vitamins, right?" he insisted. "It has to be a stupid mistake."
"The lab findings are pretty accurate, Bradley. What we were also wondering was had Paige gone on any sort of fad diet to lose weight," Hyman said.
"Absolutely not. I told you. She was into exercise. She didn't have to diet to lose weight. She was in great condition. I know I couldn't keep up with her on the jogging track," Bradley replied. Then he looked down at his wife. "Unless there's something I don't know about," he added. Geena shook her head.
"She wasn't dieting," she said.
"You say you had lunch with her two days ago, Geena?" Hyman asked softly. Geena Thorndyke looked up.
"Yes, but nothing made me sick," she added quickly.
"No, that's not what we're looking for. Do you recall what you ate?"
"We had a salad... chicken salad."
"Paige was in the habit of taking a daily vitamin anyway," Bradley said sharply.
"I know that for a fact because she was always criticizing me for not."
"Uh huh. What did you drink with your salad, Geena?"
"We had... cranberry juice," she said and shook her head so vigorously, Terri thought she was going into a convulsion.
"Well, that's a source of vitamin C," Henry muttered. "And if she was in the habit of taking vitamins daily, she would get the minimum requirements of vitamin C and none of these symptoms would have been precipitated."
"So she couldn't die of scurvy. Right?" Bradley Thorndyke cried with frustration. He turned from Hyman to Terri. They simply stared at each other.
"I'm sorry but we can't explain this, Bradley," Hyman said. "The autopsy report doesn't show a reading of ascorbic acid at all." He sighed. "Dr. Barnard can describe her symptoms when she was first brought into the emergency room. She never had an opportunity to begin any therapy. You will see a copy of the autopsy report, of course, and you will see that all the findings point to scurvy."
"But what was she doing in that cheap motel?" Geena Thorndyke asked, staring down at the floor. She was really asking herself.
No one spoke; only Geena's sobbing broke the heavy silence. She realized it and stopped crying to look up at Terri. Bradley Thorndyke turned to her too, as if he expected she had the answer to Geena's question as well as all the others. Terri felt like she was shrinking under their demanding gazes, and for the first time in her long journey to become a physician, she wanted to run away from the profession.
Nearly eight hours later, Terri emerged from the first examination room where she had seen her final patient for the day and handed Elaine the patients file. She had had little time during the remainder of the workday to dwell on Paige Thorndyke. Before visiting hours had ended, she had seen twenty-five patients. The rapid change in weather characteristic of the Catskill mountain climate engendered the usual minor epidemic of coughs and colds. Many residents stubbornly clung to the remnants of summer, dressing lightly for the daytime and forgetting that the temperatures plummeted in the late afternoon and evening as the sun settled below the peaks and treetops. Shadows grew longer, deeper, darker.
But Terri loved the Catskill fall mornings. They had that wonderfully invigorating crispness to them. Immediately after stepping out, she enjoyed inhaling deeply and feeling the rush of air fill her lungs and wash away the cobwebs woven during another restless night. Her spiders were hatched out of every diagnosis and prognosis. She had an understandable anxiety, a fear of missing something significant, making the wrong diagnosis and therefore causing the unnecessary death of a patient.
"A good doctor is never completely free of that anxiety," Hyman told her when she confessed it to him during one of their frequent tete-a-tetes. "The trick is to recognize the gray areas and be modest enough to ask for a second opinion. Unfortunately, there are some pretty arrogant bastards in our profession. Even when they make a mistake, they refuse to recognize it's their mistake. They blame it on the symptoms being too ambiguous or something. Many even blame the patients, claiming they didn't tell them everything. They see and hear what they want. I suppose there's nothing as dangerous as an arrogant doctor.
"But mind you," he added quickly, fully cognizant of her relationship with Curt,