The desk was standard hospital-issue phony walnut and chrome, pushed up against one wall. A hard-looking chrome and orange-cloth chair competed for space with a scuffed brown Naugahyde recliner. Between the chairs a thrift-shop end table supported a coffee maker and a struggling philodendron in a blue ceramic pot.
Stephanie sat at the desk, wearing a long white coat over a wine-and-gray dress, writing on an outpatient intake form. A chin-high stack of charts shadowed her writing arm. When I stepped into the room she looked up, put down her pen, smiled, and stood.
“Alex.”
She’d turned into a good-looking woman. The dull-brown hair, once worn shoulder-length, limp, and barretted, was short, frosted at the tips, and feathered. Contact lenses had replaced granny glasses, revealing amber eyes I’d never noticed before. Her bone structure seemed stronger, more sculpted. She’d never been heavy; now she was thin. Time hadn’t ignored her as she entered the dark side of thirty; a mesh of feathers gathered at the corners of her eyes and there was some hardness at the mouth. Makeup handled all of it well.
“Good to see you,” she said, taking my hand.
“Good to see you, Steph.”
We hugged briefly.
“Can I get you something?” She pointed to the coffee machine, arm jangling. Gold vermeil bracelets looped her wrist. Gold watch on the other arm. No rings. “Plain old coffee or real café au lait? This little guy actually steams the milk.”
I said no thanks and looked at the machine. Small, squat, black matte and brushed steel, logo of a German manufacturer. The carafe was tiny — two cups’ worth. Next to it sat a petite copper pitcher.
“Cute, huh?” she said. “Gift from a friend. Gotta do something to bring a little style into this place.”
She smiled. Style was something she’d never cared about. I smiled back and settled in the recliner. A leatherbound book sat on a nearby table. I picked it up. Collected poems of Byron. Bookmark from a store named Browsers — up on Los Feliz, just above Hollywood. Dusty and crowded, with an emphasis on verse. Lots of junk, a few treasures. I’d gone there as an intern, during lunch hour.
Stephanie said, “He’s some writer. I’m trying to expand my interests.”
I put the book down. She sat in her desk chair and wheeled around facing me, legs crossed. Pale-gray stockings and suede pumps matched her dress.
“You look great,” I said.
Another smile, casual but full, as if she’d expected the compliment but was still pleased by it. “You, too, Alex. Thanks for coming on such short notice.”
“You piqued my interest.”
“Did I?”
“Sure. All those hints of high intrigue.”
She half turned toward the desk, removed a chart from the stack, let it rest in her lap but didn’t open it.
“Yup,” she said, “it’s a challenging one, that’s for sure.”
Standing suddenly, she walked to the door, closed it, and sat back down.
“So,” she said, “how does it feel to be back?”
“Almost got busted on the way in.”
I told her about my encounter with the security guard.
“Fascist,” she said cheerfully, and my memory banks reactivated: grievance committees over which she’d presided. White coat disdained for jeans, sandals, bleached cotton blouses. Stephanie, not Doctor. Titles are exclusionary devices of the power elite...
I said, “Yeah, it was kind of paramilitary,” but she just gazed at the chart in her lap.
“High intrigue,” she said. “What we’ve got is a whodunit, howdunit — a did-anyone-do-it. Only this is no Agatha Christie thing, Alex. This is a real-life mess. I don’t know if you can help, but I’m not sure what else to do.”
Voices from the corridor filtered in, squalls and scolding and fleeing footsteps. Then a child’s cry of terror pierced the plaster.
“This place is a zoo,” she said. “Let’s get out of here.”
2
A door at the rear of the clinic opened to a stairway. We descended to the first basement level. Stephanie moved fast, almost jogging down the steps.
The cafeteria was nearly empty — one orange-topped table occupied by a male intern reading the sports section, two others shared by slumping couples who looked as if they’d slept in their clothes. Parents spending the night. Something we’d fought for.
Empty trays and dirty dishes cluttered some of the other tables. A hair-netted orderly circulated slowly, filling salt shakers.
On the eastern wall was the door to the doctors’ dining room: polished teak panels, finely etched brass nameplate. Some philanthropist with a nautical bent. Stephanie bypassed it and led me to a booth at the far end of the main room.
“Sure you don’t want coffee?” she said.
Remembering the hospital mud, I said, “Already filled my caffeine quota.”
“I know what you mean.”
She ran her hand through her hair and we sat.
“Okay,” she said. “What we’ve got is a twenty-one-month-old white female, full-term pregnancy, normal delivery, APGAR of nine. The only significant historical factor is that just before this child was born, a male sib died of sudden infant death syndrome at age one year.”
“Any other children?” I said, taking out a note pad and pen.
“No, there’s just Cassie. Who looked fine until she was three months old, at which time her mother reported going in at night to check on her and finding her not breathing.”
“Checking because she was nervous about SIDS?”
“Exactly. When she wasn’t able to rouse the baby, she administered CPR, got her going. Then they brought her into the E.R. By the time I arrived she looked fine, nothing remarkable on exam. I admitted her for observation, did all the usual tests. Nothing. After discharge we set the family up with a sleep monitor and an alarm. Over the next few months the bell went off a few times but they were always false positives — the baby was breathing fine. The graphs show some tracings that could be very brief apnea but there are also lots of movement artifacts — the baby thrashing around. I figured maybe she was just restless — those alarms aren’t foolproof — and put down the first episode to some quirky thing. But I did have the pulmonologists look at her because of her brother’s SIDS. Negative. So we decided just to keep a close eye on her during the high-risk period for crib death.”
“A year?”
She nodded. “I played it safe — fifteen months. Started with weekly outpatient checkups, tapered off so that by nine months I was willing to let them go till the one-year exam. Two days after the nine-month checkup they’re back at E.R., middle-of-the-night respiratory problems — the baby woke up gasping, with a croupy bark. More CPR by mom and they bring her in.”
“Isn’t CPR kind of extreme for croup? Did the baby actually pass out?”
“No, she never lost consciousness, just gasped a lot. Mom may have been overreacting, but with her losing the first child, who could blame her? By the time I got to the E.R., the baby looked fine, no fever, no distress. No surprise, either. Cool night air can clear up croup. I ran a chest X-ray and bloodwork, all normal. Prescribed decongestants, fluids, and rest and was ready to send them home but the mother asked me to admit her. She was convinced there was something serious going on. I was almost certain there wasn’t, but we’d been seeing some scary respiratory things recently, so I admitted her, ordered daily bloodwork. Her counts were normal and after a couple of days of getting stuck, she was going hysterical at the sight of a white coat. I discharged her, went back to weekly outpatient follow-up, during which the baby would have nothing to do with me. Minute I walk into the exam room she screams.”