He called his office again, and then strode purposefully out of the room to the nurses' station.
“I'd like to check on Mrs. Alexandra Parker,” he said curtly. “She was scheduled for a breast biopsy at nine. They said she'd be finished before ten. It's almost eleven now. Could you call and check if there's been a delay. I can't wait around here forever.” She raised an eyebrow at him, but didn't say anything. He looked important and well dressed, and he was very good-looking. And he had an aura of command about him, which even she responded to, though she had no idea who he was, or why he shouldn't have to wait like everyone else in the world. But she called upstairs anyway, and they told her that everything was running late. After all, this was Monday. They had all the leftover surgeries from the weekend, arms and legs and hips that had waited to be set since the night before, and appendectomies that hadn't been too hot to wait through the weekend.
He was reminded again of checking on flights, and waiting interminably at the airport. That had happened to them once when she had promised to meet him in Washington for a party, while they were dating. There had been a storm in New York, and he had waited six hours for her at the airport. This was beginning to feel like that. And he was truly exasperated by eleven-thirty.
“This is ridiculous. She's been up there long enough for open-heart surgery. They took her up three hours ago. They could at least let us know how late they're running.”
“I'm sorry, sir. There could have been an emergency that had to be put ahead of your wife's case. We can't help that.”
“Can you at least find out where she is and what's happening?”
“She's probably in the recovery room by now, unless everything went haywire and they bumped her. I'll call. Why don't you have a cup of coffee and wait in her room, and I'll come in as soon as I hear something.”
“Thanks very much.” He smiled at her, and she decided he was difficult but worth it. She called the surgical floor for him again then, and got very little information, except that Alexandra Parker was still in the O.R. They started late, and the nurse on the phone had no idea when they'd be finished.
The nurse walked back to Alex's room and found Sam and relayed the message, and he called his office again, apologizing for the eleven o'clock partners' meeting he was missing. He told them he'd catch up with them when he could, maybe even as late as one o'clock at La Grenouille. He just didn't feel right leaving without knowing what had happened.
It was finally twelve-thirty when they told him Alex was in the recovery room, four hours after she'd gone upstairs. The delays were ridiculous, he complained. And the nurse told him that Dr. Herman would be down to speak to him in a few minutes.
It was ten to one when he arrived, and Sam looked like a caged lion pacing the room, as he waited. He had been there for long enough with their dismal decor, and their antiseptic smells, and their endless waits designed for people who had nothing else to do with their lives. He had a business to run, and he couldn't sit around all day cooling his heels waiting to talk to some damn doctor.
“Mr. Parker?” Dr. Herman entered the room in his operating gown, with his mask still around his neck, and what looked like socks over his shoes. He extended a hand and shook Sam's, and very little showed in his eyes as Sam watched him.
“How's my wife?” He didn't waste any time, he assumed she was fine, and he was almost late for lunch with Simon, his assistant, and their new clients, after waiting for an entire morning.
“She's doing as well as we can expect right now. She lost very little blood, and we didn't have to give her any transfusions.” That was important to everyone these days, and he assumed it would be to Sam, but he looked unimpressed and a little confused when he heard it.
“Transfusions for a biopsy?” There was a long moment's silence. “Isn't that a little unusual?”
“Mr. Parker, as I suspected, your wife had a large mass deep in her breast, involving mainly the ducts, but it has infiltrated the surrounding tissue, although the margins of the tumor were clear. We'll have to wait another two or three days to tell us about possible lymph node involvement. But there was no question that it was a malignancy, and I believe it was a stage two cancer.” Sam's head suddenly reeled as he listened. It was not unlike what Alex had felt when she'd first heard that she had a shadow on her mammogram. All the information after that was just a jumble of sounds and noises.
“We're hoping that we got all of it,” Herman went on, “but I had already discussed with your wife the danger of a recurrence. Recurrences of breast cancer are more often than not fatal. And the important thing in successful treatment of cancers such as these is removing all of it, while it is still encapsulated, before it has spread to any other part of the system. To that end, we try to espouse extremely aggressive measures. With luck, if her lymph nodes are not excessively involved, I think we got it.”
“Just exactly what does that mean?” Sam asked, feeling sick, just asking him the question. “You took the mass out of her breast?”
“Obviously. We took the breast too, of course. It's the only way you can be absolutely sure there won't be a local recurrence. You can't have a recurrence in a breast that isn't there. It could recur in the chest wall, or travel elsewhere, of course, or metastasize, but that will depend on how advanced the tumor is, and how many lymph nodes are involved. But eliminating the breast solves a lot of problems.” Alex had understood that.
“Why didn't you just kill her? Wouldn't that solve the problem too? What kind of barbarian bullshit is that to just chop off her breast so it wouldn't spread? What kind of medicine do you people practice?” Sam was livid, and shouting.
“Cautious medicine, Mr. Parker. We endorse aggressive attacks against cancer. We don't want to lose our patients. And just so you understand, we did some axillary dissection too, which means we removed her underarm nodes, but I'm hoping she doesn't have a lot of nodular involvement. That will be confirmed by pathology in the next few days, and we'll have the results of her hormone receptor tests in about two weeks, and then we'll have a better idea how to treat her.”
“How to treat her? What else are you going to do?” He was still shouting at him. With one stupid move, they had butchered poor Alex.
“Depending on the lymph node involvement, we're probably going to have to do some fairly aggressive chemotherapy, just to make sure that there won't be a recurrence. There could be an issue of hormone therapy too, but we don't know that yet. And at her age, it's doubtful. Since we took the breast, there's no need for radiation. We won't be starting chemo for a few weeks. She'll need time to get on her feet, and we need time to assess her situation. Our tumor board will be meeting to discuss her case, of course, once we have all the pathology reports. I can assure you that your wife's treatment will be given very serious consideration.”
“Just like you gave her breast?” How could they do that to her? He still couldn't believe it.
“I promise you, Mr. Parker, there was no choice,” Peter Herman said quietly, he had dealt with outraged husbands before, and frightened ones, and those who just couldn't cope with the reality, like this one. The husbands were no different than the patients. But he had a feeling that Alex Parker had understood all the dangers better than he had. “We did a modified radical mastectomy on her, which means that we took the entire breast, and breast tissue, extending toward the breastbone, collarbone, and ribs, and her minor pectoral muscle. This means that she'll be able to have reconstructive surgery in a few months, if that's her wish, and if she's up to it during the chemo. If not, she can wait, and wear a prosthesis.” He made it all sound so simple, and even Sam knew it wasn't. Dr. Peter Herman had changed everything with a single stroke of his scalpel. And just listening to him now made her sound like a mutant.