The man was imposing, especially in his starched white coat. But he seemed less hostile than at their first meeting.
“Adam Schonberg, welcome to the Julian,” he said.
“Thank you,” said Adam, relieved and at the same time taken aback by Vandermer’s cordiality. “I’m surprised to find you here. I thought you were very happy in your practice.”
“I was at one time,” said Dr. Vandermer. “But fee-for-service medicine is a thing of the past. Here we try to keep people well, instead of just trying to cure them when they are sick.”
Adam noticed that Vandermer’s voice had an oddly flat inflection, as if he were reciting from memory. “I wanted to talk about Jennifer,” he said.
“I assumed as much,” said Dr. Vandermer. “I asked the geneticist to come by.”
“Fine. But first I want to discuss the pregdolen.”
“Has it helped your wife’s nausea?” asked Dr. Vandermer.
“She thinks so,” said Adam. “But I suspect it is simply a placebo effect. What surprises me is that you gave it to her.”
“There are a number of drugs on the market,” said Dr. Vandermer, “but I think pregdolen is the best. Normally, I don’t like to use drugs for morning sickness, but your wife’s had gone on too long.”
“But why pregdolen?” said Adam tactfully. “Especially after the negative report in the New England Journal.”
“That was a poorly designed study,” said Dr. Vandermer. “They didn’t use the proper controls.”
Unwilling to confront Vandermer directly, Adam finally said, “But you told me the last time we spoke that pregdolen was dangerous. What’s made you change your mind?”
Dr. Vandermer shook his head, puzzled. “I’ve never said the drug was dangerous. I’ve been using it for years.”
“I distinctly remember…” began Adam as two other doctors entered the lounge. One was a tall, thin man with gray hair. He was introduced as Dr. Benjamin Starr, the Julian Clinic’s geneticist.
“Dr. Starr and I were just discussing your wife’s case this morning,” said Dr. Vandermer.
“Indeed,” said Dr. Starr, launching into a detailed description of the case. His voice had the same flat inflection as Vandermer’s, making Adam wonder if all the doctors at the Julian Clinic worked themselves to death.
Adam tried to understand what Starr was saying, but the man seemed to be speaking deliberately over Adam’s head. After trying to make sense out of the reasons given for Jennifer’s amniocentesis, Adam decided he was wasting his time. It was as if both Vandermer and Starr were trying to confuse him. As soon as he could, Adam said he had to leave. Dr. Vandermer offered to buy him lunch in the cafeteria, but Adam insisted he had to go.
Walking down the hall, he decided Jennifer was right. Dr. Vandermer was a changed man, and it made Adam nervous. In fact, the whole clinic struck a false note. Looking at the beautifully decorated rooms, he could understand why the Julian had such appeal. It seemed the ideal hospital environment. At the same time, it was almost too nice and, to Adam’s mind, slightly sinister.
Back in the car, Adam hesitated before turning on the ignition. There was no doubt in his mind that Vandermer had originally proclaimed pregdolen dangerous and all that super-scientific rhetoric about Jennifer needing amniocentesis alarmed him. With his wife sequestered at her parents’, his hands were tied. The only thing he was sure of was that he did not want Jennifer taking pregdolen, which meant that he didn’t want her to keep seeing Vandermer. The problem was that she obviously trusted Vandermer and didn’t want to change doctors.
Pulling out into the street, Adam realized that Jennifer was right on two counts: he wasn’t a doctor and he knew nothing about obstetrics. He realized that if he hoped to change Jennifer’s mind, he’d better study up on the subject.
There were no parking places within blocks of the university hospital, so Adam pulled the Buick into the hospital parking garage. After he’d found a space, he went down to the medical center. The Irish fellow at the information booth recognized him and lent him a white jacket.
In the library, he selected several recent textbooks on obstetrics and began looking up both morning sickness and amniocentesis. When he was finished, he turned to a chapter on fetoscopy-the visualization of the fetus within the uterus-and stared in wonder at the photos of what his child must look like at this stage in its development.
Returning the books to the desk, Adam made his way to the hospital. After the soft carpets and gleaming paint at the Julian, the university medical center looked like a set for Dante’s Inferno. It was uniformly drab with peeling paint and stained floors. The nurses and staff appeared rushed, and their expressions indicated that their patients’ psychological well-being was not high priority.
Adam took the main elevator to Neurology on the tenth floor. Pretending that he was still a student, he marched to the nurses’ station and positioned himself squarely in front of the chart rack. There were three nurses, two ward clerks, and a resident standing about talking, but none of them so much as looked at Adam.
Dr. Stuart Smyth’s chart was in the slot for room 1066. After a furtive glance at the nurses, Adam grasped the metal-backed record, pulled it out of the rack, and stepped back into the relative quiet of the chart room. There was a doctor there, but he was on the phone making a tennis date. Adam sat down at the desk.
Curiously, Smyth was diagnosed as having tardive dyskinesia. Reading over the history, Adam learned that Dr. Smyth had no past record of psychotropic drugs. The cause of his illness was still listed as unknown, and most of the workup involved sophisticated attempts to isolate a virus.
The only positive test Adam found was the EEG, but the resident had written that the results, though slightly abnormal, were nonspecific. In short, Dr. Smyth had been poked, prodded, and bled for a myriad of tests, yet the source of his troubles still had not been discovered. He’d been in and out of the hospital for two and a half months. On a happier note, he had started to improve, though no one knew why.
Adam returned the chart and walked down the hall to room 1066. Unlike the other rooms, the door was shut. Adam knocked. After hearing what sounded like “Come in,” he pushed open the door and stepped into the room.
Stuart Smyth was seated near the window, surrounded by books and periodicals. As Adam entered, he looked up and adjusted rimless glasses.
Adam immediately saw that Christine’s observation that he and Smyth looked alike was true, and it pleased Adam because Stuart was a handsome man.
Adam introduced himself as a medical student, and Smyth, whose face was periodically contorted by a grimace, asked Adam to sit down and explained that he was making the best of his confinement by reviewing the entire field of OB-GYN. His speech was difficult to understand because his lips and tongue were also affected by distorting spasms.
Despite his impediment, Dr. Smyth was eager for company and not at all shy about his illness. Adam waited patiently as he slowly recounted the details, most of which Adam had already gleaned from the chart. He did not mention the Arolen cruise, and Adam got around to the subject by first mentioning that Dr. Vandermer was taking care of Jennifer.
“Vandermer is a great obstetrician,” said Dr. Smyth.
“He was recommended by one of the OB residents,” said Adam. “Apparently he handles a lot of the house staff.”
Dr. Smyth nodded.
“I suppose you’ve heard that he’s just returned from an Arolen cruise?”
Dr. Smyth nodded as his face bunched in a spasm.
“Did you ever go on one of the cruises?” asked Adam.
The book Smyth had been reading slid from his lap and thumped on the floor. He reached down and picked it up, but when he started to answer, his tongue wouldn’t cooperate and he ended up just nodding his head.