38

Angela worked hard at finishing a third of her turkey sandwich. There wasn’t much time till she went back on-call. Jeremy picked at his meat loaf, watched her push wilted lettuce around her plate.

She said, “I’m not very good company. Maybe I should just go.”

“Stay a while.” His beeper went off.

Angela laughed, and said, “There’s an omen for you.”

He took the call in the doctors’ dining room, now empty. An oncologist named Bill Ramirez was phoning with an emergency. A patient they’d both seen seven years ago, a young man named Doug Vilardi, with Stage III Ewing’s sarcoma of the knee, was back.

Jeremy had counseled Doug and the entire family shortly after diagnosis. Between the bad news, debilitating treatment, and losing a leg, there was plenty to cry about. But Jeremy finally figured out that what really bothered the seventeen-year-old was the prospect of sterility caused by radiotherapy.

Touching optimism, he’d thought, at the time. The survival statistics for advanced Ewing’s weren’t encouraging. But he’d gone along with the fantasy, talked to Ramirez about sperm donation prior to treatment, learned it was feasible, and helped set things up.

Doug had lost his left leg but survived his cancer- one of those bright spots that energize you. No phantom pain, no tortured aftermath. He’d started with crutches, progressed to a cane, adjusted beautifully to his prosthesis. Jeremy had heard from him last, four years ago. The kid was playing basketball with his plastic leg and learning to lay brick.

What, now?

“Relapse?” he asked Ramirez.

“Worse, goddammit,” said the oncologist. “Secondary cancer. AML or possibly a newly converted CML, I’m still waiting for Pathology to clear it up. Either way, it’s leukemia, no doubt from the radiotherapy we gave him seven years ago.”

“Oh, no.”

“Oh, yes. ‘The good news, kid, is we nuked your solid tumor to oblivion. The bad news is we nuked your hemopoietic system and gave you goddamn leukemia.’ ”

“Jesus.”

“Him I could use,” said Ramirez. “However, given the fact that Jesus didn’t answer his page, I’ll take you. Do me a favor, Jeremy. Make time to see him tonight. Soon as you can. They’re all here- him, his parents, his sister. And get this: to make matters even more pitiful, a wife. Kid got married two years ago. Used the sperm we stored for him and now she’s pregnant. Isn’t life grand? He’s up on Five West. When the hell can you make it over?”

“Soon as I finish dinner.”

“Hope I didn’t ruin your appetite.”

He returned to the table. Angela hadn’t taken a bite in his absence.

“Trouble?” she said.

“Not our trouble.” He sat down heavily, ate a bit of meat loaf, washed it down with Coke, tightened his tie, and buttoned his white coat. Then he explained the situation to her.

She said, “That is beyond tragic. Helps put things in perspective. My petty little issues.”

“Being petty’s a constitutional right,” he said. “I can’t name the amendment, but believe me, it’s definitely right there in the Bill of Rights. I see families falling apart after a traumatic diagnosis, everyone working hard at concentrating on the Big Issues. In a crisis that’s fine, but you can’t live like that indefinitely. Eventually I get around to telling them, ‘When you start to be petty again, you’ll know you’re adjusting.’ ”

She placed her hand on his. “Where is he, on Five?”

“Five West. You still on Four?”

“Uh-huh.”

“Let’s ride up together.”

He dropped her off and continued up to the cancer ward. Entertaining fantasies of bypassing the ward and taking the passageway that connected to the medical office wing. Then jogging the stairs up to the penthouse level.

He had no idea what he’d say or do if he ran into Dirgrove again, but he had a feeling he’d pull it off well.

When the elevator door opened on Five West, he walked out, looking to the most casual observer like a man with a mission.

What the hell would he say to Doug Vilardi and his family?

Most likely, he’d keep his mouth shut and listen.

The virtue of silence. Ethics of the Fathers.

At seventeen, Doug had been a tall, gawky, dark-haired kid, not much of a student, his best class, metal shop. Since then, he’d put on weight, lost some of the hair that had grown back after chemo, stuck a diamond chip in his left ear, grown a tea-colored goatee, and gotten a tattoo on his right forearm. “Marika” in blue script.

He looked like any regular guy who worked for a living, except for the pallor- that certain pallor- that sheathed his skin, and the jaundiced eyes that lit up as Jeremy entered the room.

No family, just Doug in bed. The prosthetic leg leaned in a corner. He wore a hospital gown, and bedsheets covered him from his waist down. An IV had already been hooked up, and every so often it clicked.

“Doc! Long time, no see! Look what I did to myself.”

“Being creative, huh?”

“Yeah, life was getting too friggin’ boring.” Doug laughed. Held out his hand for a soul shake. Muscles flexed and “Marika” jumped as he held on to Jeremy’s fingers.

“It’s good to see you, Doc.”

“Good to see you, too.”

Doug cried.

Jeremy sat down by the bed, took hold of Doug’s hand again, and held it. Blue-collar guy like this, try it in any other situation and you’d be cruising for a bruising.

Seven years ago, Jeremy had done a lot of hand-holding.

Doug stopped sobbing, and said, “Fuck, that’s exactly what I didn’t wanna do.”

“I think,” said Jeremy, “that you can be excused a little emotion.”

“Yeah… oh, shit, Doc, this reeks! I got a baby coming; what the fuck am I gonna do?”

Jeremy stayed with him for two hours, mostly listening, occasionally commiserating. The parents stuck their heads in after the first hour, saw Jeremy, smiled weakly, and left.

A nurse came in and asked Doug if he was experiencing pain.

“A little, in the bones, nothing heavy.” He rubbed his ribs and his jaw. The chart said his spleen was already enlarged, maybe dangerously so.

“Dr. Ramirez says you can have Percocet if you want.”

“What do you think, Doc?”

Jeremy said, “You know how you feel.”

“It wouldn’t be chickenshit?”

“Not hardly.”

“Yeah, then. Shoot me up.” Doug smiled up at the nurse. “Can I have some rum, too? Or a beer.”

She was a young one, and she winked. “On your own time, stud.”

“Cool,” said Doug. “Maybe Doc here’ll get me something refreshing.”

“Aiding and abetting?” said the nurse.

Everyone chuckled. Filling the time. The nurse shot Percocet into the IV line. The drug had no clear effect for a while, then Doug said, “Yeah, it’s taking the edge off- Doc, mind if I sleep?”

The parents and the wife were waiting right outside the door. Marika, short, pretty, with shaggy blond hair and stunned blue eyes. Her belly bore the swell of early pregnancy. She looked around sixteen.

She didn’t talk and neither did Doug’s father, Doug, Senior. Mrs. Vilardi talked for all of them, and Jeremy stayed with the family for another hour, filled his ears with weeping, stuffed his soul full of misery.

After that came the conference with Bill Ramirez, another twenty minutes answering the reasonable, caring questions of the night nurses, thinking out plans to be made for future psychological support, and, finally, charting.

When he finally stepped out into the hallway, it was early morning, and he could barely keep his eyes open.

He returned to his office to collect his raincoat and his briefcase, considered another go at the computer, thought better of it.

He drove home on autopilot, passing the now-dark façade of the Excelsior, gliding through empty, sepia streets, unaware of the moon, head blessedly free of thoughts and pictures.