“We didn’t know she was in here,” said the charge nurse defensively.

Dr. Keitzman walked over to Cathryn and put a hand on her shoulder.

“How about you, Mrs. Martel?” asked Dr. Keitzman. “Are you all right?”

Cathryn tried to talk but her voice wouldn’t cooperate, so she nodded like Michelle.

“I’m sorry you had to see this,” said Dr. Keitzman. “Michelle seems fine and she undoubtedly did not feel anything. But I know this kind of thing is shocking. Let’s go out in the hall for a moment. I’d like to talk to you.”

Cathryn strained upward to see Michelle over Dr. Keitzman’s shoulder.

“She’ll be okay for a moment,” assured Dr. Keitzman. Then, turning to the charge nurse, he said, “I’ll be just outside. I want a cardiac monitor in here, and I’d like a cardiac consult. See if Dr. Brubaker can see her right away.” Dr. Keitzman gently urged Cathryn out into the corridor. “Come down to the nurses’ station; we can talk there.”

Dr. Keitzman led Cathryn down the busy corridor to the chart room. There were Formica Parsons tables, chairs, two dictating telephones, and the massive chart racks. Dr. Keitzman pulled out a chair for Cathryn and she gratefully sat down.

“Can I get you something to drink?” suggested Dr. Keitzman. “Water?”

“No, thank you,” managed Cathryn nervously. Dr. Keitzman’s extremely serious manner was a source of new anxiety and she searched the man’s face for clues. It was hard to see his eyes through his thick glasses.

The charge nurse’s head came through the door. “Dr. Brubaker wants to know if he can see the patient in his office.”

Dr. Keitzman’s face contorted for a second while he pondered. “Tell him that she just had an episode of V-tack and I’d prefer he see her before she’s moved around.”

“Okay,” said the charge nurse.

Dr. Keitzman turned to Cathryn. He sighed. “Mrs. Martel, I feel I must talk frankly with you. Michelle is not doing well at all. And I’m not referring specifically to this latest episode.”

“What was this episode?” asked Cathryn, not liking the initial tone of the conversation.

“Her heart speeded up,” said Dr. Keitzman. “Usually it’s the upper part of the heart that initiates the beat.” Dr. Keitzman gestured awkwardly to try to illustrate what he was saying. “But for some reason, the lower part of Michelle’s heart took over. Why? We don’t know yet. In any case, her heart suddenly began to beat so fast that there wasn’t time for the heart to fill properly, so it pumped inefficiently. But that seems to be under control. What is worrying me is that she does not seem to be responding to the chemotherapy.”

“But she’s just started!” exclaimed Cathryn. The last thing that Cathryn wanted was for her hope to be undermined.

“That’s true,” agreed Dr. Keitzman. “However, Michelle’s type of leukemia usually responds in the first few days. On top of that Michelle has the most aggressive case that I’ve ever seen. Yesterday we gave her a very strong and very successful drug called Daunorubicin. This morning when we did her blood count, I was shocked to see that there was almost no effect on the leukemic cells. This is very unusual although it does happen occasionally. So I decided to try something a little different. Usually we give a second dose of this medicine on the fifth day. Instead I gave her another dose today along with the Thioguanine and Cytarabine.”

“Why are you telling me this?” asked Cathryn, certain that Dr. Keitzman knew she would not understand much of what he was saying.

“Because of your husband’s response yesterday,” said Dr. Keitzman. “And because of what Dr. Wiley and I said to you. I’m afraid your husband’s emotions will interfere and he’ll want to stop the medicines.”

“But if they’re not working, maybe they should be stopped,” said Cathryn.

“Mrs. Martel. Michelle is an extremely sick child. These medicines are her only chance for survival. Yes, it’s disappointing that as yet they have been ineffective. Your husband is right in saying her chances are slim. But without chemotherapy, she has no chance at all.”

Cathryn felt the stabbing pain of guilt; she should have brought Michelle to the hospital weeks ago.

Dr. Keitzman stood up. “I hope you understand what I’m saying. Michelle needs your strength. Now, I want you to call your husband and have him come over. He’s got to be told what’s happened.”

Even before the automatic radioactivity counter began to record the electrons emanating from the series of vials, Charles knew that the radioactive nucleotides had been absorbed and incorporated into the tissue culture of Michelle’s leukemic cells. He was now in the last stages of preparing a concentrated solution of a surface protein that differentiated Michelle’s leukemic cells from her normal cells. This protein was foreign to Michelle’s body but was not rejected because of the mysterious blocking factor that Charles knew was in Michelle’s system. It was this blocking factor that Charles had wanted to investigate. If only he knew something about the method of action of the blocking factor, perhaps it could be inhibited or eliminated. He was frustrated to be so close to a solution and have to stop. At the same time he realized that it was probably a five-year project with no guarantee of success.

Closing the cover on the tissue culture incubator, he walked to his desk, vaguely wondering why Ellen had not appeared. He wanted to discuss the Canceran project with someone knowledgeable, and she was the only person he could trust.

He sat down, trying not to think about the recent humiliating meeting with Dr. Ibanez and the Weinburgers. Instead he recalled the frustrating visit to the EPA offices that didn’t make him feel much better. Yet he could laugh at his own naiveté in thinking that he could walk into a government agency and expect to accomplish something. He wondered if there would be any way that he could get some sort of photographic proof of Recycle’s dumping. It was doubtful, but he’d try.

Perhaps if he were responsible for getting the evidence, he should sue Recycle directly rather than waiting for the EPA to do so. Charles knew very little about law, but he remembered there was a source of information open to him. The Weinburger Institute law firm on retainer.

The left lower drawer was Charles’s spot for miscellaneous pamphlets. Close to the bottom he found what he was looking for: a skinny red booklet entitled Welcome Aboard: This Is Your Weinburger Cancer Institute. In the back was a list of important phone numbers. Under services was Hubbert, Hubbert, Garachnik and Pearson, 1 State Street, followed by several phone numbers. He dialed the first.

Identifying himself, Charles was immediately switched to Mr. Garachnik’s office. His secretary was particularly cordial and within minutes, Charles found himself talking with Mr. Garachnik himself. Apparently the Weinburger was a valued customer.

“I need some information,” said Charles, “about suing a company dumping poisonous waste into a public river.”

“It would be best,” said Mr. Garachnik, “if we have one of our environmental law persons look into the matter. However, if your questions are general, perhaps I can help. Is the Weinburger Institute becoming interested in environmental pursuits?”

“No,” said Charles. “Unfortunately not. I’m interested in this personally.”

“I see,” said Mr. Garachnik, his tone becoming cool. “Hubbert, Hubbert, Garachnik and Pearson does not handle personal Weinburger employee legal problems unless special arrangement is made with the individual.”

“That could be arranged,” said Charles. “But as long as I’ve got you on the phone, why don’t you just give me an idea about the process.”

There was a pause. Mr. Garachnik wanted Charles to realize that he felt Charles’s inquiry beneath his stature as a senior partner. “It could be done as an individual or class action suit. If it were an individual suit, you’d need specific damages and if…”