Michelle, lying flat on her back, looked up at her father with tired eyes. Despite her discomfort she managed a weak smile and for a brief moment her eyes shone with the incredible luster that Charles remembered.
“Michelle,” said Charles softly, bending down so his face was close to hers. “How do you feel?” He didn’t know what else to say.
Michelle’s eyes clouded and she began to cry. “I want to go home, Daddy.” She was reluctant to admit how bad she felt.
Biting his lip Charles glanced up at the woman next to him, embarrassed by his overwhelming emotion. Looking back down at Michelle, he put his hand on her forehead and smoothed back her thick black hair. Her forehead was hot and damp. Her fever had risen. Michelle reached up and grasped his hand.
“We’ll talk about it,” said Charles, his lips quivering.
“Excuse me,” said the woman. “You must be Dr. Martel. I’m Dr. Brubaker. Dr. Keitzman asked me to see Michelle. I’m a cardiologist. This is Dr. John Hershing, our chief resident.”
Charles made no effort to respond to the introductions. “What happened?”
“She had an acute episode of ventricular tachycardia,” said Dr. Hershing. “We cardioverted her immediately, and she’s been very stable.”
Charles looked at Dr. Brubaker. She was a tall, handsome woman with sharp features. Her blond hair was piled on top of her head in a loose chignon.
“What caused the arrhythmia?” asked Charles, still holding Michelle’s hand.
“We don’t know yet,” said Dr. Brubaker. “My first thoughts are either an idiosyncratic reaction to the double dose of Daunorubicin, or a manifestation of her basic problem: some kind of infiltrative myopathy. But I’d like to finish my exam, if I may. Dr. Keitzman and your wife are in the chart room at the nurses’ station. I understand they are waiting for you.”
Charles lowered his eyes to Michelle. “I’ll be right back, sweetheart.”
“Don’t go, Daddy,” pleaded Michelle. “Stay with me.”
“I won’t go far,” said Charles, gently loosing Michelle’s grip. He was preoccupied by Dr. Brubaker’s statement that Michelle had received a double dose of Daunorubicin. That sounded irregular.
Cathryn saw Charles before he saw her and leaped to her feet, throwing her arms around his neck.
“Charles, I’m so glad you’re here.” She buried her face in his neck. “This is so difficult for me to handle.”
Holding Cathryn, Charles glanced around the small chart room. Dr. Wiley was leaning against the table, his eyes on the floor. Dr. Keitzman was sitting opposite from him, his legs crossed, and his hands clasped together over his knee. He appeared to be examining the fabric of his slacks. No one spoke, but Charles felt nervous, his eyes darting from one doctor to the other. The scene seemed too artificial, too staged. Something was coming and Charles hated the theatrics.
“All right,” said Charles challengingly. “What’s happening?”
Dr. Wiley and Dr. Keitzman started to speak simultaneously, then stopped.
“It’s about Michelle,” said Dr. Keitzman finally.
“I assumed as much,” said Charles. The vise on his stomach turned another notch tighter.
“She’s not doing as we would have hoped,” said Dr. Keitzman with a sigh, looking up into Charles’s face for the first time. “Doctors’ families are always the most difficult. I think I’ll call it Keitzman’s law.”
Charles was in no mood for humor. He stared at the oncologist, watching the man’s face twist into one of its characteristic spasms. “What’s this about a double dose of Daunorubicin?”
Dr. Keitzman swallowed. “We gave her the first dose yesterday but she did not respond. We gave her another today. We’ve got to knock down her circulatory leukemic cells.”
“That’s not the usual protocol, is it?” snapped Charles.
“No,” Dr. Keitzman replied hesitantly, “but Michelle is not a usual case. I wanted to try…”
“Try!” shouted Charles. “Listen, Dr. Keitzman,” Charles snapped, pointing a finger in Dr. Keitzman’s face. “My daughter isn’t here for you to try things on. What you’re really saying is that her chances of remission are so poor that you’re ready to experiment.”
“Charles!” said Cathryn. “That’s not fair.”
Charles ignored Cathryn. “The fact of the matter, Dr. Keitzman, is that you are so certain she’s terminal you abandoned orthodox chemotherapy. Well, I’m not sure your experimentation isn’t lessening her chances. What about this cardiac problem. She’s never had any trouble with her heart. Doesn’t Daunorubicin cause cardiac problems?”
“Yes,” agreed Dr. Keitzman, “but not usually this fast. I don’t know what to think about this complication and that’s why I asked for a cardiac consult.”
“Well, I think it’s the medicine,” said Charles. “I agreed to chemotherapy, but I assumed you would be using the standard doses. I’m not sure I agree with doubling the usual treatment.”
“If that’s the case, then perhaps you should retain another oncologist,” said Dr. Keitzman wearily, standing up and gathering his things. “Or just handle the case yourself.”
“No! Please!” said Cathryn, letting go of Charles and clutching Dr. Keitzman’s arm. “Please. Charles is just upset. Please don’t leave us.” Cathryn turned frantically to Charles. “Charles, the medicine is Michelle’s only chance.” She turned back to Dr. Keitzman, “Isn’t that right?”
“That is true,” said Dr. Keitzman. “Increasing the chemotherapy, even if it is an unusual approach, is the only hope for a remission, and a remission has to be obtained quickly if Michelle is going to survive this acute episode.”
“What are you proposing, Charles?” said Dr. Wiley. “To do nothing?”
“She’s not going to go into remission,” said Charles angrily.
“You can’t say that,” said Dr. Wiley.
Charles backed up, watching the others in the room as if they were going to force him into submission.
“How do you think she should be treated?” asked Dr. Wiley.
“We can’t do nothing, Charles,” pleaded Cathryn.
Charles’s mind screamed for him to get away. Within the hospital, close to Michelle, he could not think rationally. The idea of causing Michelle additional suffering was a torture, yet the concept of just allowing her to die without a fight was equally abhorrent. There were no alternatives open to him. Dr. Keitzman was making sense if there was a chance they could get a remission. But if a remission was impossible, then they were merely torturing the dying child. God!
Abruptly Charles turned and strode from the room. Cathryn ran after him. “Charles. Where are you going? Charles, don’t go! Please. Don’t leave me.”
At the stair he finally turned, gripping Cathryn’s shoulders. “I can’t think here. I don’t know what’s right. Each alternative is as bad as another. I’ve been through this before. Familiarity doesn’t make it easier. I’ve got to pull myself together. I’m sorry.”
With a feeling of helplessness Cathryn watched him go through the door and disappear. She was alone in the busy corridor. She knew that if she had to, she could handle the situation even if Charles couldn’t. She had to, for Michelle’s sake. She walked back to the chart room.
“The strange thing,” said Cathryn with a tremulous voice, “is that you two anticipated all this.”
“Unfortunately we’ve had some experience with families of physicians,” said Dr. Keitzman. “It’s always difficult.”