Reardon mistook Alan's hesitation for uncertainty about what was being asked of him and tried to clarify.
"What I'm saying is, what tests would you order now? What medication?"
Alan's mind was completely blank. He stabbed at an answer. "An X ray and a blood test."
"Oh, I hardly think an X ray would be necessary," Reardon said in a jovial tone, but his smile quickly faded as he stared at Alan. " 'Blood test' is a little vague, don't you think? What, specifically, would you order?"
Alan racked his brain. God, if he could only think! He played for time.
"A profile. You know—a SMAC-20."
Alan saw the concern and suspicion growing in Reardon's face. It was reflected in the other faces around him.
"Not very specific, Alan. Look. I know this is very elementary, but for the record, tell me the etiology of gout."
Tony jumped in then. "First of all, there is no record. And secondly, Dr. Bulmer is not here to be examined on gout or whatever's wrong with Dr. Reardon's foot!"
"It was not intended as such," Reardon said, "but we seem to be faced with an incredible situation here. I've asked Dr. Bulmer a question any first-year medical student could answer, and I'm still waiting for a reply."
Alan felt the room constrict around him as he sank into a fog of humiliation. Why couldn't he think? What was wrong with him?
"Well, don't hold your breath!" Tony said as Alan felt himself grabbed by the arm and pulled toward the door. "Dr. Bulmer didn't have to come here and he sure as hell doesn't have to stay here!"
Alan allowed himself to be led to the door. He heard Reardon's voice behind him.
"It would be better if he stayed. From what I've seen this morning, Dr. Bulmer appears mentally impaired and the board will have to take appropriate action."
And then they were out in the hall and heading for the parking lot.
"Shit, Alan! Shit, shit, shit!"
That was all Tony had said since they had reached the car.
"And the worst part of this whole thing is that you didn't even have to be there! Christ! What happened in there!"
Alan shook his head as he drove. He felt absolutely miserable, and Tony wasn't helping matters with his rantings.
"I don't know. I couldn't come up with the answer. I've diagnosed and treated gout countless times, but it just wasn't there. It was as if part of my memory had been blocked off, like it was there but it was hiding, or hidden. It still is."
"If they decide you're impaired, they can suspend your privileges—I remember seeing that in the bylaws. They can put you on suspension until you've been evaluated by a shrink or a drug-rehabilitation guy—"
"Drugs! You think I'm on drugs?"
"No. I know you better than that. But, Al, you haven't been yourself lately. And you looked spaced this morning when he started quizzing you. I'm sure the board thinks you're either on something or you've cracked."
Alan couldn't argue with him. He'd seen their expressions. One face lingered in the front of his memory. As Tony had propelled him from the room, Alan had glanced back and seen Lou Alberts staring after him. It was as if all their years of ill-feeling and competition had been washed away; Lou's face was a study of shock, dismay, and—worst of all—pity.
"And there's worse coming, let me tell you. The hospital is required by law to notify the State Board of Medical Examiners if any staff member is suspended because of suspected impairment or any other form of incompetence."
Impairment . . . incompetence . . . the terms rankled in Alan's brain. After fighting constantly to stay on top of clinical medicine, to be judged incompetent while so many other doctors coasted along with outdated knowledge and practices.
He slowed to a stop at an intersection and sat there, staring at the road ahead as a crystalline ball of fear formed and grew in his chest.
"Maybe they're right," he said. "Maybe I do need help."
"What are you talking about?"
"I'm lost, Tony. I don't know which way to go."
"Don't worry, Al. I'm with you all the way. We'll sit down and—"
"No!" Alan said, hearing his voice rise in pitch as the fear spread down his arms and legs, encompassing him completely. "I mean now. Here. This road! I know I've been here thousands of times, but I'm lost!"
He turned and stared into Tony's shocked eyes.
"How do I get home from here?"
___24.___
Sylvia
"You didn't have to come along," Alan said as he got into the car and sat beside her.
"I wanted to," Sylvia said and forced a smile. He looked so haggard and tired; his eyes had a haunted look.
As Ba put the car in gear and began to drive, Alan said, "I'm glad you did, though. That was why I asked if I could borrow Ba instead of hiring a cab. I need a friend along, and you're it."
His words warmed her. She was glad he considered her someone he could turn to in time of need. "But what about… ?" She didn't finish the question.
"Ginny?" He sighed. "We're barely speaking. She wants me to see a psychiatrist. Even Tony wants me to see one."
"Is that who you're seeing at Downstate? A psychiatrist?" She wanted to tell him that he was the sanest man she knew, but thought better of it. Her opinion was purely personal.
"No. No psychiatrist—at least not yet. There's something I've got to rule out first."
"Going to tell me about it?" she asked after a lengthy pause during which he seemed to go into a trance. But when he spoke, the words froze her blood.
"Got to rule out a brain tumor."
"Oh, God! You can't—"
"I can't bury my head in the sand any longer, Sylvia. My memory has gone to hell. Why do you think I'm not driving myself? Because I could get lost! Or forget where I'm going! Hell, I got lost on the way back from the hospital the other day!"
"Couldn't that just be stress?" she asked, praying for a simple answer.
"It could, but that's a wastebasket diagnosis. It could be directly related to the Dat-tay-vao, for all I know. But I have to face the possibility that a tumor could be behind it all. I had a patient a few years back with exactly the same symptoms, but he was older so I laid it off to an organic brain syndrome—Alzheimer's or the like. But the progression of his symptoms was too rapid for my comfort—as rapid as mine—so I ordered a brain scan. Guess what? He had a big midline frontal meningioma. Benign. They shelled it out and his memory was back to normal in a couple of months. So before I do anything else"—he tapped his forehead with a finger—"I've got to make sure I haven't got something growing in here."
The thought of Alan with a brain tumor made her almost physically ill. "I can see why you wouldn't want it done in Monroe Community."
"Right. Too close to home. Too many nosy trustees."
"Those trustees!" she said. "I can't believe the rotten way they've treated you! Suspending your privileges and then releasing the news immediately to the Express!
"Yeah," he said softly. She sensed his hurt and humiliation. "I didn't expect the public execution before a hearing. Anyway, I went to school with one of the radiologists at Down-state. He fitted me in for a CT scan this morning."
"Have you seen another doctor about any of this?"
Alan smiled. " 'The physician who treats himself has a fool for a patient.' Is that what you mean? I'm not treating myself, just doing a little diagnostic work."