Natural Causes (16 page)

The psychologist then sent Sarah for a number of sessions of hypnosis, and once even took a day off to drive her to Syracuse for a consultation at the university medical center. Nothing helped. Sarah simply could not connect with any event in her childhood that could have sparked such bizarre and debilitating fantasies.

During college, the disturbing dreams seemed to come less frequently, but they were no less terrifying. She tried another course of psychotherapy and hypnosis, and even consented to take some sort of pill designed, her physician said, to alter the neurologic pattern of her sleep. What the drug altered instead was her grade point average, which dropped that semester from a 3.8 to a 2.9.

Eventually peace did come for her. The answer lay in the simple mountain people whom she had traveled halfway around the world to help. In a village in the foothills
of Luang Chiang Dao, just a few miles from the Burmese border, Dr. Louis Han, placed her in the hands of a healer—a wizened, stoop-shouldered man, who was, Han said, over 110 years old.

The healer, speaking a dialect of Mandarin that Sarah could not understand, communicated with her through Han. Whether her nightmares were grounded in a past event, or perhaps even a future event, was of no consequence, he said. What mattered was that at the time of sleep, she was not at ease. The spirit that guided her throughout each day remained locked within her. The devastating dreams were nothing more than that day spirit, expressing anger at being detained and demanding a clean separation from her so that it, too, might rest and renew.

All Sarah need do to end the nightmares, the old man promised, was to spend some quiet, contemplative time at the end of each day, first embracing her guiding spirit and then releasing it.

Not even Louis Han knew the exact nature of the tea the healer brewed for her that night. But Sarah drank it willingly and soon drifted off to sleep. When she awoke, two days later, she knew the day spirit within her, an elegant, pure white swan.

Each night from then on, she meditated before going to bed, often actually seeing her swan take flight. Her days, even the most trying ones, began ending peacefully. And the vivid nightmares that had defied her and so many physicians had never recurred—not until tonight.

The hot water supply in Sarah’s building, which later in the morning would be inadequate even for a decent shower, was plentiful at such an early hour. Sarah kept the tub filled with a slow, hot stream until she trusted her shivering was gone for good.
Things happen for a reason
, she reminded herself. The belief was one of the pillars on which she had built her life.
Things happen to teach us or to send us off in other, more important directions
.
By the time she toweled off and slipped into her robe, the message in her nightmare—two of them, actually—seemed quite clear.

Understandably, but quite unacceptably, she had begun allowing the demands of work to override her life. Her periods of meditation and reflection had grown brief and generally ineffectual. The connection with her spiritual self was all but gone. She was paying less and less attention to Sarah, trusting more and more that her work on behalf of others was enough to provide her with the strength to deal with each day. The nightmare was telling her otherwise.

It was telling her something else as well: She had made more than enough appearances on center stage. Lecturing to educate medical students and other residents was one thing; providing news footage was quite another. From this morning on, she resolved, it would be back to basics and back to business. No more cameras, no more interviews.

She padded over to the window. The first streaks of dawn glowed against a dull, slate sky and shimmered off a misty rain. One other positive thing her nightmare had given her was some extra time before work. Time to get centered, to regain perspective. Beginning tomorrow, she resolved, when she wasn’t at the hospital, she would set her alarm to awaken her twenty minutes earlier. She put on a tape of ocean sounds, set a large pillow on the floor, and eased down into a lotus position.

Please let me do the right thing today
, she thought, settling herself with a few deep breaths.
For my patients and myself, let me do the right thing
.

Her breathing slowed and grew shallow. The tightness in her muscles began to disappear. Her thoughts grew more diffuse and less distracting.

Then the telephone rang.

The fifth ring told her that her answering machine was not turned on; the tenth, that the caller was determined—or in trouble. Betting a hundred to one that it would
be a wrong number, or worse, a crank, Sarah crawled over to the phone by her couch.

“Hello,” she said, clearing some residual sleep from her throat.

“Dr. Baldwin?”

“Yes?”

“Dr. Baldwin, this is Rick Hochkiss. I’m a stringer with the Associated Press, and I was at the news conference you gave yesterday.”

“You are extremely thoughtless and rude to be calling at this hour.” She debated simply hanging up. “What do you want?” she asked finally.

“Well, for starters, I’d like your comments on the accusations made about you in Axel Devlin’s column this morning.…”

•  •  •

Lisa Grayson sat before the pop-up mirror in her tray table, trying as best she could to do something with her hair. In minutes her father would be making his third visit to the hospital. This time she was ready to see him. She had made the decision the night before. But not an hour ago, a messenger had delivered a gold necklace bearing her name in elegant script, with a diamond chip dotting the “i.”

Had that been all—had her father continued to show no insight into who she was or what was important to her—she might well have decided to send him away once again. But with the gift was a note. It was written on stationery her mother had commissioned years before, featuring an etching of Stony Hill, their home. Lisa set her brush aside and studied the picture, wondering if her room had been changed at all. Then she reread her father’s words.

I’m sorry
. Five years. Five years gone from their lives together. If only he had understood that those were the only words she needed to hear.
I’m sorry.… I need you
. Lisa touched the bandage covering what remained of her arm. Now she needed him as well. Perhaps she always had.

The telephone interrupted her thoughts.

“Hello?”

“Lisa, it’s Janine at the nurses’ station. Your father’s here again.”

“Good. It’s time. Could you please send him back?”

When Willis Grayson knocked and entered her room, Lisa was on her feet, facing him. He held a rose in one hand and a newspaper in the other. He stood in the doorway for a time, getting a sense of her; then he tossed the paper and flower on the bed and rushed to embrace her.

“You have no idea how much I’ve suffered without you,” he said.

“Daddy, you wrote you were sorry for the way you treated me—for driving me away from you. That’s all you ever had to say.”

“I want you home with me. Today.”

“I think they’re not going to discharge me until tomorrow.”

“They’ll do it today if you say the word. I’ve already spoken with Dr. Snyder and Dr. Blankenship. Your blood is back to normal, and we can have your stitches taken out at our hospital.”

“How’s my room?”

“At Stony Hill?”

“Yes.”

“Why, it’s … it’s the same. The same as the day you—the same as it ever was. You’ll come?”

“I have some things to pack at home, and I want to say good-bye to my housemates.”

“Tim and I will help you,” Grayson said excitedly. “Your friend Heidi is welcome to come anytime and stay with us for as long as she wants. I’ve spoken with her several times. She’s a very fine person.”

“Can we leave here now?”

“We notify the nurses, and as soon as your doctors stop by and write the order, we’re out of here.”

“I’d like to see Dr. Baldwin before I go.”

Grayson’s expression tightened. “Lisa, could you sit down for a few minutes? There’s something we need to talk about.”

He handed her the
Herald
, folded to Axel Devlin’s column.

“Two women died? Is this true?”

“I’m afraid so. Did you take those herbs?”

“Every week. Twice a week toward the end. Both of the other women did that, too?”

Grayson nodded. “Lisa, I have two men outside I’d like you to speak with. They’re attorneys. I want them to represent us.”

“Represent us?”

Grayson gestured toward her bandage. “If someone,
anyone
, is responsible for this, and … and for what happened to my grandson, your son, I want them to pay as dearly as you have.”

“But Dr. Baldwin—”

“Lisa, I’m not saying she was responsible, or anyone else for that matter. I only want you to talk with these men.”

“But—”

“Honey, two other women and their babies have already died from this thing. We need to get to the bottom of it. For their sake, for your sake, and especially for the sake of whoever may be next.”

“As long as you promise me that nothing will be done without my approval,” she said tentatively.

“I promise.”

“Daddy, I mean it.”

“Nothing will be done without your approval. Now will you speak with these people?”

“If you really, really want me to.”

“I do.”

Grayson stepped to the doorway and motioned. Moments later two men entered carrying briefcases. One was overweight. The other was thin and sharp-featured, with hard, gray eyes.

“Miss Lisa Grayson,” her father said proudly, motioning to the heavier of the men, “this is Gabe Priest. His firm handles much of our business on Long Island.”

The lawyer stepped forward, about to offer Lisa his right hand. At the last moment, he realized what he was doing, stepped back, and nodded.

“And this man will be handling matters for us in Boston,” Grayson went on, motioning the other one forward. “Lisa, I’d like you to meet Jeremy Mallon.”

A
T ONE-FIFTEEN IN THE AFTERNOON, FOR THE FIRST
time in her professional life, Sarah asked to be replaced in the operating room. The case, a tubal ligation by laparoscope, was straightforward enough, and one she had looked forward to doing. But the morning had been a blur of conferences, explanations, phone calls and more phone calls. And no matter how she tried, she simply could not get focused enough to feel at ease in the operating room.

For a physician with distracting problems—personal
or
professional—there is no more difficult or dangerous place to be than in a hospital
. Sarah had heard that statement more than once in required courses on risk management and liability. But she had never experienced it personally. Under the best of circumstances, one lecturer had warned, the possibility of committing a serious error was like a raven, perched constantly on the shoulder of every doctor, feeding on fatigue, time constraints, routine, and loss of concentration. A collapsing marriage, financial strain, alcohol, drugs, or accusations of any sort of impropriety only heightened already disconcerting odds.

A momentary distraction, the omission of a decimal point in a medication order, the failure to notice a change in one of dozens of laboratory test results—the possibilities for disaster in an acute care facility were endless, and frequently well camouflaged.

Make the physician in question a surgeon
, Sarah thought now,
and add the pressure of having her problems become public knowledge, and the lecturer’s spectral raven turns into a vulture
. She took a cup of tea to an empty room in the residents’ sleeping quarters and lay down, trying to will her dull headache into submission.

The 5:30
A.M
. call from the AP stringer had been quickly followed by three others, all reporters, all wanting her thoughts on Axel Devlin’s column. After her tenth “No comment” and her fourth “Please don’t call me again,” she unplugged her phone.

A brief try at returning to her meditation was fruitless. Finally she pulled her yellow slicker over her Spandex and walked her bike through the soft rain to the small market at the end of her street. There were three other people in the store. Sarah felt conspicuous and ill at ease as she paid for a coffee and muffin and then, as casually as she could, a copy of the
Herald
. Huddled in a deserted shop doorway down the street from the market, she first scanned, then carefully picked through Axel Devlin’s prose.

The column did disturb her greatly, but more for its bald-faced bias and obvious intent to harm than for its content. What Devlin had written was, in essence, factual. All three of the DIC victims
had
seen Sarah in the outpatient department. And all three
had
opted to take the herbal supplement over the synthetic. But whatever had caused their bleeding problem had nothing to do with that choice. The herbs she prescribed were the precise mix that a scientifically designed study had proven superior to synthetics. She had reprints of the article, published in English in one of the most prestigious medical
journals in Asia, and would have provided a copy had she only been asked.

The content and purity of her herbal mix was the province of Kwong Tian-Wen, one of the oldest, most experienced, and most respected herbalists in the Northeast. The purity of his products, she could easily argue, rivaled or exceeded that of most pharmaceuticals, especially the generics. Time and again since government regulations had begun requiring the use of generic substitution wherever possible, one or another of the many fly-by-night manufacturing companies had been cited for peddling substandard medicine. And many times the drugs involved had life-or-death potential. Still, the punishment meted out to the companies was, more often than not, an admonition and a slap-on-the-wrist fine.