Of Flesh and Blood (4 page)

Tyler held up a hand. “The success rates—what we call the five-year survival—are all out of date for this disease. Our treatments are totally different than five years ago. Different from six months ago. I can’t give you an accurate—”

“Please, Dr. McGrath,” Laura snapped uncharacteristically. “Just give us a damn number!”

Tyler cleared his throat. He refused to let himself break off eye contact with either of them. “The textbooks quote a figure of five to ten percent.”

Laura caught her breath in mid-inhalation. “Nate has less than a ten percent chance of surviving?” she whispered.

Craig’s shoulders heaved, and he brought a hand quickly to cover his face. It was the first time Tyler had ever seen the man cry.

Tyler thumbed toward Nate’s room. “Listen to me, both of you.” His tone took on an edge. “Did you see your son back there? Nate has
not
given up. So you can’t either!” His voice rose. “Do you understand?”

“Yes,” Laura said weakly. And Craig nodded.

“Good.” Tyler offered each of them the most hopeful smile he could muster. “I’m going to need to get you to sign some consent forms for the new treatment protocol. I want to get started as soon as possible.”

After the parents consented to the new therapy, there was nothing left to say. Filing out of the room, with an arm still draped around his wife’s shoulder, Craig turned to Tyler. “Look, Dr. McGrath, I said a lot of things today . . .”

Tyler held up a hand to interrupt. “You had every right. You’re a good dad, Craig.”

Craig’s shoulders sagged and his back stooped as he seemed to shrink in front of Tyler’s eyes. “I don’t know how you do this, Doctor,” he mumbled.

Most times, the answer was easy for Tyler. He took enormous satisfaction from doing the best job he could, even under difficult circumstances. But today was an exception. Despite downplaying the statistics, he knew how horribly the odds were stacked against Nate.

Tyler had seen more than his share of cancer-related tragedy. Even when pediatric oncology was practiced perfectly, treatment failures and young deaths were an unavoidable part of the job. He knew that at times like these, the best oncologists detached themselves emotionally from patient and family. What the Staffords needed most—in fact, all they needed—from him was the absolute professional objectivity that would allow Tyler to make the soundest clinical decisions.

But the Stafford case hit him harder than most. Nate reminded him of his twin nephews—the kind of kid he would have wanted for his own. The embodiment of the child Jill and he had worked so hard, and so unsuccessfully, to conceive.

Tyler felt sad, drained, and powerless. Worst of all, he knew that as soon as he gathered himself up, he would have to go see Keisha Berry and essentially repeat the whole ordeal for the family of the eight-year-old with the adorable missing-toothed smile, infectious laugh, and an equally rare and malignant blood cancer.

An overgrowth of shrubs and weeds cluttered the once meticulously landscaped grounds, and the house’s faded tan exterior begged for a coat or two of new paint. As Lorna Simpson stood at the imposing marble-and-stone entryway, she could see beyond the dilapidation and envision what a grand estate it must have been. She remembered visiting almost forty years earlier when she was only four. She recalled how massive the mansion had seemed and had a vague memory of a strange doll collection inside, but she had no idea whether the place looked even more run-down than on her previous visit.

Lorna had risen at dawn and driven three hours from her town house outside Portland to the row of heritage mansions in Seattle’s Queen Anne district. She had come to see her great-aunt, Dorothy “Dot” Alfredson. Lorna had expected a servant or caretaker to meet her at the door, so when the huge oak door creaked open she was surprised to find her eighty-nine-year-old great-aunt on the other side.

With arms folded across her chest, the shrunken woman wore leopard-skin leggings and a long black cardigan, accessorized with a bright orange scarf. Dot’s white hair was shaved in a buzz cut, and she had generously applied lipstick and eye shadow to a face that looked as if it might have been surgically lifted more than once.

For a silent moment Dot assessed Lorna, who, in old jeans and a simple black V-neck, wore no makeup and had her hair tied in a limp ponytail. “Darling, look at you!” she finally said. “You grew up
exactly
as I imagined you would.” She stepped forward and wrapped her bony arms around Lorna, pulling her into a surprisingly tight hug.

“You look well, Dot,” Lorna said, self-consciously breaking free of the embrace. “Thanks for seeing me on such short notice.”

Dot chuckled. “These days, my social calendar boasts the odd hole, darling. In fact, my next standing engagement is my own funeral.” Her eyes twinkled as she pointed to Lorna’s beaten-up knapsack. “Leave your
luggage
here, darling. Juanita will take it to the room. Now what can I get you to drink? You
must
need a vodka tonic after that interminable drive.”

As appetizing as the offer was, Lorna feigned indifference with a shake of her head. “A glass of water would be great.”

“Fortunately, the taps are one of the few things that still run inside the old dump.” Then she added in a mutter to herself, “Water, I could have guessed.”

Ignoring Lorna’s drink request, Dot led her inside the house, through the high-ceilinged marble foyer, and into a wood-paneled living room decorated with dark teak furniture. The younger woman’s gaze was immediately drawn to the array of phallic carvings and sexually explicit sculptures (ranging widely in size, age, cultural origin, and depicted act) that covered the living room’s ornate mantel and were dispersed throughout the room. Amused and slightly embarrassed, Lorna realized they must have constituted the “doll collection” of her childhood memory. Seemingly indifferent to the provocative artwork, Dot strolled over to a chaise by the fireplace and eased herself onto it. “Tell me, darling, what brings you to the old ruin?”

You or the house?
Lorna wondered as she sat down in the wingback chair across from Dot. “I was hoping you could shed a little light on the history of the Alfredson for me.”

Dot smiled as though responding to an inside joke. “The little hospital Grandfather built.”

Lorna nodded, trying to ignore the erotic statuettes and figurines that stood on the mantel directly in her line of sight. She had not seen her great-aunt in well over thirty years; not since the Alfredsons abandoned their yearly family reunions. Even in those days, Dot had seemed strange. Eccentricity aside, the woman had a reputation as a firebrand and agitator, which helped explain how she had chewed through four marriages and why she flaunted her collection of pornographic memorabilia inside the otherwise classically furnished mansion. Lorna had heard that Dot’s memory was as ironclad as ever, and she knew that the old gossip was the keeper of most
of the family secrets. That alone had drawn Lorna to the largely forgotten mansion.

Dot fluttered a hand in the air like a bird taking flight. “So you have an interest in the history of
our
little hospital, do you, darling?”

“Very much so.” Lorna caught sight of a dark wood carving of a naked Polynesian thrusting his disproportionate anatomy toward her. She stifled a laugh as she adjusted her rimless glasses. “I’m teaching a course next term on the Pacific Northwest’s twentieth-century history.”

“Wonderful,” Dot said with a sidelong glance. “At that little community college of yours?”

Lorna bristled at the barb, all too aware of her stalled academic career. But she forced a smile. “Exactly. I am considering including the Alfredson in the syllabus. Seems to me it has played a significant role in local history.”

“How so?” Dot said, fighting off a yawn.

“Putting aside its worldwide reputation for medical innovation, think of all the famous people who have been treated at the Alfredson over the years. Elvis, John Wayne, Howard Hughes, the Shah of Iran, Bing Crosby, Rock Hudson, and too many other VIPs to count.” Lorna folded her arms across her chest. “Even a sitting president.”

“Darling, that’s
all
Ike did by the end of his term—sit and wait for the next heart attack.”

“Some people consider it the Mayo Clinic of the West Coast.”

“I suppose one could make that argument,” Dot said with little interest.

“I just finished that book,
The Alfredson: The First Hundred Years
. I was hoping—”

The elderly woman sat up with an agility that startled Lorna. “That so-called biography was utter drivel!
Painfully
inaccurate. That ridiculous man, Gerald
Fenton
Naylor, did not even bother to interview me or anyone else who might have known something about the real history. Instead, that hack toed the party line. I think Fenton transcribed his entire book from old newsletters and whatever other official propaganda he could get his greasy hands on.” Dot flung her head back dismissively. “
My Gawd
, if you suffered all the way to the end of it, you would have thought the Alfredsons and McGraths were two of the righteous tribes of Israel!”

Lorna bit back a smile. It was exactly the reaction she had hoped to elicit. “Are you saying we’re not?”

The cagey old woman eyed Lorna for a suspicious moment. “I doubt you could have earned a Ph.D. from any institution by being
that
simple. You and I both know how little love lost there is among the Alfredsons.” She touched her bright red lips. “And as for the hundred years of loving collaboration between the Alfredsons and the McGraths . . . honestly, have you
ever
heard such
utter
horseshit?”

“But Marshall Alfredson and Evan McGrath must have been close.”

Dot spat a laugh. “My grandfather
loathed
Evan McGrath. And the feeling was entirely mutual.”

Lorna glanced at the ceramic copulating Japanese couple on the end table. “What about the Alfredson’s legendary beginnings?”

“ ‘Legend’ being the pivotal word.”

“So Evan McGrath didn’t save Olivia’s life?”

“Oh, he very much did,” she said. “It was just never
enough
to compensate for everything else.”

Lorna leaned forward. “What else?”

“A long, sordid tale.” Dot heaved an exaggerated sigh. “Surely this sort of trivial ancient history would bore you to tears.”

Lorna recognized the spark of glee in Dot’s eyes and knew that the old woman was playing coy, angling to be begged. “Hardly! I’m already hooked, Dot. Please . . .”

“I doubt I can still do justice to the story. I am an
absolute
relic. Almost ninety. I can hardly keep breakfast and dinner straight.”

“Dot, your memory is fabled.” Lorna held her hand out to the older woman. “Besides, you are the only one who knows the whole story. The true story. And I would kill to hear it.”

“
Kill? Really?
” Wariness suddenly wiped away Dot’s façade of benign befuddlement. “Tell me, darling, why could this possibly matter
that
much to you?”

Lorna shifted in her seat as her mind raced to concoct an excuse.

But Dot’s suspicion vanished as quickly as it appeared. Her lips broke into a conspiratorial grin as she glanced in either direction. “You see, even Naylor’s hopeless whitewash of a book was right about the very beginning.
Marshall Alfredson and Evan McGrath
did
first meet in August of 1895.” She pointed up to the coved ceiling. “In this very house.”

Destiny, in the form of a gravely ill loved one, originally brought Marshall Alfredson and Evan McGrath together. A good judge of character, Marshall trusted Evan from the outset. And he willingly placed the fate of the most important person in his world in the young doctor’s capable hands.

—
The Alfredson: The First Hundred Years
by Gerald Fenton Naylor

The balding butler led Dr. Evan McGrath into the spacious second-floor office with windows looking out on a manicured English-style garden and rolling lawn below. Still sweating in his black jacket from the sweltering carriage ride, the twenty-nine-year-old physician lowered his heavy doctor’s bag, laden with extra instruments and bottles of medicine, as the butler silently backed out of the room.

With a pipe clamped between his teeth, Marshall Alfredson sat behind an oak desk and stared at his guest without expression or comment. The barrel-chested giant had a shock of graying red hair, muttonchop whiskers, and freckled pale skin. Everything, even his huge desk, seemed undersized relative to Marshall, whose blue vest—adorned with a thick gold fob and matching pocket watch—strained to contain his bulk. Marshall’s piercing gray eyes scanned the young doctor up and down. Evan felt suddenly self-conscious in his well-worn black suit. Automatically, he touched the patch over the elbow where the wool had frayed most.

Marshall rose from his seat and limped around the desk toward Evan. Though Evan was tall himself, Marshall towered four inches over him. He extended a massive hand to the doctor, and his grip was as crushing as Evan expected. Forgoing introductions or pleasantries, Marshall said, “Dr. Montgomery tells me you’re a decent belly man.”