Recessional: A Novel (11 page)

Unable to decipher the pattern of occupancy, Zorn finally asked Krenek as they stood at a vantage point from which they would probably not be seen: “What’s the story on number four?” and the administrator chuckled: “You might call that the pride of the Palms. The four men who often sit there are our tertulia.”

“Our what?”

“Spanish word. The tall, distinguished-looking man who always sits in the corner leading the discussion is the Colombian gentleman I told you about, Raúl Jiménez. Very capable newspaper editor in Bogotá. Won medals and such, internationally, too.” Zorn studied the very thin, austere-looking foreigner, a courtly gentleman with a finely pointed goatee. He could have been painted by Velázquez, so essentially Spanish he appeared, and so like a grandee of the royal court, for he held himself stiff and proper.

“Why did he come to the U.S.?” Zorn asked and Krenek whispered: “Exile. When he was run out of Colombia, Harvard University gave him a position teaching Hispanic culture. His lovely wife, Felícita, came with him when he retired. They usually dine together except when he convenes the tertulia.”

“And what is that?”

“An old Spanish word meaning an informal club that meets in the corner of some restaurant or bar. Eight, ten men of some local importance who like to discuss politics, poetry, philosophy. The heady topics!”

“The other men? Are they regulars?”

“Yes, and you might say they’re the brains of our establishment, the ones with reputations that have spread beyond Florida.”

“For example?”

“Going counterclockwise, the big muscular man with the shock of gray hair, that’s Senator Stanley Raborn, the Silver Fox of the Prairie. Nebraska Republican, powerful orator like the old William Jennings Bryan, also from Nebraska. He’s frequently summoned to policy meetings in Washington or cities like Chicago or L.A. His name was placed in nomination three times for vice president. He would have run as Goldwater’s VP but they felt they needed a geographically balanced ticket, and Barry took that congressman from New York. A bad mistake in my opinion.”

“He looks to be a toughie.”

“That he is. But he can also be deceptively gracious, especially when he’s about to do you in. Don’t take the senator lightly.”

“I’ll be on guard.”

“The handsome, bald-headed man to his right, the one who looks like an English duke or the colonel in charge of a Scottish regiment, that’s Ambassador Richard St. Près, pronounced Pray but spelled Près. He served in many countries, but made a name for himself in Africa. I forget what he did, but there’ve been articles about him. Very courageous. He’s important but now retired.”

Zorn whispered: “It would be interesting to hear his stories of diplomatic intrigue.”

“The last one is the man everybody loves. President Henry Armitage from a small college in Iowa. Treats us all as if we were his students and isn’t at ease until he’s satisfied we’re all OK and out of trouble.”

Zorn said: “He looks like Edmund Gwenn in that Christmas movie about Macy’s,” and Krenek said: “Not strange you should say that. He serves as our Santa Claus each year, here and in one of the elementary schools.”

Inspired by the jovial president, Zorn himself became protective of his charges: “Dining alone that way? Don’t they have wives?”

“Jiménez and the senator do. St. Près and the college president don’t. But I understand the wives encourage their husbands to attend the tertulia. They say their men need academic discussion to retain their smarts.”

“Do they discuss set topics?”

“Heavens, no! Their table seats five. That’s so they can invite an interesting visitor or other residents who might have something sharp to contribute. You’d be welcome to join them. I’ll fetch a chair.”

And in that easy way, Dr. Zorn joined the tertulia, sitting between President Armitage and Raúl Jiménez. The topic they were discussing was one they’d been considering for a large part of the year, returning to it again and again, for it was a subject of intense interest to men of their advanced ages, each well past seventy.

“We’ve been wrestling with that ugly word ‘triage,’ ” the senator explained. “Can we afford to provide first-class medical services to everyone in the nation who wants them, or will we be forced to ration the costly new machines like the MRI and expensive treatments like coronary bypasses?”

Before Zorn could respond, Jiménez said: “They tell us you’re a doctor. Your opinion would be valuable.”

“I’m not licensed to practice here in Florida, you know. But I certainly was a doctor in Chicago, an obstetrician, and the problem you just defined came up constantly—at the beginning of life, not at the end, where we know about the costly procedures.”

“What could have been a situation in which a baby doctor faced the problem of triage?” President Armitage asked, and Zorn explained: “I faced it almost every day. Let’s say a baby is born to an unmarried sixteen-year-old girl already infected with AIDS, and an alcoholic to boot. The baby girl is premature, I’ve seen scores of them. The child is doubly at risk, for AIDS and alcoholism, and she has only a slim chance of surviving or amounting to a real human being if she does survive. But we spend maybe two hundred thousand taxpayers’ dollars to keep her alive, knowing she’ll probably be dead by the time she’s eleven. Does that make sense?”

Eagerly the men started to dissect this new information, for hitherto they had focused mainly on choices facing the aged. President Armitage observed: “That deplorable case is easy to decide. You don’t hesitate. The fetus is surrendered before birth.”

“Not so fast,” Zorn said, entering the spirit of the tertulia, where opinions could be shared, defended and rebutted without giving offense. “The decision can become very dicey if the evidence is not clear.”

“But it seems so open and closed,” Armitage insisted. “The baby is doomed—can never enjoy a normal life,” and Zorn replied: “But obstetricians know that even an infected mother can sometimes give birth to a normal child, whom we can save in our prenatal units. You never terminate a life casually.”

“Indeed you do not,” Jiménez said. “Doctor, I applaud you for your common sense.”

President Armitage, determined to keep the argument focused on alternatives faced by ordinary people in their real lives, said: “Surely you must have had, in your practice, situations in which normal people faced decisions that produced anxiety. Share one with us.”

Zorn reflected for a moment, then asked: “I suppose you know about the miracle of amniocentesis?”

“Yes,” Raborn said. “We had a Senate hearing on procedures like that. You can extract fluid from the womb and detect genetic abnormalities in the unborn fetus. Extraordinary.”

“Correct. Now I want you to imagine yourself as a young husband whose wife is pregnant for the first time. But there’s a suspicious record in her family of irregular births. So to be safe we run the test and find that the fetus seems to have an extra Chromosome twenty-one. Down’s syndrome. A baby like that can produce agony in a family.”

Jiménez, a devout Catholic, protested: “Don’t stress the agony, Doctor. I’ve known several families who reared such babies and found great joy in doing so.”

“Granted,” Zorn said. “But the child usually dies in his or her early twenties having caused considerable expense in both money and emotion. Is it worth the dual investment? To save a life that can never be a life?”

“Completely unwarranted,” snapped President Armitage, who was a tough-minded realist despite his Santa Claus appearance. “I’m surprised you even pose the problem.”

“I advance it for two reasons. First, the accuracy of the test is not one hundred percent. What if you’re condemning a child who might have proved normal? Second, there’s the religious factor.”

“How does that operate?” Armitage asked, and Zorn explained: “When a couple faces its first pregnancy, it’s a mysterious affair. They tend to grow more religious, especially the women. This is God’s blessing on their union and there’s a strong desire to accept His judgment: ‘If He’s giving us a damaged child, it must be for some deep purpose we don’t understand.’ So they allow the baby to be born and more than half the time it’s severely retarded.” He ended his sentence in a very low voice, and for a moment the table was silent.

Senator Raborn, who in his public life as an interrogator had
fought to obtain clear, simple answers, asked: “So where does that leave the couple with the pregnant wife? What problem do they face?”

“Abortion.”

“No, no!” Jiménez protested. “I oppose abortion.”

“So do I,” Zorn said. “In ordinary cases. To make it easier for a careless couple. Or as a form of birth control. But in this it would be a therapeutic abortion, recommended by careful medical practice.”

“I’m in favor of that,” Senator Raborn said. “It seems the practical thing, to correct nature’s accident.”

“God does not make mistakes,” Jiménez said. “The Down’s syndrome child can bring powerful love to a family. Parents and siblings alike, they unite to nurture the unfortunate and become better human beings in doing so.”

St. Près said quietly: “When you’ve served in the underdeveloped countries in South America and Africa, you look on therapeutic abortion in a different way. It seems the humane way to go.”

“Never humane!” Jiménez said firmly, the long tradition of his Catholic heritage coming through. Then, as if conducting a debate in some parliament, he placed his hands flat on the table and reminded his tertulia: “We were supposed to be discussing triage. What’s your medical reaction there, Doctor?” And he pronounced the title with all the reverence that citizens of the Latin American countries feel toward their medical men.

Zorn said: “I side with the senator. Cost alone will demand that we ration health care. And that throws us into value judgments, severe moral dilemmas.”

“Who will make such judgments?” President Armitage asked, and Raborn said sharply: “The public. Through discussions like this, and public statements by our leaders including the church and the economists, we’ll reach a consensus.”

“And when it is reached,” St. Près said with an almost cruel insistence on facing the truth, “Seventy percent of the operations performed on people like us in the Palms will be declared nonessential. They’ll be forbidden in the regular system, but remain available through a black market, which only the rich will be able to afford.”

Such a conclusion disgusted Armitage, who rebutted with considerable force: “So you’ll ration health needs by the standard of the pocketbook?”

“Has there ever been any other way?” St. Près insisted. “Isn’t that what we do now? Tell us, Dr. Zorn, could a married couple of modest means gain entry to this establishment, and the good health advantages you provide us? Are your services not rationed by our pocket-books?”

Zorn took a deep breath, for he did not yet know how much power the ambassador wielded in the establishment, but even so, he was not afraid to answer: “You may be surprised to learn, Mr. Ambassador, that we have three widows now occupying single rooms who used to live in expensive duplexes when their husbands were alive. They’ve fallen on bad times, the poor women. Their husbands weren’t as rich as they both thought they were. We figure that our corporation made a decent profit from such a family while the husband was alive, and so we carry the widows on our books at a very low rate—very low indeed.”

“So you’re practicing your own version of humanistic triage,” President Armitage said enthusiastically, pleased to hear that their corporation had a semblance of a heart, and St. Près conceded: “I suppose that’s the way it will always work. Strict rules governing priority, but subtle ways, often secret, for circumventing them.”

“But ultimately,” the senator warned, “it will have to come down to the available dollars. Ultimately someone will have to choose who shall live and who must allow nature to take its course.”

“I know this about triage,” Armitage said. “If I’m driving my car carefully, sober, eyes on the road, and a situation over which I have no control suddenly explodes—three children running onto the road over here, an elderly man with a cane occupying half the road over there, and I have to make a split-second decision, I will invariably head away from the children and instinctively allow the car to plow into the old man. He’s had his life. He’s done whatever good he’s going to do. The children have sixty or seventy or even eighty years ahead of them in which to accomplish miracles.”

“Easy choice,” Ambassador St. Près said quietly. “Three young children, one old man. Let’s make it one child about whom you know nothing. And an old man living in a district of some affluence. He may have made a tremendous contribution, maybe he still does. Then where do your reflexes direct you to steer?”

Armitage did not hesitate: “Not even a moment’s hesitation. I’d rub out the old man. And I’ll tell you why my reflexes are conditioned to respond like that. As a college president I never lost sight of the
fact that the freshman boy, just in from the farm and starry-eyed with vast ambitions, was a damned sight more important to my college than some sixty-year-old professor whose dreams were now dead. That’s how I was conditioned to think, and that’s how I’ll always respond, automatically.”

“But if the freshman is destined to flunk out at the end of his sophomore year,” St. Près asked, keeping the pressure on, “and the doddering old professor has the capacity to leave your school two hundred thousand dollars if he’s allowed time to draft his will—if you don’t rub him out prematurely—then what?”

President Armitage said very slowly: “Then debaters like you and senators like Raborn will draft new procedures for establishing human values, and may God have mercy on all of us, for humanity will have been sacrificed to greed.”

“No,” the senator replied in an equally controlled voice. “The budget, inescapable from the moment of birth till the instant of death, will have dictated the value decisions.”

Dr. Zorn, though impressed by both the gravity and the civility with which these men argued, felt that the time had come to add a lighthearted note. Turning to Jiménez on his right, he said jovially: “I’ve noticed that you always sit in that corner chair. Is it your good-luck spot?”