Bitter Medicine Read online

  I had conscientiously read every word about the controversial sixth game of the 1985 World Series when the woman I’d spoken to at the nurses’ station appeared.

  “Did you say you came in with the pregnant girl?” she asked me.

  My blood stopped. “She—is there some news?”

  She shook her head and gave a little giggle. “We just discovered no one had filled out any forms for her. Do you want to come with me and do that?”

  She took me through a long series of interlocking corridors to the admissions office at the front of the hospital. A flat-chested woman with a faded blond rinse greeted me angrily.

  “You should have come here as soon as you arrived,” she snapped.

  I peered at the name badge that doubled the size of her left breast. “You should hand out little leaflets at the emergency entrance telling people your policies. I’m not a mind reader, Mrs. Kirkland.”

  “I don’t know anything about that girl—her age, her history, who to contact in case of any problems—”

  “Stop the soundtrack. I’m here. I’ve contacted her physician and her family, but in the meantime, I’ll answer any questions that I can.”

  The nurse’s duties weren’t pressing enough to keep her from a promising daytime soap. She leaned against the doorframe, blatantly eavesdropping. Mrs. Kirkland gave her a triumphant glance. She played better to an audience.

  “We assumed here that she was with Canary and Bidwell—we have a preferred-provider arrangement with them and Carol Esterhazy phoned in the emergency. But when I called her back to get the girl’s Social Security number, I learned she doesn’t work for the plant. She’s some Mexican girl who got sick on the premises. We do not run a charity ward here. We’re going to have to move this girl to a public hospital.”

  I could feel my head vibrating with rage. “Do you know anything about Illinois public-health law? I do—and it says you cannot deny emergency treatment because you think that person can’t pay. Not only that—every hospital in this state is required by law to look after a woman giving birth. I am an attorney and I’ll be glad to send you the exact text with your subpoena for malpractice if anything happens to Mrs. Hernandez because you denied her treatment.”

  “They’re waiting to find out if we want to move her,” she said, her mouth set in a thin line.

  “You mean they’re not treating her?” I thought the top of my head would come off and it was all I could do to keep from seizing her and smashing her face. “You get me to the head of this place. Now.”

  The level of my fury shook her. Or the threat of legal action. “No, no—they’re working on her. They are. But if they don’t have to move her they’ll put her in a more permanent bed. That’s all.”

  “Well, you give them a little phone call and tell them she’ll be moved if Dr. Tregiere thinks it advisable. And not until then.”

  The thin line of her lips disappeared completely. “You’re going to have to talk to Mr. Humphries.” She stood with a sharp gesture meant to be intimidating, but it only made her look like a malevolent sparrow attacking a bread crumb. She hopped down a short corridor to my right and disappeared behind a heavy door.

  My nurse-guide chose this moment to leave. Whoever Mr. Humphries was, she didn’t want him to catch her lounging during working hours.

  I picked up the data-entry form Mrs. Kirkland had been completing for Consuelo. Name, age, height, weight all unknown. The only items completed were sex—they’d hazarded a guess there—and source of payment, which a second guess had led them to list as “Indigent”—euphemism for the dirty four-letter word poor. Americans have never been very understanding of poverty, but since Reagan was elected it’s become a crime almost as bad as child-molesting.

  I was inking out the “Unknowns” and filling in real data on Consuelo when Mrs. Kirkland returned with a man about my age. His brown hair was blown dry, each hair lined up with a precision as neat as the stripe in his seersucker suit. I realized how disheveled I looked in blue jeans and a Cubs T-shirt.

  He held out a hand whose nails had been varnished a faint rose. “I’m Alan Humphries—executive director out here. Mrs. Kirkland tells me you’re having a problem.”

  My hand was grimy from sweat. I rubbed some into his palm. “I’m V. I. Warshawski—a friend of the Alvarado family, as well as their attorney. Mrs. Kirkland here says you aren’t sure you can treat Mrs. Hernandez because you assumed that as a Mexican she couldn’t afford to pay a bill here.”

  Humphries held up both hands and gave a little chuckle. “Whoa, there! We do have a concern, of course, about not taking too many indigent patients. But we understand our obligation under Illinois law to treat obstetrical emergencies.”

  “Why did Mrs. Kirkland say you were going to move Mrs. Hernandez to a public hospital?”

  “I’m sure you and she may have misunderstood each other—I hear you both got a little heated. Perfectly understandable—you’ve had a great deal of strain today.”

  “Just what are you doing for Mrs. Hernandez?”

  Humphries gave a boyish laugh. “I’m an administrator, not a medicine man. So I can’t tell you the details of the treatment. But if you want to talk to Dr. Burgoyne I’ll make sure he stops in the waiting room to see you when he leaves the intensive-care unit…. Mrs. Kirkland said the girl’s own doctor is coming out. What’s his name?”

  “Malcolm Tregiere. He’s in Dr. Charlotte Herschel’s practice. Your Dr. Burgoyne may have heard of her—I guess she’s considered quite an authority in obstetrics circles.”

  “I’ll make sure he knows Dr. Tregiere’s coming. Now why don’t you and Mrs. Kirkland complete this form? We do try to keep our records in good order.”

  The meaningless smile, the well-groomed hand, and he returned to his office.

  Mrs. Kirkland and I complied with a certain amount of hostility on both sides.

  “When her mother gets here, she’ll be able to give you the insurance information,” I said stiffly. I was pretty sure Consuelo was covered under Mrs. Alvarado’s health insurance—the group benefits were a major reason Mrs. Alvarado had stayed with MealService Corporation for twenty years.

  After signing a space for “Admitter—if not patient,” I returned to the emergency entrance, since that was where Tregiere would arrive. I moved my car to a proper parking space, prowled around in the heavy July air, pushed thoughts of the cool waters of Lake Michigan out of my mind, pushed thoughts of Consuelo attached to many tubes out of my mind, looked at my watch every five minutes, trying to will Malcolm Tregiere’s arrival.

  It was after four when a faded blue Dodge squealed to a halt near me. Tregiere came out as the ignition died; Mrs. Alvarado slowly emerged from the passenger side. A slight, quiet black man, Tregiere had the enormous confidence needed by successful surgeons without the usual arrogance that accompanies it.

  “I’m glad you’re out here, Vic—would you mind parking the car for me? I’ll head on in.”

  “The doctor’s name is Burgoyne. Follow this hallway straight down and you’ll get to a nurses’ station where they can direct you.”

  He nodded briefly and disappeared inside. I left Mrs. Alvarado standing in the entrance while I moved the Dodge next to my Chevy Citation. When I rejoined her, she flicked flat black eyes over me in a glance so dispassionate as to seem contemptuous. I tried telling her something, anything, about Consuelo, but her heavy silence made the words die in my throat. I escorted her down the hallway without speaking. She followed me into the garish sterility of the waiting room, her yellow MealService uniform pulling tightly across her generous hips. She sat for a long time with her hands folded in her lap, her black eyes revealing nothing.

  After a while, though, she burst out, “What did I do that was so wrong, Victoria? I wanted only the best for my baby. Was that so bad?”

  The unanswerable question. “People make their own choices,” I said helplessly. “We look like little girls to our mothers, but we’re separate people.” I didn
’t go on. I wanted to tell her that she had done her best but it wasn’t Consuelo’s best, but even if she wanted to hear such a message, this wasn’t the time to deliver it.

  “And why that horrible boy?” she wailed. “With anyone but him I could understand it. She never lacked for boyfriends—so pretty, so lively, she could pick from boys who wanted her. But she chooses this—this garbage. No education. No job. Gracias a Dios her father didn’t live to see it.”

  I said nothing, certain that this blessing had been heaped on Consuelo’s head—“Your father would turn in his grave”; “If he hadn’t died already, this would kill him”—I knew the litany. Poor Consuelo, what a burden. We sat again in silence. Whatever I had to say could bring no comfort to Mrs. Alvarado.

  “You know that black man, that doctor?” she asked presently. “He is a good doctor?”

  “Very good. If I couldn’t have Lotty—Dr. Herschel—he would be my first choice.” When Lotty first opened her clinic she’d been esa judía —“that Jew”—first, then the doctor. Now, the neighborhood depended on her. They went to her for everything, from children’s colds to unemployment problems. With time, I supposed, Tregiere would also be looked on as a doctor first.

  It was six-thirty before he came out to us, accompanied by another man in scrubs and a middle-aged priest. The skin on Malcolm’s face was gray with fatigue. He sat down next to Mrs. Alvarado and looked at her seriously.

  “This is Dr. Burgoyne, who’s been looking after Consuelo since she got here. We couldn’t save the baby. We did what was possible, but the poor thing was too little. She couldn’t breathe, even with a respirator.”

  Dr. Burgoyne was a white man in his mid-thirties. His thick dark hair was matted to his head with sweat. A muscle twitched next to his mouth and he was kneading the gray cap he’d taken off, pushing it from one hand to the other.

  “We thought if we did anything else to retard labor it might seriously harm your daughter,” he said earnestly to Mrs. Alvarado.

  She ignored that, demanding fiercely to know if the baby had been baptized.

  “Yes, yes.” The middle-aged priest was speaking. “They called me as soon as the baby was born—your daughter insisted. We named her Victoria Charlotte.”

  My stomach lurched. Some age-old superstition about names and souls made me shiver slightly. I knew it was absurd, but I felt uneasy, as though I’d been forced into an alliance with this dead infant because it bore my name.

  The priest sat in the chair on the other side of Mrs. Alvarado and took her hand. “Your daughter is being very brave, but she’s scared, and part of her fear is that you are angry with her. Can you see her and make sure she knows you love her?” Mrs. Alvarado didn’t speak, but stood up. She followed the priest and Tregiere to whatever remote recess harbored Consuelo. Burgoyne remained in the waiting room, not looking at me, or at anything. He’d stopped working his cap over, but he had a thin face with mobile, expressive planes, and whatever he was thinking was clearly not pleasant.

  “How is she?” I asked.

  My voice brought him abruptly back to the present. He jumped slightly. “Are you part of the family?”

  “No. I’m their attorney. Also a friend of theirs and of Consuelo’s doctor, Charlotte Herschel. I brought Consuelo in because I was with her at a plant up the road when she got sick.”

  “I see. Well, she’s not doing very well. Her blood pressure went down to the point where I was really worried she might die—that’s when we took the baby so we could concentrate on stabilizing her. She’s conscious now and reasonably stable, but I’m still listing her as critical.”

  Malcolm came back into the room. “Yes. Mrs. Alvarado wants to take her back to Chicago, to Beth Israel. But I don’t think she should be moved. Do you, Doctor?”

  Burgoyne shook his head. “If her blood values and blood pressure remain this way for another twenty-four hours we can talk about it then. But not now… Will you excuse me? I’ve got another patient I need to look in on.”

  He walked away with hunched shoulders. Whatever the hospital administration might feel about treating Consuelo, Burgoyne clearly had taken her situation to heart.

  Malcolm echoed my thought. “He seems to have done his best. But the situation was very chaotic up there—it’s hard to come into the middle of a case and know for sure what the progress has been. Hard for me, anyway. I just wish Lotty were here.”

  “I doubt that she could have done more than you have.”

  “She’s more experienced. She knows more tricks. It always makes a difference.” He rubbed his eyes tiredly. “I need to dictate my report while it’s still fresh in my mind…. Can you look after Mrs. Alvarado until the family gets here? I’m on call tonight at the hospital and I have to get back—I’ve talked to Lotty—she’s standing by if Consuelo’s condition changes.”

  I agreed, none to happily. I wanted to get away from the hospital, from my dead namesake, from the smells and sounds of technology indifferent to the suffering people it served. But I couldn’t abandon the Alvarados. I followed Malcolm into the hall, returning his keys and telling him how to find his car. For the first time in hours I wondered about Fabiano. Where was the father of the baby? How great would his relief be to learn that after all there was no baby, no need for a job?

  3

  The Proud Father

  I stood at the emergency entrance for a while after Malcolm left. This wing of the hospital faced open land, with a housing development perhaps a quarter mile away. By squinting it was possible to create the illusion of being on the open prairie. I watched the softening night sky. Summer twilight, with its caressing warmth, is my favorite time of day.

  At last I turned sluggish steps back down the corridor toward the waiting room. Close to the doorway I met Dr. Burgoyne coming the other way. He’d put on street clothes, and he walked with his head down, his hands in his pockets.

  “Excuse me,” I said.

  He looked up, focused on me uncertainly, then recognized me. “Oh, yes—the Alvarados’ attorney.”

  “V. I. Warshawski… Look: There’s something I need to know. Earlier today the admissions clerk told me you weren’t treating Consuelo because you thought she should be moved to a public hospital. Is that true?”

  He looked startled. I thought I could see “Malpractice Suit” flash across the mobile ticker-tape of his face.

  “When she first came in, I hoped we might be able to stabilize her so that she could get into Chicago and be treated by her own doctor in familiar surroundings. It soon became obvious that wasn’t going to happen. It certainly wouldn’t occur to me to ask a comatose laboring girl about her financial status.”

  He forced a smile. “How rumors spread from behind an operating-room door down to the clerical area is a mystery to me. But they always do. And they always end up garbled…. Can I buy you a cup of coffee? I’m pretty beat and I need to unwind a bit before I head home.”

  I looked into the waiting room. Mrs. Alvarado hadn’t returned. I suspected the invitation for coffee was in large part a desire to be friendly with the family lawyer to quiet any concerns about negligence or failure-to-treat. But my day with the Alvarados had worn me out and I welcomed a few minutes’ conversation with someone else.

  The hospital restaurant was a pleasant improvement over the dingy cafeterias most city hospitals sport. The smell of food made me realize I hadn’t eaten since breakfast twelve hours ago. I had broiled chicken and a salad; Burgoyne picked a turkey sandwich and drank coffee.

  He asked what I knew about Consuelo’s medical history and her family’s and pried gently into my relationship with them.

  “I know Dr. Herschel,” he said abruptly. “At least I know who she is. I trained at Northwestern, and did my residency there. But Beth Israel is one of the best places to go for high-risk OB training. I was accepted there for one of their house-staff OB slots when I finished my residency four years ago. Even though Dr. Herschel is now only part-time at the hospital, she’s still
a bit of a legend.”

  “Why didn’t you go?”

  He grimaced. “Friendship opened this hospital in 1980. They’ve got about twenty in the Southeast, but this was their first Midwest venture and they were pulling out all the stops to turn it into a showcase. They offered me so much—not just money, but new facilities they were planning—I couldn’t turn it down.”

  “I see.” We talked a little longer, but I’d been away from my post for forty minutes. Much as I disliked the duty, I thought I should get back to Mrs. Alvarado. Burgoyne walked me to the bend in the corridor leading back to the waiting room, then headed for the parking lot.

  Mrs. Alvarado was sitting motionless in one of the orange chairs when I came into the room. She answered my inquiries about Consuelo with ominous comments on divine providence and justice.

  I offered to take her down to the restaurant for something to eat, but she rejected the offer. She lapsed into silence and sat waiting impassively for someone to come with news of her child. Her dignified quiet had an air of helplessness that got on my nerves—she wouldn’t go to the nurses and demand information on Consuelo; she sat until permission was granted. She didn’t want to talk, didn’t want to do anything but sit with her sorrow wrapped around her, a sweater on top of her cafeteria uniform.

  It was a relief when Carol arrived with two of her brothers around eight-thirty. Paul, a large young man of twenty-two or so, had a heavy, ugly face that made him look like a particularly menacing hoodlum. When he was in high school, I used to spend the summers bailing him out of Shakespeare Station after he’d been picked up on suspicion. It was only when he smiled that his underlying intelligence and gentleness showed.

  Diego, three years younger, looked more like Consuelo—small, with fine, slender bones. Carol shepherded them into the room in front of her and went to her mother. What started as a quiet conversation quickly exploded.