Top
Free Shipping On Orders Over $35!
Get Rewarded for Ordering Your Textbooks! Enroll Now
Customer Reviews Read Reviews
Write a Review
The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.
The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.
STAT!
Dr. Terri Barnard dropped Irene Heckman's medical chart and rushed from her hospital room. The seventy-two-year-old woman had just begun to describe her chronic back pain in a slow, monotone voice as if the aches had taken over completely and turned her into another one of the walking dead, aged zombies parading through the corridors of medicare, haunting the consciences of doctors. Terri knew it was arthritis and there was little she could do in the way of a cure, especially an instant cure, but she was prepared to be patient and sympathetic despite Mrs. Heckman's laying all the blame for her aches at the foot of her doctors and an uncaring medical community. Terri had an especially good bedside manner when it came to elderly patients. It made sense for a doctor to have that quality, she thought. Most of his or her patients would be elderly, wouldn't they?
STAT!
It was originating from the emergency room, and the Community General Hospital serving the once-famous resort area in the Catskills had no doctor on duty during the fall months. The participating physicians were rotating the responsibility. Tonight, it was hers, and for the first time!
Tough luck, she thought. Only hours after beginning her rounds she was thrown right into a crisis. At age twenty-eight, she had just finished two months as an assistant to Dr. Hyman Templeman, a sixty-eight-year-old family physician who had become something of a fixture in the upstate New York community of Centerville, a village of just fewer than two thousand year-round inhabitants. During the summer resort months, it and its surrounding hamlets and villages used to jump to ten times their population. It still multiplied five or six times, and Hyman's patients did come from all the surrounding hamlets in the Fallsburg township and not only Centerville.
Terri Barnard considered the elderly hands-on physician a perfect mentor: a doctor who diagnosed almost as much from instinct as from knowledge, maintaining an almost gleeful distrust of the new technology, but willing to learn and seize upon any aid to diagnosis and treatment that proved itself. Hyman Templeman liked to refer to himself as a medical iconoclast.
Despite her youth and her high-tech medical education, Terri had an affinity for the human touch. She believed in her grandmother's adage: people get well faster when they feel the doctor really cares whether they do or not. Her grandmother always wanted her to be a doctor, but "a real doctor, like your great-uncle Abe, who thought a doctor was a man with a gift, not a man with an expensive education." It followed then that if someone was given a gift, it was ungrateful, no, sinful, for her not to use it whenever and wherever possible.
Terri seemed to be following the dream life design. She had been a brilliant student, and she had returned to practice medicine in her hometown, where it was presumed she would marry her high school sweetheart, Curt Levitt, who had himself come back to the community to become a successful attorney in his father's firm, now taking it over with two partners since his father's retirement.
"Mr. and Mrs. Yuppie America," her girlfriends called them, "the dream couple." They teased, but she recognized their underlying envy, too.
Was her life too perfect? Could such a thing be so? She thought about it often. Her grandmother had brought all of her Old World superstitions with her, not the least of which was a belief in the Evil Eye. Whenever things were going too well for you, some covetous witch could cast a wicked spell. According to her grandmother, it was best to be humble, even secretive about good fortune.
At this moment in the emergency room, however, she thought about nothing but the problem at hand. She was doing what she was quickly becoming noted for...concentrating so intently she looked like she had shut away all distracting noise and sight.
A young woman had been brought in by ambulance and was on the gurney in one of the examination rooms. The woman had lost some of her teeth, but it didn't appear to be the result of a blow to the mouth. There was no trauma, no blow to any part of her face. It appeared her teeth had simply fallen out. In fact, the young woman's face seemed to age right before Terri's eyes. The emergency room nurse looked up from the young woman, her eyes pleading for Terri to do something miraculous quickly. She pointed to a large hemorrhage on the woman's arm, just above the blood pressure cup.
"I did that," the nurse said. "With the blood pressure cup. I'm afraid to squeeze the bulb. Pressure, no matter where I place it on her body, and no matter how gently I do it, immediately produces hemorrhages."
Terri moved quickly to her side and examined the woman's neck and chest. Her eyes were open, but they were glassy, the pupils barely dilating. She stared up at the ceiling light. Petechia appeared up and down her arms and legs and over her stomach and chest. It looked as if some madman had come along with a dark-blue magic marker and poked her body for hours and hours.
"There's barely blood pressure," the nurse warned.
"My God..." Terri brought her stethoscope to the young woman's chest, but before she could suggest a therapy, she heard the young woman's heartbeat thump into silence. She looked at the nurse and then started CPR.
Nothing helped. Death had too tight a grip.
Terri felt her own face whiten in disbelief.
"How long...was she like this?" she asked the nurse.
"I don't know, doctor. The ambulance and the police just brought her in. She was found in a motel outside of Monticello. What is it? What killed her?" the nurse said, grimacing. She pulled herself away from the dead young girl as if she had already concluded whatever killed her was highly contagious.
Terri shook her head. The symptoms were clicking off against a computerlike memory bank, and what resulted made no sense.
"I don't know," she confessed. "Not without the blood work. There are too many possibilities. You better call the coroner," she said softly.
This was almost a nonstop trip directly to the hospital morgue for this woman, Terri thought. She felt like a toll booth operator, a modern-day Charon ferrying her patient across the River Styx, full of disease and illness.
Actually, this was the first patient to die in her care, as short as that care was, and although she was cognizant of the way she should react, she couldn't help what was going on inside her. Of course she was used to corpses from her medical training, and when she had interned, she had seen patients die, but this was different because it was so bizarre and had happened so quickly. And on her watch!
"Was there any identification?" she asked softly.
The nurse gazed at her clipboard.
"Paige Thorndyke, age twenty-eight. Lived in Mountain-dale."
"Thorndyke?" Terri asked looking up. "Paige Thorn-dyke?" She looked at the dead woman. Her face was unrecognizable at this point, otherwise, she would have known her. "I knew her," she muttered. "I know the Thorndykes. Her father, Bradley Thorndyke, is a commercial airline pilot for American. They live in the Greenfield Park Estates."
The nurse nodded sadly and they both turned back to the deceased young woman. Terri recalled that Paige was in junior high when she herself was a senior. There was an older brother, too, Phil, who was a year behind her and Curt. He had been on the basketball team with Curt.
A little voice in the back of her mind threatened: "You're not going to be able to do this -- you're not going to be able to practice medicine in a hometown community where you will get emotionally involved in every case."
She stared down at Paige Thorndyke for a few more moments and then covered her with the white sheet, her fingers trembling as she did so. Whatever it was that caused this, she thought, it was a horrible way to die. The emergency room was already buzzing around her. She sighed and dropped her shoulders. She had to recuperate and, after speaking to the policemen who waited in the ER lobby, go back upstairs and continue with Mrs. Heckman.
The rest of the night went just as badly. They had two motor vehicle accidents, one resulting in a fatality, dead on arrival. She couldn't believe she was looking into the vacant eyes of another corpse, two within four hours. She set one broken arm and patched up another motor vehicle victim. Then she had to pump the stomach of a four-year-old girl who had swallowed paint remover. By the time 6:00 a.m. rolled about, she was ready to check herself into the emergency ward.
But despite all the activity, she couldn't get Paige Thorndyke out of her mind. The diagnosis she had instinctively arrived at seemed ridiculous, but the symptoms supported it. When her tour ended, she walked out to the parking lot still reviewing the possibilities. She ambled slowly through the pools of cool white illumination dropped over the macadam lot by the globular pole lights and walked right past her black BMW convertible, a graduation gift from her parents. She shook her head and doubled back.
Talk about your absent-minded professors, she thought, and sifted through her pocketbook to find her car keys. As usual, she fished out her house keys first and panicked, thinking she had misplaced her car keys; but they were there, lost in the makeup case, the lipsticks, the piles of change, the hand mirror, Life Savers, and gums. How could she be so meticulous in her work and so messy and disorganized in her personal life? she wondered. Probably because I don't concentrate on myself as much as I should, she replied to her own question.
Curt had advised her to concentrate on putting her work behind her once she had left either the office or the hospital, but sometimes, that just wasn't possible, at least, not for her. Curt was wonderful about closing the door behind him. He could shut himself off so completely, it was as though he were indeed two different people.
In the beginning she thought that indicated he wasn't fully involved in what he was doing, but now she had come to believe his power of forgetting was an asset. Many a night and many a morning after a night, she tossed and turned for hours reliving what she had done the previous eight hours. She had little hope for anything different this morning, despite her physical fatigue. She imagined she looked terrible -- pale, drawn, strands of hair flying this way and that. She certainly felt drained.
At five feet ten with olive green eyes, prominent cheek bones, raven black hair that was shoulder length when she wore it down, and a firm, full figure, she looked more like aCosmopolitanmagazine cover girl than a physician. Her sensuous mouth and alluring smile drew endless compliments, but at this point in her life and her career, she found that to be more of a burden than a blessing.
Despite the many inroads women had made, medicine was still a man's domain. Patients who could choose usually chose male doctors over female. Even women discriminated against female physicians. It was maddening, but if a woman was to be accepted as a physician, she had to look brilliant and be coldly analytical, whereas a man could look goofy, have a personality, and even flirt.
She did the best she could to deal with the problem. Whenever she was on duty or practicing, she wore her hair tied in a tight, "granny bun" behind her head and wore no makeup, not even a light shade of lipstick. She had a pair of thick-rimmed, very plain glasses, her doctor glasses, she called them, and she always wore these dull-colored heavy cotton or tweed cardigan suits with a flat white blouse. Usually, she couldn't wait to get home after work and take off her physician clothes.
She would brush down her hair, apply some lipstick and some eye makeup, put on one of her pants outfits or nice blouses and sweaters with her tight-knit skirts or leather skirts and feel like...Wonder Woman. Curt kidded her about it, and said, "You accuse me of being like two different people. What about you?"
But when she chased him down, forced him to be honest, he confessed he felt more comfortable with a male doctor than a female himself and if he went in to see a doctor who was female, he would be nervous if she was what he called "a looker."
They almost got into a heated argument about it, but in the end she concluded it wasn't his fault. There were years and years of social changes yet to evolve.
Wise old Hyman Templeman had lowered his bifocals, even though all he had to do was raise his eyes, and warned her about all this when she first came to see him about the position he had advertised.
"It's like coming to bat with two strikes against you, Terri," he advised. "You want to work in your hometown where people remember you as the girl next door, a cheerleader, homecoming queen, and ask them to accept you as their family physician. I got as far away from my hometown as I could," he muttered, shaking his head, a head still crowned with a full crop of angel white hair. "I was born and bred in South Africa, you know."
She didn't know that. Funny, she thought, Hyman had been a doctor in this community for nearly forty years, and not once had she heard anyone talk about his coming from South Africa.
"And the second strike?" she asked, suspecting the answer.
"That you're a woman, what else?"
"So you wouldn't think of giving me the position then, I suppose."
"Never suppose anything," he chided gently, his bushy, gray eyebrows rising and then shifting forward as his forehead creased. "Conclude after you review all the facts. Supposing gets you onto side roads that are often dead ends. Whenever my patients ask me what I think, I say, I think I'll think about it.
"So," he concluded. "I'll think about it."
She left, never expecting he would call, but he did.
"Things are a bit boring for me these days," he said a bit impishly. "I could use some excitement around here."
"You won't regret it, Dr. Templeman. I promise I'll work hard and..."
"Now one thing right off, Terri. If we're going to work together and you want people to accept you same as they accept me eventually, you start calling me Hyman. Understand?"
"Yes, Doc...Hyman."
She had it! Her parents were overjoyed. How proud they could be, but she lowered their balloon a bit when she announced that she wasn't going to live at home. She wanted to move into Grandma Gussie's house. It had been on the market for four months without a bite, much like most of the real estate around there lately.
"But why?" her mother questioned, her face grimacing as though she were suffering real physical pain.
"I've always felt comfortable there, Mom. I just would like it for a while."
"Let her do what she wants," her father said. "She's earned the right."
"But what about Curt?" her mother pursued. Terri knew her mother had been quietly investigating all sorts of wedding preparations, anticipating that she would get the position and would practice medicine here. Terri was not surprised. After all, as soon as Terri had decided to return to the area to practice medicine, whether she worked with Hyman Templeman or not, she and Curt had become formally engaged.
"It will be a while yet, Mom."
"But..."
"Doris!" her father cried holding up his arms like someone pleading with the Almighty.
"Okay, okay. I'm just asking. A mother can ask her daughter questions, can't she?" she said and turned to her again, this time like a prosecutor who had overcome a defense attorney's objection. "Why wait now?" Her mother held her breath in anticipation of some dreadful news.
"I have to have my own space for a while," she told her. "It's important I feel independent."
"You've got your career; you're going to be married. Why do you have to feel any more independent?" her mother persisted.
Curt had wanted to know the same thing.
"Why can't we get married immediately? Why do we have to wait for you to feel secure in your profession? What does that have to do with our marriage?"
She explained as best she could that without a strong self-image, she wouldn't be able to give him all he deserved.
"Let me clean up my act first," she begged. "I'd like to be standing on my own two feet."
She knew it was difficult for him to understand. It wasn't something his mother would have ever said to his father, and despite his protest that he was just as much a modern thinking man as anyone else, he carried a great deal of old-fashioned baggage, even some he wasn't aware himself he was carrying, as his attitude about doctors had revealed.
But it wasn't all bad. She admitted to herself that she liked, even craved some of those old-fashioned values, especially Curt's reverence for the sanctity of marriage and the home. In this way Curt was more like his grandparents. Of all the grandchildren, he had been the closest to them. As a child he had worked on his grandfather's farm and absorbed his rural-flavored wisdom. He had been with both his paternal grandfather and grandmother when they died, and to this day, he missed them dearly. She liked that about him. It was one of the qualities that endeared her to him and overcame what she saw as some faults.
Terri knew that Curt sincerely believed that a man and a woman became one when they took the vows, each and every word of which he accepted and held sacred. He cherished the image of family, wanted children and a solid home life. And so, he was caught in a conflict she recognized and handled as delicately as she could. He told her he was proud of her, proud of what she had accomplished, and proud of the idea that he would be married to a doctor, but at the same time, she sensed he was afraid she would be one of these professional women willing to sacrifice the children and their needs when it came to being her own person.
"Not that I want to be like my father," he quickly emphasized. "And expect you to do everything and make all the career sacrifices like he expected of my mother. I want to be there for my kids all the time. I'm not paying any chauffeur to cart them around to their school activities and little league. We're all going to grow up together," he promised. "Can you make the same promise?" he taunted.
"I don't know, Curt," she confessed. "I'm going to try. I want the same things you want. I'm going to try, but at the moment, I don't know."
It was a more honest answer than Curt had wanted, and a little sour note resonated in the hall of their otherwise happy symphony.
Terri tried to be understanding. She believed that in many ways the modern world tested the bonds of love more than they had been tested in times when people had to struggle every day merely to survive. She had an undying faith that the love between her and Curt would overcome any and all obstacles. Was she being naive or perhaps as Hyman Templeman might say, "a little too doctor arrogant"?
Occasionally, she muttered a tiny prayer: "Oh please, please, don't let that be so."
Impulsively, she made a sharp right turn onto State Highway 17 and sped up, instead of taking County Road One down toward Centerville and to what had been
her grandmother's home. She was going to Bridgeville because that was where Curt lived, in a home once owned by his grandfather. It was another wonderful thing they shared, she thought, both currently residing in their grandparents' old homes.
She glanced at the clock in the car. It was ridiculously early to pay a visit, but she relished the idea of getting him up to answer the door and then going back to his bedroom and crawling under the covers with him.
She wanted to make love very badly; she wanted to be vibrant and sensuous and feel sexual ecstasy. She wanted to feel alive. That was it. There was no other way to get Paige's degenerating body out of her mind and to forget the glassy eyes of the dead.
Curt could barely open his eyes, and when he did, he had to squint because the old farm house faced the east and the rising sun peered over the horizon unobstructed. The house had been built on a knoll facing the long, flat fields that had once hosted acres of corn, a sea of it he used to think. Now it was all overgrown, the pale brown weeds swaying in the autumn breeze. But there were a number of beautiful large maple and hickory trees around the house, and the house had a wide and deep back yard that looked upon the mountains and woods. On the rear patio, one could feel isolated, peaceful, relaxed. Curt wanted to put in a pool, but he didn't want to go forward with any of the changes or restorations in the old house until he and Terri were married so she could be party to each and every decision. Actually, he hated the thought of changing anything in the old house, the house his grandfather had built himself.
Curt's grandfather had been a small farmer, raising dairy cows and chickens and the corn crop that once had glittered like gold out there. He and his hard-working wife, Nanny Lillian, had raised four boys and a girl. Two of the boys, Uncle Frank and Uncle Abe, now worked on Wall Street. Uncle Louie had become a merchant marine and was presently still a captain on an oil tanker. Aunt Charlotte married a banker and moved to Pennsylvania.
There was never enough money when Curt's father, uncles, and aunt were growing up. His father had to take on odd jobs and when he was old enough, work in the Catskill resorts as a busboy and finally as a waiter to earn his college tuition. But he never gave up and when he did get into law school, he graduated at the top of his class. Only after he had landed a good job with a New York City law firm did he marry Curt's mother, Marion Steele. Shortly afterward, when the opportunity presented itself, he went into his own practice, developed real estate deals in the Catskills and became one of the most respected and successful attorneys here.
There wasn't time in those days to worry about whether or not he was stepping on his wife Marion's own career goals, he once told Curt whenever they discussed Curt and Terri's long engagement. "Your mother knew that from the start. She once had some ambition to become a magazine editor and work in New York City, but she never really pursued it. Oh, she tried some freelance writing, but that didn't lead anywhere, and soon she was happy just being Mrs. William Levitt. I never heard her complain about the decisions she made. Of course, that was before all this women's liberation business, before women began to wonder why they couldn't have flies on their pants, too," he joked, half joked, actually. Curt knew his father was too much of a male chauvinist.
However, Curt's father loved and respected Terri, even though he teased her whenever he had an opportunity to do so. Curt was also aware that his father was a flirt and suspected that he might have had an extramarital affair here and there, but Curt would rather not think about it. He was like that when it came to his father -- deliberately blind to any of his faults or willing to easily excuse and rationalize them away.
Yet Curt supposed, or rather hoped, he was like his father in many ways. After all, his father was a self-made man. Curt looked more like him than any of his siblings. His younger brother Neil, who worked with Uncle Frank on Wall Street, looked more like their mother, and his younger sister Michele, who was married to a dentist in Boston, was so much a cross between their mother and father that she had a totally different look.
He had his father's six feet two inch height and the same broad shoulders, but he had his mother's smaller facial features, her slightly turned up nose and soft mouth. His father didn't have the narrow waist he once had. However, he still had a rough and ruddy complexion, a farmer boy's forearms and hands. "Just shake hands with Bill Levitt and you know you've been shook," people would say. His father and he had glimmering rust brown eyes and reddish brown hair. Both had a splatter of freckles along their foreheads, too.
His habitual gestures, holding his chin between his thumb and forefinger whenever he paused to think, or nodding softly when he was in deep thought were gestures borrowed from his father. They had the same deeply resonant voice, good for trial work, and like his father, he was impatient with small talk and bureaucracy.
Right now, he tightened his robe around his waist and stared incredulously at Terri.
"Jesus, you know what time it is?"
"I'm sorry. I just got off my turn at the hospital."
"I'm glad I don't have to keep doctor's hours." He wiped his eyes and looked at her more closely.
"What...what's wrong?" he asked.
"Oh Curt, just hold me. Please," Terri said, a little surprised herself at how vulnerable and feminine she sounded. Curt pulled her to him and pressed her against him.
"What?" He closed the door behind her quickly.
"A terrible night in the emergency room," she said. "Two deaths, one right before my eyes."
"Really? What happened?" He wiped the sleep from his eyes when she stepped back.
"One was a car fatality, but the other, the first one...Paige Thorndyke. You remember the Thorndykes. Her father is an airline pilot."
"Sure. Paige's brother Phil Thorndyke was on the varsity basketball team with me. What about Paige?"
"She's dead."
"Oh no. Also a car?"
"No." Terri shivered. He put his arm around her again.
"Easy. Want some coffee?"
"No. Let's just crawl back into your bed," she said. He looked surprised.
"Sure, but...so what killed her?"
"I'm not certain," she said as they walked toward his bedroom together. "It seems ridiculous in fact. I'll have to wait on the lab tests and speak with Hyman."
"Well, what were her symptoms?"
"Curt," she said stopping and turning so abruptly to him in the doorway, his eyebrows lifted. "If I believed her symptoms, she died of scurvy."
"Scurvy? You mean...like sailors used to get because they didn't have enough vitamin C?"
Terri nodded.
"Only, taken to a bizarre extreme." She shook her head again, this time to shake the images out of her mind.
"What the hell...can't be, can't it?"
"I don't see how," she said and began to take off her clothes. "I don't want to think about it right now. I don't want to think at all. I just want to feel."
He nodded. He understood and he was glad she had come to him. He would make love to her as gently and as lovingly as he could. In bed together there were no careers to consider, no egos to stroke. There was just honest and sincere passion.
Terri was eager to lose herself in it. She drew Curt to her as she would draw a warm blanket over her body, and as she had hoped, she forgot the dead.
Copyright © 2004 by Andrew Neiderman
Excerpted from Deficiency by Andrew Neiderman
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
Need Help? Copyright © 1999-2024