A Pocketful of Rye (12 page)

‘That's remarkably clever of you, Dr Laurence. Yes, as a matter of fact I have. But I think, I mean, I thought it was my hard toothbrush.'

I was silent, staring at him with ill-concealed misgiving intensified by this sudden and unanticipated prospect of further trouble. What had I let myself in for? Wasn't it enough to be saddled with his bitch of a mother? There wasn't a trace of T.B. in this obnoxious little smartie. At a guess I was faced by one of these obscure idiopathic blood syndromes, of which there were probably a score of different varieties, conditions that never properly clear up, run on for years, and break the back of the average G.P. with the need for repeated tests, to say nothing of probable haemorrhages and transfusions. I would not stand for it. In this instance my own modification of the Hippocratic oath was never more applicable: when stuck with a difficult and prolonged case, get rid of it. Yes, I would put through a couple of basic tests and if the results spelled trouble he would have to go to hospital. The Winton Victoria would take him if he proved pathologically interesting. With a brightening of my mood, I reflected that if he were sent home his mother could have no excuse for remaining at the clinic. I would be rid of them both, kill two birds with one stone, and be free again.

Naturally I could not fling any of this at him. He had been watching me intently as if trying to discover what was going on in my head. Assuming an air of cheerful camaraderie, a useful aspect of my best bedside manner, I picked up the enamel basin.

‘Can't have you wasting good food like this, young fellow. We'll have to do something about it.'

‘You can?'

‘Why not? There's nothing wrong with your stomach. You're anaemic. I'll just take a sample of your blood to make sure.'

‘Bleed me? Like the old apothecaries?'

‘Oh, cut out that nonsense! This is simple, and scientific. It won't hurt you a bit.'

I had some difficulty in finding and puncturing his saphenous vein, which was almost threadlike, but he was quite good about it, almost too passive. I drew off 5 c.c., stoppered the test tube after I had smeared several slides, and exclaimed cheerfully:

‘There we are. When these slides are dry we'll stain them. By tomorrow we'll know all about your red corpuscles. You can even take a peep at them under the microscope yourself.'

That perked him up slightly.

‘What an interesting situation. A boy examining his own blood. What about that little tube?'

‘We'll use that for your blood haemoglobin, and,' I added indefinitely, ‘other things.' He was obviously admiring me a lot and I scarcely liked to admit I would send it to the Kantonspital in Zürich. ‘Now relax for a bit. I must let them know in the kitchen about your diet.'

‘Bread and water?' He gave me a wan smile.

‘You deserve it. Still, what would you like?'

‘I'm rather hungry now after that emptying.' He thought for a moment. ‘Mashed potatoes and,' with another smile, ‘the meence.'

Impossible not to smile back at him.

‘We'll consider it. At least you can have the mash and some of that good gravy. Now cheer up. I'll do what I can for you.'

I went out of the room with my own words ringing derisively in my ears. ‘I'll do what I can for you.' Well, damn it, I would – at least I'd do as much as I reasonably could.

Naturally I avoided the office where I knew that both of my enemies would be expecting me. Instead I lit a cigarette and went into the test room. It wouldn't hurt the kid to wait for his supper and although I had told him I would leave the slides till the morning – since I did not want him cliff-hanging on my neck all evening – I was rather curious to have a look at them.

Still smoking, I stained them, a quick simple job, and put one on the stage of the excellent Leitz. Rather than waste my cigarette, one of the oval Abdullas Lotte got me duty free through her airline, I sat down comfortably and finished it before rising to take a look.

At first I thought my oil immersion lens was maladjusted, but as I focused and refocused the same picture came up. It made me catch my breath. Although I am no virtuoso as a biologist there was no mistaking this – it hit me full in the eye. Fascinating, actually, in its own morbid manner, the sort of thing you might never see once in a G.P.'s lifetime. This was it: the field crammed with lymphocytes, white corpuscles multiplied five or six times over. I could even make out immature forms, myelocytes, large immature corpuscles from the bone marrow never present in healthy blood. Obvious, of course, what was taking place. A hyperplasia of white cell precursors in the bone marrow, progressive and uncontrolled, crowding out the progenitors of red cells and platelets, probably even eroding the bone itself. I clipped on the second slide with the measuring scale, dropped on fresh oil, and made a rough count on one square and multiplied. That settled it.

I could scarcely unlatch myself from the eyepiece. It was one of these moments, so rare in my dreary run of the mill experience, when you strike the exceptional, have been good enough to uncover it, then see the whole sequence of events, past, present and future, laid out before you. The future? I had to stop patting myself on the back. This was bad news for young Capablanca – in fact the worst. Oddly enough, at the airport, the first time I sighted his sad little pan, I felt he was unlucky, marked out in some queer way for disaster. Born for trouble, out of that impossible failure of a marriage, the mark of the Davigans upon him. And now he'd had it. Still, though God knew it was the last thing I would have wanted, there was no denying that it solved my problem. I thought this over thoroughly for several minutes, then took up both slides and went into the office.

They were both waiting for me, one on either side of my desk, and brave Hulda actually occupying my chair. She looked at me uncomfortably, but with a glint of defiance, which told me they had been putting in more overtime on my character.

‘We attend to ask what is for Daniel's supper.'

‘Later.' I brushed it aside. ‘If I can have my desk, Matron?'

I stood there waiting for her to get up, which she did, though with reluctance. When I had seated, myself I faced up to the widow Davigan. That was how I meant to think of her now, or simply as Davigan, she had joined the tribe of her own free will, and after all she never called me anything but Carroll, and I would let her have it straight. She could expect no mercy from this throne.

‘It's like this,' I said. ‘For some time I've suspected that we've been misled by a false diagnosis. We're not dealing with a tubercular infection. Your boy has never had T.B.'

‘Then what …?' She broke off suspiciously.

‘I've just made a blood smear. Here are the slides. They show a massive increase in the white cells. Instead of the normal five to ten thousand lymphocytes per cubic millimetre there's not far short of sixty thousand … plus an abnormal proliferation of myelocytes.'

This meant nothing to her, but it chilled the Matron.

‘You are not serious, Herr Doktor?'

I liked that Herr Doktor, the first in several days.

‘Only too serious, unfortunately.'

Davigan was looking confusedly from me to the Matron.

‘This is something bad?'

‘It coot be … but natürlich we are not sure.'

I cut in firmly.

‘I regret having to tell you that I'm only too sure. It's an open and shut case. The boy has Myelocytic Leukocythemia.'

Did Davigan really get the message of these two words? I think not. At least, not entirely, for she didn't wilt. She flushed up and her suspicions of me, never absent, deepened.

‘I don't understand this sudden change and I don't like it.'

‘Are you suggesting that I like it, or that I'm in any way responsible for the sudden change?'

‘It's all very peculiar … I don't understand …'

‘We have been trying to make you understand.'

The Matron, recovering herself, suddenly cut in.

‘Who is we? Caterina
hat recht.
There must come more advice.
Ein zweiter
opinion,
und der beste.
You must bring specialist Herr Professor Lamotte from Zürich.'

‘You'd only be wasting his time. And he has none to waste. Anyhow, he'd never come this far …'

‘Then you must take the boy to him at the Kantonspital,' Hulda persisted.

On the point of refusing, I suddenly changed my mind. A second opinion, particularly Lamotte's, would take the pressure off me. They could never get round his diagnosis. It must stick. And that was all I needed. I was calm, quite sure of myself.

‘Very well. I agree. I'll ring up and make an appointment for the earliest possible day. Meantime,' I turned to Matron, ‘as you were so anxious about Daniel's supper, perhaps you'll see that he gets some
consommé
and
Kartoffel püree
with meat gravy.'

She had something to say, but thought better of it. When she had gone I stood up, and made for the door. But Cathy caught me on the way out. Her flush had left her. She looked drawn, tight-lipped.

‘I know you're up to something, Carroll, so I'm warning you. Don't try any of your dirty tricks on me or it'll be the worse for you.'

I stared her out, in chilly silence. What else could you do with such a troll?

The Zürich Kantonspital is agreeably situated on the Zürichberg, in a residential district high up on the left bank of the Limmat. An excellent site typically ill chosen, since approaching from the river by the interminable line of steep steps, you are half way to a coronary by the time you get there. The hospital is a massive structure, lamentably in the Swiss taste, with modern additions, offset by some tall and beautiful old trees, and to such patients as may be interested, it affords a striking view of three ancient churches; the Predigerkirche, the Grossmünster and the Fraumünster which, with the innumerable banks, suggest the split personality of this city – a devotion to both Mammon and the Lord.

On Saturday afternoon, of the following week, I came through the swing doors and out of the Medical Department with Daniel. It was a beautiful day and as the late autumn sunshine and crisp cool air greeted us he let out a long breath of relief.

‘Well, Dr Laurence, I'm glad that's over.'

He gave a bit of a laugh and took my hand, an action which, I need not add, embarrassed me acutely, gave me what in Scotland is called the
grue.
I was not in the best of moods. After all my trouble in making the appointment I had been hung up for most of the afternoon with only two quick chances to telephone Lotte, trying to explain why I was in Zurich without seeing her, and getting pretty well told off for my pains. Still, in the circumstances, I could not do other than let him drag on to me.

‘Surely it wasn't too bad?' I said.

‘Oh, no. I liked Dr Lamotte. Very serious, with that way he has of reading right through you. But he gave me such a nice smile as I was leaving. He's clever, isn't he?'

‘He's the tops,' I said shortly. ‘ French-Swiss. They're the best … intellectually.'

‘But I never thought he would send me in to all those young ladies, doing all sorts of things to me.'

‘Those girls are technicians … each trained to do a special test.'

‘Such as?'

‘Well, more or less everything, for example, find out all about your corpuscles, and of course your blood group.'

‘But couldn't you have done that, Dr Laurence?'

‘Naturally, if I had their equipment. You're a group A.B. if you want to know.'

‘Is that quite regular?'

‘Perfectly. It's the least common of the blood groups.'

‘What group are you?'

‘I'm group O.'

‘They did seem rather interested in my blood.' He reflected. ‘Perhaps it isn't blue enough.' He looked up as if expecting me to smile. ‘I hope Dr Lamotte gave you a good account of me.'

‘Of course he did,' I said, freeing myself from his sweaty little clutch to give him a reassuring pat on the back. ‘We'll have a chat about it presently.'

We walked through the avenue of plane trees, the dry fallen leaves crackling under our feet. I'd had nothing but a cold beef sandwich for lunch so I said:

‘We'll have something to eat before we start back.'

‘Good!' he said cheerfully. ‘As a matter of fact, now it's all over, I'm quite peckish, and ready for anything.'

This silenced me for the moment.

We got into the Opel station wagon, which I had parked in the Hospital lot, and I took him to Sprüngli's which at this hour between lunch and five o'clock was not overcrowded. Upstairs at a window table I ordered poached eggs on toast, hot milk for him, café crème for myself.

‘None of these lovely cakes?' he hinted. ‘Remember, we had a sort of agreement …'

‘You'll have a couple after your eggs.' What the hell did it matter anyway? Let him have some fun while it lasted.

As I watched his pale-skinned, tight face brighten, I looked quickly out of the window, barely seeing the heavy traffic moving in the Bahnhofstrasse or the long low blue trams swinging round the island with the newspaper kiosk in the Parade Platz.

Classic Leucocythaemia. Malignant Myelocytic type: cause still unknown. Lamotte had flattered me by confirming my diagnosis, putting a few knobs on by way of ornament. Relentlessly progressive. The multiplying abnormal cells colonizing the various organs of the body – choking liver, spleen, kidneys, lungs, proliferating in the bone marrow, pouring out more and more from the bone marrow. Symptoms: acute weakness and wasting, big belly, haemorrhage from the stomach and bowels, oedema of the feet and legs from obstruction of the lymphatic vessels. Treatment: specific medication unknown: radiations in small doses inadequate, larger doses destroy the few healthy cells: in emergencies, blood transfusions. Prognosis: indeterminate yet inevitably fatal. Minimum, six months; at the most, three years.