The manitou

T
he phone bleeped. Without looking up, Dr. Hughes sent his hand
across his desk in search of it. The hand scrabbled through sheaves of paper,
bottles of ink, week-old newspapers and crumpled sandwich packets. It found the
telephone, and picked it up.

Dr. Hughes put
it to his ear. He looked peaky-faced and irritated, like a squirrel trying to
store away its nuts.

“Hughes? This
is McEvoy.”

“Well? I’m
sorry Dr. McEvoy, I’m very busy.”

“I didn’t
meant
to interrupt you in your work, Dr. Hughes. But I have
a patient down here whose condition should interest you.”

Dr. Hughes
sniffed and took off his rimless glasses.

“What kind of
condition?” he asked. “Listen, Dr. McEvoy, it’s very considerate of you to call
me, but I have paperwork as high as a mountain up here, and I really can’t...”

McEvoy wasn’t
put.
off
. “Well, I really think you’ll be interested,
Dr. Hughes. You’re interested in tumors, aren’t you? Well, we’ve got a tumor
down here to end all tumors.”

“What’s so
terrific about it?”

“It’s sited on
the back of the neck. The patient is a female Caucasian, twenty-three years
old. No previous record of tumorous growth, either benign or malignant.”

“And?”

“It’s moving,”
said Dr. McEvoy. “The tumor is actually moving, like there’s something under
the skin that’s alive.”

Dr. Hughes was
doodling flowers with his ballpen. He frowned for a moment,
then
said:

“X-ray?”

“Results in twenty minutes.”

“Palpitation?”

“Feels like any
other tumor. Except that it squirms.”

“Have you tried
lancing it?
Could be just an infection.”

“I’ll wait and
see the X-ray first of all.”

Dr. Hughes
sucked thoughtfully at the end of his pen. His mind flicking back over all the
pages of all the medical books he had ever absorbed, seeking a parallel case,
or a precedent, or even something remotely connected to the idea of a moving
tumor. Maybe he was tired, but somehow he couldn’t seem to slot the idea in
anywhere.

“Dr. Hughes?”

“Yeah, I’m
still here. Listen, what time do you have?”

“Ten after
three.”

“Okay, Dr.
McEvoy. I’ll come down.”

He laid down
the telephone and sat back in his chair and rubbed his eyes. It was St.
Valentine’s Day, and outside in the streets of New York City the temperature
had dropped to fourteen degrees and there was six inches of snow on the ground.
The sky was metallic and
overcast,
and the traffic
crept about on muffled wheels. From the eighteenth story of the Sisters of
Jerusalem Hospital, the city had a weird and luminous quality that he’d never
seen before. It was like being on the moon, thought Dr. Hughes.
Or the end of the world.
Or the Ice Age.

There was
trouble with the heating system, and he had left his overcoat on. He sat there
under the puddle of light from his desk-lamp, an exhausted young man of thirty-three,
with a nose as sharp and pointy as a scalpel, and a scruffy shock of dark brown
hair. He looked more like a teenage auto mechanic than a national expert on
malignant tumors.

His office door
swung open and a plump, white-haired lady with upswept red spectacles came in,
bearing a sheaf of paper and a cup of coffee.

“Just a little more paperwork, Dr. Hughes.
And I thought
you’d like something to warm you up.”

“Thank you,
Mary.” He opened the new file that she had brought him, and sniffed more
persistently. “Jesus, have you seen this stuff? I’m supposed to be a
consultant, not a filing clerk.

Listen, take
this back and dump it on Dr. Ridgeway. He likes paper. He likes it better than
flesh and blood.”

Mary shrugged.
“Dr. Ridgeway sent it to you.”

Dr. Hughes
stood up. In his overcoat, he looked like Charlie Chaplin in The Gold Rush. He
waved the file around in exasperation, and it knocked over his single
Valentine’s card, which he knew had been sent by his mother.

“Oh... Okay.
I’ll have a look at it later. I’m going down to see Dr. McEvoy. He has a
patient he wants me to look at.”

“Will you be
long, Dr. Hughes?” asked Mary. “You have a meeting at four-thirty.”

Dr. Hughes
stared at her wearily, as though he was wondering who she was.

“Long? No, I
don’t think so.
Just as long as it takes.”

He stepped out
of his office into the neon-lit corridor. The Sisters of Jerusalem was an
expensive private hospital, and never smelled of anything as functional as
carbolic and chloroform. The corridors were carpeted in thick red plush, and
there were fresh-cut flowers at every corner. It was more like the kind of
hotel where middle-aged executives take their secretaries for a weekend of
strenuous sin.

Dr. Hughes
called an elevator and sank to the fifteenth floor. He stared at himself in the
elevator mirror, and he considered he was looking
more sick
than some of his patients. Perhaps he would take a vacation. His mother had
always liked Florida, or maybe they could visit his sister in San Diego.

He went through
two sets of swing doors, and into Dr. McEvoy’s office. Dr. McEvoy was a short,
heavy-built man whose white coats were always far too tight under his arms. He
looked like a surgical sausage. His face was big and moonlike and speckled, with
a snub little Irish nose.

He had once
played football for the hospital team, until he had fractured his kneecap in a
violent tackle. Nowadays, he walked with a slightly over-dramatized limp.

“Glad you came
down,” he smiled. “This really is very peculiar, and I know you’re the world’s
greatest expert.”

“Hardly,” said
Dr. Hughes. “But thanks for the compliment.”

Dr. McEvoy
stuck his finger in his ear and screwed it around with great thoughtfulness and
care.

‘The X-rays
will be here in five or ten minutes.
Meanwhile.
I
can’t think what else I can do.”

“Can you show
me the patient?” asked Dr. Hughes.

“Of course.
She’s in my waiting room. I should take your
overcoat off if I were you. She might think I brought you in off the street.”

Dr. Hughes hung
up his shapeless black coat, and then followed Dr. McEvoy through to the
brightly lit waiting room. There were armchairs and magazines and flowers, and
a fish tank full of bright tropical fish. Through the venetian blinds, Dr.
Hughes could see the odd metallic radiance of the afternoon snow.

In a corner of
the room, reading a copy of
Sunset,
was a slim
dark-haired girl. She had a squarish, delicate face – a bit like an imp,
thought Dr. Hughes. She was wearing a plain coffee-colored dress that made her
cheeks look rather sallow. The only clue to her nervousness was an ashtray
crammed with cigarette butts, and a haze of smoke in the air.

“Miss Tandy,”
said Dr. McEvoy, “this is Dr. Hughes. Dr. Hughes is an expert on conditions of
your kind, and he would just like to take a look at you and ask you a few
questions.”

Miss Tandy laid
aside her magazine and smiled. “Sure,” she said, in a distinctive New England
accent. Good family, thought Dr. Hughes. He didn’t have to guess if she was
wealthy or not.

You just didn’t
seek treatment at the Sisters of Jerusalem Hospital unless you had more cash
than you could
raise
off the floor.

“Lean forward,”
said Dr. Hughes. Miss Tandy bent over, and Dr. Hughes lifted the hair at the
back of her neck.

Right in the
hollow of her neck was a smooth round bulge, about the size and shape of a
glass paperweight. Dr. Hughes ran his fingers over it, and it seemed to have
the normal texture of a benign fibrous growth.

“How long have
you had this?” he asked.

“Two or three
days,” said Miss Tandy. “I made an appointment as soon as it started to grow. I
was frightened it was – well, cancer or something.”

Dr. Hughes
looked across at Dr. McEvoy and frowned.

“Two or three days?
Are you sure?”

“Exactly,” said
Miss Tandy. “Today is Friday, isn’t it? Well, I first felt it when I woke up on
Tuesday morning.”

Dr. Hughes
squeezed the tumor gently in his hand. It was firm, and hard, but he couldn’t
detect any movement.

“Does that
hurt?” he asked.

“There’s a kind
of a prickling sensation. But that’s about all.”

Dr. McEvoy
said: “She felt the same thing when I squeezed it.”

Dr. Hughes let
Miss Tandy’s hair fall back, and told her she could sit up straight again. He
pulled up an armchair, and found a tatty scrap of paper in his pocket, and
started to jot down a few notes as he talked to her.

“How big was
the tumor when you first noticed it?”

“Very small.
About the size of a butter-bean, I guess.”

“Did it grow
all the
time,
or only at special times?”

“It only seems
to grow at night. I mean, every morning I wake up and it’s bigger.”

Dr. Hughes made
a detailed squiggle on his piece of paper.

“Can you feel
it normally? I mean, can you feel it now?”

“It doesn’t
seem to be any worse than any other kind of bump. But sometimes I get the
feeling that it’s shifting.”

The girl’s eyes
were dark, and there was more fear in them than her voice was giving away.

“Well,” she
said slowly. “It’s almost like somebody trying to get comfortable in bed. You
know – sort of shifting around, and then lying still.”

“How often does
this happen?”

She looked
worried. She could sense the bafflement in Dr. Hughes, and that worried her.

“I don’t know.
Maybe four or five times a day.”

Dr. Hughes made
some more notes and chewed his lip.

“Miss Tandy,
have you noticed any changes in your own personal condition of health over the
past few days – since you’ve had this tumor?”

“Only a little tiredness.
I guess I don’t sleep too well at
night. But I haven’t lost any weight or anything like that.”

“Hmm.”
Dr. Hughes wrote some more and looked for a while at
what he’d written. “How much do you smoke?”

“Usually only
half a pack a day. I’m not a great smoker. I’m just nervous right now, I
guess.”

Dr. McEvoy
said: “She had a chest X-ray not long ago. She had a clean bill of health.”

Dr. Hughes
said: “Miss Tandy, do you live alone? Where do you live?”

“I’m staying
with my aunt on
Eighty-second
Street. I’m working for
a record company, as a personal assistant. I wanted to find an apartment of my
own, but my parents thought it would be a good idea if I lived with my aunt for
a while. She’s sixty-two. She’s a wonderful old lady. We get along together
just fine.”

Dr. Hughes
lowered his head. “Don’t get me wrong when I ask this, Miss Tandy, but I think
you’ll understand why I have to. Is your aunt in a good state of health, and is
the apartment clean? There’s no health risk there, like cockroaches or blocked
drains or food dirt?”

Miss Tandy
almost grinned, for the first time since Dr. Hughes had seen her. “My aunt is a
wealthy woman, Dr. Hughes. She has a full-time cleaner, and a maid to help with
the cooking and entertaining.”

Dr. Hughes
nodded. “Okay, we’ll leave it like that for now. Let’s go and chase up those
X-rays, Dr. McEvoy.”

They went back
into Dr. McEvoy’s office and sat down. Dr. McEvoy took out a stick of chewing
gum and bent it between his teeth.

“What do you
make of it, Dr. Hughes?”

Dr. Hughes
sighed. “At the moment, I don’t make anything at all. This bump came up in two
or three days and I’ve never come across a tumor that did that before. Then
there’s this sensation of movement. Have you felt it move yourself?”

“Sure,” said
Dr. McEvoy. “Just a slight shifting, like there was something under there.”

“That may be
caused by movements of the neck. But we can’t really tell until we see the
X-rays.”

They sat in
silence for a few minutes, with the noises of the hospital leaking faintly from
the building all around them. Dr. Hughes felt cold and weary, and wondered when
he was going to get home. He had been up until two a.m. last night, dealing
with files and statistics, and it looked as though he was going to be just as
late tonight. He sniffed, and stared at his scuffy brown shoe on the carpet.

After five or
six minutes, the office door opened and the radiologist came in with a large brown
envelope. She was a tall
negress
with short-cut hair
and no sense of humor at all.