The bulletin board was tacked with layers of
paper–shift schedules, cartoons-cut out of magazines,
chemotherapy dosage charts, and an autographed
picture of a famous Dodger with a young
bald boy in a wheelchair. The child held a bat with
both hands and gazed up at the baseball player,
who looked slightly ill at ease among the I.V. lines.
Raoul
picked a medical chart out of a bin and
flipped through it. He grunted and pushed a button
on a panel above the desk. Seconds later a heavyset
woman dressed in white stuck her head in.
“Yes–oh, hi, Doctor Melendez.” She saw me and
gave a nod with a question mark stuck to the end of
it.
Raoul introduced me to the nurse, whose name
was Ellen Beckwith.
“Good,” she said, “we could use you around here.”
“Dr. Delaware used to coordinate psychosocial
care on this unit. He’s an international expert on
the psychological effects of reverse isolation.”
“Oh. Great. Pleased to meet you.”
I took the proferred fleshy hand.
“Ellen,” said Raoul, “when are Mr. and Mrs.
Swope due back on the unit?”
“Gee, I dunno, Doctor. They were here all last
night and then they left. They usually come in
every day, So they shoifid be around sometime.”
He clenched his teeth.
“That’s very helpful, Ellen,” he said sharply.
The nurse grew flustered and her meaty face
took on the look of an animal corralled in an unfamiliar
pen. “I’m sorry, Doctor, it’s just that they’re not required to tell us–”
“Never mind. Is there anything new with the boy
that hasn’t been charted?”
“No sir, we’re just waiting form” she sawthe
look on his face and stopped herself. “Uh, I was
just going to change the linens in unit three, Doctor,
so if you have nothing more–”
“Go. But first get Beverly Lucas over here.”
She glanced at a challboard across the room.
“She’s signed out to page, sir.”
Raoul looked up and stroked his mustache. The
only evidence of his agony was the slight tremble
beneath the bristly hairs.
“Then page her, for God’s sake.”
She hurried off.
“And they want to be professionals,” he said.
“Working hand in hand with the doctor as equal
partners, Ludicrous.”
“Do you use anything for the pain ?” I asked.
The question threw him.
“What–oh, it’s not so bad,” he lied, and forced a
smile. “Once in a while I take something.”
“Ever tried biofeedback or hypnosis?”
He shook his head.
“You should. It works. You can learn to vaso-
dilate and constrict at will.”
“No time to learn.”
“It doesn’t take long if the patient’s motivated.”
“Yes, well–:-” he was interrupted by the phone.
He answered it, barked orders into the receiver,
and hung up.
“That was Beverly Lucas, the social worker. She’ll
be here shortly to fill you in.”
“I know Bev. She was a student here when I was
an intern.”
it
“If you say so.” He looked
much use with this family.”
“That may be true of me as well, Raoul.”
“You’re different, Alex. You think like a scientist
but can relate to patients like a humanist. It’s a
rare combination. That’s why I chose you, my
friend.”
He’d never chosen me but I didn’t argue. Maybe
he’d forgotten the way it really started.
Several years back, he was awarded a government
grant to study the medical value of isolating
children with cancer in germ-free environments.’
The “environments” came from NASA–plastic modules
used to prevent returned astronauts from infecting
the rest of us with cosmic pathogens. The
modules were filtered continuously and flooded with
air blown out rapidly and smoothly in laminar flow.
Such smooth flow was important because it prevented
pockets of turbulence where germs collected
and bred.
The value of an effective way to protect cancer
patients from microbes was obvious if you understood
a little about chemotherapy. Many of the drugs
used to kill tumors also knock out the body’s immune
system. It was as common for patients to die
of infection brought about by treatment as to perish
from the disease itself.
Raoul’s reputation as a researcher was impeccable
and the government sent him fourmodules and
tots of money to play with. He Constructed a randomized