David stood up. He felt numb. He didn’t know how long he’d been sitting at the nurses’ station. Janet directed him into the patients’ lounge.
Lloyd Kleber was staring out the window at the rain. David guessed he was in his mid-forties. His eyes were red from crying. David’s heart went out to the man. Not only had he lost a wife, but now he had the responsibility of two motherless children.
“I’m sorry,” David said lamely.
“Thank you,” Lloyd said, choking back tears. “And thank you for taking care of Marjorie. She really appreciated your concern for her.”
David nodded. He tried to say things that reflected his compassion. He never felt adequate at moments like this, but he did the best he could.
Finally, David ventured to ask for permission to do an autopsy. He knew it was a lot to ask, but he was deeply troubled by Marjorie’s swift deterioration. He wanted desperately to understand.
“If it could help others in some small way,” Mr. Kleber said, “I’m sure Marjorie would want it done.”
David stayed and talked with Lloyd Kleber until more members of the immediate family arrived. Then David, leaving them to their grief, walked over to the lab. He found Angela at the desk in her office. She was pleased to see him and told him so. Then she noticed his strained expression.
“What’s wrong?” she asked anxiously. She stood up and took his hand.
David told her. He had to stop a few times to compose himself.
“I’m so sorry,” Angela said. She put her arms around him and gave him a reassuring hug.
“Some doctor!” he chided himself, fighting tears. “You’d think I’d have adjusted better to this kind of thing by now.”
“Your sensitivity is part of your charm,” Angela assured him. “It’s also what makes you a good doctor.”
“Mr. Kleber agreed to an autopsy,” David said. “I’m glad because I haven’t the slightest idea why she died, especially so quickly. Her breathing stopped and then her heart. The consults all think it was her cancer. It probably was. But I’d like Bartlet to confirm it. Could you see that it gets done?”
“Sure,” Angela said. “But please don’t get too depressed over this. It wasn’t your fault.”
“Let’s see what the autopsy shows,” David said. “And what am I going to tell Nikki?”
“That’s going to be hard,” Angela admitted.
David returned to his office to try to see his patients in as short order as possible. For their sake, he hated being so backed up, but there had been no way to avoid it. He’d only managed to see four when Susan waylaid him between examining rooms.
“Sorry to bother you,” she said, “but Charles Kelley is in your private office, and he demands to see you immediately.”
Fearing Kelley’s visit had something to do with Marjorie’s death, David stepped across the hall into his office. Kelley was impatiently pacing. He stopped when David arrived. David closed the door behind himself.
Kelley’s face was hard and angry. “I find your behavior particularly galling,” he said, towering over David.
“What are you talking about?” David asked.
“Just yesterday I spoke with you about utilization,” Kelley said. “I thought it was pretty clear and that you understood. Then today you irresponsibly ordered two non-CMV consults to see a hopelessly terminal patient. That kind of behavior suggests that you have no comprehension of the major problem facing medicine today: unnecessary and wasteful expense.”
With his emotions raw, David struggled to keep himself under control. “Just a minute. I’d like you to tell me how you know the consults were unnecessary.”
“Oh, brother!” Kelley said with a supercilious wave of his head. “It’s obvious. The patient’s course wasn’t altered. She was dying and she proceeded to die. Everyone must die at some time or another. Money and other resources should not be thrown away for the sake of hopeless heroics.”
David stared into Kelley’s blue eyes. He didn’t know what to say. He was dumbfounded.
Hoping to avoid Wadley, Angela sought out Dr. Paul Darnell in his windowless cubicle on the other side of the lab. His desk was piled high with bacterial culture dishes. Microbiology was his particular area of interest.