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Trade Secrets

Bob Cohen

  
   There was little in the lounge other than a metal table, a couple of folding chairs, and an overstuffed threadbare sofa.  There was an electric coffee pot and a small microwave oven on the countertop above the row of cabinets along one of the walls.  And that was it.  Not even a window.  It was a small hospital, and besides, there was nobody to go home to anymore, so this would have to do.

   Artie came in with an armload of charts, put them on the table, and poured himself a paper cup of stale coffee.  He started to think about Marie while he was waiting for the microwave to beep – not that she was ever too far from his thoughts.  They had been together ever since he was a medical student.  Twenty-seven years, just the two of them, no children, but that never seemed important.  He knew about all the technicalities, all the jargon – ‘metastasis’ in particular – but he found it impossible to keep those thoughts in his head at the same time as he was thinking about his wife, his Marie.  The microwave beeped.

   He was trying unsuccessfully to dissolve the powdered creamer in his coffee when the door opened.  A small man in black clothing stood there with a hopeful look on his face: “Reservations, Monsignor McGlynn, party of one?”  Artie looked up and smiled. “Hey, come on in, Bill.  Working late, too?”
   “Yeah, but no offense, you can’t make any money in this dump.  I keep passing the plate, it keeps coming back empty.  Well, one guy threw up in it, but I think he was sick.”  They both chuckled.  The two men, despite their respective professions being sometimes at odds, had become quite close over the years.  It would be no surprise to anyone that they were both in the hospital at this late hour. “Artie, have you seen the young man in 303 west tonight?”  Another doctor would’ve said something like, ‘have you seen the pneumothorax in 303 west?’  The room number meant little to him, and he had to think.  “What’s the problem?”
   “He’s feeling pretty miserable.”  Artie frowned.  He wasn’t in the mood for this.  He started writing on the chart in front of him, “Yeah, okay, I’ll look in on him in a little bit...  gotta do some paperwork first.”  It was a polite cue, yet Bill remained in the doorway.  “You look like shit, you know?”  Without looking up from what he was doing, Artie said, “It’s been a long day.  And night.”  He’d been at the hospital working since noon although his day started much earlier than that, and Bill knew it.  He asked softly, “How’s Marie?”
   “Not good. I spoke to her doctor this morning.  They’re trying to keep her as comfortable as they can.  They, uh, we, put in a DNR order tonight”  Bill winced.  Ordinarily, this could’ve ignited an argument between them, but this was not the time.  ‘DNR’ stood for ‘Do Not Resuscitate.’  “I’m sorry, Art.”
   “Yeah, me too.”  He looked up, “Hey maybe you can do me a favor, and make sure she gets in?  What do you think?”  There was an awkward silence.  Bill knew that Marie would have no problem ‘getting in’ so he deflected the question: “Listen, when you get through, why don’t we go out for breakfast?  I can get us a discount with the collar down at the Blue Spoon.”  Artie smiled.  He had planned on taking a snooze on the couch, but he hadn’t eaten since yesterday.  “Okay, sounds good.”  As Bill was leaving, he stuck his head back in the doorway and said, “By the way, don’t forget about the kid in 303 west.  Maybe you can do something for him.”
   “Yeah, go scratch your ass, okay?”

   Artie reviewed the young man’s chart as he finished his coffee.  He returned the rest of the charts to the nurse’s station and walked over to 303 west.  It was nearly two in the morning and the floor was quiet.  As he entered the room, he heard the weak, labored breathing.  There was a frail teenager lying in the window bed.  Artie asked softly, “Are you awake?”  He opened his eyes and slowly turned his head.  “Hi, Doc...  I’m up.”
   “How are you doing?”  He discreetly checked the arm where the intravenous needle was taped, he checked the drip on the bags, he glanced at the monitors.  “I don’t know, I was feeling a little better before - ” he suddenly started coughing, a deep rattling with no real strength behind it.  “Well, let’s see.”  He began his physical examination.  The patient was deteriorating.  “Hey, Doc, what’s that smell?  It’s awful.”   Artie smiled. “That’s the Keflex, the antibiotic in the IV.  It comes out through your pores.”
   “Wow, I thought I was going crazy.”
   “No, you’re not crazy.  A little sick maybe, but not crazy.”  He didn’t want to tell him that in addition to smelling the antibiotic, he was smelling the destruction of his own lung tissue – the antibiotic was not working.  Not good.  “This stuff really burns on the way in.  Do I have to get it every six hours?  I mean, the smell’s one thing, but...”  Artie sighed, “No, you don’t.  Unfortunately, the bug you’ve got isn’t responding to this medication as well as I had hoped.”  The young man looked frightened but said nothing.  “Not to worry, though, we’ve got some more tricks up our sleeve.  I’ll give you something for the pain, and we’ll change antibiotics in the morning.  Try to get some sleep.”  Artie walked out, wondering if he’d be able to come up with a suitable trick.

   He returned to the nurse’s station.  “Give me the keys to the library, please.”  The nurse shook her head, “He’s that bad, huh?”  He glared at her silently.  She averted her eyes as she dutifully handed over the keys.

  Artie went to the office in the basement which they had converted to a library.  He walked past the computer terminals and the surprisingly respectable stacks to a small cabinet on the back wall, nestled in between some steam pipes.  He unlocked the cabinet, pocketed the key and stood there, thinking of Marie.

   Inside the cabinet was a series of three leather-bound volumes and nothing else.  On the spine of the first book, it said, ‘Trauma Management.’  The second book, quite simply, ‘Oncology.’  He took a deep breath and tried to clear his head.  The third book, the one he had come for, said ‘Infectious Diseases – A Therapeutic Approach.’  All three titles were authored by Dr. Wilfred Zeigler, or at least edited by him.  He took the book on infectious diseases and sat down at the table closest to the cabinet.

   Dr. Zeigler was a physician and scientist whose name was recognized for the most part only within the medical community.  Unlike other people who had made discoveries which would forever change the world, Dr. Zeigler’s discovery had cast him into the shadows, into a state of perpetual and closely guarded anonymity.  This was not because people wouldn’t believe it, but because, ironically, Zeigler’s discovery simply could not change anything.

   The hardworking Dr. Zeigler was just a run-of-the-mill medical researcher working for a large pharmaceutical company, mostly involved in developing new patent processes.  He was so hardworking that it killed him.  Literally.  He just keeled over one morning, face down in the Petri dish.  He later explained that it was just like the way they show it on television.  After a momentary interruption of consciousness, he sees someone slumped over a lab counter, then realizes he’s looking at himself.  His co-workers come running over.  He tries to talk to them, but they can’t see or hear him.  Zeigler isn’t frightened; he feels very peaceful and calm.  A white light emanates from above and he follows it up to what he correctly assumes is Heaven.  It doesn’t alarm him at the time, considering where he is when he discovers it, but it certainly becomes cause for alarm later: it seems that Heaven is, for all practical purposes, full.

   There was nothing special in the Petri dish to change Zeigler’s fate – it was his medically trained co-workers who ran to his aid.  Regardless of his preferences on the issue, collectively, they had sufficient skill to bring him back.  That’s when he became truly frightened.

   Contrary to what just about everybody in the world took for granted since childhood,  Zeigler began to claim (through channels, of course) that the cosmos were not limitless.  As his ideas gained hushed momentum in the medical community, the doctors called for a conference with the religious authorities.  The men of the cloth reluctantly confirmed what the doctors suspected, and the meeting nearly degenerated into a melee.  It wasn’t so much that the clergy knew of the situation, but the fact that they admitted, when pressed, to the existence of certain arrangements.  In effect, they had all made reservations for themselves.  The doctors were furious:  “What about us?” 

   So, in the interest of peace and harmony in this mortal coil, they hashed out a grudging agreement, almost like union officials negotiating a labor contract.  Priests, rabbis, ministers, etcetera, would be secure in the terms of their pre-existing deal.  After all, they argued, they did work for the company and were legitimately entitled to certain ‘retirement’ benefits.  The doctors, although they did good deeds on a daily basis (and as they made sure to point out, were occasionally called upon to play God), would not be automatically entitled to entry.  Only a limited amount of space would be set aside for them as a group prior to their individual arrivals.  They did, however, gain the concession that upon appearing at the Pearly Gates, they’d be granted an exemption from having to demonstrate past participation in organized religious activities.  The value of the medical services they had rendered to their fellow man would be considered on a case-by-case basis to determine if they would be allowed entry.  And all were agreed.  For everyone else, though, the rules would remain the same.

   This conference was supposed to have been a confidential matter, but as with anything held privy by a sizeable number of people, the information started to leak out.  The effects were felt worldwide, whether or not anyone could point a finger at the true cause with certainty.  On the religious side, there was a resurgence of fanatical groups; they started cropping up all over with increasingly larger membership rolls.  On the medical side, there was an explosion of research, leading to extraordinary new medicines and techniques for extending life – as if keeping everyone else alive could delay Saint Peter from putting out the ‘No Vacancy’ sign.

   With Zeigler in the vanguard, some doctors took this concept to extremes, keeping patients alive long past any reasonable need to do so.  The clergy tried to warn them that these methods would not be considered favorably upon review, but the doctors were driven by desperation.  The predictable response was new disease and pestilence against which even the modern miracle cures were of no use.  More and more doctors started smoking cigarettes.

   Artie was aware of all this but none of it really mattered to him tonight.  No one would accuse him of immorally trying to extend the life of the young man in 303 west.  There was simply no reason why he should be medically abandoned, unable to fight off a gang of simple, one-celled microbes.  And there could be no accusation of trying to keep him alive long enough for Marie to die.  Her case was such that there was no point in Artie even opening Volume II of the infamous Zeigler series.  What was haunting him, tonight as every night, was the thought of an infinitely permanent separation -  that Marie would get in first, then the gates would close forever.  He opened the book on infectious diseases.

   It was about three-thirty AM when Artie and Bill got to the diner.  The place was nearly empty, save for a few night owls relocated from the closing bars.  As they walked in, one of the customers reached out and said, “Hiya, how ya doin’?”  Bill shook the man’s hand, a total stranger, as Artie looked away uncomfortably.  When they sat down in their customary booth, he whispered, “Can’t you change before we go out?”  Bill laughed, “Hey schmuck, I told you, it’s for the discount.  You thought I was kidding?”

   They both ordered breakfast plates.  After their second refill, the waitress was kind enough to bring them their own pot of coffee.  Bill grinned as she walked away, comically fidgeting with his collar.  Artie didn’t react.  “Doc, you alright?”
   “Yeah, no, I’m sorry.  It’s been a real shitty day.”  He confided in Bill about his fears that the more he tried to avoid dealing with his personal problems by burying himself in his work, the more he chanced crossing the fine line into medical heroics - and thereby sealing his own fate.
   “Hey, I was only kidding before about the kid in 303, it was a bad joke – I’m sorry, okay?  I wouldn’t hang around with you if I thought you made patient care decisions on a self-serving basis.”
   “No, I know you wouldn’t...  Ah shit, Bill, it’s more than just today, though.  I don’t what I’m gonna do, with Marie and all, you know?”  He looked away, gazing out the window at nothing.
   “Well, at the risk of sounding trite, these things sometimes have a way of working themselves out.”  Artie responded with a humorless laugh. “Yeah, I’m sure everything’ll be just fine.”  They sat in silence.  Bill sensed that his friend was a thousand miles away.  “Suicide is a sin, Art.”
   “What?  You know – I thought we were off-duty.  Are you still working, or what?”  Eyebrows raised, Bill smiled:  “You feel like talking, I can put in for the overtime.”
   “You’re a jerk.”

   They had coffee and talked until the sun started to come up.  None of it actually helped Artie’s situation, although it did make him feel better.  That, and the little silver flask that Bill brought out at intervals to reinforce their coffee.  He didn’t say it, and never had, but he was grateful for his friend’s pleasant distraction.

   They were laughing at a series of off-color jokes that Bill had told him dozens of times before when there was a crashing of dishware.  Startled, they looked up as one of the early morning breakfast patrons staggered away from the counter and fell backward.  The waitress screamed, “Is he choking?  Oh God, somebody help him!”  Artie rushed over to the man as he lay prostrate on the floor and quickly determined that he was suffering from heart failure.  “Call 911 right now, get an ambulance.  Tell them a doctor’s here and it’s a confirmed cardiac.”  The panicked counterman replied in broken English, “The phone no good – for incoming, incoming!  Is no good!”  Artie turned to Bill: “Get to a payphone.  Right now, okay?  Run – there’s no time!”  He wished he had his medical bag with him as he felt along the man’s chest.  While he was doing this, the man stopped breathing.  “Somebody else, I need help here.  You, come here, please!”
   “Mouth-to-mouth?  Not me man, no way!”  It was one of the drunks.  Now the others started backing away, too.  Artie cursed under his breath as he reached behind the man's neck.  Cardio-pulmonary resuscitation was hard enough with two people and it looked like he was flying solo.  He grabbed the man’s jaw with one hand and his nostrils with another, clamped his mouth on as tightly as he could, and blew.  He saw the chest rise, but the gift of air was expelled with a sickeningly final tremolo.  Again.  He then straddled him, and with stiff elbows, began rythmic compressions.  “One... two... three... four... five...”  He spit out pieces of the other man’s breakfast as he counted.  The others stood by and watched as he changed positions.  Artie was starting to drip sweat on him.

   Bill was sweating too as he searched desperately for a phone, a passing police car, or anyone else.  The streets were deserted.  He ran for blocks before he found a payphone and it was out of order.  He cursed loudly and resumed running, praying that he was choosing the right direction.  When he finally got to a working phone he was so out of breath he almost couldn’t speak but he somehow managed to get the message across to the operator.  He hung up the phone, bent over with his hands on his knees, and retched.
   As soon as he caught his breath he started back toward the diner.  Knowing that Artie was a capable healer, he walked briskly, confident now that everything would work out all right.  He figured the ambulance would be there before he got back.  It wasn’t.

   He walked in through the diner’s front door and saw the small group standing quietly.  Then he saw Artie, lying on the floor next to the man he tried to help, eyes open, seeing nothing.  He slowly walked over and they silently parted to let him pass.  “Oh, no.”  He knelt at his friend’s side and saw that he was dead.  The stranger was stirring alongside him, dazed, but breathing on his own.  Bill stood up and sagged onto one of the stools by the counter.  “What happened?”  He wasn’t asking anyone in the diner - he was talking to Artie.  Someone murmured, “He must’ve had a heart attack himself...”  The waitress, crying, touched Bill on the arm.  He turned to her. “I know he was a friend of yours, Father.  I’m so sorry.”  Bill looked at her, smiled weakly and said, “Thank you, dear.  It’s all right, I think he’s in, now.”



© 2002 Bob Cohen

Bob Cohen is a Captain in the New York City Police Department. He has written stories and articles for SCR and print publications.

Email: fts@southerncrossreview.org