Will was sitting in the claustrophobic, chart-strewn dictation room of the hospital record department, signing off on the last of his open charts when Dave Andros popped in.
Just the man Will did not want to see.
“Hey, Will.” Andros, a short, portly bundle of energy, dropped into the chair next to Will and fixed him with his dark eyes. “How're you feeling?”
“Decent.”
He lifted Will's chin. “Let me see that incision.” Dave leaned close, tilting his head left and right, then nodded. “Damn, I do good work!”
Will laughed. “You do, Dave.”
“Yeah, I know.” He continued to stare at Will. “Well?”
“Well what?”
“What's the final word from Sloane?”
“You didn't get a report?”
“Not yet. What did they think?”
Will sighed. “Same as everybody else.”
Will had first noticed the lump in his neck a month ago while shaving: a firm, non-tender, subcutaneous mass about the size of the last phalanx of his little finger. No question—an enlarged lymph node. He'd watched it for about a week, fully expecting it to return to normal size.
Lymphomas, after all, happened to other people.
But the node did not shrink. In fact, Will suspected that it might be enlarging. And was that a second node he felt beneath it?
Uneasy now, he copped a hallway ENT consult from Dave, who said the fastest way to find out what was going on was to biopsy the node. And not to worry too much—even if it was a lymphoma, they were getting fabulous results these days.
Two days later, Dave removed the node under local in the outpatient surgical suite and sent it down to pathology for a quick read. As soon as the incision was sutured closed, Will headed for the path department where the frozen section results would be waiting for him.
He rapped on the door frame of Alex Reed's office. “What's the word, Alex?”
Reed was the hospital's chief pathologist. He was pushing sixty and his build mimicked his name; he sat folded in his chair, wrapped in a white lab coat with sleeves that were inches too short for him. He didn't smile when he looked up from his desk.
“Oh, Will. Have a seat. And close the door, will you?”
Something in the pathologist's eyes started a cold, sick dread growing in Will's gut. He closed the door but remained standing.
“What is it, Alex? Non-Hodgkin's lymphoma?”
“No. It's squamous, Will. The node was packed with squamous cell carcinoma.”
“Oh, shit.” Will's knees suddenly felt rubbery. He lowered himself into the chair. “You're sure?”
“Very. I'll be able to give you more details after I examine a full prep, but even in the frozen sections this appears to be one very aggressive-looking tumor. I suggest you get rolling on therapy right away.”
“But where the hell's the primary?”
“Could be anywhere in the head or neck. You want my guess? I'd say the tongue.”
Stunned, Will had stumbled out of Reed's office in search of Dave.
No more hallway consults now. Dave had Will come to his office where he did a thorough oral exam. He found what he thought might be the primary tumor far back at the base of Will's tongue.
“No symptoms?” Dave said. He looked a little gray; they'd been friends a long time. “No difficulty swallowing or a feeling of fullness back there?”
“No,” Will told him. “Not a thing.”
“They can be sneaky.”
Will leaned back and closed his eyes. He felt as if the walls were caving in on him.
“Why, Dave?
“You don't smoke, do you?”
He knew where Dave was going: the major causes of oral cancers were smoke and alcohol.
“Quit cigarettes in medical school, although I smoked a pipe for awhile afterward, and I still have an occasional cigar.”
Dave shook his head. “What asshole is responsible for bringing that foul habit back into vogue? How about booze?”
“Some red wine with dinner. Other than that . . .”
Why me? Will thought.
He'd seen hundreds of patients ask the same question. Usually the answer was obvious: they smoked too much, drank too much, had a family history that they'd ignored. But sometimes tumors simply happened. Will had taken decent care of himself over the years . . . this didn't seem fair.
He straightened and looked at Dave. No use miring himself in pity. He needed to attack this thing right away.
“Okay,” he said. “What am I looking at for treatment?”
“Radiation and surgery,” Dave said.
Will felt his intestines writhe at the words. “How much surgery?”
“I'd like to see an MRI before I answer that.”
The final path report was ready the next day, and it confirmed Reed's initial impression: an aggressive squamous cell Ca. The MRI brought worse news: the tumor was already infiltrating around the larynx.
A very distressed Dave Andros had then told Will what he would have to do to save his life.
Will had recoiled, unable to accept what he'd heard. At Dave's urging he took the tissue slides and the MR films out for a second opinion. The matter of where was a no-brainer: Memorial SloaneKettering in nearby Manhattan had an international reputation.
“They said the same thing you did, Dave, only some of them want to toss in a little chemo for good measure.”
Dave shook his head. “I wish there was another way, Will.” He paused, then, “When are you going in?”
Will had been dreading this moment. Last week, while driving back from his consultation with the Sloane-Kettering team, he'd come to a gut-wrenching decision. During the ensuing days he'd reconsidered it from all angles, but the decision held. Since then he'd been avoiding Dave. He knew his old friend cared about him, knew how he'd react.
Bracing himself, Will took a deep breath and said, “I'm not.”
Dave's eyes widened. “What do you mean?”
“Just what I said: no surgery, no radiation, no chemo. Nada.”
Dave shot out of his chair and began pacing, which wasn't easy, considering the confined quarters of the dictation room.
“You can't be serious! You won't last three months!”
“Probably not. But it's better than living years with what I'll have left after the surgeons and radiologists get through with me—all without a guarantee that I'll be tumor free.”
“But you'll die horribly, Will! It's a flip of the coin whether the tumor will close off your larynx or your esophagus first. If you don't choke to death, you'll die of starvation and dehydration.”
Will stared at him. “No, I won't.”
Dave stopped his pacing. “Oh, great! Just great! You think you're going to do a Kevorkian on yourself? What's it going to be? Morphine overdose? KCl? A .357 Magnum?”
Will hadn't chosen a method yet. He hadn't reached that point in his planning.
“Let's just say I won't die of starvation and dehydration.”
Dave sat again and placed a hand on Will's arm. “You're not thinking straight, Will. I know it's scary, but you can't run from this. You've got to face it down and conquer it.” He squeezed Will's arm. “The alternative is to sit and let the tumor rot you from the inside.”
“I'm not going to sit. I'm going to travel—tumor and all—and go all those places I put off seeing while I figured I still had a long road ahead of me.”
With a heavy heart, Will closed the chart before him and rose to his feet. He didn't want to argue with Dave, didn't want to see the anguish in his friend's eyes.
“And here's some words of wisdom from a man whose days are numbered: Enjoy life now, Dave. Do the things you want to do now. Don't put them off till later—sometimes later doesn't come.”
He left Dave sitting in the chart room, staring at the floor.
Will stifled a belch as he walked toward the door of his two-story faux Tudor townhouse in Mount Kisco. He'd started renting it when he and Annie separated, and wound up staying on after the divorce. It wasn't fancy, but he didn't need fancy. He needed functional. This place was situated halfway between his office and the hospital. Mostly he just slept here.
He rubbed his abdomen. He felt a little bloated. He'd overeaten again at Armondo's Place, a dinner of steak au poivre, asparagus hollandaise, twice-baked potato, and German chocolate layer cake. He figured since he no longer had to worry about the long-term effects of saturated fats, he might as well indulge in a heavy meal whenever possible.
Too soon he'd be reduced to a liquid diet.
He was inside and halfway down the hall when he heard a knock. He opened the door and found his ex-wife standing there.
“Annie. What—?”
She stepped past him. “Dave Andros called me this afternoon.”
“Oh, hell.”
He closed the door and faced her. Annie was as attractive as ever, looking considerably younger than her forty-eight years, although she appeared slightly disheveled tonight. Her chestnut hair wasn't perfectly brushed, and the whites of her large brown eyes looked red. Had she been crying?
“‘Oh, hell’ is right,” she said.
“He had no right—”
“Let's not get sidetracked on the patient privilege issue. Dave is your friend and he's worried about you. So am I, now that I know. I've been sitting out there in the parking lot for hours, waiting for you to come home.”
He was touched. “You didn't have to.”
“I'm hoping I can talk some sense into you.”
Will gave her a smile. “You never could when we were married.”
“But maybe I can now that we're not. I still care about you, Will. You know that.”
He did know that. The breakup of their marriage had been his fault. Not because of a woman, but because of another kind of mistress, a very demanding one: his practice. He hadn't been a bad father to their only daughter, but as far as husbands go, he'd been mostly absent; Annie had needed more of a presence than he could provide.
The practice . . . the damn practice. He'd known he was obsessive about it—a solo practitioner had to be. That was why hardly anyone was solo anymore. He was a dinosaur and he knew it. Not that he hadn't tried to take in a partner over the years. Tried three times. They were all good docs, but somehow they just didn't have quite the zeal he was looking for. Hell, they all wanted a weekday off. What was that about? When was the last time he'd had a weekend off, let alone a weekday.
Maybe he was too scrupulous. Maybe he hadn't been able to relinquish the exacting control he imposed on his practice. You couldn't delegate responsibility in a group practice, but at some point you had to delegate authority. Will had been unable to do that. He needed to keep his finger on all the buttons. My way or the highway. That was why it had taken over his life.
That was why he was divorced and still in love with his wife. He'd let her take the house and just about anything else she wanted. All he'd kept were his old vinyl records from the sixties and his collection of western videos.
Annie was now engaged to a real estate broker whose business seemed to run itself. He had lots of time for Annie.
But somehow Will and Annie had remained friends. Like the old cliché: They were closer now than when they'd been living together.
Lots of old clichés seemed to be hitting home lately. Especially the one about no man on his deathbed ever wishing he'd spent more time at the office.
Will wished he'd spent more time with his daughter Kelly. She was a second-year medical student now at NYU and Will realized that he hardly knew her. Since he'd learned about the tumor, he'd come to regret bitterly all the opportunities he'd missed to be with Kelly when she was growing up.
Remorse had become a cold anvil, chained to his neck, dragging behind him wherever he went.
If only he'd known then . . .
He realized he'd been saying if only an awful lot lately.
Annie was looking at him now with hurt in her brown eyes. “You weren't going to tell me, were you.”
“Sure I was. Eventually.”
“I can't believe you're acting this way. You—the doctor's doctor, Mr. Modern Medicine. It's just not like you to refuse treatment.”
“Did Dave tell you what they'll have to do to ‘cure’ me?”
“He said surgery and radiation.”
“Did he give you any details?”
“I didn't think so. All right, then, I'll tell you. First they heavily radiate my oral cavity and throat for weeks to shrink the tumor. But in the process it shrivels up my esophagus as well, and so for months to come I'll only be able to swallow watery fluids, and those with difficulty, which is just as well because the radiation will kill off my taste buds and dry up my salivary glands, and I won't be able to taste anything anyway.”
He saw Annie swallow.
“Then comes the surgery: a radical neck dissection. And I do mean radical. I lose my larynx, a big chunk of my tongue, and most of my right lower jaw. And then it's back for more radiation. And maybe chemo.”
Annie's hand crept to her mouth. “Oh, God.”
“I'll wind up with three-quarters of a face; I'll speak by burping or buzzing through a voice box; I'll eat by choking fluids and gruel down a strictured esophagus past a mutilated tongue that can't taste.”
Annie turned and stumbled toward the sparsely furnished living room. She dropped into a chair.
“I had no idea!”
Will hesitated a moment, then followed and stood over her. He laid a hand on her shoulder. He knew Annie, knew her empathy. She felt for other people, shared their pain if they were hurting. Empathy could be a curse; he could imagine what she was feeling for him now. But her genuine distress warmed him—at least she still cared about him. He was sorry he'd had to dump it on her like that, but he saw no reason to pretty it up.
She looked up at him. “But at least you'll be alive.”
“You call that living, Annie? That's not life—that's existence. And an empty one to boot: I can't practice in that state. And since I won't want to inflict my appearance on anyone, I'll wind up sitting around here alone, listening to my scratchy old records and watching my westerns. How many times do you think I can listen to ‘Eight Miles High’ and watch Ride the High Country before I finally jam the muzzle of a pistol into what's left of my mouth and end it all!”
Annie was cringing in the chair, staring at him. Will realized his voice had risen almost to a shout.
He turned away. “Sorry.”
He hadn't realized how angry he was. He was reacting like every other cancer patient he had known, thinking it wasn't fair. And it wasn't! It wasn't goddamn fair!
Calmer now, he sighed and said, “When I hear myself talk like that, I think it sounds like it's all about vanity. But it's not vanity, Annie. It's dignity. Through my entire career I struggled to preserve my patients’ dignity. I fought for their self-determination. I want the same for myself. I don't believe in life at any cost—not for me, anyway. I want to choose the manner of my leaving, and do not care to be sliced and diced, fried, and poisoned as I head for the exit.”
He sensed movement behind him, then felt Annie's arms go around him. God, that felt good.
She sobbed into his back. “Oh, Will, oh, Will! I'm so sorry. I wish there was something I could do.”
Suddenly he wanted to cry too, to turn and cling to her and bawl like a baby, to release all the screaming fear and remorse dammed up inside him. Instead, he covered her hands where they clasped over his abdomen and forced a laugh.
“Yeah. Me too. Got any magic?”
The phone rang.
It was in easy reach so he lifted the receiver.
“Dr. Burleigh?” said a woman's voice.
He recognized the accent. The woman from the place in Katonah. What was her name?
“Speaking.”
“This is Maya. Can you see me tomorrow morning?”
He hesitated, wanting to say thanks but no thanks, but a part of him, a part that desperately wanted to live and figured he couldn't possibly make matters worse, wouldn't allow it.
“Sure,” he said. “Ten o'clock okay?”
“Yes. I will see you then.”
He hung up, wondering why he was wasting what little time he had left on a nutcase like Maya.
That wasn't fair. Enigmatic, magnetic, and certainly misguided, but Will had sensed that she was quite sane. And ethical as well— she'd wanted him to see a surgeon immediately.
But that didn't answer the question of why he was consulting a psychic healer.
Perhaps because she was a mysterious stone he'd encountered on this final stretch of his road. And though he was perfectly sure he'd find nothing under it, he didn't want to leave it unturned.
“Who was that?” Annie said from behind.
He didn't turn to look at her. “No one. No one who's going to make any difference, that is.”