In the four years since he had been made director of the lab, Adam Coopersmith was, metaphorically speaking, the father of nearly two hundred children. By treating multiple-miscarrying women with large dosages of natural progesterone, he had enabled 174 of them to carry their pregnancies to term.
Some of the couples were so overwhelmed at their miraculous change in luck that they went as far as to ascribe magical powers to Adam. And many women became so emotionally attached that they would allow only him to manage the rest of their pregnancies.
Dave and Celia Anthony drove all the way from Detroit to Boston two weeks before her due date, so that he could be the attending obstetrician. For they knew instinctively that their wonder-working doctor’s reward was not his modest fee, but the enormous satisfaction he derived from sharing their own long-dreamed-of success.
The day he delivered their eight-pound little boy, the room was filled with tears of joy. No one was dry-eyed—although Adam tried not to show it.
“Isn’t he beautiful?” Celia sighed. Her husband could merely nod mutely in agreement.
“What are you going to call him?” he asked.
“Well, Doc,” Dave responded, gathering his courage. “If it’s all right with you—I mean Celia and I have talked this over—we’d like to name him ‘Adam.’ It’s the only way we have of thanking you.”
His colleagues regularly sent Adam their “hopeless” cases, and he would prescribe a series of laboratory tests—especially those he himself had devised to determine if the women were producing embryotoxins.
Of course, not all women were suitable candidates for his hormone therapy, but his scientific intuition was often able to find clues to other little-known disorders that hindered their pregnancies. The end result, in any case, was happy mothers.
And yet, sadly, there were those whom even his vast knowledge and untiring effort could not help to become parents, and he felt their failure almost as keenly as they. Paradoxically, while he had trouble remembering all his successful patients, the faces of the sad ones haunted him forever.
Such a couple was Professor and Mrs. Dmitri Avilov, recent arrivals from the USSR.
Formerly a geneticist on the staff of the Soviet Academy, Avilov was so much in the avant-garde of the field that several Western countries had for many years been urging him to emigrate. No politics were involved, merely the prospect of unmatched facilities and lavish capitalistic salaries.
Finally, at an international congress in London, the two had bolted and sought sanctuary in the American embassy.
Avilov had already selected Harvard, not merely because of the generosity of their offer, which included a lab of his own, but also because of the med school’s reputation for treating infertility. In more than five years of marriage, he and his wife had not been able to achieve a pregnancy.
Now, Adam sat across the desk from the tall, broad-shouldered Russian and his petite, full-breasted wife.
Anya Avilov was beautiful—but not by any conventional standard. She had large, deep-set brown eyes and a cherubic, heart-shaped face. But she obviously paid little attention to her appearance. Her short, dark hair fell carelessly onto her forehead, and she continually swept it back as a kind of nervous tic.
Adam’s patients did not normally radiate optimism. All of them were battered survivors of unsuccessful consultations with other specialists, veterans of countless disappointments. His group was the last port of call before they would be set adrift on a sea of desperation.
But Anya was different. Despite the outward similarity of her history to that of the hundreds of unfortunate wives he had encountered, her expression did not emanate defeat. Anya’s resilient, irrepressible cheerfulness seized his heart
By contrast, her husband was dour and pompous, but Anya tried her best to mitigate this impression by telling lighthearted, mostly self-deprecating, jokes.
This levity made her husband frown.
“Don’t act like child,” he admonished in a loud whisper. “He is world-famous professor.”
“I may be ‘famous,’ ” Adam interposed, “but I’m not allergic to a laugh.” It was his own quiet way of telling Avilov to stop leaning on his wife.
“You have lovely daughter, Dr. Coopersmith,” the Russian woman said, looking at the silver-framed photograph behind Adam’s desk. Her praise was genuine. As was the unmistakable tinge of longing in her voice.
“Thank you,” he replied gently—and self-consciously. He had always debated whether to keep Heather’s photo there, since for many patients it might be a painful reminder of what their own lives lacked.
“Look.” Anya pointed to a portrait of Toni with Heather on a shelf behind the doctor’s desk.
Avilov glanced briefly at it and turned scowling to his wife. “I think we should return to business,” he said sternly. And then, turning to Adam, he demanded, “What do you think are the prospects, Professor?”
Uneasy, Adam shuffled some of the documents and began carefully. “From what I see here, Mrs. Avilov—”
“Actually,” the husband interjected pedantically, “my wife is also Doctor Avilov.”
“Really? What’s your specialty?”
Somewhat embarrassed, Anya answered in English more broken than her husband’s, “Is cruel joke of nature. But in Russia I was trained in genekolog.”
“Oh, I didn’t know I had so charming a colleague. Do you practice here?”
She shook her head. “Not yet. Dmitri does not see patients, so he did not have to take boards. But I have to pass exams for foreign medical graduates, and my English is still very …” She motioned with her hands as if trying to grasp an elusive word.
“Unpolished?” Adam offered tactfully.
Confused, she looked at her husband and asked, “Shto eto?”
“I think Professor Coopersmith is asking if you are Polish,” Dmitri replied.
“No, no,” Adam protested. “I read your records. I can see your wife was born in Siberia.” And then, addressing Anya, he tried to steer the conversation back on course.
“Dr. Avilov, when was your last period?”
“I am sorry to say over six months,” she replied, almost apologetically. And then smiled “You do not have to be genekolog to know this is not very good sign.”
“Well, I’ll grant it isn’t the best condition for someone trying to start a family. But, as you know, amenorrhea can be caused by several factors, some of which are reversible. I suggest you go along to see my colleague Dr. Rosenthal. Hopefully, the trials he’ll run will help us pinpoint the problem.”
“More tests?” Avilov asked irately. “This cannot be. I do not think any couple in the Soviet Union has been poked or prodded or squeezed more than Anya and myself.”
At this point his wife scolded him gently, “Mitya, you know yourself doctors only trust their own labs.” And then she won him over by suggesting, “And no doubt Harvard’s methods are more advanced.”
Avilov capitulated with a melodramatic sigh. “Very well,” he said, standing up, “The eminence of your reputation persuades me, Professor Coopersmith.”
Adam glanced admiringly at Anya and responded, “Your wife’s a good soldier. You’re a very lucky man.”
“Thank you.” She smiled, and turned to her husband. “I hope you remember what he has just told you—and give my opinions more respect.”
Avilov obviously had a riposte for this, but one—it was clear—he would pronounce only after they left Adam’s office.
“I’ll be sure that Dr. Rosenthal sees you at the earliest possible moment. And you, Anya, good luck with your qualifying exams too.”
“First things first,” Dmitri interrupted, wagging an admonitory finger at Adam. “There is no hurry to practice medicine. We must quickly make family.”
At eight o’clock on the evening he received the data, Adam telephoned the Avilovs at their Watertown apartment.
“Hi, Dmitri, this is Adam Coopersmith. Can you put Anya on the other phone?”
“Is not necessary, Professor. Besides,” he added with pointed displeasure, “unlike our flat in Russia, we have only one telephone. They offered me a king’s salary and lodged me in a proletarian dump. I have already complained. Anyway, please tell me your news.”
“Well, Dr. Rosenthal will be calling you at the lab tomorrow, but knowing how anxious you two are, I thought I’d get you both started on the antibiotics right away. I’ve called in a prescription for doxycycline to the Charles Pharmacy—they’re open all night.”
“I don’t understand,” the Russian responded. “What is the infection we are being treated for?”
“The smear we did on Anya showed positive for mycoplasma,” Adam explained. “Understandably, the same was found in your sperm.”
“Oh.” The Soviet scientist’s tone suggested his surprise at being implicated. “So we have a urogenital infection. And will the treatment clear the path for everything, so to speak?”
“Well, it’s too early to say,” Adam hedged. “You two might have been walking around with this for quite a while.”
“From my knowledge of your specialty,” Dmitri said with disappointment, “that could have bad prognosis.”
“But you’ve got a live-in expert in the field,” Adam replied. “Why not consult with Anya on the ramifications of all this?”
At that moment Adam could overhear Anya Avilov’s anxious voice. She was speaking Russian, but he could nonetheless intuit what she was asking in a pleading tone.
What’s going on, Mitya, what did the doctor say?
And though he was no linguist, Adam did understand the one word Dmitri employed in response to his wife: “Nichevo.”
Nothing.
Two weeks later the couple sat once again across from Adam. In the interim they had duly taken their antibiotics and been tested by Dr. Rosenthal’s lab.
“I’m happy to say your mycoplasma is a thing of the past,” Adam announced.
Anya was not totally reassured, although her husband beamed.
“Wonderful, wonderful. Do we therefore have, as you say, a ‘tidy bill of health’?”
Adam continued slowly, “The X rays showed Anya’s tubes were open and the uterus normal—”
“Well,” Avilov interrupted, “how do you explain why she is not getting pregnant?” There was just a hint in his tone that Adam was not using his best efforts.
Knowing that the very name of her condition would be like a dagger in Anya’s heart, he answered as gently as possible.
“As we already knew, your periods are extremely irregular. And the hormone tests they’ve done suggest that you’re not ovulating. I’m afraid we’re dealing with a case of premature ovarian failure.”
“But she is so young,” Dmitri protested.
Adam got the clear impression that the husband’s ire was partially intended as a kind of reprimand for his wife. A suggestion that her unfortunate condition had somehow been a betrayal of him.
Anya covered her face and began to weep. At the same time, she was vaguely struggling to keep some professional distance.
“This happens, Dmitri,” she said between sobs. “It is rare, but it happens. For reasons they do not understand, some of the follicles do not respond to stimulation from the pituitary gland. Therefore, there can be no eggs.”
She looked at her husband, her glance clearly begging for a sign of reassurance. But he remained silent.
It took the Russian several more seconds to realize that Adam was staring angrily at him. Nothing could possibly have been lost in translation. His glare was so intense that it seemed to bear a warning: either you put your arms around her—or I will.
Anxious not to lose face with a colleague, Dmitri slowly turned and placed his hands on Anya’s shoulders.
“Is all right, darling. We could adopt. Important thing is we have each other.”
Though it was spoken in English, Adam did not believe a word.
And neither, it was clear, did Anya.
The barrel-chested Russian rose and his wife slowly followed him.
“I am sorry not to bring you good business,” she said to Adam with a wan smile.
“I beg your pardon?” Adam asked.
“I speak as one genekolog to another. I shall have no babies for you to deliver.”
“In any case, Professor Coopersmith,” Dmitri interrupted manfully, “let me congratulate you on thorough work of diagnosis.” He began to lead his wife toward the door.
“Wait,” Adam protested. “You two should have some counseling. I’d like to—”
“With great respect, Professor,” Dmitri cut him off, “I do not think such measures are indicated. We are scientists—all of us. We deal with facts and we accept them as they are.” Then, turning to his wife, he declared, “We should go.”
After they had left his office, Adam slumped back in his chair and began to brood about all the things that had been left unsaid.
And found himself whispering half aloud, “You arrogant shit, you don’t deserve a woman like that.”