Blood Test

“Officially just a couple of days. A local G.P. picked up the distended abdomen on exam. There’d been pain for a couple of weeks and fevers for the last five days. The G.P. had sneaking suspicions — not bad for a country doc — didn’t like the local facilities and sent them up here. We had to do an extensive eval — repeat physical, bloodwork, BUN, uric acid, bone marrows from two sites, immunodiagnostic markers — the non-Hodgkin’s protocol demands it. It wasn’t until a couple of days ago that we had it staged. Localized disease, no disseminated mets.

“I had a diagnostic conference with the parents, told them the prognosis was good because the tumors hadn’t spread, they filled out informed consents, and we were ready to go. The boy has a recent history of multiple infections and there was pneumocystis swimming around in his blood so we put him in Laminar Flow, planned to keep him there for the first course of chemo, and then check how the immune system was working. It looked open and shut and then I got a call from Augie Valcroix, my clinical Fellow — I’ll get to him in a minute — and he told me the parents were having cold feet.”

“No indication of problems when you first spoke to them?”

“Not really, Alex. The father does all the talking in this family. She sat there and wept, I did my best to comfort her. He asked lots of picky questions — like I said, he was trying to impress — but it was all very friendly. They seemed like intelligent people, not flaky.”

He shook his head in frustration.

“After Valcroix’s call I went right over, talked to them, thinking it was momentary anxiety — you know sometimes parents hear about treatment and get the idea we’re out to torture their child. They start looking for something simple, like apricot pits. If the doctor takes the time to explain the value of chemo, they usually return to the fold. But not the Swopes. They had their minds made up.

“I used a chalkboard. Drew out the survival graphs — that eighty-one percent stat I gave you was for localized disease. Once the tumors spread the figure drops to forty-six. It didn’t impress them. I told them speed was of the essence. I laid on the charm, cajoled, pleaded, shouted. They didn’t argue. Simply refused. They want to take him home.”

He tore a roll to shreds and arranged the fragments in a semicircle on his plate.

“I’m going to have eggs,” he announced.

He beckoned the waitress back. She took the order and gave me a look behind his back that said I’m used to this.

“Any theory as to what caused the turnaround?” I asked.

“I have two. One, Augie Valcroix mucked it up. Two, those damned Touchers poisoned the parents’ minds.”

“Who?”

“Touchers. That’s what I call them. Members of some damned sect that has its headquarters near where the family lives. They worship this guru named Noble Matthias — that’s what the social worker told me — and call themselves the Touch.” Raoul’s voice filled with contempt. “Madre de Dios, Alex, California has become a sanctuary for the psychic refuse of the world!”

“Are they holistic types?”

“The social worker says yes — big surprise, no? Assholistic is more like it. Cure disease with carrots and bran and foul-smelling herbs thrown over the shoulder at midnight. The culmination of centuries of scientific progress — voluntary cultural regression!”

“What did these Touch people do, exactly?”

“Nothing I can prove. But all I know is things were going smoothly, the consents were signed, then two of them — a man and a woman — visited the parents and disaster!”

A plate heaped with scrambled eggs arrived along with a dish of yellow sauce. I remembered his affection for hollandaise. He poured the sauce on the eggs and used his fork to divide the mound into three sections. The middle segment was consumed first, followed by the one on his right, and finally the left third disappeared. More dabbing, more imaginary crumb disposal.

“What does your Fellow have to do with it?”

“Valcroix? Probably plenty. Let me tell you about this character. On paper he looked great — M.D. from McGill — he’s a French-Canadian — internship and residency at Mayo, a year of research at Michigan. He’s close to forty, older than most applicants, so I thought he’d be mature. Ha! When I interviewed him I talked to a well-groomed, intelligent man. What showed up six months later was an aging flower child.

“The man is bright but he’s unprofessional. He talks and dresses like an adolescent, tries to get down to the patients’ level. The parents can’t relate to him and eventually the kids see through it, too. There are other problems, as well. He’s slept with at least one mother of a patient that I know about and I suspect there’ve been several others. I chewed him out and he looked at me as if I were crazy to be worried about it.”

“A little loose in the ethics department?”