Read A Case of Need Page 8


  “I don’t,” I admitted.

  We drove for a while in silence, then I said, “Can I ask you a favor?”

  “Sure.”

  “Tell me about J. D. Randall.”

  He paused. “Why?”

  “Just curious.”

  “Bullshit.”

  “All right,” I said.

  “They got Lee, didn’t they?” Conway said.

  “Yes.”

  “Did he do it?”

  “No.”

  “Are you sure?”

  “I believe what he tells me,” I said. Conway sighed.

  “John,” he said, “you’re not a fool. Suppose somebody hung this thing on you. Wouldn’t you deny it?”

  “That’s not the question.”

  “Sure it is. Anybody’d deny it.”

  “Isn’t it possible Art didn’t do it?”

  “It’s not merely possible. It’s likely.”

  “Well then?”

  Conway shook his head. “You’re forgetting the way it works. J. D. is a big man. J. D. lost a daughter. There happens to be a convenient Chinaman in the neighborhood, who is known to do the nasty deed. A perfect situation.”

  “I’ve heard that theory before. I don’t buy it.”

  “Then you don’t know J. D. Randall.”

  “That’s true.”

  “J. D. Randall,” Conway said, “is the arch-prick of the universe. He has money and power and prestige. He can have whatever he wants—even a little Chinaman’s head.”

  I said, “But why should he want it?”

  Conway laughed. “Brother, where have you been?”

  I must have looked puzzled. “Don’t you know about…” He paused, seeing that I did not. Then he very deliberately folded his arms across his chest and said nothing. He stared straight ahead.

  “Well?” I said.

  “Better ask Art.”

  “I’m asking you,” I said.

  “Ask Lew Carr,’ Conway said. “Maybe he’ll tell you. I won’t.”

  “Well then,” I said, “tell me about Randall.”

  “As a surgeon.”

  “All right, as a surgeon.”

  Conway nodded. “As a surgeon,” he said, “he isn’t worth shit. He’s mediocre. He loses people he shouldn’t lose. Young people. Strong people.”

  I nodded.

  “And he’s mean as hell. He chews out his residents, puts them through all sorts of crap, keeps them miserable. He has a lot of good young men working under him, and that’s how he controls them. I know; I did two years of thoracic under Randall before I did my cardiac at Houston. I was twenty-nine when I first met Randall, and he was forty-nine. He comes on very strong with his busy manner and his Bond Street suits and his friends with chateaux in France. None of it means he’s a good surgeon, of course, but it carries over. It throws a halo around him. It makes him look good.”

  I said nothing. Conway was warming to his subject, raising his voice, moving his strong hands. I didn’t want him to stop.

  “The trouble,” Conway said, “is that J. D. is in the old line. He started surgery in the forties and fifties, with Gross and Chartriss and Shackleford and the boys. Surgery was different then; manual skill was important and science didn’t really count. Nobody knew about electrolytes or chemistry, and Randall’s never felt comfortable with it. The new boys are; they’ve been weaned on enzymes and serum sodium. But it’s all a troublesome puzzle to Randall.”

  “He has a good reputation,” I said.

  “So did John Wilkes Booth,” Conway said. “For a while.”

  “Do I sense a professional jealousy?”

  “I can cut circles around him with my left hand,” Conway said. “Blindfolded.”

  I smiled.

  “And hung over,” he added. “On a Sunday.”

  “What’s he like personally?”

  “A prick. Just a prick. The residents say he walks around with a hammer in his pocket and a half-dozen nails, just in case he sees the opportunity to crucify somebody.”

  “He can’t be that unpleasant.”

  “No,” Conway admitted. “Not unless he’s in especially good form. Like all of us, he has his off days.”

  “You make him sound very grim.”

  “No worse than the average bastard,” he said. “You know, the residents say something else, too.”

  “Oh?”

  “Yes. They say J. D. Randall likes cutting hearts because he never had one of his own.”

  ELEVEN

  NO ENGLISHMAN IN HIS RIGHT MIND would ever go to Boston, particularly in 1630. To embark on a long sea journey to a hostile wilderness took more than courage, more than fortitude—it required desperation and fanaticism. Above all it required a deep and irreconcilable break with English society.

  Fortunately, history judges men by their actions, not their motivations. It is for that reason that Bostonians can comfortably think of their ancestors as proponents of democracy and freedom, Revolutionary heroes, liberal artists and writers. It is the city of Adams and Revere, a city that still cherishes the Old North Church and Bunker Hill.

  But there is another face to Boston, a darker face, which lies hidden in the pillory, the stocks, the dunking stool, and the witch hunts. Hardly a man now alive can look at these devices of torture for what they are: evidences of obsession, neurosis, and perverse cruelty. They are proofs of a society encircled by fear of sin, damnation, hellfire, disease, and Indians—in roughly that order. A tense, fearful, suspicious society. In short, a society of reactionary religious fanatics.

  There is also a geographical factor, for Boston was once a swamp. Some say this accounts for its outstandingly bad weather and uniformly humid climate; others say it is unimportant.

  Bostonians are inclined to overlook much of the past. Like a slum kid who makes good, the city has swung far from its origins, and attempted to conceal them. As a colony of common men, it has established an untitled aristocracy to rival the most ancient and rigid of Europe. As a city of religion, it has developed a scientific community unrivaled in the East. It is also strongly narcissistic—a trait it shares with another city of questionable origin, San Francisco.

  Unfortunately for both these cities, they can never quite escape their past. San Francisco cannot quite shake off its booming, crude, gold-rush spirit to become a genteel Eastern town. And Boston, no matter how hard it tries, cannot quite elude Puritanism and become English again.

  We are all tied to the past, individually and collectively. The past shows through in the very structure of our bones, the distribution of our hair, and the coloring of our skin, as well as the way we walk, stand, eat, dress—and think.

  I was reminded of this as I went to meet William Harvey Shattuck Randall, student of medicine.

  ANYONE NAMED AFTER WILLIAM HARVEY1 to say nothing of William Shattuck, must feel like a damned fool. Like being named after Napoleon or Cary Grant, it places too great a burden on a child, too much of a challenge. Many things in life are difficult to live down, but nothing is more difficult than a name.

  George Gall is a perfect example. After medical school, where he suffered through countless jokes and puns, he became a surgeon, specializing in liver and gallbladder disease. It was the worst possible thing he could do with a name like that, but he went into it with a strange, quiet certainty, as if it had all been foreordained. In a sense perhaps it had. Years later, when the jokes began to wear very thin, he wished he could change his name, but that was impossible.2

  I doubted that William Harvey Shattuck Randall would ever change his own name. Though a liability, it was also an asset, particularly if he remained in Boston; besides, he seemed to be bearing up well. He was husky and blond and open-faced in a pleasant way. There was an All-American wholesomeness about him which made his room incongruous and faintly ridiculous.

  William Harvey Shattuck Randall lived on the first floor of Sheraton Hall, the medical-school dormitory. Like most rooms in the dorm, his was a single, though r
ather more spacious than most. Certainly more spacious than the fourth-floor pigeonhole I had occupied when I was a student. The top-floor rooms are cheaper.

  They’d changed the paint color since my day. It was dinosaur-egg gray, then; now it was vomit green. But it was still the same old dorm—the same bleak corridors, the same dirty stairs, the same stale odor of sweat socks, textbooks, and hexachlorophene.

  Randall had fixed his room up nicely. The decor was antique; the furniture looked as if it had been bought at a Versailles auction. There was a faded, nostalgic splendor about it, with its tattered red velvet and chipped gilded wood.

  Randall stood back from the door. “Come in,” he said. He didn’t ask who I was. He had taken one look and smelled doctor. You get so you can do it, when you’ve been around them long enough.

  I came into the room and sat down.

  “Is it about Karen?” He seemed more preoccupied than sad, as if he had just returned from something important or were about to leave.

  “Yes,” I said. “I know this is a bad time…”

  “No, go ahead.”

  I lit a cigarette and dropped the match into a gilded Venetian-glass ashtray. It was ugly but expensive.

  “I wanted to talk to you about her.”

  “Sure.”

  I kept waiting for him to ask who I was, but he didn’t really seem to care. He sat down in an arm-chair across from me, crossed his legs, and said, “What do you want to know?”

  “When did you see her last?”

  “Saturday. She came in from Northampton on the bus, and I picked her up at the terminal after lunch. I had a couple of hours free. I drove her out to the house.”

  “How did she seem?”

  He shrugged. “Fine. There was nothing wrong with her, she seemed very happy. Talked all about Smith and her roommate. Apparently she had this wild roommate. And she talked about clothes, that sort of thing.”

  “Was she depressed? Nervous?”

  “No. Not at all. She acted the same as always. Maybe a little excited about coming home after being away. I think she was a little worried about Smith. My parents treat her as the baby of the family, and she thought they didn’t have confidence in her ability to make it. She was a little…defiant, I guess you’d say.”

  “When did you see her before last Saturday?”

  “I don’t know. Not since late August, I guess.”

  “So this was a reunion.”

  “Yes,” he said. “I was always glad to see her. She was very bubbly, with a lot of energy, and she was a good mimic. She could give you an imitation of a professor or a boyfriend and she was hysterical. In fact, that was how she got the car.”

  “The car?”

  “Saturday night,” he said. “We were all at dinner. Karen, myself, Ev, and Uncle Peter.”

  “Ev?”

  “My stepmother,” he said. “We all call her Ev.”

  “So there were five of you?”

  “No, four.”

  “What about your father?”

  “He was busy at the hospital.”

  He said it very matter-of-factly, and I let it drop.

  “Anyway,” William said, “Karen wanted a car for the weekend and Ev refused, saying she didn’t want her to be out all night. So Karen turned to Uncle Peter, who is a softer touch, and asked if she could borrow his car. He was reluctant, so she threatened to imitate him, and he immediately loaned her the car.

  “What did Peter do for transportation?”

  “I dropped him off at his place that night, on my way back here.”

  “So you spent several hours with Karen on Saturday.”

  “Yes. From around one o’clock to nine or ten.”

  “Then you left with your uncle?”

  “Yes.”

  “And Karen?”

  “She stayed with Ev.”

  “Did she go out that night?”

  “I imagine so. That was why she wanted the car.”

  “Did she say where she was going?”

  “Over to Harvard. She had some friends in the college.”

  “Did you see her Sunday?”

  “No. Just Saturday.”

  “Tell me,” I said, “when you were with her—did she look any different to you?”

  He shook his head. “No. Just the same. Of course, she’d put on a little weight, but I guess all girls do that when they go to college. She was very active in the summer, playing tennis and swimming. She stopped that when she got to school, and I guess she put on a few pounds.” He smiled slowly. “We kidded her about it. She complained about the lousy food, and we kidded her about eating so much of it that she still gained weight.”

  “Had she always had a weight problem?”

  “Karen? No. She was always a skinny little kid, a real tomboy. Then she filled out in a real hurry. It was like a caterpillar, you know, and the cocoon.”

  “Then this was the first time she’d ever been overweight?”

  He shrugged. “I don’t know. To tell you the truth, I never paid that much attention.”

  “Was there anything else you noticed?”

  “No, nothing else.”

  I looked around the room. On his desk, next to copies of Robbins’ Pathology and Surgical Anatomy, was a photograph of the two of them. They both looked tanned and healthy. He saw me looking and said, “That was last spring, in the Bahamas. For once the whole family managed to get a week off together. We had a great time.”

  I got up and took a closer look. It was a flattering picture of her. Her skin was darkly tanned, contrasting nicely with her blue eyes and blonde hair.

  “I know it’s a peculiar question,” I said, “but has your sister always had dark hair on her lips and arms?”

  “That was funny,” he said, in a slow voice. “Now that you mention it. She had just a little bit there, on Saturday, Peter told her she’d better bleach it or wax it. She got mad for a couple of minutes, and then she laughed.”

  “So it was new?”

  “I guess so. She might have had it all along, but I never noticed it until then. Why?”

  “I don’t know,” I said.

  He stood and came over to the picture. “You’d never think she would be the type for an abortion,” he said. “She was such a great girl, funny and happy and full of energy. She had a real heart of gold. I know that sounds stupid, but she did. She was kind of the family mascot, being the youngest. Everybody loved her.”

  I said, “Where was she this summer?”

  He shook his head. “I don’t know.”

  “You don’t know?”

  “Well, not exactly. In theory, Karen was on the Cape, working in an art gallery in Provincetown.” He paused. “But I don’t think she was there much. I think she spent most of her time on the Hill. She had some kooky friends there; she collected oddball types.”

  “Men friends? Women friends?”

  “Both.” He shrugged. “But I don’t really know. She only mentioned it to me once or twice, in casual references. Whenever I tried to ask her about it, she’d laugh and change the subject. She was very clever about discussing only what she wanted to.”

  “Did she mention any names?”

  “Probably, but I don’t remember. She could be maddening about names, talking about people casually as if you knew them intimately. Using just their first names. It was no good reminding her that you’d never heard of Herbie and Su-su and Allie before.” He laughed. “I do remember she once did an imitation of a girl who blew bubbles.”

  “But you can’t remember any names?”

  He shook his head. “Sorry.”

  I stood to go. “Well,” I said, “you must be very tired. What are you on these days?”

  “Surgery. We just finished OB-GYN.”

  “Like it?”

  “It’s O.K.,” he said blandly.

  As I was leaving, I said, “Where did you do your OB?”

  “At the BLI.” He looked at me for a moment and frowned. “And to answer your
question, I assisted on several. I know how to do one. But I was on duty at the hospital Sunday night. All night long. So there it is.”

  “Thanks for your time,” I said.

  “Sure,” he said.

  AS I LEFT THE DORMITORY, I saw a tall, lean, silver-haired man walking toward me. Of course I recognized him, even from a distance.

  J. D. Randall was, if nothing else, distinctive.

  The English court physician who, in 1628, discovered that blood circulated in a closed loop.

  A doctor cannot change his name after receiving his M.D. degree without invalidating that degree. This means that there is a great rush in the final weeks of med school among doctors flocking into court to change their names before they receive their diplomas.

  TWELVE

  THE SUN WAS SETTING, and the light on the quadrangle was turning yellow-gold. I lit a cigarette and walked up to Randall. His eyes widened slightly as he saw me, and then he smiled.

  “Dr. Berry.”

  Very friendly. He held out his hand. I shook it: dry, clean, scrubbed to two inches above the elbow for ten minutes. A surgeon’s hand.

  “How do you do, Dr. Randall.”

  He said, “You wanted to see me?”

  I frowned.

  “My secretary,” he said, “told me you had stopped by my office. About the chart.”

  “Oh, yes,” I said, “the chart.”

  He smiled benignly. He was half a head taller than I. “I think we had better clear up a few things.”

  “All right.”

  “Come with me.”

  He didn’t intend it as a command, but it came out that way. I was reminded that surgeons were the last autocrats in society, the last class of men who were given total control over a situation. Surgeons assumed the responsibility for the welfare of the patient, the staff, everything.

  We walked back toward the parking lot. I had the feeling that he had come especially to see me. I had no idea how he knew I was there, but the feeling was very strong. As he walked, he swung his arms loosely at his sides. For some reason, I watched them; I remembered the neurologist’s law of swinging arms.1 I saw his hands, which were huge, all out of proportion to the rest of his body, huge hands, thick and hairy and red. His nails were trimmed to the required one-millimeter surgical length. His hair was cut short and his eyes were cold, gray, and businesslike.