Table of Contents
Praise for Doctors and Erich Segal
Also by Erich Segal
Title Page
Copyright
Dedication
Epigraph
Prologue
1. Innocence
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
2. Becoming Doctors
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
3. Being Doctors
Chapter 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Chapter 42
Chapter 43
Chapter 44
Chapter 45
Chapter 46
Chapter 47
Chapter 48
Chapter 49
Chapter 50
Chapter 51
Chapter 52
Chapter 53
Chapter 54
Chapter 55
Chapter 56
Acknowledgments
About the Author
Praise for Doctors and Erich Segal
‘Inspires us to understand the moral dilemmas that plague medics’
The Sunday Times
‘A page-turner all the way’
USA Today
‘An enormous hit’
Evening Standard
‘What a rare storyteller.’
Detroit News
‘Funny, touching, and infused with wonder, as all love stories should be.’
San Francisco Examiner
‘[A] master storyteller’
Daily Express
‘A lump forms in the throat and starts growing until it feels like a football coming up sideways. You either fight it or let it out.’
New York Times
‘Beautifully written … profoundly moving’
Sunday Express
Also by Erich Segal
Love Story
Oliver’s Story
Man, Woman and Child
The Class
Acts of Faith
Prizes
Only Love
DOCTORS
Erich Segal
www.hodder.co.uk
First published in Great Britain in 1998 by Bantam Press
A division of Transworld Publishers Ltd
This edition published by Hodder & Stoughton in 2013
An Hachette UK company
Copyright © Karen Segal 1998
The right of Erich Segal to be identified as the Author of the Work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition being imposed on the subsequent purchaser.
All characters in this publication are fictitious and any resemblance to real persons, living or dead is purely coincidental.
A CIP catalogue record for this title is available from the British Library
ISBN 978 1 444 76845 9
Hodder & Stoughton Ltd
338 Euston Road
London NW1 3BH
www.hodder.co.uk
For Karen and Francesca
‘The most fundamental principle of Medicine is love.’
PARACELSUS (1493–1541)
The Great Art of Surgery
‘We have turned doctors into gods and worship their deity by offering up our bodies and our souls – not to mention our worldly goods.
‘And yet paradoxically, they are the most vulnerable of human beings. Their suicide rate is eight times the national average. Their percentage of drug addiction is one hundred times higher.
‘And because they are painfully aware that they cannot live up to our expectations, their anguish is unquantifiably intense. They have aptly been called “wounded healers”.’
BARNEY LIVINGSTON, M.D.
Doctors
‘… the United States loses the equivalent of seven medical-school graduating classes each year to drug addiction, alcoholism, and suicide.’
DAVID HILFIKER, M.D.
Healing the Wounds
Prologue
With a single exception they were all white. And with five exceptions all male.
Some were brilliant bordering on genius. Others, genius bordering on madness. One had played a cello recital at Carnegie Hall, another had played a year of professional basketball. Six had written novels, two of which had actually been published. One was a lapsed priest. One was a graduate of reform school. All were scared to death.
What had brought them together on this bright September morning in 1958 was their common status as first-year students at Harvard Medical School. They had gathered in Room D to hear a welcoming address by Dean Courtney Holmes.
His features could have come straight from a Roman coin. And his demeanor gave the impression that he had been born with a gold watch and chain instead of an umbilical cord.
He did not have to call for quiet. He merely smiled and the spectators hushed.
‘Gentlemen,’ he began, ‘you are collectively embarking on a great voyage to the frontiers of medical knowledge – which is where you will begin your own individual explorations in the yet-uncharted territory of suffering and disease. Someone sitting in this room may find a cure for leukemia, diabetes, systemic lupus erythematosus and the deadly hydraheaded carcinomas …’
He took a perfectly timed dramatic pause. And with a sparkle in his pale blue eyes he added, ‘Perhaps even the common cold.’
There was appreciative laughter.
Then the silver-haired dean lowered his head, perhaps to signify that he was deep in thought. The students waited in suspense.
When at last he looked up and began to speak again, his voice was softer, an octave lower.
‘Let me conclude by disclosing a secret – as humbling for me to reveal as for you to hear.’
He turned and wrote something on the blackboard behind him.
Two simple digits – the number twenty-six.
A buzz of bewilderment filled the room.
Holmes waited for quiet to return, drew breath, and then gazed straight into the spellbound auditorium.
‘Gentlemen, I urge you to engrave this on the template of your memories: there are thousands of diseases in this world, but Medical Science only has an empirical cure for twenty-six of them. The rest is … guesswork.’
And that was all.
With military posture and athletic grace, he strode off the podium and out of the room.
The crowd was too dazzled to applaud.
1
INNOCENCE
‘They enter the new world naked, cold, uncertain of all save that they enter …
‘But now the stark dignity of entrance – Still,
the profound change has come upon them: rooted, they grip down and begin to awaken.’
WILLIAM CARLOS WILLIAMS (1883–1963)
Pediatrician and poet
1
Barney Livingston was the first boy in Brooklyn to see Laura Castellano naked.
One August morning in the summer he turned five, he wandered into his backyard and was saluted by an unfamiliar voice.
‘Hi.’
He glanced toward the neighboring garden. Peering over the fence was a blond little girl who looked about his age. He felt a twinge of nostalgia for the previous occupants, who had included a terrific punchball player named Murray. And from what he’d heard, these new people didn’t even have a boy.
Barney was therefore surprised when, after introducing herself, Laura suggested they play catch. He shrugged a sort of dubious okay, and went to get his Spauldeen.
When he returned a moment later clutching a small rubber ball, pink as Bazooka bubble gum, she was standing in the middle of his garden.
‘How did you get here?’ he asked.
‘I climbed over the fence,’ she answered nonchalantly. ‘Okay, vámonos, throw me a high one.’
Understandably, Barney was slightly off balance and bobbled the ball that Laura had deftly caught and vigorously tossed back. For he was still disconcerted by the fact that Murray had been seven years old and still had needed assistance to get over the fence, whereas this Laura had apparently vaulted it with ease.
After an energetic half hour, Barney decided that Laura had satisfactorily filled Murray’s shoes (sneakers, actually). He reached into his pocket and produced a pack of cigarettes labeled ‘Lucky Stripe.’ and offered one to her.
‘No, thanks,’ she responded, ‘my father says I have an allergy to chocolate.’
‘What’s an allergy?’
‘I’m not sure,’ she confessed. ‘We’d better ask my papacito. He’s a doctor.’
And then the inspiration struck her. ‘Hey, why don’t we play Doctor and Patient.’
‘How does that go?’
‘Well, first I “esamen” you, then you “esamen” me.’
‘Sounds kinda boring.’
‘We would have to take our clothes off—’
‘Yeah?’ Maybe this could be interesting after all.
Office hours were held beneath a venerable oak tree in the far corner of the Livingston garden. Laura instructed Barney to remove his striped polo shirt so she could establish that her patient’s chest was sound. This was accomplished by means of an imaginary stethoscope.
‘Now take off your pants.’
‘Why?’
‘Come on, Barney, play the game!’
With some reluctance, he stepped out of his blue shorts and stood there in his underpants, beginning to feel silly.
‘Take that off, too,’ the young physician ordered.
Barney glanced furtively over his shoulder to see if anyone might be watching from the house and then removed his final garment.
Laura looked him over carefully, giving special attention to the tiny pendant between his legs.
‘That’s my faucet,’ he explained with a touch of pride.
‘It looks more like a penis,’ she replied with clinical detachment. ‘Anyhow, you’re okay. You can get dressed.’
As he eagerly obliged, Laura inquired, ‘Want to play something else now?’
‘No fair – now it’s my turn to be the doctor.’
‘Okay.’
In an instant she had disrobed completely.
‘Wow, Laura – what happened to your … you know …’
‘I don’t have one,’ she answered somewhat wistfully.
‘Oh gee, why not?’
At this moment a strident voice interrupted the consultation.
‘Baaar-ney! Where are you?’
It was his mother at the back door. He hastily excused himself and peered around the tree trunk. ‘I’m here, Mom.’
‘What are you doing?’
‘Playing – with someone.’
‘Who?’
‘A girl called Laura from next door.’
‘Oh, the new family. Ask her if she wants cookies and milk.’
An impish face popped out from its arboreal concealment. ‘What kind of cookies?’ Laura asked cheerfully.
‘Oreos and Fig Newtons,’ Mrs Livingston said, smiling. ‘My, aren’t you a sweet little girl.’
Theirs was a childhood paradise called Brooklyn, filled with joyous sounds: the clang of trolleys blending with the tinkle of the bells from the Good Humor Man’s chariot of frozen fantasies. And most of all, the laughter of the children playing stickball, punchball – even hockey games on roller skates – right in the streets.
The Brooklyn Dodgers weren’t just a baseball team, they were a cast of characters – a Duke, a Pee Wee, and a Preacher pitching on the mound. They even had a guy who could run faster than you said his name: Jack Robinson.
They gave their hearts for Brooklyn.
So who cared if they could never beat the New York Yankees?
But not in 1942, for the Americans were still waging war on three fronts: in Europe against the Nazis, in the Pacific against the hordes of Tojo, and at home against the OPA. This was the body President Roosevelt established to ration the civilian supply of essential items to make sure the GIs had the best of everything.
Thus while Field Marshal Montgomery was engaging Rommel at El Alamein, and Major General Jimmy Doolittle was bombing Tokyo, back in Brooklyn Estelle Livingston was battling to get extra meat stamps to ensure the health and growth of her two sons.
Her husband, Harold, had been called up one year earlier. A high school Latin teacher, he was now at a military base in California learning Japanese. All he could tell his family was that he was in something called ‘Intelligence.’ That was very appropriate, Estelle explained to her two young sons, since their father was, in fact, very, very intelligent.
For some unexplained reason, Laura’s father, Dr Luis Castellano, had not been drafted at all.
‘Is Laura nice, Barney?’ Estelle asked as she tried to coax yet another forkful of Spam into her elder son’s mouth.
‘Yeah, she’s okay for a girl. I mean, she can even catch a ball. Talks kinda funny though.’
‘That’s because the Castellanos are from Spain, dear. They had to run away.’
‘Why?’
‘Because the bad people called Fascists didn’t like them. That’s why Daddy is in the Army. To fight the Fascists.’
‘Does Daddy have a gun?’
‘I don’t know. But I’m sure if he needs one, President Roosevelt will see that he gets it.’
‘Good – then he can shoot all the bad guys in the penis.’
A librarian by profession, Estelle was all in favor of enriching her son’s vocabulary. But she was taken aback by his newest verbal acquisition.
‘Who told you about penises, dear?’ she asked as matter-of-factly as she could.
‘Laura. Her dad’s a doctor. She doesn’t have one, though.’
‘What, dear?’
‘Laura doesn’t have a penis. At first I didn’t believe her, but she showed me.’
Estelle was at a loss for words. She merely stirred young Warren’s cereal and wondered how much he already knew. With time, Barney and Laura went on to better games. Like Cowboys and Indians or Gls and Jerries (or Japs), democratically changing from goodies to baddies with each passing summer day.
A year went by. The Allied troops were now invading Italy and the Yanks in the Pacific were reconquering the Solomon Islands. Late one night Barney’s brother, Warren, woke up screaming, with a fever of a hundred and three. Fearing the worst – the dreaded summer scourge, infantile paralysis – Estelle quickly wrapped the perspiring little boy in a bath towel and carried him down the front steps and over to Dr Castellano. Barney, confused and frightened, followed a step behind.
Luis was still awake, reading a medical journal in his cluttered little study, and r
ushed to wash before beginning an examination. His big hairy hands were surprisingly swift and gentle. Barney watched in awe as the doctor looked down Warren’s throat, then listened to his chest, all the while trying to calm the sick child.
‘Is okay,’ he kept whispering, ‘just breathe in and out for me, yes niño?’ Meanwhile, Inez Castellano hurried to fetch cold water and a sponge.
Estelle stood mute with terror, Barney clinging to the folds of her flowered bathrobe. She finally found the courage to ask, ‘Is it – you know … ?
‘Cálmate, Estella, is not polio. Look at the scarlatiniform eruption on his chest – and especially the enlarged red papillae on his tongue. Is called “strawberry tongue”. The boy has scarlet fever.’
‘But that’s still serious—’
‘Yes, so we must get someone to prescribe a sulfa drug like Prontosil.’
‘Can’t you – ?’
Clenching his teeth, Luis replied, ‘I am not permitted to write prescriptions. I have no license to practice in this country. Anyway, vámonos. Barney will stay here while we take a taxi to the hospital.’
During the cab ride, Luis held little Warren, dabbing his neck and forehead with a sponge. Estelle was reassured by his confident manner yet still puzzled by what he had told her.
‘But Luis, I thought you were a doctor. I mean, you work at the hospital, don’t you?’
‘In the laboratory – doing blood and urine tests.’ He paused and then added, ‘In my country I was a physician – I think a good one. Five years ago when we first came, I studied English like a crazy man, reread all the textbooks, and passed the examinations. But still the State Board refused to license me. Apparently, to them I am a dangerous alien. I belonged to the wrong party in Spain.’
‘But you were fighting against the Fascists.’
‘Yes, but I was a Socialist – something also sospechoso in America.’
‘That’s outrageous.’
‘Bueno – it could be worse.’
‘I don’t see how.’
‘I could have been caught by Franco.’
At the hospital, Luis’s diagnosis was immediately confirmed and Warren given the medication he suggested. Nurses then bathed him with alcohol-soaked sponges to bring down his fever. By 5.30 A.M., he was pronounced well enough to go home. Luis escorted Estelle and the boy to a cab.