Terminal (A Medical Thriller)
Terminal: Chapter 1

February 26

Friday, 9:15 A.M.

“Oh, God, here she comes!” Sean Murphy said. Frantically he grabbed the charts stacked in front of him and ducked into the room behind the nurses’ station on the seventh floor of the Weber Building of the Boston Memorial Hospital.

Confused at this sudden interruption, Peter Colbert, a fellow third-year Harvard medical student, surveyed the scene. Nothing was out of the ordinary. It appeared like any busy internal medicine hospital ward. The nurses’ station was a beehive of activity with the floor clerk and four RN’s busy at work. There were also several orderlies pushing patients on gurneys. Organ music from the soundtrack of a daytime soap could be heard drifting out of the floor lounge. The only person approaching the nurses’ station who didn’t belong was an attractive female nurse who Peter felt was an eight or nine out of a possible ten. Her name was Janet Reardon. Peter knew about her. She was the daughter of one of the old Boston Brahmin families, aloof and untouchable.

Peter pushed back from the counter where he had been sitting next to the chart rack and shoved open the door to the back room. It was an all-purpose office with desk-high countertops, a computer terminal, and a small refrigerator. The nurses held their reports in there at the end of each shift, and those who brown-bagged it used it as a lunchroom. In the back was a lavatory.

“What the hell’s going on?” Peter demanded. He was curious to say the least. Sean was against the wall with his charts pressed to his chest.

“Shut the door!” Sean commanded.

Peter stepped into the room. “You’ve been making it with Reardon?” It was part question, part stunned realization. It had been almost two months ago at the outset of Peter’s and Sean’s rotation on third-year medicine that Sean had spotted Janet and had asked Peter about her.

“Who the hell is that?” Sean had demanded. His mouth had gone slack. In front of him was one of the most beautiful women he’d ever seen. She was climbing down from the counter after retrieving something from the inaccessible top shelf of a wall cabinet. He could tell she had a figure that could have graced any magazine.

“She’s not your type,” Peter had said. “So close your mouth. Compared to you she’s royalty. I know some guys who have tried to date her. It’s impossible.”

“Nothing is impossible,” Sean had said, watching Janet with stunned appreciation.

“A townie like you could never get to first base,” Peter had said. “Much less hit a home run.”

“Want to bet?” Sean had challenged. “Five bucks says you are wrong. I’ll have her thirsting for my body by the time we finish medicine.”

At the time, Peter had just laughed. Now he appraised his partner with renewed respect. He thought he’d gotten to know Sean over the last two months of grueling work, and yet here he was on the last day of medicine surprising him.

“Open the door a crack and see if she’s gone,” Sean said.

“This is ridiculous,” Peter said, but he opened the door several inches nonetheless. Janet was at the counter talking to Carta Valentine, the head nurse. Peter let the door shut.

“She’s right outside,” he said.

“Damn!” Sean exclaimed. “I don’t want to talk to her right now. I’ve got too much to do, and I don’t want a scene. She doesn’t know I’m leaving for Miami for that elective at the Forbes Cancer Center. I don’t want to tell her until Saturday night. I know she’s going to be pissed.”

“So you have been dating her?”

“Yeah, we’ve gotten pretty hot and heavy,” Sean said. “Which reminds me: you owe me five bucks. And let me tell you, it wasn’t easy. At first she’d barely talk to me. But eventually, utter charm and persistence paid off. My guess is that it was mostly the persistence.”

“Did you bag her?” Peter asked.

“Don’t be crude,” Sean said.

Peter laughed. “Me crude? That’s the best example of the pot calling the kettle black that I’ve ever heard.”

“The problem is she’s getting serious,” Sean said. “She thinks because we slept together a couple of times, it’s leading to something permanent.”

“Am I hearing marriage here?” Peter asked.

“Not from me,” Sean said. “But I think that’s what she has in mind. It’s insane, especially since her parents hate my guts. And hell, I’m only twenty-six.”

Peter opened the door again. “She’s still there talking with one of the other nurses. She must be on break or something.”

“Great!” Sean said sarcastically. “I guess I can work in here. I’ve got to get these off-service notes written before I get another admission.”

“I’ll keep you company,” Peter said. He went out and returned with several of his own charts.

They worked in silence, using the three-by-five index cards they carried in their pockets bearing the latest laboratory work on each of their assigned patients. The idea was to summarize each case for the medical students rotating on service come March 1.

“This one has been my most interesting case,” Sean said after about half an hour. He held the massive chart aloft. “If it hadn’t been for her I wouldn’t even have heard about the Forbes Cancer Center.”

“You talking about Helen Cabot?” Peter asked.

“None other,” Sean said.

“You got all the interesting cases, you dog. And Helen’s a looker, too. Hell, on her case consults were pleading to be called.”

“Yeah, but this looker turned out to have multiple brain tumors,” Sean said. He opened the chart and glanced through some of its two hundred pages. “It’s sad. She’s only twenty-one and she’s obviously terminal. Her only hope is that she gets accepted by the Forbes. They have been having phenomenal luck with the kind of tumor she has.”

“Did her final pathology report come back?”

“Yesterday,” Sean said. “She’s got medulloblastoma. It’s fairly rare; only about two percent of all brain tumors are this type. I did some reading on it so I could shine on rounds this afternoon. It’s usually seen in young children.”

“So she’s an unfortunate exception,” Peter commented.

“Not really an exception,” Sean said. “Twenty percent of medulloblastomas are seen in patients over the age of twenty. What surprised everyone and why no one even came close to guessing the cell type was because she had multiple growths. Originally her attending thought she had metastatic cancer, probably from an ovary. But he was wrong. Now he’s planning an article for the New England Journal of Medicine.”

“Someone said she was not only beautiful but wealthy,” Peter said, lamenting anew he’d not gotten her as a patient.

“Her father is CEO of Software, Inc.,” Sean said. “Obviously the Cabots aren’t hurting. With all their money, they can certainly afford a place like the Forbes. I hope the people in Miami can do something for her. Besides being pretty, she’s a nice kid. I’ve spent quite a bit of time with her.”

“Remember, doctors are not supposed to fall in love with their patients,” Peter said.

“Helen Cabot could tempt a saint.”

JANET REARDON took the stairs back to pediatrics on the fifth floor. She’d used her fifteen-minute coffee break trying to replace Sean. The nurses on seven said they’d just seen him, working on his off-service notes, but had no idea where he’d gone.

Janet was troubled. She hadn’t been sleeping well for several weeks, waking at four or five in the morning, way before her alarm. The problem was Sean and their relationship. When she’d first met him, she’d been turned off by his coarse, cocky attitude, even though she had been attracted by his appealing Mediterranean features, black hair, and strikingly blue eyes. Before she’d met Sean she hadn’t known what the term “Black Irish” meant.

When Sean had initially pursued her, Janet had resisted. She felt they had nothing in common, but he refused to take no for an answer. And his keen intelligence pricked her curiosity.

She finally went out with him thinking that one date would end the attraction. But it hadn’t. She soon discovered that his rebel’s attitude was a powerful aphrodisiac. In a surprising about-face, Janet decided that all her previous boyfriends had been too predictable, too much the Myopia Hunt Club crowd. All at once she realized that her sense of self had been tied to an expectation of a marriage similar to her parents’ with someone conventionally acceptable. It was then that Sean’s Charlestown rough appeal had taken a firm hold on her heart, and Janet had fallen in love.

Reaching the nurses’ station on the pediatric floor, Janet noticed she still had a few minutes left on her break. Pushing through the door to the back room, she headed for the communal coffee machine. She needed a jolt to get her through the rest of the day.

“You look like you just lost a patient,” a voice called.

Janet turned to see Dorothy MacPherson, a floor nurse with whom she’d become close, sitting with her stockinged feet propped upon the countertop.

“Maybe just as bad,” Janet said as she got her coffee. She only allowed herself half a cup. She went over and joined Dorothy. She sat heavily in one of the metal desk chairs. “Men!” she added with a sigh of frustration.

“A familiar lament,” Dorothy said.

“My relationship with Sean Murphy is not going anywhere,” Janet said at length. “It’s really bothering me, and I have to do something about it. Besides,” she added with a laugh, “the last thing I want to do is to be forced to admit to my mother that she’d been right about him all along.”

Dorothy smiled. “I can relate to that.”

“It’s gotten to the point that I think he’s avoiding me,” Janet said.

“Have you two talked?” Dorothy asked.

“I’ve been trying,” Janet said. “But talking about feelings is not one of his strong points.”

“Regardless,” Dorothy said. “Maybe you should take him out tonight and say what you’ve just said to me.”

“Ha!” Janet laughed scornfully. “It’s Friday night. We can’t.”

“Is he on call?” Dorothy asked.

“No,” Janet said. “Every Friday night he and his Charlestown buddies get together at a local bar. Girlfriends and wives are not invited. It’s the proverbial boys’ night out. And in his case, it’s some kind of Irish tradition, complete with brawls.”

“Sounds disgusting,” Dorothy said.

“After four years at Harvard, a year of molecular biology at MIT, and now three years of medical school, you’d think he’d have outgrown it. Instead, these Friday nights seem to be more important to him than ever.”

“I wouldn’t stand for it,” Dorothy said. “I used to think my husband’s golf fetish was bad, but it’s nothing compared to what you’re talking about. Are there women involved in these Friday night escapades?”

“Sometimes they go up to Revere. There’s a strip joint there. But mostly it’s just Sean and the boys, drinking beer, telling jokes, and watching sports on a big-screen TV. At least that’s how he’s described it. Obviously I’ve never been there.”

“Maybe you should ask yourself why you’re involved with this man,” Dorothy said.

“I have,” Janet said. “Particularly lately, and especially since we’ve had so little communication. It’s hard even to replace time to talk with him. Not only does he have all the work associated with med school, but he has his research too. He’s in an M.D.-Ph.D. program at Harvard.”

“He must be intelligent,” Dorothy offered.

“It’s his only saving grace,” Janet said. “That and his body.”

Dorothy laughed. “At least there’s a couple of things to justify your anguish. But I wouldn’t let my husband get away with that juvenile Friday night stuff. Hell, I’d march right in and embarrass the heck out of him. Men will be boys, but there have to be some limits.”

“I don’t know if I could do that,” Janet said. But as she took a sip from her coffee, she gave the idea some thought. The problem was that she’d always been so passive in her life, letting things happen, then reacting after the fact. Maybe that’s how she got herself into this kind of trouble. Maybe she needed to encourage herself to be more assertive.

“DAMN IT, MARCIE!” Louis Martin shouted. “Where the hell are those projections? I told you I wanted them on my desk.” To emphasize his displeasure, Louis slapped his hand on his leather-bound blotter, sending a flurry of papers wafting off into the air. He had been feeling irritable ever since he’d awakened at four-thirty that morning with a dull headache. While in the bathroom searching for aspirin, he’d vomited into the sink. The episode had shocked him. His retching had come with no warning and no accompanying nausea.

Marcie Delgado scurried into her boss’s office. He’d been yelling at her and criticizing her all morning. Meekly she reached across the desk and pushed a stack of papers bound with a metal clip directly in front of the man. In block letters on the front cover was: PROJECTIONS FOR BOARD MEETING FEBRUARY 26.

Without even an acknowledgment, much less an apology, Louis snatched up the documents and stormed out of the office. But he didn’t get far. After half a dozen steps, he couldn’t recall where he was going. When he finally remembered he was headed for the boardroom, he wasn’t sure which door it was.

“Good afternoon, Louis,” one of the directors said, coming up behind him and opening the door on the right.

Louis stepped into the room feeling disoriented. He hazarded a furtive glance at the people sitting around the long conference table. To his consternation, he was unable to recognize a single face. Lowering his eyes to stare at the packet of papers he’d carried in with him, he let them slip from his grasp. His hands were shaking.

Louis Martin stood for another moment while the babble of voices in the room quieted. All eyes were drawn to his face, which had turned ghostly pale. Then Louis’s eyes rolled up inside his head, and his back arched. He fell backward, his head striking the carpeted floor with a dull thump. Simultaneous with the impact on the floor, Louis’s body began to tremble before being overwhelmed by wild tonic and clonic muscular contractions.

None of Louis’s board of directors had ever seen a grand mal seizure, and for a moment they were all stunned. Finally, one man overcame his shock and rushed to the side of his stricken chairman. Only then did others respond by racing off to nearby telephones to call for help.

By the time the ambulance crew arrived, the seizure had passed. Except for a residual headache and lethargy, Louis felt relatively normal. He was no longer disoriented. In fact, he was dismayed to be told he’d had a seizure. As far as he was concerned, he’d only fainted.

The first person to see Louis in the emergency room at the Boston Memorial Hospital was a medical resident who introduced himself as George Carver. George seemed harried but thorough. After conducting a preliminary examination he told Louis that he would have to be admitted even though Louis’s private internist, Clarence Handlin, had not yet been consulted.

“Is a seizure serious?” Louis asked. After his prostate operation two months earlier, Louis was not happy about the prospect of being hospitalized.

“We’ll get a neurology consult,” George said.

“But what’s your opinion?” Louis asked.

“Seizures with sudden onset in an adult suggests structural brain disease,” George said.

“How about talking English,” Louis said. He hated medical jargon.

The resident fidgeted. “Structural means exactly that,” he said evasively. “Something abnormal with the brain itself, not just its function.”

“You mean like a brain tumor?” Louis asked.

“It could be a tumor,” George said reluctantly.

“Good Lord!” Louis said. He felt himself break out in a cold sweat.

After calming the patient the best he could, George went into the “pit,” as the center of the emergency room was called by those that worked there. First he checked to see if Louis’s private physician had called in yet. He hadn’t. Then he paged a neurology resident stat. He also told the ER clerk to call the medical student who was up for the next admission.

“By the way,” George said to the clerk as he was returning to the cubicle where Louis Martin was waiting. “What’s the name of the medical student?”

“Sean Murphy,” the clerk said.

“CRAP!” SEAN said as his beeper went off. He was certain that Janet had long since disappeared, but just to be sure, he opened the door carefully and scanned the area. He didn’t see her, so he pushed through. He had to use the phone out in the nurses’ station since Peter was hogging the one in the back room, trying to get last-minute lab reports.

Before Sean called anybody, he approached Carla Valentine, the head nurse. “You guys looking for me?” he asked expectantly. He was hoping they were because then the page would involve some easily performed scut work. What Sean feared was that the page was coming from either admitting or the ER.

“You’re all clear for the moment,” Carla said.

Sean then dialed the operator and got the bad news. It was the ER with an admission.

Knowing the sooner he got the history and physical done, the better off he’d be, Sean bid farewell to Peter, who was still on the phone, and went downstairs.

Under normal circumstances Sean liked the ER and its constant sense of excitement and urgency. But on the afternoon of his last day on his medicine rotation, he didn’t want another case. The typical Harvard medical student’s workup took hours and filled between four and ten pages of tightly written notes.

“It’s an interesting case,” George said when Sean arrived. George was on hold on the phone with radiology.

“That’s what you always say,” Sean said.

“Truly,” George said. “Have you ever seen papilledema?”

Sean shook his head.

“Grab an ophthalmoscope and look at the guy’s nerve heads in both eyes. They’ll look like miniature mountains. It means the intracranial pressure is elevated.” George slid the ER clipboard along the countertop toward Sean.

“What’s he got?” Sean asked.

“My guess is a brain tumor,” George said. “He had a seizure at work.”

At that moment someone came on the phone line from radiology, and George’s attention was directed at scheduling an emergency CAT scan.

Sean took the ophthalmoscope and went in to see Mr. Martin. Sean was far from adept at using the instrument, but after persistence on his part and patience on Louis’s part, he was able to catch fleeting glimpses of the mounded nerve heads.

Doing a medical student history and physical was a laborious task under the best of circumstances, and doing it in the emergency room and then up in X-ray while waiting for a CAT scan made it ten times more difficult. Sean persisted, asking as many questions as he could think of, especially about the current illness. What Sean learned that no one else had was that Louis Martin had had some transient headache, fever, and nausea and vomiting about a week after his prostate surgery in early January. Sean had stumbled onto this information just before Louis began his enhanced CAT scan. The technician had to order Sean out of the CAT scanner room and into the control room moments before the study commenced.

Besides the technician running the CAT scanner, there were a number of other people in the control room including Dr. Clarence Handlin, Louis Martin’s internist, George Carver, the medical resident, and Harry O’Brian, the on-call neurology resident. They were all grouped around the CRT screen, waiting for the first “cuts” to appear.

Sean pulled George aside and told him about the earlier headache, fever, and nausea.

“A good pickup,” George said while he pulled pensively at the skin at the edge of his jaw. He was obviously trying to relate these earlier symptoms to the current problem. “The fever is the curious part,” he said. “Did he say it was a high fever?”

“Moderate,” Sean said. “102 to 103. He said it was like having a cold or mild flu. Whatever it was, it went away completely.”

“It might be related,” George said. “At any rate this guy is a ‘sickle.’ The preliminary CAT scan showed two tumors. Remember Helen Cabot upstairs?”

“How can I forget?” Sean said. “She’s still my patient.”

“This guy’s tumors look very similar to hers,” George said.

The group of doctors around the CRT screen began talking excitedly. The first cuts were coming out. Sean and George stepped behind them and peered over their shoulders.

“Here they are again,” Harry said, pointing with the tip of his percussion hammer. “They’re definitely tumors. No doubt at all. And here’s another small one.”

Sean strained to see.

“Most likely metastases,” Harry said. “Multiple tumors like this have to come from someplace else. Was his prostate benign?”

“Completely,” Dr. Handlin said. “He’s been in good health all his life.”

“Smoke?” Harry asked.

“No,” Sean said. The people in front moved to give Sean a better view of the CRT screen.

“We’ll have to do a full metastatic workup,” Harry said.

Sean bent over close to the CRT screen. The areas of reduced uptake were apparent even to his inexperienced eye. But what really caught his attention was how much they resembled Helen Cabot’s tumors, as George had said. And like hers, they were all in the cerebrum. That had been a point of particular interest with Helen Cabot, since medulloblastomas generally occurred in the cerebellum, not the cerebrum.

“I know statistically you have to think of a metastasis from lung, colon, or prostate,” George said. “But what are the chances we’re seeing a tumor similar to Helen Cabot’s? In other words, multifocal primary brain cancer like medulloblastoma.”

Harry shook his head. “Remember, when you hear hoof-beats you should think of horses, not zebras. Helen Cabot’s case is unique even though there have been a couple of similar cases recently reported around the country. Nonetheless, I’ll be willing to wager anyone that we’re looking at metastatic tumors here.”

“What service do you think he should be on?” George asked.

“Six of one, half dozen of another,” Harry said. “If he’s on neurology, we’ll need an internal medicine consult for the metastatic workup. If he’s on internal medicine, he’ll need the neuro consult.”

“Since we took Cabot,” George suggested, “why don’t you guys take him. You interact better with neurosurgery anyway.”

“Fine by me,” Harry said.

Sean groaned inwardly. All his work doing the history and physical was for naught. Since the patient would be admitted to neurology, the medical student on neurology would get credit for it. But at least that meant Sean was free.

Sean motioned to George that he’d see him later on rounds, then slipped out of the CAT scan room. Although he was behind on his off-service notes, Sean took the time for a visit. Having been thinking and talking about Helen Cabot, he wanted to see her. Getting off the elevator on the seventh floor, he walked directly down to room 708 and knocked on the half-open door.

Despite her shaved head and a series of blue marker stains on her scalp, Helen Cabot still managed to look attractive. Her features were delicate, emphasizing her large, bright green eyes. Her skin had the translucent perfection of a model. Yet she was pale, and there was little doubt she was ill. Still, her face lit up when she saw Sean.

“My favorite doctor,” she said.

“Doctor-to-be,” Sean corrected her. He didn’t enjoy the charade of playing doctor like many medical students. Ever since he graduated from high school he’d felt like an imposter, play-acting first at the role of a Harvard undergraduate, then an MIT fellow, and now a Harvard medical student.

“Have you heard the good news?” Helen asked. She sat up despite her weakness from the many seizures she’d been having.

“Tell me,” Sean said.

“I’ve been accepted into the Forbes Cancer Center protocol,” Helen said.

“Fantastic!” Sean said. “Now I can tell you I’m heading there myself. I’ve been afraid to mention it until I heard you were going too.”

“What a marvelous coincidence!” Helen said. “Now I’ll have a friend there. I suppose you know that with my particular type of tumor they’ve had a one hundred percent remission.”

“I know.” Sean said. “Their results are unbelievable. But it’s no coincidence we’ll be down there together. It was your case that made me aware of the Forbes. As I’ve mentioned to you, my research involves the molecular basis of cancer. So discovering a clinic where they are having hundred-percent success treating a specific cancer is extraordinarily exciting for me. I’m amazed I hadn’t read about it in the medical literature. Anyway, I want to go down there and replace out exactly what they’re doing.”

“Their treatment is still experimental,” Helen said. “My father emphasized that to me. We think the reason they’ve avoided publishing their results is that they first want to be absolutely sure of their claims. But whether they’ve published or not, I can’t wait to get there and start treatment. It’s the first ray of hope since this nightmare started.”

“When are you going?” Sean asked.

“Sometime next week,” Helen said. “And you?”

“I’ll be on the road the crack of dawn on Sunday. I should be there early Tuesday morning. I’ll be waiting for you.” Sean reached out and gripped Helen’s shoulder.

Helen smiled, placing her hand over Sean’s.

AFTER COMPLETING report, Janet returned to the seventh floor to look for Sean. Once again the nurses said he’d been there only moments earlier but apparently had disappeared. They suggested paging him, but Janet wanted to catch him off guard. Since it was now after four she thought the best place to replace him would be Dr. Clifford Walsh’s lab. Dr. Walsh was Sean’s Ph.D. advisor.

To get there, Janet had to leave the hospital, brace herself against the winter wind, walk partway down Longfellow Avenue, cross the medical school quadrangle, and climb to the third floor. Even before she opened the door to the lab, she knew she’d guessed correctly. She recognized Sean’s figure through the frosted glass. It was mostly the way he moved that was so familiar. He had surprising grace for such a stocky, muscular frame. There was no wasted motion. He went about his tasks quickly and efficiently.

Entering the room, Janet closed the door behind her and hesitated. For a moment she enjoyed watching Sean. Besides Sean there were three other people busily working. A radio played classical music. There was no conversation.

It was a rather dated and cluttered lab with soapstone-topped benches. The newest equipment were the computers and a series of desk-sized analyzers. Sean had described the subject of his Ph.D. thesis on several occasions, but Janet still wasn’t a hundred percent certain she understood it all. He was searching for specialized genes called oncogenes that had the capability of encouraging a cell to become cancerous. Sean had explained that the origins of oncogenes seemed to be from normal “cellular control” genes that certain types of viruses called retroviruses had a tendency to capture in order to stimulate viral production in future host cells.

Janet had nodded at appropriate times during these explanations but had always found herself more interested by Sean’s enthusiasm than the subject matter. She also realized that she needed to do some more basic reading in the area of molecular genetics if she was to understand Sean’s particular area of research. Sean had a tendency to assume that she had more knowledge than she had, in a field where advances came at a dizzying pace.

As Janet watched Sean from just inside the door, appreciating the V that his broad shoulders and narrow waist formed, she became curious about what he was currently doing. In sharp contrast to many other visits she’d made over the last two months, he wasn’t preparing one of the analyzers to run. Instead he seemed to be putting objects away and cleaning up.

After watching for several minutes, expecting him to notice her, Janet stepped forward and stood right next to him. At five-six Janet was relatively tall, and since Sean was only five-nine, they could just about look each other in the eye, especially when Janet wore heels.

“What may I ask are you doing?” Janet said suddenly.

Sean jumped. His level of concentration had been so great he’d not sensed her presence.

“Just cleaning up,” he said guiltily.

Janet leaned forward and looked into his startlingly blue eyes. He returned her stare for a moment, then looked away.

“Cleaning up?” Janet asked. Her eyes swept around the now pristine lab bench. “That’s a surprise.” Janet redirected her eyes at his face. “What’s going on here? This is the most immaculate your work area has ever been. Is there something you haven’t told me?”

“No,” Sean said. Then he paused before adding, “Well, yes, there is. I’m taking a two-month research elective.”

“Where?”

“Miami, Florida.”

“You weren’t going to tell me?”

“Of course I was. I planned on telling you tomorrow night.”

“When are you leaving?”

“Sunday.”

Janet’s eyes angrily roamed the room. Absently, her fingers drummed on the countertop. She questioned to herself what she’d done to deserve this kind of treatment. Looking back at Sean, she said: “You were going to wait until the night before to tell me this?”

“It just came up this week. It wasn’t certain until two days ago. I wanted to wait until the right moment.”

“Considering our relationship, the right moment would have been when it came up. Miami? Why now?”

“Remember that patient I told you about? The woman with medulloblastoma.”

“Helen Cabot? The attractive coed?”

“That’s the one,” Sean said. “When I read about her tumor, I discovered…” He paused.

“Discovered what?” Janet demanded.

“It wasn’t from my reading,” Sean corrected himself. “One of her attendings said that her father had heard about a treatment that is apparently achieving one hundred percent remission. The protocol is only administered at the Forbes Cancer Center in Miami.”

“So you decided to go. Just like that.”

“Not exactly,” Sean said. “I spoke to Dr. Walsh, who happens to know the director, a man named Randolph Mason. A number of years ago they worked together at the NIH. Dr. Walsh told him about me, and got me invited.”

“This is the wrong time for this,” Janet said. “You know I’ve been disturbed about us.”

Sean shrugged. “I’m sorry. But I have the time now, and this is potentially consequential. My research involves the molecular basis of cancer. If they are experiencing a hundred-percent remission rate for a specific tumor, it has to have implications for all cancers.”

Janet felt weak. Her emotions were raw. Sean’s leaving for two months at this time seemed the worst possible situation as far as her psyche was concerned. Yet his reasons were noble. He wasn’t going to the Club Med or something. How could she get angry or try to deny him. She felt totally confused.

“There is the telephone,” Sean said. “I’m not going to the moon. It’s only a couple of months. And you understand that this could be very important.”

“More important than our relationship?” Janet blurted out. “More important than the rest of our lives.” Almost immediately Janet felt foolish. Such comments sounded so juvenile.

“Now let’s not get into an argument comparing apples and oranges,” Sean said.

Janet sighed deeply, fighting back tears. “Let’s talk about it later,” she managed. “This is hardly the place for an emotional confrontation.”

“I can’t tonight,” Sean said. “It’s Friday and…”

“And you have to go to that stupid bar,” Janet snapped. She saw some of the other people in the room turn to stare at them.

“Janet, keep your voice down!” Sean said. “We’ll get together Saturday night as planned. We can talk then.”

“Knowing how upset this leaving would make me, I cannot understand why you can’t give up drinking with your trashy buddies for one night.”

“Careful, Janet,” Sean warned. “My friends are important to me. They’re my roots.”

For a moment their eyes met with palpable hostility. Then Janet turned and strode from the lab.

Self-consciously, Sean glanced at his colleagues. Most avoided his gaze. Dr. Clifford Walsh did not. He was a big man with a full beard. He wore a long white coat with the sleeves rolled up to the elbows.

“Turmoil does not help creativity,” he said. “I hope your leaving on this sour note does not influence your behavior down in Miami.”

“Not a chance,” Sean said.

“Remember, I’ve gone out on a limb for you,” Dr. Walsh said. “I assured Dr. Mason you’d be an asset to his organization. He liked the idea that you’ve had a lot of experience with monoclonal antibodies.”

“That’s what you told him?” Sean questioned with dismay.

“I could tell from our conversation that he’d be interested in that,” Dr. Walsh explained. “Don’t get your dander up.”

“But that was what I did three years ago at MIT,” Sean said. “Protein chemistry and I have parted ways.”

“I know you’re interested in oncogenes now,” Dr. Walsh said, “but you wanted the job and I did what I thought was best to get you invited. When you are there, you can explain you’d rather work in molecular genetics. Knowing you as I do, I’m not worried about you making your feelings known. Just try to be tactful.”

“I’ve read some of the work of me chief investigator,” Sean said. “It’s perfect for me. Her background is in retroviruses and oncogenes.”

“That’s Dr. Deborah Levy,” Dr. Walsh said. “Maybe you can get to work with her. But whether you do or not, just be grateful you’ve been invited at this late date.”

“I just don’t want to get all the way down there and get stuck with busywork.”

“Promise me you won’t cause trouble,” Dr. Walsh said.

“Me?” Sean asked with eyebrows arched. “You know me better than that.”

“I know you too well,” Dr. Walsh said. “That’s the problem. Your brashness can be disturbing, to put it mildly, but at least thank the Lord for your intelligence.”