Fertility: A Novel Read online

  Fertility

  A Novel

  By

  Denise Gelberg

  Permission sought for use of excerpts from “My Mother,” by Abraham Sutzkever. A, Sutzkever: Selected Poetry and Prose, translated by Barbara Harshay. University of California Press, 1991.

  The characters and events depicted in Fertility: A Novel are fictional. Any similarity to actual persons or events is coincidental.

  Kindle Edition

  Copyright 2012, Denise Gelberg. All rights reserved.

  Yiddish Terms

  A be kezunt — be well

  Alter kocker — lecherous older man

  Boychik — little boy

  Brokh — misfortune

  Bubbe — grandmother

  Chutzpah —audacity, nerve

  Efsha — perhaps

  Essen — eat

  Farblondjhet — confused, to wander aimlessly

  Gevalt — oh my God

  Gott in himmel — God in heaven

  Kayn aynhoreh — knock on wood, spare us the evil eye

  Kinder — children

  Kleine kint — little child

  Kleine mamela — sweet little girl

  K’naker — one who self—aggrandizes

  Kvell — to burst with pride

  Landsmen — countrymen

  Macher — a big shot

  Maidel — girl; maidela — little girl

  Mandelbrot — hard pastry, similar to Italian biscotti

  Mazel tov — best of luck

  Mein kint — my child

  Mensch — an admirable human being; plural, menschen

  Meshuggena — crazy person

  Meshugge — crazy, mad

  Mishegoss — insanity

  Mitzvah — blessing

  Momzer — bastard

  Schlep — carry, pull

  Schmuck — a bastard

  Schpiel — story

  Seichel — wisdom, street smarts, ingenuity

  Shana — beautiful

  Shankeit — a beauty

  Shlong — penis

  Shtarker — strong one

  Tsoures — troubles

  Tushie — rear end, bottom of a child

  Vai iz mer — woe is me

  Zadda — grandfather

  Dedicated to my mother,

  the Rivka in my life

  CHAPTER ONE

  The screams were a primordial code alert to the hospital staff, sending them sprinting toward the source. Entering the pediatric isolation room, the staff instantly understood the distraught mother’s protests to the gods. Her two-week-old daughter lay bleeding from every orifice. With mounting dread, the parents watched the red stain spread across her tiny diaper. Had the physician on call been a man of faith, he would have prayed for help. As it was, he methodically set to work to save the tiny infant’s life.

  * * *

  Sarah Abadhi opened her eyes to a cold, dark Monday in November. Listening to the wind howling outside the windows of her third floor walk-up, she decided to ignore the alarm, for a few minutes at least. Closing her eyes again, she drifted off, hearing nothing of the six a.m. news droning from the clock radio. Then a thought intruded: the phone call from Harry that had awoken her in the middle of the night. She threw off the covers and got out of bed.

  Harrison Meinig, Sarah’s boss, had a way of demanding attention. Harry, as he was known by everyone, led the health care practice in the white-shoe law firm where she was a fifth-year associate. His call was about the university hospital a few blocks from her Manhattan apartment. Apparently, there had been a medical error involving the child of a VIP. Sarah had to meet Harry there by seven; there would be no time for her usual Monday morning swim.

  But not to worry. Sarah was, above all, a practical person. After being miserable for a long time, she reconciled with the life she led. She didn’t expect to be happy — in fact, she swore off hope, particularly when it came to men, which gave her the courage to tackle each day. Few people would have guessed the lovely looking woman with the impressive vita worshipped at the altar of low expectations.

  Right after hanging up with Harry, Sarah had gotten up and chosen her clothes for the early morning meeting. Now, as she struggled to rouse herself, she caught the forecast: a cloudy day with highs in the 30s. After a quick shower, she opted for textured black tights and the black pumps that wouldn’t annoy the blisters she had earned during the NYC marathon the week before. With a dab of lipstick and some gold jewelry for her neck, wrist and ears, she was satisfied that she’d achieved the right look for an attractive but serious attorney. She shoveled a bowl of microwave oatmeal into her mouth, put her coffee in a travel mug and was out the door by 6:40.

  Harry was already in the conference room of the risk manager’s office when she arrived at 6:57. He wore the label “distinguished” like a birthright with his thick, silver-gray hair, steel blue eyes and still sharply angled jaw. He was tapping his fingers on the table as Sarah came through the door. Julie Bonner, the hospital’s vice president for public relations, and an exhausted-looking John Mess, head of the risk management office, rounded out the group. An air of anxiety hung in the room as Sarah joined them at the conference table.

  “Good morning,” she said as she waited for the news that would undoubtedly make it anything but a good morning for either the hospital or the patient involved in the case.

  John Mess didn’t waste any time outlining the events that brought them together. “Yesterday afternoon the two-week-old infant of Mark Arkin was brought into the ER with what appeared to be a staph infection. After evaluation in the ER, the infant was admitted to an isolation room in our children’s wing. The pediatric fellow, Dr. Richard Smith, followed protocol, ordering the antibiotic clindamycin, and the blood thinner heparin for the IV flush. The infant appeared to be stable when the parents left for a consultation with one of our lactation specialists. When they returned, the infant was in a medical crisis — bleeding from her eyes, ears, nose, mouth, rectum and vagina.”

  Sarah prided herself on seeming unflappable at work, but the image of a two-week-old baby bleeding out made her regret eating breakfast. The fact that the father of the baby was real estate mogul Mark Arkin only served to make matters worse.

  Julie Bonner sensed the change in Sarah’s mood straight away. “Are you all right, Sarah?”

  “Absolutely. Please continue, John. How did the staff respond?” Sarah replied without hesitation.

  Mess checked his notes and then looked up. “Dr. Smith immediately suspected a dosing error with the heparin. He attempted to counteract its blood-thinning properties by administering vitamin K and protamine sulfate. The attending physician, Dr. Esther Cho, was called in. She concurred with Dr. Smith’s treatment. The bleeding was slowed. This morning the infant is in critical but stable condition. It is considered to have a good chance of survival.”

  Sarah noticed that Mess didn’t use the child’s gender when he spoke. She wondered if that impersonal approach allowed him to deal more easily with hospital-induced suffering.

  “Where are you in your investigation of the dosing error?” Harry asked.

  Now it was Mess’s turn to grow pale. “Well,” he began slowly, “we’ve discovered a couple of problems. It appears the floor was understaffed for RNs. You know, people have started their Christmas shopping and it’s hard to get staff willing to come in for weekend shifts this time of year. Plus, a stomach flu has run through a lot of the staff over the last couple of weeks. I know, I know,” he said, raising his hands, “no excuse that will help in a lawsuit, but that’s the reality.”

  Sarah jumped in. “How short staffed was the floor?”

  Bonner, as smooth as ice, had her story prepared. “As John indicated,
the hospital was overtaken by a virulent strain of gastroenteritis last week. It decimated our ranks at all levels. Yesterday we were down three RNs on the floor where the Arkin baby was being treated. Some of the remaining RNs volunteered to work extra hours, but the nursing staff was still shorthanded. It is possible this unavoidable staff shortage may have contributed to the mistake in the dosage of heparin given to the baby.”

  “How big a mistake are we talking about?” Harry asked.

  “A thousand times the correct dose,” Mess replied.

  All the air seemed to be sucked out of the room. Sarah couldn’t get the picture of the bleeding baby out of her mind. Finally, she asked, “Could the overdose be the result of an illegibly or incorrectly written order?”

  Mess was pleased he could put that question to rest. “We’ve just instituted computer entry for all medication orders. We have the order for heparin and it was correctly typed into our system.” He quietly added, “We believe that perhaps someone misread either the order or the heparin label.”

  “So you think the dosing error can be traced to either the pharmacy or the floor nurse?” Harry asked.

  Bonner offered up a possible culprit. “One of our most senior and trusted nurses, Joyce Hilker, was assigned to the Arkin baby. She administered the heparin. I hear she’s inconsolable.”

  “Contrition doesn’t usually help when there’s a dead or damaged baby involved,” Sarah pointed out as she shifted in her chair. “How could she have made the type of mistake we’re talking about?”

  “Well, that’s the point we’re at,” Bonner said. “We think it’s possible that the mistake wasn’t entirely hers. As Harry speculated, it’s likely the pharmacy was involved as well. That’s something we hope you can figure out ASAP.”

  Then Harry asked the obvious question, given the father’s tough-guy reputation. “So what is Arkin threatening us with? Did he have his lawyer crib-side through the night?” He posed the question only partly in jest.

  “Amazingly, no lawyers yet and no threats to sue,” Mess said. “Arkin and his wife haven’t left the baby. They are understandably upset. Well, that’s something of an understatement. I guess the mother, especially, is beside herself. But Arkin isn’t too far behind.”

  Harry’s level of agitation — always at a simmer — was bubbling up. “Okay, so we’ve got to jump on this before Arkin has the chance to get his troops in position. Sarah will do some preliminary interviews of the staff today. Then we’ll know more about where we stand.”

  Sarah nodded in agreement, but she had to wonder how Harry could be so cold in talking about a two-week-old baby. She knew there was some history between Arkin and him, though the specifics were sketchy. Something about a real estate deal where Harry and his client got clobbered. In any case, she knew what she had to do.

  “I’d like to go back to our office, get some files, a digital recorder and a stenographer. I can be back here by 8:30 at the latest. Can I use this room for my interviews?” Mess nodded his assent.

  “I’d like to sit in on the interviews,” Bonner said.

  “I’d rather you didn’t,” Sarah responded, without missing a beat. “I find I get a better result if I do the interviews without the employer in the room. The recorder and the stenographer are sufficient reminders that the stakes are high. You and John will have a full report of my findings after all of the preliminary interviews are completed — which I hope will be by the end of today.”

  Sarah could tell that Bonner wasn’t pleased, but Harry backed her up. “You’ll have your chance with them, Julie, but we find that the first interview right after the incident — conducted by an outsider — yields the best information.”

  Mess turned to Bonner. “Any sign that the media have gotten wind of this yet?”

  “Not yet, but I figure that it’s just a matter of hours, maybe a day at best. I’m working on a statement.”

  “Okay, so Sarah will be back shortly. And by the end of the day, we’ll know better where we stand.” Harry got up to leave. Sarah was right behind him.

  “Thanks, Harry. I’d like a report — at least a verbal report — from Sarah by, shall we say, five o’clock?” he said, directing his attention now to Sarah.

  “Of course,” Sarah nodded. “You can facilitate my work by calling in the pharmacist that filled the order, and the nurses and doctors that treated the baby yesterday. Some of them may have the day off since they worked the weekend, but see what you can do.”

  “Don’t worry about that. I’ll round everyone up,” Bonner assured her. They all shook hands before Sarah and Harry left.

  Hailing a cab outside the hospital, Harry could hardly contain himself.

  “What a cluster fuck. Cluster fuck, Sarah — a military term — when everything and everybody fucks up. Shit. No wonder we get paid so well. Defending a bunch of fuck-ups.”

  Sarah responded calmly. “We’ll get this sorted out and figure out how to contain the damage. Let’s just hope that baby makes it — and makes it intact.” Settlements for damaged babies were often astronomical — rightfully so, Sarah thought.

  The Ethiopian cabbie that picked them up drove like he was on a mission, which in fact he was. Sarah had called ahead to get a steno lined up. When she got to the office she quickly scanned the hospital’s voluminous malpractice insurance policy, e-mailed her paralegal to highlight the provisions pertinent to a case such as this, canceled her noontime dental cleaning and headed back to the hospital with Doris Ostrom, the firm’s most trusted steno, in tow.

  CHAPTER TWO

  Dr. Richard Smith must have been numb from exhaustion. There was no other way he’d miss the tall, attractive brunette coming in the hospital’s main entrance as he was on his way out. But even a renowned ladies’ man required sleep, and this ladies’ man was anxious to get home and collapse. It was 8:24 a.m. and he’d been on duty since noon the day before. So much for his scheduled twelve-hour shift. This was Monday, his day off — funny how schedules became meaningless when a baby was bleeding out. Shit. He hoped that when he came back the next day, that baby would still be alive and, just as important, that she hadn’t suffered irreparable harm at the hands of her so-called health care providers.

  Rick Smith loved being a fellow in pediatric intensive care medicine. He’d been a decent student in med school, but had really hit his stride during his pediatric residency, when his tenacity in dealing with the very sickest patients won him notice. He was like a dog with a bone, unable to rest until he got to the bottom of what laid his patient low. Then he was relentless in his efforts to beat back the illness and return the child to a normal life. If his patient suffered a trauma by accident — or sometimes at the hands of a cruel adult — he was like a highly skilled craftsman restoring a work of art after an assault. He was a funny combination: carefree player on his rare days and nights off, and driven perfectionist the rest of his waking hours.

  As he walked to his apartment he kept thinking about that baby, blood oozing even through the pores of her skin. With an overdose so large, it was nothing short of a miracle that she had stayed alive long enough for the antidote to kick in. He had a hunch she was a fighter. He had worked on babies whose spirits were so well defined that he marveled at their drive and, for lack of a better word, attitude. This baby was one of those. After only fourteen days of being on the planet, she already knew what she wanted and what she didn’t. It could make a kid a pain in the ass, but for survival purposes, it was a real plus. Maybe she came by it honestly; the tabloids routinely portrayed her old man as a royal hard ass. From what Rick could see as he worked through the night, Mark Arkin was just a normal dad, scared that his kid wouldn’t pull through, probably making private deals with his maker to save her life.

  Just as he put his key into the deadbolt lock of his apartment door, his phone rang. It was the hospital. Shit. He’d made sure to bring the house staff up to speed — on the overdose case in particular. What the hell could they want now? He let it go to voice m
ail. Once inside he pulled off his clothes, peed, brushed his teeth and headed for bed. But then he thought better of it. Maybe he should just answer the call and get it out of the way. He called the number back.

  “This is Dr. Smith on what’s supposed to be my day off. This had better be good.”

  “Dr. Smith, this is Nancy Howland, Julie Bonner’s assistant. Ms. Bonner asked me to let you know that you’ll be needed for a meeting with the hospital’s attorney today. The meeting is in reference to the Arkin infant’s case.” She attempted to sound authoritative while remaining pleasant. She knew how the fellows and residents guarded their limited time off.

  “And who might Julie Bonner be?” he asked, making no attempt to hide his annoyance. Clearly, the hospital was getting its ducks in a row for a lawsuit while an eight-pound infant was fighting to stay alive. He was not alone in finding the bean counters and lawyers infuriating in the face of the life-and-death struggles that made up an average day in his department.

  “Ms. Bonner is the hospital’s vice president for public relations. She is assisting the risk management office and the attorneys in their investigation of the child’s treatment. Every person involved is being interviewed today.” Nancy Howland knew she had to stand her ground. Bonner had made it clear there would be no excuses accepted — even if a car service had to drive the staff member to the hospital for the interview.

  “Well, that’s just dandy…what’s your name? Nancy? I’ve been on call since noon yesterday. I haven’t had any sleep in over twenty-four hours. And as much as I’d like to help you, I’ll be spending today between the sheets. Alone, I might add.”

  Howland knew she had to persevere and get him in for an interview, or Bonner would have her head on a platter. His address was displayed on her computer screen right above his phone number — he lived just a couple of blocks away. She decided to make a deal. “I understand completely, Dr. Smith. The interviews will be conducted throughout the day, and I am scheduling you last. We’ll expect you at 4:30. That will give you a chance to catch up on your rest.”