Natural Causes

CHAPTER 10

SARAH FOLLOWED GLENN PARIS THROUGH THE FRONT entrance to the amphitheater and up onto the stage. Only the last few rows of the hall were empty, and people were still trickling in. The three Boston television stations, representing the big three networks, each had a pod of lights, a video man, and a reporter set between the low stage and first row of seats. Although Sarah rarely watched television, she recognized two of the newspeople. Clearly, the possibility of the outbreak of some rare disease held more than a little public allure.

The podium, covered with wine-color velvet, was festooned with microphones, a dozen or more. Behind it were five folding chairs, three to one side and two to the other. Eli Blankenship and Randall Snyder were already seated, with one empty chair between them. Paris motioned Sarah to that seat.

If Paris was nervous about the event or the absence of a representative from the Centers for Disease Control, it did not show in his face or manner. He measured the hall for a time, then buttoned his jacket and crossed over to the three physicians.

"Well, we certainly can't cry apathy about this one," he said softly. "This whole show would have been a bit tighter if the CDC could have gotten someone up here, but we'll just have to make do. I'll make a few introductory remarks, then you Eli, you Randall, and finally you, Sarah. I would suggest keeping your statements brief and filling in as questions are asked. The only advice I would give you is to remember that the less you say, the harder it will be for them to misquote you. I'm going to limit each of you to ten minutes, including questions. If it seems appropriate at the end, I'll allow a few more. And don't worry, you'll all do fine."

Sarah knew the "all" was aimed directly at her.

"He really loves this stuff, doesn't he," she said as Paris approached the podium.

"He should," Blankenship responded. "He's very good at it. You, on the other hand, look a little peaked. Are you going to make it?"

"I thought I'd be fine until I got up here. Look at that mob."

Blankenship reached over a meaty hand and gave her a fatherly pat on the shoulder.

"Just remember the old medical adage," he said. "All bleeding eventually stops."

"That's very reassuring. Thank you."

Paris's introductory remarks, made without notes and delivered without a hitch, painted the picture of an institution devoted to the health and welfare of the citizens of Boston, and fearless about stepping forward to confront problems of public concern.

"We have been in close contact with the epidemiology division of the Centers for Disease Control in Atlanta," he said, "and they have promised to send us one of their top people to augment our own intensive investigation. I had hoped he would be here in time to participate in this news conference-" He gestured to the empty chair beside his. "-but unfortunately that wasn't possible."

The three cases of DIC, he stressed, might add up to nothing more than coincidence. However, the approach decided upon by the Medical Center of Boston was to take the bull by the horns and begin an immediate investigation, while keeping the public aware in an ongoing manner.

Sarah was disturbed that Paris would tout the imminent arrival of a CDC epidemiologist, when he had just told her he did not know if one was even coming at all. But she reasoned that the exaggeration was harmless enough, and given the circumstances, understandable. He was simply trying to diffuse as many issues as possible. And in fact, by the time he introduced Eli Blankenship, it was as if the Herald item had not forced his hand at all.

Buoyed by the CEO's performance, Sarah felt some of her tension abate. Still, it was not until Blankenship was finishing his formal remarks that she felt comfortable enough to look out at the audience. If, as she remembered once hearing, the amphitheater held 250, at least 200 were there. Many of those attending were residents and medical school faculty, including Andrew, who was back in his traditional last-row center seat. But a significant number, judging from their appearance and dress, seemed simply to be from the community. Among them, Sarah recognized one woman with whom she was training to do home birth, just as she had with Lisa. It wasn't difficult to imagine her thoughts and concerns.

But it was another woman, seated not far from Andrew, whom Sarah found the most interesting. She was African in her skin color, hairstyle, dress, and jewelry. And even through the lights and distance, her uncommon beauty was obvious. Sarah was scanning the audience when she realized the striking young woman was looking straight at her, smiling.

I know you from someplace, don't I? Sarah thought. But from where?

Blankenship lumbered back to his seat to a smattering of applause. Sarah whispered congratulations, even though she realized that she had been preoccupied with the woman in the last row and had missed his final answer.

As Sarah expected, Randall Snyder was down-to-earth and reassuring in his presentation and responses to questions. The three DIC cases were certainly a cause for concern, he said. But without a careful review, especially of the way the diagnoses were made, it was still too soon even to link them. Meanwhile, he concluded, the public should rest assured that his department would be carefully screening all obstetrical patients for any abnormality suggesting an increased susceptibility.

The applause for Snyder was measurably louder than it had been for Eli, even though his presentation had not been nearly as substantive. The power of the fatherly image, Sarah acknowledged, recalling at the same time that she had voted for substance over fatherly image in almost every presidential election since she turned eighteen and had only once backed the winner.

Finally it was her turn. In an effort to keep reasonably organized, she had printed the points she wanted to make on a set of three-by-five file cards. By the time her five-minute presentation was over, she had covered most of what was on them. Throughout her remarks, though, she felt a gulf separating her from the audience. She knew that, in spite of herself, she was sounding stilted, and far more proselytizing and pompous than she had intended.

Hey, everyone, this isn't me! she wanted to scream out. These are issues I really care about. I would love to talk about them-but with you, not at you. How about we all go to the Arnold Arboretum, throw some blankets on the grass, and really get into why people become ill, what it means to be sick, and what it takes to get well?

Concluding her formal remarks, she thanked everyone for their concern and involvement and invited questions. In an instant the audience, which had seemed indifferent and half asleep, became a kelp forest of waving arms and hands. Sarah glanced over at Paris to see if he wanted to step up beside her and choose. But the CEO just smiled and winked. She shrugged, turned back to the forest, and pointed.

"Do you honestly think your acupuncture and Lisa Summer's imaging of her blood cells stopped her bleeding?"

Of course I do, you idiot!

"I believe strongly that they were two of the factors. As I said, there were other efforts going on at the same time."

"Have you ever stopped someone's bleeding with your techniques before?"

Perhaps if you tried your very hardest, ma'am, you could sound even more patronizing.

"Not specifically. But I have assisted on several operations in which only acupuncture anesthesia was used. Each time, the amount of bleeding was impressively minimal."

"Tell us more about your background. You mentioned working in a holistic healing center. Where was that?"

Glenn, is it time yet?

"Right here in Boston. It was called the Ettinger Institute."

Annalee! In disbelief, Sarah stared across the audience at the woman in the last row. Annalee Ettinger smiled and waved. It had been seven years since Sarah had seen the girl Peter had brought home from Mali as a child and subsequently adopted. But time was hardly the reason that recognition had come so slowly. When Sarah moved out of their Back Bay condominium, Annalee had been a dear and interesting fifteen-year-old. But she was also painfully shy and markedly overweight. Her transformation was miraculous. Her face, with its wonderfully high cheekbones, seemed almost sculpted.

Sarah's gaze shifted to her long enough to confirm that the connection had been made. Annalee smiled and nodded.

"Ettinger," the questioner went on. "Is that the same Ettinger who does those programs on TV for that diet powder?"

"I-I really don't know," Sarah said. "Outside of catching Jeopardy! once in a while in the on call room, I almost never have time to watch television. And I haven't been in touch with Mr. Ettinger in many years."

"It is," a woman called out. "It is the same man, I'm taking that stuff of his and I've already dropped thirty pounds. It's fantastic."

The audience laughed roundly, and Sarah knew that she had lost control of the session. Glenn Paris quickly stepped to the podium.

"Dr. Baldwin, thank you very much," he said.

He motioned her to her seat and led the audience in applause. Perhaps it was the somewhat controversial nature of her presentation, perhaps the lack of a crisp, definitive closing; whatever the reason, Sarah felt that the audience reaction to her was polite but hardly enthusiastic. If Snyder got the tens of thousands of dollars in prize money and the chance to return tomorrow to defend his championship, and Blankenship got the home entertainment center, she had just won best wishes and a Jeopardy! board game.

Oblivious to the supportive whispers from Blankenship and Snyder, Sarah focused on a spot of floor next to Glenn Paris's shoes, waiting for the words that would send everyone home. Her performance had been far from stunning, but not a disaster. Best of all, it was over. Now there were questions-seven years' worth-occupying her thoughts. And the answers to them all were as close as Annalee Ettinger.

Glenn Paris ended the session with the promise to keep the public informed of any developments. Immediately, a number of reporters rushed onto the stage, rudely jostling one another as they jockeyed for position around the speakers. Concerned about the delay, Sarah made eye contact with Annalee, who assured her with a dismissive gesture that she was in no hurry.

Finally the gaggle of questioners began to disperse. Sarah accepted a pat on the back from Paris and was about to leave him when an older woman approached, a leather portfolio tucked beneath one arm. Sarah had noticed her standing at the back of the auditorium throughout the conference. She was quite unimposing-five feet four or so-conservatively dressed in a straight, dark skirt and blazer. Her short, carefully permed hair was an equal mix of brown and gray. And although her face had a pleasant, peaceful quality, her features were nearly lost behind round, oversized tortoiseshell spectacles. In her survey of the crowd, Sarah had cast the woman as a grandmother from the community, too self-conscious to work her way past people and into a seat.

"Dr. Baldwin, Mr. Paris," she said, "my name is Rosa Suarez."

Her pronunciation of her name was distinctly Latin.

"Yes, Mrs. Suarez," Paris said, unable to cull the hint of impatience from his voice. "What can we do for you?"

The woman smiled patiently. "That man from the Centers for Disease Control about whom you spoke-the top-notch epidemiologist you were promised?"

"Yes," Paris said. "Yes, what about him?"

"Well, I am he."