Natural Causes

CHAPTER 13

July 6

SARAH STOOD IN THE OPERATING ROOM BENEATH AN icy, blue-white light. She was delivering an infant by cesarean section before a gallery of observers that included, it seemed, every person with whom she had had any contact over the eventful week just past.

"Too bad, your baby's dead," she said to the patient, whose face was covered with a sheet. She turned to the gallery and bowed. "Too bad, everyone, her baby's dead. Too bad."

Glenn Paris smiled down at her approvingly, as did Randall Snyder and Annalee Ettinger. Alma Young, in uniform, applauded and blew her kisses. Several reporters from the press conference gave her A-okay signs. Others photographed her. Then, with a flourish, she whisked the sheet aside only to see herself. Her eyes were bloody hollows; her mouth was agape in a silent scream of death.

Sarah awoke shrieking, bathed in a chilling sweat. It was four-thirty in the morning.

Trembling, she pushed herself out of bed and pulled on her robe. Then she put on some tea and drew a hot bath. She was terrified, she knew, not only by the disturbing content of her dream, but by the fact that she had experienced it at all. For much of her early life, she had been a slave to all manner of nightmares. The most consistent scenario, often recurring as many as two or three times a week, revolved around her being bound, gagged, and totally helpless. From there, on any given night, she would be stabbed repeatedly, beaten, smothered, thrown from a great height, or hurled into the sea. Never in the horrible dreams did she actually see the face of her assailant. On rare occasions, the man-she never doubted it was a man-would burn her with cigarettes. At times the vivid nightmares so haunted her, so dominated her life, that she would simply refuse to go to sleep.

In her mid-teens, at the suggestion of a concerned teacher, she began seeing a psychologist. It seemed obvious to the woman that some event in Sarah's past-isolated or recurrent-was at the core of her terror. The therapist did what she could to get at that source. But Sarah's mother, already drifting deeper and deeper into her dementia, could supply little useful information.

The psychologist then sent Sarah for a number of sessions of hypnosis, and once even took a day off to drive her to Syracuse for a consultation at the university medical center. Nothing helped. Sarah simply could not connect with any event in her childhood that could have sparked such bizarre and debilitating fantasies.

During college, the disturbing dreams seemed to come less frequently, but they were no less terrifying. She tried another course of psychotherapy and hypnosis, and even consented to take some sort of pill designed, her physician said, to alter the neurologic pattern of her sleep. What the drug altered instead was her grade point average, which dropped that semester from a 3.8 to a 2.9.

Eventually peace did come for her. The answer lay in the simple mountain people whom she had traveled halfway around the world to help. In a village in the foothills of Luang Chiang Dao, just a few miles from the Burmese border, Dr. Louis Han, placed her in the hands of a healer-a wizened, stoop-shouldered man, who was, Han said, over 110 years old.

The healer, speaking a dialect of Mandarin that Sarah could not understand, communicated with her through Han. Whether her nightmares were grounded in a past event, or perhaps even a future event, was of no consequence, he said. What mattered was that at the time of sleep, she was not at ease. The spirit that guided her throughout each day remained locked within her. The devastating dreams were nothing more than that day spirit, expressing anger at being detained and demanding a clean separation from her so that it, too, might rest and renew.

All Sarah need do to end the nightmares, the old man promised, was to spend some quiet, contemplative time at the end of each day, first embracing her guiding spirit and then releasing it.

Not even Louis Han knew the exact nature of the tea the healer brewed for her that night. But Sarah drank it willingly and soon drifted off to sleep. When she awoke, two days later, she knew the day spirit within her, an elegant, pure white swan.

Each night from then on, she meditated before going to bed, often actually seeing her swan take flight. Her days, even the most trying ones, began ending peacefully. And the vivid nightmares that had defied her and so many physicians had never recurred-not until tonight.

The hot water supply in Sarah's building, which later in the morning would be inadequate even for a decent shower, was plentiful at such an early hour. Sarah kept the tub filled with a slow, hot stream until she trusted her shivering was gone for good. Things happen for a reason, she reminded herself. The belief was one of the pillars on which she had built her life. Things happen to teach us or to send us off in other, more important directions. By the time she toweled off and slipped into her robe, the message in her nightmare-two of them, actually-seemed quite clear.

Understandably, but quite unacceptably, she had begun allowing the demands of work to override her life. Her periods of meditation and reflection had grown brief and generally ineffectual. The connection with her spiritual self was all but gone. She was paying less and less attention to Sarah, trusting more and more that her work on behalf of others was enough to provide her with the strength to deal with each day. The nightmare was telling her otherwise.

It was telling her something else as well: She had made more than enough appearances on center stage. Lecturing to educate medical students and other residents was one thing; providing news footage was quite another. From this morning on, she resolved, it would be back to basics and back to business. No more cameras, no more interviews.

She padded over to the window. The first streaks of dawn glowed against a dull, slate sky and shimmered off a misty rain. One other positive thing her nightmare had given her was some extra time before work. Time to get centered, to regain perspective. Beginning tomorrow, she resolved, when she wasn't at the hospital, she would set her alarm to awaken her twenty minutes earlier. She put on a tape of ocean sounds, set a large pillow on the floor, and eased down into a lotus position.

Please let me do the right thing today, she thought, settling herself with a few deep breaths. For my patients and myself, let me do the right thing.

Her breathing slowed and grew shallow. The tightness in her muscles began to disappear. Her thoughts grew more diffuse and less distracting.

Then the telephone rang.

The fifth ring told her that her answering machine was not turned on; the tenth, that the caller was determined-or in trouble. Betting a hundred to one that it would be a wrong number, or worse, a crank, Sarah crawled over to the phone by her couch.

"Hello," she said, clearing some residual sleep from her throat.

"Dr. Baldwin?"

"Yes?"

"Dr. Baldwin, this is Rick Hochkiss. I'm a stringer with the Associated Press, and I was at the news conference you gave yesterday."

"You are extremely thoughtless and rude to be calling at this hour." She debated simply hanging up. "What do you want?" she asked finally.

"Well, for starters, I'd like your comments on the accusations made about you in Axel Devlin's column this morning…"

• • •

Lisa Grayson sat before the pop-up mirror in her tray table, trying as best she could to do something with her hair. In minutes her father would be making his third visit to the hospital. This time she was ready to see him. She had made the decision the night before. But not an hour ago, a messenger had delivered a gold necklace bearing her name in elegant script, with a diamond chip dotting the "i."

Had that been all-had her father continued to show no insight into who she was or what was important to her-she might well have decided to send him away once again. But with the gift was a note. It was written on stationery her mother had commissioned years before, featuring an etching of Stony Hill, their home. Lisa set her brush aside and studied the picture, wondering if her room had been changed at all. Then she reread her father's words.