Natural Causes

IATROGENIC: ILLNESS OR INJURY CAUSED BY THE WORDS OR ACTIONS OF A PHYSICIAN.

Sarah flashed on the sign that once hung over Peter Ettinger's desk. There was every reason to believe that the patient's striking turn for the worse was due to his treatment, not his disease-to the diuretics, not the aneurysm. She reached the operating suite doors just as the litter was being wheeled into one of the ORs.

"Andrew, wait!" she cried out.

It took less than half an hour for the old man to respond to his magnesium infusion and wake up. Until his retirement a year before, Terence Cooper had been a boatbuilder of some note. He had a cackling laugh and a wonderful, toothless smile. And upon meeting Sarah, he immediately asked her out on a date, assuring her that his wife wouldn't mind all that much.

"Mrs. Cooper keeps telling me to try out new things," he said.

Sarah let him squeeze her hand and then turned to leave. Until that moment, Andrew had said very little to her. Now he stepped between her and the door.

"I can explain about room four twenty-one," he said softly.

"I couldn't care less," she responded. "Except that you should have been more alert after you got down here. If you hadn't been… sleeping, I suspect you would have checked those chems before you took him to the OR."

"I suspect you're right."

"Good," Sarah said, easing past him and into the hallway. "I love being right."

"Thanks for saving my bacon," he called out after her. "You're a hell of a doctor."

Sarah considered some sort of response, then just shook her head and continued on. Her pager sounded just as she reached the OB/Gyn floor. She responded, expecting to hear Andrew, anxious to continue mending fences. Instead, the voice on the line was Annalee Ettinger's.

• • •

Sarah sat on the edge of the bed in the small resident's call room, listening sadly to Annalee's account of what had transpired with her father.

"I couldn't tell what upset him more," Annalee said, "my going to see any M.D. at all, or my going to see you in particular."

"I'm the least important factor in this equation. I know an obstetrician in Worcester who would be happy to do a home birth for you."

"Peter's insisting on no M.D.s. Midwives only. He's even talking about flying some in from Mali."

"How do you feel about all this?"

"I feel sorry for you for what's being written in the papers. But that stuff hasn't influenced me one way or the other."

"Good."

"And even the things Peter promised-the money, and the recording chance for Taylor and all. But no matter how hard I try, I can't get past all the things Peter's done for me-from the very beginning."

"I understand."

"I know he's not perfect, but-"

"Annalee, you don't have to explain. I understand. Besides, you're a healthy young woman in great shape. I have no reason to think there'll be any problems. I'll send you the name of the obstetrician in Worcester, just in case you want his help in any way."

"Thanks for not making this any harder for me, Sarah."

"Nonsense."

There was a prolonged, uncomfortable silence.

"Sarah, there's something else," Annalee said finally. "Peter insisted I sit in on part of a meeting in his office."

"Go on."

"Four men and Peter. They want to hire him to check into the composition of that herbal supplement of yours and to check up on someone named Kwang or Kwok or something. Do you know who that is?"

Sarah was beginning to feel queasy.

"Yes, I know who that is," she said. "Who were the men?"

"Two were suits from New York-lawyers. They were there with this guy, Willis Grayson, the father of the girl you saved. The dude must be big stuff, because Peter was like a puppy around him. He acted as if I was supposed to know who he was, too, but I didn't."

"Who was the other man?" Sarah asked. Her hands felt like ice around the receiver.

"Another lawyer. Oilier than the others, if you know what I mean. His name's Mallon."

"Unfortunately, I know him, too."

"Sarah, Peter said some pretty unkind things about you. I think that's what he wanted me to hear. He said you were never as good an herbalist or acupuncturist as you liked to believe. I was on the edge of telling him to stop, or just walking out, but I just couldn't do either one. I'm-I'm sorry."

"Annalee, don't be sorry," Sarah said. "Just do what feels right, and don't lose touch with me. I appreciate your calling me like this."

"I'm sorry," Annalee said again.

Sarah hung up without another reply. She felt there was a chance that if she tried to speak, she would begin to cry. And Annalee did not deserve that sort of additional stress. How crazy. When they were together-at work and as lovers-Peter had told her and anyone else who would listen that she was one of the finest American herbal therapists and acupuncturists he had ever known. Now, suddenly, she was an inept fraud.

Sarah bunched the pillow beneath her head and stared wearily at the ceiling. The truth was that in becoming an M.D., in trying to blend the best of eastern and western medicine, she had become a threat to practitioners on both sides. That Andrew and Peter, the two practitioners attacking her now, both happened to be male may or may not have had significance. But she suspected it did.

For a time, blanketed by a pall of loneliness and isolation, she wept. Soon, though, she felt her spirit begin to regroup within a nidus of anger. Beyond tweaking two bulbous egos, she had done nothing wrong. If it was a fight they wanted, it was a fight they would get. She picked up the phone and paged Eli Blankenship. Within a minute he returned her call.

"Dr. Blankenship," she said. "I don't know exactly who I'm supposed to talk to, or what I'm supposed to do, but I'd like to meet with you as soon as possible. I think I'm about to be sued."