Shock

FOUR

THERE WAS NO TRANSITION period. One minute Joanna was fast asleep, and the next she was fully awake. She found herself staring up at a high, unfamiliar, embossed-tin ceiling.

"Well, well, the sleeping beauty has awakened," a voice said.

Joanna turned in the direction of the voice and found herself looking up into an equally unfamiliar face. At the exact instant she was going to ask where she was, her momentary confusion was replaced by full comprehension of her situation.

"Let's get your blood pressure," the nurse said as he took his stethoscope from around his neck and put the earpieces into his ears. He was an impeccably groomed individual, close to Joanna's age, dressed in surgical scrubs. His name tag said MYRON HANNA. He began inflating a blood pressure cuff already present around Joanna's left upper arm.

Joanna watched the man's face. His eyes were glued to the pressure gauge while he pressed the stethoscope's bell against the crook of her elbow. As the cuff deflated she felt her pulse surge through her arm. The man smiled and removed the apparatus.

"Your blood pressure is fine," he said. He then reached for her wrist to time her pulse.

Joanna waited until he was through. "What about my procedure?" she asked.

"Your procedure is all done," Myron said as he recorded his findings on a clipboard.

"You're joking," Joanna said. She had no appreciation of the passage of time.

"Nope, you're all done," Myron repeated. "And it was successful, I assume. Dr. Saunders must be pleased."

"I can't believe it," Joanna said. "My roommate told me when you wake up from anesthesia, you're sick to your stomach."

"That's rare nowadays," Myron said. "Not with propofol. Isn't it great stuff?"

"Is that what I had?"

"Yup!"

"What time is it?"

"A little after nine."

"Do you know if my roommate, Deborah Cochrane, has had her procedure?"

"She's having it as we speak," Myron said. "How about sitting up for me on the side of the bed?"

Joanna did as she was told. Her mobility was limited by the IV still attached to her right arm.

"How do you feel?" Myron asked. "Any dizziness? Any discomfort?"

"I feel fine," Joanna said. "Perfectly normal." She was surprised, especially by the lack of pain.

"Why don't you sit there for a few minutes," Myron suggested. "Then, if you are okay, we'll yank the IV and send you downstairs to change back into your street clothes."

"Fine by me," Joanna said. As Myron recorded her blood pressure and pulse, she glanced around at her surroundings. There were three other beds besides hers. None was occupied. The room was antiquated; it had clearly missed whatever facelift other parts of the Institute had received. Old tile lined the walls and floors, the windows looked old, and the sinks were made of soapstone.

The ersatz recovery room reminded her of the archaic operating theater where she'd had her procedure, and the thought gave her a shudder. It was the kind of OR in which she could imagine lobotomies being performed against vulnerable patients' wishes. When she'd first been wheeled in, the setting had reminded her of a gruesome, several-hundred-year-old painting she'd seen once of an anatomy lesson. In the painting the tiers of seats disappearing up into the darkness were occupied by leering men gazing down at a skinned, ghastly pale corpse.

The door to the recovery room opened. Joanna turned and spotted a short man with a shock of dark hair. His pale complexion made her think again of the old anatomy lesson painting. She saw he'd stopped short, and his surprised expression quickly changed to irritation. He was attired in a long doctor's white coat over green surgical scrubs.

"Hello, Dr. Saunders," Myron said, looking up from the desk.

"Mr. Hanna, I thought you told me the patient was still asleep," Dr. Paul Saunders snapped. His eyes stayed glued to Joanna's.

"She was, sir, when we spoke," Myron said. "She just woke up, and everything is fine."

Joanna felt acutely uncomfortable under the man's unblinking gaze. Joanna had reflexive, visceral reaction to authority figures thanks in part to her emotionally distant, staunchly disciplinarian, oil-company-CEO father.

"Blood pressure and pulse are all normal," Myron said. He stood up and started forward but stopped when Dr. Saunders held up his hand.

The doctor advanced toward Joanna with his mouth set. His nose had a wide base that gave the false impression of closely spaced eyes. But by far his most distinguishing characteristics were irises of slightly different colors and a minute widow's peak of white hair that quickly lost itself in the rest of his mildly unruly coiffure.

"How do you feel, Miss Meissner?" Paul asked.

Joanna noticed his tone was devoid of emotion, similar to the tone her father had used to ask her how her day had been back when she was in elementary school. "Okay," she answered, unsure if the man cared particularly or even wanted her to respond. Marshaling her courage, she asked: "Are you the doctor who did my egg retrieval?" She'd been put to sleep before Paul's arrival into the operating room.

"Yes," Paul replied in a manner which discouraged further questions. "Would you mind if I had a look at your abdomen?"

"I suppose not," Joanna said. She glanced at Myron, who immediately came around the other side of the bed. He encouraged her to lie back supine and then pulled the sheet up to her waist to cover her legs.

Paul gently pulled up the johnny, being careful to keep the sheet covering Joanna's lower half in place, and gazed down at Joanna's exposed midriff. Joanna lifted her head to look herself. There were three Band-Aids. One was directly below her navel, and the other two were in the lower quadrants forming an equilateral triangle.

"No sign of any bleeding,' Myron said, "and the gas has been absorbed."

Paul nodded. He pulled the johnny back to cover Joanna's abdomen and turned to leave.

"Dr. Saunders," Joanna called out impulsively.

Paul stopped and turned back.

"How many eggs did you get?"

"I can't remember exactly,' Paul said. "Five or six."

"Is that good?"

"It's perfectly adequate," Paul said. A faint smile graced his heretofore grim expression. Then he left.

"He's not much of a conversationalist," Joanna commented.

"He's a busy man," Myron said. He pulled the sheet back to expose her legs. "Why don't you stand up and see how that feels. I think you're about ready to have that IV taken out."

"Does Dr. Saunders do all the egg retrievals?" Joanna asked as she sat up and dropped her feet over the side of the bed. Then she slid off to stand while holding the johnny closed behind her back with her left hand.

"He and Dr. Donaldson do them together."

"Do you think his coming in here means my roommate's procedure is done?"

"'That would be my guess," Myron said. "How do you feel? Any dizziness at all?"

Joanna shook her head.

"Then let's get that IV out and get you on your way."

Fifteen minutes later Joanna was at the locker extracting her clothing, shoes, and bag. There were four other patients in hospital garb sitting on the couches and chairs and flipping through magazines. None of them paid her any attention. Deborah's locker was still locked up tight.

As Joanna entered the same changing room she'd used earlier, Cynthia arrived with Deborah in tow. Deborah's face lit up with a broad smile when she caught sight of Joanna, and she immediately rushed over to squeeze into the changing room. She closed the door behind her.

"How did it go for you?" Deborah demanded in a whisper.

"It wasn't bad at all," Joanna answered, unsure why they were whispering. "The anesthesiologist said I might feel a little burning in my arm when he gave me the 'milk of amnesia, but I didn't feel a thing. I don't even remember going to sleep."

"Milk of amnesia?" Deborah questioned. "What the hell is that?"

"It's what the anesthesiologist called the medicine he gave me," Joanna said. "It was so rapid. It was like somebody just turned out the lights. I didn't feel a thing through the whole procedure. And on top of that, I'm happy to report I didn't have any nausea when I woke up."

"Not even a little queasiness?"

"Nothing. And I woke up the same way I went to sleep: really suddenly." Joanna snapped her fingers to emphasize her point. "The whole experience was benign. How was yours?"

"Truly a piece of cake," Deborah said. "No worse than a routine pap smear."

"No pain?"

"A little, I suppose, when the local anesthetic went in, but that was it. The worst part was the humiliation of being looked into."

"How many eggs did they get?"

"I haven't the slightest idea," Deborah admitted. "I assume only one. That's how many we women put out each month without hormonal hyperstimulation."

"They got five or six from me."

"Well, aren't we impressed," Deborah said in a playfully sarcastic tone. "How do you know?"

"I asked," Joanna said. "The doctor came by when I was in the recovery room. His name's Dr. Saunders. You must have met him, because he's the one who does the egg retrievals along with Dr. Donaldson."

"Was this Dr. Saunders a rather short guy with unusual eyes?"

"He's the one. I think he's also kinda strange as well as quiet. What was weird was that he seemed to act mad when he found out I was already awake."

"Get out of here!" Deborah blurted.

"I'm serious."

"The reason I'm surprised is that he acted mad with me, too."

"No kidding!" Joanna said. "Then he's definitely got a problem, which is reassuring because I was wondering if I was making it up. You know me with authority figures."

"All too well," Deborah said. "And you think he was irritated because you were awake?"

"Yes," Joanna said. "He snapped at the nurse because the nurse had told him a few minutes earlier on the phone that I was still asleep. I suppose he had it in his mind to breeze in and breeze out. Instead, he had to relate to me, such as it was."

"That's absurd," Deborah said.

"The nurse excused his behavior by saying he was a busy man."

"He was equally inappropriate with me. Like everybody else he'd started in about wanting to use general anesthesia, and how much better it would be. But I just said no way. So he got mad. And you know what: It dawned on me why they had me suffer not eating or drinking since midnight. They thought they were going to talk me into it."

"You didn't have it, did you?"

"Hell no!" Deborah said. "I told them I was ready to get up and walk out, and I came close. If it hadn't been for Dr. Donaldson, who smoothed things over, I think I would have. But anyway, it all worked out."

"Let's get out of here," Joanna said.

"I'm with you," Deborah responded. She opened the louvered changing room door, winked at Joanna, and disappeared.

Joanna could hear Deborah out in the waiting room banging open her locker as Joanna peeled off the hospital clothing and tossed it into a convenient hamper. For a moment she gazed at herself in the changing room's full-length mirror. The thought of the small incisions beneath the Band-Aids made her shudder. They stood as minute reminders that someone had recently been looking into her innards.

The crash of the neighboring louvered door closing snapped Joanna back to reality. Fearful of keeping Deborah waiting, who was notoriously quick at dressing, Joanna concentrated on getting into her clothes. Once that was accomplished she began brushing out her hair, which she'd pulled back into a ponytail for the procedure but which was now a mass of snarls. Before she was finished, she heard Deborah emerge into the waiting room. "How are you doing in there?" Deborah called through the door.

"Almost ready," Joanna answered. Her hair was giving her more trouble than usual, with loose ends dangling in her face. She'd had bangs in high school that she'd grown out in college. After a last check in the mirror, she finally opened the changing room door. Deborah rewarded her with an exasperated expression.

"I hurried," Joanna said.

"Sure you did," Deborah said as she got to her feet. "You should try short hair like mine. You'll save yourself a lot of grief; it's ten times easier."

"Never," Joanna said jokingly, but she meant it. Despite the difficulties, she treasured her long hair.

The two women called out a thank you to Cynthia, and she waved in acknowledgment. The women sitting on the couch and the chairs looked up, several smiled, but all had returned to their reading before Joanna and Deborah had passed through the swinging doors.

"I just realized there's something we forgot to ask about," Deborah said as they walked down the main hallway.

"Do I have to ask, or are you just going to tell me?" Joanna said with a sigh, when Deborah failed to complete her thought. She found it mildly irksome that Deborah had a tendency not to finish a thought unless prompted.

"We forgot to ask how or when we were going to be paid."

"It's certainly not going to be in cash," Joanna said.

"I know that!" Deborah grumbled.

"It will be by check or wire," Joanna said.

"All right, but when?"

"The contracts we signed stipulated we would be paid when we had performed our service, which we've now done. So they'll pay us now."

"You seem to be more trusting than I," Deborah said. "I think we should inquire about it before we leave."

"That goes without saying," Joanna said. "I think we should page Dr. Donaldson if she's not out in the main waiting room."

The two women came to the threshold of the waiting room and glanced around the generous space. Nearly every seat was taken. There were spotty areas of hushed conversation but in general the room was surprisingly quiet for being so crowded.

"Well, no Dr. Donaldson," Deborah said. Her eyes swept the room once again to be certain.

"So, let's have her paged," Joanna said.

Together they approached the central desk. The receptionist was an attractive, young, amply endowed redhead. She had pouty, full lips like many of the women gracing the covers of the magazines displayed in the grocery checkout line. Her nameplate said ROCHELLE MILLARD.

"Excuse me," Joanna said to get the woman's attention. She was surreptitiously reading a paperback book cradled in her lap.

The book disappeared as if by magic. "Can I help you?" Rochelle asked.

Joanna asked for Dr. Donaldson to be paged.

"Are you Joanna Meissner?" Rochelle questioned.

Joanna nodded.

Rochelle's eyes switched to Deborah. "Are you Miss Cochrane?"

"I am," Deborah said.

"I have something for each of you from Margaret Lambert, the comptroller." Rochelle opened a drawer to her right and pulled out two envelopes with cellophane windows. Neither was sealed. She handed them to the surprised women.

After exchanging a covert, conspiratorial smile, the two women peeked inside their respective envelopes. A moment later their eyes met with new smiles.

"Bingo!" Deborah said to Joanna. She laughed. Then she turned to the receptionist and said: "Mille grazie, signorina. Partiamo a Italia."

"The first part means a thousand thanks in Italian," Joanna said. "The rest I'm not sure about. And forget about paging Dr. Donaldson. It's not necessary."

Leaving the confused receptionist, Joanna and Deborah started for the door.

"I feel a little like a thief taking this kind of money out of here," Deborah said sotto voce as they wended through the crowded room. Like Joanna she was clutching her envelope in her hand. She avoided eye contact with anyone, fearing she might be forced to face someone who'd had to mortgage her home to pay for infertility treatment.

"With this many patients here I think the Wingate can afford it," Joanna responded. "I'm getting the distinct feeling this business is a virtual money machine. Besides, it's the prospective clients who are actually paying us, not the clinic."

"That's just the point," Deborah said. "Although I suppose those people choosey enough to demand a Harvard coed's egg can't be hurting for cash."

"Exactly," Joanna said. "Concentrate on the idea that we are helping people, and they, in their gratitude, are helping us."

"It's hard to feel altruistic getting a check for forty-five thousand dollars," Deborah said. "Maybe I feel more like a prostitute of sorts than a thief, but don't get me wrong, I'm not complaining."

"When the couples get their children, they'll be thinking they got the better deal by a long shot."

"You know, I think you are right," Deborah said. "I'm going to stop feeling guilty."

They emerged into the crisp New England morning. Deborah was about to descend the stairs when she became aware that Joanna was hesitating. Glancing at her friend's face she noticed that Joanna was grimacing.

"What's the matter?" Deborah asked with concern.

"I just had a pang down here in my lower abdomen," Joanna said. She gestured with her left hand over the area. "I even felt a twinge in my shoulder, of all places."

"Do you still feel it?"

"Yes, but it's better."

"Do you want to go back and see Dr. Donaldson?"

Joanna tentatively pushed against her lower belly just in from the crest of her left hip. There was a mild degree of discomfort until she let go. Then she got another stab of pain. A whimper escaped from her lips.

"Are you all right, Joanna?"

Joanna nodded. Like the first spasm, the pain had been fleeting except for a remaining mild ache.

"Let's go page Dr. Donaldson,' Deborah said. She grasped Joanna's arm with the intention of leading her back into the Wingate Clinic, but Joanna resisted.

"It doesn't feel that bad," Joanna said. "Let's go to the car."

"Are you sure?"

Joanna nodded again, gently extracted her arm from Deborah's grip, and started down the steps. At first it felt decidedly better to walk slightly bent over, but after a half dozen steps she was able to straighten up and walk relatively normally.

"How does it feel now?" Deborah questioned.

"Pretty good," Joanna asserted.

"Don't you think it would be a better idea to go back in and see Dr. Donaldson, just to be on the safe side?"

"I want to get home," Joanna said. "Besides, Dr. Smith specifically warned me about having the kind of pain I'm experiencing, so it's not as if it's unexpected."

"He warned you about pain?" Deborah asked with surprise.

Joanna nodded. "He wasn't sure which side I would feel it on, but he said I'd have a deep ache with some stabs of sharp pain which is right on the money. The surprise for me is that I didn't feel it until now."

"Did he have any suggestions for what to do for it?"

"He thought ibuprofen would suffice, but he said that if it didn't, I could have a pharmacist call him through the clinic's telephone number. He said he's available twenty-four hours a day."

"That's strange they gave you a warning about pain," Deborah said. "Nobody warned me, and I haven't had any. I think maybe you should have insisted on local anesthesia like I did."

"Very funny," Joanna said. "I liked being asleep through the ordeal. It was worth a bit of pain and the mild inconvenience of having to get three stitches removed."

"Where did you have stitches?"

"At the peephole sites."

"Are you going to have to come back here to get them removed?" Deborah asked.

"They told me any medical person could do it," Joanna said. "If Carlton and I are talking by then, he can do it for me. Otherwise I'll just stop in the health service."

They reached the car and Deborah went around to the passenger side to open the door for her roommate. She even supported Joanna's arm as Joanna climbed in. "I still think you should have had local anesthesia," she said.

"You're never going to convince me," Joanna said with conviction. Of that, she felt sure.