Silent Justice: A Ben Kincaid Novel of Suspense

Now

BILLY’s MOMMY FIGURED HE probably had the flu. There wasn’t that much to it at first—just coughs, runny nose, congestion. She went through the usual drill: rest, lots of liquids, and occasional doses of Tylenol. After a week, though, he still wasn’t any better, and his fever was climbing. His appetite had disappeared; he had to be forced to eat and even then ate precious little. He seemed pale, and this was a twelve-year-old boy in the midst of an Oklahoma summer. He moved more slowly, although he still wasn’t willing to curtail his social life.

“Gee, Mom, I gotta go out. Gavin’s got a new computer game. They say it makes Doom 2 look like sissy stuff.”

Cecily Elkins, Billy’s mother, checked the reading on the thermometer. “You’re not going anywhere until your temperature comes down.”

“But Mo-om—”

“Don’t Mom me. You’re staying in bed.”

“Oh, all right. Great.” He glanced back at her. “What about you?”

“What do you mean, what about me?”

“You look kinda tired yourself. You’ve been workin" too hard.”

Come to think of it, she was rather tired. Having a sick child at home for a week was a major strain, no two ways about it. But how many twelve-year-olds would’ve noticed?

“Tell you what, pardner,” she said, fluffing his pillow. “If you’ll stay in bed, I’ll go take a short nap.”

“Make it a long one, Mom. You need your rest.”

She put her hands on her hips. “Now wait a minute. Who’s the parent here?”

Billy laughed.

“I think I’m supposed to be in charge, buster, remember?”

“I think we should take care of each other, now that it’s just the two of us.” Billy’s expression was innocent and without guile. “Isn’t that right?”

She wanted to hug him, but she resisted, since she knew he would complain about it.

More days passed and Billy still did not get well. Cecily became most concerned, however, when she noticed the bruises. There were several of them up and down his arms. When she removed his shirt, she found them on his chest as well. That was when she began to suspect they might be dealing with something other than the flu. She made an appointment for Billy to see his pediatrician that afternoon.

Dr. Harlan Freidrich tried to mask his concern, but it was obvious to Cecily that he was alarmed by Billy’s appearance. He said words that were calming and reassuring, but Cecily ignored the words and focused on the doctor’s eyes. The eyes were worried.

Yes, he had some upper respiratory congestion. Yes, there must be an infection of some sort. The bruises might be an indicator of some sort of anemia, he explained, a deficiency of blood platelets. Billy’s lymph nodes were also slightly swollen. Eventually, in his calm, there’s-nothing-to-worry-about voice, Dr. Freidrich told Cecily that he suspected Billy had some sort of blood disorder. That hit her hard, but what struck even stronger was the creeping sensation she got from peering into the doctor’s eyes. What he had told her was horrible. But she sensed there was something more, something he suspected but dared not tell her—yet.

If Cecily had not looked at the chart left behind in Billy’s hospital room, two weeks later, she might not have been prepared for the worst. But she had looked—and why shouldn’t she? She knew it shouldn’t have been left on that desk, that it was an accident that resulted when the nurse tried to do too many things at once. But Billy was her son, damn it. She had a right to know anything there was to know. Even things the doctors were not yet prepared to tell her.

Much of the gibberish on the chart meant little or nothing to her. “Underweight, lethargic, twelve-year-old. Normally active, but not of late. Easy bruisability.” She skipped to the analysis of the now dozens of blood tests that had been performed. “Results indicate generalized lymphadenopathy, although no petechiae. The spleen was not palpable.” It didn’t sound good, but she didn’t really know what it meant.

She continued flipping through the pages. The day before, the doctors had performed what they called a bone marrow aspiration. Decoding the doctor’s atrocious handwriting, she read the results. “Thirty-eight percent blast cells.” Next to the results, the doctor had drawn an arrow and written in: “Definite signs of leukemogenesis.”

That afternoon, Dr. Freidrich called Cecily into his office. He had also wanted Billy’s father to be present, but when Cecily called him, he said he was in the middle of an important project at work and couldn’t get away. So Cecily was alone when she received the bad news she already knew was coming.

“Your son has leukemia,” the doctor said. He cleared his throat, then walked around his desk and sat in the chair beside her. “There’s no doubt in our minds. It’s acute lymphocytic leukemia.”

Cecily steeled herself, tried not to react. After all, she had known it was coming. She was proud of herself, in a strange way, proud that she wasn’t behaving like a typical weak-kneed mother. She would show the doctor that she had strength. That she had what it took to weather this crisis.

“The next few weeks will be critical for Billy,” the doctor continued. “We’re going to try to induce a remission through a combination of radiation and drug therapy. I believe the chances of remission in this case are good. But I have to be honest with you. There’s also about a ten percent chance that Billy will… pass away. In the next few weeks.”

Cecily heard his words, but she felt oddly distant, as if she wasn’t really there at all. Her eyes focused on the window behind the doctor’s desk. She watched the cars racing up and down Maple, shoppers headed for Wal-Mart, diners going to the Blackwood Bar-B-Q. She focused on the glints of sunlight that streamed through the window, refracted, and formed miniature rainbows on the wall. She wasn’t really there. She wasn’t really there.

“The greatest potential hazard we face in the upcoming weeks is not from the leukemia itself but from the risk of infection. The chemo will kill the cancer cells in Billy’s blood and bone marrow, but it will also damage his immune system. The simplest infection—a cold, even—could cause him to … pass away.”

There it was again, that evil phrase. Pass away. What was this man, a priest or something? Why didn’t he just say what he meant? Why didn’t he just tell her that the boy she had carried in her womb and nurtured for twelve years might die?

“I know there must be a thousand thoughts running through your mind at this time,” Dr. Freidrich continued. “Let me put some of them to rest. This is not your fault. No one knows what causes leukemia. There’s nothing you could’ve done to prevent this.” He placed his hand on the edge of her chair. “I want you to know we’re going to do everything we can to help your Billy.”

Damn right, she thought silently. Damn straight you’ll do everything you can. And more important, so will I. I will not let my baby boy die. I will not allow it.

The initial treatment of chemo and radiation took about a month. Billy received several blood transfusions, as the doctors worked to increase his platelet count. Cecily spent every night with Billy throughout his hospital stay. Every night. Billy’s hair began to fall out and he was constantly nauseated. His platelet count remained low, but it did not drop further, and no new bruises appeared on his skin. At the end of the month, the doctors could find no traces of leukemic cells in his blood or bone marrow. They declared him to be officially in remission. The treatment had been a success.

After he was discharged, Billy had to visit the hospital twice a week on an outpatient basis to complete an extended maintenance program, which included more chemo. He obviously didn’t enjoy it. He was tired of throwing up all the time and he wanted his hair to grow back. But for a twelve-year-old who had been through what he had, he remained remarkably chipper.

“Mom, I think next summer I’m gonna want to play baseball,” Billy announced one evening during dinner.

Cecily raised an eyebrow. This was an interesting development. She’d been trying to get him to go out for baseball for three years, but he’d never shown any interest. He preferred soccer. Baseball was a sissy game. Or used to be, anyway.

“What brought on this about-face?”

“Well … I think the kids at school are startin" to get suspicious.”

“Suspicious? Of what?”

“Of me. Wearin" this baseball cap every day.” Billy wore a baseball cap at school to hide the fact that most of his hair had fallen out. Everyone knew this, but Billy preferred to imagine everyone thought it was just a fashion statement. “I was thinkin" maybe if I was actually playing baseball, it might seem more natural.”

Cecily couldn’t resist a smile. She was so proud of her son. He had been through so much, but still had not lost his spirit. “Tomorrow we’ll go to Wal-Mart and buy you a baseball mitt. What d’ya say?”

“All right!”

Billy did not play baseball the following summer. Five months later, during a routine visit, Dr. Freidrich noticed that Billy’s blood platelet count had decreased. He immediately ordered a bone marrow aspiration, and when that proved inconclusive, he ordered a second and a third. By this time Billy was experiencing constant nosebleeds, and the bruising had returned with a vengeance. The fourth aspiration revealed 46 percent blasts.

Dr. Freidrich met Cecily in the hospital corridor outside Billy’s room. He instinctively clasped her hand, something he had never done before with a patient or their relatives.

“Tell me,” she said, her lips pressed together to prevent them from quivering. “Just tell me.”

“He’s relapsed,” the doctor said quietly. “The leukemia is back.”

“Can we restart the full-time treatment? Induce another remission?”

“Probably.” The doctor drew in his breath slowly. “But even if we do, it will only be temporary. We have to look at this realistically. The chances of an absolute cure in this case are … remote.”

“This isn’t a case,” Cecily said, struggling to maintain control. “This is my son.”

“I know that, but—”

“I want him to start back with the radiation. And the chemo. Immediately.”

The doctor nodded, holding his private thoughts in reserve. “As you wish.” He hesitated a moment, then added, “Cecily, I’d like to give you some names.” He pulled a scrap of paper out of his white lab coat. “These are parents of some of my other patients.”

“I’m not going to some soapy support group,” Cecily said firmly. “I’m too busy to spend my time sitting in a circle whining.”

“Cecily … these parents also have sons. And their boys also have leukemia. Some of them … even more advanced than Billy’s.”

Wordlessly, Cecily took the list he proffered. Her eyes scanned the names. “Colin Stewart? He lives on the same block we do.”

The doctor nodded.

“Ed Conrad. Jim Foley. These boys go to the same school as Billy. How can this be?”

“There’s no explaining cancer, Cecily.”

“But didn’t you tell me leukemia was very rare?”

“Yes. Fewer than four children out of one hundred thousand each year.”

“But—these are four children who live within a mile of one another!”

“And there are others besides. I’m not the only pediatrician in Blackwood. Do yourself a favor, Cecily. Talk to some of the other mothers.”

She shook her head, then crumpled the paper in her hand. “I’ve got a boy to take care of.”

Dr. Freidrich reinstituted a program of full-time radiation and chemotherapy, and by the end of the month, the disease was once again in remission. But by April Billy’s platelet and white-blood cell counts were falling again. Dr. Freidrich performed several bone marrow biopsies. It seemed the number of cells in Billy’s blood marrow was now decreasing altogether. He recognized this as a condition called aplastic anemia. It was not leukemia, but it could be just as deadly. And there was no reliable treatment for it. After considerable thought, he decided to send Billy home. He feared the worst, but there was nothing he could do about it.

Three weeks later, on Mother’s Day, Billy did not wake up in the morning at his usual time. When Cecily went in to check on him, his breathing was shallow and raspy. Hard as she tried, she could not wake him.

My God, she thought silently. This is it. It’s happening.

Straining with all her might, she lifted him out of bed. He roused slightly, but was still too weak to walk.

“Mommy,” he said quietly.

She clenched her teeth, fighting back her emotions. He hadn’t called her Mommy for years.

“Mommy, I don’t feel so good.”

“It’s all right, baby,” she said, running toward the car as fast as she could. “I’m going to take you to the doctor.”

The prospect made him wince. “Mommy.” His voice was so soft she had to bend her ear toward his mouth to hear. “I think I’m going to go now.”

“You are not going anywhere,” Cecily said firmly. “I will not allow it.”

She tossed him into the front seat and started the car. She hadn’t dressed yet, but that wasn’t important. She only stopped long enough to snatch her purse, because she knew if she didn’t bring her health insurance card the hospital probably wouldn’t even let her through the door. She started the car and blazed down Park toward the hospital.

As she approached Maple, she noticed that Billy’s eyes were closed and his chest wasn’t moving. Breathe, she thought, as she pulled the car over and climbed across the seat. Breathe, she commanded, as she pounded on his fragile chest. Breathe, she pleaded, as she pressed her lips against his. Please, God. Just let him breathe!

A roving police officer spotted Cecily’s car on the side of the road, saw what was happening, and called for an ambulance. But by the time it arrived, Billy was long gone.

Cecily forced herself to retain her fixed, impassive expression. She would not break down, she told herself. She would not be typical. She would not give them what they wanted.

As the paramedics loaded Billy’s body into the ambulance, one of them spoke to her. “Is your boy one of Dr. Freidrich’s patients?”

She stared at him, at first not comprehending. His voice was pulling her to the present, tugging her back to earth. “Yes. How did you know?”

“My boy Jim had leukemia, too. I’m Ralph Foley.”

Ralph Foley, she thought. Of course. She remembered seeing Jim Foley’s name on the list Dr. Freidrich had given her.

“I know what you must be going through right now,” Foley said. “Me and some of the others have a group that gets together once a week. If you ever need someone to talk to …”

“I’m not a talker,” Cecily said. She climbed into the back of the ambulance and accompanied her boy to the hospital.

Once the formalities were over, Cecily knew she was free to leave. But somehow, she couldn’t make herself do it. Her feet refused to take the first step. To leave the hospital would be to acknowledge that it was all over, that Billy was gone, truly gone, never to return again. She had sworn to herself that she would not let her son die. She had sworn to him that she would not let him die. She had failed them both.

All at once, tears flowed like floodwater. The dam had burst. Everything she had resisted, everything she had been holding back for months, came gushing out.

She was racked with pain, gasping for air with great heaving breaths. Her whole body trembled. She hurriedly found a chair in the waiting room and sat in it before she collapsed. The aching was like an electric current radiating through every part of her body. She was so tired, tired of fighting, tired of losing. Exhausted. And her baby boy was gone.

“Can I be of help?”

She turned and saw a priest, dog collar and all, sitting behind her, his hand outstretched. She did not know him, but she thought he belonged to that Episcopal church on West Elm.

She wiped her face clear. “Not unless you can perform miracles.”

The priest was not offended. “That is not within my power. But I can listen.”

“Talk, talk, talk.” She realized her voice was louder than it needed to be. It sounded shrill, awful, even to her own ears. “Why is everyone so goddamn anxious to talk?” She turned her back on him.

“Listen to me,” the priest said gently. “You’re going through a difficult time. You’ve lost someone you cared about very much. I don’t know who he was, but I know he was important to you. So important that maybe you don’t think you can go on without him.”

“Of course I can go on,” she said, once again wiping her eyes. “Don’t you see? This isn’t about me. It’s about Billy. What happened to him isn’t right. It isn’t fair.

“The world is unfair, at times. We don’t understand what happens, or why.”

“I understand perfectly what happened,” Cecily said, forcing herself to her feet. “But this is what I don’t understand. This is what I have no answer for. How could God let this happen? And why?”

The priest placed his arm around her shoulder, but he did not attempt to answer her question. Cecily thought that was probably wise. There were no answers. Not with him, not with anyone else. No answers. No answers at all.

In the weeks and months that followed Billy’s death, Cecily became obsessed with the question she had raised that night in the hospital: Why had this happened? She had always believed in a rational, logical world. She had studied science before she married, hoping to become a biologist. She had been taught to believe in cause and effect, trial and error. Nothing happened without a reason. Anything could be explained, if one only had the analytical tools to comprehend it. But no matter how she tried, what she read, or whom she talked to, she was unable to uncover a solution to the enigma she most wanted resolved: why her precious boy died.

Until one morning she read a story on the front page of the Blackwood Gazette. And then she knew.