Handle With Care Read online



  'Did you ever see something that looked wrong on Charlotte O'Keefe's sonogram?'

  'Yes, when we did one at twenty-seven weeks.' I glanced at Charlotte and remembered that moment when I first looked at the screen and tried to make the image into something it wasn't, the sinking feeling in my stomach when I realized that I would have to be the one to tell her. 'There were healing fractures of the femur and tibia, as well as several beaded ribs.'

  'What did you do?'

  'I told her that she needed to see another doctor, someone in maternal-fetal medicine who was better equipped to deal with a high-risk pregnancy.'

  'Was that twenty-seven-week ultrasound the first indication you had that there might be something wrong with the plaintiff's baby?'

  'Yes.'

  'Dr Reece, have you had other patients who were diagnosed with abnormal fetuses in utero?'

  'Several,' I said.

  'Have you ever advised a couple to terminate the pregnancy?'

  'I've presented that option to numerous families when malformations are diagnosed that aren't compatible with life.'

  Once, I had a case where a thirty-two-week fetus had hydrocephaly - so much fluid on the brain that I knew the baby couldn't be born vaginally, much less survive. The only way to deliver would have been C-section, but the fetal head was so large that the incision would have destroyed the mother's uterus. She was young, it was her first pregnancy. I offered her the options, and eventually we drained the fluid from the head by piercing it with a needle, causing a cranial hemorrhage. The baby was then delivered vaginally, and died within minutes. I remembered showing up at Charlotte's house that night with a bottle of wine, and telling her I had to drink the day away. I'd slept on her couch afterward, and had awakened to find her standing over me with a steaming mug of coffee and two Tylenol for my throbbing head. 'Poor Piper,' she had said. 'You can't save them all.'

  Two years later, that same couple came back to me when they were having another baby - who was born, thank goodness, perfectly healthy.

  'Why didn't you counsel termination for the O'Keefes?' Guy Booker asked.

  'There was no definitive reason to believe the baby would be born impaired,' I said, 'but even beyond that, I never thought termination would be an option for Charlotte.'

  'Why not?'

  I looked up at Charlotte. Forgive me, I thought.

  'For the same reason she didn't agree to amniocentesis when we thought there was a risk of Down syndrome,' I said. 'She'd already told me she wanted this baby, no matter what.'

  Charlotte

  I

  t was hard to sit here and listen to Piper giving a chronicle of our friendship. I imagine it had been just as hard for her when I had been the witness. 'Were you close to the plaintiff after she gave birth?' Guy Booker asked.

  'Yes. We'd see each other once or twice a week, and we talked every day. Our kids would play together.'

  'What sorts of things did you do together?'

  God, what had we done? It didn't really matter. Piper had been the kind of friend with whom I didn't have to fill in the spaces with random conversation. It was okay to just be with her. She knew that sometimes I needed that - to not have to take care of anyone or anything, to simply exist in my own space, adjacent to hers. Once, I remembered, we told Sean and Rob that Piper had a conference in Boston at the Westin Copley Place, and that I was going along to talk about having a baby with OI. In reality, there had been no conference. We checked in to the Westin and ordered room service and watched three sappy movies in a row, until we could not keep our eyes open.

  Piper had paid. She always paid - treating me to lunch out, or coffee, or drinks at Maxie's Pad. When I tried to go dutch, she'd make me put my wallet away. I'm lucky enough to be able to afford it, she said, and we both knew that I wasn't.

  'Did the plaintiff ever have a conversation with you where she blamed you for her daughter's birth?'

  'No,' Piper said. 'In fact, the week before I was served, we went shopping together.'

  Piper and I had tried on the same red blouse in between Emma's and Amelia's buying fits, and to my shock, it had looked fantastic on both of us. Let's both get one, Piper had said. We can wear them home and see if our husbands can tell us apart.

  'Dr Reece,' Booker asked, 'how has this lawsuit affected your life?'

  She sat up a little straighter in the chair. It wasn't very comfortable; it hurt your back, made you wish you were somewhere else. 'I've never been sued before,' Piper said. 'This was the first time. It's made me doubt myself, even though I know I didn't do anything wrong. I haven't practiced since. Every time I try to get back on that horse . . . well, it starts moving away from me. I suppose I understand that, even if you're a good physician, bad things sometimes happen. Bad things that nobody wishes for, and that nobody can explain.' She looked directly at me, so intently that a shiver went down my spine. 'I miss being a doctor,' Piper said, 'but nowhere near as much as I miss my best friend.'

  'Marin,' I whispered suddenly, and my lawyer bent her head toward mine. 'Don't.'

  'Don't what?'

  'Don't . . . just don't make it worse for her.'

  Marin raised her eyebrow. 'You have got to be kidding,' she murmured.

  'Your witness,' Booker said, and she rose to her feet.

  'Isn't it a violation of medical ethics to treat someone you know well on a personal level?' Marin asked.

  'Not in a small town like Bankton,' Piper said. 'If that was the case, I wouldn't have any patients. As soon as I realized there was a complication, I stepped down.'

  'Because you knew you were going to be blamed?'

  'No. Because it was the right thing to do.'

  Marin shrugged. 'If it was the right thing to do, why didn't you call in a specialist as soon as you saw complications during the eighteen-week ultrasound?'

  'There weren't complications during that ultrasound,' Piper said.

  'That's not what the experts have said. You heard Dr Thurber say that the standard of care, after an ultrasound reading like Charlotte's, would have been a follow-up ultrasound, at the very least.'

  'That's Dr Thurber's opinion. I respectfully disagree.'

  'Hm. I wonder whom a patient would rather listen to: a doctor who's established in his field, with numerous awards and citations . . . or a small-town OB who hasn't been near a patient in over a year.'

  'Objection, Your Honor,' Guy Booker said. 'Not only was that not a question but my witness doesn't need to be vilified.'

  'Withdrawn.' Marin walked toward Piper, tapping a pen against her open palm. 'You were best friends with Charlotte, right?'

  'Yes.'

  'What did you talk about?'

  Piper smiled a little. 'Everything. Anything. Our kids, our pipe dreams. How we sometimes wanted to kill our husbands.'

  'But you never bothered to have a conversation about terminating this pregnancy, did you?'

  During interrogatories I had told Marin that Piper had not discussed aborting the baby with me. And the way I had remembered it up to this point, that's exactly the way it was. But memory is like plaster: peel it back and you just might find a completely different picture.

  'Actually,' Piper said, 'we did.'

  Although Piper and I were best friends, we didn't touch very often. A quick hug sometimes, a pat on the back. But we weren't like teenage girls, who walk with their arms twined around each other. Which was why it felt so strange to be sitting beside her on a couch, her arm wrapped around me while I cried against her shoulder. She was bony, birdlike, when I would have expected her to be strong and fierce.

  I had held my hands over the bowl of my belly. 'I don't want her to suffer.'

  Piper sighed. 'I don't want you to suffer.'

  I thought of the conversation Sean and I had had after we left the geneticist's office the day before, after being told you had - at worst - lethal OI and - at best - severe OI. I had found him in the garage, sanding the rails of the cradle he'd been making in anticipation