A Case Of Need Part 6

He didn't have a drink in his hand, and he was smoking rather slowly and deeply. "Say," I said, "you want to watch that." He laughed. "My social protest for the night."Judith said, "I tried to tell him somebody would smell it.""n.o.body here can smell anything," Hammond said. It was probably true; the room was thick with blue smoke. "Besides, remember Goodman and Gilman."9"Still. Be Careful."

"Think of it," he said, taking a deep drag. "No bronchogenic carcinoma, no oat-cell carcinoma, no chronic bronchitis and emphysema, no arteriosclerotic heart disease, no cirrhosis, no Wernicke-Korsakoff. It's beautiful."

"It's illegal."He smiled and pulled at his moustache. "You're up for abortion but not maryjane, is that it?""I can only take one crusade at a time."

A thought came to me as I watched him suck in a mouthful of smoke and exhale clear air. "Norton, you live on the Hill, don't you?"

"Yes.""Do you know anybody named Bubbles?"He laughed. "Everybody knows Bubbles. Bubbles and Superhead. They're always together.""Superhead?""Yeah. That's her bag at the moment. He's an electronic musician. A composer. He likes things 9 Goodman and Gilman, The Pharmacological Basis of Therapeutics, The Pharmacological Basis of Therapeutics, the definitive text of pharmacology used by doctors. There is a discussion of the effects of marijuana on page 300 which has been widely quoted in recent legal proceedings. the definitive text of pharmacology used by doctors. There is a discussion of the effects of marijuana on page 300 which has been widely quoted in recent legal proceedings.

that sound like ten dogs howling. They're living together.""Didn't she live with Karen Randall?""I don't know. Maybe. Why?""What's her real name? Bubbles."He shrugged. "I never heard her called anything else. But the guy: his name is Samuel Archer.""Where does he live?""Over behind the State House somewhere. In a bas.e.m.e.nt. They have it fixed up like a womb.""A womb?""You have to see it to believe it," Norton said, and he gave a relaxed, satisfied sigh.

TEN.

JUDITH SEEMED TENSE ON THE DRIVE BACK. She sat with her knees together and her hands clasped around them. She was squeezing her hands hard; the knuckles were white. with her knees together and her hands clasped around them. She was squeezing her hands hard; the knuckles were white."Something wrong?""No," she said. "Just tired."I said, "Was it the wives?"

She smiled slightly. "You've become very famous. Mrs. Wheatstone was so upset that she missed a bid at this afternoon's game, I understand."

"What else did you hear?"

"They all asked me why you were doing it, helping Art. They thought it was a marvelous example of a man sticking by his friend. They thought it was heartwarming and humane and wonderful."

"Uh-huh.""And they kept asking why.""Well, I hope you told them it's because I'm a nice guy."She smiled in the darkness. "I wish I'd thought of that."Her voice was sad, though, and her face in the reflected light of the headlights was drawn. I knew it wasn't easy for her to be with Betty all the time. But somebody had to do it.For some reason, I remembered my student days and Purple Nell. Purple Nell was a seventy-eight-year-old former alcoholic who had been dead a year before she became our cadaver. We called her Nell, and a lot of other things, small grim jokes to help us get through our work. I remembered my desire to quit, to stop cutting the cold, damp, stinking flesh, to stop peeling away the layers. I dreamed of the day I would be finished with Nell, when I could forget her, and the smells, and the feel of greasy, long-dead flesh. Everyone said it got easier. I wanted to stop, to be finished and done. But I never quit until all the dissections had been completed, all the nerves and arteries traced out and learned.After my initial harsh experience with cadavers, I was surprised to find I was interested in pathology.I like the work and have learned to push from my mind the smells and the sight of each new corpse, each new postmortem. But somehow autopsies are different, in some strange sense more hopeful. At autopsy you are dealing with a man, newly dead, and you know his story. He is not a faceless, anonymous cadaver but a person who had recently waged a very private battle, the only private battle in life, and lost. Your job is to find out how, and why, he lost, in order to help others who will soon do battle-and yourself. It is a far cry from the dissection cadavers, which exist in a kind of sickening, professional death, as if their only purpose in their twilight, embalmed afterlife is to be thoroughly, inspectably dead.

WHEN WE GOT HOME, Judith went in to check on the kids and call Betty. I took the sitter home. She was a short, pert girl named Sally, a cheerleader at Brookline High. Normally, when I drove her home we talked about neutral, safe things: how she liked school, where she wanted to go to college, things like that. But tonight I was feeling inquisitive, and old, and out of touch, like a man returning to his country after an extended time abroad. Everything was different, even the kids, even youth. They weren't doing what we had done. They had different challenges and different problems. At least, they had different drugs. Perhaps the problems were still the same. At least, that was what you wanted to think.

Finally I decided I had had too much to drink at the party, and had better keep my mouth shut. So I let Sally talk about pa.s.sing her driver's test, and nothing more. As she talked, I felt both cowardly and relieved. And then I thought that it was foolish, that there was no reason for me to be curious about my babysitter, no reason to get to know her, and that if I tried it might be interpreted wrongly. It was safer to talk about drivers' licenses; solid, respectable, reasonable ground.

Then, for some reason, I thought of Alan Zenner. And something Art had said. "If you want to know about this world, turn on your television to an interview program, and turn off the sound." I did, a few days later. It was bizarre: the faces moving, the tongues going, the expressions and the hands. But no sound. Nothing at all. You had no idea what they were saying.I FOUND THE ADDRESS in the phone book: Samuel F. Archer, 1334 Langdon Street. I dialed the number. A recorded voice came on."I am sorry, sir, the number you have dialed is not in service at this time. If you hold the line, an operator will give you further information."I waited. There was a series of rhythmic clicks, like the beat of a telephone heart, and then the operator. "Information. What number are you calling?""Seven-four-two-one-four-four-seven.""That number has been disconnected.""Do you have another listing?""No, sir."Probably Samuel F. Archer had moved, but perhaps he hadn't. I drove there directly. The apartment was located on a steep hill on the east slope of Beacon Hill, in a battered apartment building. The hallway smelled of cabbage and baby formula. I went down a flight of creaking wooden stairs to the bas.e.m.e.nt, where a green light flashed, illuminating a door painted flat black.A sign said, G.o.d GROWS HIS OWN.I knocked.From inside, I could hear screeches, whines, warbles, and something that sounded like groans. The door opened and I faced a young man in his twenties with a full beard and long, damp black hair. He wore dungarees, sandals, and a purple polka-dot s.h.i.+rt. He looked at me blandly, showing neither surprise nor interest. "Yes?""I am Dr. Berry. Are you Samuel Archer?" "No.""Is Mr. Archer in?""He's busy right now.""I'd like to see him.""You a friend of his?"

He was staring at me with open suspicion. I heard more sounds-a grating, a rumble, and a long, drawnout whistle.

"I need his help," I said.He seemed to relax slightly. "This is a bad time.""It's urgent.""You're a doctor?""Yes.""You have a car?""Yes.""What kind?""Chevrolet. Nineteen-sixty-five.""What's the license?""Two-one-one-five-sixteen."

He nodded. "O.K.," he said. "Sorry, but you know how it is these days. You can't trust anyone.1 Come in." He stepped back from the door. "But don't say anything, all right? I'll tell him first. He's composing, and he gets pretty wrapped up. It's the seventh hour and it should be O.K. But he does flip out easy. Even late." Come in." He stepped back from the door. "But don't say anything, all right? I'll tell him first. He's composing, and he gets pretty wrapped up. It's the seventh hour and it should be O.K. But he does flip out easy. Even late."

We walked through what seemed to be a living room. There were studio couches and a few cheap lamps. The walls were white, and painted in weird, flowing designs in fluorescent colors. An ultraviolet lamp heightened the effect."Wild," I said, hoping that was the right thing."Yeah, man."We went into the next room. The lighting was low. A pale, short boy with an immense head of curly blond hair squatted on the floor surrounded by electronic equipment. Two speakers stood by the far wall. A tape recorder was running. The pale boy was working with his equipment, twirling k.n.o.bs, producing the sounds. He did not look up at us as1 The Federal narcotics agents, or "narcs," are known in Boston to favor Chevrolets with licenses beginning with 412 or 414.we entered. He seemed to be concentrating hard, but his movements were slow."Stay here," said the bearded boy. "I'll tell him."I stood by the door. The bearded boy approached the other and said gently, "Sam. Sam."Sam looked up at him. "Hi," he said."Sam, you have a visitor."Sam seemed puzzled. "I do?" He still had not noticed me."Yes. He is a very nice man. A very nice man. Do you understand that? He is very friendly.""Good," Sam said slowly."He needs your help. Will you help him?""Sure," Sam said.The bearded boy beckoned to me. I came over and said to him, "What is it?""Acid," he said. "Seventh hour. He should be coming down now. But go easy, right?""O.K.," I said.I squatted down so I was on Sam's level. Sam looked at me with blank eyes."I don't know you," he said finally."I'm John Berry."Sam did not move. "You're old, man," he said. "Really old." old.""In a way," I said."Yeah, man, wow. Hey, Marvin," he said, looking up at his friend, "did you see this guy? He's really old: "Yes," Marvin said. "Hey, wow, old.""Sam," I said, "I'm your friend."

I held out my hand, slowly, so as not to frighten him. He did not shake it; he took it by the fingers and held it to the light. He turned it slowly, looking at the palm, then the back. Then he moved the fingers.

"Hey, man," he said, "you're a doctor.""Yes," I said."You have doctor's hands. I can feel it.""Yes.""Hey, man. Wow. Beautiful hands."He was silent for a time, examining my hands, squeezing them, stroking them, feeling the hairs on the back, the fingernails, the tips of the fingers."They s.h.i.+ne," he said. "I wish I had hands like that.""Maybe you do," I said.He dropped my hands and looked at his own. Finally he said, "No. They're different.""Is that bad?"He gave me a puzzled look. "Why did you come here?""I need your help.""Yeah. Hey. O.K.""I need some information."I did not realize this was a mistake until Marvin started forward. Sam became agitated; I pushed Marvin back."It's O.K., Sam. It's O.K.""You're a cop," Sam said."No. No cop. I'm not a cop, Sam.""You are, you're lying."

"He often gets paranoid," Marvin said. "It's his bag. He's worried about freaking out.""You're a cop, a lousy cop.""No, Sam. I'm not a cop. If you don't want to help me, I'll leave."'You're a rock, a cop, a sock, a lock.""No, Sam. No. No."He settled down then, his body relaxing, his muscles softening.I took a deep breath. "Sam, you have a friend. Bubbles.""Yes.""Sam, she has a friend named Karen."He was staring off into s.p.a.ce. It was a long time before he answered. "Yes. Karen.""Bubbles lived with Karen. Last summer."Yes."Did you know Karen?""Yes."He began to breathe rapidly, his chest heaving, and his eyes got wide.I put my hand on his shoulder, gently. "Easy, Sam. Easy. Easy. Is something wrong?"

"Karen," he said, staring across the room. "She was . . . terrible."

"Sam-""She was the worst, man. The worst.""Sam, where is Bubbles now?""Out. She went to visit Angela. Angela . . ."

"Angela Harding," Marvin said. "She and Karen and Bubbles all roomed together in the summer."

"Where is Angela now?" I asked Marvin.At that moment, Sam jumped up and began to shout "Cop! Cop!" at the top of his lungs. He swung at me, missed, and tried to kick me. I caught his foot, and he fell, striking some of the electronic equipment. A loud, high-pitched whee-whee-whee filled the room.Marvin said, "I'll get the thorazine."2"Screw the thorazine," I said. "Help me." I grabbed Sam and held him down. He screamed over the howl of the electronic sound."Cop! Cop! Cop!"He kicked and thrashed. Marvin tried to help, but he was ineffectual. Sam was banging his head against the floor."Get your foot under his head."He didn't understand."Move!" I said.He got his foot under, so Sam would not hurt his head. Sam continued to thrash and twist in my grip. Abruptly, I released him. He stopped writhing, looked at his hands, then looked at me."Hey, man. What's the matter?""You can relax now," I said.2 Thorazine is a tranquilizer, universally used as an antidote to LSD and employed to end bad trips. However, when other psychedelic compounds such as STP are used, thorazine heightens the drug effect instead of abolis.h.i.+ng it. Thus physicians who see LSD psychosis in the EW no longer automatically administer thorazine.

"Hey, man. You let me go."I nodded to Marvin, who went and unplugged the electronic equipment. The howls stopped. The room became strangely silent.Sam sat up, staring at me. "Hey, you let me go. You really let me go."He looked at my face."Man," he said, touching my cheek, "you're beautiful."And then he kissed me WHEN IGOT HOME, Judith was lying awake in bed."What happened?"As I undressed, I said, "I got kissed.""By Sally?" She sounded amused."No. By Sam Archer.""The composer?""That's right.""Why?""It's a long story," I said."I'm not sleepy," she said.I told her about it, then got into bed and kissed her. "Funny," I said, "I've never been kissed by a man before."She rubbed my neck. "Like it?""Not much."

"That's strange," she said, "I like it fine," and she pulled me down to her.

"I bet you've been kissed by men all your life," I said.

"Some are better than others.""Who's better than others?" "You're better than others." "Is that a promise?"

She licked the tip of my nose with her tongue. "No," she said, "that's a come-on."

WEDNESDAY.

OCTOBER 12.

ONE.

ONCE A MONTH, the Lord takes pity on the Cradle of Liberty and lets the sun s.h.i.+ne on Boston. Today was that day: cool, bright and clear, with an autumn crispness in the air. I awoke feeling good, with the sharp expectation that things would happen.

I had a large breakfast, including two eggs, which I ate with guilty relish, savoring their cholesterol. Then I went into my study to plan the day. I began by drawing up a list of everyone I had seen and trying to determine if any of them were suspects. n.o.body really was.

The first person to suspect in any abortion question is the woman herself, since so many are self-induced. The autopsy showed that Karen must have had anesthetic for the operation; therefore she didn't do it.

Her brother knew how to do the procedure, but he was on duty at the time. I could check that, and 235 might, later on, but for the moment, there was no reason to disbelieve him. might, later on, but for the moment, there was no reason to disbelieve him.

Peter Randall and J. D. were both possibilities, technically speaking. But somehow I couldn't imagine either of them doing it.That left Art, or one of Karen's Beacon Hill friends, or somebody I hadn't met yet and didn't even know existed.I stared at the list for a while, and then called the Mallory Building at the City. Alice wasn't there; I talked with another secretary."Have you got the path diagnosis on Karen Randall?""What's the case number?""I don't know the case number."Very irritably, she said, "It would help if you did.""Please check it anyway," I said.I knew perfectly well that the secretary had a filecard system right in front of her, with all the finished posts for a month arranged alphabetically and by number. It would be no trouble for her.After a long pause, she said, "Here it is. v.a.g.i.n.al hemorrhage secondary to uterine perforation and lacerations, following attempted dilation and curettage for three-month pregnancy. The secondary diagnosis is systemic anaphylaxis.""I see," I said, frowning. "Are you sure?""I'm just reading what it says," she said."Thanks," I said.I hung up, feeling odd. Judith gave me a cup of coffee and said, "What happened?""The autopsy report says Karen Randall was pregnant.""Oh?""Yes.""Wasn't she?""I never thought so," I said.I knew I could be wrong. It might have been proven in the micro exam, where the gross had shown nothing. But somehow it didn't seem likely.I called Murph's lab to see if he had finished with the blood-hormone a.s.say, but he hadn't; it wouldn't be finished until after noon. I said I'd call him back.Then I opened the phone book and looked up the address of Angela Harding. She was living on Chestnut Street, a very good address.I went over to see her.

CHESTNUT STREET ISOFF CHARLES, near the bottom of the Hill. It's a very quiet area of town houses, antique shops, quaint restaurants, and small grocery stores; most of the people who live here are young professionals-doctors and lawyers and bankers- who want a good address but can't yet afford to move out to Newton or Wellesley. The other people who live here are old professionals, men in their fifties and sixties whose children are grown and married, permitting them to move back to the city. If you are going to live anywhere in Boston, you have to live on Beacon Hill. There were, of course, some students living here, but usually they were stacked three or four deep in small apartments; it was the only way they could afford the rents. Older residents seemed to like the students; they added a little color and youth to the neighborhood. That is, they liked the students so long as the students looked clean and behaved themselves.

Angela Harding lived on the second floor of a walk-up; I knocked on the door. It was answered by a slim, dark-haired girl wearing a miniskirt and a sweater. She had a flower painted on her cheek, and large, blue-tinted granny gla.s.ses.

"Angela Harding?""No," said the girl. "You're too late. She's already gone. But maybe she'll call back."I said, "My name is Dr. Berry. I'm a pathologist.""Oh."The girl bit her lip and stared at me uncertainly."Are you Bubbles?""Yes," she said. "How did you know?" And then she snapped her fingers. "Of course. You were the one with Superhead last night.""Yes.""I heard you'd been around.""Yes."She stepped back from the door. "Come in." The apartment had almost no furniture at all. A single couch in the living room, and a couple of pillows on the floor; through an open door, I saw an unmade bed."I'm trying to find out about Karen Randall," I said."I heard.""Is this where you all lived last summer?""Yeah.""When did you last see Karen?""I haven't seen her for months. Neither has Angela," she said."Did Angela tell you that?""Yes. Of course.""When did she say that to you?""Last night. We were talking about Karen last night. You see, we'd just found out about her, uh, accident.""Who told you?"She shrugged. "The word got around.""What word?""That she got a bad sc.r.a.pe.'"Do you know who did it?"

She said, "They've picked up some doctor. But you know that."

'Yes," I said."He probably did it," she said, with a shrug. She brushed her long black hair away from her face. She had very pale skin. "But I don't know.""How do you mean?"

"Well, Karen was no fool. She knew the score. Like, she'd been through the routine before. Including last summer."

"An abortion?""Yeah. That's right. And afterward she was real depressed. She took a couple of down-trips, real freaks, and it shook her up. She had this thing about babies, and she knew it was rotten because it gave her freak trips. We didn't want her to fly for a while after the abortion, but she insisted, and it was bad. Real bad."

I said, "How do you mean?""One time she became the knife. She was sc.r.a.ping out the room and screaming the whole time that it was b.l.o.o.d.y, that all the walls were covered with blood. And she thought the windows were babies and that they were turning black and dying. Really bad news.""What did you do?""We took care of her." Bubbles shrugged. "What else could we do?"She reached over to a table and picked up a jar and a small wire loop. She swung the loop in the air and a stream of bubbles floated out and drifted gently downward. She watched them. One after another, they fell to the floor and popped."Real bad.""Last summer," I said, "who did the abortion?"Bubbles laughed. "I don't know.""What happened?""Well, she got knocked up. So she announces that she's going to get rid of it, and she takes off for a day, and then comes back all smiling and happy.""No problems?""None." She swung out another stream of bub-bles and watched them. "None at all. Excuse me a minute."She went into the kitchen, poured a gla.s.s of water, and swallowed it with a pill."I was coming down," she said, "you know?""What was it?""Bombs.""Bombs?""Sure. You know." She waved her hand impatiently. "Speed. Lifts. Jets. Bennies.""Amphetamine?""Methedrene.""You on it all the time?""Just like a doctor." She brushed her hair back again. "Always asking questions.""Where do you get the stuff?"I had seen the capsule. It was at least five milligrams. Most of the black-market material is one milligram."Forget it," she said. "All right? Just forget it.""If you wanted me to forget it," I said, "why did you let me see you take it?""A shrink, too.""Just curious.""I was showing off," she said."Maybe you were.""Maybe I was." She laughed."Was Karen on speed, too?"

"Karen was on everything." Bubbles sighed. "She used to shoot speed."

I must have looked puzzled, because she madejabbing motions at her elbow with her finger, imitating intravenous injection."n.o.body else shoots it," Bubbles said. "But Karen went all out."I said, "Her trips . . .""Acid. Once, DMT.""How did she feel afterward?""Like h.e.l.l. She was really turned off. Wired out. Down, you know, they were really down-trips.""Did she stayed turned off?""Yeah. The rest of the summer. Never made it once with a guy for the rest of the summer. Like she was afraid.""Are you sure about that?""Yeah," she said. "Sure."I looked around the apartment. "Where is Angela?""Out.""Where did she go? I'd like to talk to her.""She really needs to talk to you, right now."I said, "Is she in some kind of trouble?""No.""I'd like to talk to her."Bubbles shrugged. "If you can find her, talk to her.""Where did she go?""I told you. Out.""I understand she's a nurse," I said."That's right," Bubbles said. "You got the-"At this point, the door opened and a tall girl burst into the room. She said, "That b.a.s.t.a.r.d isn't anywhere, he's hiding, the rotten-"

She stopped when she saw me.

" 'Lo, Ang," Bubbles said. She nodded to me. "You got an oldie but goodie here to see you."

Angela Harding swept into the room and slumped on the couch, and lit a cigarette. She wore a very short black dress, black-net stockings, and patent-leather black boots. She had long dark hair and a hard, cla.s.sically beautiful face with bones that looked chiseled; the face of a model. I had trouble picturing her as a nurse.

"You're the one who wants to know about Karen?"I nodded."Sit down," she said. "Take a load off."Bubbles said, "Ang, I didn't tell him-"

"Get me a c.o.ke, would you, Bubbles?" Angela said. Bubbles nodded quietly and went into the kitchen. "You want a c.o.ke?"

"No, thanks."She shrugged. "Suit yourself." She sucked on the cigarette and stubbed it out. Her movements were quick but she kept her composure, a calm in her face. She lowered her voice. "I didn't want to talk about Karen in front of Bubbles. She's pretty upset about it.""Karen?""Yes. They were close.""And you?""Not so close.""How's that?"

"She came on strong, in the beginning. Nice girl, a little wild, but fun. Very strong in the beginning. So we decided to share a room, the three of us. Then later Bubbles moves in with Superhead, and I'm stuck with Karen. It wasn't so easy."

"Why?""She was a crazy kid. She was nuts."Bubbles came back with the c.o.ke. "She wasn't.""Not around you. She had an act for you.""You're just mad because of-""Yeah. Right. Sure." Angela tossed her head and s.h.i.+fted her long legs. She turned to me and said, "She's talking about Jimmy. Jimmy was a resident I knew, in OB.""That was the service you were on?""Yes," she said. "Jimmy and I had a thing, and I thought it was good. It was was good. Then Karen stepped in." good. Then Karen stepped in."Angela lit another cigarette and avoided my eyes. I could not really tell whether she was talking to me or to Bubbles. Obviously the two girls did not agree."I never thought she'd do it," Angela said. "Not your own roommate. I mean, there are rules .'. .""She liked him," Bubbles said."She liked liked him. Yeah, I suppose so. For a quick seventy-two hours." him. Yeah, I suppose so. For a quick seventy-two hours."Angela stood up and paced up and down the room. Her dress barely reached to mid thigh. Shewas a strikingly beautiful girl, much more beautiful than Karen."You're not fair," Bubbles said."I don't feel feel fair." fair.""You know what you're saying is a lie. You know that Jimmy-""I don't know anything," Angela said. "All I know is that Jimmy's in Chicago now finis.h.i.+ng his residency, and I am not with him. Maybe if I was-" She stopped."Maybe," Bubbles said."Maybe what?" I said."Skip it," Angela said.I said, "When did you last see Karen?""I don't know. It must have been August sometime. Before she started school.""You didn't see her last Sunday?""No," she said, still pacing. She didn't even break step. "No.""That's funny. Alan Zenner saw her last Sunday.""Who?""Alan Zenner. He was a friend of hers.""Uh-huh."

"He saw her, and she told him she was coming over here."

Angela and Bubbles exchanged looks. Bubbles said, "The dirty little-""It's not true?" I asked."No," Angela said tightly. "We didn't see her.""But he was positive-""She must have changed her mind. She usually did, you know. Karen changed her mind so often you wondered if she had one."

Bubbles said, "Ang, listen . . .""Get me another c.o.ke, will you?"

There was no mistaking the command in the voice. Bubbles got up meekly for another c.o.ke.

"Bubbles is nice," Angela said, "but a little naive. She likes everything to be sweet and nice in the end. That's why what happened to Karen bothers her so much.""I see."She stopped pacing and stood in front of me. Her body took on a rigidity that melted slowly into an icy calm. "Was there anything in particular you wanted to ask me?""Just if you'd seen Karen.""No. The answer is no."I stood. "Well then, thank you for your time."Angela nodded. I went to the door. As I left I heard Bubbles say, "Is he leaving?"And Angela said, "Shut up."TWOSHORTLY BEFORE NOON I called Bradford's office and was told that one of the staff was taking Dr. Lee's case. The man was named George Wilson. My callwas put through to him. Over the phone he sounded smooth and self-confident; he agreed to meet me for drinks at five, but not at the Trafalgar Club. We would meet at Crusher Thompson's, a bar downtown.After that, I had lunch in a drive-in and read the morning papers. The story about Art's arrest had finally broken, big, hitting all the front pages, though there was still no link to Karen Randall's death. Along with the story was a picture of Art. There were dark, s.a.d.i.s.tic circles under his eyes. His mouth drooped in a sinister way and his hair was disheveled. He could have been any cheap hood.

The stories didn't say much, just a bare outline of the facts of his arrest. They didn't have to say much: the picture said it all. In a way it was clever. You couldn't move for a prejudicial pretrial publicity on the basis of an unflattering picture.

After lunch I smoked a cigarette and tried to put it all together. I didn't have much success. The descriptions I had heard of Karen were too conflicting, too uncertain. I had no clear picture of her, or what she might have done. Particularly what she might have done if she arrived in Boston for a weekend, pregnant, and needing an abortion.At one I called Murphy's lab again. Murph answered the phone."Hormones Unlimited.""h.e.l.lo, Murph. What's the word?""On Karen Randall?""Murph, you've been doing homework."

"Not exactly," he said. "The City just called. Wes-ton was on the phone. Wanted to know if you'd brought in a blood sample."

"And what did you say?"Yes."And what did he say?""Wanted to know the results. I told him.""What are the results?"

"All the hormone and excretion metabolite levels are flat low. She wasn't pregnant. Absolutely impossible."

"O.K.," I said. "Thanks."

Murph had just put some life back into my theory. Not much, but some.

"You going to explain all this, John?""Not now," I said."You promised.""I know," I said. "But not now.""I knew you'd do this to me," Murph said. "Sarah will hate me." Sarah was his wife. She thrived on gossip."Sorry, but I just can't.""h.e.l.l of a thing to do to an old friend." "Sorry.""If she divorces me," Murph said, "I'm naming you as co-defendant."

THREE.

I ARRIVED AT THE MALLORY PATH LABS AT THREE. Thefirst man I ran into was Weston, who was looking tired. He gave me a lopsided smile of greeting."What did you find out?" I said."The findings are negative," he said, "for pregnancy.""Oh?"

"Yes." He picked up the folder containing the path protocol and thumbed through it. "No question."

"I called here earlier and was told the report was three months' pregnancy."Weston said carefully, "Whom did you talk with?""A secretary.""There must have been some kind of mistake.""I guess," I said.He handed me the folder. "Want to see the slides, too?""Yes. I'd like to."We walked to the pathologists' reading room, a long room divided into individual cubicles, where the pathologists kept their microscopes and slides, and wrote up their autopsies.We stopped at one booth."There it is," Weston said, pointing to a box of slides. "I'll be curious to have your opinion on them when you're through."He left me, and I sat down in front of the scope, switched on the light, and began work. There were thirty slides in the box, made from all the major organs. Six had been made from different parts of the uterus: I began with them.

It was immediately clear that the girl was not pregnant. The endometrium was not hyperplastic. If anything, it appeared dormant and atrophic, with a thin proliferative layer, few glands, and decreased vascularity. I checked several other slides to be sure. They were all the same. Some contained thromboses from the sc.r.a.ping, but that was the only difference.

As I looked at the slides I considered their meaning. The girl had not been pregnant, yet she had been convinced she was. Therefore her periods must have stopped. That could account for the dormant appearance of the endometrium. But what had caused the periods to stop? I ran through the differential in my mind.In a girl of this age, neurogenic factors came immediately to mind. The pressures and excitement of beginning school and moving to a new environment might have temporarily suppressed menstruation-but not for three months, and not with the a.s.sociated signs: obesity, change in hair distribution, and so on.Then there were hormonal disorders. Adrenal vir-ilizing syndromes, Stein-Leventhal, irradiation. All of them seemed unlikely for one reason or another, but there was one quick way to find out.

I put the adrenal slide under the stage. There was good evidence of cortical atrophy, particularly in the cells of the zona fascicularis. The zona glomerulosa appeared normal.

Rule out virilizing syndromes and adrenal tumor.

Next I looked at the ovaries. Here the changes were striking. The follicles were small, immature, withered-looking. The whole organ, like the uterine endometrium, had a dormant appearance.

Rule out Stein-Levanthal and ovarian tumor.Finally, I put the thyroid slide under the stage. Even under the lowest power, the atrophy of the gland was apparent. The follicles were shrunken and the lining cells were low. Clear hypothyroidism.That meant that the thyroid, adrenals, and ovaries were all atrophic. The diagnosis was clear, though the etiology was not. I opened the folder and read through the official report. Weston had done it; the style was brisk and direct. I came to the micro write-ups. He had noted the endometrium was low and aberrant-looking, but he had considered the other glands to be "of normal appearance, question mark early atrophic changes."I shut the folder and went to see him.HIS OFFICE WAS LARGE, lined with books, and very neat. He sat behind an old, heavy desk smoking a briar pipe, looking scholarly and venerable."Something wrong?" he asked.I hesitated. I had been wondering whether he had covered up, whether he had joined the others who were out to frame Art. But that was ridiculous; Weston couldn't be bought, not at his age, not with his reputation. Nor was he particularly close to the Randall family. He would have no reason to falsify the report."Yes," I said. "I wondered about your micro diagnosis."He puffed the pipe calmly. "Oh?""Yes. I've just reviewed the slides, and they seem pretty atrophic to me. I thought perhaps-"

"Well, John," Weston said, chuckling, "I know what you're going to say. You thought perhaps I'd want to review them." He smiled at me. "I have have reviewed them. Twice. This is an important postmortem and I did it as carefully as I know how. The first time I examined the slides, I felt as you did, that they seemed to show pan hypopituitarism affecting all three target organs-thyroid, adrenals, gonads. I felt that very strongly, so I went back to the gross organs. As you yourself say, the gross organs were not strikingly abnormal." reviewed them. Twice. This is an important postmortem and I did it as carefully as I know how. The first time I examined the slides, I felt as you did, that they seemed to show pan hypopituitarism affecting all three target organs-thyroid, adrenals, gonads. I felt that very strongly, so I went back to the gross organs. As you yourself say, the gross organs were not strikingly abnormal."

"It might have been recently acquired," I said."Yes," he said, "it might. That's what makes it so difficult. Then, too, we'd like a look at the brain, to check for evidence of neoplasm or infarction. But that's not possible; the body was cremated this morning.""I see."

He smiled up at me. "Sit down, John. It makes me nervous to have you standing like that." When I was sitting, he said, "Anyway I looked at the gross, and then went back to the slides. This time I was less certain. I wasn't fully convinced. So I checked some old cases of pan hypopit, reviewed the old slides, and finally looked at the Randall slides a third time. By then I felt I could not be certain of a diagnosis of pituitary dysfunction. The more I looked, the less certain I felt. I wanted some kind of corroboratory evidence-brain pathology, or X rays, or blood hormones. That was why I called Jim Murphy."

"Oh?"

"Yes." His pipe went out; he relit it again. "I suspected you'd taken the blood sample to do estradiol tests, and that you'd get Murphy to do it. I wanted to know if you'd also decided to have other hormone levels checked-TSH, ACTH, T4, anything that might help."

"Why didn't you just call me?""I did, but your lab didn't know where you were."I nodded. Everything he had said made perfect sense. I felt my body slowly relaxing.

"By the way," Weston said, "I understand some skull films of Karen Randall were taken a while back. Any idea what they showed?"

"Nothing," I said. "They were negative."Weston sighed. "Pity.""I'll tell you something interesting though," I said."What's that?""They were ordered because she complained of blurring vision."Weston sighed. "John, do you know the most common cause of blurring vision?""No.""Lack of sleep," Weston said. He pushed the pipe to the side of his mouth and held it in his teeth. "What would you do if you were in my position? Make a diagnosis on the basis of a complaint which led to negative X rays?""The slides are are suggestive," I reminded him. suggestive," I reminded him.