Jonathan could not believe it. But the older doctor, with enjoyment and relentlessness, gave him the undeniable and the dreadful facts.
“In here,” said Jonathan to Tom Harper. They went into an examination room with its table and a desk and two chairs, its bright lights and windowless walls covered with white paint, its cabinets of instruments. Dr. Harper sat down, and Jonathan noticed his stiff care. Jonathan closed, then carefully locked, the door. “What’s this?” asked Tom. “Don’t want to be interrupted?”
“That’s correct,” said Jonathan. He stood near the door and looked intently and closely at his friend, the long thin body, the unusually slender wrists below the stiff white cuffs and the cheap cuff links, the shabby but polished boots, the sleaziness of his suit with the long old-fashioned coat at least eight years old. But more than that he saw the bony and yellowish face, the sunken darkness under the clear gray eyes, the clefts about his mouth, and the curious lack of luster of his light brown hair. His ascetic nose appeared unusually sharpened and pointed and his mouth was bloodless, the humorous, kindly mouth that could express so much sympathy and pity and patience. He had a little brown mustache, and its ends were waxed. For some reason this struck Jonathan poignantly. Then he tightened his own mouth and looked sternly at his friend.
“I’m not going to run around the mulberry bush, Tom,” he said. “You know I’m on the Board, here. Dear old Louis Hedler has told me he more than suspects you’re taking morphine from the supplies, and as doctors have easy access to drugs anyway—there being no law as yet to register drugs and control them—this spells just one thing to me. Tell me if I’m wrong.”
Tom Harper’s sallow face had begun to sweat, though the room was not hot. The drops of sweat became larger on his forehead, as if they were tears. He said nothing. Jonathan went to him then, roughly took his chin in his hand, and tilted Tom’s face to the ceiling light. He looked down into the eyes and saw the pinpointed pupils. He looked at Tom’s hands and saw the muscle tremor. Then he angrily seized the other man’s arm and pulled up the coat sleeve, tore out the cuff link of the worn but meticulously starched cuff, rolled up the sleeve—it was darned—and saw the needle marks. He dropped the lifeless arm. Dr. Harper had not offered the slightest resistance. He had become flaccid.
“A week ago,” said Jonathan, watching the other doctor slowly and dreamily pulled down his sleeves, “you operated on an old man, Finley. Gallbladder. A nasty, bloody, dangerous operation, I admit, but you’re famous for your cholecystectomies, Tom. You do things I’d hesitate to do, and you do them with flair and success. You haven’t lost a patient yet. People come even from Philadelphia for your operations. I’ve seen you in action. Old Finley had a routine case, calculi, no inflammation, no complications. Field pretty open, I’m told. Yet, you tied off his common duct, Tom, and even when his resultant symptoms were urgently called to your attention, you said it was ‘nothing.’ And so, he died. It was told me that you were ‘airy’ about the whole matter.”
Dr. Harper scrupulously fastened his cuff link. His head was bent. The drops of sweat were falling down his cheeks now, one by one, and Jonathan thought he could hear them drip.
“Old Finley hasn’t been the only one, has he, Tom? Simple operations—not your usual kind—but four patients have died in the past month. Louis insisted on autopsies, unusual around here. He’d been suspecting you for a long time, months. And in every death there were the signs of carelessness, stupidity, incredible clumsiness. Louis doesn’t like you, Tom. You’re one of “us,’ and so to be wary of, and guarded against, and watched, and triumphantly found out and disgraced, if possible. But Louis, to give him credit, now won’t let a surgeon operate when he suspects he is an addict. Drug addiction among doctors and surgeons is common these days and they all say it is ‘harmless.’ When they merely bungled, but the patient didn’t die, or they managed in spite of the drugs, Louis used to say nothing. He let them go on. But now Louis draws the line. Tom, aren’t you going to say anything?”
Dr. Harper spoke in a far voice, as if nothing mattered. “I did my best. I don’t know how it happened—I didn’t even know about the autopsies. I suspected—yes, I suspected how it had come about. I warned myself not to operate.” His voice died away as if he were infinitely weary.
“Then, why did you?” Jonathan was both enraged and horrified and could hardly control himself. “You’ve murdered five innocent people! Yet, you still operate! You’re a murderer, Tom. If we didn’t close ranks, you’d be up on charges of malpractice at the very least. Tell me, why did you, damn you? Knowing your addiction and unreliability, and the danger, why did you?”
“Are you going to revoke my privileges?” Dr. Harper brushed away the falling sweat and then looked stupidly at the back of his hand. “You won’t do that to me, Jon.” He shook his head over and over. “You won’t do that to me.” He began, to Jonathan’s awful exasperation and increasing horror, to cry. He bent his head on his chest and stammered, “No, you won’t do that to me, Jon. There’s Thelma and my four children.”
Jonathan sat down in a straight chair and thrust his own shaking hands violently into his pockets. “Tom, I am going to do just that. I’m going to prefer charges against you, with Louis, and you’ll never operate again until you can give us all assurances that you’ve stopped taking the drugs. And you’ll never see the inside of another hospital.”
The stricken doctor continued his dry soft weeping as if he had not heard. “You won’t do that to me, Jon. I need the money. I’m forty-six years old. In the past six months I’ve made five thousand dollars. Five thousand dollars! Four of them went to pay off old debts. I have six operations scheduled. Next week. One hundred dollars apiece—six hundred dollars. A fortune. I must have that money, Jon.” He spoke with quiet and desperate firmness.
“You’re not going to make it. You’re not going to murder anyone else in this hospital or anywhere else.” Jon spoke heavily, for his instincts were informing him that rage could not shake this unfortunate man, nor threats, for something more terrible was destroying him, even more terrible than the morphine he was giving himself. “Listen to me, Tom, if you can. Try to focus on me. Look at me, damn you, and stop that ridiculous womanish crying! Tom, I’m your friend. I know how hard it’s been for you and Thelma.”
“No,” said Dr. Harper. “You don’t know, Jon. Look at me, Jon. I’m dying.”
“I don’t believe it!”
“It’s true. I have what you call the Beast, Jon. I have gastric cancer.”
“Who told you?” Jonathan’s voice was rough because he did not want to believe this monstrous thing.
“Jon, I’m a doctor, too. You know how we are. If we suspect something is wrong with us, or we have a few symptoms, we are the ones who get medical advice last, and besides we’re too busy. Then, we know all there is to know, and that makes cowards of us. It isn’t ignorance that makes us cowards, contrary to the old saw. It’s knowledge. It started several months ago. For a considerable time I’d been having epigastric pain, and I thought, ‘Oh, if I don’t stop taking on so much, I’ll be developing an ulcer,’ so I took the usual antacids. I began to lose weight, and Thelma said I was working too hard, which I was—all those debts. Then I lost my appetite and started to vomit—and about three months ago I had that famous coffee-ground vomitus. I examined my blood. Anemia, and then I found occult blood in my stools. The classic picture; nothing vague. My mother died of cancer, you know. Now I don’t sleep very much—except—”
He made an exhausted and vague movement of his thin and trembling hands and then dropped them on his knee.
“You know the prognosis of that, Jon.”
“Would you mind if I examined you?” Jonathan still did not believe it. Tom Harper silently stood up and removed his clothing. Jonathan was aghast to see his rib cage clearly visible; his legs were only bone covered with a thin layer of muscle and skin. Tom lay down on the examination table, and Jonathan silently examined him for the most part, asking questions only when necessary. Once he said, “If only to God we had an X-ray machine here in town!”
“What if we had? It would just be interesting to doctors but not for me, Jon. Well?”
“Get dressed.” Jonathan carefully washed his hands so that he would have something to do and so calm himself. He wiped his hands on a clean towel, then sat down near his friend.
“I suppose you know that it’s already metastasized to the liver? And to the supraclavicular lymph nodes and peritoneum?”
“Yes, I know. As a doctor and as a patient—I know.”
“Why the hell didn’t you come to me months ago?”
“To have you tell me the truth?”
“I’ve seen two rare operations, Tom—resection. I can do it myself. I assisted at one, in New York.”
Tom smiled drearily. “How long did the patient survive after that?”
“A year longer than he would have done without an operation. But another is still surviving, not in a rare and roaring state of health, but he’s still alive.”
“If he were a doctor, would he be able to keep up his practice?”
“No. Frankly, no.”
“You see,” said Tom, “it would have been worthless to me, even if I had survived. What would I do without medicine? I can’t do anything else. And there are my children and my wife. Well. Now you know. I can keep going on morphine, Jon. It keeps the pain down enough. I’ll be making enough money to give Thelma a little breathing space. There’s five thousand dollars in life insurance—all I could afford. The boys won’t have much chance, but at least they’re healthy. I’ve got to go on, Jon. I can’t stop.”
Jonathan looked down at his narrow, polished boot. He swung it back and forth, his hps pursed as if whistling. His manner was nonchalantly thoughtful, but he was thinking rapidly. Tom Harper finished dressing. He, too, washed his hands mechanically at the basin, then, sighing, he smoothed his damp hands over his thick brown hair.
“Tom,” said Jonathan, “you are a country-born boy. You lived on your father’s farm until you entered medical school. And twelve or fourteen years ago he sold the farm so you could continue? But you know farming.
“I have three farms. One of them is about two hundred acres. I have a tenant farmer there, in a house by himself. The farmhouse is big, with running water, and comfortable and has been renovated. It’s very old, but it’s a fine house. The farm is stocked with some truck. Three hundred head of cattle, Holsteins. My bulls have won a lot of prizes, and my cows, too. The farm’s perfectly equipped; it brings me a good income, even after my tenant farmer gets his share, and he gets a very generous share. Excellent man, with a family, and his house isn’t far from the main house. A good school two miles away. Highway nearby—less than an hour’s drive to Hambledon. A church a mile away. Rolling country.
“I want you to go and live in that farmhouse, Tom, and take Thelma—who’s a country girl herself—and your four children. A healthy and tranquil life for all of you. And I guarantee you this, and will sign a contract with you to that effect: Thelma is to occupy that house during her lifetime, unless she marries again, and the children with her until they leave permanently for marriage or career. And the income from the farm, after the tenant farmer’s share, goes to you, as long as you live, and to Thelma, as long as she lives, or until she marries again, which I doubt she will do. There’ll be no fine print, Tom, but just as I’ve told you.
“I’ve seen temporary remissions in what you have, Tom. A life without strain and with peace, and with the knowledge that your children are provided for—Thelma can save from the income for their education—and your wife, too, will prolong your life for a few months, perhaps. You’ll have peace of mind, above everything else. And, Tom, I will, within the next few days, arrange that all expenses of the farm be paid by me, and all improvements, even to the seed and fertilizer, new machinery, and everything else. You’ll have no extraneous expenses. If Thelma dies prematurely, your children will live there under the same provisions.
“Now, what do you think about that?”
Tom said nothing. He merely looked at Jonathan with tortured stupefaction, his emaciated face working without a sound. His hands knotted together, and then he wrung them over and over.
Jonathan said, “There’s the little village of Russellville down the road, and old Dr. Jonas fives there and practices what he can practice. But he is a good man, a Dr. Bogus himself. Occasionally, when you feel well enough, you can help him out—once in a while. No night calls, no deliveries, no operations, of course. Simple diagnoses. You know the farming regions, and people.
“Tom, your addiction to drugs comes from your pain, and I know that only morphine can relieve it. So, take a good supply with you, a very good supply, but use it only when absolutely necessary. For you know as well as I do that as long as it’s possible for a cancer patient to function even a little adequately, it’s best to keep the dosage as low as it can be. Or later—nothing will help the pain except death. And we want to postpone that as long as we can for Thelma’s sake and the sake of your children. On the farm, without stress and the necessity to work as a surgeon, you will find that you can keep the dosage pretty low for a long time and save its real benefits—for the last.”
He stood up. He could not look at his friend’s face now; it was too much for him. “Do you want me to tell Thelma for you, Tom? Will it be better that way? Or shall I go with you now and we’ll tell her together? She’s a sensible woman, Thelma.”
“Jon,” said Dr. Harper, in a very low and rusty voice. “Yes, Tom?”