-1-
Thursday, April 28, 1977
SANFORD
One
last
look in the hall mirror. I straightened my tie,
brushed my hand over
that unruly clump of hair above my right ear.
Should I be suave and
assured, or would I come off better as wide-eyed
and enthusiastic,
maybe even a little eccentric? As I glanced at
the gray
fabric-covered log book in my hand, I caught the
reflection of my
smile in the mirror. Perfect. Cool,
self-possessed, yes. Suave was
the way to go.
I
didn't
need to check my watch, but did anyway. Couple
of minutes past one,
almost an hour till the press conference. By
five o'clock, I'd be on
the local news, right at the top, and tomorrow
morning, my face would
be on every screen from San Francisco to
Timbuktu. Well, my face and
Giselle Hearn's, fair enough. I'd make sure to
say I couldn't have
done it without her, but there'd be no doubt
who'd been the project
leader, and who, the co-worker. I smiled again.
Good
move, borrowing Giselle's lab log last night,
then canceling my
appointments and staying home this morning. My
office staff would've
been driving me nuts, wanting to know what all
the fuss was about. Instead, I'd put in five
solid hours, studying the log and my pile of
reprints from Nature,
Lancet,
and The
American Journal of Obstetrics and Gynecology.
For more than a year, I'd been keeping up with
that literature, but
I wanted to be sure I had the material down
cold, every detail. I
couldn't afford a misstep.
I
walked
out into the corridor, took the elevator down to
the lobby, clapped
Albert, the doorman, on the arm. "Hey, Doc,"
Albert
rumbled. "Them Seadogs gonna win today?"
The
Emerald Seadogs, Major League Baseball's brand
new representatives in
the Pacific Northwest, were supposedly starting
their existence under
a lucky sign, double-sevens. But before the end
of the first month
of that auspicious 1977 season, the Seadogs were
already hopelessly
in the cellar, couldn't win for losing. "Don't
know, Albert. I
only bet on horses, but if I did bet baseball, I
think I'd keep my
money in my pocket on that one." The old doorman
cackled.
With
its
long winters of short, gray, drizzly days,
Emerald is the suicide
capital of the country. This past season had
been a prizewinner,
barely a glimpse of sun between Christmas and
Easter. But today, the
sky was a glorious blue, not a cloud anywhere,
and I threw back my
head to take in the warmth of the mid-day
sunlight. From this day
on, that sun would shine on me, nonstop.
Patients would clog my
office. I'd see my photo in newspapers,
magazines, on the tube. My
name would be front and center in articles and
popular histories; I'd
get whole chapters in reproductive medicine
textbooks. Rotary Club
presidents and chairmen of university
departments would book me for
talks. It was not beyond reason to expect that
one day I'd get a
call to come give a speech in Stockholm. My
parents would finally
have to hand it to me. Their son was about to
become a legend in
medicine.
Most
of
my colleagues lived in big houses in one or
another of the fancy
Emerald suburbs, which entitled them to drive
nearly an hour to and
from work, sometimes in the middle of the night.
Not for me. An
easy seven-minute walk, and I was at my office
in the Emerald Medical
Tower, linked by skybridges to Puget Community
Hospital on one side,
and the new glass-and-steel Washington Public
University Medical
Complex on the other.
I
strode
into the Tower Lobby, past patients, some in
wheelchairs, or making
their way slowly on canes. White-coated doctors
talked to
white-capped nurses. Techs pushed blood-draw
carts and EKG machines. For all the attention
they weren't giving me, I could've been
walking along a sidewalk in midtown Manhattan,
but that was about to
change. Tomorrow, people on all sides would
stop, point, whisper to
their companions, "Hey, isn't that Dr. Colin
Sanford? You know,
the guy..."
As I
walked into my waiting room, a buzz of talk went
silent. Lettie and
Sally, the receptionists, Kinsey and Ruth Ellen,
the nurses, Megan,
the nurse-practitioner, stood in a circle in
front of the reception
counter. One look at me, and they froze in
place, a body with five
chalky faces, five open mouths and ten
saucer-eyes. Barbara Renfro,
the office manager, stood off from the others,
stone-faced, leaning
against the end of the counter. Her Adam's apple
bobbed up, down, up
again.
The
room
reeked of trouble. Had one of my patients keeled
over with a
pulmonary embolism? Did the pediatricians find a
serious birth
defect in a baby? Nah, either way, a nurse would
have called my
beeper. I looked past the mob to Barbara. "Got
something to
tell me?"
She
motioned me down the hall past reception, to my
consulting office.
I
followed her along the corridor, into the
office, closed the door. She rested a hand on my
arm. "Oh, Dr. Sanford. Dr. Hearn
is...dead."
"Dead?
No."
"She
was shot. Murdered. In her lab, a little while
ago. And..."
"What,
Barbara?"
"Mr.
Kennett did it."
"Mr.
Kennett? Why on earth would he ever -"
"And
after he killed Dr. Hearn, he shot himself. A
Detective Baumgartner
called here not five minutes ago, looking for
you. He got your name
off Mr. Kennett's newborn-nursery ID bracelet. I
told him we
expected you any time now, and he said he wants
you to go over to the
lab immediately to talk to him."
I
pride
myself on keeping a cool head in emergencies.
"I'll get over
there ASAP. Would you please cancel the press
conference for me?"
"Of
course." She took a step away. "Dr.
Sanford...did the
conference have something to do with the
Kennetts?"
I
nodded.
As
she
walked out of the office, I stared at the log
book in my hand. Doubly fortunate now that it
wasn't sitting in a desk drawer in
Giselle's office, where the cops would find it.
It was my ticket to
the future, but it also contained seeds for
disaster, which I'd
stumbled on the night before. No reporter at the
press conference,
rushing to get the story out, would have looked
inside that log, but
the scientists we'd beaten to the finish line
would want to review
it, and to say the least, some of the material
could be embarrassing. I thought I knew what to
do about it, and had figured to sit down
with Giselle after the conference to get her on
board. But that idea
had been knocked into a cocked hat along with
the conference. In any
case, the log had to go someplace out of sight
for the time being,
absolutely-positively safe where no one would
think of checking.
I
scanned
the room. Stash it in my desk? That'd be the
first place anyone
would look. Two walls of bookshelves, filled
with medical textbooks,
monographs, and leather-bound journals. Good
camouflage, but not
good enough. The faux-woodgrain metal file
cabinet next to my desk? Negative. A file
cabinet would be Number Two on any search, right
after my desk...but wait, here's an idea. I
stepped across the room,
lowered a shoulder, tipped the cabinet. Below
the bottom drawer was
a nice little recess. Good. I tossed the log
book into the cavity,
gave a short silent thanks for all those
after-work hours at the gym,
then lowered the cabinet.
I
hung my
suit jacket on a hook behind the door, grabbed a
white coat from an
adjacent hook, shrugged it on, and rushed out,
through the waiting
room, into the hallway, down the corridor to the
skybridge. I could
deal with a little delay in my plans. First
things first, and the
first thing was to talk to Joyce Kennett. Going
to the lab and
talking to the cops would need to settle for
second.
-2-
SANFORD
I'm
a
doctor, an OBGYN. I opened my office in
Emerald in 1965, and by
1970, my practice was the biggest in
town. Patients knew when they
came to me, they'd get the best care
possible, and they'd get it
directly from me. No partners, no
interns, no med students. I
always did have an eye for the main
chance — no point denying the
obvious — and during the late 'sixties,
I saw laparoscopy was the
coming thing in my field. And why not?
Would you want your surgery
performed through the customary
five-inch slash in the breadbasket if
it could be neatly accomplished via a
thin optical instrument slipped
through a tiny puncture into the
abdomen? So I took myself off to
Philadelphia to learn the procedure from
the guru, Guiseppe Allegri,
and I've got to tell you, Allegri was
impressed. He said he'd never
seen anyone with such a knack for the
procedure. When I got back
home, I wangled an interview with the
medical editor of The
Emerald Times,
to tell the city all about Band-Aid
surgery, now available right in
its own back yard. My office phones
didn't stop ringing for days.
Then,
in
the mid-seventies, federal research grants
began to dry up. The
University faculty panicked. None of them
had ever dreamed of
dirtying their hands by laying them on
patients, but necessity really
is a mother, and the professors started
promoting themselves as
super-specialists, the ultimate experts.
What they didn't say was
that hands-on care at the U would in fact be
provided by residents
and med students, and the professors' role
would consist of
initialing trainees' chart notes. But you
can sell people anything,
and I started to notice a patient here, a
patient there, leaving my
care to go to "The Northwest's Preeminent
Medical Center." Which pissed me off,
royally.
You've
got
to keep an eye on your opposition, so I was
a regular at the
Wednesday morning University OBGYN Grand
Rounds, where professors,
fellows, and residents honed their
one-upsmanship skills,
pontificating on esoteric topics. At the
first session after
Christmas break, in January, 1976, the
speaker was Dr. Giselle Hearn,
a PhD embryologist. The room was packed. Dr.
Hearn talked about her
experiments on the behavior of chromosomes
at fertilization in mice,
which she hoped would shed light on factors
that cause errors during
that process, and produce conditions like
Down Syndrome. Near the
end of the hour, she said she was convinced
there would be no real
breakthroughs until studies being carried
out in other research
centers on human gametes started to yield up
critical information.
I
didn't
realize she'd flung a gauntlet until Gerry
Camnitz flew to his feet,
no small accomplishment given the size and
weight distribution of L.
Gerald Camnitz, MD. The Professor and
Chairman of OBGYN had the look
of an angry, red-faced walrus in a
sharply-tailored gray suit, pink
shirt, and narrow blue tie. "Dr. Hearn, this
is not a public
forum for departmental policy. It is an
educational session. Kindly
stick to your subject."
Hearn's
face
and body language told everyone in that room
they were about to
get a preview of the Bicentennial fireworks
display. She blinked at
Camnitz like a cow, offended at having
gotten a gratuitous poke in
the udder from a stick in the hand of a
nasty little boy. "I've
not gone off my topic, Dr. Camnitz. I've
merely stated a matter of
fact. If it happens to conflict with your
prejudices, you might do
well to reconsider."
I'd
had
no idea what was obviously running deep
below the calm surface waters
of the University OBGYN Department. A couple
of medical students
snickered. Camnitz silenced them with a
glare, then turned back to
Hearn. "All right, Dr. Hearn. Since you
insist on pursuing
this, I will restate my policy. We are not
going to start down the
slippery slope of experimentation on human
embryos, not in my
department. The ethical, moral, and legal
implications are too
uncertain. Would you propose to flush human
beings down a sink when
they're no longer of use to you? Would you
be concerned even the
slightest bit that attempts at in vitro
fertilization might produce
monstrously abnormal children?"
"I
never
said anything about in vitro -" Hearn began,
but Camnitz
shouted her down with, "This conference is
over. Thank you all
for coming." I thought he might follow that
with an order for
Hearn to go to the Dean's office and serve
detention, but instead, he
stormed out of the auditorium. There was a
brief silence, followed
by a sound like the swarming of a million
angry bees. Don Gardiner,
a young assistant professor, poked an elbow
into my ribs. "Welcome
to the halls of ivy."
I
muttered, "Yeah," but I was thinking about
in vitro
fertilization and embryo replacement.
Not
a
week later, I was talking to Joyce and James
Kennett, one of my
infertility couples. They had what's called
idiopathic infertility,
which is doctor-talk for "I don't have a
goddamn clue." Joyce's temperature records
showed she ovulated right on schedule,
every twenty-nine days plus or minus one.
X-ray contrast studies
indicated no blockage of her fallopian
tubes. Her uterus was
perfectly normal, inside and out. James'
sperm were lively and
quick. The couple hit the mattress at a
frequency that should
already have borne them a football team.
Artificial insemination
with James' sperm had been no more
efficacious than the natural
process.
They
were
both up tight, squirming in the chairs
opposite my desk. Not unusual
for infertility patients. They'd been trying
for a year before they
first came to see me, and I'd been working
with them for an equal
length of time. Two years of having every
menstrual period be a
disaster of dashed hopes does things to
people, and in any case, this
couple was predisposed to emotional
problems.
James
had
a history of borderline paranoid
schizophrenia, had been doing well
for years on psychotherapy and medication,
but he'd gotten himself
fired from several retail clerk jobs after
customers complained
about what they took as insults or
smart-alecky comments. This
translated into endless bouts of relapsing
financial pins and
needles.
Joyce,
a
biology teacher at Emerald Community
College, had the anatomy,
physiology, and biochemistry of conception
down pat, which made the
couple's failure — her word, not mine — all
the more galling. She'd tried a bunch of
dietary manipulations and folk remedies,
none
of which were any more effective than
traditional approaches.
I
brought
up the possibility of adoption, but the two
of them shot that down in
a hurry. Joyce insisted she was going to
have "my own
baby," no ifs, ands, or buts. "And it's
going to be my
baby, too," James barked. "No way some other
guy's sperm
is going to get her pregnant, not if I have
anything to say about
it."
Joyce
rested
a hand on his arm, something I'd seen her do
before when he
looked like he might be about to lose it.
Once I
saw his muscles relax, I reviewed the past
eleven months of
investigations and treatments, and was about
to launch into an
explanation of a journey through the terra
incognita of infertility,
when Joyce gave James a look that brought me
up short. It asked,
"Are you ready?"
He
nodded.
Joyce
turned back to me. "We've decided to go to the
University."
Like
a
slap in the face. I was stunned. "Why?"
"We
thought it would be a good idea to see one of
the infertility
specialists there."
I
shook
my head. "I guess you can do that, but they
don't know anything
I don't know. I read the same journals they do,
and attend all kinds
of conferences at the U and around the country."
James
pulled at the back of his collar. Joyce sat a
little straighter in
her chair. "They work in this field all the
time, but it's only
a part of your practice," she said. "Maybe
there's some
new research that isn't even published yet."
They
were
going, no question. Infertility patients are
like trains with
disabled brakes. They wanted the benefit of new
research. Were they
thinking of in vitro fertilization? They weren't
about to get that
at the U, though, were they?
But
they
couldn't get it from me, either. I swallowed
bile, got up, and
extended my hand. "I wish you luck," I said.
"Keep
in touch. If they help you conceive, I'll
certainly want to know the
details."
James
nearly fell over his feet, thanking me for
trying to help. He pumped
my hand as if he expected to see water gush out
of my mouth. Joyce
was cooler, but still cordial. "I'll definitely
let you know,"
she said. "And if we're successful, I'd like to
come back and
have you take care of my pregnancy and
delivery."
Knick-knack,
paddy-whack,
toss the dog a bone. "It would be my pleasure,"
I said.
For
the
rest of the afternoon, I had to force myself to
keep my mind on
business at hand. After the office closed and
I'd written up the
charts for the day, I walked across the
skybridge to the University
Medical Complex, stopped by the cafeteria,
grabbed some dinner, and
picked at it. This was my personal Pearl Harbor,
and I was not about
to lie down and let those hypocritical
University bastards wipe out
my practice. I had an idea, which, I'll admit,
made me more than a
little nervous. If it didn't work out, things
could get ugly.
But
what
if it did work out?
I
left my
tray with most of the food uneaten, no great
loss, hustled out of the
cafeteria, and down the hall to the Med Center
Library.
The
library closed at midnight, and that's when I
left, stepping lively,
carrying a fistful of copied journal articles
from medical centers
around the world. The papers described the
scientific and clinical
procedures which one day might produce babies
through in vitro
fertilization, and discussed the ethical and
religious arguments that
swirled around those procedures. Catholics were
opposed, no
surprise, but the secular ethicists were split
into two camps. One
group was as strongly opposed as the Catholics,
claiming that since
there was no way to tell in advance whether the
procedure was safe
and would produce normal children, it
constituted unethical
experimentation on the unborn, or even on the
unconceived. The other
group insisted the work was right and proper,
because it might both
alleviate the human misery of infertility, and
give life to
individuals who otherwise never would exist.
It
was
clear a race was on to be first to the finish
line, and that the
leaders were a team in England, consisting of
Robert Edwards, a
physiologist who'd spent some time doing
research at Johns Hopkins,
and Patrick Steptoe, a clinical gynecologist.
Edwards seemed to have
gotten a good handle on the protocol for
fertilizing human eggs and
culturing embryos. Steptoe's expertise? He was a
leading
laparoscopist who'd published a book, "Laparoscopy
in
Gynaecology,"
which I'd read hot off the press in 1967. In the
journal articles,
he'd described his approach to recovering human
eggs from ovaries
just before ovulation, and I had no trouble
seeing that with a little
practice, it would be a piece of cake for me.
The question was
whether Giselle Hearn could pick up on Edwards'
reports, and do the
laboratory side of the work as well as I could
do the clinical.
Once
I
set my mind to an idea, I never waste time. Next
day, after I
finished with my morning patients, I hustled
across the skybridge to
the Department of Obstetrics and Gynecology,
then down the hallway to
the research wing, and into Dr. Hearn's lab
area. Hearn was standing
in a corridor, talking to a young woman in a
white coat, probably a
tech. I waited until the girl smiled, nodded,
and walked away; then,
before her boss could move on to whatever she
had in mind to do next,
I walked up to her. "Dr. Hearn."
She
had
no idea who I was. "I'm Colin Sanford. I
practice OBGYN at
Puget Community."
Her
face
said, "Then why don't you go off and practice a
little OBGYN?"
"I
need to talk to you," I said.
"About
what?"
"I
have an idea I'm pretty sure will interest you."
Then, I added,
"I was at your conference last week." I looked
around to
make sure no one was close. "Gerry Camnitz is
not only a
pompous ass, he's a stupid man. You should be
able to extend your
work to humans, and I know how you can do it."
She
didn't know what to make of me, and I couldn't
blame her.
"We
can't talk about it
here," I said. "Let me take you to dinner
tonight."
That
earned me a world-class fish eye.
"Dr.
Hearn, I'm not trying to mash on you, and I'm
not playing games. I'm
as serious as I've ever been. I don't think
you'll want to walk away
from my proposal. Meet me at Charley's
Boathouse, seven o'clock, and
I'll tell you about it."
She
didn't say yes, she didn't say no. Just stood
there, trying to sort
me out.
"What
can you lose?" I added. As it turned out, only
her life, but
how could I know?
