Herbert S. Heineman, M.D.

Print this chapter

PART II

Chapter 20: Missing Limbs

One had a family, the other a successful law practice. Each saw what she herself might have become but for the choice she’d made. They were like two amputees, one missing a leg and the other an arm, each coveting the other’s pair of limbs and knowing that her pair was coveted by the other. They were the best of friends.

A week after Eden’s recovery from anaphylaxis, the two women went to lunch. Bobbie leaned back in her chair and stretched her legs.

“Ah, what a life,” she said with a deep sigh.

Karen, moved by the profundity of this remark, asked, “Yours, everyone’s, or whose?”

“Right now, mine. Though, to be frank, I don’t know whether I’m up to being intellectual about it or just using words to groan with.”

“Well, if it’s the latter, you’ve chosen well. Should I try to upstage you, commiserate with you, or shut up and eat?”

“Here comes the food. I’m hungry.”

“Something’s on your mind,” Karen said after they’d been served. She studied her friend’s face. “Care to tell me about it?”

“Let’s eat. Then we’ll see.” They ate. Periodically Karen looked at Bobbie, but Bobbie was either studying her plate or looking at far distances. At length Karen found a safe way to break the silence.

“Is your deposition still going on?”

“It’s over.” Then she added, “What a jerk.”

“Who?”

“I can’t tell who’s coaching who, the doctor or the lawyer. You know the Santoro case?”

“Name sounds familiar. Diabetic foot?”

“Yes. Are you ready for this?  Here’s poor Mrs. Santoro, short, roly-poly, and likes high heels. She also has bunions and she’s diabetic. Put it together, what do you get? Ulcers that keep coming back. George Wilson, her family doc, always takes cultures, gives an antibiotic, instructs her in foot care, and sees her twice a week till it’s healed. Must have had a dozen x-rays. He’s also warned her plenty of times about her shoes. No complaint against him.”

“So what happened?”

“A year ago both feet broke down at the same time. More x-rays, and now she had osteo in the left big toe. Wilson told her she needed surgery and referred her to Don Shuster.”

“Go on.”

Bobbie paused for effect. “Shuster operated on the wrong foot. Couldn’t tell by looking, of course, both had ulcers. But the x-rays were right there. A clear case of res ipsa loquitur.”

“Then why are they fighting it? Besides, how much damage did he do with the surgery?”

“First, he took off the big toe and the head of the metatarsal. Now she can’t walk so well, and he’d owe her thousands just for that. Second, he still has to go back and do the side he should’ve done in the first place. That’s a second operation with all the risks.”

“OK,” Karen said, “a few thousand more. And she must be pretty upset, so there’s pain and suffering: More thousands. Still, it’s all incontestable. Why escalate the legal costs?”

“It might have stopped there, except that the operative wound got infected, and she ended up with a transmetatarsal. So there goes half the good foot. After that, what would you expect when the same Doctor Shuster trains his artillery on the foot that’s already infected?”

“Oh boy.”

“Yes, indeed. And here’s where you see witness coaching at its best. No way Shuster could have thought this one up by himself.”

Karen held her breath.

“He had the nerve to say that Mrs. Santoro would have needed surgery on her right foot anyway. Diabetic foot is a bilateral disease, says Doctor Shuster, and even if she only had osteo on one side now, sooner or later she’d have it on the other. He concedes he did the wrong amputation first ― generous, don’t you think? ― but he insists the error was relative.”

Karen’s jaw dropped. “He claims he did a prophylactic amputation?”

“Not in those words, but he had the arrogance to insist he helped this woman. I asked him why he hadn’t amputated below the knee, or above it, considering that’s how diabetics often end up. His lawyer instructed him not to answer.”

“Are they going to trial with that? They’ll get laughed out of court.”

“Oh, he’d have to pay for his mistake and for the risk of a second operation. But she may not get as much as she should because, who knows? the jury might buy his argument. You know juries.” Karen did; that’s how her career had taken off years ago.

“Do they have an expert to back Shuster?”

“You bet your sweet life they do. They can always find an expert to back the doctor, no matter what. But we can talk about that another time.”

Bobbie suddenly fell silent and stared into space again. When it appeared that she wasn’t going to talk any more about Mrs. Santoro, Karen asked her softly:

“What is it, Bobbie? You look as if you just remembered something unpleasant.”

“If it’s that obvious, I’m glad you’re the only one watching. You know, there are times when I don’t find anything uplifting in this work.”

“Because of Shuster?”

“No. Though dealing with bastards like that would throw a wet blanket over a million-dollar settlement. But I’ve been feeling it more and more lately, even without provocation.”

“But you’ve done so well. And I’m honestly happy for you. I mean it.”

“I know you are. But I’m not all that happy for myself. I had visions of something greater than redistributing doctors’ wealth among their victims. Not that that isn’t a real service. But it’s so small, with so little impact. When I think of law in the larger sense ― you know, real legal issues, scholarship, legislation ― what I’m doing here strikes me as awfully banal.”

“You’re not thinking of quitting, are you?”

“I don’t have the guts. Suppose I wanted to run for office or a judgeship, think of what it would take to build myself up. I’m forty-four. I don’t know if it’s really too late or midlife crisis only makes it seem that way. Either way, I can’t see doing anything about it.”

“Funny how things look from different perspectives,” Karen said, tracing a pattern on the tablecloth with her spoon. “Here I am, a perpetual associate, a case of arrested development, looking at a professional success story, envying you. It was my own decision, of course, so I’m not crying unfair, but I feel so totally inferior. And now you tell me you’re not content.”

“You’d have done it different, Karen. I came to F & D while you were on leave, and I got to know you before we ever met. It was common knowledge around the office that you had your sights on the bench, or teaching law. So that’s where you’d be by now. But my ambition was to become a successful trial lawyer, and now that I am one it doesn’t seem enough.”

“Your retrospective projection of my career path is flattering,” Karen said with a touch of irony, “but you’re looking ahead from 1971 when you say that, and you’re overlooking what I’d have learned along the way, like you did, that could have derailed me. . . .But maybe I’m just trying to make myself feel better by downplaying my missed chances.”

“It’s all speculation, what might have been, what could have been,” Bobbie went on, her spoon now doing duty on the tablecloth. “Only the retrospectoscope shows us the truth. And not always, at that. Memory can be deceptive. But you know something?” She looked at her friend, a rueful smile on her face. “Once in a while I think about Bruce. We celebrated my partnership by deciding to get divorced. It’s hard to think of one without the other.”

“May I plead friend’s prerogative and ask a tactless question?”

“It’s not tactless coming from you. Besides, there isn’t anyone else I can talk with ― unless I want to spend seventy-five dollars for fifty minutes, or whatever they charge. So ask.”

Karen smiled. “I won’t charge. One of these days you can repay me in kind. If you had to do it over again, would you do any differently?”

“Technically, that presupposes that in 1971 I knew how things would be in 1987. The very point you made. If Bruce and I had stayed together and had a family, who knows how satisfied I’d have been ten years later? We might have had other marital difficulties and split anyway; I might have been an unhappy mother; and I can guarantee you I’d have been thinking constantly about the brilliant career prospects I’d thrown over. No, Karen. It’s tempting to say I should have chosen differently, but all I’d really be saying is that I’m not feeling good now. You know, the grass is always greener . . .”

“You must have had many opportunities to get married again. When I saw you going with Kenny Whitehead for months on end, I was really hoping something would come of it.”

“It almost did. But great guy that he was, he was no improvement over Bruce. For that matter, there was nothing wrong with Bruce. I was the problem. And Kenny has two children from his first marriage. Teenagers. They probably wouldn’t pay any attention to me, but still I’d feel some responsibility. And I’m scared of that responsibility.”

“That’s ridiculous! You’d be wonderful.”

“I’m not talking competence. I have problems wanting to be a mother. The kids would see right through me. They’d have every right to resent me.”

Bobbie paused, correcting for the umpteenth time the pattern she was tracing on the tablecloth, then summed up. “I really don’t know what to do.”

After another pause, she looked Karen in the face. “So if you haven’t figured it already, I also envy you. So you’re not a hard-charging lawyer, or judge, which I’m convinced you could’ve been. But you have balance in your life, a husband and a daughter. I know those relationships take up time, but your return is beyond calculating. And they perpetuate themselves. You don’t have to kill yourself to keep them alive. What do I have? My career. Fine as long as I give it everything I’ve got ― which takes more enthusiasm than I’m feeling right now ― and if I lose it, or get dissatisfied, what do I have then? Money and loneliness.”

“I don’t know what to say,” Karen said. “Either you’ve been doing a masterful job of hiding your feelings, or I’m too obtuse to see the obvious. I had no idea you were that unhappy. So you bitch about how some people don’t have a right to sue, how some doctors don’t have a right to practice medicine, how hospitals throw roadblocks in your way. I’ve always taken your complaints at face value, because I’ve had the same experience. But—”

“Let me finish the thought for you.”

“OK, my lunch treat if you’re right, yours if you’re wrong.”

“That’s a sucker deal, with you deciding after the fact, but I accept.” Lightening the mood was worth the risk. “What you’re thinking is that we both work with the same garbage, and why doesn’t it bother you as much as me? The answer is, this garbage is only part of your life, and you have that wonderful domestic scene to go home to; but that same garbage is my life.”

“That would have been my question,” Karen said. “but I didn’t have the answer. Anyway, lunch is on me, so you see you didn’t need to worry about my honesty.”

“Good.” Bobbie allowed herself a smile now. “Getting it off my chest helps, although dumping it on you is no way to treat a friend, is it?”

“Yes, it is. And if you think we have time, there’s something on my mind too.”  She called the office from the payphone. On her return, she found Bobbie presiding over a fresh carafe of coffee. “Yes, thanks,” she said. She added sweetener, stirred slowly, wiped her spoon, folded the napkin, placed the spoon on it, and took a sip. Bobbie waited patiently.

“I don’t know where to begin,” Karen began.

Bobbie gently encouraged her. “Start anywhere. Go backwards, forwards, sideways, it doesn’t matter. It’ll fall into place.”

“I don’t like the way I feel.” Again there was a pause lasting more than ten seconds.

“About your job?” Bobbie asked.

“That’s part of it.” Another pause. “Maybe I should first digest what you told me.”

“If you think that would be better,” Bobbie said, “we can wait. It’s your call.”

“Oh, I don’t know. I’ll still have my doubts. Even without the grandiose projections you made for me ― which were echoes of my own, after all ― I might feel different by now from the way you do. People aren’t the same. I just can’t help wondering what it would be like.”

“Does the mere fact of asking that question bother you?”

“The question, no. The answer, yes.”

“Let me guess, again. This one’s for dinner? What’s bothering you is that having regrets about your career seems like an act of disloyalty to Eden. Right?”

“You missed your calling,” Karen answered with a smile. “You could be charging seventy-five dollars for fifty minutes. But then, you’re already making more than that.”

“I guess,” Bobbie continued, “if relationships have a downside, that’s it. You can’t say, I’d gladly give back my family for the career I should have had. Guilt gets in the way.”

“Not only that. You said family relationships perpetuate themselves. But your own experience will tell you they aren’t guaranteed. . . . I hope I’m not hurting you by saying that.”

“It’s all right, Karen. You’re not telling me anything I haven’t known for years. Go on.”

“Well, divorce is not the only threat.”

Bobbie looked up sharply. “What do you mean?”

Karen hesitated, afraid of going too far. “How ironic it is that bride and groom pledge themselves to each other until death do them part.”

Bobbie was about to ask again what Karen meant, but the answer dawned on her.

“My God!” She did not offer to bet another meal; this was too serious.

Karen continued: “Twice now Edie’s been at death’s door. After four years I thought I’d recovered from the first. But this last time really did it to me. I live in perpetual fear of what’s going to happen next. I have this dreadful feeling that I’m going to lose her.”

“What a horrible thing to contemplate.” Bobbie covered Karen’s hand with her own.

Karen looked up, tears in her eyes. “You still don’t know all of it. If she should die, I’m not sure which I’d mourn more, her or what I gave up to have her.”

Bobbie could find no words of comfort.