Con couldn’t sleep. Visions of Jill, cured of her leukemia, full of energy, with golden tresses and arched eyebrows fully grown out, perfused his brain and made him wish he could walk with her right then, maybe even kiss her. He willed himself to wait till Sunday morning after breakfast before calling to confirm their date. When he finally did, Mrs. Wonderlin answered the phone on the third ring.
“Hello, this is Connor Flynn, from the hospital. May I speak with Jill?”
“Oh,” she answered, “you’re her friend, aren’t you? You also get transfusions.”
“I’d love to be her friend, though we don’t really know each other well enough. How’s she doing? We agreed we’d take a walk together this afternoon. It’s such a beautiful day. We’ve never met outside the hospital, you know.”
“Yes, I remember you well. Jill talked a lot about you. She really likes you. But she won’t be able to keep your date, I’m sorry to say. She’s back in the hospital. She wanted me to call you but I’ve been so upset, I just couldn’t think straight.”
For a moment Con was speechless. “What happened?” he finally asked. “She seemed OK on Friday.”
“By the time we got home she was complaining of pain in her back and sides, and she was shivering even though the house was warm. She lay down and we were expecting her to sleep it off, whatever was bothering her. A half hour later she came downstairs, sort of unsteady on her feet, and told us that she’d just been to the bathroom and her urine was dark like she’d never seen before. She hadn’t flushed so she could show us. And it was just like she said. Because of the shivers we took her temperature and it was 102. This scared the dickens out of us and we took her right to the hospital.
“They told us it sounded like a possible transfusion reaction, meaning she’d gotten mismatched blood. Now how was that possible? They knew her type, they knew she’s O-negative, and she’d been transfused many times before without any trouble. They said they needed to do some tests, but then they couldn’t locate the bag she’d been transfused from. The whole setup had been dismantled and discarded. It’s almost as if they know they did something wrong and were trying to hide the evidence. But I guess things like that happen on holiday weekends, with substitute staff.
“Anyway, I didn’t mean to ramble on. I’m sure she’d like to see you, so if you can find the time, do go visit her.”
Con didn’t hesitate for an instant. “Of course I will. I’m just so sorry this happened, and I can’t understand why. I was getting blood at the same time and I’m OK.”
❖❖❖❖❖
Doctor Calvin McCrae, a pediatrician who was single and living alone, had volunteered to supervise the transfusion unit over Thanksgiving weekend, so that Joan Brent could spend the time with her husband and children. He had done so a number of times before, and it had required nothing of him except to be available if needed. He had not been called once in at least two years. And he wasn’t called on the day Jill and Con received their transfusions. The telephone call from Doctor Hugh Wetherill, director of the blood bank, on Monday morning made him wish he had.
“This is Doctor McCrae.”
“Wetherill here.”
“Hi, how was your weekend?”
A pause. “How was yours?”
“Great! I ate so much I still can’t get hungry.”
“Well,” and Wetherill’s tone took on an icy quality, “this isn’t going to help your appetite. Weren’t you on call?”
“Yes, and I lucked out — again. No interruptions.”
“Obviously you haven’t heard. There was a hemolytic transfusion reaction on Friday: A-positive blood to O-negative recipient. Fifteen-year-old girl with acute myelocytic leukemia. Is — or was — in line for possible marrow transplant.”
McCrae’s skin turned to a field of goosebumps. How was this possible? A transfusion reaction and no phone call! His number was easily available to anyone at the hospital who might need him. Did he miss the phone ringing? Was he out of earshot? The question was more than rhetorical, for it reflected on the effectiveness of communication between hospital and staff. But for McCrae it had an additional, deeply personal connotation. Reflexively he recalled the last day of Eden Avery’s life. That seventeen-old girl had died because of his negligence. Was this girl another of his victims?
“My phone didn’t ring. I don’t see how I could have missed it. I didn’t leave home all weekend. Are you sure they called? My number’s right there!”
Wetherill explained: “I spoke with the mother. It wasn’t your fault. Nor the switchboard’s. The girl seemed OK when she left the unit and didn’t feel sick until they were home. Then, back pain, weakness, discoloration of the urine, the whole nine yards — classic textbook hemolysis. Mother brought her back when she developed chills and fever. It’s good she did, because the girl’s in renal shutdown now. Hasn’t passed a drop of urine in the last forty-eight hours and her BUN and creatinine are rising. We’re transferring her to Pediatrics, and you’re going to have to make some decisions.”
You bet, thought McCrae, speechless. Acute leukemia, facing bone marrow transplant; acute renal failure, facing hemodialysis, maybe even kidney transplant; chemotherapy; more transfusions. What are her chances of surviving all that?
None, as it turned out. Even as Doctors Wetherill and McCrae struggled with Jill Wonderlin’s immutable fate, McCrae was paged to receive the news that she’d lapsed into a coma. Within minutes she stopped breathing, presenting him with a new dilemma, namely, whether or not to try to resuscitate her.
He ran to the Pediatrics floor, took one look at Jill, and saw fresh bruises on her forearms. Saying a silent prayer for guidance and forgiveness, he ordered the staff to let her be. If her parents consented, an autopsy would be performed, which McCrae expected to confirm his snap diagnosis that she had suffered an intracerebral hemorrhage. He would tell the parents what he honestly believed to be true: that the odds were simply too great and nothing could be done for their daughter.
Con arrived at noon unaware of the morning’s dramatic events. He asked the receptionist where he could find Jill Wonderlin.
“You didn’t hear?”
Con gasped. “Hear what?”
“Jill died this morning, about ten o’clock I’d say. I don’t know any more than that. Go up to Pediatrics, fourth floor west. The doctors are up there with the parents. You’re a relative?”
Con didn’t bother to answer. He made straight for the elevator.
There was a crowd at the nurses’ station. He introduced himself and a woman he’d met in the transfusion unit approached him. “I’m Mrs. Wonderlin,” she said. “I remember you; you’re Jill’s friend, aren’t you? I got the call from the hospital not long after we talked this morning.”
He wiped a tear from his cheek and saw that Mrs. Wonderlin had been crying too. “I just don’t know what to say,” and then he sobbed uncontrollably. She put a hand on his shoulder and asked: “Would you like to see her?”
He didn’t know whether seeing her would make him feel better or worse, but he nodded. “Yes.”
She was lying supine, eyes closed, seemingly at peace, a shade paler than he remembered her. Her head was uncovered, and he saw the most visible effect of her chemotherapy. He would have liked to place his cap on her head but thought that might be seen as disrespectful. Irresistibly, he bent down and kissed her on both cheeks. “Oh God,” he whispered. The image of them walking hand in hand along Wissahickon Creek, which now had no counterpart in reality, was more than he could bear, so he turned and left the room.
Later, in a calmer frame of mind, he would reflect that he had hardly known this girl. Yet he knew he would never forget her. There had been hope that she’d survive the leukemia. A new bone marrow could have given her a new lease on life. It was the transfusion reaction that killed her.
As he returned to the nurses’ station, he saw a familiar face that he’d missed when he first came up. It was Nurse García, self-dubbed Florence Nightingale or whatever. He fixed her with a look of hatred so intense he would have been hard put to explain it to anyone else. But he felt justified, for it was not just her error, it was her attitude while committing it. She had made light of the transfusion itself. She had lamented having to work on a holiday weekend. She had a dark complexion and talked with a foreign accent.
But Con had also played a role in Jill’s death. After all, who received the blood that should have been Jill’s? And who was the intended recipient of the blood that killed her?
So it was not just Nurse García; it was also he, Connor Flynn. And he would never be held to account. In reality, no court would try him, far less convict him of her death, because his imagination was way off the mark legally. But deep down he felt complicit, and his conscience would forever judge him.
Nurse García was dismissed unceremoniously, with poor prospects of finding work again as a nurse for any employer who took the trouble to look into her history. The Wonderlins could have won a jury award, or a settlement, of millions in a malpractice suit against the hospital, were not their daughter already suffering from a life-threatening illness to begin with, one that would not have been cured by any number of properly matched blood transfusions. As it was, they accepted a one million-dollar settlement and invested it in U.S. Treasury bonds, to be used at an indeterminate time in the future for a cause specifically devoted to Jill’s memory.
The Wonderlins were readily convinced by Doctor McCrae that knowing the proximate cause of Jill’s death might help a future child in a similar situation. So they consented to an autopsy, which confirmed McCrae’s suspicion that Jill had suffered a massive hemorrhage in the brain.
In an ironic twist of fate, Con’s bone marrow slowly began to produce blood cells, a rare example of spontaneous recovery from aplastic anemia, which he, in his besotted way, construed as the result of Jill’s sacrifice. By the time he graduated from high school, he was six months beyond his last transfusion and, for all intents and purposes, in good health. He had tried to revive a semblance of social life, but the memory of Jill had kept getting in the way. No girl survived the inevitable comparison with Jill.
Mrs. Wonderlin had said that Jill really liked him. Whether Jill would have cried for him was a question he’d never be able to answer, but their attraction had undeniably been mutual. The difference was in their attitudes to their diseases: hers was fatalistic, based on knowledge; his, indifferent, based on denial and ignorance.
She had died and he had lived.
At his mother’s urging — she being an alumna — he applied for admission to Oberlin College. He was accepted and — at his father’s urging, he being a successful car salesman — decided on a business major.
Shortly after Con’s graduation from high school, his father was offered a promotion to head a Buick dealership in New York City. The position came with a generous pay and benefits package. There was nothing to keep the Flynns in Philadelphia, so he accepted. They made a down payment on a house in Brooklyn on a quiet cul-de-sac within easy reach of a subway station. Con would visit them there on breaks from classes at college, and the journey would take less time than it would to Philadelphia.