He knew Alison meant well. She was a fine doctor. He knew she had to do what she was doing. She had to push him and Claudia, knowing they would have said, "Let Teddy alone. We'll wait and see what happens. Let him be a happy child." Of course she had had to push them. Acute leukemia had to be treated right away. The sooner you started therapy the more likely the child would survive.
The other docs would never ordinarily have allowed the father of a patient to accompany them to the lab. Not even Dooley, though this was his lab. Fallot, Groenington, and White must have been aware of how they would have felt in his shoes. Alison had a new baby daughter, chubby and perfect. Tony had two older children, healthy active boys aged eleven and fourteen. Dr. Fallot had no children, yet he had a perfect manner for kids, both forthright and sympathetic; he was one of the most caring doctors Dooley had ever met. The fact that the three doctors didn't manufacture consoling phrases made it clear they understood how he felt - they knew no words would have helped if the patient were their child.
Fallot had overheard Dooley's remarks. "It's done now, Dooley," he said. "We'll know in a few minutes."
A few minutes was an exaggeration. They'd be lucky to take less than an hour at this, even though Tony would hurry preparing the slides. The favorite question of pathologists, who were often rushed by surgeons holding patients under anesthesia in operating rooms, was, "Do you want it fast or do you want it right?"
Dooley wanted it fast and right.
Tony immediately began to prepare the bone both as sections for cellularity and touch preparations for cytology. His assistant, who was following Tony's instructions, simultaneously ran up smears with less usual stains, Sudan Black B, myeloperoxidase, para-aminosalicylic acid and nonspecific esterase histochemical. Many hands make light work.
Fallot touched Dooley's shoulder. Dooley nodded his head to acknowledge the encouraging gesture, but he couldn't utter a word.
Teddy's fevers and weakness had gone on too long.
When Teddy first started feeling sick, Dooley had thought it was just a virus. An FUO, he told Claudia, nothing to worry about, just one of the ubiquitous fevers of unknown origin, caused by one of the hundreds or thousands of viruses out there. In a few days it would go away.
But it didn't go away. Their little boy kept running the fever and his throat hurt and his lymph nodes were enlarged and still Dooley kept saying it couldn't be serious. Finally, they took him to his pediatrician, Alison White.
Maybe bacterial, Dr. White said. She took a throat culture, but she couldn't isolate any specific bacterium. "Maybe infectious mononucleosis," she said. "These symptoms are pretty typical."
Claudia, already worried, asked, "Isn't mono something only teenagers get? The kissing bug?"
"Actually, no, not only teenagers, even though it's called the kissing bug a lot. Mono is an Epstein-Barr virus infection. We think half the children in the U.S. have had it by age five. Most of the time, it doesn't cause enough symptoms for anybody to notice."
Teddy was four.
His fever would go up in the afternoon, down in the morning.
"Well, then test him for Epstein-Barr," Claudia said. Dooley knew this wouldn't help. Claudia, of course, was not a doctor, and anyway by now he'd been reassuring too often, so she didn't really believe what Dooley told her. He let Alison explain.
Alison said, "So many people carry the virus, Claudia, that finding it won't tell us whether it's the organism causing his symptoms. Although," she added cautiously, "if the test turned up negative, we'd know it had to be something else." If there were no Epstein-Barr antibodies, they'd know it wasn't mono. Something else like what? Alison said "Let's wait and see."
Copyright 2002 by Barbara D'Amato. All rights reserved, including the right to reproduce this book, or portions thereof, in any form.
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