Chapter 34: The Order
There were three things on the order and it took him twenty minutes to explain them, and he explained them to me as though I were going to be the one carrying them out, which nobody else in that year did.
The first was an overnight recording oximeter.
A soft probe on the foot, a recorder the size of a cigarette packet, five consecutive nights, at home, in his own cot.
“It samples oxygen saturation and pulse rate every two seconds, all night,” he said. “It does not care whether anybody is awake to see it.”
That was the whole of the sentence, and he did not look up while he said it.
Then he said the thing that told me he had understood my table completely.
“Five nights. I want at least two of them to be nights when the father is in the house, and at least two when he is not.”
I said I could not control that, and that I was not consulted about anything in that house any more, including the hour at which I was allowed into a room.
“You can find it out. Your ledger woman knows by breakfast.”
“You are testing my column.”
“I am testing the child,” he said. “Your column is only telling me when to look.”
It is the nearest thing to a compliment I was paid that year, and he did not intend it as one, and I have kept it anyway.
The second thing was a blood draw, and this is where it became impossible.
Not a routine draw. A draw within two hours of an episode.
“Two hours,” he said. “Not the following morning. Two.”
He wrote out the panel and I copied it that night, because I wanted to know what I was carrying.
Full blood count. Metabolic panel. Capillary gas if it can be got. Serum and urine, held.
“Held for what?”
“For a comprehensive screen.”
I asked what a comprehensive screen was.
He answered in the flattest voice he had used all morning. “It is a list of substances.”
“And you can’t run it the next day.”
“For some of them you cannot run it at nine o’clock the same morning.”
Then he stopped, put both hands flat on the desk, and told me what he was not going to do.
“I am not writing a suspicion into this child’s chart today.”
“Why not?”
“Because a chart is a legal document, and it is read by people looking for a reason to close a file.”
“If I write a word like poisoning beside a correlation with no mechanism, then in four weeks a hospital lawyer reads it and this becomes a dispute about me.”
“And your child stops being a patient and becomes a case.”
I said a case was exactly what I wanted.
“No,” he said. “You want a diagnosis. A case is what you are given instead of one.”
I did not accept that at the time, and I want it recorded that I argued with him.
I said children die while careful men are being careful.
He took it. He did not flinch and he did not defend himself.
“Yes,” he said. “They do.”
“Then—”
“And children die because somebody made an allegation on a Friday that fell apart on a Tuesday, and after that nobody would open the file again.”
He said it with no heat at all, which is why it went in.
The third thing was the smallest, and it was the one that undid everything.
All of it needed a signature.
“Consent for the study. Consent for the draw. Consent to hold specimens. One form, three boxes.”
He turned it round on the desk and laid the pen on top of it.
Not for me to sign. He was showing me where the line ran.
“Who signs?”
“The child’s father. He has sole parental responsibility.”
“His grandmother is in the house. She has offered to help.”
“She cannot sign this.”
“The fiancée has lived there since February.”
“She cannot sign it either, and if she did I would not accept it.”
“So it has to be Victor Blackwood.”
“It has to be Victor Blackwood, in his own hand, with a date beside it.”
I looked at the form for a while. It was two sides of gray photocopy with a box for the printed name and a box for the relationship to the patient.
Three boxes and a line, and the next six months of a child’s life sitting on top of a man who was in Texas until Sunday and who had offered me a good reference.
“He’ll sign it,” I said, and I believed it completely, because I had not yet understood that a man can agree with you sincerely on a Sunday and still not have done it by Thursday.
“I hope so.”
“He will. I’ll put it in his hand myself.”
Dr. Moreno folded it into three, put it in an envelope, and wrote nothing on the front.
“Miss Carter. Do not give that to anybody but him.”