Monday, April 14, 2008

Second page

As they sat at the pine table sipping tea from bone china cups she asked about his children. “Robert is in India working with UNESCO. Jeremy works in the City at what they call a hedge fund, whatever that is. Apparently it has nothing to do with horticulture. Joanna is in San Diego at the Scripps and Elizabeth is raising five of our grandchildren in Surrey. And you? Have you remarried?”

“Prof, if I had you would have been invited to the wedding.” Her husband had died three years previously of a particularly vicious sarcoma. The whole process had taken four months from beginning to end. She had taken six months leave of absence from her job afterwards.

“Do you still talk to him?”

“Not so much now,” she replied, “do you still talk to Dorothy?” His wife had died a year ago after a long decline into Alzheimer’s.

“All the time. I became used to not getting a reply when she was alive.”

They sipped some more tea and then he said, “Right, that’s got that out of the way. What have you really come for?”

“I have a problem.”

“Yes, that much is obvious. What sort of problem? Is it a medical one? Or financial, administrative, social, or romantic? I must warn you I have no money, the national health service has been through three reorganisations since I retired, my views on society haven’t changed since the nineteen sixties and I know nothing about the modern sexual mores.”

“I want to show you a blood slide.”

“In that case you had better come into my study. Bring your tea.”

In the study he switched on his microscope, the one his colleagues had bought for him when he retired from the hospital. She took the slide from her handbag and handed it to him. He quickly adjusted the focus and moved the stage rapidly from left to right.”

“Yes. Typical M3. Do you still call it that? Promyelocytic leukaemia with faggot cells.”

“Prof!” she said, shocked, “You mustn’t call them that. Sultan bodies is the correct name.”

“After Claude? Why ever not? Collections of granules that look like meatballs, why can’t I call them faggots?”

“Because that’s a slang term for homosexuals.”

“Really? I had no idea. Still, what’s that got to do with the price of fish? Meatballs came first.”

She changed the subject, “Anyway it’s not a typical M3. It doesn’t have the chromosomal translocation and it did not respond to ATRA.”

“ATRA?”

She sighed. This was a mistake. He was even more out of touch than she thought. “All trans retinoic acid. A form of vitamin A. It was a Chinese discovery after you retired.”

“Well, did he respond to chemotherapy?”

“Not to conventional drugs, but we did get a remission with arsenic.”

“Arsenic?”

“That was after your time too. Arsenic trioxide turns out to be a useful drug in leukaemia.”

“I am afraid, my dear, that I am not going to be much help to you. My knowledge was useful for a certain time, but I am like a horse breeder in the age of the automobile. Time passes and life moves on. You have convinced me, if indeed I needed convincing, that I should stick to my dahlias.”

She tried again, “Look at the lymphocytes.”

He returned to the microscope and a few seconds later he said, “Chediak-Higashi granules?”

“You agree. Have you ever seen it before?”

“Why, yes, I believe I have. Let me see.” He walked across the room and opened a glass fronted bookcase filled with navy-blue notebooks. He withdrew one from the top shelf, opened it then replaced it. He counted five along and removed another one. He began to turn pages over quickly. “Yes, I thought so. June the sixth, 1974. George Turner, aged 35. M3 with Chediak Higashi bodies in the lymphocytes. Goodness me, a second case after all this time. My dear, do you want to write a paper?”

“If we did, we would have to include Peter Swift as a co-author.”

“From Belfast? Did he refer your patient to you?”

“No. He has a patient precisely similar.”

“Remarkable. Like London buses.”

1 comment:

Pat Spiller said...

. . . and the plot thickens with new character introductions. You have me hooked. Write faster. Is there 'bad blood' between the old doc and Peter? Hmmmmm. Medical competition? More intimate? What???? Write faster......