Jonathan Kellerman - The Conspiracy Club

Raging emotions, dead tissue.

Polar opposites was the way Jeremy Carrier had always seen it.

In a hospital setting, no two disciplines were less connected than psychology and pathology. As a practitioner of the former, Jeremy prided himself on an open mind; a good psychotherapist worked hard at avoiding stereotypes.

But during all his years of training and clinical work at City Central Hospital, Jeremy had met few pathologists who didnt fit a mold: withdrawn, mumbly types, more comfortable with gobbets of necrosed flesh, the abstract expressionism of cell smears, and the cold-storage ambience of the basement morgue, than with living, breathing patients.

And his fellow psychologists, psychiatrists, and all the other soldiers of the mental health army, were, more often than not, overly delicate souls repelled by the sight of blood.

Not that Jeremy had actually known any pathologists, even after a decade of passing them in the hallways. The social structure of the hospital had regressed to high school sensibilities: Us-Them as religion, a lusty proliferation of castes, cliques, and cabals, endless jockeying for power and turf. Adding to that was the end-means inversion that captures every bureaucracy: the hospital had devolved from a healing place needing funds to treat patients to a large-scale municipal employer requiring patient fees to meet its staff payroll.

All that created a certain asocial flavor.

A confederacy of isolates.

At City Central, like was attracted to like, and only the last-ditch necessities of patient care led to cross-pollination: internists finally admitting defeat and calling in surgeons, generalists taking deep breaths before plunging into the morass of consultation.

What reason could there be for a pathologist to contact a psychologist?

Because of all that- and because lifes hellish wrist-flick had turned Jeremy Carrier into a tormented, distracted young man- he was caught off-balance by Arthur Chesss overture.

Perhaps Jeremys distractibility formed the basis for all that followed.

For nearly a year, Jeremy had seen Arthur once a week, but the two men had never exchanged a word. Yet here was Arthur, settling down opposite Jeremy in the doctors dining room and asking if Jeremy cared for company.

It was just before 3 P.M., an off-hour for lunch, and the room was nearly empty.

Jeremy said, Sure, then realized he was anything but.

Arthur nodded and settled his big frame into a small chair. His tray bore two helpings of fried chicken, a hillock of mashed potatoes glazed with gravy, a perfect square of corn bread, a small bowl of succotash, and a sweating can of Coca-Cola.

Staring at the food, Jeremy wondered: Southern roots? He tried to recall if Arthurs voice had ever betrayed Southern inflections, didnt think so. If anything, the old mans baritone was flavored by New England.

Arthur Chess showed no immediate interest in conversation. Spreading a napkin on his lap, he began shearing through the first piece of chicken. He cut quickly and gracefully, using long fingers tipped by broad nails stubbed short. His long white lab coat was snowy-clean but for a disturbing spatter of pinkish stains on the right sleeve. The shirt beneath the coat was a blue pinpoint Oxford spread-collar. Arthurs magenta bow tie hung askew in a way that suggested intention.

Jeremy figured the pathologist for at least sixty-five, maybe older, but Arthurs pink skin glowed with health. A neat, white, mustachless beard, which gave insight into what Lincoln s wouldve looked like had Honest Abe been allowed to grow old, fringed Arthurs long face. His bald head was lunar and imposing under cruel hospital lighting.

Jeremy knew of Arthurs reputation the way one is aware of a strangers biography. Once Head of Pathology, Professor Chess had stepped down from administrative duties a few years ago to concentrate on scholarship. Something to do with soft-tissue sarcomas, the minutiae of cell-wall permeability, or whatnot.

Arthur also had a reputation as a world traveler and an amateur lepidopterist. His treatise on the carrion-eating butterflies of Australia had been featured in the hospital gift shop, alongside the usual paperback diversions. Jeremy had noticed the single stack of dry-looking, dirt brown volumes because they drabbed in comparison with the jackets of lurid best-sellers. The brown stack never seemed to reduce; why would a patient want to read about bugs that ate corpses?

Arthur ate three bites of chicken and put down his fork. I really do hope this isnt an intrusion, Dr. Carrier.

Not at all, Dr. Chess. Is there something you need?

Need? Arthur was amused. No, just seeking a bit of social discourse. Ive noticed that you tend to dine alone.

My schedule, lied Jeremy. Unpredictable. Since his life had gone to hell, hed been avoiding social discourse with anyone but patients. Hed gotten to the point where he could fake friendly. But sometimes, on the darkest of days, any human contact was painful.

Lifes little wrist-flick

Of course, said Chess. Given the nature of your work, that would have to be the case.

Sir? said Jeremy.

The unpredictability of human emotions.

Thats true.

Arthur nodded gravely, as if the two of them had reached a momentous agreement. A moment later, he said, Jeremy- may I call you Jeremy?- Jeremy, I noticed you werent at our little Tuesday get-together this week.

A situation came up, said Jeremy, feeling like a child caught playing hookey. He forced a smile. Unpredictable emotions.

Something that resolved well, I hope?

Jeremy nodded. Anything new come up at T.B.?

Two new diagnoses, an adenosarcoma, and a CML. Typical presentations, the usual spirited discussion. To be honest, you didnt miss a thing.

Our little Tuesday get-together was Tumor Board. A weekly ritual, 8 to 9 A.M., in the larger conference room, Arthur Chess presiding over a confab of oncologists, radiotherapists, surgeons, nurse specialists. Commanding the slide projector, wielding a light wand, and his voluminous memory.

For nearly a year, Jeremy had been the mental health armys representative. In all that time, hed spoken up once.

Hed attended his first Tumor Board years before, as an intern, finding the experience an ironic grotesquerie: slides of tumor-ravaged cells click-clicked on a giant screen, the images obscured by nicotine haze.

At least a third of the cancer doctors and nurses were puffing away.

Jeremys supervisor at the time, an astonishingly pompous psychoanalyst, had wielded a Meerschaum pipe of Freudian proportions and blown Latakia fumes in Jeremys face.

Arthur had been running things back then, too, and hed looked much the same, Jeremy realized. The chief pathologist hadnt smoked, but neither had he objected. A few months later, a wealthy benefactor touring the hospital poked her head in and gasped. Soon after, the hospital passed a no-smoking rule, and the mood at subsequent Tumor Boards grew testy.

Arthur sectioned a tiny square of corn bread from the host slab and chewed thoughtfully. No loss for you, Jeremy, but I do believe that your presence contributes.

Really.

Even if you dont say much, the fact that youre there keeps the rest of us on our toes. Sensitivity-wise.

Well, said Jeremy, wondering why the old man was bullshitting him so shamelessly, anything that helps sensitivity.

The time you did speak up, said Arthur, taught us all a lesson.