vomited her coffee break blueberry muffin. By then, a doctor in a crisp white jacket had arrived.
“Of course I remember you,” Dr. Arthur said.
“You were the woman who was so sensitive to ketamine. How could I forget?”
“I just wanted to be sure you wouldn’t use it again,” Marissa said. She hadn’t recognized Dr. Arthur at first since he’d not treated her since the biopsy. But after he’d started her IV, something jogged her memory.
“All we need today is a little Valium,” Dr. Arthur reassured her.
“And I’m going to give you a little right now. This should make you pretty sleepy.”
Marissa watched him inject the drug into the side port of her IV. Then she rolled her head straight. Now that the egg retrieval was about to begin, her attitude about the procedure had changed from fifteen minutes earlier. She was no longer ambivalent.
As the Valium hit her system, Marissa’s mind calmed, but she didn’t sleep. She dwelt on the thought of her blocked tubes and what might have caused the blockage. Then she began to consider the different procedures she had undergone. She, remembered how she felt waking up from the general anesthesia after her laparoscopy.
As soon as she was lucid, Dr. Carpenter had told her that her tubes appeared so scarred that microsurgery was totally out of the question. He said that all he’d been able to do was take a biopsy. He let her know then that her only chance for a baby was in-vitro fertilization.
“Are we ready?” a booming voice called.
Marissa lifted her head, raised heavy eyelids, and looked up at the bearded face of Dr. Wingate. Lying back, she tried to dissociate herself from her body to cope with her anxiety. Her mind wandered back to her visit to Dr. Ken Mueller in the department of pathology at the Memorial after her laparoscopy. The Women’s Clinic frequently sent some of their specimens to the Memorial to confirm their diagnoses. Marissa had been told that her fallopian tube biopsy had been forwarded there.
Hoping to maintain her anonymity, Marissa had searched for her slides herself. Shed knew that the Women’s Clinic used her social security number as her case number.
Once Marissa had the slides, she sought out Ken. They’d been friends since medical school. She asked him to look at the microscopic sections for her, but didn’t say they were hers.
“Very interesting,” Ken said after a brief scan of the first slide.
He sat back from the microscope.
“What can you tell me about the case?”
“Nothing,” Marissa said.
“I don’t want to influence you. Tell me what you see.”
“Sort of a quiz, huh?” Ken said with a smile.
“In a way,” Marissa said.
Ken went back to the microscope.
“My first guess is that it’s a section of fallopian tube. It looks as if it’s been totally destroyed by an infectious process.”
“Right on,” Marissa said with admiration.
“What can you say about the infection?”
For a few minutes Ken silently scanned the specimen. When he finally spoke, Marissa was stunned.
“TB!” he announced, folding his arms, “Tuberculosis?” Marissa almost fell off her chair. She’d expected nonspecific inflammation, never
TB.
“What makes you say that?” she asked.
“Look in the field,” Ken told her.
Marissa gazed into the scope.
“What you are looking at is a granuloma,” Ken said.
“It’s got giant cells and epithelioid cells, the sine qua non of a granuloma.
Not a lot of things cause granulomas. So you have to think of TB, sarcoid, and a handful of funguses. But you’d have to put TB at the head of the list for statistical reasons.”
Marissa felt weak. The idea that she had any of those diseases terrified her.
“Can you do any other stains to make a definitive diagnosis?”
Marissa asked.
“Sure,” Ken said.
“But it would help to have some history on the patient.”
“Okay,” Marissa. said.
“She’s a healthy Caucasian woman, mid-thirties, with a completely normal
“Of course I remember you,” Dr. Arthur said.
“You were the woman who was so sensitive to ketamine. How could I forget?”
“I just wanted to be sure you wouldn’t use it again,” Marissa said. She hadn’t recognized Dr. Arthur at first since he’d not treated her since the biopsy. But after he’d started her IV, something jogged her memory.
“All we need today is a little Valium,” Dr. Arthur reassured her.
“And I’m going to give you a little right now. This should make you pretty sleepy.”
Marissa watched him inject the drug into the side port of her IV. Then she rolled her head straight. Now that the egg retrieval was about to begin, her attitude about the procedure had changed from fifteen minutes earlier. She was no longer ambivalent.
As the Valium hit her system, Marissa’s mind calmed, but she didn’t sleep. She dwelt on the thought of her blocked tubes and what might have caused the blockage. Then she began to consider the different procedures she had undergone. She, remembered how she felt waking up from the general anesthesia after her laparoscopy.
As soon as she was lucid, Dr. Carpenter had told her that her tubes appeared so scarred that microsurgery was totally out of the question. He said that all he’d been able to do was take a biopsy. He let her know then that her only chance for a baby was in-vitro fertilization.
“Are we ready?” a booming voice called.
Marissa lifted her head, raised heavy eyelids, and looked up at the bearded face of Dr. Wingate. Lying back, she tried to dissociate herself from her body to cope with her anxiety. Her mind wandered back to her visit to Dr. Ken Mueller in the department of pathology at the Memorial after her laparoscopy. The Women’s Clinic frequently sent some of their specimens to the Memorial to confirm their diagnoses. Marissa had been told that her fallopian tube biopsy had been forwarded there.
Hoping to maintain her anonymity, Marissa had searched for her slides herself. Shed knew that the Women’s Clinic used her social security number as her case number.
Once Marissa had the slides, she sought out Ken. They’d been friends since medical school. She asked him to look at the microscopic sections for her, but didn’t say they were hers.
“Very interesting,” Ken said after a brief scan of the first slide.
He sat back from the microscope.
“What can you tell me about the case?”
“Nothing,” Marissa said.
“I don’t want to influence you. Tell me what you see.”
“Sort of a quiz, huh?” Ken said with a smile.
“In a way,” Marissa said.
Ken went back to the microscope.
“My first guess is that it’s a section of fallopian tube. It looks as if it’s been totally destroyed by an infectious process.”
“Right on,” Marissa said with admiration.
“What can you say about the infection?”
For a few minutes Ken silently scanned the specimen. When he finally spoke, Marissa was stunned.
“TB!” he announced, folding his arms, “Tuberculosis?” Marissa almost fell off her chair. She’d expected nonspecific inflammation, never
TB.
“What makes you say that?” she asked.
“Look in the field,” Ken told her.
Marissa gazed into the scope.
“What you are looking at is a granuloma,” Ken said.
“It’s got giant cells and epithelioid cells, the sine qua non of a granuloma.
Not a lot of things cause granulomas. So you have to think of TB, sarcoid, and a handful of funguses. But you’d have to put TB at the head of the list for statistical reasons.”
Marissa felt weak. The idea that she had any of those diseases terrified her.
“Can you do any other stains to make a definitive diagnosis?”
Marissa asked.
“Sure,” Ken said.
“But it would help to have some history on the patient.”
“Okay,” Marissa. said.
“She’s a healthy Caucasian woman, mid-thirties, with a completely normal
Similar Books
