Bitter Harvest Page 4

  Although Velma Farrar had her doubts about her new daughter-in-law and was not particularly welcoming at first, Mike’s parents tried to draw Debora into the family. Their efforts met with little success. One Christmas, the elder Farrars drove from Kansas City to Cincinnati—six hundred miles. Mike was still at the hospital when they arrived. “Debora had been reading a book in the back room,” he recalled. “She came out, let them in, and then went back to the bedroom and continued to read.”

  At other times, too, Debora virtually ignored Mike’s parents. On one such occasion, “I was on call,” he said. “Debora got home from work and they were there at our apartment. She walked past them to the bedroom and they didn’t see her again all night.”

  Clearly, Mike and Debora had a very different concept of family. Obviously, their principal common interest was medicine, and few professions demand as much in terms of time and commitment. It was relatively easy to overlook hollow spaces in their marriage, simply because they had so little time to contemplate them.

  In retrospect, Debora and Mike seemed so mismatched that they might have been pieces from two different puzzles. Debora was a loner and as unpredictable as a caged tigress. She didn’t like housework or care about neatness for its own sake. She was highly intelligent about things but had virtually no aptitude for dealing with human beings, a flaw that was subtly undermining her medical career. Mike—gregarious, punctilious, neat—was progressing rapidly at the University of Cincinnati’s medical school, and higher-ups had their eyes on him. He was a passionate man, and his wife was disinterested in sex.

  At the beginning of their relationship, it was Debora who had held the reins of power. She had been the resident about to go into practice, the laughing, witty woman in a cherry-red sports car, while Mike had been the poverty-stricken medical student. In Cincinnati, the balance of power at first became almost equal; then Mike’s star rose while Debora’s descended. But to an outsider looking in on them in 1980, they would have appeared to be a solid couple. With two M.D.’s in the family they could count on being wealthy. Mike was immersed in his medical training and loved what he was doing. Although his goals were entirely clear in his mind and Debora would change the focus of her career often, they seemed to have a workable marriage.

  But then Debora began to have health problems, and Mike suspected she was taking drugs, either regularly or sporadically. “When I was an intern,” he said later, “occasionally I would find these bottles of sedatives or narcotics . . . Dalmane and Valium, that kind of thing. Sometimes Tylenol Number 3 or Tylox or Percodan. I’d find them at home, but they would have some patient’s name from the clinic at the hospital on them. It wasn’t very often, but I would find them from time to time. I asked Deb about those, and she would say, ‘Oh yeah—I picked that up when the patient brought his drugs in and I forgot to give it back to him.’”

  At first, Mike wasn’t much concerned. In that inner-city hospital, many patients were on “a jillion different medicines,” which they commonly brought in in paper bags so that the residents could take inventory and keep track on the chart. It was within the realm of possibility that Debora could have found vials that had fallen on the floor or been left behind, and slipped them into the pocket of her lab coat.

  “Anyway,” Mike recalled, “I remember coming home one day and there was a gouge in the wall—with a big black mark. . . . Clearly one of our wrought-iron chairs had been knocked into the wall, and it was lying on the floor. I went into the bedroom and Debora was lying there. She was sick and complaining of a terrible headache and was just kind of out of it. I thought, ‘What’s this?’ She continued to complain about these headaches, and said she felt awful, and had all these problems.”

  Not only did Debora have excruciating headaches in the back of her head—an unusual site for a headache—but Mike was alarmed to see that she sometimes walked with a staggering gait, as if she was dizzy. Afraid that she might have a brain tumor, he took her in for a consultation with a neurologist at his own hospital.

  Asked what health problems she had had recently, Debora mentioned that she had injured her wrist in a fall and had developed an infection so intractable that she’d had to have surgery to drain it. Mike agreed that her recovery from the wrist incident had been complicated.

  After a series of tests, the neurologist diagnosed Debora as suffering from an unusual condition, cerebellar migraine. The cerebellum is located in the back of the brain and migraines in that area would account for Debora’s headaches. She was given a prescription for beta blockers, drugs usually prescribed for high blood pressure.

  “Ultimately,” Mike recalled, “she did get better, so that’s what I assumed it was. Later, with more incidents, I realized that she probably had some continuing pain in her wrist and was using these narcotics to ease it.”

  Debora Green had another affliction: she suffered chronically from insomnia. “She tried every way I know of to get [a good night’s] sleep—and she never could,” Mike said. “I think the sleeping pills were to let her get some rest. But, at the time, I believed her explanation that she had absentmindedly pocketed both the painkillers and the sleeping pills.”

  Although Mike and Debora used no birth control, Debora did not conceive for almost two years after their wedding—perhaps because their intercourse was so infrequent. But when Debora found she was pregnant, in the spring of 1981, she was very pleased—and so was Mike. Aside from their shared nearsightedness, they were perfect genetic specimens for producing exceptional children. Debora’s IQ was 165, and Mike had tested at genius level. They were both healthy and attractive. A child born of their union would be smart, strong, and fair to look upon.

  Timothy Farrar, born on January 20, 1982, was all those things. Debora had asked to have an epidural anesthetic, but her labor was overdue and had to be induced. Once the contractions started, Debora’s cervix dilated so rapidly that there was no time to inject the numbing anesthetic—so Tim was born, perforce, by natural childbirth. Mike was in the delivery room and remembers being thrilled to have a son. Debora would also recall that her husband was beside himself with happiness at Tim’s birth. The baby boy would have “Farrar” for his last name, as would all their children.

  Debora was a good mother; she nursed her son and took a six-week maternity leave so that she could stay with him for the first month of his life. But she never intended to be a stay-at-home mother. She had worked right up to the end of her pregnancy and, having hired a warm-hearted Jamaican nanny to take care of Tim, she went back to school. She had received a fellowship to study hematology and oncology at the University of Cincinnati.

  Tim’s birth was unplanned, but welcome. Both Mike and Debora decided that they should have a second child within three years, so Debora’s next pregnancy was a mutual decision. Lissa was born two days after Christmas, 1984. Once again, Debora had requested an epidural; but this time the anesthesiologists mistakenly gave her a spinal anesthetic, which often leaves the patient with a severe headache. Nevertheless, Debora was out of bed the next day and walked down to the nursery with two-year-old Tim so he could look at his new baby sister.

  Tim would always be the child who most resembled Debora physically. He had her coloring, her features, her sturdy, square body. He was blond (his hair would later turn russet) and brown-eyed, full of beans and very masculine, but Lissa was a delicate elfin baby, dark-haired and petite, with her father’s rounded forehead and fine features. Debora and Mike now had the perfect family: a little boy and a baby girl.

  Again Debora went back to work almost immediately. Although she and Mike both had fellowships in internal medicine and were supposedly working the same hours, she was usually back at their apartment by four in the afternoon, while he worked three or four hours later. “She used to tell me that was because I was inefficient and I spent too much time stopping to talk to people,” Mike recalled. “And part of that was true—but I just don’t think she ever had a burning desire to excel. She never really wanted to
be an excellent or outstanding doctor. Interestingly enough, here is a woman who is brilliant—and she had to take her oncology boards twice. Both times, she failed. She barely passed the internal medicine boards. Those were difficult tests, but if you’re an American who goes to a university training program, who works hard and does a reasonable amount of study, you should be able to pass those. . . . She was just ill-prepared.”

  Mike rarely saw Debora studying medical books; she read only for pleasure. She went to classes and on rounds, and her keen mind made it possible for her to retain far more than most students—but it was not enough to pass her board exams.

  The day the test results arrived was not a good one. Mike’s letter said, “Congratulations! You have passed the boards for cardiovascular disease,” while Debora’s began, “We regret to inform you . . .”

  Debora opened both envelopes and phoned Mike. She was angry and crying—in hysterics—and accused him of caring only about his own test scores. She blamed him for her failure: she’d had to take care of Tim and Lissa, she said, and hadn’t had enough time to study. The truth was that both of them had cared for the babies until they were put down for the night, and that Mike then read medical books while Debora went upstairs with a novel.

  Debora never passed either her hematology or oncology board examinations. That would not bar her from practicing in those specialties, but if patients checked, they would find she was not “board-certified.” She seldom read literature on medical advances in her field, and she rarely attended seminars and conventions. Apparently she had no desire to mingle with her fellow oncologists.

  In 1985, Mike had one more year of his cardiology fellowship in Cincinnati to complete, but Debora was finished. With their dependable nanny caring for Tim and Lissa, she started a private practice in oncology and hematology. Dealing with cancer patients requires both compassion and acceptance of what is often tragic beyond words. Most oncologists manage to maintain enough emotional distance to protect themselves, while still evincing true concern for their patients. Although Debora insisted that she chose her specialty because she loved people so much, both her husband and her co-workers were appalled at her indifferent approach to patients.

  Again, Mike wondered why. “She had trouble dealing with patients,” he recalled. “I can remember listening to her talking to a patient one night when she was on call. It was clear that the patient needed to go into the emergency room and that she would have to go in and check on her. Debora was very passive-aggressive with the patient—angry about the whole thing.” Nurses, too, were puzzled by her behavior toward patients. One commented, “She was the strangest doctor I’ve ever worked with in my life.” Another found her “cold” and “unfeeling.”

  Mike, however, was emerging as a “real superstar,” according to a physician who worked with him in Cincinnati. “He was so good at everything. He showed unusual maturity. He related extremely well and had extremely good judgment, all of which marked him as someone who would be a superior cardiologist.”

  In the spring of 1986, he completed his fellowship and agreed to stay at the University of Cincinnati as an assistant professor at the medical school; he would also serve as medical director of the heart transplant unit. “But the chairman of cardiology resigned and they were bringing in new people,” Mike said. “I wasn’t sure what my future would be there.” A physician friend in Kansas City, Missouri, invited Mike to join his partnership, so he and Debora decided to move back there rather than wait to see how things would shake out with the new regime at the university.

  It was July 1, 1986, when they settled in Kansas City. Twelve twenty-four West Sixty-first Terrace, in an older, upscale neighborhood near the Country Club Church, was a beautiful house with stucco walls crisscrossed with heavy beams, and a brick façade with arched passageways that led into a side garden. After so many years of studying and deprivation, Debora and Mike brought their children home to the area where they had met and been married—the Kansas-Missouri border, where the wind blew all the time, a steady, almost comforting sound in the trees. It was, really, a whole new start. They both looked forward to their careers and to raising their two children. On West Sixty-first Terrace, children abounded and the neighbors were friendly. But the move meant leaving behind their nanny, who had been with Tim for four years and Lissa for two. Debora and Mike would have to interview applicants for child care in their home, and Debora did not go back to work until they found a new nanny.

  Mike went into private practice with the group in KCMO, and Debora soon joined another group of physicians. They were on staff at many of the same hospitals and occasionally ran into each other during the day. Debora was thirty-five that summer, and Mike was thirty-one.

  Mike’s practice did very well, although he ultimately moved on to join another group of doctors. At the end of Debora’s first year in her group, both she and Mike expected that she would be offered a partnership. That was medical protocol—but the offer didn’t come. Such a slight is almost unheard-of.

  “I knew what the reason was.” Mike sighed. “She could not get along with patients—she drove them away. So she left that first practice in Kansas City at the end of the year, and went into private practice on her own.”

  But the doctors in her group practice may have had more serious reasons for not offering Debora a partnership. An old bugaboo raised its head soon after they moved to Kansas City. Mike noticed that once again Debora’s gait was off-balance enough to make her stagger slightly, and her speech was sometimes slurred. And, though she had always written with flowing cursive letters so perfect they could have been used in a penmanship manual, Debora now began to scribble. A doctor she worked for called Mike and said, “Hey, what’s wrong with our Debora? She’s not being as attentive to details, and her writing has really deteriorated. What’s going on?”

  There were other signs. Mike’s sister Karen was getting married and his whole family was thrilled with the new son-in-law. Debora had not been welcomed into his family with open arms and she began to complain that she was sick of hearing about Karen’s wedding. “One night,” Mike said, “she actually called my sister up and told her that we weren’t coming . . . for the wedding, and she was pretty insulting and her speech was slurred and almost incoherent.”

  Debora had physical problems besides her wrist injury. Some years earlier, she had fallen while climbing stairs at the University of Cincinnati and somehow gotten a puncture wound in her knee. A stubborn infection developed; extremely painful, it required a ten-day hospitalization. Much like her wrist injury, the mysterious infection required draining by syringe several times a day. Antibiotics finally cured it, but Debora had had chronic pain in her knee ever since.

  Now, with Debora behaving so bizarrely, Mike deduced what the problem was. His heart sank. She was using drugs again. He searched their house and found a drawer jammed with sleeping pills and painkillers—potent narcotics, including Tylox.

  Mike told Debora that he had to talk to her alone. With the bedroom door closed so that neither Tim, Lissa, nor their nanny could hear, he silently lined up the narcotics vials on the dresser. For once, she did not shout at him. There was no way she could explain having so many bottles of Tylox, prescribed to different names, none of them hers.

  “My knee has been bothering me,” she said weakly. “It’s hard to keep on my feet without something to ease the pain.”

  “Debora, you can’t do this,” Mike said softly. “These prescriptions aren’t for you—these are for your patients. They have bone pain, and you have a minor knee injury. I don’t believe you’re taking Tylox for pain—I’m afraid you’re in trouble again.”

  After a long silence, Debora lifted her head. “You’re right,” she agreed. “I know I have to stop. And I will. I promise you.”

  “Are there any more of these?” Mike asked. Debora shook her head. He stared at her, drew a deep breath, and began to gather up the vials of pills and capsules. “I’m going to throw them out,” he said. �
�I’m going to believe you when you say it won’t happen again.”

  As far as Mike could tell, Debora kept her promise. Things got better for them after that, and he didn’t notice any suspicious signs that Debora was using narcotics.

  Rather than apply to join another group practice in Kansas City, Debora opened her own office, and having a one-woman practice seemed to work for her. She was on staff at St. Mary’s Hospital. It wasn’t a really busy hospital, and there weren’t many doctors there covering oncology. For the first time since she had gotten her M.D., Debora didn’t have other physicians looking over her shoulder or second-guessing how she treated her patients. Her quick temper and her confrontational behavior when she was questioned were, for a time, not an issue. She employed an answering service and hired a woman to do her billing.

  “It really went pretty well for her,” Mike said of Debora’s solo practice, which lasted a little less than a year. “The problem was that St. Mary’s closed. And then Debora got pregnant with Kelly. She was pretty upset about that.”

  Although Debora was thirty-seven, which is no longer considered unusually late for childbearing, she and Mike had assumed that there would be no more children. She was shocked when, in May of 1988, she recognized the unmistakable symptoms of pregnancy. This, added to the closing of the only hospital where she had felt comfortable, effectively ended her attempt to establish a private practice in Kansas City.

  Kelly was born almost exactly four years after Lissa—on December 13, 1988. This time Debora got the epidural anesthetic she had chosen for each of her deliveries. All through the labor, Mike stood beside Debora’s bed, trying to comfort her. He fed her ice chips, rubbed her back, and reached out to hold her hand. But she brushed him away impatiently; she didn’t want him to touch her at all. They had been married nine years and this was their third baby, but Debora seemed to resent Mike because she was delivering a child she didn’t want, a child who had interfered with the first successful practice she had ever had.