The Good Doctor || Andy Betz

          Today, my doctor informed me of two life changing events. The first was that he diagnosed me with a terminal case of Alagille syndrome. This means I have insufficient duct capacity for bile to flow from the liver to the gall bladder and small intestine. This is why I have always had trouble digesting fats.

          Alagille is genetic, and as a result, bile accumulates in my liver, causes scarring, and prevents my liver from eliminating wastes from my bloodstream. I have always looked as if I have jaundice and xanthomas. To make matters worse, both my heart and lungs will soon begin to suffer. He calls this problem a ventricular septal defect.

          Combined, my death certificate would include tetralogy of Fallot, as well as Alagille. The former would kill me if the genetic irreversibility of the latter didn’t. He calculated I may have another 20 years if I was very lucky. Otherwise, I should not make any plans to live past five.

          I asked him (after I recovered from a near heart attack), what was the second of my life changing events?

          This is where my life took an eerie turn for the worse.

          My doctor lowered the blinds, took his phone off the hook, and turned on the radio to a constant static. He then asked me to lean close while he spoke.

          “I can help you with a few more years, if you have more money than morals.”

          Now I became intrigued.

          “What you require is a constant flow of spare parts. You will require a heart transplant, new kidneys, and a new liver. You will need these new parts, maybe more, every ten years is you wish to survive.”

          I had the money and the insurance. I asked the doctor to place me on every transplant list.

          “In your case, it is not that simple. I may be able to find one organ, once. After that, a board of review will examine your case and deny you further treatment. You have a tough match for genetics with your AB blood type.” He continued. “What I am offering is not moral, but in the way I am offering it, at least the process is legal.”

          I had to ask, “How legal?”

          With a look over both his shoulders, he replied with a single word. “Barely.”

          By close of business that day, I wrote the first of many checks to the good doctor. His plan was simple. He would locate four surrogate mothers each willing to father a single child from me. Each mother could be blood type A, B, or AB. In that way, I may father at least one child who was AB. So far, my odds were good.

          If I got this lucky, I was to pay each of the women a bonus to sign away all rights and knowledge of the newborn children. Then, I was to use the remaining time I had until one of two possibilities presented themselves. Either I would die leaving one to four orphans to State care, or, I would have the opportunity to create an accident so common to young children. I would have the doctor’s recommendation for my child’s spare parts I so desperately needed that they so desperately would not need. If the “donor” had Alagille, then I would get maybe an extra 10 years before I had to schedule another incident. If they did not have Alagille, I could live another 20, maybe more. Best case, all four children have my blood type, but not Alagille. One to three would need to be sacrificed and the remaining one (I will refer to as Mr. Lucky) might get to live long enough to inherit my fortune when old age claims what my child cannot prevent.

          Just before I signed the first check, I took a long look in the mirror. I am 31 years old, but look 61. I am feeling the hand of Death closing his grip. I have much to live for.

          The cost of my life is high. Higher than any price anyone has ever paid. I will settle the last ledger debt with whatever God I find. Until then, I checked my soul at the bathroom door.

          I can get used to signing these checks.

Five years later.

          Jason, Edward, and William walked with me home from Tony’s funeral. I haven’t spent much time with the boys recently because of my illness. I wasn’t there when Tony needed me (a great alibi). The boys will see a professional about their dreams. In a few weeks, I will take them to a new home to help them forget.

Ten years later.

          Jason should have never ridden that motorcycle without a helmet. The police told me the hit-and-run driver didn’t even slow down. The car was stolen and filled with drug paraphernalia and residue. By the time the paramedics arrived, Jason was DOA.

          Edward and William wanted to go to boarding school. Edward left a week later for London. William wanted to go to a school in upstate New York. They both had a penchant for medicine.

Seven years later.

          William was as genetically problematic as I am. While his organs were still viable, they would only give me half the time that Tony’s did. Knowing this, Edward will meet his demise much later than William. Edward’s will be my final harvest. I want him to be in the best of health when I need him most.

          Until then, my focus is on William. I know I am damned, but I have no choice. Next week is homecoming at SUNY and I will surprise him with an early visit. The doctor already set up a clinic (bought and paid for by me) nearby and was waiting for my usual call. I had my alibi established. William would have difficulties drinking his favorite soda from his favorite restaurant that used those ice cubes just slightly larger than the average person’s throat. The choking will block oxygen from reaching his brain, but will not destroy enough organ cells to make them un-transplantable. The good doctor will just happen to be open this early when the patrons of the restaurant will call for a doctor who just happens to be in his clinic. All I have to do is add a few of my plastic ice cubes to my drink and then switch it with his. William loves to gulp and crush ice. I have many witnesses who will testify to that account. Even Edward will sign an affidavit with the court officials to that account.

          I met William and the two of us walked in together. I ordered sodas and burgers for the two of us. When the waitress brought the drinks, I had a few minutes with my son. He seemed distracted which made the addition of the plastic cubes easier than I thought. I would miss William.

          However, William opened his backpack and removed a plain manila envelope to give to me. Inside was a series of pictures, bank statements, and medical records from my doctor. Apparently, William had enough time between my transplants to piece together the entirety of my life extension activities and the role of my doctor in the process.

          Before I spoke, he took the lead.

          “Dad.” I never heard the sarcasm in his voice previously.

          “Dad, you’ve been a very bad boy. I present to you some copies of all it will take to make you see the inside of Death Row. There, you may possible spend your remaining days agonizing in the pain you so richly deserve. That is, until you find a few needles in your arm ending the torture you made us endure. I know about what you did to Jason and Tony and I know why. I even know about your doctor. Hell, I know about the fake ice and your plan to have me choke on it.”

          So now it was my turn. “What do you want from me?” I still had an ace-in-the-hole with Edward. I played it cool for a while.

          The waitress came with the burgers and we began eating, but not drinking.

          “What I want is simple. I need you to die today. I would prefer if you would go quietly, but I could afford a scene if you wish to test my resolve. What will it be, Dad?”

           I never got a chance to answer. The pain became unbearable. My mouth was on fire. I wanted to drink my soda, despite the plastic cubes, but William had more in store for me.

           He deliberately spilled both of our sodas, his over my burger. Without even asking, the waitress came back with a rag, cleaned the soda, removed the glasses, contents, and my burger. I never saw her again.

          “What you are experiencing, Dad, is a reaction to your heart condition brought on by an overdose of nitroglycerin pills so commonly prescribed, so commonly misused.”

          The pain was like acid. I couldn’t even speak. I tried to stand, but couldn’t.

          “Now, Dad, you are suffering the initial stages of myocardial infarction, maybe even a stroke. When I spoke with your good doctor, he became very eager to sell you out when I presented him with similar incarceration details. He was most cooperative with the meds. He has seen the light and is now in my employ.”

          I could only mouth “Edward”, as if he could help me.

          “Don’t rely on Edward. He doesn’t know what I know, so when he inherits your money, as per your recent will, I will make a surprise visit and, with the help of the doctor, finish what you began. Edward is an athlete. His organs are in great shape. I may even live long enough and inherit enough from Edward to give you grandchildren with oodles of healthy organs I will need for my future.”

          I wasn’t much of a father, but at least I taught one son well, maybe too well.


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