What would you do to heal your child?
Dr. Jonathan Morrison saves his son’s life with a kitchen knife tracheotomy , but finally realizes he has been in denial about the true cause of his son’s worsening symptoms.
When he is contacted by Advanced Genomic Research, their promise of creating a revolutionary new treatment for his son seems too good to be true. And there is a catch.
He is faced with an impossible choice – abandon a possible cure for his son, or embrace an ethical compromise that will change him forever.
His painful journey unearths a shocking revelation that will lead to either redemption or damnation….and the demise of countless unsuspecting victims, including everyone he loves.
The Greater Good examines the potential for nefarious use of stolen genetic information, and the ways these practices could destroy lives and compromise our freedoms.
What would you do to heal your child?
Dr. Jonathan Morrison saves his son’s life with a kitchen knife tracheotomy , but finally realizes he has been in denial about the true cause of his son’s worsening symptoms.
When he is contacted by Advanced Genomic Research, their promise of creating a revolutionary new treatment for his son seems too good to be true. And there is a catch.
He is faced with an impossible choice – abandon a possible cure for his son, or embrace an ethical compromise that will change him forever.
His painful journey unearths a shocking revelation that will lead to either redemption or damnation….and the demise of countless unsuspecting victims, including everyone he loves.
The Greater Good examines the potential for nefarious use of stolen genetic information, and the ways these practices could destroy lives and compromise our freedoms.
Chapter One
Jonathan Morrison pulled the car door closed, rubbed his eyes and let out a weak sigh. He willed his eyelids to rise; the flashes of light and swirls of color from the pressure on his retinas receded and a sea of cars came into focus through the grime-streaked windshield. The hospital parking lot was packed. He wasn’t surprised. When he left the emergency room, an hour later than usual, there were still thirteen people in the waiting room and a gridlock of patients on gurneys. Three multiple-injury car accidents near the end of his shift, in addition to the normal case load, had pushed the ER beyond capacity. He was amazed how frequently a small hospital ER in a listless suburb of New York could get so overwhelmed.
He stayed until all the patients were triaged and treatment had begun on the most acute injuries. The most disturbing case was a pregnant teenager, not wearing her seatbelt, whose head had incompletely penetrated the windshield. When her head was extracted from the spider web that was once a sheet of glass, the bleeding from a headband of lacerations covered her face in a crimson mask. Jon fleetingly imagined the injuries were caused by a crown of thorns. Twelve years of Catholic education, he had thought wryly. Remarkably, the head wounds and a concussion were her only injuries. It could have been much worse. She could have been decapitated instead of nearly scalped.
He would get home late again. Leah, the babysitter, knew that sometimes she would have to stay longer than usual. Such was the nature of watching the twin nine-year-old sons of a recently separated doctor just beginning his emergency medicine fellowship.
His plans for the evening were simple: try to spend some time with the boys before they went to bed, then collapse onto his. No television. No checking homework. Hopefully, Leah had taken care of that. He only prayed he was unconscious before a cluster headache sabotaged his night. Not that it mattered, though. Sometimes they woke him from a deep sleep, as if an intruder had crept into his bedroom and jammed a scalpel into his eye. He put the car into gear and weaved his way out of the lot.
Leah looked up from Principles of Plane Geometry. Jon could still smell burgers and another less pleasant odor underneath. He dropped onto a kitchen chair. “How’d it go today, Leah?”
“Alright, I guess. Mike had some stomach trouble. I think he’s getting sick again. He was okay when I picked them up, but started coughing right before dinner. The inhaler helped.”
Not again, Jon thought. “Did he eat?” When Mike was sick, he completely lost his appetite.
She shook her head. “Not a thing. Said his stomach felt whoopsy, whatever that means."
Jon sighed. “Need a ride home?” he asked, massaging his temples. He hoped not.
“No, thanks. My dad’s on his way.” She hesitated as she put the textbook into her backpack.
Jon looked up, his hands still on his head. “What is it, hon?”
"Dr. Morrison, is Mike getting worse? He seems to be sick all the time lately."
She was right. He was getting worse, and Nussbaum, the pediatrician, wasn’t getting a handle on it. He treated the symptoms, but couldn't seem to come up with a definitive diagnosis. Jon suspected Nussbaum’s perpetually jammed office and advancing age might be affecting his diagnostic abilities and had planned to bring Mike to the pediatrician at the hospital, but just couldn’t seem to find the time. Besides, the boy did respond to Nussbaum’s treatments, albeit temporarily.
"He'll be okay, Leah. We'll get him better before you know it."
She smiled. “They're great kids, Dr. Morrison.”
“They are at that.”
She shook her head and giggled. “Of course you know they’re great kids—they're yours. Jeez, I'm such an oatmeal brain sometimes."
Jon smiled at the responsible, but sometimes ditsy, fifteen-year-old.
As she grabbed her bag and left through the kitchen door, Jon dropped his keys onto the counter and called up the stairs.
“I’m home, guys.”
“Mike's sick again, Dad. Spewed all over the bathroom."
"Coming." Jon heard the harsh cough. It sounded thicker, wetter. As he trudged up the stairs, he noticed a familiar stench. Mike always had a sensitive stomach, with frequent diarrhea and vomiting when they took long rides in the car, but that too was getting worse, like his frequent colds.
Back on antibiotics, he thought, as he entered Mike’s room. At least three or four times each winter he was on medication. He decided he had let it go too long and promised himself that he would take Mike to the hospital for a complete work-up the next day he had off. Hadn’t he made that promise to himself before? He knew he had, but there never seemed to be enough hours in the day. Tomorrow. He’d bring him tomorrow. Hopefully.
Mike was sitting up in bed reading a Dark Knight comic book. Jon placed his hand on the boy’s pale forehead. No fever.
“Rough day, buddy?”
Mike shrugged. “I think I might have to stay home from school tomorrow," he whispered in a gravelly voice, looking at his father hopefully.
Jon caressed his son’s head. "We’ll see. How about coming to work with me tomorrow so a friend of mine can look you over?” Most of the doctors were good about seeing a colleague's family, even on short notice.
Mike didn’t protest about yet another doctor's appointment, as he often did. He slowly nodded and lowered his head to continue reading.
In his study on the first floor, Jon sat in what he thought of as his headache recliner, the one luxury he had allowed himself. It was only place he could attempt to sit still when an attack came.
He intended to rest for a few minutes, but almost immediately was sound asleep.
He was ten years old and walking home from the schoolyard on the corner with his best friend Anthony, wondering what his friend’s mother was making for dinner. An Italian immigrant, she lived to feed people, and was delighted with Jon’s hearty appetite. His skinny friend would pick at his food, infuriating his mother, eventually eating a peanut butter and jelly sandwich, but Jon would try anything she put in front of him. He loved the unfamiliar but enticing aromas and the constant drama in his friend’s raucous household. Anthony's sister, whom Jon secretly had a crush on, was the other reason he was always there.
Anthony’s grandfather, Pasquale, a crotchety seventy-five-year-old who spoke no English, was always on the front porch, his fedora tipped to one side, smoking and scanning the block like an unofficial sentinel. Jon couldn’t remember a time when he wasn't planted on a folding chair, worn, yellow teeth clenched on a soggy cigar, coughing, and yelling furious Italian curses at the kids when a baseball threatened the tomato plants in the front yard.
They approached Anthony's house, as they had done many times, discussing the relative merits of the coyly posed, partially clad models in an old Playboy magazine Anthony had somehow gotten his hands on and hidden under some loose roofing tiles on the garage behind the schoolyard. As they got closer, they could hear the uncle hacking away, only this time it was much worse. More like a drawn-out choking sound than a cough, it reminded him of a car engine trying to start, but unable to turn over.
A high-pitched scream cut through the din. The more they hurried to reach Anthony's house, the slower their progress, as if they were walking in chest-high water. The scream got louder, blotting out the sound of the rumbling cough-choke. They had to get there, something was wrong. Jon couldn't understand what the screamer was saying. Bad, mad, yike, clod, blared. It made no sense. He was shaking from side to side now.
Jon’s eyes sprung open, the shriek still echoing in his ears.
“Dad! Something’s wrong with Mike!”
Jon opened his eyes and saw his red-faced son pushing him back and forth on the recliner. For a moment he didn’t know where he was.
“Huh?”
“Hurry!” Jack had tears in his eyes. “Mike’s face is blue!”
When he realized what Jack was saying, he leapt from his chair and bolted toward the stairs, smashing his shin on the coffee table, then falling over. As he scrambled to his feet, he fell again, crab crawled to the door, pulled himself to his feet using the doorknob, and bounded up the stairs.
Jon wasn’t prepared for what he saw when entered his son's room.
Sitting up on the bed, Mike's hands were at his neck. His eyes were wide and seemed to bulge from his cyanotic face.
Jon spun toward Jack. "Go into my room, call 911. Tell them our address and that your brother is not breathing. Go!” Jack bolted from the room.
Jon turned back to Mike, shaking him by the shoulders.
“Mike. Can you hear me? Mike!”
He pried open Mike's mouth and peered as far down as he could. Nothing was visible, although he thought he saw what could have been a small amount of mucus deep down. He instinctively gave him a few whacks between the shoulder blades. Nothing. The color of Mike's face deepened from blue to a sickly plum color.
Jon grabbed him by the shoulders, lifted him off the bed, and placed his joined hands under his rib cage. Two thrusts, nothing. He tried again, and again. Nothing. Jon's panic now exploded like a bomb in his head.
"Jack, did you call? Jack. Jack!"
He appeared in the doorway, crying.
"Did you tell them our address?"
He nodded, not taking his eyes off his brother.
"Go downstairs and wait at the front door. Bring them up as soon as they get here."
Jack seemed frozen in place.
"Now!"
His son turned and ran down the stairs. Jon heard the front door slam against the wall.
Mike’s back still resting on him, Jon tried the Heimlich maneuver again.
Absolutely no response. Nothing at all. It was like squeezing a hard pillow.
He gently lowered Mike onto the bed, then ran to the stairs and started down, but tripped on the third step. Losing his balance, he prevented himself from going down headfirst by snaring the banister with his fingertips at the last moment.
Once in the kitchen, he snatched the first item he needed from the drying rack next to the sink. He then slammed open drawer after drawer, one of them coming out of the cabinet and flying across the room, spraying its contents across the floor. He couldn’t find what he was looking for. His heart slammed into his chest wall with each beat.
Where the hell was the ambulance?
His mind in overdrive, Jon saw the scenario playing out as if he were an observer in the room.
What he needed was in the junk drawer. Grabbing the items, he hurled himself up the stairs and back to Mike's room.
When he returned, Mike was unconscious and limp. He pressed his fingers into the side of his son’s neck.
Still a pulse.
Four minutes. How long wasn't he breathing before Jack got me up? Four minutes. Four fucking minutes!
He had only four minutes to open the airway or Mike would have permanent brain damage. Tipping his son’s head back, he palpated the Adam’s apple, and with the steak knife from the kitchen made a vertical cut down its center, extending to about a half inch below. He found the notch between the cricoid and thyroid cartilage and made a second, horizontal cut at the deepest portion. Sweat coursing down his face, he spread open the incision with his fingers and found his entry point. Using the knife again, he punctured the trachea, creating a small slit. Blood oozed down both sides of Mike's neck and through Jon's fingers.
As he worked a hard-plastic straw into the opening, he tipped it up, so that the straw went down into the trachea and extended to the side of Mike’s face. The edges of the cut tissue closed around the straw, and he could hear air flowing through it. He secured the straw with a strip of duct tape and stared at his son as the boy’s color returned, barely breathing himself.
Mike's eyes fluttered open. He turned his petrified face to his dad and stared, struggling to breathe, but air was making it in. Jon fell over onto the carpet and heard the commotion of the paramedics tearing up the stairs.
What would you do if you were presented with the means to help your medically disadvantaged child but knew that it was ethically dubious? That is the crux of Frank Sapienza's book, The Greater Good.
His main character, Dr Jon Morrison, recently separated, is the father of twin boys, Mike and Jack. It is Mike who concerns him, as Mike has Cystic Fibrosis and his prognosis for a long and healthy life is limited by this condition. Living in denial of the seriousness of his son's condition, Jon is given a rude awakening when he is brought face to face with Mike's mortality.
This life-or-death incident acts as a catalyst, as the stark reality of losing his son hits Morrison. He would do anything to save him and so, we arrive at a crossroads for our hero when he is presented with an moral dilemma: should he do something that goes against the ethical code of any health care professional and rules of confidentiality and receive money to help with expensive treatment for Mike; or potentially, watch his son die but keep his principles intact as a doctor and trusted health practitioner?
What I liked about this book most are the questions that it raises. It is very easy to sit as an observer and judge the actions of a character and be appalled at their behaviour but Sapienza portrays Morrison's situation with balance and humanity, showing the dilemma that he has in choosing his course of action. I don't want to go too much into the particulars here because that would spoil the story but I was constantly putting myself into Morrison's shoes and contemplating what I would do if faced with the same scenario.
The novel also raises questions about who to trust and, in particular, how we place a lot of trust in hospitals, surgeries, medical practitioners, and assume that they always have our best interests at heart but what if they don't?
As the book is a thriller, it is perhaps easy to guess that there are consequences for Morrison in the choices that he makes; however, Sapienza does not have Morrison completely disregard his conscience and it is ultimately his inability to ignore or override his principles that leads him into a dangerous situation and a further choice: to continue or confront?
The pace is good, the characters are believable, the conclusion credibly satisfying.