Excerpt of Desperate Measures by Kate Wilhelm

The Milton Frei Hospital in Manhattan specialized in plastic surgery and cosmetic reconstruction. Middle Eastern royal families sent their daughters there to get new noses; Broadway stars changed the shape of their faces; politicians went for liposuction before an upcoming campaign. Accident victims went there to get rebuilt. Small, discreet, and correspondingly expensive, it could have been a four-star European hotel, with plush-carpeted corridors, tasteful oil paintings on the walls, statuary in the lobby, marble urns filled with plants, and air freshened to smell like a pine forest after a rainstorm.

Today two men stood outside one of the private rooms, the bigger man, Dr. Graham Minick, with his face close to the glass panel, peering inside. He was still wearing his greatcoat on which a smattering of snow had melted to make the coat look polka-dotted. It was a magnificent coat, long enough to come to his galoshes, with deep shoulder flaps, voluminous in all dimensions. Since he was a large man, thick through the chest, with heavy bones, he needed such a garment. He was shaking water drops from a crushed wool hat with a broad brim. It looked like hell, he knew, but it kept the rain and snow off; it was warm, and he liked it. He was sixty years old, too old to sacrifice comfort for style. Now he stood hunched over, gazing into the room.

The object of his prolonged scrutiny was an adolescent boy sitting at a barred window across the room with his back to the door. The boy appeared to be tall and gangly, wearing a baseball cap, blue jeans, and a sweater, and he seemed to be writing or doodling, looking up and out the window, then down again frequently.

"Fill me in," Dr. Minick said. "Why is he here, not Bellevue?"

The other man was Jack Waverly, the resident physician of the hospital and its finest surgeon. Slender, slightly built, he looked like an adolescent himself next to Graham Minick. They had been friends for most of their lives, had gone to medical school together. Almost peevishly he said, "I was hoping you'd get here early enough to go over his records, have a talk about him, before you meet his parents. They're waiting, by the way."

"Let them wait. You have any idea what those streets are like? It's a fucking miracle I got here at all. Tell me what I should know about this."

"Right. Right. Alexander" — he motioned toward the room — "has been my patient most of his life. He was born with a gross deformity, half his face practically undeveloped, brain partly exposed, no external ear on the right side of his head, a misplaced eye — just a real mess. We've done what we can, and he's due back for more surgery in a few years after he's fully grown. Anyway, about two weeks ago while he was walking in Central Park a bunch of hooligans jumped him and were in the process of beating him to death when a cop stopped the action. The officers took Alexander to the ER and called his parents. They hustled him over here in an ambulance. He wasn't hurt seriously, nothing broken, but he was damaged."

He took a breath and repeated it. "He was damaged. And no one saw it or realized how badly damaged. Two days ago he overdosed on God alone knows what all. He had saved his own pain medication, added whatever he found in his mother's room, took it all with a good dollop of whiskey and tried to die. They found him on the floor and rushed him to me. We pumped him out. He's weak and shaky, but he'll be okay physically."

Dr. Minick turned away from the window to face Jack Waverly, and for a moment they were both silent. Graham Minick's son had killed himself with a mixture of prescription drugs and alcohol when he was fourteen. Minick had left his practice, gone back to school, and become a psychologist who specialized in juvenile crisis management. Two years ago his wife of thirty-three years had died of breast cancer.

In a low voice he said, "I'm tired, Jack. In April my resignation takes effect, and I'm going home. That boy needs someone who will be around for him, not me." He started to walk away.

Jack Waverly put his hand on his friend's arm, stopping him. "I know," he said. "And God knows you've earned a rest. But, Graham, that boy needs someone now, right now. He'll try again, and he'll succeed next time. He's brilliant; he'll figure out a way that won't fail. Later, after you get him through the next few weeks, we'll find someone else. But right now he needs the best there is. You, Graham. He needs you."

Graham Minick had been a good medical doctor, an excellent diagnostician, and he was a better psychologist. He knew when to prod and when to wait. Studying Jack Waverly's lean face, he prodded. "What else?"

"When they brought him in this time," Jack said, "my first thought was, Why hadn't they let him go? A few more hours and it would have been over for him. And it would have been a blessing." He turned away and thrust his hands into his pockets, started to move toward the office. "That's when I knew we needed you. Come on. They're waiting."

Dolly Feldman was tall and thin — painfully thin, Dr. Minick thought — and she was very beautiful in a sleek, stylish way. She had been a model and now, in her mid- thirties, she had arrived at the peak of her beauty, with pale shiny hair, almond-shaped green eyes, exquisite bones, and the experience and knowledge to emphasize each perfect feature. Dolly owned and operated a modeling agency.

Her husband, Arnold, was also one of the beautiful people, like a male model on the cover of a paperback romance. He was climbing the highest rung very soon. He was six feet tall and well muscled, his hair a carefully arranged unruly mop of brown curls, good square chin, candid brown eyes....

"You can't imagine what it's been like," Dolly was saying in the lounge. Most of the time her voice was low and throaty, until she forgot. Then she became shrill. She was shrill now. "Having to hide him away. I mean, people can be so cruel, stare, make comments. You just can't imagine!"

Dr. Minick could well imagine what it would be like to be hideously ugly in the house of such beautiful people.

"It wasn't our choice," Arnold said soberly. "Alexander is quite self-conscious, of course, and he won't come out of his room if we have guests, or go anywhere with us. He chooses to be a hermit."

"Jack reported him to the police!" Dolly exclaimed. "I didn't think Jack would betray us like that."

They were seated in fine brocade-covered chairs around an octagonal table that held a coffee service: silver carafe, bone china cups and saucers, pretty linen napkins — all unused. Now Jack leaned forward and poured himself coffee. Everyone else had refused earlier. "I told you, juvenile suicide attempts are always reported," he commented. "It's the law. The state will make certain he gets help."

"Social workers!" Dolly cried. "We can't have social workers prying into our lives!"

"What do you want me to do?" Dr. Minick asked then, tired of Dolly, tired of her sober and thoughtful husband, tired of this beautiful lounge. He had seen pictures of Alexander Feldman; he knew the boy would never look any better than he did now, and now he looked like a monster, with a metal plate in his head and no hair on that side, one eye more than an inch lower than the other and too far to one side, a fake ear on one side, a poorly formed mouth with thin lips that Jack had created for him, a nose that Jack had built, a chin that started out normal, then faded to nothing.... This was the face that Jack built. It was much worse than the pictures indicated, Jack had said. The boy had no muscles on that side of his face; one half could smile, frown, move with speech; the other side was forever frozen in a grimace. But the boy had the intelligence of a genius.

"We thought," Arnold said in a measured way, "that perhaps you could recommend a school that caters to people like Alexander, where he wouldn't feel so out of place. Perhaps teach him a trade, or even let him work there later."

Warehouse him, Dr. Minick thought. He nodded and stood up. "I'll have a talk with him," he said.

"He won't talk to you!" Dolly cried. "You don't understand. He won't talk to anyone. We tried counseling, and he refused to say a word. Not a word. He won't even talk to us, his mother and father."

"If not me, then the court will appoint someone else," Dr. Minick said.