Beautiful Ruins (24)

“I’m supposed to go to Switzerland for treatment. Maybe they’re going to do it there, this scope thing. They wanted me to go two days ago, but I came here instead.”

“Why?”

She glanced at Pasquale. “I’m meeting a friend here. He picked this place because it’s quiet. After that, I might go to Switzerland.”

“Might?” The doctor was listening to her chest, poking and prodding. “What is to might? The treatment is in Switzerland, you should go there.”

“My mother died of cancer . . .” She paused and cleared her throat. “I was twelve. Breast cancer. It wasn’t the disease so much as the treatment that was difficult to watch. I’ll never forget. It was . . .” She swallowed and didn’t finish. “They cut out her breasts . . . and she died anyway. My dad always said he wished he’d just taken her home and let her sit on our porch . . . enjoy the sunsets.”

The doctor let his stethoscope fall. He frowned. “Yes, it can make worse the end, treatment for cancers. It is not easy. But every day is better. In the United States are . . . advances. Radiation. Drugs. It is better now than it was with your mother, yes?”

“And the prognosis for stomach cancer? Has that gotten any better?”

He smiled gently. “Who was your doctor in Rome?”

“Dr. Crane. An American. He worked on the film. I guess he’s the best there is.”

“Yes.” Dr. Merlonghi nodded. “He must be.” He put the stethoscope over her stomach and listened. “You went to the doctor complaining of nausea and pain?”

“Yes.”

“Pain here?” He put his hand on her chest and Pasquale flinched with jealousy.

She nodded. “Yes, heartburn.”

“And . . .”

“Lack of appetite. Fatigue. Body aches. Fluid.”

“Yes,” the doctor said.

She glanced at Pasquale. “And some other things.”

“I see,” the doctor said. Then he turned to Pasquale and said in Italian, “Can you wait in the hall a moment, Pasquale?”

He nodded and backed out of the room. Pasquale stood outside in the hallway, on the top step, listening to their hushed voices. A few minutes later, the doctor came out. He looked troubled.

“Is it bad? Is she dying, Doctor?” It would be terrible, Pasquale thought, to have his first American tourist die in the hotel, especially a movie actress. And what if she really was some kind of princess? Then he felt ashamed for having such selfish thoughts. “Should I get her to a bigger city, with proper care?”

“I don’t think she’s in immediate danger.” Dr. Merlonghi seemed distracted. “Who is this man, the one who sent her here, Pasquale?”

Pasquale ran down the stairs and returned with the single sheet of paper that had accompanied Dee Moray.

Dr. Merlonghi read the paper, which had a billing address at the Grand Hotel in Rome, to “20th Century Fox special production assistant Michael Deane.” He turned the sheet over and saw there was nothing on the back. Then he looked up. “Do you know how a young woman suffering from stomach cancer would present to a physician, Pasquale?”

“No.”

“There would be pain in the esophagus, nausea, lack of appetite, vomiting, perhaps some swelling in the abdomen. As the disease progressed or the cancer spread, other systems would be affected. Bowels. Urinary tract. Kidneys. Even menstruation.”

Pasquale shook his head. The poor woman.

“These could be the symptoms of stomach cancer, yes. But here is my problem: what doctor, when encountering such symptoms, would conclude—without endoscopy or biopsy—that the woman has stomach cancer, and not a more common diagnosis?”

“Such as?”

“Such as . . . pregnancy.”

“Pregnancy?” Pasquale asked.

The doctor shushed him.

“You think she’s . . .”

“I don’t know. It would be too early to hear a heartbeat, and her symptoms are severe. But if I was presented with a young female patient complaining of nausea, abdominal swelling, heartburn, and no menstruation . . . well, stomach cancer is extremely rare in young women. Pregnancy . . .” He smiled. “Not so rare.”

Pasquale realized they were whispering, even though Dee Moray wouldn’t have understood their Italian. “Wait. Are you saying that maybe she doesn’t have cancer?”

“I don’t know what she has. Certainly there is a family history of cancer. And maybe American doctors have tests that haven’t reached us. I’m just telling you that I couldn’t determine that someone has cancer based on those symptoms.”

“Did you tell her that?”

“No.” The doctor seemed distracted. “I told her nothing. After all she has been through I don’t want to give her false hope. When this man comes to see her, perhaps you can ask him. This . . .” He looked at the paper again. “Michael Deane.”

This was the last thing Pasquale wanted to ask some American movie person.

“One other thing.” The doctor put his hand on Pasquale’s arm. “Isn’t it strange, Pasquale? With this film being made in Rome, that they would send her here?”

“They wanted a quiet place with a view of the sea,” Pasquale said. “I asked if they wanted Venere, but her paper said Vergogna.”