ALL IN JEST, by Carl Douglass, is my favorite book of all of his novels, and, in fact of all the fiction books I have read. Sybil Norcroft, M.D., PhD, F.A.C.S. is a brilliant and highly accomplished woman in a man’s field. She is nearing the pinnacle of success in her specialty of neurosurgery and has benefitted her patients, her hospital, and her community greatly. She is not called the “Snow Queen” for nothing; the woman seems to have ice water in her veins instead of blood, is something of a femanazi; and not everyone is altogether fond of her or applauds her successes.
As the novel opens, Dr. Norcroft is embroiled in a serious malpractice lawsuit stemming from a death of the scion of a very rich and prominent family which travels in the same rarefied atmosphere as Sybil and her husband, Charles Daniels. The young man was a nurse at Joseph Noble Hospital where Sybil works, and he died during a pituitary tumor operation she performed using a novel approach through the nose to the base of the skull. He bled to death, and the cause of that is not altogether certain. The foremost transsphenoidal surgeon in the world, a professor from Canada, is the star witness against Dr. Norcroft. The neurosurgeon defendant steels herself to hear the famous surgeon’s description that could possibly spell the end of her rising career.
Brendan McNeely, R.N. seeks Dr. Norcroft’s help because of a discharge of milk from his nipples indicative of an active pituitary tumor. There is nothing else unusual about him; and Sybil does a quick routine physical, laboratory, and radiological examination to verify the presence of the small but potent tumor. For his convenience, she moves the process quickly along and schedules him for the routine surgical procedure the following day. She had previously antagonized the head OR nurse and the hospital’s foremost ENT specialist—the nurse for Sybil’s political activism on behalf of feminist women, and the doctor because she refuses to have him be a paid assistant in the surgery. A nurse would be a fine assistant, she insists to the pushy ENT specialist.
The operation proceeds in a nearly bloodless approach, and the floor of the pituitary gland is removed in a few minutes. A magnified television view records the operative steps with high definition clarity. A small incision in the dural covering of the pituitary goes without incident; but when it is extended, a Krakatoa-like eruption of bleeding begins and despite all efforts becomes unstoppable. The aggrieved ENT specialist comes in to help and is greeted with gratitude. It is all to no avail, and Brendan McNeely dies. It is not long until Paul Bel Geddes, a malpractice attorney with a reputation of aggressive pursuit of his clients’ rights, files a malpractice suit, Sybil’s first.
The discovery period of the case is prolonged, rancorous, and full of grossly inappropriate behavior on the part of the attorney for the plaintiff, and is generally inconvenient and obnoxious for Sybil. However, the time for the actual trial is overly long and moves with glacial celerity. But the dreaded day does come, at last.
The courtroom scintillates with the verbal and evidentiary sparring between the attorneys, the witnesses—including the OR nurse and the ENT specialist-- and Dr. Norcroft. Her attorney is every bit the match for Mr. Bel Geddes, and the fight becomes one involving the taking of no prisoners.
After it is over, Dr. Norcroft is treated with frank disrespect by the nurse who presented condemning evidence against her; and, unfortunately for both, the two of them have to cross paths several times a day. That disrespect and disharmony becomes of little consequence as a series of malpractice suits stream in from Paul Bel Geddes.
There is a suit for a patient Sybil sees briefly for leg pain and swelling caused by blood clots. Sybil makes the diagnosis and declares that it is not a neurosurgical problem. The patient dies of a pulmonary embolism. The next suit grows out of an incident in the hospital’s emergency room. A young man is seriously injured in a car crash and has a large hemorrhage in his chest. He is mentally foggy from his low blood pressure, but otherwise neurologically intact indicating that he does not have a blood clot in his head. Sybil gives an okay to proceed without further involvement of neurosurgery, and the ER doctors and the trauma surgeons take him up to the operating room. He dies of his massive injuries. Another suit comes from a man who is operated upon for a ruptured disc in his back, and again for another ruptured disc at a lower level on the opposite side. He claims that his back pain never got better and that it is wrong for him not to receive complete disability and to be able to quit work, and most importantly that Sybil had operated at the wrong level, on the wrong side, and had failed to remove the offending disc. One more suit comes because Sybil evaluates a Mexican woman who suffers a temporary stroke after being attacked by purse snatcher. The woman improves then appeares to deteriorate; there is ample evidence that she is malingering. An arteriogram is performed which is unremarkable.
The cases have several things in common: all of the patients appear to be exaggerating or malingering; they all have Paul Bel Geddes as their lawyer; and they are all conducted in a wearying war of attrition against Sybil Norcroft. All depositions are scenes of farce and gross disrespect; and they all seem to be interminable.
Instead of letting her fall into despair, Sybil’s husband buys her a run-down old ranch as a birthday present. She is able to make it into her sanity saving project. A group of Mexican migrant workers who are driven from the neighboring ranch by a nasty owner after not paying them a month’s wages, come forlornly by her place. They take to each other, and the Mexicans pitch in with enthusiasm to create a splendid Paso Fino horse ranch. In time, Sybil makes them her partners, and the ranch prospers. The Mexican families are devoted to Sybil, and they become less recipients of her largesse or even partners and become real friends. After multiple nasty encounters with Paul Bel Geddes, all of which make her, the Patrona, sad and depressed, she and her new friends hatch an ingenious plan to correct the injustice Sybil is experiencing.
That plan becomes a carefully crafted long term project. When it comes time to put it into motion, it is flawless. What finally happens is left for the reader to discover. It is the stuff of irony, hence the title of the book, ALL in JEST.
-Kristina N. Shimazaki, B.A., Polyglot linguist
trained at La Intitut Le Manoir, La Neuveville,
Switzerland. She holds a diplomate in the
French language from the Universite’ of