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Essay/Term paper: A case of needing: serious revisions

Essay, term paper, research paper:  Research Papers

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A Case of Needing: Serious Revisions

Michael Crichton has penned some of the most engaging, timely, and
thoroughly accessible tales to be published in the last twenty-five years. What
his novels lack in literary merit and distinctive style they make up for in
crisp plotting and edge-of-your-seat suspense. From alien viruses to regenerated
dinosaurs, from evil Japanese monoliths to the insidious maneuverings of the
modern corporation, Crichton latches onto the scientific and political
controversies of the day, and squeezes out of them every last ounce of shock
value. At least, that's usually what he does.
A Case Of Need could have used quite a bit more shock value. The problem
is largely a matter of timing; when the book came out in 1969, the moral dilemma
surrounding illegal abortions was still a hot enough topic to seem ripped from
the headlines. Though abortion certainly remains a hot-button issue, the debate
has shifted. For the time being, at least, the argument centers on whether or
not the act should be legal, not on whether or not doctors are currently
breaking the law by performing them.
The antiquated plot line is not the story's main flaw. The biggest
drawback here is a one-two punch of highly technical prose employed to relate a
thoroughly dull story. Karen Randall, the daughter of an eminent physician, dies
as the result of a botched abortion. Art Lee, a Chinese obstetrician, is accused
of performing the D & C that has resulted in her death. Though Lee is known to
be an abortionist, he vehemently denies any involvement in the case. Lee calls
upon his friend, forensic pathologist John Berry, to clear his name.
John Berry careens back and forth from one Boston hospital to another,
trying to figure out who actually performed Randall's abortion, and why it
killed her. The investigation is complicated by the fact that Randall was not
even pregnant. Slowly, a picture emerges of Randall as a freewheeling, loose
woman with several abortions in her past, and connections to some shadowy
underworld characters. Berry ultimately discovers that a drug-dealing musician
was actually at fault for Randall's death.
Why did Michael Crichton write this book? The answer seems fairly
obvious. Still fairly immersed in his medical school learnings, Crichton must
have seen it as a chance to demonstrate just how much knowledge he had gained
during his time at Harvard. Numerous medical procedures are described in detail,
supplemented by footnotes and appendices for readers not in the know.
All of this technical gobbledygook turns out to be almost totally
superfluous. Berry clears Lee's name largely through old-fashioned detective
work rather than through forensic pathology. That Randall was not actually
pregnant turns out to be one of the very few salient clues that science reveals.
Of course, without all that medical jargon, this book would have been
almost entirely a study of law and American society, with science providing
little more than a context in which the story can unfold. Crichton makes the
terminology slightly more palatable by making Berry a fairly sarcastic and
cynical practitioner of his craft. Still, one can only stomach so much detailed
description of autopsies, biopsy examinations, and crit readings.
It is surprising that Crichton devoted so much ink to these scientific
proceedings, when the ethics that lie behind the novel's central act (or, at
least, supposed central act) are so much more engaging. The notion that abortion
represents one of the murkiest legal and moral issues in the medical community
is mentioned, but not expounded upon in any great detail.
Various statistics are quoted suggesting that abortion is a fairly safe
procedure, and a doctor friend of Berry's makes a fairly eloquent speech
regarding the positive aspects of getting rid of unwanted pregnancies, but there
is no strong case ever made for either side.
What would have been most engaging, in course, would have been strong
arguments made for both sides. There is perhaps no issue as divisive as abortion,
no modern medical procedure that elicits such strong passion from advocate both
for and against. Granted, Crichton was writing a potboiler, and excessive
philosophizing would have turned the book into an even greater dud than it
already is. However, a little solid, even-handed consideration of the themes
raised would have gone a very long way.
Another prominent ethical issue that courses throughout the book is
Berry's methods of investigating the case. The story opens with an excerpt from
the Hippocratic oath. Berry then proceeds to gain information through
impersonation, deceit, threats, and other assorted trickeries. This is by no
means, in and of itself, a misstep. Few doctors could claim to be choirboys.
However, the ways in which Berry employs highly questionable fact-
gaining techniques should not be rendered with so little self-consciousness.
Berry is so driven by a desire to know the truth that he will sacrifice his
honesty to achieve that end. Like the moral quagmire that is abortion, this
dichotomy deserves far more attention than Crichton seems willing to give.
Where does Crichton focus his attention? He spends most of his time
dazzling the reader with his intricate knowledge of every medical procedure
under the sun. Perhaps the editor is truly to blame for this mind-numbingly dull
aspect of the book. At least there were footnotes. At least they tried. However,
annotations can never replace clear, concise, everyday prose. While
investigating whether or not Randall was pregnant or not, Berry learns this
incredibly illuminating information from a colleague (p. 83):

"'Only proteins can be denatured, and steroids are not
proteins, right? This'll be easy. See, the normal rabbit
test is chorionic gonadotrophin in urine. But in this lab
we're geared to measure that, or progesterone, or any of a
number of other eleven-beta hydroxylated compounds. In
pregnancy, progesterone levels increase ten times. Estriol
levels increase a thousand times. We can measure a jump
like that, no sweat.'"

A jump like what? All of this technical language does go a long way
towards demonstrating that these are actual doctors talking to each other, but
the "Dr." that comes before their names would have sufficed. All that is really
being related here is that it can be determined whether or not Randall was
pregnant. The rest is quite literally commentary, and particularly intelligible
commentary at that.
This major flaw, however, also represents the novel's greatest triumph.
If one learns nothing else from the story, one gains an appreciation from the
importance of method in forensic pathology. The painstaking details related
about every step in the forensic process may be overly specific, but they
succeed at conveying how delicate, how intricate, and how surprisingly exact a
science it can be.
Each twist and turn in the examination is detailed: the study of blood
samples, the dissection of the corpse, the consideration of diet, age, even the
psychological profile of the victim. Those these details range from gory to
mundane, they manage to eloquently convey the process involved, even as they
obscure the relevance of each step in the process.
With all this emphasis placed on Berry's attention to detail, it is
surprising how completely one important detail is overlooked: the role of the
police in such an investigation. A burly cop named Peterson swaggers in and out
of the story, but no serious mention is ever made of what the authorities are
doing to figure out what happened.
The case against Lee rests entirely on Randall's mother's claim that her
daughter said that Lee performed the abortion. In reality, it is unlikely the
police would rest on such scant evidence.
Would they do it differently from Berry? If so, how? There seems to be
some suggestion that Berry is a renegade, investigating the case by playing
outside the rules, but this fails to become an engaging aspect of the plot,
because there is no rule-abiding investigator with which to contrast him. One is
led to believe that Berry's style is clever and unconventional, but his choices
actually seem rather practical. An exploration of how such cases normally get
handled would have made the tale far more engaging.
While A Case Of Need does manage to ignore its own central themes, make
the accessible complicated, and forego even the mildest attempt at illuminating
character study, it still has a few things going for it. The roles of racism,
institutional power, and fear of professional embarrassment in the course of a
medical examination are cleverly explored.
Dr. Lee would not have found himself so easily railroaded had he only
had the luck to have been born Dr. Smith. Lee's lawyer, George Wilson, is
himself not aided any by his African-American heritage. As a recent trial that
need not even be named clearly demonstrated, in a criminal matter, science will
always take a back seat to racial politics. Crichton was well aware of this
twenty-five years before it became thunderingly clear to the rest of his fellow
Justice can be obscured by much besides the color of the accused's skin.
The power of the accuser is of great importance as well. Lee is dumped into such
hot water not because he might have botched the abortion of some nameless young
Karen Randall is the daughter of an eminent, powerful doctor, a doctor
willing to manipulate medical findings and force his colleagues to rush to
judgment in order that someone might be punished for Karen's death. Without
becoming preachy, Crichton reveals how corrupt and selfish big medicine can be.
Another Randall is willing to play fast and loose with the facts as well.
Karen's uncle, Peter Randall, also a doctor, performed two abortions on her in
the past. Revealing this information might help to bring the truth about her
death to light, but it also would soil Peter's pristine reputation.
Peter will go so far as to torch an incriminating automobile rather than
let the truth be known. From the evils of the all-powerful hospital to the
darker recesses of one physician's heart, the cruelest and most self-serving
side of the noblest science is placed out in the sun for all to see.
It's interesting to consider what Crichton might do today if he were
given a chance to revise this story. Aside from the twisters that would likely
rip through Boston as computer-generated actors morphed into velociraptors,
there would likely also be a more concerted effort to make the story not more
three-dimensional, but less.
The reduction of complex issues to easily grasp able arguments is what
makes Crichton so fantastically popular. You don't need a deeply considered
position on the dangers of modern genetics to weigh in on Jurassic Park. You
don't need any understanding of the world economy to hiss at the bad guys in
Rising Sun. Those stories are focused, even though at may be at the expense of
telling the whole story. Here, the focus is hazy at best.
Berry's investigative techniques, the importance of medical data, even
the motives and actions of most of the minor characters, go largely unexplained.
We are left with the trees, but little forest in which to view them. Crichton
creates an intricate web of medical intrigue, but then leaves the map to guide
the reader through it shoddy and half-finished.
Of course, Crichton is a skilled craftsman, and this is why the book is
not a total waste. By creating interesting (if somewhat stereotypical) stock
characters, and placing them in somewhat contrived situations, Crichton does
manage to explore some of the more complex issues surrounding a medical crime.
However, through excessive detail and an unwillingness to weigh in
sufficiently on some of the more important ethical dilemmas inherent to his tale,
Crichton ends up obscuring more than he reveals. A Case of Need is much like a
botched autopsy: all the guts are ripped out into the open, but we are able to
learn little from them.


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