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