by Robin Cook
Kim replaced the chart and moved alongside the bed. Gently he raised the sheet to glance at the dressing. Kim always instructed his residents to use minimal dressing. If there was unexpected bleeding, Kim wanted to know about it sooner rather than later.
Satisfied, Kim replaced the sheet before straightening up to look for his other patient. Only about half the beds were occupied, so it didn’t take long to scan them.
“Where’s Mr. Glick?” Kim asked. Ralph Glick had been Kim’s first case.
“Ask Mrs. Benson at the desk,” the nurse responded. She was preoccupied putting her stethoscope in her ears and inflating Sheila Donlon’s blood pressure cuff.
Mildly irritated at the lack of cooperation, Kim walked over to the central desk but found Mrs. Benson, the head nurse, equally preoccupied. She was giving detailed instructions to several housekeeping workers who were there to break down, clean, and change one of the beds.
“Excuse me,” Kim said. “I’m looking . . .”
Mrs. Benson motioned to Kim that she was busy. Kim thought about complaining that his time was more valuable than the housekeepers’, but he didn’t. Instead he rose up on his toes to look again for his patient.
“What can I do for you, Dr. Reggis?” Mrs. Benson said as soon as the housekeepers headed off toward the recently vacated bed.
“I don’t see Mr. Glick,” Kim said. He was still scanning the room, certain he was overlooking the man.
“Mr. Glick was sent to his floor,” Mrs. Benson said curtly. She pulled out the controlled-substance log and opened it to the appropriate page.
Kim looked at the nurse and blinked. “But I specifically asked he be kept here until I finished my final case.”
“The patient was stable,” Mrs. Benson added. “There was no need for him to remain and tie up a bed.”
Kim sighed. “But you have tons of beds. It was a matter of . . .”
“Excuse me, Dr. Reggis,” Mrs. Benson said. “The point is Mr. Glick was clinically ready to go.”
“But I had requested he be kept,” Kim said. “It would have saved me time.”
“Dr. Reggis,” Mrs. Benson said slowly. “With all due respect, the recovery-room staff doesn’t work for you. We have rules. We work for AmeriCare. If you have a problem with that, I suggest you talk to one of the administrators.”
Kim felt his face redden. He started to talk about the concept of teamwork, but he quickly changed his mind. Mrs. Benson had already directed her attention to the loose-leaf notebook in front of her.
Murmuring a few choice epithets under his breath, Kim walked out of the recovery room. He yearned for the old days back at the Samaritan Hospital. Stepping across the hall, he stopped at the OR desk. With the aid of the intercom, he checked on the progress of his last case. Tom Harkly’s voice assured him the closure was proceeding on schedule.
Leaving the operating suite, Kim marched down the hall to the newly constructed family lounge. It was one of the few innovations AmeriCare had instituted that Kim thought was a good idea. It had come from AmeriCare’s concern for amenities. The room was specifically designated for the relatives of patients in the operating or delivery rooms. Prior to AmeriCare’s purchase of the University Medical Center, there had been no place for family members to wait.
By that time of day it was not crowded. There were a few of the omnipresent expectant fathers pacing or nervously flipping through magazines while waiting for their wives to have Caesareans. In the far corner a priest was sitting with a grieving couple.
Kim glanced around for Mrs. Gertrude Arnold, the wife of Kim’s last patient. Kim wasn’t looking forward to talking with her. Her peppery and truculent personality was hard for him to bear. But he knew it was his responsibility. He found the late-sixties woman in the opposite far corner away from the grieving couple. She was reading a magazine.
“Mrs. Arnold,” Kim said, forcing himself to smile.
Startled, Gertrude looked up. For a nanosecond her face registered surprise, but as soon as she recognized Kim, she became visibly irritated.
“Well, it’s about time!” Mrs. Arnold snapped. “What happened? Is there a problem?”
“No problem at all,” Kim assured her. “Quite the contrary. Your husband tolerated the procedure very well. He’s being . . .”
“But it’s almost six o’clock!” Gertrude sputtered. “You said you’d be done by three.”
“That was an estimate, Mrs. Arnold,” Kim said, trying to keep his voice even despite a wave of irritation. He’d anticipated a strange response, but this was more than he’d bargained for. “Unfortunately the previous case took longer than expected.”
“Then my husband should have gone first,” Gertrude shot back. “You’ve kept me waiting here all day not knowing what was happening. I’m a wreck.”
Kim lost control and in spite of a valiant effort, his face twisted into a wry, disbelieving smile.
“Don’t you smile at me, young man,” Gertrude scolded. “If you ask me, you doctors are too high and mighty, making us normal folk wait all the time.”
“I’m sorry if my schedule has caused you any distress,” Kim said. “We do the best we can.”
“Yeah, well, let me tell you what else happened,” Gertrude said. “One of the AmeriCare administrators came to see me, and he told me that AmeriCare wasn’t going to pay for my husband’s first day in the hospital. They said he was supposed to be admitted this morning on the day of surgery and not the day before. What do you say to that?”
“This is an ongoing problem I’m having with the administration,” Kim said. “When someone is as sick as your husband was before his surgery, I could not in good conscience allow him to be admitted the day of surgery.”
“Well, they said they weren’t going to pay,” Gertrude said. “And we can’t pay.”
“If AmeriCare persists, then I’ll pay,” Kim said.
Gertrude’s mouth dropped open. “You will?”
“It’s come up before and I’ve paid before,” Kim said. “Now, about your husband. Soon he’ll be in recovery. They’ll keep him there until he’s stable, and then he’ll go to the Cardiac floor. You’ll be able to see him then.”
Kim turned and walked from the room, pretending not to hear Mrs. Arnold calling his name.
Retreating back up the hall, Kim entered the surgical lounge. It was occupied by a handful of OR nurses on their breaks and a few of the staff anesthesiologists and anesthetists. Kim nodded to those people he recognized. Having been working at the University Medical Center only since the merger six months previously, Kim didn’t know all the staff, particularly the evening and night people.
Pushing through the door into the men’s surgical locker room, Kim pulled off his scrub top and threw it forcibly into the hamper. He then sat on the bench in front of the bank of lockers to unpin his watch from the waistband of the pants. Tom, who’d taken a shower, was busy putting on his shirt.
“It used to be when I finished a case I felt a certain euphoria,” Kim commented. “Now I feel a vague, unpleasant anxiety.”
“I know the feeling,” Tom said.
“Correct me if I’m wrong,” Kim said. “This all used to be a lot more fun.”
Tom turned from facing the mirror and chuckled. “Excuse me for laughing, but you say that as if it were a sudden revelation.”
“I’m not talking about the economics,” Kim said. “I’m talking about the little things, like getting respect from the staff and appreciation from patients. Nowadays you can’t take anything for granted.”
“Times are a-changing,” Tom agreed. “Especially with managed care and the government teamed up to make us specialists miserable. Sometimes I fantasize about one of the responsible bureaucrats coming to me for a bypass, and I make him get it from a general practitioner.”
Kim stood up and pulled off his scrub pants. “The sad irony is that all this is happening when we cardiac surgeons have the most to offer the public.”
Kim was about to t
oss his pants into the hamper by the door, when the door opened and one of the women anesthesiologists, Dr. Jane Flanagan, stuck her head in. Catching sight of Kim’s skivvy-clad body, she whistled.
“You came mighty close to having these sweat-soaked pants draped over your noggin,” Kim warned.
“For such a view it would have been worth it,” Jane joked. “Anyway, I’m here to inform you that your public awaits you out here in the lounge.”
The door closed and Jane’s perky face disappeared.
Kim looked at Tom. “Public? What the hell is she talking about?”
“My guess is you have a visitor,” Tom said. “And the fact that no one has come in here leads me to believe it must be female.”
Kim stepped over to the cubbyholes filled with scrub tops and bottoms and took a clean set. “What now?” he questioned irritably.
At the door Kim paused. “If this is Mrs. Arnold, the wife of my last case, I’m going to scream.”
Kim pushed out into the lounge. Instantly he saw it wasn’t Gertrude Arnold. Instead, Kelly Anderson was at the coffee urn, helping herself to a cup. A few steps behind her was her cameraman with a camcorder balanced on his right shoulder.
“Ah, Dr. Reggis,” Kelly exclaimed, catching sight of the surprised and none-too-pleased Kim. “How good of you to come to talk with us.”
“How the hell did you get in here?” Kim asked with indignation. “And how did you know I was here?” The surgical lounge was like a sanctuary that even nonsurgical doctors were hesitant to violate. For Kim the idea of being confronted by anyone here, much less Kelly Anderson, was too much to bear.
“Brian and I knew you were here thanks to your former wife,” Kelly said. “As for how we got up here, I’m happy to say we were invited and even escorted by Mr. Lindsey Noyes.” Kelly gestured toward a gray-suited gentleman standing in the doorway to the hall who’d hesitated to come in himself. “He’s from the AmeriCare–University Med Center PR department.”
“Evening, Dr. Reggis,” Lindsey said nervously. “We just need a moment of your time. Miss Anderson has graciously decided to do a story commemorating the six-month anniversary of our hospital merger. Of course, we’d like to assist her in any way we can.”
For a moment Kim’s dark eyes darted back and forth between Kelly and Lindsey. On the spur of the moment he wasn’t certain who irritated him more, the muckraking journalist or the meddlesome administrator. Ultimately he decided he didn’t care. “If you want to help her, then you talk to her,” Kim said before turning to go back into the locker room.
“Dr. Reggis, wait!” Kelly blurted. “I’ve already heard the prepared AmeriCare side. We’re interested in your personal view, from the trenches, so to speak.”
With the locker-room door open a crack, Kim paused and debated. He looked back at Kelly Anderson. “After that piece you did on cardiac surgery, I vowed never to talk to you again.”
“And why is that?” Kelly said. “It was an interview. I didn’t put words in your mouth.”
“You quoted me out of context by editing your questions,” Kim fumed. “And you left out most of the issues I said were of primary importance.”
“We always edit our interviews,” Kelly said. “It’s a fact of life.”
“Find another victim,” Kim said.
Kim pushed open the locker-room door and had taken a step within, when Kelly called out again: “Dr. Reggis! Just answer one question. Has the merger been as good for the community as AmeriCare contends? They say they did it for purely altruistic reasons. They insist it’s the best thing that’s happened to medical care in this city since the discovery of penicillin.”
Kim hesitated again. The absurdity of such a comment made it impossible for him not to respond. Once again he turned back to Kelly. “I have trouble understanding how anyone could say such a ludicrous statement and have a conscience clear enough to sleep at night. The truth is that the entire rationale for the merger was to benefit AmeriCare’s bottom line. Anything else they may tell you is rationalization and pure bull.”
The door closed behind Kim. Kelly looked at Brian. Brian smiled and gave Kelly the thumbs-up sign. “I got it,” Brian said.
Kelly smiled back. “Perfect! That was just what the doctor ordered.”
Lindsey coughed politely into a closed fist. “Obviously,” he said, “Dr. Reggis has given his personal view, which I can assure you is not shared by other members of the professional staff.”
“Oh really?” Kelly questioned. She let her eyes roam the room. “Anybody here wish to make a comment concerning Dr. Reggis’s statement?”
For a moment no one moved.
“Pro or con?” Kelly prodded.
Still no one moved. In the sudden silence, the hospital page could be heard like the backdrop of a TV melodrama.
“Well,” Kelly said brightly, “thank you all for your time.”
Tom slipped on his long white hospital coat and arranged the collection of pens, pencils, and flashlight in its upper front pocket. Kim had come into the locker room and, after removing his clothes and throwing them into the hamper, had gotten into the shower. He’d not said a word.
“Aren’t you going to tell me who was out there?” Tom said.
“It was Kelly Anderson from WENE News,” Kim said from the shower.
“In our surgical lounge?” Tom questioned.
“Can you believe it?” Kim said. “She was dragged up here by one of the AmeriCare admin guys. Apparently my ex told her where to find me.”
“I hope you told her what you thought of that piece she did on cardiac surgery,” Tom said. “After my car mechanic saw it, I swear he raised his rates. I mean talk about backwards; my income’s plummeting and service people are upping their charges.”
“I said as little as I could,” Kim said.
“Hey, what time were you supposed to pick up Becky?” Tom asked.
“Six o’clock,” Kim said. “What time is it now?”
“You’d better get a move on,” Tom said. “It’s already heading toward six-thirty.”
“Damn,” Kim said. “I haven’t even done my rounds yet. What a life!”
THREE
Friday, January 16th
By the time Kim did his rounds and checked Mr. Arnold in the recovery room, another hour had passed. En route to his former wife’s house in the University section of town, he pushed his ten-year-old Mercedes and made record time. But it was still going on eight when he pulled up behind a yellow Lamborghini directly in front of Tracy’s house.
Leaping from the car, Kim jogged up the front walk. The house was a modest affair built around the birth of the twentieth century, with a few Victorian gothic touches, like pointed arch windows in the second-floor dormers. Kim took the front steps in twos to reach the columned porch, where he rang the bell. His breath steamed in the wintery chill. While he waited he fanned his arms to keep warm. He wasn’t wearing a coat.
Tracy opened the door and immediately put her hands on her hips. She was plainly anxious and irritated. “Kim, it’s almost eight. You said you’d be here by six at the latest.”
“Sorry,” Kim said. “It was unavoidable. The second case took longer than anticipated. We ran into an unexpected problem.”
“I suppose I should be used to this by now,” Tracy said. She stepped out of the way and motioned for Kim to step inside. She closed the door behind him.
Kim glanced into the living room and saw a smart, casually dressed, mid-forties man in a suede fringe jacket and ostrich cowboy boots. He was sitting on the couch, with a drink in one hand and a cowboy hat in the other.
“I would have fed Becky if I’d had any idea it was going to be this late,” Tracy said. “She’s starved.”
“That’s easy to remedy,” Kim said. “I mean, we are planning on going out to dinner.”
“I wish you would have at least called,” Tracy said.
“I was in surgery and didn’t get out until five-thirty,” Kim said. “It’s not like I
was out golfing.”
“I know,” Tracy said with resignation. “It’s all very noble. The problem is, you were the one who picked the time, not me. It’s a matter of consideration. Every second I thought you were about to arrive. Luckily we’re not flying commercial.”
“Flying?” Kim questioned. “Where are you going?”
“Aspen,” Tracy said. “I’ve given Becky the number where I can be reached.”
“Aspen for two days?”
“I feel it’s time for me to have a little fun in my life. Not that you would know what that is, apart from your surgery, of course.”
“Well, as long as we’re being nasty and sarcastic,” Kim said, “thanks for sending Kelly Anderson to the surgical lounge. That was a pleasant surprise!”
“I didn’t send her,” Tracy said.
“She said you did.”
“I just told her I thought you were in surgery,” Tracy said.
“Well, it’s the same thing,” Kim said.
Over Kim’s shoulder, Tracy saw her guest stand up. Sensing he was uncomfortable from undoubtedly overhearing her exchange with her former husband, Tracy motioned to Kim to follow her into the living room.
“Enough of this bickering,” she said. “Kim, I’d like you to meet a friend of mine, Carl Stahl.”
The two men shook hands and eyed each other warily.
“You two entertain yourselves,” Tracy suggested. “I’ll run upstairs and make sure Becky has everything she needs. Then we can all go our separate ways.”
Kim watched Tracy disappear up the stairs. Then his gaze returned to Tracy’s apparent boyfriend. It was an uncomfortable situation, and Kim couldn’t help feel some jealousy, but at least Carl was several inches shorter, with significantly thinning hair. On the other hand, the man was tanned despite its being mid-winter. He also appeared in reasonable physical shape.
“Can I get you a drink?” Carl suggested, motioning toward a bottle of bourbon on a side table.
“Don’t mind if I do,” Kim said. Kim had never been much of a drinker, although over the last six months a nightly cocktail had become a habit.
