Several times each day, he had visited with Annie, who was progressing reasonably well in the coronary unit. He had also discharged old Chris Gow after a day and a half of good nursing care and after arranging for social services to help him get medicare coverage, physical therapy, and one meal a day at home. Contrary to Wilton Marshfield’s dire prediction, there had been no repercussions from Frank or anyone else regarding the old mans hospitalization.
All in all, they had been two interesting and rewarding days—the sort that more than made up for medicines liabilities as a career.
This day, however, was the one Zack had been awaiting. It would start with his first major case in the O.R.—the removal of a woman’s ruptured cervical disc—and it would end with dinner at Suzanne’s. He smiled to think of how misguided his apprehension about coming to Sterling had been.
“Okay, everyone, find a seat.”
The staff president, a pale, doughy internist named Donald Norman, called out the order as he hand-shook his way to the front of the room.
Norman had interviewed Zack twice on behalf of Ultramed, and it was actually in spite of the man and those two sessions that Zack had decided to come to Davis at all. A graduate of one of the medical schools in the Caribbean, Norman had been subsidized and trained at Ultramed hospitals and was a company man right down the line. His portion of the interviews had consisted of little more than a mirthless litany of Ultramed procedural and medical policies, each accompanied by a set of statistics justifying the “guideline” as beneficial to the welfare of both patient and hospital.
While Norman hailed the streamlined corporate approach as “revolutionary and unquestionably necessary,” Zack wondered if it amounted to a sort of gentrification of health care.
And he made no points whatever with the man by saying so.
To make matters worse between the two of them, Zack’s spontaneity and relaxed, eclectic approach to medicine sat poorly with Norman, who, though no more than a year or two older than Zack, wore a three-piece suit, smoked a curved meerschaum, and generally conducted himself like some sort of aging medical padrone.
In the end, with Zack’s decision still very much in the air, several of the other physicians on staff managed to convince him that Ultramed-Davis was far more flexible in its policies and philosophy than Donald Norman liked to believe.
Norman took his place at the front table and gaveled the meeting to order with the underside of an ashtray.
During the secretary’s, treasurers, and committees’ reports, several latecomers straggled in, including Suzanne, looking lithe and beguiling in sandals and a floral-print dress. She was accompanied by Jason Mainwaring, who, Zack noticed in spite of himself, wore no wedding ring, although he did sport a sizable diamond on one little finger. The two took seats on the opposite side of the room and continued a whispered conversation, during which the charismatic general surgeon touched her on the arm or hand at least half a dozen times.
Zack spent a minute or two trying, unsuccessfully, to catch her eye, and then gave up and turned his attention to the meeting.
“Any additions or corrections to the committee reports?” Norman was saying. “If not, they stand accepted as read. Old business?”
One hand went up, accompanied by low groans from several parts of the room.
“Yes, Dr. Beaulieu,” Norman said, taking no pains to mask the annoyance in his voice.
From his seat, five or six rows in front of Zack, Guy Beaulieu stood, looked deliberately about the room, and finally marched up to the speakers podium—a move that prompted several more groans.
Zack, who had not seen Beaulieu in three or four years, was struck by the physical change in the man. Once energetic and robust, he was now almost pathologically thin. His suit was ill-fitting and his gaunt face had a sallow, grayish cast. Still, he held himself rigidly erect, as had always been his manner, and even at a distance, Zack could see the defiant spark behind his gold-rimmed bifocals.
“Thank you, Mr. President,” Beaulieu began, with a formality that probably would have sounded unnatural and patronizing coming from most in the room, but coming from him, did not. His speech still bore an unmistakable French-Canadian flavor, especially his “th” diphthongs, which sounded more like d’s. “I know that many of you are becoming a bit weary with my monthly statements on behalf of those who are not being cared for by this institution, as well as against those of you who have slandered my name in this community. Well, I promise you that this will be the last in that series. So, if you will just bear with me …”
He removed a couple of sheets of yellow legal paper from his suit-coat pocket and spread them out on the podium. Once again, there were muted groans from several spots in the room.
Zack glanced over at Jason Mainwaring, who now sat motionless, staring impassively at the man. At that moment Suzanne turned and caught his eye. Zack waved a subtle greeting with three fingers, and she nodded in return. She seemed, even at a distance, to be preoccupied.
“I would like to inform the medical staff of Ultramed-Davis Hospital,” Beaulieu read, adjusting his bifocals, “that I have retained the Concord firm of Nordstrom and Perry, and have filed a class-action suit against this hospital, its administration, its medical staff, and the Ultramed Hospitals Corporation on behalf of the poor and uninsured people in the Ultramed-Davis treatment area. I am being joined in this effort by a number of present and former patients who fall into that group, including Mr. Jean Lemoux, Mr. Ivan MacCregor, and the family of Mme. Yvette Coulombe.
“The charges, which include unlawful and callous discharge from the hospital, improper patient transfer, and refusal to treat, are currently under review by Legal Assistance of New Hampshire, who have promised a decision in the next two weeks as to whether or not they will join our effort. As I have said many times before, sound, compassionate medical care is a right of all people, not a privilege. The attitude of this facility has, over the past three years, become one of, ‘Why should you get health care just because you are sick?’ We intend to fight that policy.”
Zack glanced around the room and catalogued myriad reactions among the physicians; few, if any of them, seemed sympathetic, and none of them appeared very threatened or upset. Some were openly exchanging looks and gestures of disgust, and one was actually circling a finger about one ear.
There are a few docs out there beating the bushes for a job because they thought the same thing, Iverson. Wilton Marsh-fields warning against bucking the Ultramed system echoed in Zack’s thoughts as he studied the sea of blank and disapproving expressions. Suzanne’s, he noted, fell vaguely in the second group.
Beaulieu, too, paused and looked about, but then he continued as if unperturbed.
“In addition to the charges outlined above, we shall document a progressive and unethical blurring of the distinction between medical suppliers and providers, to the point where the care of patients throughout and without this facility is being compromised. We have evidence to back up our position, and every day we acquire more. It is my hope that those on the medical staff who have information which will further substantiate our claims will come forward and present such information to me or to our attorney, Mr. Everett Perry. I assure you that all such disclosures will be kept in the strictest confidence.”
The man, for all of his “crustiness,” as the Judge had put it, had guts, Zack acknowledged. Again he scanned the room; guts, yes, but not a speck of visible support.
“Finally,” Beaulieu read on, “I would like to announce that I, personally, have initiated legal action against a member of this staff, as well as against the administration of this hospital, who are, I believe, responsible for the slanderous, inaccurate, and highly damaging rumors regarding my personal and professional conduct. I call upon any physician who has knowledge of this matter to come forward. Again, I promise strictest confidence. Remember, there but for the grace of almighty God go any one of you.
“I thank you for your patience, and would welcome yo
ur questions and comments.”
Not a hand was raised. Beaulieu nodded in a calm and dignified manner, and then returned to his seat, apparently unmindful of the many annoyed and angry expressions that were fixed on him.
The staff meeting proceeded uneventfully. At the end of “new business,” Zack was formally introduced and welcomed with brief, measured applause. Sensing that some verbal acknowledgment of the greeting was called for, he stood up.
“Thank you all very much,” he began. “It feels great to be home again, and to be on the medical staff of the hospital in which I was born. As Dr. Norman noted in introducing me, in addition to my neurosurgical practice, I shall try to function as a medical neurologist until we are large enough, and lucky enough, to get one of our own. It is my hope to care for all those who need help in my area of expertise”—he glanced over at Guy Beaulieu—“regardless of their ability to pay.
“I would also like to thank our radiologists, Drs. Moore and Tucker, as well as my brother Frank, for their work in obtaining our CT scanner. It’s a beautiful piece of equipment, and both radiologists have gone out of their way to become versed in its use. Sometime soon, the three of us plan to present some sort of workshop on the interpretation and limitations of the technique.
“Since my nearest backup is close to a hundred miles away, I’ll be on twenty-four-hour call, except during my vacation, which is scheduled from August third through August fifth … three years from now. Thank you.”
There was laughter and applause from around the room.
“Oh, one more thing,” Zack added as the reaction died away. “I expected there might be some unusual problems arising from my decision to return and set up shop in the town where I was born and raised. So I’d like to make it perfectly clear that there is absolutely no truth to the rumor—started, I believe, by Dr. Blunt over there, who delivered me and was my pediatrician—that I won’t go into the operating room without the one-eyed teddy bear I insisted on clinging to during his examinations.”
Suzanne, with Jason Mainwaring in tow, caught up with Zack in the corridor.
“Zack, hi,” she said. “Thanks for the laughs in there. Have you met Jason?”
“I think briefly, a few months ago,” Zack said, shaking the surgeons hand. “Nice to see you again.”
“Same here,” Mainwaring said, in a pronounced drawl. “That was a cute little speech, Iverson. I was especially partial to the line about the teddy bear.”
“Thanks” Zack said, wondering if the man was being facetious.
“I even liked that other one. About your next vacation being so far away. You’re a funny man.”
“Thanks again.”
“However,” the surgeon continued, “I would caution you against makin’ any more inflammatory statements about this Beaulieu business until you know all the facts. Y’see, Iverson, I’m the staff member Beaulieu alluded to in there—the one he’s suin’. And noble as you tried to sound in your little pronouncement there, you and Beaulieu aren’t the only ones who do charity work. I operate on plenty of folks who can’t pay, too.”
Zack was startled by the mans rudeness.
“Well,” he said, “I’m glad to hear that. I only hope they get their money’s worth.”
“You know,” Mainwaring countered, “I’ve always heard that only the most arrogant and sadistic surgeons elect to spend their professional lives suckin’ on brain.…”
“Hey, guys, what is this?” Suzanne cut in. “This sounds like the sort of exchange you both should have put behind you when you climbed down from your tree houses and started high school. Jason, what’s with you? Were you attacked in your crib by a mad neurosurgeon or something?”
Mainwaring smiled stiffly. “My apologies, Iverson,” he said.
He extended his hand, but shielded from Suzanne the hostility in his eyes was icy.
“Hey, no big deal, Jason. No big deal.”
“Good. Well then, we’ll have to see what we can do about drummin’ up a little neurosurgical business for y’all.”
“Thanks.”
“Meanwhile, you might try to steer clear of politics around this place—at least until you’ve been here long enough to learn everyone’s name.” He checked his gold Rolex. “Suzanne, dear, I b’lieve we still have time to complete our business. Nice to see you, Iverson. I’m sure you’ll make the adjustment to this sleepy little place just fine.”
Without waiting for a response, he took Suzanne’s arm and strode down the hallway.
Andy O’Meara, red-cheeked, beer-bellied, and beaming, strolled among the tables of Gillie’s Mountainside Tavern, shaking hands and exchanging slaps on the back with the twenty or so men enjoying their midday break in the smoky warmth. Over nearly twenty years he had come to know each and every one of them well, and was proud to call them his friends.
“Andy O, you old fart. Welcome back!”… “Hey, it’s Mighty Mick. Way to go, Andy. Way to go. We knew you’d beat it.”
First the cards and candy and flowers when he was in the hospital, and now this welcome back. They were a hell of a bunch. The very best. And at that moment, as far as Andy O’Meara was concerned, he was the luckiest man alive. Tomorrow would be Independence Day—the day for celebrating the birth of freedom. And this day was one for celebrating his own rebirth.
“Hey, Gillie,” he called out, the lilt of a childhood in Kilkenny still coloring his speech. “Suds around, on me.”
After three months of pain and worry, after more than a dozen trips to Manchester for radiation therapy, after sitting time and again in the doctors office, waiting for the other shoe to fall, waiting for the news that “We can’t get it all,” he was back on the road, cured. The bowel cancer that had threatened his very existence was in some jar in the pathology department at Ultramed-Davis Hospital, and whatever evil cells had remained in his body had been burnt to hell by the amazing X-ray machines. The backseat and trunk of his green Chevy were once again filled with the boxes of shoes and boots and sneakers that he loved to lay out for the merchants along route 16, and the rhythm of his life had at last been restored.
“To the luck of the Irish,” he proclaimed as he hoisted the frosted mug over his head.
“And to you, Andy O,” Gillie responded. “Were glad to have you back among the living.”
Andy O’Meara exchanged handshakes and hugs with each man in the place, and then set his half-filled tankard on the bar. It was his first frosty in more than twelve weeks, and with a full afternoon of calls ahead of him, there was no sense in putting his tolerance for the stuff to the test.
He settled up with Gillie and stepped out of the dim, pine-paneled tavern, into the sparkling afternoon sunlight. He prided himself on never being late for a call, and Colson’s Factory Outlet was nearly a thirty-minute drive through the mountains.
He switched on the radio. Kenny Rogers was admonishing him to know when to hold and know when to fold. The country/western music, usually Andy’s staple, seemed somehow out of keeping with the peace and serenity of this day. At the edge of the driveway he stopped and changed to a classical program on WEVO, the public station.
Better, he thought. Much better.
The tune was familiar. Almost instantly, it conjured up images in Andy’s mind—softly falling snow … a stone hearth … a roaring fire … family. As he hummed along, Andy tried to remember where he had heard the haunting melody before.
“… What child is thi-is, who laid to re-est in Mary’s la-ap, lay slee-eeping? …”
He surprised himself by knowing many of the words.
“This, thi-is is Christ the Ki-ing, whom shepherds gua-ard and angels sing.…”
It was the Christmas carol, he suddenly realized. That was it. As a child in Ireland it had been one of his favorites. How strange to hear it in the middle of summer.
He paused to let a semi roar past. The noise of the truck was muted—almost as if it made no sound at all. Andy shrugged. As wonderful as it felt to be back on the road again, it
also felt a little odd.
“… Haste, ha-aste to bring him lau-au-aud, the Ba-abe, the so-on of Ma-ry.…”
He closed the windows, turned on the air conditioner, and swung out of the drive onto route 110. The green of the mountainside seemed uncomfortably bright. He squinted, then rubbed at his eyes and wondered if perhaps he should stop someplace to pick up a pair of sunglasses. No, he decided. No stops. At least not until after Colson’s.
Settle down, old boy, he said to himself. Just settle down.
He adjusted the signal on the radio and settled back in his seat, humming once again.
Route 110 was two lanes wide, with a narrow breakdown space on either side. It twisted and turned, rose and dropped like an amusement-park ride, from Groveton on the Vermont border, along the ridge of the Ammonoosuc River Valley, to Sterling and Route 16. A scarred, low, white guardrail paralleled the road to Andy’s right, and beyond the rail was the gorge, at places seven hundred feet deep.
Andy’s restless, ill-at-ease sensation was intensifying, and he knew he was having difficulty concentrating. He adjusted his seatback and checked his safety harness. The guardrail had become something of a blur, and the solid center line kept working its way beneath his left front tire. He tightened his grip on the wheel and checked the speedometer. Forty-five. Why did it feel like he was speeding?
Subtly, he noticed, the trees on the mountainside had begun to darken—to develop a reddish tone. He rubbed at his eyes and, once again, forced the sedan back to the right-hand lane. Twenty-five years on the road without an accident. He was damned if he was going to have one now.
Ahead of him, the scenery dimmed. A tractor trailor approached, sunlight sparking brilliantly off its windshield.
Suddenly, Andy was aware of a voice echoing in his mind—a deep, slow, resonant, reassuring voice, at first too soft to understand, then louder … and louder still. “Okay, Andy,” it said, “now all I want you to do is count back from one hundred … count back from one hundred … count back from one hundred …”
Flashback (1988) Page 6
