Out loud, Andy began to count. “One hundred … ninety-nine … ninety-eight …”
A blue drape drifted above him, then floated down over his abdomen.
“Ninety-seven … ninety-six …
Hands, covered by rubber gloves, appeared in the space where the drape had been.
“Ninety-five … ninety-four … Why aren’t I asleep?” his mind asked. “Ninety-three … ninety-two.”
“Bove electrode, please,” the low voice said. “Set it for cut and cauterize.”
Another pair of gloved hands appeared, one of them holding a gauze sponge, and the other, a small rod with a metal tip. Slowly, they lowered the metal tip toward his belly.
“Ninety-one … ninety—”
Suddenly, a loud humming filled his mind. The metal tip of the rod touched his skin just below his navel, sending a searing, electric pain through to his back and down his legs.
“Jesus Christ, stop!” Andy screamed. “I’m not asleep! I’m not asleep!”
The wall of his lower abdomen parted beneath the electric blade, exposing a bright yellow layer of fat.
“Eighty-nine! … Eighty-eight! … For God’s sake, stop! It’s not working! I’m awake! I can feel that! I can feel everything!”
“Metzenbaums and pick-ups, please.”
“No! Please, no!”
The Metzenbaum scissors sheared across Andy’s peritoneum, parting the shiny membrane like tissue paper and exposing the glistening pink rolls of his bowel.
Again, he screamed. But this time, the sound came from his voice, as well as from within his mind.
His vision cleared at the moment the right headlight of his automobile made contact with the guardrail. The Chevy, now traveling at nearly ninety miles an hour, tore through the protective steel as if it were cardboard, crossed a narrow stretch of grass and gravel, and then hurtled over the edge of the gorge.
Strapped to his seat, Andy O’Meara watched the emerald trees flash past. In the fourth second of his fall, he realized what was happening. In the fifth, the Chevy shattered on the jagged rocks below and exploded.
6
The cafeteria of Ultramed-Davis, like most of the facility, had been renovated in an airy and modern, though quite predictable, style. The interior featured a large, well-provisioned salad bar, and a wall of sliding glass doors opened onto a neat flagstone terrace with a half-dozen cement tables and benches.
Pleasantly exhausted from his three-hour cervical disc case, Zack sat at the only table partially shaded by an overhanging tree and watched as Guy Beaulieu maneuvered toward him through the lunchtime crowd.
During the summer Zack had spent as an extern at the then Davis Regional Hospital, Beaulieu had been extremely busy with his practice and with his duties as president of the medical staff. Still, the man always seemed to have enough time to stop and teach, or to reassure a frightened patient, or to console a bereaved family.
And from that summer on, the surgeons blend of skill and compassion had remained something of a role model for Zack.
“So,” Beaulieu said as he set down his tray and slid onto the stone bench opposite Zack, “thank you for agreeing to dine with me.”
“Nonsense,” Zack replied. “I’ve been looking forward to seeing you ever since I got back to town. How is your wife doing? And Marie?”
“Clothilde, bless her heart, is as good as can be expected, considering the filthy stories she has had to contend with these past two years. And as for Marie, as you may have heard, she grew weary waiting for you to propose and went ahead and married a writer—a poet of all things—from Quebec.”
Zack smiled. He and Marie Beaulieu had been friends from their earliest days in grammar school, but had never been sweethearts in any sense of the word. “Knowing Marie, I’m sure he’s very special,” he said.
“You are correct. If she could not have you, then this man, Luc, is one I would have chosen for her. In an age when most young people seem to care for nothing but themselves, he is quite unique—consumed by the need to make a difference. He works for a village newspaper and crusades against all manner of social injustice while he waits for the world to discover his poems.”
“Kids?”
“They have two children, and I don’t know how on earth they manage to feed them. But manage they do.”
“And they’re happy,” Zack said.
“Yes. Poor and crusading, but happy, and as in love—more so, perhaps—than on the day they were married.”
Zack held his hands apart. “C‘est tout ce que conte, nest ce pas?”
Beaulieu’s smile was bittersweet.
“Yes,” he said. “That is all that matters.” He paused a beat for transition. “So, your old friend Guy Beaulieu is a little short of allies in this place.”
“So it sounds,” Zack said, picking absently at his salad.
Beaulieu leaned forward, his eyes and his voice conspiratorial. “There is much going on here that is not right, Zachary,” he whispered, “Some of what is happening is simply wrong. Some of it is evil.”
Zack glanced about at the newly constructed west wing, at the helipad, at the clusters of nurses and doctors enjoying their noontime breaks on the terrace and inside the cafeteria.
“You’ll understand, I hope, if I say that I see little evidence of that around me. Could you be more specific?”
“Your father spoke to you, yes?”
“Briefly.”
“So you know about the lies.”
“I know something of the rumors, if that’s what you mean.”
Beaulieu leaned even closer. “Zachary, I beg your confidence in this matter.”
“That goes without asking,” Zack said. “But I have to warn you of something. The Judge on Sunday, and you again this morning, suggested that at least some of your quarrel might be with Frank. You should know that I have absolutely no desire to take sides in that disagreement. Your friendship means a great deal to me. I don’t know if I’d even be a surgeon today if it weren’t for your influence. But Frank’s my brother. I can’t imagine lining up against him.”
“Even if he was in the wrong?”
“In my experience, Guy, right and wrong are far more often shades of gray than black and white. Besides, I tried my hand at crusading during my years at Boston Muni. All it got me was a tension headache the size of Alaska. I should have bought stock in Tylenol before I took my first complaint to the Muni administration. I’ll listen if you want to talk, but please don’t expect anything.”
“Thank you for the warning,” Beaulieu said. “Even though I have a great fondness and respect for you, and even though, as you no doubt gathered, I haven’t much support around this place, I was reluctant to share with you what I know, largely because of Frank. But then, when you said what you did at the meeting this morning—I mean about treating anyone, regardless of their ability to pay—well, I sort of took that as an invitation to talk.”
Zack sighed.
“You thought correctly,” he said finally. “I fight it tooth and nail, but when I’m not looking, the part of me that can’t stand seeing people get screwed always seems to sneak to the surface.”
“Yes, I heard what you did for that old woodcutter the other night.”
“You did?”
“Don’t be so surprised. This hospital, this entire town, in fact, has a communication system that would make the Department of Defense green with envy. You had best accept that fact and adjust to it if you’re going to survive here. Drop a pebble in the lake and everyone—but everyone—will feel the ripple. That’s why stories, such as those that have been spread about me, are so damning. In no time at all, everyone has heard a version.”
“Like that old game—telephone.”
“Pardon?”
“It’s a party game we used to play. Everyone sits in a circle, and the first person whispers a secret to the one next to him. Then the secret goes all around the circle, and by the time it gets back to the one who started it, it has tota
lly changed. It bothers me terribly to think that anyone would deliberately be doing anything to hurt you, especially making the sort of accusations the Judge says have been flying around.”
“They are lies, you know, Zachary. Every last one of them.”
Zack studied the Frenchman’s face—the set of his jaw, the dark sadness engulfing his eyes. “I know, old friend,” he said at last. “I know they are.”
“So …” Beaulieu tapped his fingertips together, deciding where to begin. “What did you think of my little prepared statement this morning?” he asked finally.
“Well, the truth is, I thought you handled yourself, and expressed yourself, very well.”
Beaulieu smiled. “Diplomatically put, my boy. But please, continue, and remember, my feelings are quite beyond being hurt.”
Zack shrugged. “Okay, if you really want to know the truth, I kept thinking that all that was missing from the whole scenario was a horse, a lance, a shaving-bowl helmet, and Sancho Panza.”
This time, the older surgeon laughed out loud.
“So, you think I am tilting at a windmill, is that it? Well, my young friend, let me give you a closer look at that windmill. Richard Coulombe. Do you know him?”
“The pharmacist? Of course I know him. I called in a prescription to him just yesterday.”
“And did you know that he does not own his pharmacy anymore?”
“The sign says Coulombe Drug.”
“I know what the sign says. I also know that Richard is now an employee, and not a proprietor. He sold his store nearly two years ago to a chain outfit named Eagle Pharmaceuticals and Surgical Supplies. I do not know how that particular deal, with that particular company, was brought about, but I can guess now that it was no accident. Richard did not want to sell, but he needed the money to pay an enormous debt—a hospital bill and a surgeons bill, Zachary—run up by his wife, now his late wife, Yvette, during a series of cancer operations.”
Beaulieu chewed on a bite of sandwich as he gauged Zack’s reaction.
“Did you perform the operations?” Zack asked.
The surgeon shook his head. “The Coulombes had been my patients for many years, but shortly before Yvette began having symptoms, the rumors about me began circulating. Like most of the other people in town, they decided, or were told—I’m still not exactly certain which—to go and see Jason Mainwaring, instead. They were also told that their insurance coverage was quite limited, but that barring complications, most of Yvettes bills would be covered.”
“But complications there were.”
“Four separate operations, all of them indicated and due to unforeseeable circumstances, as far as I can tell; but four nonetheless. Then there was a protracted stay in the Sterling Nursing Home. In fact, Yvette never did return home before she died.”
“And, of course, there were more bills for that. I get the picture.”
“Actually,” Beaulieu said gravely, “you haven’t gotten the picture at all … yet. You see, Ultramed Corporation not only owns our hospital, it now owns both nursing homes in town as well. Did you know that?”
“No,” Zack said. “No, I didn’t.”
“The corporate name is the Leeward Company. They own nursing homes and rehabilitation centers all over the east and midwest, and about three years ago they purchased the two here in Sterling. But what not so many people know, including me until just a few months ago, is that Leeward is a division of Ultramed, bought out by them precisely four years ago. The bills for all three institutions—Ultramed-Davis and the two nursing homes—are actually spit out of the same computer. I’m not going to tell you who’s in charge of that computer, but you can guess if you wish.”
“I don’t have to,” Zack said, wondering why Frank had never mentioned the purchase of the nursing homes to him. “Coulombes story is a very sad one, especially with the unfortunate outcome for his wife. But I see nothing evil or even immoral in it.”
“That is because you are missing a piece of the puzzle,” Beaulieu said. “A crucial piece. And remember,” he added, “what I am about to reveal to you is just the tip of the iceberg.”
“Go on,” Zack said, wishing now that the man would not.
Beaulieu pulled a folded typed sheet from his jacket pocket, smoothed it out on the table, and slid it across to Zack. “As I mentioned before,” he said, “I do not have too many allies in my little crusade. But I do have some. One of them has spent nearly six months traveling from place to place, trying to gather information for me. Just last week he came up with this. It’s a list of the boards of directors of two companies.”
Zack scanned the parallel lists of names, headed simply R and EPSS. Five of the ten names on each list were identical.
“What do these letters stand for?” he asked.
The fire in Guy Beaulieu’s eyes intensified. “The R stands for RIATA of Boston, the megaglomerate that owns Ultramed. In a sense, they are our bosses, Zachary. Yours, mine, and every other doctors in town.”
“And the other?”
“The other, my friend, stands for Eagle Pharmaceuticals and Surgical Supplies—the corporation that bought out Richard Coulombe. Their boards of directors interlock.”
Beaulieu illustrated his point by sliding the fingers of one hand between the fingers of the other.
Before he could respond, Zack saw movement at the corner of his eye. He slid the paper onto his lap at the instant a shadow fell across the table. He and Beaulieu looked up.
Frank, smiling benignly, stood not five feet away from them, holding a tray of food.
“Are you gentlemen having a heart-to-heart?” he asked. “Or do you have room at the table for one more?”
Carefully, Zack folded the sheet of paper and slid it into his pocket, although he sensed the move was a fruitless one. Frank had heard at least part of their conversation. Of that, he was almost certain.
A Bach fugue was playing on the small cassette deck by the sink. Barbara Nelms, staring glumly at the bathroom mirror, ran a finger over the furrows in her forehead and the crows feet at the corners of her eyes. The creases had, it seemed, appeared overnight. Instinctively, she reached for her makeup kit. Then, just as quickly, she snapped off the tape, turned and walked from the bathroom. If she was bone-tired, if she was stressed close to the breaking point, if frustration and fear had aged her six years in six months, why in the hell should she try to hide it anymore?
The product of a perfectly uncomplicated upbringing in Dayton, Ohio, and four idyllic years as a business and marketing major at tiny St. Marys College in Missouri, she had always prided herself on being a model parent, wife, citizen, and member of society. She was a registered Democrat, a voting Republican, an officer in the PTO three years running, a scout leader, a reader at church, a better than average pianist and tennis player, and, at least according to her husband, the best lover a man could ever want.
But now, after six months of haggard guidance counselors and harried school resource workers, of evasive, pompous behavioral psychologists and bewildered pediatricians, none of that mattered. She had dropped off all committees, hadn’t picked up a tennis racket in weeks, and couldn’t remember the last time she and Jim had had sex.
Something was wrong, terribly wrong, with her son. And not only could none of the so-called specialists they had seen diagnose the boys problem, but each seemed bound and determined to convince her that it fell in someone else’s bailiwick.
The violent episodes, occurring at first monthly, but now almost once a week, had enveloped Toby in a pall of melancholy and fear so dense that he no longer smiled or played or even spoke, except for occasional monosyllables in answer to direct questions—and then only at home.
Situational depression; delayed autism; childhood schizophrenia; developmental arrest with paranoid ideation; acting out for secondary gain; the labels and explanations for Toby’s condition were as varied—and as unacceptable—as the educators and clinical specialists who had applied them.
The boy was sick, and he was getting sicker.
He had lost nearly ten pounds from a frame that had not an ounce of fat to begin with. He had stopped growing. He had failed to satisfy the requirements for promotion to the fourth grade. He avoided interacting with other children.
He had been given vitamins, antidepressants, Thorazine, Ritalin, special diets. She had taken him to Concord, and then to Boston, where he had been hospitalized for four days. Nothing. Not a single objective clue. If anything, he had returned from the medical mecca even more uncommunicative than before.
Now, as she prepared to drag her son to yet another specialist—this one a young psychiatrist, new in town, named Brookings—Barbara Nelms felt the icy, all-too-familiar fingers of hopelessness begin to take hold.
Toby’s episodes at first seemed like horrible nightmares. Several times she had actually witnessed them happen—watched helplessly as her sons eyes widened and grew glassy, as he withdrew into a corner, drifting into a terrifying world he would share with no one. She had listened to his cries and had tried to hold him, to comfort him, only to be battered about the head and face by his fists.
In the end, there was nothing she could do but stay close, try her best to see that he didn’t hurt himself, and wait. Sometimes the episodes would last only half an hour, some times much longer than that. Always they would end with her son mute, cowering, and totally drained.
Perhaps this will be the day, she said to herself. Perhaps this man, Brookings, the first full-time psychiatrist in the valley, would have the answer.
But even as she focused on this optimistic thought, even as she buttoned her blouse and smoothed the wrinkles she should have ironed from her skirt, even as she went to her sons room to fetch him for yet another evaluation at yet another specialists office, Barbara Nelms knew that nothing would come of it. Nothing, perhaps, except another label.
And time, she also knew, was running out.
Flashback (1988) Page 7
