by Gen LaGreca
The cab driver raised his eyes to peer at David through the rearview mirror. “How do you like that?” he said, snickering.
“I don’t particularly,” said David, averting his eyes in an attempt to end the conversation.
But the cab driver pressed on as he drove into the livelier nightlife of the Theater District. “You think the governor wouldn’t take kickbacks?”
“I don’t know—” David began, but his words suddenly froze.
Outside the window, workers were erecting a new billboard where a poster of Nicole had stood. The giant ad displayed the reopening date of Triumph with a twenty-foot-high picture of the new Pandora, touted to be “Broadway’s latest dance sensation.” He was grateful that Nicole could not see that particular sight.
As the cab crawled in traffic detoured because of the explosion, a new radio show began. “Good evening,” a soothing voice droned, “I’m Adam Nutley, your Sunday night host for The Week in Review. Tonight our topic is medicine and the state. Can a doctor disregard government regulations and treat a patient as he pleases? Neurosurgeon David Lang apparently thinks so. This week his experimental nerve-repair surgery on dancer Nicole Hudson, who was blinded in the gas explosion, has raised a furor in the Burrow administration, as well as in his own family.”
“That guy’s finished,” quipped the driver.
David did not listen to commentaries, as he knew they would have no bearing on his actions. He wanted to ask the driver to change the station but decided not to invite more looks through the rearview mirror.
“Here is what Dr. David Lang said in a news conference after the surgery,” said Adam Nutley.
David heard an excerpt of his statement to the press. As he had only spoken a few words in the cab, the driver apparently did not recognize the voice over the radio as his.
“This surgery is a private matter between me and my patient. It’s none of the governor’s business what I do in the OR,” said David over the airwaves.
“Dr. Lang was peppered by questions after his statement,” continued the show’s host. “Here are some of them.”
“Dr. Lang,” asked one reporter, “if this treatment is successful, do you stand to gain personally from it?”
“I do.”
“Did you really use drugs that weren’t approved?” asked another reporter incredulously.
“They were approved—by me.”
“Did you perform a procedure that wasn’t authorized?”
“It was authorized—by my patient.”
“But Dr. Lang, how can you know that you’re right?”
“How can a bureaucrat in Albany know better?”
Adam Nutley interjected: “And here is what Governor Burrow said about the surgery.”
“My responsibility is to protect the patient,” droned the governor through the static reception. “Here we have a doctor who bypassed the law, subjecting a helpless accident victim to an operation not approved through the proper regulatory channels and to drugs not authorized by the appropriate agencies. I will not see the public turned into guinea pigs for someone’s reckless experiments.”
“The issue,” said Adam Nutley, “is complicated by the fact that the head of the Bureau of Medicine, Dr. Warren Lang, is the surgeon’s father. The governor was asked if the doctor might get off easy, considering his connections.”
“Absolutely not! The surgeon has already been suspended,” said Governor Burrow. “Warren Lang’s integrity is unimpeachable. I know he’ll do what’s right.”
“What is right?” interjected Adam Nutley.
“Even his old man won’t be able to bail him out,” said the cabbie indifferently. “Not in an election year.”
The taxi came to a standstill, waiting its turn to pass construction trucks and blocked lanes. David noticed an unusually vigorous effort by the city to repair the roads damaged by the explosion. Was that another sign of an approaching election? He wondered if he and Nicole would face ruin because someone wanted to win an election. They were the innocent, wanting nothing from anyone, only to be left alone, yet they were somehow in the way.
“We asked the state’s foremost medical authorities for their views on Dr. Lang’s experimental surgery,” said the radio commentator. “First let’s hear from the president of the New York Academy of Medicine.”
“A doctor has an obligation to serve society,” said a voice David recognized. “We repudiate brash, egotistical, lawbreaking actions by a physician, and we repudiate David Lang.”
The announcer next introduced the head of the New York Alliance of Neurosurgeons. “Doctors seeking new techniques and discoveries must work within the system,” said another voice David knew. “Lawlessness is unacceptable in bringing about social change, even if such change ultimately proves to be of great value.”
David cracked the window of the cab, and the incessant whine of the city intruded. He felt a sickening knot in his stomach at the thought of the thousands of dollars in dues he had paid to the organizations whose leaders were just quoted, organizations whose alleged purpose was to protect doctors. He was not surprised at censure from members of his profession—only at the biting power it had to hurt him.
But the voices of New York’s medical leaders were mere pinpricks compared to the next one piercing his ears, a voice stinging with bitterness: “The surgery performed by Dr. David Lang flies in the face of established medical beliefs about nerve regeneration,” said his brother. “It also flies in the face of other established beliefs, ones that brought us Mack Burrow, the Bureau of Medicine, and CareFree. If we accepted Dr. Lang’s brazen experiment, then we would have to challenge much more than our medical beliefs.
“If Dr. Lang can perform his work by his own judgment, then why do we need the Bureau of Medicine? If his patient is capable of—and better off—handling her own medical treatment, then why do we need CareFree? While Governor Burrow parades in the ornate robe of public benefactor, David Lang points his finger, saying the emperor isn’t wearing any clothes.
“What would it mean if the emperor were naked? Think of the statutes, committees, and departments that would be useless. Think of the thousands of inspectors with nothing to inspect. Think of the unused tax money that could be refunded to the people. What a waste! This is why Dr. Lang’s deed must not be forgiven. As the president of Riverview Hospital, I . . .”—the first crack appeared in the voice—“. . . have no choice but to . . . denounce him.”
Randy’s statement reached a bowed head in the back of the cab. It was not the words that disturbed David but the pain in the voice uttering them.
“If this doctor wants a friend, he’d better get a dog,” said the cabbie.
David knew that he had many supporters, but they could not risk their positions by speaking out publicly. They were the majority of his colleagues, who silently watched his plight with the sympathetic stares reserved for the condemned. Although David was officially suspended, his colleagues tacitly gave him as much control as possible. When he transferred his preoperative cases to other surgeons, they accepted the patients regretfully. In theory David also relinquished his postoperative cases. In practice, however, his colleagues looked the other way while he continued to monitor these patients. Such gestures of respect, David knew, would never be made known to the public.
“In the interest of presenting both sides of the issue, we interviewed an outspoken supporter of Dr. Lang, the president of Morgan Pharmaceuticals, Philip Morgan,” said Adam Nutley. “He issued his statement on Thursday morning, immediately after the surgery.”
David suppressed a gasp at the mention of his trusted friend and former college classmate who had risen from being a bench chemist to heading his own drug company. He did not know that Morgan had issued any statement regarding Nicole’s surgery. David had thought of his friend only yesterday when CareFree had announced the removal of three of Morgan’s drugs from its formulary. The drugs were too expensive and an unnecessary duplication of other medications, the agency h
ad claimed. The sudden action wiped out the firm’s sales of those drugs in New York State, David knew. Now he was mortified to realize that the ban had come immediately after Morgan was foolish enough to have defended him.
The leather-tough voice of Phil Morgan bristled on the radio. “You can bet something’s terribly wrong in the world when a top surgeon like David Lang has to take orders from a bureaucracy. Dr. Lang had the courage to do what we all dream of. Sure, we bicker among ourselves about the regulations, but then we smile politely and open our doors to the next inspector who drops by our office to look around, and it’s all so pleasant. Undoubtedly, David Lang will be hanged, but somehow I think he’s better off than the rest of us patsies.”
David gasped audibly. The driver glanced through the rearview mirror to see two hands covering a lowered face.
“Are you okay, buddy?”
“Yes,” the surgeon whispered.
Phil Morgan’s banned drugs included an anesthetic used in David’s surgeries. CareFree’s quest to provide free medication within its troubled budget had resulted in the use of fewer and less-expensive products. What would happen to Phil’s company? David wondered anxiously. Would it stop doing business in New York State, as other pharmaceutical firms already had?
“We contacted the secretary of medicine,” said Adam Nutley, “but he declined to comment.”
How do you like that?” asked the cabbie.
David did not reply.
“When the politicians bash this doctor, that don’t mean anything. But when other doctors blast him and his own family won’t stick up for him and his only friend is a drug-company exec, it makes you wonder.”
“You can stop here.”
With the cab barely halted, David paid the driver and jumped out. He walked a few blocks past the row of theaters to the Hudson River, its murky waters trembling in the moonlight, until he reached the sprawling campus of West Side University and its medical school. Few lights shone in the buildings that Sunday night, and no cars appeared in the campus parking lots. David met no one along the lamppost-lit road to the William Mead Research Center. There, medical investigators like him kept laboratories and performed animal studies. However, the other researchers, warmed by the mantle of respectability, worked by day; he prowled at night.
The oppressive humidity and dank smell of the river made David wish for a hearty rain. But the sky was clear. Where was the downpour, he wondered, to cleanse the muddy waters that he waded in? At the desolate entrance to the brick research building, a black cat crossed his path. The two creatures startled each other.
The wooden door creaked when David’s key opened it. The empty halls amplified the thump of his footsteps. The plaintive wail of a restless laboratory animal was his only greeting. When he arrived at the small, windowless laboratory that he kept on the second floor, a digital clock beeped to signal the hour: 10:00. He locked the door, galvanized by the task at hand.
He examined three of five cats caged in his lab. He had operated on those three in the nights after Nicole’s surgery. In each cat, he had simulated Nicole’s injury by transecting the optic nerves; then he repaired them as he had in her case. After checking his recuperating feline patients, David created a sterile field on his lab counter, prepared his instruments, and readied the last two animals for the same surgery. His plan was to perform the second operation on each of the five cats prior to Nicole’s next surgery. With his suspension, he did not know how he would complete Nicole’s treatment, only that he would. Operating on the cats would help him to foresee any possible problems, thus better preparing him for her second procedure. He wished he could perform hundreds of animal experiments before reentering the sacred temple that was Nicole’s brain.
However, five felines were the only animals he possessed—five precious cats! They were not yet registered with the authorities. David had obtained them after he had successfully performed the nerve-repair treatment on the spinal cords of other felines. He’d intended to experiment on the fresh cats but had failed to gain approval from the BOM. He’d considered trying to procure more animals from a shelter but could find no way to circumvent the probing applications. Although hundreds of local pound animals were euthanized weekly, the laws forbade their use in medical experiments. Why? he wondered, but he had no time to search for an answer. As David applied an anesthesia mask to a cat’s face, he tried to forget the laws that he was breaking, to anesthetize himself to everything save the one performance that he must orchestrate flawlessly—Nicole’s second surgery, with the dancer’s fate resting on the outcome.
The surgeon had no permission from the state to conduct animal experiments. Performing two surgical procedures on the same animal, as he was planning, required a special permit. The feline operations were supposed to be performed in a surgical area, not at a lab bench, and with a licensed veterinarian present. The animals were supposed to be housed in a special room under controlled conditions, not in a cage in a windowless lab. The litany of regulations he was violating was lengthy. He tried not to think of the growing number of medical researchers who were targeted by hostile groups infiltrating their labs, accusing them of infractions, and masterminding their arrests on cruelty-to-animal charges. He had witnessed the chilling sight of a colleague handcuffed and taken away in a police car for lesser offenses.
According to the law, David was cruel and inhumane, yet he could never bear to see an animal mistreated. He had always kept his animals well fed, clean, comfortable, and pain-free. Was he comfortable and pain-free? Was Nicole? What entity was charged with the prevention of cruelty to them? he wondered. The sound of a sudden movement startled him, but it was only one of the cats stirring. He again focused on his work. Finally, he reached a point at which the laws, the inspectors, the whole of his worries faded like a nightmare exposed to the first rush of sunlight. David was inside a mammalian brain and fascinated with its majestic geography. He did not hear the clock’s hourly beep again until six the next morning.
He had completed his surgeries on the fourth and fifth cats when he heard the first voices in the hallway that Monday morning. While he was cleaning up, someone knocked on his door.
“Yes?” He cautiously opened the door a sliver.
“Excuse me, Doctor.”
David relaxed. It was only Gary, the supervisor of the janitorial crew. “My attendant left a note that you didn’t want service on Thursday or Friday, so I came this morning for the trash.”
“Thanks, Gary, but I’d like to empty the garbage myself for the next few weeks, until I let you know otherwise.”
David’s foot behind the door prevented it from opening wider and exposing the animals. Gary glanced at him curiously. The surgeon smiled uneasily, hoping the cats would remain silent.
“Okay, Gary?”
“Sure, Doctor. Just let me know when you want my people in there again.”
“I will.”
David finished his work, satisfied that no one else had seen him. It was early enough to leave the building before the researchers arrived. He slipped out of the lab and locked the door. Just then a hand grabbed his shoulder, startling him.
“What are you doing here, pal? And why are you so jumpy?” It was Randy.
“I had some cleaning up to do. What are you doing here?”
“I have a meeting in the building. How’s Nicole?”
“Fine.”
“Say, I’m glad I ran into you.”
“What’s up?”
“You know the old man hasn’t issued any statements about you.”
“I heard he has no comment.”
“He’s hesitating. No one knows what he’ll do. I spoke to him yesterday, and I think he’s mortified at the prospect of punishing you. Maybe he’ll find a string to pull. That’s why you need to be on your best behavior.”
David thought he heard a cat stirring behind the door.
“Don’t break any more laws, David. Don’t even jaywalk. And maybe the old man will decide to rejoin the h
uman race and save you. But you must be a model citizen.”
“I want you to stay out of this! You didn’t denounce me enough. You weren’t harsh enough—”
“If you don’t have any sense, then do it for me, because I worry about you. Even though I have a squad ready to pounce on you if you so much as glance at the OR, there are lots of other rules you could break. Promise me you won’t.”
“You know my promises aren’t worth much.” David’s head dropped painfully at the mention of the subject of promises.
“So make one that is. Promise you’ll be a model citizen.”
“Drop it.”
“The old man’s your only chance, so don’t throw kerosene on the fire . . . or maybe you already have.” Randy’s eyes moved suspiciously to the lab door. “What are you doing here anyway? Cleaning up? At seven in the morning?”
David’s eyes widened in panic as he noticed a ball of cat fur on his pants. Would Randy see it? Would he uncover a secret that he must not learn?
“Okay, okay! Damn you, brother,” he whispered, his irritation softened by affection. “Don’t worry about me. I’ll try to be a . . . reasonably . . . model citizen.”
Chapter 17
A Light Extinguished
A few blocks from the university campus, the rising sun hit the east wing of Riverview Hospital, turning its rows of windows into sheets of sparkling crystal. Inside a glass panel midway up the tall structure, the still-pink rays of early morning light warmed the face and wrinkled the nose of a sleeping Nicole Hudson. She dreamed of dancing under a spotlight on the stage of a great hall, with her red ballet slippers brushing against a blond wood floor. Other dancers surrounded her in a kaleidoscope of costumes. As the sun’s heat intensified in the hospital room, the patient grew warmer, began tossing, and finally awakened. She threw off the covers and opened her eyes. The face so untroubled in sleep suddenly lost its serenity, for the scene with her eyes open was blank. The precious sensation of a new day’s sun was reduced to a few tiny beads of perspiration on her warm forehead.
