by Sanjay Gupta
CHAPTER 46
H
ooten skipped the bird-watching and headed straight for the hospital at 5 AM. He didn’t want to make a big deal about vacating his office, nor did he want some sort of funereal procession of colleagues coming by to wish him well, none of them daring to mention the horrible mistake that had precipitated his sudden departure. The silence would hang over the room like a suffocating gas.
Hooten wished someone would have the nerve to bring it up, to rebuke him, accuse of him of hypocrisy for all the times he’d made junior surgeons squirm for less egregious lapses. Hooten wished he could stand in front of his colleagues and own up to his mistake at M&M instead of slinking out under the cover of darkness.
The hospital’s lawyer said he did not want Hooten to linger, a lame duck and a legal liability. Hooten threatened to stay, to ride it out, but he knew he needed to step down. Somehow, the case had made it into the Free Press and was picked up by the Associated Press, illustrating the desperation of the undocumented, dying for five dollars an hour. The story ran in papers across the country, a black eye for the hospital that Hooten had worked so hard to better.
As a final act to show he retained a shred of control, Hooten threatened an age-discrimination lawsuit until the hospital granted his one wish. Smith and the board reluctantly agreed, and for that Hooten was grateful. The hospital would be a better place as a result.
“Maybe it’s for the best,” Martha had said when Hooten had confessed what he’d done. He’d been sitting on the side of the bed, staring at the carpet, crying like a schoolboy. She’d put her arm around his shoulder. He shrugged it off.
“Tell it to that worker on life support,” Hooten said. The patient had survived the operation, but he did not wake up. A ventilator breathed for him while the Mexican consulate tried to learn the man’s identity. The time Hooten wasted opening the wrong side of the head cost both men the rest of their lives. Hooten did not think he deserved affection. He felt a deep rage at how his reputation could be lost in an instant. He was the surgeon who operated on the wrong side of the patient’s brain. Everything else he did was now a footnote. Oh, and he worked for more than twenty years to improve the quality of care at Chelsea General.
Hooten would walk out of the hospital and not look back. Martha had been urging Hooten to retire for the last year or two. Martha had lost two of her close friends in quick succession, one with a heart attack and the other to ovarian cancer. She was keenly aware that their time together in the golden years was not guaranteed.
Hooten would get his chance to say good-bye to his friends and co-workers. They’d hold a retirement dinner for him. He was sure of that. They’d probably choose a restaurant rather than one of the hospital’s function rooms, at the lawyer’s suggestion. And they’d probably hang his portrait in the hospital’s main entrance as was customary.
Hooten used the electronic key to unlock the car, and the accompanying beep startled a mourning dove. The bird flew in a straight line from the underbrush into the low branch of a pine, its wings whistling as it flew.
As he drove to the hospital, Hooten thought how this would be his last trip there. The route seemed new. Along one stretch, he saw a law office he’d never noticed before. It was in an old Victorian house. The sign out front said O’BRIEN AND SHEA. Had that been there all along? He must have been thinking about the hospital. Hooten tried to use this observation to cheer himself up. Surely, as one door closed, another opened.
At the hospital, someone had set a stack of flat boxes outside his office. Hooten got to work. He boxed the framed pictures, the diplomas, the honorary degrees, the medals, and the knickknacks. He had an ornate set of chopsticks he’d received when he spoke at Osaka University. There was a Buddha he’d picked up in China, and a beer stein he’d bought in Germany after a conference at the Max Planck Institute. He stared at his Mark Roth Untitled 1964 painting for a long time. Despite its mystique, he had always known what it meant for him. A gray rectangle inside a black space. All of his life, he had lived in the smaller, brighter inner box, protected from the blackness that surrounded most people. He worked hard to get there, always knowing that in a split second he could find himself outside, looking in. It had happened. The blackness was now surrounded by gray. He also looked at the picture of the scarlet ibis. Maybe it was time to finally take Martha to South America and find the rare bird for himself. “Bad things happen to good people,” he muttered to himself. Hopefully, the people at Chelsea General would learn from his terrible mistake, and it would never happen again. Hooten was always still the teacher, even as he was summarily dismissed from his post as chief.
It was surprising how easy it was to pack a lifetime’s memorabilia. He had all his things boxed before seven. J. J. Jerome leaned into the office as though he had just happened by.
“Morning, Dr. Hooten. You need some help carrying boxes?”
“Yes, thank you, Mr. Jerome.”
Jerome wheeled in a hand truck and stacked the boxes. One remained.
“I can come back and get that one, Dr. Hooten.”
“I can manage.”
Hooten bent down, lifted the box, and headed for the door. Jerome started following but stopped.
“You forgot a picture, Dr. Hooten.”
Hooten wheeled around. There on the shelf overlooking the desk was a picture of Hooten next to Dr. Sydney Saxena. They were both smiling, standing in identical poses, hands clasped in front. The hospital had taken the picture three or four years earlier after Hooten presented Saxena with the Julian T. Hoff Outstanding Young Professor Award.
“Thanks, Mr. Jerome. I didn’t forget that. I’m leaving that one. Can you make sure it doesn’t get tossed.”
“Sure thing, Dr. Hooten.”
With that, Hooten turned for the door.
Villanueva’s funeral was as enormous as the man himself. It brought together the different currents of his life. From his old neighborhood in Detroit, a few middle-aged men and women whose brown faces had been either worn or sharpened from a lifetime of hard work. From his football days, there were four hulking men with bad knees and sport coats that no longer fit. From Bloomfield Hills, his ex-wife and several of their old neighbors, men and women who had peered out of bow windows to see an enormous man playing catch with their sons. From his new neighborhood, the bartender Soupy Campbell and a few of the regulars at O’Reilly’s. From the hospital, doctors, nurses, orderlies, parking attendants. Villanueva had an effect, it seemed, on almost everyone at Chelsea General who came into contact with his enormous presence.
Sydney sat next to McManus. Dr. Um-So and his wife were there. Dr. Smythe sat with another similar-looking man. Park sat in the back row with his wife and three children. Ty sat by himself a few rows up.
Tina had taken news of the Big Cat’s death particularly hard. She was still in the hospital. She was out of her medically induced coma. Her brain seemed to be intact, but she remained heavily sedated. Even in the painkiller-induced fog, Tina had this thought: Everything principled in her life seemed to be falling away.
Nick sat in the front row, next to his mother. His eyes were red and downcast. Initially, he had blamed himself for his father’s death. If only he had started the car on the first try. If only he had convinced his father not to buy him the car. If only. His mother had convinced Nick that his father was a walking time bomb. If it wasn’t then, she said, his heart would have caught up with him soon. “It’s just the way he lived.” As she explained this, she thought about her ex-husband’s passion for life and made a note to drop the aloof lawyer she had been dating.
The priest said a few words about eternal salvation. The congregation sang “Amazing Grace.” Then Dr. Nancy Reid, one of Villanueva’s professors from residency, walked up to the stage. Reid was small and bookish, the physical antithesis to the Big Cat. She had to adjust the microphone at the pulpit downward and was so short most of the congregation only saw the top of her head. She coughed a couple of times as she tr
ied to stifle her crying. “Jorge was my friend,” she started. “He was a flawed man. But he was deep, he was genuine.” Reid came out from behind the pulpit. “I never dared imagine the day Gato would die, but I guess it does not surprise me it happened like this, doing what he loved and trying to make someone’s life better and happier.”
She gave a compassionate smile to Nick, who wiped his eyes. “I remember my initial skepticism when a former professional football player told me he wanted to become a healer. I thought, What does this big dumb jock know about medicine? Boy, was I wrong,” she continued. The congregation laughed. “I am sure the people here from Chelsea General will agree that when George was around, everyone was somehow better. Patients healed quicker, and doctors performed at a higher level. That was the magic of George. You see, George was not content to be a wonderful doctor himself. He wanted others to follow his high standards, and he was not afraid to rattle a few cages.” Many nodded in agreement. “You would never have expected it, but he was the most gifted clinician we have ever trained. He had more clinical acumen in his eyes than a room full of diagnostic equipment. More important, despite his sometimes bombastic ways, he was also the most honorable man I have ever met. You could always count on George to do the right thing. Good-bye my dear friend and student. You left way too soon.”
One of Villanueva’s old teammates followed. He limped up to the pulpit. He was a former NFL tackle named Vic Warren, whose gut now outreached his barrel chest. Warren rubbed his flat top, gripped the pulpit for support, and then told the story of Villanueva’s rookie year. In the NFL, rookies were routinely hazed. They would have to carry the veterans’ playbooks or do push-ups or other tasks on command. Some of the hazing was uglier still. A few of the older white veterans on the Lions tried to get a rise out of Villanueva with ethnic slurs, Warren said.
“I won’t repeat them here because we’re in a church and all,” Warren said. “Another thing rooks would have to do was sing their college fight song in the dining hall. Remember, this was long before hip-hop or rap or any of that crap.” Warren looked embarrassed and turned to the priest. “Pardon me, Father.
“George probably got it worse than anyone I had ever seen. I remember once walking into practice seeing a circle of veterans around Gato. They were taunting him while he was doing push-ups. He had done two hundred perfect push-ups while singing the Michigan fight song, ‘Hail to the Victors,’ at the top of his lungs. They had only asked for a hundred push-ups, but George didn’t want to leave any doubt that he could take whatever they threw at him and more.” Warren paused. “By doing that, I don’t know, George somehow let everyone know he was proud of where he came from but didn’t take himself too serious.” Warren’s eyes clouded with tears. “That was the kinda guy he was.”
Nick looked up briefly at the former football player, but tears came and he returned his gaze to the cathedral’s stone, his hands over his face.
Hooten followed Warren. This was the first time many of his former colleagues had seen him since his sudden departure from the hospital. Hooten wore his signature bow tie and stood ramrod-straight.
“How do we measure a man?” Hooten asked. He looked out over the congregation and let the question hang the way he might let a question about a surgical decision hang in M&M.
Sydney wondered whether Hooten might be asking the question about himself. She felt sorry that Hooten’s career would be marked by a terrible mistake as its final act, the kind of mistake he fought hard to prevent others from making.
Ty thought briefly of Quinn McDaniel and of his own brother, neither of whom lived long enough to become a man. Ty thought of himself. He could only measure himself by the goals he set for himself and the effort he put into them: He would always treat the patient’s family as though it were his own, and he would always push his skills to the top of his profession.
“George Villanueva was a man of enormous appetites,” Hooten continued. “That was obvious. He devoured life. He jumped in with two feet and invited everyone around him to jump in with him.” This brought a few smiles.
“I’m not telling anyone in this church anything he or she doesn’t know. I’m sure everyone in this room can think of a story. Some of them should wait until we’re outside church.” The mourners laughed, grateful for a relief from their grief, and Hooten waited for the laughter to subside.
“George Villanueva was remarkable in one other way. He was a doctor who upheld the highest standards. More than any doctor I’ve worked with, he did not let anything or anyone get in the way of providing the best care possible.” Hooten paused again. He was distracted by thoughts of the white supremacist. That was an aberration for Villanueva. He had let his prejudices—justifiable as they were—get in the way there. Hooten looked up at the packed cathedral.
“George just did not care whose feathers were ruffled. It didn’t matter if it was a homeless person who wandered in off the street or one of our civic leaders. George was absolutely passionate about making sure that person got the best care modern medicine has to offer. George was one of the rare doctors who—day in, day out—lived his ideals. So I ask you—all of you—when you walk out of this place. Honor George. Do your best to live your ideals.”
More hymns were sung. The organist played a somber recessional. And the mourners went out, blinking in a bright midday sun.
Driving back to the hospital, pulling into the enormous parking deck, walking across the footbridge into the original Chelsea General building, walking the busy hallways flush with patients, family members, house staff, doctors, administrators, there were no outward signs anything had changed at Chelsea General.
Patients entering the emergency room with a fractured leg or wandering up to the information desk looking for the newborn grandson or heading to radiology to learn if the persistent cough was lung cancer wouldn’t notice anything different. The hospital still inhaled the staff and the patients and exhaled the staff, the treated, and the dead.
For the doctors, nurses, and others who had been to Villanueva’s memorial service, reentry into Chelsea General came with a sense of emptiness. The Gato Grande’s ferocious, funny, and outlandish presence would no longer be there to cure, educate, amuse. They went back to their departments, reviewed charts, checked on patients, sat at monitoring stations but did so without energy. Time would fill this hollowness, and the memory of Villanueva would fade. His presence would be missed less, and his name would not come up as frequently. He would devolve in their collective memories into something of a caricature: a brilliant buffoon in giant scrubs.
Someone at the hospital had videotaped the funeral for the doctors, nurses, and techs who had to work. When Tina watched on a portable DVD player Sydney brought her, Hooten’s words stuck with Tina, and she repeated them like a mantra: “Live up to your ideals. Live up to your ideals. Live up to your ideals.” The words hung in the air like a dare. She had not been living her ideals, personally or professionally. In a flash, Tina realized what she needed to do, regardless of the personal consequences.
Ty Wilson, Chelsea’s greatest natural athlete, was walking down the operating room hallway. He had not a shred of self-doubt as he started washing his hands at the scrub sink. “Live up to your ideals,” he said. More than that, Ty knew in his heart that he was human. Medicine was a human profession. He made mistakes. All doctors made mistakes. The lapses arrived unannounced. They came in broad daylight, hidden from view by hubris or pride or ignorance or stubbornness. They arrived in the shadows, creeping behind inattention or distraction or fatigue. The medical errors were always there, waiting for their moment, waiting for human frailty.
After Quinn McDaniel died, Ty wanted to be forgiven for his deadly error in judgment. He thought forgiveness would make things right. If he could receive forgiveness from Quinn’s mother and his peers, he thought, that would be the first step to righting his wrong.
More than forgiveness, Ty had wanted to redeem himself. He wanted to do something that would somehow
compensate for what he had done. Part of him realized that simply wasn’t possible, and he froze. Doubt consumed him. No effort could undo what he had done. All he could do—all anyone could do—was learn from mistakes and move on—becoming a better doctor in the process, and hopefully teaching countless other doctors to do the same.
Sung Park was sitting on the porch telling Pat stories about Villanueva. The rare laughter she displayed during their romantic dinner now occurred almost every day. “He was at all-you-can-eat Chinese buffet,” Sung was saying. “He ate so much the owner come from kitchen and kick him out of restaurant.” They both started laughing. “But he was very special man. Whenever he go to restaurant, he always look around the room and pay for at least one table of people he didn’t know.” Pat smiled.
“I love you Sung, and I love that you remember your friend that way.”
Sydney walked into her new office and saw the picture Hooten had left behind. She picked it up and dusted it off. She stared hard at Hooten, and mouthed, Thank you, Boss, for everything.
CHAPTER 47
S
ydney sat down in the chair Harding Hooten had occupied for as long as she had been at the hospital. The cream-colored walls were bare, with nail holes where the framed photographs had hung, each marking a milestone in Hooten’s personal and professional life. Hooten as chief resident. Hooten with President Clinton when he had visited the hospital. Hooten with his son in his high school graduation cap and gown. And so on. Where the pictures had been, the paint was a little brighter. The sun hadn’t hit those spots, and the effect was odd, almost unsettling. A pattern of rectangles marked the walls on either side of Sydney, like ghosts of Harding Hooten’s career. Sydney remembered reading how the atomic bomb dropped on Nagasaki vaporized some of the victims, leaving only a shadow on the wall behind them.
