by Judith Lucci
Alex found Robert deep in thought when she returned.
He looked at her expectantly, his voice reserved as he addressed her, "Well, what are they?"
Alex turned papers in the file. "In November you did an abdominalplasty and a breast augmentation on Elaine Morial Logan. Now she's complaining that her new belly button's disfigured, and her breasts are too large. She's also complained that you were short-tempered and angry with her when she came in for her follow-up visit. Several weeks ago her lawyer called and threatened a malpractice action because his client maintains she never knew that her 'new' breasts were silicon and could possibly cause cancer."
Robert face flushed with anger. "That's a pile of crap. What bullshit. We discussed the silicon controversy in detail. Elaine Logan will never be satisfied with herself or her body. I didn't want to do the surgery anyway because I knew there'd be trouble, and her psychiatrist, Dr. Desmonde, agreed with me. All of this is noted in the medical record." Robert gestured angrily towards the file on Alex's desk.
"Why'd you do the surgery, Robert?" Alex gave him a curious look. She saw another flash of impatience as he responded, his voice disgusted and terse.
"It was political. I got a bunch of pressure from the hospital diversity committee. Apparently, she complained to some of the black physicians that I refused to operate on her because she was black. Of course, that’s BS as well. Consequently, the committee and Don insisted, pressured me to do the surgery. They wanted to avoid any negative publicity from the Morial Logan family."
Alex rolled her eyes, but she believed Robert's story. She continued, "Well, according to Don, Elaine Morial Logan is causing us considerable negative publicity in the black community. I don't need to remind you of her social standing or her network in New Orleans."
"Hell yes, I know their standing. I am from here, remember?”
Alex grimaced at his response. "Robert, be careful what you say. This woman and her family are potentially dangerous to us, both politically and economically. Her husband represents St. Bernard's Parish in the legislature. We're trying to get approval to build a new facility there. If her brother succeeds in his bid for mayor, CCMC will need him as a friend. We don't need the Morial and Logan families as enemies."
Robert shrugged it off, resigned, "Okay, Alex. Sorry. I still think you should be able to defend this. Where's the complaint now?"
"Well, it comes before the hospital risk and medical malpractice committee in two weeks. If Logan files, we'll settle out of court."
"That’s bull-shit. You can’t be serious. I've done nothing wrong." Robert, clearly angry, stopped for a moment. "If anything, I exercised extreme prudence by not even wanting to operate on this lady. I knew she was a problem. As far as I'm concerned, administration got me into this. They can damn well get me out. It's a set-up, and I'm furious about it. That’s the last time I’ll be their damn patsy. What else?" Anger was clear in Robert's voice as he slammed his fist on the table.
"The other complaint is an internal one lodged by several operating room nurses and techs who, at this point, must remain anonymous. They complained your behavior in the operating room is erratic and unsafe and that you are always short-tempered."
"This is preposterous! I have great rapport and working relationships with the OR staff. Who filed this? I don't believe it." Robert's face was suffused with anger.
"Robert, you know I can't tell you."
"Tell me what you can, please." He gave her his pitiful look she remembered from way back. She relented some.
"Well, mainly they complained of emotional and profane outbursts when you couldn't schedule your surgeries to meet your time constraints. You exhibited some, and I quote, 'acting out' behaviors. They also report that you yelled at them when a sterile field was set up incorrectly."
"Hell, yes, I was angry when they set the sterile field incorrectly the third time. That idiot, Bette Farve, keeps hiring these incompetent OR techs instead of RNs. Setting up the sterile field incorrectly delayed the surgery for forty-five minutes. Has anybody calculated what that cost the hospital in lost time and money? Besides, the patient had an additional forty-five minutes of anesthesia he didn't need -- that could have caused problems for him and us." Robert shook his head disgustedly. "What's the unsafe practice complaint?"
"It's unclear. Apparently one of your patients died during surgery and one OR staff member maintains the reason he died was because you incorrectly hooked him up to the heart-lung pump." Alex set the file down and looked hard at Robert.
His mouth flopped open. He was shocked. "That's absurd. I don't even do that, the cardiac techs do."
"This OR staffer says you rarely, if ever, check the settings on the pump. That's the unsafe practice complaint."
"Dammit, that's their job. They're licensed to do it." Robert stood and began pacing around Alex's office. "Something's wrong here. This is a witch-hunt. Has to be. I don't understand it. I need to go, Alex, and think these things over. I'll talk to you later."
As Robert left her office, all his attention was focused on the barrage of complaints against him. He didn’t see the tall dark-haired man with the swarthy complexion outside her door.
Alex decided to pack it in. It had been a long day.
Chapter 3
Alex walked home from the medical center. She lived in the Riverbend area of the city, less than a mile from the hospital. Crescent City Medical Center was located on Prytania, between St. Charles Avenue and the river, in the shadow of Interstate 10. The location allowed easy access to its hundreds of patrons. Alex's home was a few blocks off St. Charles and she could, weather permitting, easily walk back and forth. The horrendous New Orleans traffic made walking preferable to driving and the exercise benefits were another boost.
As Alex reached home, she smiled at how well the restoration of her house had turned out. She'd decided to live in the Riverbend area of New Orleans because the neighborhood was convenient to work, and she loved the architecture. She'd purchased a large town house shortly after arriving in New Orleans, and divided it into two apartments, renting the lower flat. The house was built in 1875 and was considered old “New Orleans”. Many of her favorite restaurants and shops were within walking distance.
When Alex reached her front courtyard, she was jarred out of her daydreaming as her cell phone began ringing. Searching for it in her purse, she opened the front door only to note the obviously loud ringing of her house phone. She answered and felt a pang of guilt as she heard the deep voice of Mitch Landry on the other end.
"Alex, you haven't forgotten our dinner plans have you? I've been calling and calling for an hour."
Alex smiled into the phone. "No, of course not. I'm sorry, I should have called you. I just walked in. It's been a long day, and, to be completely honest, I've been tied up all day. However, I'm starving, ready and willing, so tell me our plan." Her voice was light-hearted.
Mitch checked his watch. "Well, it's now about six-thirty. Pick you up at eight? I've reservations at the Café Degas for eight-thirty."
"Sounds great. See you then."
Alex hung up the phone, guilty about forgetting her date with Mitch. Most people would die for a male companion like him. He was handsome, intelligent, and well connected. As an architectural historian and preservation consultant, he'd never be wealthy, but money seemed unimportant to him. Mitch was a pleasant escape from her day-to-day grind at the hospital and offered refreshing company. Besides, Mitch was very sexy, and she really liked him.
Her spirits brightened as she showered, dressed for her dinner date, and found herself mentally comparing Mitch with Robert. They were entirely different, she thought, in appearance and personality. Mitch was tall and dark with a muscular build. Robert was of slighter stature with much lighter coloring. Both men had a fervent passion for their work and both men were self-absorbed in their careers.
This is ridiculous. Why should I compare these two? My marriage to Robert has been over for years. It's crazy for me to
even be thinking this way. Robert's completely out of my life. But, in all honesty, Alex had to wonder about her reaction to him today in her office. She heard the doorbell ringing and saw Mitch standing between the two Grecian Columns in her courtyard. She answered the door, her heart beating rapidly.
Mitch looked devastatingly handsome as he stood in the doorframe. He was perfect, too perfect Alex sometimes thought. But he sure looked good in dark trousers and a white shirt open at the neck. And he was in excellent physical shape and Alex knew he worked out most days. His wavy dark hair was combed back from his face. He was tall, dark, handsome, and exciting.
Alex's heart began beating a little faster at the sight of him. Once again, she wondered why Mitch, whom she'd been seeing exclusively for over four months, was reticent to start a physical relationship with her. At first, Alex had been relieved that Mitch hadn't pressured her into intimacy. Yet, several times she'd felt vulnerable and rejected at the end of the evening. It was probably residual feelings that stemmed from the rejections of her father and Robert. More recently, Mitch seemed to be moving towards intimacy again, although his usually warm and inviting conversation often became stilted and aloof at the close of the evening.
Mitch's eyes lit up at the sight of Alex, and he appraised her admiringly. "You look great... That teal color of your dress sets off your eyes, and I like your hair down. You look so carefree and comfortable." Mitch groped for the proper words.
"I know, relaxed and casual. Bridgett tells me the same thing. I guess I must look like an old maid at the hospital. To quote my idiotic boss, 'I have to dance with the big boys, so appearance is important'." Alex paused for a moment and inhaled the fragrance of the spring flowers. "These flowers are beautiful. How about a glass of wine?"
"Sure. I told Andre at the Café we might be a little late. Do you have any of that Virginia Chardonnay we enjoy so much? I'm pretty impressed with Virginia wine."
"The Chardonnay is from Barboursville Vineyards, near my grandparents’ farm. Help yourself. I also have some Brie, heated with honey and almonds, on the coffee table in the living room. I'll be in as soon as I arrange these flowers."
Mitch poured two glasses of the Chardonnay in Alex's wine glasses and gazed appreciably around her living room. The furnishings were impeccably beautiful, simple, and elegant, just like Alex. It's funny how people reflect their homes, Mitch mused, as he studied the lovely walnut library cabinet on the wall opposite the sofa. As his eyes continued to survey the room, Mitch again noted the architectural design of the flat. The heavily carved mantels and decorative woodwork in the living and dining rooms were left natural, and pale blue silk wallpaper pulled together the pastels in the living room.
Alex returned with the fresh flowers in a cut-glass vase, which she placed on the dining room table. She sat on the sofa next to Mitch. After reaching for her wine and taking a sip, she asked, "How's your newest project going? Did you get your historical foundation funding for the Arcadia Village Project?"
Mitch's face showed the animation he felt for his newest project. He was the project director on a plan to restore several historical structures in southwest Louisiana. He was excited about the project. Since most of his work was in the French Quarter and in the Garden District, the opportunity to work on rural preservation would display his knowledge and ability in the areas of Creole and Arcadian architecture.
Mitch smiled and answered her question. "Yes. It's great. Next week I begin the Arcadian Village in Lafayette. Would you like to visit the project? It's a nineteenth-century Cajun settlement and it represents rural Louisiana.” He continued, "Let’s plan a weekend soon so you can see the work as it unfolds.” He looked at his watch.
Alex warmed at the possibility of a field trip to Mitch’s architectural projects. “So I can have a full appreciation of your talents,” Alex teased. “I would love to. When can we go?”
"Soon, but I haven’t done anything yet.” Mitch glanced again at his watch and said, “We had better get going. We don't want to keep Andre waiting too long. I’d hate to lose our table."
As they left her apartment and walked toward Mitch's car, Alex again savored the New Orleans night, and the fragrance of lilac and wisteria created an aura of romance. The pair decided to walk home. As Alex slipped her hand into Mitch's, she felt him stiffen slightly. She felt rebuffed and wondered why he continued to see her. He doesn't seem to have any sexual interest in me, so what’s this all about, she thought. I don't understand his reticence. We go together well and have similar interests. He did seem to care for her and was warm and generous with his time and his gifts. Besides, she liked him better than she liked any male companion she'd had since her divorce. That made it even harder to accept.
The ambiance at the Café Degas was perfect. Like many fine restaurants in New Orleans, it had an eclectic decor. There were no sidewalls, only louvered shutters in case of extreme cold or rain. The evening was almost warm enough for al fresco dining, but Mitch, fearing the night would turn cool, ushered Alex to a table in the corner.
The cuisine was excellent. After listening to the specials, Alex chose beef and Mitch selected crepes.
Their dinner conversation revolved around various topics.
"Your grandfather's in town. Read about it this morning in the paper. How's he doing?"
"Great. I talked with him earlier. He has a meeting tonight and he's leaving late tomorrow. We're having drinks tomorrow afternoon."
"Are he and your grandmother staying with you?"
"My grandmother isn’t here. He's alone and staying at Palm Court. It's a quick trip. Some political brouhaha, I’m sure. He's especially good at those." Alex smiled, thinking of Adam Lee's particular talent for making people see things his way. "My grandmother swears the Congressman could make a leopard change his spots if given enough time."
Mitch noticed her smile. "You're close to them, aren't you? Any chance I'll ever get to meet him?"
Alex was surprised and taken back. "Umm, no. I doubt it, at least not this visit. He's tight for time. I'll introduce you to both of them later. They'll be here in June for another meeting." A warm flush come over her face. She felt a little guilty about denying him the chance to meet her grandfather. She hoped Mitch was not offended by her response.
Recognizing her embarrassment, Mitch reached for her hand. "It sounds good to me. Are you ready for the Extravaganza Saturday night?"
Mitch had invited her to the costumed ball sponsored by the Krewe of Endymion. The Endymion Extravaganza was this weekend and was the largest and most lavish ball in New Orleans.
Alex had been anticipating the ball for weeks. She'd gone overboard in having Yvonne LaFleur design a sumptuous gown for her, justifying the purchase with the idea she could wear it again in a few years. Alex was hoping the Endymion Extravaganza would be the beginning of an intimate relationship between her and Mitch. They'd decided to stay overnight at the Fairmount Hotel, the night of the ball, and had plans to spend the weekend in the Quarter. She smiled in anticipation.
"Alex, am I boring you? Why are you smiling? You're in another world." Mitch's eyes were warm over the candlelight.
Alex was immediately apologetic. "Sorry. I was thinking about the Extravaganza and how much fun we're going to have. I'm looking forward to it. What were you saying, Mitch?"
"Nothing important. How about some café au lait and cheesecake? I'll buy the whole thing and you can take it home. I know how much you love it. It'll be the perfect ending to our meal."
Alex nodded in agreement.
"How are things going at the hospital? You seem a little distracted tonight?"
"Busy. Healthcare is changing everywhere, and we are trying to prepare for the changes the Affordable Care Act will bring in. Of course, no one understands Obamacare. Nobody understands the health care bill. Not even Obama. The legislation is over 1,000 pages! There are all kinds of fears and concerns over health reform and the entire healthcare industry is fiercely competitive and focused on cheap care
but good results. I know it’s going to cost us millions and we will see significant job losses in health care providers, especially nurses, because reimbursement will decline. Most small to medium size hospitals are estimated to lose at least a million dollars a year in Medicare reimbursements.” Alex noticed that Mitch was paying rapt attention and continued, “Obamacare includes $575 billion in cuts to Medicare to pay for a Medicaid expansion to provide health care for the poor, but these cuts are going to hurt those of us in acute care. The elderly are our most expensive and costly patient population. It's very competitive here, more than in most places, or at least that's what I hear from my colleagues. Look what's happened here in the past few weeks. American Hospital Corporation bought 80 percent of Tulane for $180 million. Then, they immediately merged with Health Quest and formed another huge conglomerate. Health Trust, as it’s known, now owns twenty-five hospitals in Louisiana. It's going to be difficult for smaller hospitals to compete with these big boys." Alex paused for a second, thinking, then continued, "Health Trust even has international holdings, and when you factor national health insurance programs into it, the times will be dangerous at best and the outcomes and quality of care uncertain. Most experts believe care will be substandard. These huge conglomerates are buying up hospitals in Europe, specifically in England and Switzerland, and I understand they're even negotiating with hospitals in South America. Makes you wonder who'll still be in business in a few years with the fierce competition. It’s a turbulent time for healthcare," Alex added.
Mitch responded, "How many hospitals can they buy without it being a monopoly?"
Alex looked speculative. "All but one, I suppose. I'm not as worried about monopolies as I am about legal risks and cost-cutting to save money on patient care. Hospitals are struggling to survive. These mergers and buyouts affect a hospital's credibility and image. Obamacare is going to make things even harder and more expensive. Look what's happened recently in Florida and in Boston, especially the hospital that gave 10 times the amount of chemotherapy drugs and killed the patient. These errors are tragic and have long-term consequences. It'll take those hospitals years to recover from the negative publicity."
