Extreme Measures

by Michael Palmer

  "The point is that the whole goddam hospital knows what we did.

  This Caduceus may see you as someone who might be willing to bend the rules a bit in the interest of getting some stuff done around here; something that hasn't been approved by the H.E.

  Committee. Isn't that what it sounded like?"

  "Sort of. But that damn electrolarynx sure gave the whole thing a sinister cast."

  "Regardless, we should know whether or not the guy is for real in a few hours."

  "What do you mean?"

  "Well," he said, "if Marshall gets that job in the E.R I think you can safely say that Caduceus is a bag of shit."

  "What if I get it?"

  Subarsky lowered his skateboard-sized feet to the floor," In that case, my friend," he said, "I guess you won't really know."

  The administrative wing of White Memorial, located on the ground floor of the Drexel Building, was designed to impress. Crystal chandeliers overhung Oriental carpeting, and cracked, ornately framed oil portraits lined the walls.

  Guarding the entry to the corridor, a busty, broad shouldered receptionist coolly appraised Eric from behind a Louis XIV desk.

  "I'm Dr. Najarian," he said. "I'm here for a committee meeting."

  After spending several hours with Subarsky, he had returned to his apartment and changed-first into the dark suit he had last worn at his med school graduation, and which he ultimately decided was woefully outdated; next into brown slacks and a tweed sport coat that turned out to have a two-inch tear along one shoulder seam; and finally into gray trousers and his navy-blue blazer. It was fortunate, he acknowledged, that he wasn't any more nervous about the meeting, because the search for the right attire had spanned his entire wardrobe. still, the receptionist seemed to approve of the result.

  "Dr. Teagarden's committee?" she asked, smiling and pushing her shoulders back just a bit.

  "That's right."

  "Well, they're just getting started. She asked me to have you candidates wait down there in the sitting room."

  "um… exactly how many of us candidates are there?"

  "Oh, just two. Dr. Marshall's already there."

  "What?"

  "He's been here for half an hour."

  "Bad."

  "Pardon?"

  "Nothing. Listen, thanks. Thanks a lot."

  "No problem. If you need anything, my name's Susan."

  Eric thanked her again and headed down the corridor.

  "Anything at all," he heard her say.

  "So," Eric said as he entered the plush sitting area, "you're the other candidate the receptionist was talking about. what a surprise."

  "Just a second," Marshall said, engrossed in a book, which Eric managed to see was something by John Updike. "I just want to finish this page.

  Updike's some talent, don't you think?"

  "I haven't read him." In fact, Eric reflected somewhat wistfully, he hadn't read anything outside of medicine in longer than he could remember.

  "Well, then," Marshall said with genuine enthusiasm, "you've got a real treat in store."

  With his tortoiseshell glasses and aquiline features, Reed Marshall resembled Clark Kent, and in fact was called that in some quarters of the E.R.

  Eric settled into a high-backed oxblood leather chair and watched as Marshall finished. The two of them had known each other since internship, and had shared many of the victories and much of the heartache that went with becoming a physician. 'two years older than Eric, Reed had a wife, a son, a circle of successful friends, and virtually universal respect around the hospital.

  Initially, Eric had been put off by Marshall's patrician roots and Harvard education, and by an aloofness that Eric interpreted as snobbishness. But one night, as they sat sipping coffee after working side by side on the casualties of a multivehicle catastrophe, Reed confessed that he was envious of Eric's coolness under fire.

  "That's crazy," Eric had replied. "You're the iceman Everyone in the E.

  R. knows it."

  "What I am," Reed said, with deadly seriousness, "is scared to death of freezing up or of doing the wrong thing, and even more terrified of having anyone know how I'm feeling. In fact, I can't believe I'm telling you this."

  "Hey, don't worry. Nothing you say win ever leave this room.

  You're just exhausted right now, that's all.

  Believe me. I'm frightened at crunch time too. How could anyone who's human not be?"

  "I didn't say frightened; I said terrified. I want to laugh when someone says I'm as good at this as you are."

  "Listen, Reed," Eric had said, "this isn't a contest.

  We didn't select ourselves for this residency-all those professors did.

  Our job is just to do our best. And believe me, your best is damn good."

  Beginning with that night, a mutual respect, almost a tacit friendship had grown between them.

  And over the years that followed, not once had either of them mentioned the exchange again. As far as Eric knew, Reed had come to grips with his dragons. Eric believed that in terms of knowledge, dedication, and rapid response to life-threatening emergencies, he held a definite edge on Marshall. But there were other intangibles-Marshall's dry wit, poise, and eclectic intellect-that made any choice between the two of them difficult.

  "Any idea why they sent for the two of us at once?" Eric asked after Reed had set his book aside.

  "Nope. All I've heard is that they've made their decision.

  Knowing ol' Grendel Teagarden, we'll probably learn that some hard-nosed woman from Stanford has been recruited for the position, and you and I are gonna be out of work."

  Teagarden, the tyrannical chief of surgery, was as renowned for her outspoken feminism and undisguised partiality toward female physicians as she was for her skill in the O.R. Her volatile capriciousness had made or broken any number of careers.

  "Are you sure you want this job?" Eric asked.

  Marshall grinned.

  "I'm sure Carolyn wants me to want it. You're not married, so you don't know that that's quite enough."

  He laughed somewhat wistfully. "oh, I want it, too, Eric," he said finally. "It'd be foolish to say I don't, although even I can't say how much. Put another way, my ulcer may be rooting for you, but my ego is pulling for me. Still, I see the whole question as moot because I have no doubt I didn't get it."

  "Nonsense."

  "This from the man who not only is a legend at his work, but who just happens to have saved a trustee's life."

  "He never even sent me a thank-you note."

  "Jesus. Well, that's no surprise, given the holier than-thou philosophy of this place. Speaking of which, before we get called in there, I want to thank you for doing your best not to make a big deal out of all this."

  It was Eric's Turn to smile, "You mean not openly," he said.

  "Of course. The whole damn committee has been doing its best to set us at each other's throats, privately and in public."

  "The famous WMH pyramid."

  "Exactly. Room for one and only one at the top.

  Survival of the nastiest. We both deserve a pat for not taking their bait. I know how much you want the position, and the real truth is, if it didn't mean so much to Carolyn to stay around here, I might have actually considered pulling out of the running.":'You don't have to say that."

  "It's true… Well, at least, it might be true."

  "I wonder what in the hell they're doing in there," Eric said.

  "Two-on-one with Grendel?"

  "God, what a prospect! If so, my money's on Teagarden. Say, listen, does the name Caduceus mean anything to you?":'Aside from the obvious?" 'Aside from the obvious."

  Reed Marshall shrugged and shook his head. "No bells," he said.

  "Why?"

  "Nothing. Maybe later we can-"

  The door to the conference room opened and Dr. Joe Silver stepped out.

  A ferretlike man in his late forties, Silver stood no more than five foot five in the two-inch lifts that,
rumor had it, he wore even to bed.

  He had been the chief of emergency services for five or six years, and ran his office in an autocratic manner that would have made Napoleon proud. He was knowledgeable enough, but he had no sense of people's needs or how to deal with them straightforwardly. And over their years of association with the man, neither Eric nor Reed Marshall had been able to develop anything approaching a warm relationship with him.

  "Gentlemen," Silver said, "we apologize for keeping you waiting.

  If you'll both come in please…

  Both? Eric wondered why the committee would do something so insensitive. Surely, after three months, and interview upon interview, it would have been more appropriate to speak with the losing candidate alone. He thought back to the eerie call. The caper, whoever he or she-was, seemed so confident of being able to affect the selection process. Was Joe Silver Caduceus? It was so like the man to play control games with people.

  The committee was seated at a massive hardwood table, with Sara Teagarden at the head. She was a large, androgynous woman with close-cropped auburn hair and gold-rimmed granny glasses. That day she was dressed in a royal-blue suit with a large pearland-diamond broach on the lapel. It was an outfit that somehow made her appear even more intimidating than usual. As she welcomed them Eric tried unsuccessfully to match the cadence of her voice with that of the caller.

  Joining the heads of surgery and emergency medicine on the search committee was Dr. Haven Darden, the chief of medicine. The highly publicized demise of Craig Worrell, the former associate director of emergency services, had bathed White Memorial in an intensely unfavorable light, and the high-powered makeup of the search committee underscored the hospital's determination to put the whole- matter to rest. Silver, Teagarden, Darden-Eric had not faced a panel such as this one since his internship application days. He wondered if the triumvirate was about to take the WMH pyramid philosophy to the limit by engaging the two of them in a medical quiz-down.

  As if reading Eric's mind, Haven Darden said, "Now don't get worried, you two. We're not about to start firing clinical problems at you."

  Of the three committee members, Darden, a tropical medicine specialist, was the one Eric felt was least in his corner. Like Reed Marshall, he had come straight up through the Harvard system. Unlike Marshall, though, he had risen from abject poverty. His life, from his illegitimate birth in a ghetto in Port-auprince, Haiti, through his escape to the United States and his subsequent adoption by a wealthy black physician, had been chronicled in various Harvard publications.

  There was a rumor that somewhere not far down the line, Darden was slated to become the first black dean in the history of the university.

  His detractors, and there were a number, pointed to his inability to make any major research contributions to his field.

  But his reputation for clinical brilliance kept all but the most vociferous enemies at bay, and residents often jockeyed their schedules to be on the wards when Darden visited.

  Darden's English was clipped and precise, with just the hint of an accent. And unless he could change his speech radically, Eric decided, there was no way he could have been the caller. He struggled to force thoughts of Caduceus from his mind and to concentrate on the business at hand. In a minute or two the committee's decision would be known, and the whole bizarre affair would most likely be exposed as a hoax.

  "Gentlemen," Sara Teagarden began, "we don't wish to drag this business out any more than you do.

  However, I am sure you know that we are trying to recoup some pretty heavy losses in the public's confidence in our hospital, and in particular in our emergency service. I would like Dr. Silver to explain how and why we have arrived at our decision. But first, I would like to be certain that both of you are still interested in becoming his associate. Dr. Marshall?"

  "I'm still in."

  "And Dr. Najarian?"

  "Yes "Very well. Dr. Silver, will you please explain our current position."

  Eric gripped the edge of his chair as Joe Silver straightened his notes and adjusted his reading glasses.

  "Reed, Eric," he began, "I first want to congratulate each of you for the impression you've made on this committee, and also to thank you on behalf of President Tertensen, the trustees, and all of White Memorial for the marvelous years of service you've rendered here. As you know, the previous associate E.R. director brought us more ill will and bad ink than any hundred other doctors who have ever worked here combined…

  Despite the tension of the moment, Eric and Reed exchanged amused glances. Craig Worrell had gone to the well of his perversion once too often, and had been videotaped soliciting sex from a young woman emergency-room patient in exchange for a hefty narcotics Prescription.

  He was arrested soon after in his BMW in the hospital garage as he urged the undercover policewoman to hurry up and get on with her Part of the deal so that he could return to duty. The entire Boston press and TV corps seemed to have been present for the bust. A month later, while free on bail, Worrell vanished. Since then there had been rumored sightings of the man, but nothing more.

  Silver continued, "We three are understandably, I think you'll agree, reluctant to make a final choice if there is the slightest uncertainty.

  We know that you expected a decision today, and we appreciate that this may seem cruel, but we have voted to, ah, put off making our selection for perhaps another two or three weeks. If this decision puts either of you in a position where you need to withdraw your application, please tell us at this time."

  Silver's pronouncement hit Eric like an uppercut.

  No decision-the one option he hadn't considered. But the committee had made a definite choice. At least, that was what Silver himself had intimated not two days before. What in the hell is going on?

  Eric stared at his chief and then, one at a time, at the others on the committee. Their faces seemed plastic, unreal.

  Eric'? Excuse me, Eric?"

  "Huh? Oh, sorry."

  Silver looked at him oddly.

  "Eric, Reed here has indicated that he is willing to put matters on hold for two or three more weeks.

  We're waiting to hear whether or not you can do the same." Eric battled to bring his thoughts together.

  "Of course," he heard himself say. "It's fine with me to wait."

  The plastic faces grinned approvingly.

  "Excellent," Sara Teagarden said. "Dr. Darden, have you any comments?"

  The internist looked first at Reed, and then at Eric.

  "I would only beg you gentlemen's forgiveness and understanding in this matter. If it were possible, I believe we would choose to keep both of you. However, things being as they are, and with the trustees and press watching our every move, there are a few more avenues we wish to explore, a few more inquiries to make. If either of you has problems or questions, I am sure any of us would be happy to meet with you."

  Without further comment, Sara Teagarden hoisted herself to her feet, shook hands with the candidates, and adjourned the meeting.

  "You okay, Eric?" Marshall asked after the others had left. "You look green."

  This is bullshit. Absolute, insane bullshit, Eric wanted to holler.

  Instead he just shrugged.

  "Sure, I'm fine," he said. "I… I had just prepared myself for a decision today one way or the other."

  "Me too. I ran into Teagarden just yesterday, and she made it sound as if it was all over. I even had the feeling from things she said that you had gotten the job. I didn't want to say so out there, but it's the truth.

  Well, listen, I'm due back at the E.R so I'll see you later.

  It's only another couple of weeks." He punched Eric lightly on the arm.

  "You keep your nose clean now, ya hear?"

  "You too," Eric said. "You never know when big brother-or big, big sister-may be watching."

  Eric stood motionless as Marshall hurried off. The two of them had never spent any real time together outside of the hospital. Now, as th
eir time at WMH was nearing an end, he wished they had.

  Susan, the receptionist, was watching Eric as he approached.

  "How'd it go?" she asked.

  "It didn't. Nothing happened."

  "Well, committees are like that. I've taken minutes at some meetings, and you wouldn't believe how little a group of M.D.'s can get done."

  "You said it. Well, see you in a couple of weeks."

  "Wait, " she said. "I have something for you."

  She handed him a plain envelope. DR. ERic NAJARIAN was printed on it in a meticulous hand. Eric's knee-jerk reaction was that the envelope was a note from her, but he quickly realized from her expression that it was not.

  "A candy striper dropped this off for you a little while ago," Susan said. 'She was real cute, but a little too young for you, I think."

  Eric was too distracted to pick up the.woman's cue. He fingered the envelope for a moment.

  "Thanks," he mumbled, and headed off.

  "I'm here all day," Susan said.

  Eric turned into the main corridor of the hospital, and then leaned against a wall and tore the envelope open. The note inside was printed in the same hand as was his name.

  WEAR THIS, AND WE WILL KNOW, was all it said.

  Wedged in one corner of the envelope was something metallic.

  His fingers stiff and cold, Eric pulled out the object and held it so that no,passerby could see. it was a stickpin bearing a black oval stone, possibly obsidian. Inlaid in the stone was a finely tooled gold caduceus.

  April 9

  "Name?"

  "Laura Enders. I already told you that."

  "No, ma'am. I have your name. I need the name of the guy who's missing."

  "Oh. It's Scott Enders. But he's also called himself Scott Shollander."

  "A.k.a. Shoflander," the desk sergeant mumbled as he pecked out the name on his typewriter.

  Laura was just a few minutes into her session with the Boston policeman, but already she wished she could leave. Although he hadn't introduced himself, his name tag read SGT. THOS. CAMPBELL. He was a red-faced, potbellied man, probably in his late fifties, obviously burnt out and totally unenthusiastic about his job. And the more she listened to her own answers to his questions, the more she knew there was no chance he would be of any help.