by Allen Wyler
Just then, out of nowhere, Anne announced rather loudly, “Right now, this very moment, I could go outside, get in my car, and drive straight off a cliff, and no one would give a damn.” Her heavily bagged eyes stared at a distant point beyond the wall behind Alex.
Uneasy silence came over the table as all eyes turned to her. She dropped her dejected gaze to her untouched plate of catfish and drained the double Johnny Walker Red in her right hand.
She serious? He glanced at Garrison, who simply continued to rock the ice in his glass of scotch back and forth, seemingly unconcerned and as inscrutable as ever. Lisa shot Alex a told-you-so glance.
Andrew cleared his throat. “Yes, well, the way it works here is you must have a member—either Garrison or myself, but Garrison’s been around the longest, so he’s the natural one for the task—to host you here in the men’s bar two or three consecutive Thursdays. Thursday evenings are when the membership committee convenes for a bit of conviviality. Protocol is for him to introduce you so you may chat them up, tell them a bit about yourself. If they decide they like you, you’re invited to hand over an outrageous initiation fee. This is how the application process works. Right, Garrison?”
Lisa, still staring at Anne, began to say something when Alex almost imperceptibly shook his head. He asked Andrew, “How is a person supposed to know this?”
Andrew made a face. “I assume you’re to know this from being told so by your sponsoring members. Serves as an internal selection process of sorts.”
“I’ll bring you down next week if you like,” Garrison quickly volunteered.
“Wait a sec.” Alex held up his hand. “What does this place have to do with the university?”
Andrew laughed. “Seriously? Absolutely nothing. Why?”
For a moment Alex was slack jawed. “Well, the name is the University Club.”
Andrew paused to sip water. “Only because an applicant is required to hold a university degree as a prerequisite for membership consideration. Nothing more, nothing less.”
This made no sense. “Because?”
Andrew nodded for Garrison to answer.
“The club originated in a, uh, political period much different than now,” Garrison said. “By requiring a university degree, a segment of society was automatically excluded from membership. Well, I guess excluded is a harsh word, but I can’t think of any other way to explain it at the moment.” Garrison seemed to struggle for the right words, perhaps aware the others at the table might be a tad more socially liberal than the club’s forefathers.
“You mean African Americans?”
Garrison nodded. “Well, them too.”
“Them too? Who else isn’t allowed membership?” Alex asked in shock, now wondering if squash remained a sufficient reason to join.
“Jews aren’t allowed in either,” Garrison said matter-of-factly.
“Are you serious?” Alex saw Lisa roll her eyes.
Lisa held up her hand. “Wait a minute, back up. I want to ask about the ‘men’s bar,’” she said, using finger quotes. “What’s that all about?”
Garrison smiled, perhaps aware he was about to ruffle her feathers further. “Women aren’t allowed in here except for the Friday dinners, like we’re having now. Otherwise …” he simply held up both palms in an I-didn’t-make-the-rule gesture.
“And the point of that silly rule is?” she asked.
“The way it was explained to me,” Andrew said, “is that this area provides a sanctuary, a place where a man is able to enjoy a drink with fellow members without worry of being disturbed.”
“You’re—”
Andrew continued, “Should a wife call looking for her husband, the bartender—who knows every member by name—will hold up the phone for all to see and call the man’s name. If said man wishes to not be disturbed, he’ll not say a word. The bartender will then tell the wife he’s not here.” He raised his eyebrows as if to be held innocent of the misogynous attitude of the club’s Board of Governors. Alex was having difficulty deciding whether Andrew bought into the idea or was being sufficiently diplomatic to thwart any blowback to his executive position with Proctor and Gamble. Did the Canters join purely to satisfy social commitments required of him at work, or did they seek a self-image status symbol? Just another ambiguity that made them a curiosity to Alex.
“What if a single woman applies for membership?” Lisa asked, obviously irritated.
Garrison shrugged. “She should know enough not to.”
Lisa turned to Anne. “C’mon, let’s go to the little girl’s room.”
“Clyde, I’d like you to meet a new partner of mine, Alex Cutter.” A scotch and water in hand, Garrison was standing next to the polished oak bar with one foot on the brass rail; it was the first Thursday evening since the enlightening catfish dinner.
A ruddy-faced, overweight man swiveled away from his cronies, recognized Garrison with a smile, then looked Alex up and down. Having sized up the situation, Clyde extended a meaty right hand, his other hand still gripping a tumbler of amber liquor. “You another brain cutter?”
“Guilty as charged, sir.” Alex shook hands. Can’t believe I’m actually stooping to this.
“Where y’all from?”
Nothing like getting straight to it. Alex filled him in on his background. Several of the men were smoking cigarettes, the polished wood bar scattered with heavy, amber-colored glass ashtrays which the black bartender constantly emptied and wiped clean.
“Alex’s a squash player,” Garrison said. “Been fixing to join the club so’s he can play. Got himself a pretty little bride who’d love to run around the tennis courts in one of those short white skirts.” After jokingly elbowing Alex, he explained, “Clyde here chairs the membership committee.” He gave a wink only Alex would see, Garrison now fully into his back-slapping good-ol’-boy shtick that seemed suspiciously natural for a man who grew up on an Iowa farm.
Clyde introduced him to the man on his right, and then the two began double-teaming him while Garrison faded into the sidelines, letting the little drama play out without him. Alex felt slimy for sucking up to these men but kept telling himself maybe they really were good people. As the conversation continued into right-wing politics, Alex quickly realized he had nothing in common with them. For the sake of obtaining a membership, he played along with the charade.
They were well into their second bourbon when one of the men seemed to scrutinize Alex more closely. “You Jewish?”
The other men’s eyes turned to him. Stunned, Alex was at a loss for words.
“How did it go?” Lisa asked, following him into the bedroom. “Will we be allowed the privilege of joining such an exclusive pinnacle of high society?” She still hadn’t adjusted to the concept of the men’s bar.
Dead tired, Alex wanted nothing more than to go straight to bed, to become horizontal and relax his aching lower back. Days were quickly becoming fuller than he’d ever imagined possible, his caseload exploding, a sign the referring physicians and patients respected his skills. “Take good care of the patients and communicate with the referring docs” had been Waters’s two-step recipe for building a successful practice. Alex was impressed at just how simple but effective the strategy—especially coming from a died-in-the-wool academician—turned out to be. But it was like any other business, he supposed; good customer service generates more business.
“We’ll see. Jesus, I can’t believe I spent an evening sucking up to four flaming John Bircher bigots right out of Two Banjo country. One even had the audacity to come right out and ask if I’m Jewish.”
Lisa giggled at that. “What’d you tell him?”
“I asked him if I looked Jewish. They didn’t push it after that. How was your day?” He moved into the bathroom to lay out his wallet and keys in case of being called in, despite not being on call that night.
“Great. I’m really getting into working at the thrift store.”
He smiled, pleased at the joy in her words. In their
prior life Lisa didn’t have hobbies or other outside interests, devoting most of her energies to her job. Now she was volunteering for a cause she felt passionate about—animal welfare—and the satisfaction clearly came through in her voice.
35
“Been looking for you,” Reynolds told Alex. They crossed paths in the surgeon’s lounge, Alex preparing to start two routine craniotomies. Reynolds settled into the couch next to him and lowered his voice. “Friend of mine is on the study section that reviewed your grant. What I’m going to tell you is obviously confidential, and if you repeat this to anyone, I don’t care if it’s the Virgin Mary herself, I’ll deny every word before I drive a spike through your heart. We absolutely, one hundred percent clear on this?”
“We are.”
“Two members of that group are big buds with your best friend, Weiner. Seems when your grant came up for discussion, everybody but those two loved it and gave it high enough scores to be funded. Weiner’s buddies torpedoed it.”
Alex’s heart sank. “It won’t get funded?”
Reynolds appeared genuinely distressed with the news. “Nope.”
Alex sat quite still, not even breathing, his shock morphing to rage. “You absolutely sure about this?”
“Hell yeah. And I’m wondering if this has been the problem with your funding all along.”
Before Alex could respond, a nurse stuck her head in the room and made eye contact. “Doctor Cutter, we’re ready in Room Three.”
“Doctor Cutter?”
Alex glanced up from the heavy Zeiss operating microscope, a twinge of pain shooting down his spine from the sudden change in posture. According to the twenty-four-hour wall clock, he’d been working in the same position for two straight hours. He arched his back and rocked his neck back and forth in an attempt to loosen it up. “Yes?”
The circulator stood next to Cole, peering over the drapes. “Doctor Berger wants your help. He’s across the hall in Two.”
Can’t you see I’m in the middle of a case?
Alex paused to inspect his gloves, making sure there was no rip, an automatic habit of his anytime he stepped away from a surgery. “What’s the problem?”
“Don’t know, but he says he needs your help,” she replied in an apologetic tone. Because of an increasing surgical caseload, Ellen had taken to assigning the same crew each day. The OR personnel were becoming as tight-knit as family, protecting each other when need be.
Alex handed the suction and Cushing forceps up to Chuck Stevens. He was in the middle of resecting what had turned out to be a glioblastoma. In spite of having suspected the diagnosis from the characteristics in the CT images, it was always depressing when pathology confirmed it. No matter how many times it happened, Alex would never become desensitized to the sadness of that diagnosis. Malignant brain tumors were a deeply depressing fact in an inherently depressing surgical subspecialty. Worse yet, the patients universally seemed to be good people. Not that he’d feel any better about making the diagnosis on a real asshole.
“Lawrence, I want you to sit here and wait for me,” he said, draping a damp surgical towel over the craniotomy opening to keep the exposed brain moist. “Chuck, irrigate this every few minutes and don’t give Lawrence an instrument unless it’s a flaming emergency. And if an emergency does happen, have someone come get me before you dare hand it to him. I’ll want to gown and glove again when I get back, so might as well get those ready.”
Chuck and Lawrence laughed.
“What’s up?” Alex asked, backing through the door into Berger’s room to protect the sterility of his gown and gloves.
“Can’t find the tumor.” Berg stood at an open craniotomy, cleaning his gloves with a wet lap-pad. Alex preferred to sit when operating, elbows propped on a draped Mayo table. This set-up provided superior stability, plus his legs didn’t get as tired. He never understood why most neurosurgeons stood to operate, especially considering having foot controls for the cautery and power tools. Steve Stein stood next to Berg, holding a sucker.
Alex stopped at the X-ray view box to read the CT. A mass the size of a nickel lit up about two centimeters below the surface of the right frontal pole, producing a modest amount of edema. The well-defined borders and degree of edema suggested it likely was a metastatic tumor. He noted the patient’s name: Yolanda. Age sixty-two. “She right- or left-handed?”
“Right,” said Stein.
This put the odds overwhelmingly in favor of the tumor being in the brain hemisphere that didn’t control speech, increasing the likelihood of getting away with an aggressive, more complete removal. The bad news was that if the tumor was metastatic, she would undoubtedly have additional ones the CT didn’t show. Alex held out his arms for the circulator to strip his gloves. “I’ll reglove but not regown.”
Carefully, making certain to not contaminate Alex’s gown, the circulator peeled off the gloves.
“Lot of pressure in there,” Alex said, wiping off his new gloves with a wet lap pad. The increased pressure from the tumor and edema pushed glistening brain surface against the path of least resistance, bulging it out of the craniotomy opening. “Give Ultrasound a call, ask them to join us,” he said to the circulator, then turned to the scrub tech. “Blunt-tipped biopsy needle, please.”
While the scrub tech searched her instruments for the needle, Alex probed the sterile drapes with his fingers, feeling for the bridge of the nose and the two eye sockets. They would provide landmarks with which to orient the exact skull position, which was obscured by the drapes. Keeping his left index finger and thumb on the bridge of the nose, he studied the CT scan, mentally visualizing the exact relationship of the tumor with respect to those landmarks. He glanced from CT to skull and back again until confident of his hand in relation with the needed trajectory to the mass. “How deep’s that puppy?” he asked Stein.
Before printing a copy of the scan, a radiologist had superimposed a thin white cross-hatched line from the inner surface of the skull to the tumor’s center, and this provided an exact measure of the depth. The resident read the number of hatches on the line. Simple enough.
“Five centimeters.”
“Mark that depth on the needle, please,” Alex told the scrub tech. “Then hand it to me.” Turning to Martin he said, “One pass. If we don’t hit it, we’ll need to ultrasound it.” Slowly and gently, using his fingertips to sense resistance, he inserted the needle perpendicular to the brain surface into the soft edematous brain, following his estimated trajectory, and watched the blue Sharpie mark on the needle approach the glistening surface to indicate depth. His fingers felt the blunt tip meet sudden resistance. He’d hit the tumor capsule.
“Bingo! Got it.” He drew a deep breath. “Give me that marker.” Left hand holding the needle firmly in place, he drew X, Y, and Z axes on the craniotomy drapes with the sterile Sharpie to help guide his approach to the tumor. Handing the needle back, he began a quick dissection straight to the tumor, which shelled out without any additional bleeding.
“Okay, I’m done,” Alex said, stripping off his gloves. “Steve, may I see you outside for a moment? You don’t mind if I have a word with him, do you Martin?”
“Go on, I’ll start closing.”
They walked out in the hall. “You still friends with some of the residents at the old place?” Alex was at the scrub sink now, freshening up his scrub.
“We talking Vanderbilt?” Steve, still fully gowned, was careful to avoid touching anything nearby.
“No. My old place.” Alex quickly lathered up.
“Yeah, sure. Why?”
Alex kneed off the water valve while continuing to work the lather around his hands. “This conversation stays confidential. I’m dead serious, okay?”
“Yes.”
“Dead serious.”
“Got it, boss.”
“Make a few calls, find out if Weiner is still padding the billings out there.”
“Why? What’s going on?”
No way he’d tell
him, no matter how much he trusted him. “Nothing. Just let me know what you find out.”
Alex was laying down sutures quickly now, Lawrence snipping threads. He felt guilty denying Lawrence the job of closing the case, but he needed to make up time for the craniotomy scheduled on the heels of this one. Linda poked her head in the room. “You called?”
“I did, thanks. Any chance you could have someone run across the street to pick up two muffulettas and two diet Dr. Peppers?”
“I’m all over it, Doc.”
As soon as Linda left, Chuck said, “We can work straight through, flip the room in fifteen minutes if you want.”
“Naw. I appreciate the offer, but you guys need a break. Go grab lunch first. Bob and I’ll wait in the lounge. Just give us a shout when you’re good to go.”
Chuck’s dedication impressed Alex. He hadn’t encountered a better scrub nurse or tech. “Remind me where you trained?”
“The United States Navy,” Chuck said proudly. “When I enlisted, they asked what I wanted to do. Told them I wanted to be a corpsman, so they sent me to scrub tech school instead. Didn’t complain none ’cause I figured I was getting a skill I could use when my four years were up.”
Alex wondered if some of his drive for excellence was due in part to not having a nursing degree, wanting to show he was as good as the nursing school graduates. Regardless, he was as good as they got.
“Love these things, but man, do they have the salt.” Alex held up the second half of his muffuletta. “Makes me as thirsty as hell by halfway through a second case. It happens every time, but I can’t stop eating them.”
“Yeah, they’re a total gut bomb. Expands like a nuclear explosion. Awfully damn good, though,” Cole said before taking another bite of his sandwich.
They were on a couch in the surgeon’s lounge, a constant flux of scrub-clad personnel coming and going, chatting and joking. Some were using the phones scattered around the lounge for calls or to dictate op reports while, on the large corner TV, Wolf Blitzer was discussing something Alex couldn’t make out with the volume low and the ambient noise high. Alex leaned closer to Cole. “I want to ask you something confidential.”
