Cutter's Trial

by Allen Wyler

  “I wanted to introduce Clarence Hill.” Without waiting for an answer, Garrison stepped into the office, followed by a smaller, round-faced man, hands shoved deep in the pockets of his white coat, which had, like all the clinic physicians’ coats, his name embroidered in red above the left breast pocket. Alex was immediately drawn to Hill’s intense eyes: two hard marbles behind round, wire-frame glasses. He had the puckered face of a professional lemon sucker. A crescent of close-cut black hair trailed thick stubble down the back of his neck.

  Alex came around the desk to shake hands with the new surgeon. “Alex Cutter.”

  “Nice to meet you.” As they shook hands, Alex felt the distinct vibe of being sized up.

  “Clarence will be helping with the vascular work,” Garrison explained, beaming, his right hand now on the new man’s shoulder like a proud father. “Right, Clarence?”

  “Absolutely, Garrison.” Clarence glanced up admiringly at Garrison as if addressing a general. Then those marbles lasered back at Alex. “You do mostly tumors, don’t you.” Made as a statement instead of a question. A verification.

  Interesting. “I do.”

  “Building a nice practice of it, too,” Garrison added. “Better get you around to meet some of the other new folk. Got a lot of ’em since you were here last.”

  As Alex watched the two leave, he experienced a vague sense of unease, an off-putting feeling. A forewarning? He stood perfectly still, afraid the slightest distraction would derail his gelling impression before it could be brought into focus. A déjà vu chill snaked down his spine, then, just as quickly, disappeared. He’d been here before. Not literally, of course, but encounter-wise. He wasn’t sure where, or with whom, but he knew the outcome hadn’t been good.

  “What’s going on between the new guy and Garrison?” Alex casually asked Dave Ray. They had just finished a tennis match at the public courts a few miles from Alex’s house. The courts were located roughly equidistant between their two homes, so it worked well for a quick match. Surprisingly, the courts were never used on Saturdays, the only time Alex could routinely count on being available these days.

  After mopping his face with a wadded white towel, Dave asked, “Going on how?”

  Alex zipped the cover over his Wilson racket. “They seem very close. In a lot of ways. Even to the point that Clarence does vascular work. Something’s going on there, just like there’s something between Linda and Garrison—but not the same, if you know what I mean.”

  Dave wiggled his eyebrows at that remark before dropping onto the courtside bench with a heavy sigh. “Totally off the record?”

  Alex sat beside him, towel in hand, mopping the back of his neck. “That’s reciprocal, you know.”

  “Just so it’s understood.” Dave dried his face again. “You know Clarence was Garrison’s golden boy throughout his residency, don’t you?”

  Alex tossed down his towel and relaxed against the bench. “I’d heard something to that effect.”

  “Well, it was pretty obvious. He followed him around like a little puppy. People used to make jokes about it, things like how discolored Clarence’s nose was. The only surprise came when he took the job at the Gulf practice instead of coming home soon as Uncle Sam released him. That was pretty much what everyone ’round here expected.”

  “Why did he take the other job?” Alex inspected his racket grip. Looked about time to replace the sweat-soaked wrap.

  Dave shrugged. “Who knows? But getting back to your original question, I suspect he’s fixing to be the next CEO come time for Garrison to retire. Do that and he’ll have followed him pretty much to a tee.”

  That explained his impression of Clarence earlier. “How you feel about that?”

  Dave snorted. “Day that happens is the day I’m out of here.”

  “Oh? Why’s that?”

  Dave leaned back against the bench slats with eyes closed against the waning sun, his wadded towel in hand. “Lots of reasons. Not even sure I can explain all of them, ’cause I’m not sure I completely understand. Gut instinct mostly. But since you asked, guess it all boils down to a serious lack of trust.” Dave seemed to weigh his last statement a moment. “Yeah, that about sums it up. A serious lack of trust.”

  Interesting. “Care to elaborate?”

  “Not sure I can. Can’t point to one thing and say, ‘See!’ It’s a bottom-line impression, I guess. But there’s one thing you should understand about Clarence: he’s very spiritual.”

  “Spiritual? Not sure I follow. What’s that mean?”

  “Expect you’ll understand soon enough.” With a tired groan, Dave pushed off the bench, the towel now thrown over his shoulders, white Izod tennis shirt sweat-welded to his hairy chest. “Don’t forget we got us a business meeting first thing in the morning. Breakfast will be served as usual.”

  Alex pushed off the bench, pleasantly fatigued from work and exercise. Towel also around his neck, he shouldered his racket bag and fell in beside Dave for the half-block walk to the parking lot. “Been meaning to ask about that. Five thirty’s early. Why? Why not five thirty in the evening?”

  Dave laughed and dropped his faded bag on the hood of his sunbaked car before rummaging through it for his keys. “Easy. That’s the only way we can make sure these meetings end. And that’s only because most the partners have cases to start. We tried evening meetings once, but everyone had something to say, so they took forever. Besides, dinner’s more expensive than breakfast.”

  “I noticed not everyone shows up for those meetings.”

  “Lotta partners don’t. You’d be surprised at how many don’t give a flip about how their clinic runs. Alls they want is a monthly paycheck and their share of the quarterly profit. You want to gain power in this clinic, show up at the business meetings and take an active role. You’d be surprised how easy it is. That’s the reason I think your new best friend, Clarence, has a shot at succeeding.”

  38

  “Morning, Garrison,” Alex said, entering the crowded conference/library room, the walls filled with medical books and bound journals. A thick mahogany table capable of comfortably seating twelve occupied the center of the room with extra chairs crammed in behind the ones at the table. A side-table pushed against a bookcase held stainless steel serving dishes of scrambled eggs, bacon, grits, and a twenty-five-cup coffee urn with a stack of inverted white Styrofoam cups on its right. The smell of salty grease stoked Alex’s appetite after having slipped out without waking Lisa. He was famished.

  “Morning, Alex. Glad you could make it,” Garrison said. Clarence sat directly to Garrison’s left, all bright eyed and eager.

  Alex spooned eggs, bacon, and two slices of toast—he hadn’t been able to develop a taste for grits and doubted he ever would—onto a paper plate and poured a cup of black coffee. He settled into the one unoccupied seat, which happened to be on Berger’s right. He immediately speared a fork full of eggs to pop into his mouth.

  “Down here, folks say the blessing before they start eatin’.”

  Still chewing, Alex glanced up to see where the loud voice came from. Hill was sending him a serious dose of laser-eye. The room fell silent, the other partners either avoiding eye contact or simply studying their folded hands. No one else had touched their food, Alex realized. Clarence turned to Garrison. “Isn’t that right, Dr. Majors?”

  Alex swallowed. He felt betrayed and alienated, as if someone had purposely led him into a social trap. In the meetings prior to Clarence’s arrival, no one said a damn thing before eating. Why were things now different? Then he remembered Dave’s words: He’s very spiritual.

  He decided to not take the bait and tell Hill to fuck off. Clearly, Clarence’s presence was the only difference from previous meetings. Interesting. Even more interesting was that no one seemed up to the task of challenging him. In the next instant Alex intuitively grasped the significance of the moment: a battle line was now drawn. Setting down his fork, he sat back. “Knock yourself out, Clarence.”
/>   Head bowed, Clarence reached for the hands of the surgeons to either side of him. “Thank you, heavenly father, for the bounty we are about to receive.”

  Alex was sorely tempted to bite off a hunk of bacon. Don’t be juvenile. He glanced at Berger, who simply stared at his plate of bacon and eggs, hands clasped in his lap. Neither he nor Alex held the hand of the partners to either side.

  Meeting over, Alex walked with Martin Berger to the sky bridge, the other partners having abruptly dispersed to start their busy days, which, for most, would end sometime after 7:00 p.m.

  “Have we always done that?” Alex asked.

  Martin shot him a sideways glance. “Done what?”

  “Say the blessing or grace or whatever it’s called before breakfast business meetings. It wasn’t done for the ones I attended.” He still hadn’t grown used to seeing people pray before meals in restaurants or at the University Club, and certainly not with Clarence’s apparent fervor. Did people feel obliged to make these public displays out of deep religious conviction or simply because it seemed the socially expected norm here, making them afraid to be pegged as different if they didn’t? A societal lemmings phenomenon. Good question, one he suspected would remain unanswered. The cynical side of him suspected the latter.

  Martin scratched the side of his chin. “Do now, now that Hill’s back. He used to make a huge point of it as a resident, so I reckon people figure we’re back to the way things were then.”

  “And you’re okay with that? I mean, being Jewish.”

  Martin checked his fingernails. “Makes no never mind to me. Why? Bother you?”

  Not the answer he expected. “You bet it does. I don’t like being forced to participate in other people’s religious rituals. I resent it.”

  “How come? Doesn’t hurt anyone.”

  Is he kidding? He studied Martin’s craggy poker face. “Guess it comes down to what I just said; I don’t like people forcing their personal religious beliefs on me. I find that obnoxious. It’s saying there’s good religion and bad religion and his is the good one. Where does the Christian belief of tolerance come into play the way he’s running things?”

  “He can believe what he wants. Doesn’t bother me.”

  “To tell you the truth, that surprises me.”

  Martin shrugged. “Didn’t see anyone else object. After all, this ain’t called the Bible Belt for nothing.”

  Alex continued to stare at him. “There’s more to it than just religion.”

  “Like what?”

  “You’re all empowering him every time you sit back and let him dictate something as trivial as a blessing. The problem is, once a person like him starts to gain that kind of power, it becomes a momentum thing. Next thing you know, he’ll have Garrison’s job. You happy with that idea?”

  “I’ll be retired by then.” He looked serious.

  Fuming, Alex headed to the stairs. “Unbelievable. Catch you later.”

  39

  “Brought these,” Alex said, handing four CDs to Cole. One Cal Tjader, two Freddy Kings, and one Albert King. “Some of my prime music.”

  Cole quickly shuffled through the discs. “Wow, these are terrific. Especially Freddy’s Texas Cannonball album. And Tjader’s ‘Doxy.’ What order you want?”

  “Dealer’s choice.” He set the mitered wood box for his loupes on the stainless steel counter, freeing his hands to begin sorting CT scans to display. “Love them all. Especially ‘Answer to the Laundromat Blues.’ Although Freddy’s ‘Stuck In Lodi’ is a close second. Listen the hell out of that one.”

  “Excuse me, Doctor Cutter.” the chief resident popped his head into the OR. “You seen Brett Johnson this morning?” Brett was the first-year resident recently assigned to his service.

  Alex set down the scans. “No, I haven’t. Why?”

  The resident appeared to choose his next words carefully before stepping a bit closer and lowering his voice. “Apparently the paging operator couldn’t reach him all night. I was wondering if maybe he’d been working with you.”

  Alex resumed sorting CTs. He’d recently caught a whiff of grumbling amongst the residents concerning Johnson’s performance, but nothing concrete—mostly issues with his availability when taking call. He and Reynolds tended to delegate minor disciplinary matters to the residents in the belief that peer pressure could be more effective than top-down dictatorial rule. “Haven’t seen him.”

  “Okay. I’ll have the general surgery resident scrub with you till he shows.”

  Alex nodded. First-year general surgery residents hated their mandatory rotation on neurosurgery, mostly because they weren’t allowed to do much in the OR or were saddled with the scut work the higher-ranking neurosurgery residents sloughed off on them. The reverse happened when the first-year neurosurgery residents rotated through general surgery, so it was a mutual “fuck you” situation. Since surgeons of each specialty needed a firm grasp of surgical theory and principles, the cross-fertilization experience was seen as worthwhile. Besides, you never knew what kinds of situations one might encounter in the real world. Alex once met a general surgeon in Alaska who saved a patient’s life by removing an epidural hematoma before air-evacuating him to Seattle. The astute surgeon witnessed a similar surgery as a first-year resident.

  Alex was at the scrub sink taping the top edge of his mask to the bridge of his nose when the general surgery resident showed up acting mildly annoyed. Alex felt sorry for him.

  Alex and Chuck were draping the patient when Brett Johnson pushed through the doors into the OR. “Morning, Doctor Cutter.”

  Alex glanced at the wall clock and noted the time. “You’re late, Johnson.”

  “Yes, I am. Sorry about that. Had to finish up a patient over at the trauma center. I’ll go scrub.”

  “You’re off the hook,” Alex told the surgery resident. “Go see if there’s another case you can help on, and thanks for covering.”

  Without moving his eyes from the wound edge, Alex reached up toward Chuck. “Rainey clip.”

  Chuck placed the clip applier snugly into Alex’s hand. In one smooth motion, Alex had the plastic clip over a small length of incision and released the applier, so the clip now compressed the freshly cut scalp edge to control bleeding. This process would be repeated along both edges of the incision. Out of the corner of his eye, he noticed Johnson push back into the room with his hands up, skin glistening wet. Johnson called to Chuck. “Need a towel.”

  Alex glanced at the clock. “How long did you scrub?”

  “Five minutes. Why?”

  “You sure about that?”

  “Why would I lie?”

  Good question. “Because you only scrubbed for two minutes. I timed it. Go back out and do it right, Johnson, and this time make it a full five minutes. I’m timing you.”

  “Sorry,” Alex said to Chuck once Johnson left the room.

  “Don’t be. It’s those little things, cutting corners, that end up biting you in the ass. Learned that one a long time ago. The hard way, too. Thing I like about working with you is you go by the book and don’t shortcut good technique. Keeps us both out of trouble, which actually saves time in the long run.”

  Alex appreciated that he and Chuck were like-minded. “Thanks. Rainey.”

  Once Johnson gowned and gloved and stood shoulder to shoulder with him, Alex said, “Since this is your first day on service let me ask you—what do you know about the way I do things?” Alex continued working, Chuck handing him the correct instruments without being asked.

  “Don’t know a thing.”

  Bullshit. A universal fiber of every residency culture was the gossip pool, the chatter between members—comparing notes and criticizing attendings. This program was no different from any other.

  “Okay then, here are the rules of engagement …”

  40

  “Doctor Cutter, there’s a man outside, says he wants a word with you.” Kasey stood in the doorway to his office.

  This was his clin
ic day and Alex was between patients, dictating a note. “From your tone of voice, I assume he isn’t a patient.” The clinic did not allow drug salesmen access to the physicians.

  Kasey stepped in the office and closed the door. “He’s an FBI agent.”

  FBI? Why would the FBI want to talk to me? He glanced at his watch. “He say what it’s about?” Wait. Could it be …?

  She was giving him a questioning look. “No, sir.”

  “Before you show him in, explain that he gets only five minutes.” Alex quickly finished dictating his note.

  Kasey ushered in a fireplug Asian, perhaps 5'9", 170 pounds, making Alex think sumo wrestler. Kasey shut the door as she exited.

  “John Suzuki,” the man said, offering his FBI credentials for Alex to view.

  Alex returned the wallet. He didn’t offer the agent a seat nor take one himself, for it would prolong the meeting and he had a full clinic. “What can I do for you?”

  Suzuki slid the ID back into his suit coat. “You are Doctor Alex Cutter?”

  “I am.”

  “Did you contact the Medicare fraud tip line several months ago?”

  Aw, that’s it. Alex extended a hand toward the visitor chairs in front of his desk. “Here, have a seat.” This would take longer than five minutes.

  “Can you spare a moment?” Clarence sauntered into Alex’s office.

  “Sure. What’s up?” Alex set the Sony recorder on the chart of the patient for whom he was dictating a note and swept a hand toward the two chairs on the other side of his desk. “Have a seat.”

  “That’s all right; this won’t take but a few seconds.” Clarence, like Garrison, wore scrubs regardless of whether or not he had a case scheduled that day. Alex figured Garrison routinely wore them as an excuse for not having to decide what to wear. Clarence, on the other hand, wore them to mimic Garrison.