“His secretary, of course.”
“Of course.” Fred Larkin was not the type to deign to dial a phone number himself. “Put her on hold and hurry back here for a second.”
As Connie bustled her short, plump frame into his office, Alan hit the button on his phone and said, “Hello?”
When a female voice on the other end said, “Just a minute, Dr. Bulmer,” and put him on hold, Alan handed the phone to Connie. She smiled and held it to her ear.
After a short pause, she said, “Hold on, Dr. Larkin,” and hit the hold button. Giggling, she handed the phone to Alan and hurried out of the office.
Alan waited for a slow count of five and then opened the line.
“Fred! How are you?”
“Fine, Alan,” he said in his officious voice. “Listen, I don’t want to take up much of your time, but I thought you should know what one of your patients is saying about you.”
“Really? Who?” Alan knew who, what, and why, but decided to play dumb.
“Mrs. Marshall.”
“Elizabeth? I didn’t even know she was mad at me!”
“I don’t know about that. But as you know, I scoped her right knee in January and she’s refusing to pay the last two-thirds of her bill.”
“Probably because she doesn’t have the money.”
“Well, be that as it may, she says”—he gave a forced laugh here—“that you told her not to pay it. Can you believe that?”
“Sure. In a sense, it’s true.”
After a long silence on the other end of the line, Larkin said, “You admit it?”
“Uh-huh.” Alan waited for the explosion.
“You son of a bitch!” Larkin shouted into the phone. “I half figured you put her up to it. Where the hell do you get off telling one of my patients not to pay my bill?”
“To say you charge too much is an understatement, Fred. You gouge. You never gave that old lady a clue how much you’d charge her for a look into her joint plus a little trimming of her cartilage. You did it in twenty minutes in the outpatient surgery department—which means your overhead was zero, Fred—and you charged her two thousand bucks! Then—and this is the kicker—then she had to come to me for an explanation of exactly what it was you did for her. You charge at a rate of six thousand bucks an hour and I have to do the explaining! Which I couldn’t do because as usual you never bothered to send me a copy of the procedure summary.”
“I explained everything to her.”
“Not so she could understand it, and you probably had four more procedures lined up. Answering a few questions would take too much time. And when she told your office that Medicare and her other insurance only covered six hundred of the bill, she was informed that that was her problem. And you know what she said to me?”
Alan had now arrived at the point that infuriated him the most. He could feel himself coming to a boil. He tried to control it, knowing he could slip into a shouting rage at any minute.
“She said, ‘You doctors!’ She lumped me with you! And that pissed me off. Ill will from guys like you who treat patients like slabs of meat spills over onto me, and I don’t take kindly to that.”
“Don’t give me any of your holier-than-thou crap, Bulmer. Nothing gives you the right to tell a patient not to pay!”
“I didn’t tell her that, exactly.” Alan’s temper was stretched to the breaking point, but he managed to keep his voice low. “I told her to send your bill back to you in the shape of a rectal suppository. Because you’re an asshole, Fred.”
After a second or two of shocked silence, Larkin said, “I can buy and sell you, Bulmer.”
“A rich asshole is still an asshole.”
“I’m taking this to the hospital board and to the medical society. You haven’t heard the last of this!”
“Yes, I have,” Alan said, and hung up.
He was annoyed with himself for sinking to name calling, but could not deny that he’d enjoyed it.
He glanced at his watch. Nine-thirty already. He would be playing catch-up the rest of the morning.
Alan’s mood lightened immediately when he saw Sonja Andersen waiting for him in the examining room. He smiled at the pretty little ten-year-old he’d been following for the past three years and mentally flipped through her medical history. Sonja had been a normal child until age four when she contracted chicken pox from her older sister. It was not the usual uncomplicated case, however. A varicella meningitis developed, leaving her with a seizure disorder and total hearing loss in her right ear. She was a brave little soul and had been doing well lately. No seizures for the past year, and no visible ill effects from the Dilantin she took twice a day to control them.
She held up an iPod with super-lightweight headphones.
“Look what I got, Dr. Bulmer!” Her face was bright and open, her smile unstudied sincerity. She seemed genuinely glad to see him.
Alan was just as happy to see her. He loved pediatrics more than any other facet of his practice. He found something in caring for a child, whether sick or well, that gave him a special satisfaction. Perhaps this communicated itself to the children and their parents, explaining why an unusually large segment of his practice, nearly 40 percent, was devoted to children under twelve.
“Who gave you that?”
“My uncle. For my birthday.”
“That’s right—you’re ten now, aren’t you? What kind of music do you like?”
She smiled. “Loud.”
He watched as she put on the headphones and began bouncing to what ever she was hearing. He lifted the left earpiece away from her head and said,
“What’s playing?”
“The new song by Polio.”
He forced a smile, acutely aware of the generation gap. He’d heard Polio’s music—a mindless blend of punk and heavy metal. They made Eminem sound refined and were one of the reasons he kept the stack of homemade oldies CDs in his car. “What say we turn it off for the moment and let me give you the once over.”
He checked her heart, lungs, blood pressure, checked her gums for the telltale signs of long-term Dilantin therapy. All negative. Good. He turned on the otoscope, fitted it with a speculum, and moved to her ears.
The left looked fine—the canal was clear, the drum normal in color and configuration with no sign of fluid in the middle ear. He came around to the other side. As usual, her right ear looked as normal as the left. Her deafness there was not caused by a structural defect; the auditory nerve simply didn’t carry the messages from the middle ear to the brain. He realized with a pang that she would never hear her favorite songs in stereo—
And then it happened.
First a sensation in his left hand where he gripped the auricle of her ear, a tingling, needling pleasure surging from there through his whole body, making him tremble and break out in a sweat. Sonja whimpered and clutched at her ear with both hands as she lurched away, toppling off the examining table and into her mother’s arms.
“What?” was all the startled woman could say as she hugged her child against her.
“My ear! He hurt my ear!”
Weak and more than a little frightened, Alan sagged against the examining table.
The mother came to his defense. “He barely touched you, Sonja!”
“He gave me a shock!”
“It must have been from the rug. Isn’t that right, Dr. Bulmer?”
For a second Alan wasn’t exactly sure where he was.
“Right,” he said. He straightened and hoped he didn’t look as pale and shaky as he felt. “That’s the only explanation.”
What he’d felt just now reminded him of the shock he’d received from the derelict in the emergency room last night. But this afternoon he’d felt more pleasure than pain. An instant of searing ecstasy and then…what? Afterglow?
He managed to coax Sonja back up onto the table and complete the examination. He checked the right ear again. No problem this time. No sign of injury, either. Sonja left a few minutes later, still
complaining of pain in her ear.
Alan went into his consultation room to sit at his desk for a moment. What the hell had happened in there? He couldn’t explain it. He had used the same technique with the same otoscope and speculum for years without incident. What had gone wrong today? And that feeling…!
Alan didn’t like things he couldn’t explain. But he forced his mind to file it away for later and rose to his feet. He had a full schedule and had to keep moving.
The next half hour went smoothly. Then Henrietta Westin showed up.
“I just want a checkup.”
Alan was immediately alert. He knew Henrietta Westin was not the checkup type. She was a born-again Christian who herded her three kids and husband in at the first sign of a cold or fever, but trusted in the Lord for herself. Which meant she usually waited until she was well into bronchitis and on the way to pneumonia or 10 percent dehydrated from an intestinal virus before she dragged herself into the office.
“Anything wrong?” Alan asked.
She shrugged and smiled. “Of course not. A little tired maybe, but what do you expect when you’re pushing forty-five in a month? I suppose I should praise the Lord I’ve had my health this long, at least.”
That had an ominous ring to it.
Alan checked her over. He found nothing remarkable other than a slight elevation in her blood pressure and pulse rate, the former no doubt secondary to the latter. She had a gynecologist she saw regularly for any “female problems” she might have; her last gyn exam had been four months ago and everything had been normal.
Alan leaned back against the counter and looked at her. He had touched her palms and found them slick with perspiration. Those hands were now clutched tightly in her lap, the knuckles white. This woman was about to explode with tension. He decided to arrange some thyroid studies but, since her weight hadn’t changed in the last two years, he doubted that was the problem.
He closed her chart and pointed to his consultation room door. “Get dressed and meet me in there and we’ll talk.”
She nodded. “All right.” As he stepped toward the door she said, “Oh, by the way…”
Here it comes, he thought. The real reason for the visit.
“…I found a lump in my breast.”
He flipped her chart back onto the counter and moved to her side.
“Didn’t Dr. Anson examine you?” Alan knew her gynecologist to be a painstakingly thorough physician.
“Yes, but it wasn’t there then.”
“When did you first notice it?”
“Last month.”
“You check your breasts monthly?”
She averted her eyes. “No.”
So it could have been there three months. Damn!
“Why didn’t you come in sooner?”
“I…I thought it might go away. But it didn’t.” A single sob broke through. “It got bigger!”
Alan laid a gentle hand on her shoulder. “Hang on now. It might be a cyst—which is nothing but a fluid-filled sack—or something equally benign. Let’s check.”
She unsnapped her bra and pulled it off under the paper cape. Alan lifted the cape and looked at her breasts. He immediately noticed a little dimpling of the skin two inches from the left nipple at two o’clock.
“Which breast?”
“The left.”
This was looking worse all the time. “Lie back.”
In an effort to stave off the inevitable, Alan examined the right breast first, starting at the outer margin and working toward, around, and finally under the nipple. Normal. He did the same on the other side but started under her arm. There, beneath the slippery mixture of perspiration, deodorant, and shaven stubble, he felt three distinctly enlarged lymph nodes. Oh, hell! He moved over to the breast itself, where he found a firm, fixed, irregular mass under the dimpled area. His stomach tightened. Malignant as all hell.
—and then it happened again.
The tingling, the ecstasy, the small cry from his patient, the instant of disorientation.
“What was that?” she said, cupping her hands over her left breast.
“I don’t…I’m not sure,” Alan said, alarmed now. This was the second time in less than an hour. What was—?
“It’s gone!” Mrs. Westin cried, frantically running her fingers over her breast. “The lump—praise God!—it’s not there anymore!”
“Of course it is,” Alan said. “Tu—” He almost said tumors. “Lumps don’t just disappear like that.” Alan knew the power of denial as a psychological mechanism; the worst thing that could happen now was for her to fool herself into believing that she had no mass in her breast. “Here. I’ll show you.”
But he couldn’t show her.
It was gone.
The mass, the dimpling, the enlarged nodes—gone.
“How did you do it, Doctor?”
“Do it? I didn’t do anything.”
“Yes, you did. You touched it and it disappeared.” Her eyes glowed as she looked at him. “You healed it.”
“No-no.” He hunted for an explanation. “It must have been a cyst that broke. That’s it.” He didn’t believe that—breast cysts did not rupture and disappear during examination—and from the look on her face, Henrietta Westin didn’t believe it either.
“Praise the Lord, He has healed me through you.”
“Now just hold on there!” This was getting out of hand. Almost frantic now, Alan rechecked the breast again.
This can’t be! It’s got to be here!
But it wasn’t. He couldn’t find a trace of the mass.
“Bless you!”
“Now wait a minute, Henrietta. I want you to have a mammogram.”
As she straightened and refastened her bra, her eyes still held that glow. “If you wish, Doctor.”
Don’t look at me like that!
“Today. I’ll call the hospital now.”
“Anything you say.”
Alan fled the examining room for his desk. He picked up the phone to call the radiology department at Monroe Community Hospital…and stopped. For a few seconds he couldn’t think of the hospital’s main number, one he called at least a dozen times a day. Then it came back to him. This thing must have shaken him up more than he’d realized.
Jack Fisher, the chief radiologist, was not crazy about the idea of squeezing another mammogram into his schedule, but Alan convinced him of the urgency of this particular request and Jack reluctantly agreed to find a slot for Mrs. Westin.
Alan managed to do a competent job on the rest of the morning’s patients, even though he knew he gave a couple of them the bum’s rush. He couldn’t help it. It was an effort to concentrate on their problems when his mind throbbed with the question of what had happened to the tumor in Henrietta Westin’s breast. It had been there. He’d felt it. And there was no way it could have been anything less than a malignancy with those nodes in the axilla.
And then it had been gone.
This was crazy.
His state of distraction had one unexpected benefit: He hardly heard Mr. Bradford as he went through his usual catalog of the color, caliber, and frequency of each of his stools since his last visit.
Finally, lunchtime came. He sent Connie and Denise out to eat while he made his call-backs. He wished Ginny were still working here. She’d started off as his receptionist when he first moved into the building but soon decided it wasn’t for her. Maybe she was right. After all, none of the other doctors’ wives she hung around with worked for their husbands.
He heard the phone ring up front at Connie’s desk, saw a light start blinking on the phone beside him. It was the private line he reserved for the hospital, pharmacists, and other doctors. He stabbed at it.
“Hello.”
“Nothing there, Alan.” It was Jack Fisher, the radiologist. “A little fibrocystic disease, but no mass, no calcifications, no vascular changes.”
“And you checked the axilla like I asked you?”
“Clean. Both sides. Cl
ean.”
Alan didn’t speak. Couldn’t speak.
“Okay, Alan?”
“Yeah. Yeah, sure, Jack. And thanks a lot for squeezing her in. I really appreciate it.”
“Anytime. Sometimes the only way to handle these kooks is to humor them.”
“Kook?”
“Yeah. The Westin lady. She was going on and on to anyone who’d listen about how you had ‘the healing touch.’ How she’d had a tumor there for the past month and with a single touch you made it disappear.” He laughed. “Every time I think I’ve heard it all, somebody comes up with a new one.”
Alan managed to get off the phone with a modicum of grace, then slumped into his chair and sat staring at the grain in the oak paneling on the opposite wall.
Henrietta Westin now had a left breast that felt normal and showed clean on mammography. But that hadn’t been the case two hours ago.
He sighed and stood up. No use worrying about it. She wasn’t going to lose her breast or her life, that was the important thing. When he had more time he’d try to figure it out. Right now it was time for a bite to eat and then into the afternoon session.
The phone rang again. It was a patient line this time. He hadn’t signed out to the answering service yet so he picked it up.
It was Mrs. Andersen and she was sobbing. Something about Sonja. About her ear.
Oh, Christ! Just what he needed now.
“What’s wrong?” he asked. “Is she still in pain?”
“No!” the woman wailed. “She can hear out of her right ear again! She can hear!”
“How do I look?”
Alan snapped back to the here and now. He’d made it through the afternoon hours without committing any medical negligence, but now that he was home his thoughts kept veering toward Sonja Andersen and Henrietta Westin.
He looked up. Ginny was standing at the far side of the kitchen table, modeling slacks and a blouse of different shades of green.
“You look great.” It was the truth. Clothes fit her perfectly right off the rack. The greens of the fabric caught the green of her contacts. “Really great.”
“Then how come I always have to ask?”
“Because you always look great. You should know that.”
The Touch Page 7
