Charlatans

by Robin Cook

  “No, he didn’t.”

  “At least that’s reassuring,” Ava said. “I’m starting to get an idea of how you should present this case.”

  “Really?” Noah questioned. He sat up straighter. She was impressing him again, and he was eager to hear what she had in mind.

  “Keeping him from getting mad is going to be key,” Ava said. “That’s number one. Number two, you have to steer the discussion away from the concurrent-surgery issue. That’s mainly for your sake. And number three, you have to avoid the issue of Anesthesia, meaning me, supposedly making the wrong decision about spinal versus general anesthesia.”

  “That’s easier said than done,” Noah complained. “The facts are facts. I can’t change them.”

  “What you will have to do is keep away from the troublesome facts. For instance, there is no reason to mention that the patient had been under anesthesia for an hour or more. As bad as that was, it didn’t contribute to the death. Instead, emphasize the two points Dr. Mason is most emotional about—namely, the lack of a resident H&P and that the patient ate a breakfast that Admitting didn’t uncover. If you are clever and mildly verbose, those two issues could be an hour discussion in and of themselves. Tell me! How many cases are scheduled for the conference?”

  “Five so far,” Noah said. “There could be more.”

  “Perfect,” Ava said. “Listen! Save Vincent’s case until last. Since the M&M has to be adjourned in an hour and a half without fail since surgery is scheduled and everybody has to get to the OR, you can run out of time. What do you think?”

  Noah toyed with his food while he pondered Ava’s suggestion. The more he thought about it, the better he liked it, because it could work. The scheduling of the presentations was totally up to him. He had initially thought of doing the Vincent case first since there was so much interest in it, but there was no reason he couldn’t do it last, and if no one knew it was going to be last, no one, like Dr. Hernandez, could complain and try to change it. There was a good chance that whatever the discussion was, it could be prematurely terminated.

  “I think you have some good points,” Noah said.

  “I do, too,” Ava agreed. She picked up her wineglass and motioned with it toward Noah. They clinked glasses. “We have a few more days to plan, but I think we’re making headway. To your success!”

  —

  AFTER GETTING the serious stuff out of the way, Ava and Noah switched to more lighthearted banter as they finished their dinner and cleaned up the plates and flatware. Ava dominated the conversation, since she was full of stories about her recent travels and athletic episodes, such as her latest bungee-jumping excursion. Noah had been amazed to hear that she had flown all the way to New Zealand to do it, although she also used the trip to scuba-dive in shark cages off the southern coast of Australia. Noah was fascinated but also intimidated, as it made his life seem all that more insular and hospital-bound. The last trip he had taken had been more than two years ago, and only to New York City. He’d gone with Leslie to see a play, and only for a single Saturday night. At the time he had been reluctant to go, since he had several patients he’d operated on in the hospital. Although he had arranged for people to cover for him, it didn’t seem right, since he couldn’t help but put himself in his patients’ shoes.

  “How about we head up to the study and relax?” Ava offered when the kitchen was back to spic-and-span. “We can have a cordial if you’d like.”

  “Thank you, but I think I’ll pass on the cordial. Sorry. Two glasses of wine are enough for me.”

  “Hey, don’t be sorry. I’m impressed with your self-restraint. Your dedication is awe-inspiring. I’d want you to be my doctor any day.”

  “Thank you,” Noah said.

  While trailing Ava as they headed up the second flight of stairs from the kitchen level, Noah worked up his courage to ask: “Hey, do you take your trips solo or with friends?” He made it sound as if the idea just occurred to him, whereas he’d been wondering about it since he’d heard about all her travels the previous evening. He didn’t know what answer he wanted to hear.

  “It depends,” Ava said. “My fun trips like to New Zealand and the previous one to India I went alone. With my business travel, I’m usually accompanied.”

  “Seems to me it would be more fun the other way around,” Noah said.

  “You have a point,” Ava said. “Are you interested in going with me when I go back to New Zealand for a repeat bungee-jump?” She laughed in her unique and charming fashion.

  “I wish,” Noah said. “If you don’t mind my asking, are your business trips because of your nutrition background?”

  Ava stopped several steps short of the landing outside the study and turned around to face Noah, who was forced to stop as well. She was smiling, but her tone was accusatory. “Have you been spying on me?”

  “In a fashion,” Noah confessed. “I looked at your LinkedIn page. I was impressed that you majored in nutrition. I think it is a neglected area of expertise when it comes to doctors.”

  “I agree,” Ava said. Her voice had returned to normal. “That’s why I chose it as an undergraduate major. But to answer your question, my business trips do involve my background in nutrition, at least indirectly.”

  Ava didn’t elaborate, but rather turned back around and continued up the stairs. Noah followed her into the study. He was dying to ask her more about her business, which he assumed had to be remarkably successful, but he felt reluctant. He didn’t want to push it. While she went over to get a bottle of Grand Marnier and a glass from a bookshelf, he took the same velvet club chair he’d occupied the night before. He watched her, fascinated by the way she moved, which was accentuated by her flared dress. He was hypnotized by her entire persona.

  “Are you sure you don’t want just a nip?” Ava said, holding up the liquor bottle in Noah’s direction. She took the other club chair.

  “Thank you, no,” Noah said. “I also visited your Gail Shafter Facebook page and the fan page. I was truly amazed at the number of your followers.”

  “I have to admit I have a lot of fun with it. I’ve even gotten some offers to advertise products.”

  “Have you done that?” Noah asked.

  “No, I haven’t,” Ava said. “I do it for pleasure, not for business.”

  “I got a chuckle when I saw that Gail Shafter endorsed you on your LinkedIn page.”

  Ava treated Noah to another one of her laughs. “Guilty as charged,” she said. “I just couldn’t help myself.”

  “Last night you offered to explain to me why you use a fake name on Facebook. If you’re willing, I’d like to hear.”

  “Purely for a sense of freedom,” Ava said. “The beauty of the virtual online world is anonymity. Using a made-up name magnifies that and enhances my freedom. I’m sure you have heard the expression: On the Internet no one knows you are a dog.”

  It was Noah’s turn to laugh. “No, I haven’t heard that. But I get it.”

  “Using a made-up name allows me to avoid my own hang-ups,” Ava explained. “I don’t have to be me. I can project onto Gail Shafter whatever identities I want. And using my avatar, technoself, I can do it without fear of being judged. If someone doesn’t like my digital me and acts like a troll, I can block them. In real life I can’t do that. And social media can be wonderfully dynamic, whereas real-life social interaction tends to be static.”

  “I’ve never heard the term technoself. Is that something new?”

  “In the tech world, nothing is new. As soon as something is out, like a new app, the next day it is old. Things are changing at warp speed. So no, it is not new. In fact, technoself studies have become an entire interdisciplinary domain of scholarly research. It is where our culture is going. We are all becoming cyborgs with our devices, particularly with our phones.”

  “You’re making me feel old.”

&nbs
p; “In the teenage mind, you are old. They are the ones who are driving the pace.”

  “You mentioned you were addicted to social media when you were a teenager, and it was a disaster. How so?”

  “I became obsessed with my digital reputation to the detriment of everything else, including my schoolwork. At one point, I got cyberbullied on SixDegrees to the point I couldn’t go to school for a week. Well, it wasn’t called cyberbullying back then, just harassment. But it was a disaster. I did so poorly academically that I didn’t even think about going to college after high school. I had to work, so I worked for a dentist. Luckily, I quickly saw the light.”

  “Is that why Gail Shafter works for a dentist?” Noah asked.

  “You got it. It’s something I know about.”

  “What about dating apps and websites? Do you use them?”

  “Of course. Why not? They are particularly fun. Especially now with the swipe-right-or-swipe-left feature. Hot-or-not, what a great game! It empowers even the most pitiful creeps. Online, anyone who is digitally clever can be popular or even famous. Look at the Kardashians.”

  “Have you ever met anyone in real life that you met on a dating app?”

  “Hell, no! I’d never in a million years do that. Everybody lies on those sites. I like to play around with them, but I’d never actually look for anyone on Tinder or any of the others. We’re all becoming narcissistic charlatans to one degree or another. Meeting up with someone you met online would be too risky. Besides, it would defeat the whole anonymity thing.”

  “Aren’t you worried somebody sufficiently enamored with Gail Shafter and armed with technical knowhow could get Gail’s address here on Louisburg Square?”

  “There was a time when that might have happened because I had a proxy server that turned out to be almost worthless. But my computer people set me up with a proper encryption. There’s no worry now. And what about you?”

  “What do you mean?”

  “Have you ever used a dating app or website?”

  Noah didn’t answer right away. Like most people, he had, but questioned if he should admit it to Ava. What convinced him to come clean was that she readily admitted she’d used them herself so there would be no judgment. “Actually, I did use OkCupid for a couple of weeks not long after it came out. So I used it once.”

  “Uh-oh,” Ava voiced. She flashed a knowing smile. “This is sounding serious. Did you meet someone online and then meet up with them in person?”

  “I did,” Noah admitted. “Her name was Leslie Brooks. She was a Columbia undergrad. We ended up living together for the last year of my medical school, and then she came up here to Boston to go to Harvard Business School.”

  “Sweet,” Ava said with sincerity. “I guess there are some successes. Are you guys still together?”

  “Nope,” Noah said. “She left two years ago for a finance job in New York.”

  “Four years together; that’s impressive. Are you still seeing each other?”

  “No,” Noah said simply. “She couldn’t really adjust to my commitment to medicine, which I don’t blame her for. In retrospect, she was counting on my hours getting less as I advanced up the training ladder, like it does for most people. Unfortunately, for me they got more, so she bailed out. She’s engaged now.”

  “I think only those of us in medicine understand,” Ava said. “So who are you seeing now?”

  “No one,” Noah said. Inwardly he cringed, wondering if Ava would think of him as socially hopeless.

  “That doesn’t seem appropriate for a healthy man like yourself,” Ava said with a slight, mischievous smile. “As a fellow doctor, I’d like to ask how you manage.”

  Noah stared back at Ava. He agonized for a beat, questioning if he should take the bait. “I’m resourceful,” he said after a pause. “There is always online porn.”

  Ava roared with laughter and clapped her hands. “You are a trip, Dr. Rothauser. Now I have to wonder which of us is more addicted to the Internet.”

  “There’s no way I am addicted,” Noah said. He found her mirth contagious and was laughing at himself even though he questioned why he had said what he did. He was thankful she had taken the comment in a nonjudgmental, humorous fashion.

  After putting down her liquor glass, Ava leaned forward. “Last night I showed you most of my house. But there is one cool thing I did not show you. Interested?”

  “Sure,” Noah said with a shrug. “Give me a clue.”

  “I put a deck on the top of the building and the view is to die for. And it’s a beautiful summer night.”

  He followed her up two flights of the central, nautilus-like stairway that spiraled from the very first floor. When they gained the sixth and final floor and pretending to be out of breath, Noah said, “With all these stairs you don’t need to work out.”

  “Sometimes I take the elevator,” Ava said.

  “Elevator? I didn’t know you had an elevator.” Noah had never been in a private home that had an elevator.

  “The doors are disguised so as not to be intrusive,” Ava explained. She pointed to the wall to their immediate right. “Here’s one here.”

  All Noah could see was a door-sized, rectangular, grooved outline that even cut through the dado and its trim. “Wow,” he said. “I never would have guessed. But there’s no call button.”

  “It’s WiFi,” Ava said. “Welcome to the tech world.”

  As Noah followed Ava into the room, he berated himself for acting like such a simpleton. Looking around, he guessed he was in the master bedroom. It was a large space occupying the entire width of the house. The west wall was a bank of French doors with the lights of the city visible through the multipanes just above the row of buildings that lined the next street down the hill.

  “This is my bedroom,” Ava said proudly.

  “Very nice,” Noah said. In actuality, he thought it was a lot more than nice. The room had a high cathedral ceiling, and the bed was at least a king and was set against the north wall; both cats were curled up against decorative pillows. Behind the bed was a trompe l’oeil mural of an open window looking out onto a European mountain scene. The south wall had a period marble fireplace similar to those in the living room. A second door on the east wall led into the marble master bath. The lighting was subdued, giving the room an overall restful ambience.

  “And the view is terrific,” Noah added.

  “You haven’t seen nothing yet,” Ava said playfully. She opened one of the French doors, stepped out onto a narrow balcony, and gestured for Noah to follow.

  Moving from the air-conditioned, dehumidified interior, Noah could feel the summer warmth and moisture. He looked out at the view, noticing he could see into multiple apartments in the buildings on the other side of the alley. “Very nice,” he repeated.

  “This way,” Ava said, as she tugged his arm to follow her. At the northern end of the narrow balcony was a black wrought-iron circular staircase that led up into the darkness.

  As Noah climbed after Ava, he felt a touch of acrophobia. Just over the low handrail as he went up he could see down six floors into a neighboring garden. A moment later he was up on the very top of Ava’s house, standing on a raised deck with a more substantial handrail. The view was truly spectacular, with a good portion of the city of Boston spread out in front of him. From where he was standing he could see over the tops of the buildings in the foreground. In the middle distance was a wide stretch of the Charles River that made it appear more like a lake than a river. “You are right, this is to die for,” Noah said.

  “You’re looking directly at MIT,” Ava said.

  “Where?” Although he had spent two years at the famed school getting his Ph.D., it was hard to pick out the details from the panorama he was viewing.

  “Straight ahead,” Ava said. She pointed with her left hand while she put her right hand on No
ah’s shoulder to pull him closer. She also pushed against him so that he could sight directly along the length of her arm.

  “Okay,” Noah managed. But he was no longer trying to distinguish which buildings of the thousands he could see belonged to MIT. Instead, he was acutely aware of Ava’s hand in the crook of his neck and shoulder with her forearm pressed against his back. He was even more aware of her body pressed up against his. She was busy describing various buildings so he could orient himself to the MIT campus, but he wasn’t listening to her voice. He was listening to his body, which was sending alarm bells to his brain. And the messages were not going to the higher-function areas involved with rational thought.

  “Can you see the dome?” Ava asked, referring to the building at the very center of MIT.

  As if he were being manipulated by some exterior force, Noah turned toward Ava and looked dreamily into her eyes. As there wasn’t that much difference in their heights, their faces were close. Ava responded by also turning her body toward him. “I’m getting the message that you are not all that interested in looking at MIT,” she said.

  Noah didn’t answer. Instead he leaned forward in slow motion, turning his head to the side in the process. Ava’s head tipped back. A moment later their lips came together as they embraced.

  It was a long, sustained kiss. At its conclusion Noah slowly leaned back, although their arms continued to envelop each other. His eyes were fixed on hers, although in the half-light he could only assume hers were on his. Noah sensed an overpowering urge to make love to her. It had been a long time since he had had such feelings, and the sheer intensity of the desire caught him by surprise. Previously he had worried that arriving early might have scared her off. Now he was worried that if she knew the fierceness of his passion, she would be literally frightened. It was so encompassing that it even scared him to a degree.

  “I think we should go down to my bedroom,” Ava said. “Will you be okay navigating the stairs?”

  “I think so,” Noah croaked. Reluctantly, he let go of her.