by Robin Cook
“The possibility of an affair was just mentioned in passing,” Noah said. “The hospital doesn’t care. What both of them were irritated about was Dr. Mason’s complaint that I have been protecting you.”
“Oh my goodness,” Ava said. “This keeps getting worse. I hate to think we’ll become a source of gossip. What did you end up saying?”
“Not much,” Noah admitted. “I denied that I was protecting you, of course, because the implication was that I was doing something underhanded. I’m not doing anything I don’t think is right. You were certainly not to blame in either of these unfortunate cases, and I’m more than happy to say so.”
“Thank you again.”
“You’re welcome,” Noah said. “We need to get busy and plan the next M&M like we did for the last one because the Gibson case will need to be presented, and Dr. Mason most likely will be a bear. On the Vincent case his hands were tied because he was the surgeon. With the Gibson case, there’s no such luck. You’ll have to gird yourself. It might not be pretty, but at least the concurrent-surgery issue is not involved.”
“I’ll help you plan however I can,” Ava said. “Does this mean you’ve forgiven me?”
“Why didn’t you contact me? Why not a simple text saying you were all right?”
“At first I was just too overwrought and knew you wouldn’t be satisfied with a simple text. Then after a day or so I felt embarrassed I’d been so emotional. I thought it best to apologize to you in person. That’s why I’m here. I just got back to Boston and came straight here. I haven’t even been home yet. I’m sure you have been concerned, and I would have been concerned if it had been the other way around.”
“Where were you? It looked like a fancy hotel in your selfie.”
“Oh, good, you saw it. I really posted it for you to show you that I was all right.”
“I saw it,” Noah said. “But I couldn’t tell where you were.”
“Washington, D.C. It was the Ritz.”
“Were you playing tourist or working?”
“I was working,” Ava said. “The trip had been scheduled months ago. Actually, the timing was good. Being busy helped pull me out of an emotional nosedive.”
“What type of consulting do you do, if I can ask?”
Ava regarded Noah for a few beats. He sensed she was debating whether she wanted to tell him, which only fired up his curiosity. Whatever she was doing had to be exceptionally lucrative. Not every consultant stayed at the Ritz.
“I’m hesitating because I think you’re not going to approve,” Ava said.
“If you think telling me that is going to make me less interested, you’re wrong. Why would I not approve of your consulting work?”
“I consult for the NSC.”
“Really,” Noah said. He didn’t know if he was more shocked or impressed. “You consult for the National Security Council?” The National Security Council was the U.S. president’s principal forum for national-security and foreign-policy matters.
Ava had recovered enough from her earlier tears to laugh her usual laugh. “I wish. No, I work for the Nutritional Supplement Council. I’m a combination spokesperson/lobbyist. My NSC is a lobby group lavishly funded by the nutritional-supplement industry.”
“Okay,” Noah said. He nodded. “Now I understand why you questioned if I would approve. As a doctor, I do have strong negative feelings about the industry, which I equate to a bunch of snake-oil manufacturers and salesmen.”
“But on the positive side, they pay well,” Ava said.
“How did you happen to start working for them? I would think as a doctor you’d find it problematic. It’s a little like colluding with the enemy.”
“I started working for them from the day I received my combined M.D. and B.S. nutrition degree,” Ava said. “I’d run up a big debt from college and medical school. I had to pay my own way after my father died of a heart attack in my junior year of high school. The NSC and its deep pockets have been kind of a savior.”
“I suppose I can relate,” Noah said. “I’ve had my share of economic problems, some of which are still going on. As you know, my father also died of a heart attack when I was in high school, and I’ve got a huge debt as well. My mother helped when I was in college, but when I got to medical school, she came down with early-onset Alzheimer’s and lost her job. At that point the tables were turned, and I had to support her.”
“I’m sorry to hear that,” Ava said. “Sounds like you had it harder than I.”
“I guess your bosses at the NSC were pleased that you had both a B.S. and an M.D.,” Noah said. “Especially now, with you being on the BMH staff.”
“You have no idea,” Ava said. “They love me and treat me like a queen. My life would be totally different if it weren’t for the NSC. At the same time, I do them a big service. I’m probably the main reason the 1994 law that took the FDA off their back hasn’t been amended. That’s the law that absolves the industry from having to prove efficacy or even safety. It’s kind of a joke, really, but who am I to say. Besides, it is fun. I get to dine with senators and congressmen.”
“But you’re a doctor and a committed one. Why doesn’t that keep you awake at night?”
“Believe it or not, it’s what the American public wants. They are convinced they don’t want government bureaucrats messing with their pills, elixirs, and botanicals, whether they are worthless or not or even dangerous. They want to believe in the magic pill to make up for their unhealthy lifestyle. Taking a pill is a lot easier than eating right, exercising, and getting a decent night’s sleep.”
“Do you believe the public is that stupid?” Noah said.
“I do,” Ava said. “Did you ever see the commercial that Mel Gibson did back when the supplement industry was lobbying Congress to pass the 1994 law?”
“I didn’t. Or if I did, I was in the sixth grade, and it probably went over my head.”
“I was in the seventh grade,” Ava said. “I didn’t see it back then, but one of my NSC bosses showed it to me last year. It is a classic. Mel Gibson’s house is raided by armed FDA agents acting like a SWAT team, and he’s arrested for taking vitamin C supplements. It’s hilarious, but it was very effective. The public really thinks the government wants to take away their beloved vitamins. You should watch the video.”
“I’ll have to check it out,” Noah said.
“You didn’t answer when I asked you if I’ve been forgiven for disappearing for a few days,” Ava said. “Was that intentional?”
“I suppose you are forgiven,” Noah said halfheartedly.
“That doesn’t sound so convincing,” Ava said.
“I was really worried about you,” Noah said.
“I understand, but I’m all right. I’ve mostly recovered, except for random episodes like when I first arrived here. But I think I am ready to go back to work tomorrow. And I’m interested in starting to plan for the next M&M whenever you are.”
“Okay,” Noah said, “you’re forgiven. I can appreciate how upset you must have been.”
“Thank you,” Ava said. “Now, what time is it?” She looked at her watch. “Oh, dear. It’s later than I thought. But how about coming back with me to my house? I have a car waiting outside.”
“That’s your SUV I saw earlier with its blinkers on?” Noah asked with surprise. The idea hadn’t even occurred to him. The idea of having a driver wait an indeterminate amount of time seemed excessively extravagant.
“It’s the car that the NSC arranged to pick me up at the airport. As I said, I came directly here. We could have a snack or a glass of wine if you would like. I’m wide awake.”
“Four forty-five A.M. is going to come all too quickly for me,” Noah said. “I’ve been working like a dog. I’ll have to take a rain check.”
“Fine,” Ava said as she stood. “Maybe tomorrow evening you can come over
when you get out of the hospital, and we can have a bite. I’ve missed you.”
“Maybe,” Noah said. The real reason he was reluctant to take her up on her offer to go directly back to her house was that he wasn’t sure how he felt emotionally. He didn’t know if he wanted to get right back into the saddle after falling off the horse. “Sometimes Mondays are very busy, and I don’t get out until late,” he added as an afterthought.
“Well, let’s see how it goes,” Ava said. “Anyway, the offer stands.”
He walked her down to the front door. Like the first evening they had spent together, she surprised Noah by initiating a double-cheek kiss. Then, with him holding the door open, she said: “I’m really glad to see you, but in the hospital I think we should still play it safe and ignore each other. Dr. Mason’s suspicions might not be common knowledge, and it would be best not to give them any sort of credence. Okay?”
“Okay,” Noah managed. As usual, she had him off balance. “I’ve missed you as well. Welcome home!”
He watched her run across the street and open the SUV door. Before she climbed in she turned and waved. Noah waved back, then closed and dead-bolted the door. In contrast to her seeming burst of energy, he felt mentally and physically exhausted.
16
THURSDAY, JULY 20, 7:48 P.M.
Noah entered Toscano and approached the hostess desk. He told Richard, the handsome owner/manager whom he had formally met two nights ago, that he was there once again to pick up a take-out order. As he waited, Noah glanced around at the busy scene. All the tables and the lengthy bar were filled and a buzz of happy conversation and laughter permeated the room. None of the diners were thinking of sickness, injury, or death, which consumed Noah’s world on a daily basis. Usually he would have felt jealous of their normal lives and their facility at easy conversation. But tonight he wasn’t jealous in the slightest, as he was anticipating another delightful evening of his own.
The past Monday had been busy for Noah, even more than he had expected. So was the rest of the week. But any reluctance he might have entertained on Sunday night, the night Ava unexpectedly appeared at his door, about restarting his secret, intense relationship with her had progressively lessened. Although Monday morning he’d awakened still feeling that the prudent course would be to go slowly, as the day wore on he found himself becoming more and more excited about the prospect of seeing her that evening. Passing her several times in the surgery corridor, where they both scrupulously avoided any recognition of the other, only served to fan the embers of his passion into a full blaze. The secrecy alone lent a delicious libidinousness to the whole situation.
By the time Noah got to her house well after 9:00 P.M. Monday night, he was wound up like an old-fashioned clock. Apparently, it had been the same for her, because they ended up making love on the floor in the foyer just inside the inner door. In the background, they could hear occasional chatter by passing pedestrians out on the sidewalk as they were that close, but it didn’t affect their ardor in the slightest. After they were spent they lay for a time on the carpet runner, staring up at the hallway chandelier. It was a tender time as they reaffirmed how much they had missed each other, an emotion augmented by guilt on her part for not having texted him and worry on his part for not having heard from her.
Later, over take-out food, Noah had learned how hard it had been for Ava to do her consulting work while she was in Washington, since it meant meeting with or having meals with senators and congressmen who were members of key committees. She told Noah that she had suffered from a mild form of PTSD, or post-traumatic stress disorder, with persistent GI symptoms and recurrent nightmares about failing to get an endotracheal tube placed. She also confessed how close she’d come to calling Dr. Kumar to say that she was resigning.
Noah’s reaction to all this was similar to how he had responded the previous night in his apartment, reminding her of her board certification and that she had been hired by one of the country’s most prestigious hospitals. He told her that it had not been an accident that she had handled superbly more than three thousand anesthesia cases at BMH without a significant complication. He also reminded her that she had made several major contributions to the hospital. The first had been playing the key role behind the program of recapturing vast quantities of anesthetic gases rather than venting them into the atmosphere, which saved the hospital money and was also environmentally appropriate. The second had been that she had sat with him on the hybrid operating room committee, whose work resulted in the current remodel of the entire Stanhope Pavilion OR complex.
So far Noah had ended up staying overnight at Ava’s for the entire work week, arriving somewhere between 6:15 P.M. at the earliest, which happened on Tuesday, and 9:52 P.M. at the latest, which happened on Monday, and leaving each morning a tad before 5:00 A.M. Every night they had gotten take-out food from a Charles Street eatery and then spent hours talking while they ate and sipped a bit of wine.
In many ways, Noah found getting to know Ava like peeling an onion. Every time he learned something new, he found another layer, something he didn’t know or suspect, like the fact that she had a nearly photographic memory or that she was a talented computer coder, a skill she had picked up herself, mostly thanks to her love of computer gaming. Photographic memory and coding were aptitudes that Noah appreciated because he shared them.
Perhaps the most astounding new thing Noah learned about Ava was that she was fluent in Spanish, French, and German and spoke enough Italian to get along traveling the back roads in Italy. Why it surprised him was because language was not one of his fortes, and he had struggled through Latin and Spanish in high school courses. He also came to realize that, in contrast to himself, she had a sixth sense about reading people, something that came in particularly handy with her lobbying efforts. She explained to him how easy it was for her to discover a senator’s or a congressman’s opinion on a specific issue and then how to change it if it wasn’t in line with her NSC bosses’ desires.
“You never order dessert,” Richard, the restaurant owner, said. He interrupted Noah’s thoughts when he brought out the package of take-out food. “We have some delicious selections. How about I throw in some tiramisu on the house just so you can try it?”
“Thank you, but no,” Noah said. He doubted Ava would want it, even though she could certainly get away with it, considering the amount of exercise she did every day in her workout room. Noah didn’t feel the same about himself. With as little aerobic exercise as he got, he was lucky he hadn’t put on significant weight.
“Perhaps next time,” Richard said graciously, handing the credit card receipt to Noah.
Noah walked quickly up the hill to Louisburg Square. Now that he had the food he was in a hurry, and not just because he wanted the food to be hot but because he was even more eager than usual to see Ava. Earlier that afternoon they had practically collided with each other, with him pushing into the PACU and her coming out. At first both had been horrified, but when no one seemed to notice since it happened frequently to other people, they had both found it like a bit of slapstick comedy, since they’d been trying so hard to avoid each other.
Noah pushed the doorbell and in the far distance could hear the phone inside the house. The next thing he heard was the door lock clicking open. He’d learned that at any phone extension in the house it was possible to see who was at the door and then release the lock.
Once inside, Noah kicked off his shoes and took the main stairs down to the kitchen. Ava was busy setting out place mats, flatware, and napkins at the countertop table. To Noah she looked as fetching as usual, this time in sweatpants, a mock-neck tank top, and bare feet. Her hair was damp and her skin was glowing from a recent hot shower after her workout.
While Ava opened a bottle of wine and Noah unpacked the take-out food and put it on plates, they had a good laugh about their near collision at the PACU entrance that afternoon and how they’d both panicked
.
“It’s a good thing Janet Spaulding didn’t see us,” Ava said, still giggling.
“It’s amazing how she seems to know everything that goes on in the OR,” Noah agreed.
Once they had started on their meal, Ava said: “I hate to bring up a sore subject, but have you spoken with Dr. Jackson?”
“Not yet,” Noah admitted.
“Any reason why?” Ava questioned. “The M&M is coming up quickly. Only three more work days before it’s here.”
“The same reason I put off talking with Dr. Mason for the last M&M,” Noah said. “I’m a coward.”
“I can understand,” Ava said. “It could be almost as bad as talking with Dr. Mason. He is not as narcissistic, but they share some of the same personality traits.”
“I know. That’s the reason I’ve put off having the meeting.”
“But it is important to know his mind-set,” Ava said. “I’d like to know if he’s still mad.”
“Me, too,” Noah said. “Have you heard anything from Dr. Kumar to make you think that Dr. Jackson complained to him?”
“Not a thing.”
“Okay, good,” Noah said. “I think his threats to talk with our bosses was just his venting in the heat of the moment. Dr. Hernandez hasn’t said anything to me, either. Best-case scenario is that Dr. Jackson realizes some of the blame falls on his shoulders. If that’s true, we are in a far better position than with Dr. Mason.”
“We need to find out how he feels to plan your presentation,” Ava said. “When do you think you will be talking with him?”
“Now that you’ve reminded me, I’ll try to do it tomorrow.”
“I hate to be pushy, but it could be important.”
Eager to change the subject, Noah said, “The first time I was here, when you were showing me your fabulous computer setup, you said something interesting after admitting how much you enjoyed social media and how much time you spend doing it. You said it’s allowed you to learn more about yourself than if you’d done psychoanalysis. Were you being serious?”
