She failed to notice the curious glances that several patients in the day room gave her. It was completely out of character for Dr. Desmonde to rush. She was the coolest, calmest, most collected cucumber that most of the patients had ever seen.
Rose was relatively indifferent to the physician's movements, but was concerned. She'd been worried about Dr. Desmonde for the past few days and had heard through the patient grapevine that Anthony had just attacked her. Rose, in her confused and flustered state, really liked Dr. Monique. She decided the physician might need some help, so she decided to follow her.
As Monique entered the hall between Pavilion I and Pavilion II, she looked around furtively. The last thing she needed was someone reporting to Whitset that she'd been hovering and snooping around his office. Her heart froze when she thought of the possible repercussions, but she shook off the fear. Monique looked around again, just to be safe. The coast was clear.
She didn't see the waiflike profile of Rose peering at her from around the corner.
Dr. Desmonde tentatively turned the knob on Whitset's door. It was locked. Just my luck, she thought to herself. She thought for a second and then pulled the master key to the psychiatric unit from her pocket. She inserted the key into the lock, her heart pounding in her chest. She'd never broken into anything before. Please Lord, please Lord, let it open, she prayed to herself. She was in luck. The lock clicked with a slight turn of her wrist and she pushed the door open. She entered Whitset's office, closing the door softly behind her.
The first thing that struck the psychiatrist when she opened the door was the darkness of the office. The heavy curtains had been drawn over the double windows opposite the door. As her eyes adjusted to the darkness, she noted that the office was immaculate. Nothing was out of place. Whitset's highly polished walnut desk was completely clear of any notes, files, or correspondence. The leather desk set and inkstand were easily visible. The round, leather container held four different colored ballpoint pens. Several pencils with sharp points were also in the container. A bookcase held several psychiatric reference books and several recent journals were on an end table, next to a pair of leather side chairs. All in all, the office looked like a magazine advertisement for office furniture. It was as if no one really worked in the place. It didn't even have a scent. It smelled like nothing. Monique sniffed again. Well, maybe it did smell like something. She could smell something metallic. It had a salty, metallic scent, kind of like old blood.
After looking around a second time, Monique decided the most impressive thing about the office was that it was unimpressive – except for its neatness, which was pretty typical of an obsessive personality. She continued to look around carefully, convinced that if she searched closely enough, she'd find something. She walked around to the side of Whitset's desk and switched on his brass desk lamp. A warm glow from the light bathed the office in a comfortably colored hue. The polished wood of the desk gleamed brightly in the lamplight. Monique's eyes searched the desk and nearby bookcases for any possible clues.
Once again, her senses were heightened to the metallic smell. What was that smell? As she tried to open the desk drawers, her eyes noted something glistening in the lamplight. It was hanging out of the bottom left desk drawer. Monique reached to pick it up and found it was a slender gold chain that was caught in the drawer. She tried to pull it out, but couldn't because it was stuck between the drawer and the desk frame. Monique reached down to examine the chain more closely. She saw that the chain was broken and missing several links. The clasp was in place. The chain looked like one a woman would wear. It was much too fragile to be male jewelry.
Monique tried for several moments to detangle the chain from the desk drawer. Convinced that she couldn't remove the chain, Monique looked around the office again. Her eyes fell on Whitset's diplomas, which were hanging neatly on the wall over his bookcase. He had an undergraduate degree from some university in Europe. His graduate degree was a Master’s in business administration from the University of Pennsylvania. Monique looked closely at the date on the MBA. The degree was conferred in 1966. Immediately, her heart started beating hard. It seemed impossible. Whitset certainly didn't appear old enough to have received a Master’s degree in 1966! She didn't think he was over forty-five. If he had received a Master’s degree in 1966, he must be a lot older than she thought he was – how then could he look so youthful? Monique intuitively knew that it wasn't Whitset's degree. She quickly looked back at his undergraduate degree. It was awarded in 1963. Damn, that was impossible!
As she stood contemplating this information, there was a soft knock on the office door. Her heart sank. She immediately killed the light and ducked behind the desk, holding her breath for what seemed like an eternity. Her pulse beat rapidly. Wow, the smell was overwhelming. What was that smell? At that point, Monique noted a green bottle, the shape that red wine came in, on the bottom bookcase near the back. She picked it up a sniffed. Oh My God, the smell of old wine and metal about knocked her out. She had to take several deep breaths to recover. Whew, she thought to herself. If I drank that stuff, I'd be loco, crazy too.
After several minutes of silence, Monique rose from her hiding place and slipped surreptitiously out of the office. When she reached her own office, she pulled out her personnel file on Whitset. Her eyes scanned his resume. His date of birth was recorded as January 27, 1951f. Monique smiled a half smile. She knew Whitset was smart, but she doubted he was smart enough to have been awarded a Master’s degree when he was only fifteen years old! Her watch beeped. It was almost 3:15. She rushed over to the main campus to the executive meeting, her face highly colored because of her discovery.
25
Alex was getting antsy at the meeting. She found herself fidgeting in her chair. Where was Monique? Where was Commander Françoise? She'd expected that he would attend the meeting to report on the progress of the investigation. Don was obviously getting cross about being held up by his 'employees'. Favre was droning on and on about how safe the psych units were and how other hospitals didn't have the sophisticated monitoring systems that CCMC had installed several years ago. Farve maintained the staffing numbers in the Pavilion were better than the staffing numbers of several hospitals considered competitors to Crescent City Medical.
Alex wanted to hug Robert Bonnet, present at the meeting because he was acting chief of surgery, when he interrupted Bette Farve’s drone.
Robert directly addressed the nurse executive in a reasonable tone, "Ms. Farve, how can you suggest that the Pavilion is safe? Only last night an elderly patient was murdered and no one heard her screams because the only staff member was on the far hall, a long distance from where the incident occurred."
Bette raised her eyebrows and gave the handsome surgeon a dirty look. "Dr. Bonnet, last night was an extreme and unusual situation. There'd been an emergency over on the prison unit. All other staff had been sent over there to handle it. This is an isolated incident!" Farve gave Robert a tight little smile.
Elizabeth spoke up, "It may be an isolated incident, but it still has a heavy impact. There should be enough staff to cover the unit, even when there's a problem. When the media gets a hold of this, as I believe they already have – based on the stack of messages on my desk – we’re going to be in for some nasty, negative publicity." Elizabeth Tippett used her advantage well and looked straight at Don Montgomery.
Montgomery didn't respond, but Whitset did. "I believe we are blowing the repercussions of this incident out of proportion in relationship to the actual threat. Accidents happen in hospitals. They happen every single day—”
Elizabeth interrupted the psychiatric administrator, "Really, Mr. Whitset, accidents and incidents do occur in hospitals regularly, but it's a bit extreme to have a patient murdered by another patient on the psychiatric unit. I believe you're the one underestimating the potential disaster here."
Alex wanted to give Liz a standing ovation. She was proud of Elizabeth for the way she was standing up to Whits
et. She had emerged from a shrinking violet just a few months ago to a strong member of the executive team. She was a master at dealing with the press and sorting out difficult, press related issues. Elizabeth had a well-connected press network, which complimented her ability to perform her job well.
Whitset stared at Liz and gave her a chilling look.
Even Alex could feel the coldness his manner exuded.
He said in an icy voice, his black glittering eyes raking the media director's face and upper torso, "My dear, I do believe you're wrong."
Elizabeth maintained her composure and said simply, "No, Mr. Whitset, I'm right." She turned to Bette Farve and said, "Besides, it's clear to me that our sophisticated equipment you mentioned, Ms. Farve, was useless last night – particularly since there were no staff members available to monitor it!" She glared at the nurse executive, her eyes displaying her displeasure.
Bette just stared at the table. There was nothing she could say.
Alex and Robert both eyed each other after they saw the look of intense hatred Lester Whitset gave Elizabeth Tippett. Elizabeth seemed not to notice. Alex was glad. It was bad enough that she and Robert were worried.
Montgomery checked his watch and eyed the group. "Where in the hell is Dr. Desmonde? And, where is that useless police commander? I was sure he would be here to entertain us with his consistent incompetence." Don looked around at the group to see which of the members appreciated his humor. Bette Farve and Lester Whitset both smiled broadly.
Alex, per usual, was disgusted with Don. She said, "Don, I believe Dr. Desmonde is on her way. There was another incident up on the unit and—”
Whitset about fell out of his chair, “What incident, what happened?"
Alex looked around the room and said, "I don't know the details. Monique will tell us when she arrives."
Don was livid and his faced flushed bright red. "Shut up, Alex. I know what happened and I don't care about that." Don paused as the door to the conference room opened, "Well, well, well, look who finally made it," Don sneered as Monique entered the conference room.
Robert was angry as well, but his voice was calm. "Don, please watch what you say and keep this meeting professional. Dr. Desmonde and Ms. Destephano don't deserve your sarcasm and disrespect."
Alex flashed Robert a smile. She could hardly believe the CEO had told her to shut up.
Don ignored Robert and said, "Dr. Desmonde, I don't recall you telling me I was going to need double staff to take care of these wackos. Did you tell me that, Dr. Desmonde?" Don's voice was demanding and so sarcastic that Alex could feel Robert get ready to say something else to him. She placed her hand on Robert's arm and whispered to him to let Monique handle Montgomery.
"No, I didn't tell you that precisely, Don. What I did tell you was that there was a distinct possibility our workload would increase significantly and that we may need more staff later. That, I believe, is when you, as our esteemed leader, hired Mr. Whitset's company to manage the psychiatry service!" Monique's voice was disdainful and patronizing.
Whitset had been watching the exchange with a great deal of interest. He interjected, "Yes, Mr. Montgomery did hire us around the time he signed the state contract. He was obviously worried about the costs of caring for such a diverse population of psychiatric patients. My company assured him that we had helped many other hospitals do the same type of thing we have done here at Crescent City – successfully managing a changing population of psychiatric patients without increasing costs. We're successful here. It's a good model." Whitset smiled broadly, his thin lips curling over his small rodent like teeth.
Monique could hardly abide Whitset's tiresome ponderosity. What a pile of bullshit, she thought to herself. When she couldn't stand it any longer, she addressed the pompous Whitset.
"Mr. Whitset, your model may be a good financial model for the hospital, but it is a poor clinical model. I'm sure the only reason it's saved the hospital money is because you cut staffing positions."
If looks could kill, Whitset would have eradicated Monique. But, he remained silent.
Elizabeth Tippet pushed her long, dark hair back and looked at Whitset as though he were a moron. "I'm a bit confused by your comments. I wouldn't call these recent events successful, Mr. Whitset. I'd call them tragic. I agree with Dr. Desmonde. I vote we increase the staff to the levels she's suggested. It's pretty clear to me that we’re understaffed over there. I, for one, don't want any more of these patient or staff incidents to occur."
"I second Elizabeth's suggestion. I trust Dr. Desmonde's judgment implicitly in these matters." Dr. Bonnet smiled warmly at Monique and continued talking. "She is a nationally known expert in her field and she knows the internal needs of her department."
Don Montgomery gave Robert Bonnet a deprecating look.
He'd always hated and distrusted the surgeon. In some respects, Alex believed Don was jealous of Robert.
"Thanks, Bonnet. What a surprise! You physicians never disagree with each other." His voice was laced with sarcasm and disdain as he sneered at Robert.
Montgomery turned to Whitset. "What do you want to do, Whitset? It's really your call, you know. You're in charge of the Pavilion. If you think we need the staff, we'll work it out."
Alex intervened. "Don, I object to giving him this authority. He's hired contract help. This system is an administrative disaster. I would certainly like him on our team, but I wouldn't give him the authority to make the decision. In fact, I don't think he has that authority based on hospital by-laws and policy."
Whitset's eyes shot daggers at Alex, his black eyes penetrated her face.
Alex could feel the coldness he exuded. She could feel the chill as it washed over her.
Don shrugged his shoulders and looked at Whitset. "Don't know, Whitset. What do you think?"
Whitset managed a complete turnabout. He looked at the group, nodding at Donald Montgomery. His smile was pleasant and his voice congenial. "Thanks, Don. Thank you all for your input. I'm not in favor of hiring additional staff. We don't need them. According to my numbers, CCMC is well staffed. The staff we have are competent and are used to caring for the type of patients we admit. Secondly, our productivity would drop if we hired ten new positions. It would take us over six months to hire and train them. Hiring these people makes no business sense at all – particularly because we don't need them. I figure these positions would cost us better than $1 million the first year. I'm against it."
Bette Farve nodded her head in agreement with Lester Whitset. "I quite agree with Mr. Whitset. If we have money for positions, Don, I'd much rather put the FTEs in critical care or on the medicine units. Psych is doing okay. Besides, it's hard to fill psych nursing positions. We have to pay them more because of the perceived notion that working with these patients can be more dangerous. I'm against increasing the staff over there." Bette rolled her eyes at the 'perceived notion' that caring for psych patients could be dangerous.
Monique interrupted, "Perceived notions, really Bette, you are intolerable. Two nurses have been attacked in the Pavilion!"
Alex gave Bette Farve a disgusted look and shook her head. One thing about Bette was that she never disappointed. For some reason, she always expected that the nursing leader would emerge as supportive of nursing and their needs. Farve never did. I ought to be used to her by now, Alex thought. At least I know what to expect, she mused. I guess it's better than people shooting from the hip. Expect nothing, get less. That's going to be the way I approach her.
Alex spoke, "I recommend, from a legal standpoint, that we fill the slots. We have a file full of complaints from patients, staff, and visitors about how unsafe the Pavilion is. We're required by law to provide for the reasonable safety of those who visit our premises. If we don't, we could be liable for all types of actions."
"Now, now, now, Alex. Perhaps you're being a little overzealous. Aren't you flaunting your lawyer credentials?" Lester Whitset looked at her, a mollifying smile on his face. His voice was
so low she could hardly hear him.
"Absolutely not, Mr. Whitset. I'm only being reasonable and prudent, doing my job as the hospital attorney. Dr. Desmonde has offered a convincing argument, substantiated by statistics, that we are severely understaffed here in psychiatry. Her numbers aren't even adjusted for the severity of our patient index or patient population. Our overall patient acuity is higher than that of any other hospital in New Orleans. Therefore—”
Alex was interrupted by Whitset as he jumped up from his seat and leaned across, practically lying on the conference table across from her, his face white again with fury. He looked like a little boy who was pouting. "We will not hire any additional staff! It's my decision, and it’s final! It's no longer open for discussion." Whitset stared around the room.
Alex was incredulous. How dare that creepy SOB undermine her? She looked at Don and said, "Don, really, we must have some type of closure here.”
Montgomery looked at the hospital lawyer and shrugged his shoulders. "It's Whitset's decision, Alex. He has the last say. It's in his contract."
Alex was incredulous. "No, no, Don. You're wrong. It's our contract. Whitset is contracting with us. We are in charge here. We are driving the bus."
Robert looked scornfully at Whitset. "What's in this for you, Whitset? A bigger bonus based on dollars saved at the end of the year?"
Whitset said nothing and continued to look around the room.
Alex's sense of smell was assaulted by a strange odor. She couldn't quite place it, but it was very familiar. She looked around to see if anyone else noticed it. Whatever the smell was, it had a metallic taint.
Elizabeth said clearly, "I must go on record here as being positively opposed to this decision."
Robert and Alex nodded their heads in agreement with Liz.
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