Godplayer

by Robin Cook

  Arranging the pole next to the bed, he turned and sat down, intending to lift his feet and stretch out. Instead he stifled a scream.

  Like an apparition, a white-clad figure emerged from the bathroom.

  “My God!” said Jeoffry, letting out his breath. “You really startled me.”

  “Lie down, please.”

  Jeoffry complied immediately. “I never expected you at this hour.”

  Jeoffry watched as the visitor pulled out a syringe and started to inject the contents into Jeoffry’s IV bottle. He seemed to have some difficulty in the darkness as Jeoffry heard the bottle clank repeatedly against the pole.

  “What kind of medication am I getting?” asked Jeoffry, unsure if he should say anything but sufficiently confused as to what was going on to overcome his hesitancy.

  “Vitamins.”

  To Jeoffry it seemed like a strange time to be getting vitamins, but the hospital was a strange place.

  Jeoffry’s visitor gave up trying to get the needle into the base of the IV bottle and switched to the injection site in the plastic tubing close to Jeoffry’s wrist. This was far easier and the needle immediately slipped through the small rubber cap. Jeoffry watched as the plunger was rapidly depressed, causing the fluid to back up in the tubing, raising the level in the chamber above his head. He felt a twinge of pain but assumed it was just the rise in pressure in the IV.

  But the pain did not disappear. Instead it got worse. Much worse.

  “My God!” cried Jeoffry. “My arm! It’s killing me!” Jeoffry could feel a white-hot sensation that began at the IV site rise up in his arm.

  The visitor grabbed Jeoffry’s hand to keep it still and opened the IV so it ran in a steady stream.

  The pain that Jeoffry thought had been unbearable got worse and spread like molten lava into his chest. He swung his free hand over to grasp his visitor.

  “Don’t touch me, you friggin’ faggot.”

  Despite the pain, Jeoffry let go. To his bewilderment was added fear… a terrible fear that something awful was happening. Desperately Jeoffry tried to free his arm with the IV from the intruder’s grip.

  “What are you doing?” gasped Jeoffry. He started to scream, but a hand was clamped roughly over his mouth.

  At that moment Jeoffry’s body experienced its first convulsion, arching up off the bed. His eyes rolled up and disappeared inside his head. Within seconds the spasms increased to become a grand mal seizure, rocking the bed back and forth. The intruder dropped Jeoffry’s arm and pulled the bed away from the wall to reduce the banging. Then he checked the corridor and ran back to the stairwell.

  Jeoffry convulsed in silence until his heart, which had begun to beat irregularly, fibrillated for a few seconds, then stopped. Within minutes Jeoffry’s brain ceased functioning. He continued to convulse until his muscles exhausted their depleted store of oxygen…

  • • •

  Thomas felt as though he’d just closed his eyes when the nurse bent over and shook him awake. He rolled over in a daze and looked into the woman’s smiling face.

  “They need you in the OR, Dr. Kingsley.”

  “Be right there,” he said thickly.

  Thomas waited while the nurse beat a hasty retreat, then swung his feet to the floor. He paused a few minutes for the dizziness to clear. Sometimes, thought Thomas, sleeping for too short a time was worse than no sleep at all. He steadied himself at the entrance, then stumbled over to his locker. Getting out a Dexedrine, he washed it down with water from the drinking fountain. Then he changed into a fresh scrub suit, but not before he’d rescued the half pill he’d left in the soiled shirt’s breast pocket.

  By the time Thomas got down to OR 18, the Dexedrine had cleared his head. He considered scrubbing right away but then decided it was better to find out first what he was up against.

  The residents were standing around the anesthetized patient, their gloved hands resting within the sterile field. The scene did not look auspicious.

  “What’s the…” began Thomas, his voice hoarse. He hadn’t spoken since awakening except for the few words to the nurse. He cleared his throat. “What’s the problem?”

  “You were right about the hemopericardium,” said Peter with respect. “The knife penetrated the pericardium and cut the surface of the heart. There’s no bleeding, but we wondered if we should close the laceration.”

  Thomas had the circulation nurse locate a stool and put it behind Peter. From that vantage point, he could see into the incision. Peter pointed to the laceration and bent to the side.

  Thomas was relieved. The laceration was inconsequential, having missed any significant coronary vessels.

  “Just leave it as is,” said Thomas. “The marginal benefits of suturing it aren’t worth the possible problems the suture might cause.”

  “Good enough,” said Peter.

  “Leave the pericardium open, too,” warned Thomas. “It will reduce the chances of running into a problem with tamponade in the postoperative course. It will serve as a drainage point if there is any bleeding.”

  An hour later Thomas crossed from the hospital to the Professional Building. When he entered his office he felt unpleasantly wired from the Dexedrine. Over and over he kept worrying about Ballantine and Sherman’s presence in the hospital that night. It was obvious they were having some kind of secret meeting, and, as he wondered what they were plotting, he felt his anxiety mount. Now he knew he would be unable to sleep unless he took something.

  He rarely got such a surge from a single Dexedrine but decided it was probably due to his general exhaustion. Going over to his desk, he gobbled another Percodan. Then, fearful that he might have trouble waking up in the morning, Thomas called Doris. He had to let the phone ring a long time. Mentally he retraced the complicated route from her bed to the phone by the bay window. He wondered why she didn’t get an extension.

  “Listen,” said Thomas when she answered. “You’ve got to come into the office at six-thirty.”

  “That’s only a couple hours from now,” protested Doris.

  “Jesus Christ,” shouted Thomas angrily. “You don’t have to tell me what time it is. Don’t you think I know? But I have three bypasses starting at seven-thirty. I want you over here to make sure I’m up.”

  Thomas slammed the phone down in its cradle, seething. “Goddamn selfish bitch,” he said out loud as he punched his pillow into submission.

  Seven

  Cassi’s eyes blinked open. It was a little after five in the morning and was not yet light outside. The alarm wasn’t scheduled to go off for another two hours.

  For a while she lay still, listening. She thought perhaps some sound had awakened her but as the minutes passed, she realized that the disturbance had come from within her head. It was the classical symptom of depression.

  At first Cassi tried turning over and drawing the covers up over her head, but she soon recognized it was useless. She couldn’t go back to sleep. She got out of bed, knowing full well that she would be exhausted that day, especially since Thomas had made her accept an invitation to go to the Ballantines that evening.

  The house was frigid, and she was shivering before she got on her bathrobe. In the bathroom she turned on the quartz heater and started the shower.

  Stepping under the water, Cassi reluctantly allowed herself to remember the reason for her depression-the discovery of the Percodan and the Talwin in Thomas’s desk. And Patricia was undoubtedly going to inform her son that Cassi had again been snooping in his study. Thomas would guess that she’d been looking for drugs.

  Getting out of the shower, Cassi tried to decide what to do. Should she admit she’d found the drugs and confront him? Was the presence of the drugs sufficiently incriminating? Could there be another explanation for their presence in Thomas’s desk? Cassi doubted it, considering the additional fact of Thomas’s frequently pinpointed pupils. As much as Cassi did not want to believe it, Thomas was most likely taking the Percodan and Talwin. How much, Cassi had
no idea. Nor did she have any idea how much she was to blame.

  The thought occurred to Cassi that maybe she should seek help. But who to turn to? She had no idea. Patricia obviously wasn’t the answer, and if she went to any of the authorities, then Thomas’s career could be ruined. Cassi felt almost too depressed to cry. It was a no-win situation. No matter what she did or didn’t do, it was going to cause trouble. Lots of trouble. Cassi was aware that her relationship with Thomas could very well be at stake.

  It took all her strength to finish getting ready for work and make the long drive to the hospital.

  Cassi had no more than dumped her canvas bag on her desk when Joan’s head came through the door.

  “Feeling any better?” asked Joan brightly.

  “No,” said Cassi in a tired, flat voice.

  Joan could sense her friend’s depression. From a professional point of view she knew Cassi was worse than she’d been the previous afternoon. Unbidden, Joan came into Cassi’s office and closed the door. Cassi didn’t have the energy to object.

  “You know the old aphorism about the sick doctor,” said Joan: “ ‘He who insists on taking care of himself learns he has a fool for a patient.’ Well, that applies in the emotional realm as well. You don’t sound so good to me. I came in here to apologize for foisting my opinions on you yesterday, but looking at you now, I think it was the right thing to do. Cassi, what’s happening to you?”

  Cassi was immobilized.

  There was a knock on the door.

  Joan opened it and confronted a tearful Maureen Kavenaugh.

  “Sorry, Dr. Cassidy is occupied,” said Joan. She closed the door in Maureen’s face before the woman could respond.

  “Sit down, Cassi,” said Joan firmly.

  Cassi sat down. The idea of forceful direction was appealing.

  “Okay,” said Joan. “Let’s hear what’s going on. I know you have your hands full with your eye problem. But it’s more than that.”

  Once again Cassi recognized the seductive pressure of the psychiatric interview on the patient to talk. Joan inspired confidence. There was no doubt about that. And Cassi could be assured of confidentiality. And in the last analysis Cassi desperately wanted to share her burden with someone. She needed some insight if not merely support.

  “I think Thomas is taking drugs,” said Cassi in a voice so low Joan could barely hear. She watched Joan’s face for the expected signs of shock, but there weren’t any. Joan’s expression didn’t change.

  “What kind of drugs?” asked Joan.

  “Dexedrine, Percodan, and Talwin are the ones I know of.”

  “Talwin is very common among physicians,” said Joan. “How much is he taking?”

  “I don’t know. As far as I am aware, his surgery hasn’t suffered in the slightest. He’s working as hard as ever.”

  “Uh huh,” nodded Joan. “Does Thomas know you know?”

  “He knows I suspect the Dexedrine. Not the others. At least not yet.” Cassi wondered how soon Patricia would tell Thomas she’d been in his study.

  “There’s a euphemistic term for this,” said Joan. “It’s called the ‘impaired physician.’ Unfortunately it is not all that uncommon. Maybe you should read up on it; there’s a lot of material in the medical literature although doctors themselves usually hate to confront the problem. I’ll give you some reprints. But tell me, has Thomas exhibited any of the associated behavioral changes-like embarrassing social behavior or disruption of his appointment schedule?”

  “No,” said Cassi. “As I said before, Thomas is working harder than ever. But he did admit that he is getting less enjoyment from his work. And he seems to have less tolerance lately.”

  “Tolerance for what?”

  “For anything. For people, for me. Even his mother, who essentially lives with us.”

  Joan rolled her eyes. She couldn’t help it.

  “It’s not that bad,” said Cassi.

  “I’ll bet,” said Joan cynically.

  The two women studied each other in silence for a few minutes.

  Then Joan asked tentatively, “What about your married life?”

  “What do you mean?” asked Cassi evasively.

  Joan cleared her throat. “Often physicians abusing drugs will suffer episodes of impotence and actively seek extramarital affairs.”

  “Thomas has no time for extramarital affairs,” said Cassi without hesitation.

  Joan nodded, beginning to think that Thomas did not sound very “impaired.”

  “You know,” said Joan, “your comment about Thomas’s low frustration level and the fact that he’s getting less enjoyment from his work these days is suggestive. Many surgeons are slightly narcissistic and share some of the side effects of the disorder.”

  Cassi didn’t respond, but the concept made sense.

  “Well, it’s food for thought,” said Joan. “It’s an interesting idea that Thomas’s success could be a problem. Narcissistic men need the kind of structure and constant feedback you get in a competitive surgical residency.”

  “Thomas did remark that there was no longer anyone for him to compete with,” said Cassi, catching Joan’s train of thought.

  Just then Cassi’s phone rang. As Joan watched her friend pick up the receiver, she was pleased. Cassi was already acting less depressed. In fact, she managed a smile when she realized it was Robert Seibert.

  Cassi kept the conversation brief. After she hung up, she told Joan that Robert was in seventh heaven because he got another SSD case.

  “That’s wonderful,” said Joan sarcastically. “If you’re about to invite me to the autopsy, thanks but no thanks.”

  Cassi laughed. “No, in fact I declined myself. I’ve scheduled patients all morning, but I told Robert I’d come up at lunch to go over the results.” Talking about time made Cassi glance at her watch. “Uh oh! I’m late for team meeting.”

  The meeting went well. There’d been no catastrophes overnight nor any new admissions. In fact, the resident on call was pleased to report that he’d gotten nine hours of undisturbed sleep, which made everybody extremely jealous. Cassi got a chance to discuss Maureen’s sister, and the consensus was that Cassi should encourage Maureen to contact her herself. There was general agreement that it was worth the risks to bring the sister into the treatment process if possible.

  Cassi also described Colonel Bentworth’s apparent improvement as well as his attempts to manipulate her. Jacob Levine found this particularly interesting but warned Cassi about jumping to premature conclusions.

  “Remember, borderlines can be unpredictable,” said Jacob, taking off his glasses and pointing them at Cassi for emphasis.

  The meeting broke up early since there were no new admissions nor new problems. Cassi declined an offer of coffee, as she did not want to be late for Colonel Bentworth. When she got back to her office, he was waiting by the door.

  “Good morning,” said Cassi as brightly as she could, opening her office door and entering.

  The colonel was silent as he followed Cassi in and sat down. She self-consciously took her place behind the desk. Cassi didn’t know why, but the colonel exacerbated her professional insecurities, especially when he stared at her with those penetratingly blue eyes which she finally realized reminded her of Thomas’s. They were both the same startling turquoise.

  Bentworth again did not look like a patient. He was impeccably dressed and seemed to have totally regained his air of command. The only visible hint he was the same person Cassi had admitted several weeks earlier were the healing burns on his forearm.

  “I don’t know how to begin,” said Bentworth.

  “Maybe you could start by telling me why you’ve changed your mind about seeing me. Up until now you’ve refused private sessions.”

  “Do you want it straight?”

  “That’s always the best way,” said Cassi.

  “Well, to tell the truth, I want a weekend pass.”

  “But that kind of decision is usually made by
the group.”

  Group was Bentworth’s major therapeutic agent at the moment.

  “That’s true,” said the colonel, “but the goddamn ignorant sons of bitches wouldn’t let me go. You could overrule them. I know that.”

  “And why would I want to overrule the people who know you the best?”

  “They don’t know me,” shouted Bentworth, slapping his hand on the desk.

  The sudden movement frightened Cassi, but she said quietly, “That kind of behavior is not going to get you anywhere.”

  “Jesus Christ!” said Bentworth. He got up and paced the small room. When Cassi didn’t react, he threw himself back into his chair. Cassi could see a small vein throbbing in his temple.

  “Sometimes I think it would be easier just to give up,” said Bentworth.

  “Why didn’t the members of your group think you should have a weekend pass?” asked Cassi. The only thing she was prepared for on Bentworth’s part was manipulative behavior, and she wasn’t going to fall for it.

  “I don’t know,” said the colonel.

  “You must have an idea.”

  “They don’t like me. Is that good enough? They’re all a bunch of jerks. Blue-collar workers, for Christ’s sake.”

  “That sounds pretty hostile.”

  “Yeah, well, I hate them all.”

  “They happen to be people like you with problems.”

  Bentworth didn’t respond immediately, and Cassi tried to remember what she’d read about treating borderline personalities. The actuality of psychiatry seemed a thousand times more difficult than the conceptualization. She knew that she was supposed to play a structuring role, but she wasn’t sure exactly what that meant in the context of the current session.

  “The crazy thing is that I hate them, yet I need them.” Bentworth shook his head as if he were confounded by his own statement. “I know that sounds weird, but I don’t like to be alone. The worst thing is for me to be alone. It makes me drink, and liquor makes me go nuts. I can’t help it.”