Godplayer

by Robin Cook

  “In a couple of days you’ll wonder why you were nervous.”

  “It’s easy for you to say, dressed in street clothes.” Robert held up his wrist with its plastic name tag. “I’ve become a statistic.”

  “Maybe it will make you feel better to know that your courage has prodded me into action. I’m being admitted tomorrow.”

  Robert’s expression changed to one of compassion. “Now I feel foolish. Here I am worried sick over a couple of teeth while you face eye surgery.”

  “Anesthesia is anesthesia,” said Cassi.

  “I think you are doing the right thing,” said Robert. “And I have a feeling that your operation is going to be a hundred percent successful.”

  “What about your own chances,” teased Cassi.

  “Um… fifty-fifty,” said Robert, laughing. “Hey, I got something to show you.”

  Robert stood up and went over to the nightstand. Picking up a folder, he joined Cassi on the edge of the bed. “With the help of the computer, I collated the data we have on the SSD cases. I found some interesting things. First of all, as you suggested, all of the patients were on IVs. In addition, over the past two years, the cases increasingly involved patients who were in stable physical condition. In other words, the deaths have become more unexpected.”

  “Oh God,” said Cassi. “What else?”

  “I played around for a while with the data, punching in all the parameters for our study except surgery. The computer spat out some other cases, including a patient by the name of Sam Stevens. He died unexpectedly during cardiac catheterization. He was retarded but in excellent physical condition.”

  “Was he on IV?” asked Cassi.

  “Yup,” said Robert.

  They stared at each other for several minutes.

  “Finally,” said Robert, “the computer indicated that there was a preponderance of males. Curiously enough, where the information was available, the computer pointed out an unusually high number of homosexuals!”

  Cassi looked up from the papers to Robert’s friendly gaze. Homosexuality had never been mentioned between them, and Cassi felt a reluctance to discuss it.

  “I went to pathology to visit you this morning,” she said, changing the subject. “I missed you, but I did find some of Jeoffry Washington’s slides. When I looked at the sections taken from the IV site, I found white precipitate along the inside of the vein. At first I thought it was artifact, but they were present on all but one of the sections. Do you think they might be significant?”

  Robert pursed his lips. “No,” he said finally. “Doesn’t ring any bells. The only thing I can think of is that when calcium is inadvertently added to a bicarbonate solution, it causes a precipitation, but that would be in the IV bottle, not the vein. I suppose the precipitation could run into the vein, but it would be so apparent in the bottle that everyone would see it. Maybe I’ll have an idea when I look at the section. Meanwhile, enough of this morbid stuff. Tell me about the party last night. What did you wear?”

  Cassi glossed over the evening. There was a chance Robert would hear what had happened on the hospital grapevine, but she didn’t want to bring it up. In many ways Cassi was surprised Robert hadn’t noticed her reddened eyes. He was usually so observant. She decided he was understandably preoccupied with his admission to the hospital. Promising to visit the next day, Cassi left before she was tempted to burden him with her own troubles.

  Larry Owen felt like a piano wire drawn out to its limit, ready to snap at the slightest increase in tension. Thomas Kingsley had arrived late that morning and was furious that Larry had waited for him to physically appear before beginning to open the first patient’s chest. Even though Larry completed the procedure with record speed, Thomas’s foul mood had not changed. Nothing pleased the surgeon. Not only had Larry done a piss-poor job, but the scrub nurses weren’t handing him the instruments properly; the residents weren’t giving him adequate exposure, and the anesthesiologist was an incompetent son of a bitch. As chance would have it, Thomas was given a faulty needle holder, which he’d thrown against the wall with such force it had snapped in two.

  Yet Larry had weathered this kind of abuse before. What was making him crazy was Thomas’s operative performance. It had been obvious from the moment he began work on his first patient that the surgeon was exhausted. His usually flawless coordination was off and his judgment faulty. And worst of all, Thomas had an uncontrollable tremor. It almost gave Larry heart failure to watch Thomas bend over the heart with a razor-sharp needle and try to direct the instrument to the dainty piece of saphenous vein he was attempting to sew to the minute coronary vessel.

  Vainly Larry had hoped the tremor would lessen as the morning progressed. Instead it got worse.

  “Would you like me to sew this one on?” asked Larry on several occasions. “I think I can see a bit better from my position.”

  “If I want your help, I’ll ask for it,” was Thomas’s only reply.

  Somehow they got through the first two cases with the bypasses sewn reasonably in place and the patients off the heart-lung machine. But Larry was not looking forward to the third case, a thirty-eight-year-old married man with two little children. Larry had opened the patient’s chest and was waiting for Kingsley to return from the lounge. The resident’s pulse was racing, and he had begun sweating heavily. When Thomas finally burst through the OR door, Larry felt his stomach knot with fear.

  At first, things went reasonably well, although Thomas’s shaking was no better and his frustration level seemed even lower. But the open-heart team, wary after the first two cases, was careful not to cross him in any way. The hardest job fell to Larry, who tried to anticipate Kingsley’s erratic movements and do as much of the actual work as Thomas would allow him. The real trouble didn’t begin until they’d started sewing the bypasses in place. Larry couldn’t watch and turned his head away as Thomas’s needle holder approached the heart.

  “Goddammit,” shouted Thomas.

  Larry felt his stomach churn as he saw Thomas yank his hand from the operative site, the needle buried in his own index finger. Inadvertently Thomas also pulled out one of the large catheters that took blood from the patient to the heart-lung machine. As if a faucet had been turned on, the wound filled with blood and in seconds began soaking the sterile drapes and dripping onto the floor.

  Desperately Larry plunged his hand into the wound and groped blindly for the clamp holding the suture around the vena cava. Luckily his hand hit it immediately. Deftly he pulled up on the tape and the blood loss slowed.

  “If I had decent exposure this kind of problem wouldn’t happen,” raged Thomas, pulling the needle out of his finger and dropping it on the floor. He stepped back from the table nursing his injured hand.

  Larry managed to suck out the blood from the wound. As he reinserted the catheter from the heart-lung machine, he tried to think what he should do. Thomas wasn’t fit to operate anymore that day, yet to say anything risked professional suicide. In the end Larry decided that he could no longer stand the tension. When he’d secured the operative site, he stepped away from the table and joined Thomas, who was being regloved by Miss Goldberg.

  “Excuse me, Dr. Kingsley,” said Larry with as much authority as he could muster. “This has been a trying day for you. I’m sorry we haven’t been more on the ball. The fact of the matter is that you are exhausted. I’ll take over from here. You needn’t reglove.”

  For a moment Larry thought Thomas was going to slug him, but he forced himself to continue. “You’ve done thousands of these operations, Dr. Kingsley. No one is going to fault you for being too tired to finish one of them.”

  Thomas began to shake. Then, to Larry’s astonishment and relief, he snapped off his gloves and left.

  Larry sighed and exchanged glances with Miss Goldberg.

  “I’ll be right back,” said Larry to the team. With his gloves and gown still on, Larry left the OR. He hoped that one of the other staff cardiac surgeons would be availabl
e and was relieved when he saw Dr. George Sherman coming out of OR No. 6. Larry took him aside and quietly related what had happened.

  “Let’s go,” said George. “And I don’t want to hear a word about this outside of the OR, understand? It could happen to any one of us, and if the public learned about the incident it would be disastrous, not just for Dr. Kingsley, but for the hospital.”

  “I know,” said Larry.

  Thomas was angrier than he had ever been. How dare Larry suggest he was too tired to proceed? The scene had been a nightmare. It was the haunting fear of such disaster that had originally forced him to take an occasional pill to sleep. He’d been perfectly capable of finishing the operation, and if he hadn’t been so upset over Cassi’s infidelity, he certainly would not have left. Furiously he stomped into the surgical lounge and used the phone by the coffee machine. He called Doris to make sure there were no emergencies and asked her to reschedule his afternoon patients for another day. He was already late, and he didn’t think he could stand to see patients. Doris was about to hang up when she remembered that Ballantine had called, asking if Thomas would stop by his office.

  “What did he want?” asked Thomas.

  “He didn’t say,” said Doris. “I asked him what it was in reference to, in case you’d need a patient folder. But he said he’d just like to see you.”

  Thomas told the nurse at the main desk that he’d be in Dr. Ballantine’s office in case there was a call. To steady himself and relieve his headache, which had gotten steadily worse, he took another Percodan from his locker. Then he donned a white lab coat and left the lounge wondering what the meeting could be about. He did not think the chief would call him in to discuss the scene at the party with George Sherman, and it certainly couldn’t have anything to do with the episode with Larry Owen. It must have something to do with the department in general. He remembered the trustee’s odd comment the night before and decided Ballantine was finally going to let Thomas in on his plans. There was always the chance that Ballantine was thinking about retiring and wanted to discuss turning over the department to Thomas.

  “Thanks for coming in to see me,” said Dr. Ballantine, as soon as Thomas was seated in his office. He seemed somewhat ill at ease, and Thomas shifted in his chair.

  “Thomas,” Ballantine finally began. “I think we should speak frankly. I assure you that whatever we say will not leave this room.”

  Thomas rested an ankle on his knee, steadying it with his hands while his foot began to pump rhythmically.

  “It’s been brought to my attention that you might be abusing drugs.”

  Thomas’s foot stopped its nervous movement. The low-grade headache became a pounding agony. Although anger flooded his consciousness, his expression stayed the same.

  “I want you to know,” said Dr. Ballantine, “that this is not an uncommon problem.”

  “What kind of drugs am I supposed to be taking?” asked Thomas, making a supreme effort to rein in his emotions.

  “Dexedrine, Percodan, and Talwin,” said Dr. Ballantine. “Not uncommon choices.”

  With narrowed eyes, Thomas studied Dr. Ballantine’s face. He hated the older man’s patronizing expression. The irony of being judged by this inept buffoon drove Thomas to the brink of frenzy. It was lucky that the Percodan he’d taken in the lounge was beginning to work.

  “I’d like to know who brought this ridiculous lie to your attention,” he managed to ask quietly.

  “That is not important. What matters…”

  “It’s important to me,” said Thomas. “When someone starts this kind of vicious rumor, they should be held accountable. Let me guess: George Sherman.”

  “Absolutely not,” said Dr. Ballantine. “Which reminds me. I spoke to George about the regrettable incident last night. He was mystified by your accusation.”

  “I’ll bet,” snapped Thomas. “It’s common knowledge that George tried unsuccessfully to marry Cassi before I met her. Then I gave them the opportunity by working so many nights…”

  Dr. Ballantine interrupted. “That doesn’t sound like much solid evidence, Thomas. Don’t you think that you might be overreacting?”

  “Absolutely not,” said Thomas, uncrossing his legs and letting his foot down with a bang. “You saw them together yourself at your party.”

  “All I saw was a very beautiful girl who seemed only interested in her husband. You’re a lucky man, Thomas. I hope you know that. Cassi is a special person.”

  Thomas was tempted to stand up and leave, but Ballantine was still talking.

  “I believe that you have been driving yourself too hard, Thomas. You’re trying to do too much. My God, man, what are you trying to prove? I can’t even remember the last time you took a day off.”

  Thomas started to interrupt, but Dr. Ballantine cut him off.

  “Everyone needs to get away. Besides, you have some responsibility to your wife. I happen to know Cassi needs eye surgery. Shouldn’t she be getting some of your time?”

  Thomas was now reasonably certain that Ballantine had talked with Cassi. As incredible as it sounded, she must have come to him with her wild stories about drug addiction. It wasn’t enough, thought Thomas with anger, that she went to his mother. She also had to see his chief of service. Thomas suddenly realized that Cassi could destroy him. She could ruin the career that he’d spent his whole life constructing.

  Luckily for Thomas, his sense of preservation was stronger than his anger. He forced himself to think with cold, hard logic as Ballantine finished.

  “I’d like to suggest that you take some well-earned vacation.”

  Thomas knew that the chief would love to have him out of the hospital while the teaching staff whittled away at his OR time, but he managed to smile.

  “Look, this whole thing has gotten out of hand,” Thomas said calmly. “Maybe I have been working too hard, but that’s because there has been so much to do. As far as Cassandra’s eye problem is concerned, of course I’m planning to spend time with her when she’s laid up. But it really is up to Obermeyer to tell her how best to handle her retinal problems.”

  Ballantine started to speak, but Thomas interrupted him.

  “I listened to you, now hear me,” said Thomas. “About this idea that I’m abusing drugs. You know that I don’t drink coffee. It’s never agreed with me. So it’s true that I occasionally take a Dexedrine. But it has no more effect than coffee. You just can’t dilute it with milk or cream. I admit it has different social implications, especially if someone takes it to escape from life, but I only use it on occasion to work more efficiently. And as far as the Percodan and Talwin are concerned: yes, I’ve taken them at times. I’ve had a propensity for migraines since I was young. I don’t get them often, but when I do, the only thing that helps is Percodan or Talwin. Sometimes the one, sometimes the other. And I’ll tell you something. I’ll be happy to have you or anyone else audit my prescribing habits. You’d see in an instant the amount of these drugs that I prescribe and for whom.”

  Thomas sat back and folded his arms. He was still trembling and did not want Ballantine to notice.

  “Well,” said Ballantine with obvious relief. “That certainly seems reasonable.”

  “You know as well as I,” said Thomas, “that all of us take a pill now and then.”

  “True,” said Dr. Ballantine. “The trouble comes when a physician loses control of the number he takes.”

  “But then they’re abusing the drug,” said Thomas. “I’ve never taken more than two in twenty-four hours, and that’s only with a migraine.”

  “I must tell you that I feel relieved,” said Dr. Ballantine. “Frankly, I was worried. You do work too hard. I still mean what I said about your taking some vacation.”

  I’m sure you do, thought Thomas.

  “And I want you to know,” continued Ballantine, “that the whole department only wants the best for you. Even if we see some changes down the line, you will always be the keystone of our service.”


  “That’s reassuring,” said Thomas. “I suppose it was Cassandra who came to you about the pills.” Thomas’s voice was matter of fact.

  “It really doesn’t matter who called it to my attention,” said Dr. Ballantine, standing up. “Especially since you’ve laid my fears to rest.”

  Thomas was now positive it had been Cassi. She must have looked in his desk and found bottles. He was swept by another wave of anger.

  He stood up, his fists tightly clenched. He knew he had to be alone for a while. Saying good-bye and forcing himself to thank Ballantine for his concern, Thomas hastily made his way out of the office.

  Ballantine stared after him for a moment. He felt better about Thomas, but not completely reassured. The scene at the party nagged him, and there were those persistent rumors that had cropped up recently among the house staff. He didn’t want trouble with Thomas. Not now. That could ruin everything.

  When the door to the waiting room opened, Doris quickly dropped the novel she was reading into a drawer and closed it with one smooth, practiced motion. Seeing Thomas, she picked up the telephone messages and came around from behind the desk. After being alone in the office all afternoon, she was happy to see another human being.

  Thomas behaved as if she were part of the furniture. To her surprise, he went past her without the slightest acknowledgment. She reached out to grasp his arm, but she missed, and Thomas continued into his office as if he were sleepwalking. Doris followed.

  “Thomas, Dr. Obermeyer called and…”

  “I don’t want to hear about anything,” he snapped, starting to close his door.

  In commendable saleswoman fashion, Doris got a foot over the threshold. She was intent on giving Thomas his messages.

  “Get out of here,” screamed Thomas. Doris stepped back in fright as the door slammed in her face with jarring force.

  The fury that he’d suppressed during the harrowing interview with Ballantine engulfed him. His eyes searched for some object on which he could vent his anger. He grabbed up a bud vase Cassi had given him when they were engaged and smashed it on the floor. Looking at the shattered pieces, he felt a little better. He went over to his desk, pulled out the second drawer, and grabbed a bottle of Percodan, spilling several of the tablets onto his desk. He took one, putting the rest back, then went into the washroom for a glass of water.