by Robin Cook
Thomas needed a breath of air. The two Talwin he’d taken before leaving the office had had disappointingly little effect on his mood. He’d never felt such anxiety before. The Friday afternoon conference had been a disaster. And on top of that were the mushrooming problems with Cassi.
Thomas stood on the deserted bridge for almost half an hour, letting the damp breeze chill him to the bone. The discomfort was therapeutic, making it possible for him to think. He had to do something. Ballantine and his cohorts were intent on destroying everything Thomas had carefully built. In his hand he gripped a drug vial, intending to throw it into the water. But he didn’t. Instead he returned it to his coat.
Slowly Thomas felt better. He had an idea, and as the idea took form, he began to smile. Then he laughed, wondering why he hadn’t thought of it before. With a new surge of energy he returned to his car and warmed his fingers by holding them over the defroster vent.
After pulling into the garage, he crossed the courtyard to the house at a run. He moved the drug container to his suit pocket when he took off his coat and, feeling better than he had all day, went in to greet his mother.
“I’m so glad you’re on time,” she said. “Harriet is just putting dinner on the table.” She took his arm and led him into the dining room. He knew she was in a good mood because she had him to herself, but she managed to inquire politely about Cassi before serving herself from the platter of Yankee pot roast.
When Harriet had gone back into the kitchen, she began asking about Thomas’s day.
“Are things going better at the hospital?”
“Hardly,” said Thomas, not eager to discuss the worsening hospital situation.
“Have you spoken with George Sherman?” asked Patricia with disgust.
“Mother, I don’t want to talk about hospital politics.”
They ate in silence for a few minutes, but Patricia could not contain herself and again spoke up. “You’ll know what to do with the man when you become chief.”
Thomas put down his fork.
“Mother, can’t we talk about something else?”
“It’s hard to avoid the issue when I can see how much it is bothering you.”
Thomas tried to calm himself with a series of deep breaths. Patricia could see him tremble.
“Look at you, Thomas, you’re like a spring wound too tightly.” Patricia reached over to stroke her son’s arm, but Thomas evaded her touch by pushing back his chair and standing up.
“The situation is driving me crazy,” admitted Thomas.
“When do you think you’ll be chief?” asked Patricia, watching her son begin to pace back and forth like a caged lion.
“God, I wish I knew,” said Thomas through clenched teeth. “But it better be soon. If not, the department will be in shambles. Everyone seems to be going out of their way to destroy the cardiac vascular program I set up. Boston Memorial is famous because my operating team made it so. Yet instead of letting me expand, they are constantly cutting down my time in the OR. Today I learned that my surgical time is being reduced again. And you know why? Because Ballantine made arrangements for the Memorial Teaching Service to have free access to a large state mental institution out in the western part of the state. Sherman went out there and said the place was a cardiac surgical gold mine. What he didn’t say was that the average mental age of the patients was less than two years. Some of them are actually deformed monsters. It makes me furious!”
“Well, won’t you be backing the house staff on those cases?” asked Patricia, trying to think of the positive side of the issue.
“Mother, they are mentally defective pediatric cases, and Ballantine plans to recruit a full-time pediatric cardiac surgeon.”
“Well, then, that won’t affect you.”
“But it will,” shouted Thomas. “It will put more pressure on me to cut back my OR time.” Thomas felt his temper rising. “My patients will either have dangerous delays before surgery or will have to go elsewhere.”
“But surely your patients will be scheduled first, dear.”
“Mother, you don’t understand,” said Thomas, making an effort to speak slowly. “The hospital doesn’t care that I only take on patients who not only have a good chance of survival but are worth saving. To build the reputation of the teaching school, Ballantine would rather sacrifice valuable OR time for a bunch of imbeciles and defectives. Unless I become chief I won’t be able to stop them.”
“Well, Thomas,” said Patricia. “if they don’t give you the position, you’ll just have to go to another hospital. Why don’t you sit down and finish your dinner?”
“I can’t just go to another hospital,” shouted Thomas.
“Thomas, calm down.”
“Cardiac surgery requires a team. Don’t you understand that?” Thomas threw his napkin into his half eaten food.
“You’ve upset me!” he shouted irrationally. “I come home for once expecting a little peace and you upset me!” He stormed out of the room, leaving his mother wondering what on earth she had done.
Walking down the upstairs corridor, Thomas could hear the surf breaking on the distant beach. The waves must be four to six feet high. He loved the sound. It reminded him of his childhood.
Snapping on the light in the morning room, he looked around. The white furniture had a harsh, cold appearance. He hated the way Cassi had insisted on redecorating the room. There was something brazen about it despite the lace curtains and flowered cushions.
He stayed for only a short time before going back to his study. With trembling hands he found his Percodan. For a while he entertained the idea of returning to town to see Doris. But soon the Percodan began to make him feel calmer. Instead of going out into the frigid night, he poured himself a Scotch.
Thirteen
Cassi had hoped that she’d become accustomed to the opthalmologist’s light, but each time Obermeyer examined her was as uncomfortable as the last. It had been five days since her surgery, and except for the insulin reaction, the postoperative course had been smooth and uneventful. Dr. Obermeyer had come by each day to peer into her eye for a moment, always saying that things were looking good. Now on the day of her scheduled discharge, Cassi had been escorted over to Dr. Obermeyer’s office for one last “good” look, as he called it.
To her relief, he finally moved the light away.
“Well, Cassi, that troublesome vessel is in good shape, and there’s no rebleeding. But I don’t have to tell you that. Your vision has improved dramatically in that eye. I want to follow you with fluorescein studies and at some point in the future you may need laser treatments, but you’re definitely out of the woods.”
Cassi was not certain what laser treatments involved, but it didn’t dampen her enthusiasm for getting out of the hospital. Convinced that her fear of Thomas had been imaginary and that a good deal of their problems were at least partially her own fault, she was anxious to get home and try to put her marriage back on course.
Although Cassi was entirely capable of walking, the green-smocked volunteer who came to escort her back to her room in the Scherington Building insisted that she ride in a wheelchair. Cassi felt silly. The volunteer was almost seventy and had a disturbing wheeze, but she wouldn’t give in, and Cassi had to allow the woman to push her back to the room.
After she was packed, Cassi sat by her bed and waited for her formal discharge. Thomas had canceled his office hours and was going to drive her home around one-thirty or two. Since she had been admitted, his loving attention had not faltered. Somehow he’d managed to find time to visit four or five times a day, often eating dinner in the room along with Cassi’s roommates, whom Thomas had charmed. He’d also completed plans for their vacation, and now with Dr. Obermeyer’s blessings they were to leave in a week and a half.
The thought of the vacation alone was enough to make Cassi feel enormously happy. Except for their honeymoon in Europe, during which Thomas had taken time out to operate and lecture in Germany, they’d never been away together for more
than a couple of days. Cassi was anticipating the trip like a five-year-old waiting for Christmas.
Even Dr. Ballantine had visited Cassi during her hospital stay. Her insulin overdose seemed to have particularly unnerved him, and Cassi wondered if he felt responsible because of their talks. When she tried to bring up the subject, he refused to discuss it.
But what really made the rest of the hospitalization so pleasant was Thomas. He had been so relaxed the last five days, Cassi had even been able to talk to him about Robert. She had asked Thomas if she really had met him in Robert’s room the night Robert died or if she’d dreamt it. Thomas laughed and said that he indeed did find her there the night before her surgery. She had been heavily sedated and hadn’t seemed to know what she was doing.
Cassi had been relieved to know she had not hallucinated all the events that night, and although she still questioned certain vague memories, she was willing to ascribe them to her imagination. Especially after Joan made Cassi comprehend the power of her own subconscious.
“Okay,” said Miss Stevens, bustling into the room to see if Cassi was ready. “Here are your medicines. These drops are for daytime use. And this ointment is for bedtime. I also tossed in a handful of eye patches. Any questions?”
“No,” said Cassi, standing up.
Since it was a little after eleven, Cassi carried her suitcase down to the foyer and left it with the people at the information booth. Knowing that Thomas would be busy for at least another two hours, Cassi took the elevator back up to pathology. One of the vague memories she’d not wished to discuss with Thomas concerned the SSD data. She could remember something about the data, but it wasn’t clear, and the last thing she wanted to do was suggest to Thomas she was still interested in the study.
Reaching the ninth floor, Cassi went directly to Robert’s office. Only it was no longer Robert’s. There was a new name plate in the stainless steel holder on the door. It said Dr. Percey Frazer. Cassi knocked. She heard someone yell to come in.
The room was in sharp contrast to the way Robert had kept it. There were piles of books, medical journals, and microscopic slides everywhere she looked. The floor was littered with crumpled sheets of paper. Dr. Frazer matched the room. He had unkempt frizzed hair that merged into a beard without any line of demarcation.
“Can I help you?” he asked, noting Cassi’s surprised reaction to the mess. His voice was neither friendly nor unfriendly.
“I was a friend of Robert Seibert,” said Cassi.
“Ah, yes,” said Dr. Frazer, rocking back in his chair and putting his hands behind his head. “What a tragedy.”
“Do you happen to know anything about his papers?” asked Cassi. “We’d been working on a project together. I was hoping to get hold of the material.”
“I haven’t the slightest idea. When I was offered this office, it had been completely cleaned out. I’d advise you to talk to the chief of the department, Dr…”
“I know the chief,” interrupted Cassi. “I used to be a resident here myself.”
“Sorry I can’t help you,” said Dr. Frazer, tipping forward again in his chair and going back to his work.
Cassi turned to go, but then thought of something else. “Do you know what the autopsy on Robert showed?”
“I heard that the fellow had severe valvular heart disease.”
“What about the cause of death?”
“That I don’t know. They’re waiting on the brain. Maybe they haven’t finished.”
“Do you know if he was cyanotic?”
“I think so. But I’m not the one to be asking. I’m new around here. Why don’t you talk to the chief?”
“You’re right. Thanks for your time.”
Dr. Frazer waved as Cassi left the office, closing the door silently behind her. She went to look for the chief but he was out of town at a meeting. Sadly Cassi decided to sit in Thomas’s waiting room until he was ready to go. Seeing Robert’s old office already occupied had brought his death back to her with unpleasant finality. Having been forced to miss the funeral, Cassi sometimes had trouble remembering her friend was gone. Now she wouldn’t have that problem anymore.
When Cassi reached Thomas’s office she found the door locked. Checking her watch, she realized why. It was just after twelve and Doris was on her lunch break. Cassi got security to open the door to the waiting room and settled herself on the rose sofa.
She tried flipping through the collection of outdated New Yorker magazines, but she couldn’t concentrate. Looking around, she noticed that the door to Thomas’s office was ajar. The one thing Cassi had been effectively denying for the past week was Thomas’s drug taking. With the change in his behavior, she wanted to believe that he’d stopped. But when she was sitting in his office, curiosity got the better of her. She got up, walked past Doris’s desk, and entered the inner office.
It was one of the few times she’d been there. She glanced at the photos of Thomas and other nationally known cardiac surgeons that were arranged on bookshelves. She couldn’t help noticing that there were no pictures of herself. There was one of Patricia, but that was with Thomas Sr. and Thomas himself when he was in college.
Nervously, Cassi seated herself behind the desk. Almost automatically her hand went to the second drawer on the right, the same one where she’d found the drugs at home. As she pulled it out, she felt like a traitor. Thomas had been behaving so wonderfully the last week. Yet there they were: a miniature pharmacy of Percodan, Demerol, Valium, morphine, Talwin, and Dexedrine. Just beyond the plastic vials was a stack of mail-order forms for an out-of-state drug firm. Cassi bent over to look more closely. The firm’s name was Generic Drugs. The prescribing doctor was an Allan Baxter, M.D., the same name that had been on the vials she’d found at home.
Suddenly she heard the waiting room door shut. Resisting a temptation to slam the drawer, she quickly eased it shut. Then, taking a deep breath, she walked out of Thomas’s office.
“My God!” exclaimed Doris with a start. “I had no idea you were here.”
“They let me out early,” said Cassi with a smile. “Good behavior.”
After recovering from her initial shock, Doris felt compelled to inform Cassi that she’d spent the entire previous afternoon canceling today’s office patients so that Thomas could take her home. Meanwhile, she glanced at the inner office, then closed the door.
“Who is Dr. Allan Baxter?” asked Cassi, ignoring Doris’s attempt to make her feel like a burden.
“Dr. Baxter was a cardiologist who occupied the adjoining professional suite that we took over when we added the extra examination rooms.”
“When did he move?” asked Cassi.
“He didn’t move. He died,” said Doris, sitting down behind her typewriter and directing her attention at the material on her desk. Without looking up at Cassi, she added, “If you’d like to sit down, I’m sure that Thomas should be along soon.” She threaded a sheet of paper into her machine and began to type.
“I think I’d prefer to wait in Thomas’s office.”
As Cassi passed behind her desk, Doris’s head shot up. “Thomas doesn’t like anyone in his office when he’s not there,” she protested with authority.
“That’s understandable,” returned Cassi. “But I’m not anyone. I’m his wife.”
Cassi went back through the door and closed it, half expecting Doris to follow. But the door didn’t open, and presently she could hear the sound of the typewriter.
Going back to Thomas’s desk, she quickly retrieved one of the mail order forms, noting that it was not only printed with Dr. Baxter’s name, but also his DEA narcotics number. Using a direct outside line, Cassi placed a call to the Drug Enforcement Administration. A secretary answered. Cassi introduced herself and said she had a question about a certain physician.
“I think you’d better talk with one of the inspectors,” said the secretary.
Cassi was placed on hold. Her hands were trembling. Presently one of the inspectors came on the l
ine. Cassi gave her credentials, mentioning that she was an M.D. on the staff at the Boston Memorial. The inspector was extremely cordial and asked how he could be of assistance.
“I’d just like some information,” said Cassi. “I was wondering if you keep track of the prescribing habits of individual physicians.”
“Yes, we do,” said the inspector. “We keep records on computer using the Narcotics and Drugs Information Systems. But if you are looking for specific information on a particular physician, I’m afraid you can’t get it. It is restricted.”
“Only you people can see it, is that right?”
“That’s correct, Doctor. Obviously we don’t look at individual prescribing habits unless we are given information by the board of medical examiners or the medical society’s ethics committee that suggests there is an irregularity. Except, of course, if a physician’s prescribing habits change markedly over a short period of time. Then the computer automatically kicks out the name.”
“I see,” said Cassi. “There’s no way for me to check a particular doctor.”
“I’m afraid not. If you have a question about someone, I’d suggest you raise it with the medical society. I’m sure you understand why the information is classified.”
“I suppose so,” said Cassi. “Thanks for your time.”
Cassi was about to hang up when the inspector said, “I can tell you if a specific doctor is duly registered and actively prescribing, but not the amount. Would that help?”
“It sure would,” said Cassi. She gave Dr. Allan Baxter’s name and DEA number.
“Hang on,” said the inspector. “I’ll enter this into the computer.”
As Cassi waited, she heard the outer door close. Then she heard Thomas’s voice. With a surge of anxiety she stuffed the drug order form into her pocket. As Thomas came through the door the inspector came back on the line. Cassi smiled self-consciously.
“Dr. Baxter is active and up-to-date with a valid number.”
Cassi didn’t say anything. She just hung up.
Thomas was both talkative and solicitious as he drove Cassi home. If he’d been angry at her presence in his office, he’d hidden the fact beneath a welter of questions about how she was feeling. Although Cassi insisted she felt fine, Thomas had made her wait by the hospital entrance so that he could run and bring the car around.