“Well, that was something, wasn’t it?” said Hecuba.
Not: Are you hurt? Not: Thank you for saving my life.
Hecuba straightened out her skirt. “Now back to what we were discussing, Millard,” she said. “I’m confident you’ll be pleased with the proposal I sent to Thatcher. I can make you a copy, if you’d like, but if you trust me, we can just say that we’re all in agreement.”
Millard squeezed his eyes until his sockets throbbed.
“No!” he shouted. “Just no. No! No! NO!”
“Are you all right?” asked Hecuba.
“Am I all right? Now you ask that? Jesus, lady, I was just mauled by a lynx! I might have died. And you’re babbling on about succession plans. Are you nuts?”
“No need to raise your voice,” replied Hecuba. “I was trying to keep us focused.”
That was enough to open the floodgates; he only regretted, in hindsight, that he hadn’t recorded this speech for Stan Laguna’s entertainment. “This is why nobody likes you,” he shouted. “This, Hecuba, is why you’re universally despised—why your approval rating around here would be lower than Saddam Hussein and North Korea and pubic lice. Are you hearing me? How anyone so narcissistic, so tone-deaf, so lacking in common sense or decency or compassion, could graduate from medical school, let alone practice psychiatry, is a mystery that no legion of Hibernian monks and Talmudic scholars could possibly unravel. So no, Hecuba, your plan is not okay with me. Not at all. You’re the last person on the face of the goddamn planet I would let take over my division. I would sooner give the job to Attila the Hun or the Son of Sam or Jack-the-fucking-Ripper. Now get out! Out!” He slammed a chair against the wall. “And never ever come back!”
Hecuba Yilmaz did not appear at all nonplussed. “I didn’t realize you were so upset,” she said. “You’re still in shock, Millard. I know you don’t mean any of that.” She rose and walked toward the door. “No reason to feel guilty. I have a thick skin. We’ll just pretend this never happened, all right? And I’ll tell Thatcher Van Doren that we’re all in accord—”
A knock on the door cut her short.
“Are you okay?” asked Miss Nickelsworth.
“We’re fine,” answered Hecuba. To Millard she added, “Have a safe vacation. I worry about you, Millard. You’re under too much stress.”
And then she yanked open the door and stepped past Millard’s secretary, her heels drumming a staccato toward the elevators. Millard pressed the clumped tissues to his wounded cheek, hoping Miss Nickelsworth might not observe his injuries, but he felt the heat of his own blood trickling down his chin.
Miss N. shook her head—more disapproving than alarmed. “Gracious, Dr. Salter, I thought you were going to be more careful.”
“I did the best I could. I wasn’t expecting her to claw me.”
“You should report her. I know it’s not my place . . . but truly, you should.”
How amusing, Millard thought. He’d unwittingly left Miss N. with the impression that Hecuba Yilmaz had carved a half-pound of flesh from his face—and he saw no reason to disabuse her of this inference. As a falsehood, his omission somehow seemed an honest one, as though attributing this attack to Hecuba accurately reflected her inner state of being. In addition, blaming Hecuba—at least for the day—absolved him of the need to report his encounter with the lynx to the authorities, which was liable to involve filing a police report and thoroughly mucking up his schedule.
“Let’s get you bandaged up,” said Miss N. “Before you run out of blood.”
She departed for an instant and returned with a first aid kit. The oblong metal box appeared as though it dated from the start of Miss Nickelsworth’s tenure, possibly military surplus of the Korean War. One side featured the lettering “Johnson & Johnson’s VACATION FIRST AID” and a large red cross; the other read: “Manufactured in New Brunswick, NJ.” Inside, the tin contained an elastic bandage, a glass bottle of rubbing alcohol and a set of swabs, enough Q-tips to rid an entire brigade of earwax, a spool of medical tape, several two-by-two cotton patches, and an assortment of tweezers, scissors, and clippers. Thankfully, no Mercurochrome. Miss Nickelsworth snipped off four strands of tape and dressed his wound.
“You should have been a nurse,” he said.
“I could have been a nurse,” she retorted. “But my sister was already a nurse, so my father sent me to Katharine Gibbs for shorthand. To diversify, he said—but the truth was he wanted someone to type his correspondence. He was in the women’s hosiery business. But then he died and I ended up here.” She placed the final band of tape below Millard’s eye. “That’s neither here nor there. This isn’t nursing. This is basic first aid. Every girl in my high school class could do this when we graduated. We were taught tangible skills. Nowadays, these girls can’t even sew on a button for themselves . . . . There you go. Let’s hope you don’t need stitches.”
Millard’s more serious medical concern wasn’t bleeding, but infection—some exotic, lynx-borne relative of cat scratch fever. Fortunately, these tropical bacteria tended to have incubation periods of several days. “I’ll be fine, Miss N.,” he said, patting her handiwork.
Millard returned to his desk and wrote his secretary a check for $120. The same as the previous year. He slipped it inside a business envelope. “This may sound strange,” he said, “but I’m giving my Christmas presents early this holiday season—for tax purposes. It’s good for six months, so if you prefer, you can wait until December to open it.”
Miss Nickelsworth stashed the envelope inside her blouse. “It’s mighty odd to be getting a Christmas present in July,” she said, yet objected no further. “I thank you for it. Now if you’re all right, Dr. Salter, I’ll be catching my bus . . . .”
“Better than all right,” said Millard. “I could wrestle an ox.”
He followed Miss Nickelsworth through the corridor and ducked into the adjacent washroom. His reflection belied his claims to health. While the laceration to his face was no longer visible, a second, shallower claw mark scored his neck at the clavicle, which had started to swell under his collar. Ugly hemorrhagic stains disfigured the flesh below his right knee. Little remained of his shirt between the plackets and the left shoulder. He buttoned all three buttons of his jacket like a schoolboy or one of those Internet millionaires—somebody who didn’t know better. (“Sometimes, always, never,” Papa had instructed of buttoning a dress suit. “Never button the bottom button.”) The result concealed his damaged shirt, but made him look like a ringmaster at the circus.
Time to go home, Millard decided. He’d earned a shower and a shave. His Hippocratic oath be damned—he’d head for the service elevator and leave Jack Cappabucci to stew in his own deceitful juices. Why did he have any obligation to the fellow? Cappabucci wasn’t a patient. Hell, he was the opposite of a patient. Millard returned to his office, delighted with his escape plan, and found Cappabucci seated on the Aeron chair across from his desk. The celebrated malingerer wore his shirtfront open, tufts of coarse gray hair sprouting from his chest. His aviator sunglasses perched atop his bold, glabrous crown.
“I thought you might have forgotten . . . .”
“I didn’t forget you,” said Millard. “But you really can’t burst in here like this . . . . This is a private office, Mr. Cappabucci.”
“I apologize,” said Cappabucci. “Sincerely.”
The man did sound sincere; that was his sociopathic charm at work. Ted Bundy had harnessed his allure to beguile and slaughter young women; Bernie Madoff tapped his charisma to swindle investors. Cappabucci’s goals proved far more simplistic, even if he drew upon the same techniques: He wished to use the hospital as a motel. But since he wasn’t actually undomiciled, merely renting an apartment for profit, he earned none of Millard’s sympathies.
Most of the malingerers at St. Dymphna’s proved rather inept. Either they feigned improbable symptoms (hallucinating in black-and-white, shaking hands with imaginary friends, hearing voices on only one side of
their heads) or they proffered histories easy to debunk. Millard took pride in unmasking these impostors: watching a “deaf man” jump when he shouted a profanity in the next room, calling the Department of Veterans Affairs to ascertain that a “decorated combat pilot” had actually played cornet in the air force marching band. Someday, Millard joked to the medical students, he’d switch sides and run how-to workshops. Or publish Malingering for Dummies and sell copies for five dollars outside heroin treatment clinics and homeless shelters. But Cappabucci, through sheer audacity and force of will, had managed to con generations of headshrinkers. You had to give the bastard credit.
“I’ve come to negotiate,” said Cappabucci.
Millard remained beside the open door, one hand firmly gripping the knob; his facial wound seared underneath the two-by-twos. He considered responding, I don’t negotiate with terrorists. Instead, he waited for Cappabucci to exhaust his machinations.
“Look, buddy,” said his visitor—as though speaking to a prep school chum. “I don’t want to cause you any trouble. Let’s have a truce.”
“I didn’t know we were in conflict,” said Millard.
“Conflict? We’re at war!” Cappabucci’s cheeks flushed; his nostrils flared. “You wrote in a medical chart that I’m not mentally ill—that my schizophrenia is, and I quote, ‘a tragicomic enterprise reminiscent of the best acting of Lon Cheney’ and ‘a farce straight out of the Marx Brothers.’ Do you really expect me to take that lying down?”
“It’s just one doctor’s opinion.”
“You’ve caused me a heap of trouble, Millard. But I’m willing to let bygones be bygones. You retract your accusations, make a few emendations to the medical record—you can say you had me confused with a different patient—and we’ll chalk this up to a good old-fashioned misunderstanding.”
Millard counted backwards from five in his head. “I’m not going to change my note,” he replied. “Because that would be fraud. Something I imagine you are rather familiar with, Mr. Cappabucci. Now if you’ll please leave my office . . . .”
The toggle in Cappabucci’s warped psyche shifted instantly from flattery to menace.
“You don’t know what you’re getting yourself into, Salter,” he threatened. “I’ve already filed a complaint with the Office of Mental Health. If we can’t work this out today, I’ll have no choice but to take the matter up with the Justice Center and the Office of Professional Medical Conduct. I have contacts in Albany. I swear I’ll have your license for this!”
Millard forced a grin. “I’m an old man, Mr. Cappabucci,” he said. “OPMC takes years to investigate these sorts of grievances . . . . I could be dead by then . . . .”
“You’ll wish you were.”
“You may be right,” agreed Millard. “Now I’ll have to ask you to leave. If you don’t leave, our security officers will provide you with an escort.”
The threat of force brought Cappabucci to his feet. “You’re doing something stupid . . . .”
“That’s because I’m a very stupid person,” said Millard. “It’s my nature.”
He’d discovered over the years that agreeing with such denunciations always proved more effective than defending against them. Most assailants gave up on the spot, often sheepishly, as though they’d been caught boxing a deflated punching bag. Jack Cappabucci scowled at Millard and shuffled from the office with his hands in his trouser pockets.
At last! He was finally alone. The wall clock read 4:35 pm.
Millard fingered the pink memo sheet on which Miss Nickelsworth had jotted the oncology chairman’s name and phone number, crossing her sevens and zees. He knew Augusto Pineda casually from many years at the same hospital, but not well enough for a social call. Pineda was something of a legend. In 1968, a Latino street gang, Los Rebeldes—an offshoot of the Young Lords, modeling themselves after the Black Panthers—had occupied Lutheran Hospital in Spanish Harlem as a protest against substandard care. For nineteen days, armed with high-caliber firearms, they controlled access to the facility, managing everything from nursing schedules to meal orders. The gang even had patients fill out customer satisfaction surveys, a novelty at the time. (Art Rosenstein had been an intern during the crisis and claimed the hospital had never run better.) That was the era before SWAT teams and shoot-to-kill orders; a liberal mayor negotiated a settlement and the militants were granted immunity, on the condition they surrender their weapons. Several of them went on to prominent roles in the Puerto Rican Civil Rights Movement, others ended up junkies or drifted toward more commonplace offenses. Two committed a high-profile kidnapping and later fled to Havana. Augusto Pineda, touched by his work at Lutheran, enrolled in pre-med classes at the local community college and later transferred to Harvard.
Millard dialed the number and a receptionist answered on the first ring.
“Millard Salter for Augusto Pineda,” he said. “I’m returning his call.”
A moment later, Pineda’s warm baritone greeted him. “Millard. Gusto Pineda here. Sorry to pester you, but I wanted to make sure we touched base about the rabbi.”
“Not a problem,” replied Millard. “What’s going on?”
“I’m sorry to tell you this, but Ezra Steinmetz is dead.”
“Heavens,” said Millard—feeling surprised, even though he had expected this outcome ever since his secretary had mentioned Pineda’s call. “I saw him this morning.”
“How did he appear?”
“Exhausted. Uncomfortable. But not like a man at death’s door, although he seemed pretty convinced he was done for,” said Millard. “I suppose you can never tell with cancer.”
Like suicide, thought Millard. The warning signs often emerged in hindsight.
“It wasn’t cancer,” said Pineda. “He slashed his own throat with a razor blade.”
12
Millard hurried through the subterranean caverns of St. Dymphna’s, black bag clasped to his chest, a pair of rubber bands securing his trouser leg to his calf. Two floors above, along the central arcade of the Luxdorfer Pavilion, his colleagues, weary, work-whacked, raced to catch commuter trains and theater curtains. Late afternoon witnessed a subtle power shift in the hospital—the senior attendings departing, replaced by overtasked residents and petrified interns who made easy marks for demanding families and domineering nurse managers. Visiting hours ran from five o’clock to seven thirty, an opportunity for well-intentioned friends and relatives to undermine the painstaking medical planning of the day. Narcotics and tranquilizers, declared taboo at noon, flowed like mountain springs six hours later. Parents smuggled candy bars to their diabetic children; love-blind companions trafficked malt liquor and miniature schnapps bottles onto the detox unit. Chaos, always present, shook off its latency. A schedule of the daily program was traditionally posted on every inpatient psychiatric unit in the hospital, and during Millard’s own residency, a clever colleague had filled the space following “DINNER & EVENING ACTIVITIES” with the words “The Inmates Take Over.” By contrast, in the sub-basement, the close of business hours saw the purveyors of so-called ancillary services revving up for real labor: cafeteria workers in mesh snoods pushing dinner carts, pharmacists preparing for overnight inventory, a trio of “engineers” struggling to steer a floor buffer. It was already a quarter to five. Millard darted from passageway to fluorescently lit passageway, under the Hapsworth Annex, past the linens stockroom, through the lower intestines of the medical student dormitory, planning to emerge only a block from the 96th Street subway station. After forty-nine years at the hospital, and numerous efforts to avoid his bosses, he knew every shortcut.
Millard’s path carried him past the lounge where the students shot pool and along a corridor lined with banks of lockers. He nearly toppled a young woman toting a laundry basket as he rounded a corner, accepted a greeting from a buff kid in salmon club shorts and Birkenstocks whom he might have lectured in his “Brain & Behavior” course, but he couldn’t be certain, because after a year or two, all of the face
s blended together. Especially the men. A gangling, auburn-haired girl wearing only pajama bottoms and a sports bra—he recognized her as a fourth-year student—approached him on her trek to the recycling bins, and after a moment of recognition, looked away, mortified. Nobody expected to meet their psychiatry preceptor opposite their garbage room. While he felt badly for surprising the girl, it was not badly enough for him to travel at street level and risk another encounter with Hecuba or Denny Dennmeyer, or whomever those vindictive Furies had determined to inflict upon him.
The rabbi’s death weighed heavily upon Millard. A young father’s self-destruction under the duress of cancer was far different from an old man’s premeditated suicide. Maybe that was a rationalization, but— He cut himself short. His decision had been made, a culmination of months of conscientious deliberation. No sound reason existed to reconsider it. Millard pushed open the reinforced door leading to the emergency staircase and the street beyond. Despite the red-lettered warning, he knew from experience that no alarm would sound. On the landing, he found a young woman snuffling into her drawn-up blouse. The sound of the heavy door scraping the cinder block drew her attention and she looked up in alarm. A second elapsed before Millard recognized the swollen eyelids and trickling liner as belonging to Lauren Pastarnack.
“Oh my God!” she exclaimed. “Dr. Salter.”
“Excuse me,” he apologized. “Are you all right?”
She nodded vigorously and attempted to speak, but lapsed into another bout of tears. The girl’s white coat and stethoscope draped over the handrail.
Millard set down his bag. “There, there,” he said. “You’ll talk when you’re ready.”
Pastarnack refused to wait. “She was dead . . . .” she spluttered between sobs. “I thought she was only sleeping . . . but she was dead . . . . Oh God, you think I’m pathetic . . . .”
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