The Chairmen

by Robert I. Katz

  “I’m on the Search Committee,” Kurtz said.

  “Yeah? I didn’t know that. So, what do you think?”

  “The first meeting is this afternoon. Moller is the Chairman.”

  “Moller is okay,” Steinberg said.

  Paul Moller was the Chairman of Surgery at Easton. Another chairman who was not a lunatic, Kurtz thought, except that Moller barely qualified as a chairman. Easton, though the residents all spent some time there, was not University Hospital. Moller had the title of Chairman, but it was a title at least one step down on the scale of academic prestige. For places like Easton, places that made their money by doing cases, not by receiving tuition or an enormous amount of grant money, the chairman had to be a clinician. Moller was a good surgeon. He had a few papers on his CV, but they were case reports and clinical studies. Moller was not a research clown. Interesting that the Dean had picked Moller to Chair the Committee, now that he thought about it. Definitely sending a message.

  Steinberg said, “Serkin is also on the Committee.”

  Kurtz frowned. “I didn’t know that.” Stewart Serkin was the Chairman of Anesthesiology at both Staunton and Easton, the almost new Chairman of Anesthesiology, speaking of things to worry about. The verdict was still out on Serkin. He had arrived only four months ago from Wisconsin, where he had been Vice-Chair for Research. An inauspicious title. “Not surprising, though,” Kurtz said.

  “No.” Steinberg’s voice was flat. Kurtz had heard rumors that the anesthesia staff did not exactly love their new Chairman.

  “How’s the patient?” Kurtz asked.

  “Fine,” Steinberg said.

  Kurtz grunted. Larry Reed, aside from his abscess, was a healthy specimen. He didn’t have atherosclerosis or diabetes or even high blood pressure. He had a functioning immune system. He wasn’t septic. With a little luck, his abscess would drain, his infection would vanish and he would walk out on his own two feet, another miracle of modern medicine.

  Kurtz hoped so.

  Twenty minutes later, the patient tucked into a corner of the Recovery Room, Kurtz grabbed his white lab coat from the rack hanging on the wall by the OR and put it on over his scrubs. He glanced at his watch. Just enough time to grab a quick lunch before the first meeting of the Search Committee…

  Staunton College of Medicine sat overlooking the Hudson River, a couple of miles down from Columbia-Presbyterian, which Staunton considered its principal competition. Columbia, one of America’s oldest and most prestigious medical schools, was barely aware that Staunton existed, but Staunton liked to imagine that the two schools were fighting it out for dominance in the New York market. Of course, NYU and Cornell might have also had something to say on the subject, but they, too, were not exactly focused on the threat that Staunton represented to their own prestige.

  Staunton was New York City’s youngest medical school but maintained a solid academic reputation, with respectable (though by no means remarkable) levels of NIH and industrial funding. The school’s primary teaching hospital was Staunton University Medical Center, 600 beds, fully owned by the school. In addition to CUMH, Staunton maintained affiliation agreements with a number of area hospitals, most prominently Easton, a 350-bed place only a few blocks to the west of Times Square.

  Christina Pirelli had been the Chairman of the Department of Obstetrics and Gynecology at Staunton for a little over eighteen months. She had followed the usual academic path for an ambitious physician, a fellowship in maternal-fetal medicine with a follow-up stint in the lab. She then accepted a position at St. Louis and stayed for seven years, rising to Associate Professor, before being recruited to be Chief of Maternal-Fetal at Wake Forest. Five more years and she was ready. The Chair at Staunton opened and after a brief search, here she was.

  Along the way, she had accumulated two ex-husbands and a daughter, now a freshman at Swarthmore.

  Christina liked the job. Most of it was routine but solving problems and making things work better gave her a lot of satisfaction. Some of the staff were prima donnas but none of them were insane and all of them were at least competent. It was a good department and a good situation and she liked coming to work in the morning. Or she had liked coming to work…she frowned down at the brown mailing envelope sitting on her desk. Tentatively, she reached out a finger, gave it a little spin, then picked it up and opened it, already suspecting what she would find.

  I’m enjoying this. I’m enjoying the look on your face as you read this. I’m imagining the questions running through your brain. You do know what this is about; oh, yes you do, though you may not know that you know, and when I come for you, you won’t be surprised. Bitch.

  Actually, Christina had no idea what this was about, and she had no desire at all to find out. Christina began to crumble the letter, as she had crumbled the two previous letters, preparatory to dropping them in the wastebasket, then she slowly sighed, shook her head and picked up the phone. Three was three too many…too many to ignore, at least. She dialed Security. “Asshole,” she muttered.

  The Committee, aside from Paul Moller, who Kurtz knew pretty well, was comprised of Todd Dunn, the Chairman of Urology at Staunton, Stewart Serkin, John Nye, the Chief of Cardiology at the school, a biochemist named George Linn, Ralph Castillo, a pharmacologist, and Christina Pirelli.

  Kurtz walked in five minutes late but still found himself the only one in the room. Moller walked in a few minutes later, shook his head, sighed, and sat down at the head of the table. The biochemist and the pharmacologist arrived soon after, opened their briefcases and proceeded to read student papers. George and Ralph had evidently done this before. The rest of the committee trickled in soon after. A good-looking brunette in a gray business suit sat down next to Kurtz, gave him a smile and said, “Hi, I’m Christina Pirelli.”

  “Richard Kurtz.”

  “I’ve heard of you. You’re a surgeon, right?”

  Kurtz nodded.

  “This is my third search in the past year,” Christina said. “It’s getting to be a real pain.”

  “My first,” Kurtz said.

  “Lucky you.” Christina shook her head, opened up a briefcase, pulled out a sheaf of papers and began to read.

  The last one to arrive was Serkin, a short man with a thick head of graying hair, a brush moustache and a long, narrow face. Serkin walked into the room, smiled pleasantly and said, “Let’s get going. I have things to do.” Moller glanced at the clock, sighed again, and said, “Sure. First, why don’t we all introduce ourselves? Richard?”

  They went around the room, calling out their names and departmental affiliations, then Moller smiled and rubbed his hands together as if something had actually been accomplished. “Okay,” he said, and glanced once again at the clock. “The Dean is supposed to be here to give the committee its charge. We’ll wait another two minutes, and then if he doesn’t show up, we’ll begin.”

  At that moment, a tall man with a long nose, curly black hair and sad, hang-dog eyes walked into the room: James Kushner, the Dean. The Dean sat down next to Moller and smiled around the table. “Nice to see all of you,” he said. A few inspirational statements, a couple of clichés, a rumination on the academic mission, a pronouncement on the responsibilities of institutions such as their own to bravely lead into the future, and a brief sentence of thanks followed. The only statement of any significance involved the finances, and how cardiac affected the public perception of the institution. “Cardiac surgery is high profile,” the Dean said. “The public pays attention to cardiac surgery. Cardiac surgery makes money, and that money supports a lot of other departments that don’t make money.

  “Peter Reinhardt has been a good chairman. He’s built a successful department. Replacing him won’t be easy. What we need, obviously, is somebody who can provide leadership, somebody who the department, as well as the institution, is going to respect. The person you select for this position must be a clinician. He must also be a good clinical manager. Scholarly work is necessary, of course. The
chairman must be a scholar. An academic department cannot survive if its leader is not an academic. The right person will not be easy to find. I want you to conduct a national search. Staunton deserves a national search.” The Dean smiled. “Any questions?”

  Nobody raised their hand. “All right, then,” the Dean said. “Let me know if you need anything, and keep me informed of how it’s going.”

  “Thank you,” Moller said.

  The Dean nodded, smiled again and walked out.

  “Okay,” Moller said. “The institution has hired the search firm of Bender and Boyd to do the leg work. They’ve already put advertisements in JACC, Chest, Thoracic Surgery, The New England Journal and Academic Medicine and they’ve written to all the surgical chairmen in the country asking them to submit the names of viable candidates. CV’s from interested applicants have already started coming in. The search firm gives them an initial screen and then sends us the ones that make the cut.” Moller smiled around the table and passed a series of file folders to each member of the Committee. “These are the first. I’m sure we’ll get a lot more. Look them over. We’ll meet weekly in order to decide which ones to interview. I hope to have a short list of the top three within three months.

  “Any questions?” he said.

  Dunn and Serkin exchanged looks. Serkin stared down at the pile of folders and wrinkled his nose. Both men shrugged. Serkin, Dunn, Christina Pirelli and John Nash rose to their feet and trooped out. Castillo and George Linn followed. Moller looked at Kurtz and raised an eyebrow. “Well? What do you think?”

  “I’m sure they’re a really swell group when you get to know them,” Kurtz said.

  Moller puffed out his cheeks. “It’s going to be a long few months,” he said.

  “Cheer up,” Kurtz said. “Maybe none of them will show up for the next meeting.”

  Moller snorted. “Fat chance,” he said.

  Chapter 3

  He sipped his coffee and closed his eyes, letting the rich, dark flavor roll around his tongue. He smiled. He didn’t used to pay so much attention to his morning coffee, but he found that having a new purpose, a new cause, tended to focus him on so much more. Everything, he found, seemed suddenly filled with significance. Life had so much more meaning. He used to drink just about anything. Now, it was Gevalia. He sipped his coffee and pondered. Was it time to expand his activities? Yes, he thought. It was. It was time to take his campaign beyond the initial target, to let the institution itself know that it was under siege.

  He selected a new crayon, one never before used for any lesser purpose (green, this time, yes, green would do nicely) and began to write.

  For Kurtz, the next few days were uneventful: a few routine cases, patients in the afternoon, work out in the evenings, try to ignore Lenore’s mother, who was calling about fifteen times a day. Lenore had had plenty of practice. Kurtz had not yet mastered the technique. Since the wedding was only six months away, Kurtz figured he had better learn fast.

  Esther Brinkman wanted a big wedding. Anything else, it seemed, would scandalize the neighborhood. Kurtz tried to stay out of it. So far as he was concerned, his own role was to show up, look good, parrot his lines and smile. If Lenore wanted it, Kurtz wanted Lenore to have it. But a big wedding was not what Lenore wanted. Lenore wanted a small wedding, the immediate family, a few close friends.

  “Did you know that getting married is considered to be one of the most stressful times in your entire life?” Lenore said.

  “I believe I did read that somewhere, along with having a baby, starting a new job and buying a house. Could you pass the chicken?”

  They were eating in a little restaurant just off Pell Street, in Chinatown. A long line of hopeful diners snaked out the front door and gathered on the sidewalk. “I don’t want my wedding to be stressful,” Lenore said. “I want it to be fun.”

  “I like fun,” Kurtz said. “Fun is good.”

  “Mother is being difficult.”

  “Nothing new there.”

  Lenore grinned and spooned a generous helping of shrimp with chili sauce onto her plate. “The secret to dealing with my mother,” she said, “is to keep things as simple as possible. Don’t let yourself be distracted by what Aunt Mimi said about traditional weddings in 1947 or by the sacrifices that Great-Grandpa Isaac made back in the stetl, just so his daughters could be properly married.”

  “Did these sacrifices include a dowry? I wouldn’t mind a dowry.”

  Lenore raised an eyebrow. “You don’t need a dowry. You get to sleep with me.”

  “I already get to sleep with you. Isn’t a dowry supposed to certify a change in the relationship?”

  Lenore smiled sweetly. “I’ll think of something special for the wedding night.”

  Kurtz smiled back. She probably would, too.

  “You have to be firm,” Lenore said. “Just say no.”

  Easier said than done but Kurtz was beginning to catch on. When saying no didn’t shut her up, you smiled and ignored her. For this, it was handy to have a prop, maybe a newspaper to bury your face in. A newspaper, Kurtz had noted, was his future father-in-law’s favorite method. Stanley Brinkman went nowhere without his copy of the New York Times.

  Despite the occasional bout of lunacy, Esther Brinkman wasn’t a bad sort, Kurtz reflected, and he had reluctantly grown almost fond of his future mother-in-law. She had grown up in an era when young women were expected to have babies, take care of the house and not pursue a career. That had worked fine so long as Lenore and her sister were children, but once they grew up and moved out, Esther Brinkman had nothing to focus her rather formidable intelligence on. Thank god, she had recently joined her cousin Sylvia’s real estate firm. It gave her less time to drive her daughters insane.

  Kurtz had met Sylvia and her husband, Milton Hersch, at a family dinner over the holidays. Sylvia was a hard driving, focused and successful career woman who nevertheless looked upon the world with benign good will. She seemed to regard family and employees as extensions of each other. She would bring chicken soup to workers who had minor colds and dispense advice freely regarding children, husbands and relationships. The employees, like her children, had learned to ignore her advice but tended to indulge her. The chicken soup was excellent, her matzoh balls as light and fluffy as clouds.

  Esther, Kurtz was amused to see, regarded her older cousin as a role model, which made sense, since they were a lot alike. They even looked alike, being small, gray haired and round.

  “Your mother still mad about the rabbi?” Kurtz asked.

  The rabbi was reform. An orthodox rabbi would not marry a Jew and a non-Jew. “Probably.” Lenore shrugged. “She’s not saying. I told her that unless she dropped the subject, we’d go to a justice-of-the-peace.”

  Another secret, Kurtz had learned, was never to make empty threats. If you say it, you mean it. Lenore meant it.

  Kurtz sighed. As Moller had said, it was going to be a long few months. At least Larry Reed was doing well.

  A hospital never really slept, even in the middle of the night. The halls were brightly lit. Buzzers were buzzing. Beepers beeped. Nurses and doctors and even the occasional patient who couldn’t stand the lumpy bed or his roommate’s snoring, walked up and down the halls.

  Nobody paid you any attention, though, not if you looked like you belonged and knew where you were going. You had to sign in downstairs, if you were a visitor, and visiting hours were long over, but of course, there were exceptions. If your loved one was having emergency surgery or your wife was in labor, you could hang around until the crisis was over. The staff was supposed to show an ID card but the guard barely glanced at it, and even then, you could slip past the guards if you knew how. The entrance to the staff parking lot had no security. The hallway leading to the back stairs, in the front lobby, started before the guard post. Walk in the front door, turn left, and you could go anywhere you liked.

  No cameras either, not inside the building. Cameras represented a gross violation of patient c
onfidentiality. No cameras, no sign in, no record.

  So easy, he thought. So vulnerable. A hospital was its own little world, with its customs and rules and ways of doing things. So easy to wander through and blend in and then, when they were least expecting it, to pounce.

  He almost laughed as he walked along, nodded to one nurse, smiled at another, tipped his hat to a third. Soon, he thought. Soon…he could hardly wait.

  “You know,” Mahendra Patel said, “the operating rooms could really use a little more direction.”

  Stewart Serkin stared at him. “What do you mean?”

  “The surgeons overbook their rooms. There’s no penalty for the surgeons for coming in late. The pre-op checklists are supposed to make the whole process safer but they’re slowing everything down. The nurses won’t let us bring patients into the OR’s until they’ve finished with the checklists, and also counted their instruments. Housekeeping is slow and they need more help. We sometimes wait for fifteen minutes or more once a patient leaves until they get in and start cleaning things up for the next case. Our turnover times average nearly fifty minutes. That’s way too long.”