The Chairmen

by Robert I. Katz

  “Answer me, you bitch,” the voice said.

  Okay, more than a little. She had had caller ID installed on her home phone but the guy seemed to have a scrambler of some sort. The numbers that it reported were random. The police had so far been able to do nothing.

  If she put the phone down, the SOB would only call back. If she took it off the hook, then nobody else would be able to reach her. She looked at the clock on the wall, considering. She wasn’t on call and she did have her beeper and her cell phone, though she never quite trusted the cell phone. In Christina’s experience, cell phones tended to have dead zones, though dead zones were much rarer than they used to be, particularly here in the city. Mirthlessly smiling, she hung up the phone, waited five seconds, then picked it up again and listened. Good. A dial-tone. She put the ear-piece down next to the cradle and checked to see that the cell phone and the battery in her beeper were fully charged.

  She went into her den and tried to go over the income projections for next year. However, after ten minutes of reading the same two lines she realized that her mind just wasn’t in it. That phone call…there had been at least a dozen of them, and Christina wasn’t the only one who was getting them. Most of the nurses on the obstetrical unit were also being harassed. For all she knew, half the women in the hospital were getting the same disgusting treatment. It wasn’t the sort of thing you liked to talk about. Grimly putting down the flow chart, she looked at her watch. She had a hysterectomy scheduled for the morning, as well as two post-due patients coming in for induction of labor. Damn it, she really didn’t need this.

  And besides, her tits did not hang down to her waist and the fat on her ass did not jiggle, not more than a little, and that little, she had it on good authority, was a definite turn-on. She did masturbate in the shower, now and then, but there was no way the pervert could have seen that.

  Shaking her head, she rose to her feet and padded into the bedroom. Obviously, she wasn’t going to be able to concentrate on income projections. She might as well try to get some sleep.

  Maybe, now that she thought about it, she’d take a shower first, a nice, long, hot one. It would calm her down.

  Chapter 8

  The monthly meeting of the OR Committee at Easton was scheduled for 8:00 AM the next morning. Kurtz rarely missed an OR committee meeting. Not that they ever accomplished very much but he was expected to go, and you just weren’t one of the boys if you didn’t participate in the group dynamic, even if every single member of the committee knew that it was a waste of time. He often regretted having accepted membership when Moller offered it to him. Kurtz’ problem, he often thought, was an exaggerated sense of civic responsibility. A more boring and basically dysfunctional organization would be difficult to imagine. For one thing, the majority of the members were the surgical chairmen at Staunton, a bunch of strutting bulls if ever there was one. Aside from the surgical chairmen, membership consisted of the head OR nurse, the Chief of Anesthesia, the OR administrator and two ad hoc members appointed by the chairman, in this case Kurtz and John Watkins, a gynecologist who wasn’t a bad guy but who hardly ever opened his mouth.

  Kurtz was on time. The majority, as usual, wandered in late. Most went over to the coffee pot on the side table and fixed themselves a cup before sitting down. Vinnie Steinberg arrived, hesitated, then found a seat next to Kurtz. He looked grim. Kurtz didn’t blame him. This was Steinberg’s first meeting as Chief and Patel had been popular. “Relax,” Kurtz said. “What can they do to you?”

  “Eat me alive?”

  “Hey, don’t worry. They’ll cook you first. The pain won’t last more than twenty minutes, thirty at the most.”

  “What a relief.” Steinberg grimaced.

  Moller, perched serenely at the end of the table, gave Steinberg an encouraging smile, then called out, “Let’s get going, people.” He waited a few moments for everybody to sit down and stop talking, then said, “First of all, does everybody accept the minutes from last month’s meeting?”

  Ralph Akins, the Chairman of Orthopedics, big, fat and balding, raised a lackadaisical hand. “Motion to accept.”

  Reese Stephens, Chairman of Urology, thin, beady-eyed and also balding, said, “Seconded.”

  Moller looked around the table. Nobody spoke. “Minutes accepted as written,” Moller said. Then he smiled, “As our second order of business, I would like to welcome Dr. Steinberg to the committee.”

  Everybody stared at Steinberg. Steinberg gave a weak smile back.

  “Okay,” Moller said, “next item is the OR statistics for last month. Irene?”

  The rest of the business was routine until the open forum at the end. Moller glanced at the clock and said, “There’s one more item that we need to discuss.” He looked at Steinberg. “An important item, I’m afraid. The Department of Anesthesiology is changing their system of night coverage. I would like to hear from Dr. Steinberg exactly what this is going to mean for us.”

  Steinberg looked glum but he nodded resolutely. “Basically, night coverage is expensive. For the past few years, we’ve had an attending anesthesiologist and four residents in-house, and on most nights, there aren’t enough cases to justify these numbers. From now on, there’s going to be only one resident in the OR and we’re only going to do life threatening emergencies after 8:00 PM.”

  Evidently, most of the dignitaries assembled around the table had already heard this news. They stared at Steinberg, looking grim.

  “That’s insane,” Akins said flatly. “Sure, some nights there are no cases at all, but some nights there are three or four at once. What happens then?”

  “The sickest patient will go first. The others will have to wait.”

  “And what if they can’t wait?”

  “If a case really can’t wait, then we’ll call someone in from home. Like I said, we’re only going to do life threatening emergencies.”

  Many cases were not life threatening, not immediately at least, but they couldn’t wait forever. They were urgent. A broken hip, a hot appendix, for instance. Such cases could wait for a few hours but they certainly could not wait for a slot to open up in the elective schedule, which could take days.

  Kyle Lerner, the OR administrator, rose to his feet. Lerner had black, neatly groomed hair and a brush moustache. Kurtz had never seen him look harried or disheveled or without a smile on his face. He had started out as an operating room nurse and was known to be ambitious. “I was speaking with Dr. Serkin just yesterday,” Lerner said. “He assured me that all urgent cases would be done.”

  Steinberg stared at him. “That’s not the policy,” he said.

  Lerner stared back. “Maybe you misunderstood.”

  “I don’t think so.”

  Moller interrupted. “Obviously, there’s some confusion. I’m going to ask Dr. Steinberg to clarify his department’s position and get back to us by next month’s meeting.”

  “When is this new policy supposed to take effect?” Stephens asked.

  “The first of the month,” Steinberg said.

  Which was only a week away. Stephens shook his head. “Next month’s meeting will be too late.”

  “All right,” Moller said. “I’ll ask Dr. Steinberg to talk to his chairman and get back to me, personally, by Friday. How’s that?”

  Stephens shrugged. Nobody else spoke.

  “Any other business?” Moller said. “No? Then the meeting’s adjourned.”

  “Sponge,” Kurtz said.

  The scrub nurse handed him a long clamp with a rounded end. A folded piece of gauze was held at the tip. Gingerly, Kurtz inserted the sponge into the wound and tried not to gag. Theoretically, this should have been an easy case, the debridement of a decubitus ulcer on an old man, bedridden with Alzheimer’s. The wound, unfortunately, was necrotic all the way down to his sacrum, and what was almost as bad, nobody had known, not the nurses who were supposedly taking care of him, not the residents who were supposedly changing his dressing every other day.

 
“You have an explanation for this?” Kurtz asked.

  Levine’s face was pale. His hands, as they held a retractor, trembled slightly. “It didn’t look this bad, yesterday,” he said.

  Part of Levine’s distress may have been guilt, for somehow or other not noticing the extent of the patient’s condition. Part may have been revulsion for the truly awful smell of rotting flesh mixed with feces arising from the patient’s rear end.

  Sandra Jafari stood to the side, holding a retractor. She swayed a little. Her face was green, her hand barely trembling. Kurtz hoped she didn’t faint. “Sandra, why don’t you go sit down?” he said.

  She nodded, cleared her throat but said nothing, handed the retractor over to a nurse. She stripped off her gloves and surgical gown and left the room. Levine gazed after her and frowned.

  Kurtz wasn’t feeling too good, himself. He grunted. The old guy was going to die, if not from this, then from pneumonia or a stroke or an MI. Kurtz knew the signs. Impossible to make a tragic mistake in a case like this. Death, in fact, would be relief to all concerned, but that wasn’t the point. The point was that a serious complication had gone unnoticed and he was pissed off.

  Kurtz’s hands worked steadily, cutting away the dead tissue, irrigating the open wound with gallons of antibiotic infused saline, then packing it with iodophor gauze.

  “Get him a bed in the ICU,” Kurtz said. “He’s going to need it.”

  Levine glumly nodded.

  “To be perfectly honest,” Lenore said, “I don’t know these people. I would rather be going to a movie.”

  “To be perfectly honest,” Kurtz replied. “So would I.”

  “Hard to argue with a man who agrees with you,” Lenore observed.

  “Only one of the many reasons why you adore me and can’t live without me.”

  She gave him a distant clinical look, rolled her eyes and coughed. “How do I look?” she asked.

  She looked gorgeous, but then, she always did. She was wearing a black blouse with green and pink highlights and a matching green skirt. “Good,” he said.

  “Then let’s get going.”

  They were going to Paul Moller’s for a party, cocktails plus a dinner buffet. Informal, supposedly. Ordinarily, Kurtz would have looked forward to it, since he liked Moller, and Moller’s wife, Sara, was a great cook. However, what with the Search Committee and the Dean’s unconventional request, Kurtz was not in a mood to be reminded of business. He was uncomfortably aware that new and potentially more serious crimes could be committed at any moment, and, quite frankly, he still had little idea of how to track down the culprit.

  He had reviewed the data that Patrick O’Brien provided, which included cross-checking and correlating the various spreadsheets. Patrick knew his job. Nobody who had taken vacation matched up with the gaps in the delivery of the notes, and neither did anybody on the list of employees who had filed grievances of one sort or another. Basically, they were nowhere.

  The party, however, proved to be entertaining. Christina Pirelli was there. Christina, as Kurtz had heard, liked to party. She looked good. Her hair was piled on top of her head in thick black ringlets and she was dressed in a plunging blue dress, her impressive décolletage threatening to burst out of the front with every deep breath. A slim, balding man, middle-aged and at least three inches shorter than Christina’s own imposing height stood by her side, saying nothing, looking up at her with bemusement as she cracked off-color jokes and related long and involved anecdotes, most of them regarding her own sexual misadventures. “I was at a meeting to discuss the new monitors we’re getting for OB and somebody started talking about the contract negotiations. They said that I got everything out of the Dean but his pants. Well, I guess I was a little distracted at the moment and so I said, ‘Gee, whiz, if I could’ve gotten his pants, I would have traded away all the rest of it.’ Suddenly, they’re all giving me disapproving looks, but I ask you, have you ever seen a sexier man than the Dean?” She smiled benignly down at the bald head by her side. “He’s almost as sexy as you, Snookums.”

  “Who is that?” Lenore asked.

  “Christina Pirelli, the Chairperson of Ob-Gyn.”

  Lenore looked at Christina Pirelli for a long moment, then grinned. “So, tell me, have you ever seen a sexier man than the Dean? Aside from Snookums?”

  Kurtz scratched his head, thinking about it. “I guess the Dean just isn’t my type,” he said. “Come on, I’ll introduce you.”

  Lenore, somewhat to Kurtz’ surprise, seemed to get along just fine with Christina Pirelli. Not more than ten minutes had passed before the two of them were ensconced in a corner of the room with glasses of white wine, their heads together, giggling. A few lowered glances were cast in Kurtz’ direction, followed by more giggling, which made Kurtz vaguely uncomfortable. A few minutes later, three other women who Christina seemed to know sat down and joined the conversation.

  With Lenore apparently having a good time without him, Kurtz decided to leave her to it. He said hello to Moller and mixed himself a Bloody Mary, which he sipped contentedly while watching a Knicks game on the TV in Moller’s den. Two other men who Kurtz did not know but recognized from the hospital were already there. After a few minutes, Snookums wandered in, sat down and began to watch along with the rest.

  Nobody said anything until halftime. The Knicks were down by seventeen. All the men except for Snookums and Kurtz rose to their feet, shaking their heads in sad resignation, and left the room. Snookums looked at Kurtz, smiled and held out his hand. “I’m John Crane,” he said.

  “Richard Kurtz.”

  “I know. Christina told me about you.”

  “Yeah?” Kurtz said.

  “She likes you. She said you’re not a stuffed shirt.”

  Kurtz sipped his drink. “Christina is okay,” he said.

  John Crane grinned, looking suddenly like a lovestruck puppy, and said, “Oh, yeah.”

  Kurtz grinned back. “Known her long?”

  “About a month. I met her up on the OB floor. I’m a neonatologist.” Crane looked suddenly uncomfortable. “Some strange things are happening up on OB.”

  Kurtz looked at him. “Oh?” he said.

  “Strange things,” Crane said again. He frowned at the TV. A group of good-looking women in cheerleading costumes were performing a dance routine. “I probably shouldn’t talk about it,” he said.

  “No,” Kurtz said, “I imagine you shouldn’t.”

  Crane gave a tired grin. “Except that Christina tells me you already know.”

  Kurtz sighed. “Maybe I do,” he said, “and maybe I don’t. ‘Strange things’ can mean anything at all. Why don’t you tell me about it?”

  “Somebody is making crank phone calls to the obstetrics floor.”

  “Okay, that I do know,” Kurtz said.

  Crane frowned at him then shrugged. “She won’t talk about the details, not to me, but I know they bother her.” Crane stared down at his drink with a grim expression.

  So far, aside from keeping himself apprised of the situation and examining the data, Kurtz had stayed away from direct involvement. He was a consultant, not the lead detective on the case, which would presumably be Patrick O’Brien, or maybe Harry Moran. On the other hand, not much had happened so far to make it all go away. Maybe the time for reticence was over. “I’ll talk to Christina,” Kurtz said.

  Crane looked up at him, sudden hope in his eyes. “Would you do that?”

  Kurtz cracked a smile. “Yeah,” he said. “I guess I better.”

  Joseph Banks was fifty-two, tall, lean and balding. He had a thin smile and knowing eyes. He looked around the room at the members of the committee and waited calmly for the first question. “Dr. Banks,” Serkin said, “what particular expertise would you bring to the position? What do you have to offer that sets you apart?”

  Banks smiled. And why shouldn’t he? Kurtz thought. An easy pitch like that one fairly begged to be hit out of the ballpark. Banks had a hundred and fifteen p
apers, with nearly four million in grants from the NIH.

  Serkin had expressed great enthusiasm for Bank’s application. Kurtz had been ambivalent. Director of Cardiac Surgery at University of Alabama for nearly ten years, his books were balanced, his surgical expertise universally acknowledged. If anybody was ready for a chairmanship, it should have been Banks, but Banks had a problem, at least to Kurtz’ way of thinking. He was, according to reports, arrogant, overbearing and obnoxious.

  “It’s not his job to be liked,” Serkin had said. “It’s his job to make the Department run better, to train the residents and fellows, to take care of his patients and to advance scientific knowledge.”

  “I know the academic mission,” Kurtz said. He felt like uttering an obligatory Sieg Heil. The academic mission was like the Holy Grail, the Bible or the Torah, to be brought out, admired and meditated upon, on occasions both special and routine. The academic mission, after all, was what distinguished them all from the mundane world of private practice.

  Serkin had looked at him and sniffed.

  In the end, Kurtz had gone along. The guy did have an impressive CV, and despite any personal failings, he also had an impressive record of accomplishment. Might as well interview him. And so here he sat, looking down, or so Kurtz imagined, upon them all.

  “I have ten years of experience in organizing a service,” Banks said. “I’ve trained over thirty fellows and I’ve more than doubled the departmental research funding. I look at things from a systems approach. No one individual can effectuate change, not all by himself. Everything we do in medicine involves a system. If you want to make things better, then you have to change the system, and that requires cooperation and consensus.”

  That actually sounded intelligent. Kurtz gave Banks a long, level look. Maybe he had misjudged the guy. Maybe Serkin was right all along.

  Serkin smiled. Moller nodded his head. Nash leaned forward and asked, “Tell me about your research.”

  And so it went. An hour on the hot seat and then off to see the Dean.