Kurtz grinned. “Come here,” he said.
“Okay,” Lenore said, “I mean, since you asked me so nicely.”
Francis Xavier Jensen came across well. He had read the information packet. He asked reasonable questions. He could speak with insight regarding networking, cost containment and faculty development. He had good ideas and stated a definite interest in the job. The only problem was his wife. The Jensens currently lived outside Atlanta, where they owned a large house on four acres that had cost them a little over two hundred thousand. For two hundred thousand anywhere within reasonable commuting distance of Manhattan, you might get a small cottage with a front lawn about the size of a postage stamp.
Marcia Cohen did her best, pointing out the museums, the art galleries, the theatres, the restaurants and all the myriad attractions that made New York the greatest city in the world. Mrs. Jensen did acknowledge that these were attractions, but she seemed, in the end, unconvinced.
“I don’t know,” Marcia Cohen said.
The Dean looked glum. “The husband won’t be happy if the wife doesn’t want to live here.”
Marcia Cohen gave an expansive, eloquent shrug.
“Well,” the Dean said, “we’re not going to write him off, at least not yet. I like him, and he is interested.”
“See what Henry Tolliver is like.”
The Dean smiled reluctantly. “You think the third time will be the charm?”
“Could be. If none of them work out, the Search Committee will have to reconvene.”
“Peter Reinhardt,” the Dean said, “is going to retire, whether we have a replacement or not. He wants to play golf and he’s tired of waiting.”
“Let’s look on the bright side,” Marcia Cohen said. “I have a good feeling about Henry Tolliver.”
“I hope you’re right,” said the Dean.
That evening, Sandra Jafari brewed a cup of tea. When the tea was strong enough for her purpose, she put in two teaspoons of sugar, hesitated, then put in a third. She sipped, nodded her head, and opened a small medicine bottle, from which she extracted twenty capsules. Carefully, she pried apart each capsule and emptied them into her tea. She stirred the tea until all the powder had dissolved, then sat down on a couch and drank the tea. By the time she had finished, she felt herself growing sleepy. She suppressed a sniffle, angrily wiped a tear from the corner of her eye, then lay down upon the couch and closed her eyes.
Within minutes she was unconscious. Minutes later, the front door of the small apartment opened and Jennifer Wu, Sandra Jafari’s roommate and best friend, returned home early from a date. “Sandy?” Jennifer called.
There was no response. Frowning, Jennifer Wu walked over to her friend and peered down at her. “Sandy?” she said again. Jennifer saw the medicine bottle, still open on the table. Her eyes widened. “Oh, my god,” she whispered, then she grabbed her cell phone and dialed 911.
Chapter 12
“It was Valium,” Moran said. “She had a prescription for it.”
Kurtz gave a morose, sour grunt. Kurtz was angry. Kurtz knew Sandra Jafari. Kurtz liked Sandra Jafari. Like all medical students, Sandra Jafari worked very, very hard. She was bright, highly motivated and earnest, even if she didn’t have much talent for surgery.
“I understand she was a student of yours,” Moran said.
“Yeah.”
“The roommate says she’s been depressed lately,” Moran said.
“I hadn’t noticed.”
“What had you noticed?”
Kurtz shook his head. “Nothing. The students spend most of their time with the residents and the other students. I saw her on rounds, a couple of times in surgery. It wasn’t social.” Kurtz shrugged and scowled out the window. “She didn’t laugh much. I guess I noticed that. I figured she was the serious sort.” Kurtz was not happy. Was any of this was his fault? Should he have suspected that something was going on? “She asked intelligent questions,” Kurtz said. “She did her work.”
“That’s all?”
“Yeah.”
“Not too much to go on.”
“Valium is for anxiety, not depression,” Kurtz said. “In fact, it’s contraindicated in depression. Valium can make depression worse.”
“So they tell me.” Moran shrugged. “She had also been anxious.”
“About what?”
Moran peered down at his notepad. “According to her internist, nothing too specific. She was studying too hard. Her parents are from the old country and wanted her to get married and have kids. They were never supportive of her goal to become a doctor. She felt like the world was closing in on her, or some bullshit like that. He referred to it as ‘formless anxiety.’ Frankly, when I talked to him, he seemed less interested in his patient’s current condition than he was in justifying the fact that he gave her the stuff.”
“Can you blame him?” Kurtz asked. “He’s feeling guilty. I’m feeling guilty.”
Moran shrugged and gave a thin smile. “Her anxiety wasn’t quite as formless as the old boy thought. Her roommate found these in her bedroom, sitting out on the desk.” He waved a manila folder in Kurtz’ direction.
The folder contained letters, nine of them, printed in black crayon on white paper with no return address. The first was typical:
Doctor Kurtz was talking about you in the cafeteria. He was laughing. He said that he never had a more clumsy student. You’re not doing well in Surgery. A doctor has to be able to draw blood without spilling it. Too bad…
The author of the letters seemed to know Sandra Jafari quite well, well enough, at least, to have stimulated the poor girl’s anxiety. All of the letters were similar. They named names and specific incidents. A wave of anger swept over him. “That son of a bitch,” he muttered.
“Any truth to this stuff?” asked Moran.
“I never spoke about her in the cafeteria. I never spoke about her at all. It’s true that she wasn’t the best medical student I’ve ever had, but she was nowhere near the worst. Frankly, she was clumsy. She wasn’t stupid, though. She wasn’t going to get Honors in the rotation but she was in no danger of failing. She just wasn’t cut out for surgery. One of the more cerebral specialties, medicine maybe, or psychiatry, one that doesn’t emphasize procedures.” He shrugged. “That son of a bitch,” he said again.
“We’re analyzing the paper,” Moran said, “and the crayon. Maybe we’ll come up with something.”
“Fat chance,” Kurtz said.
“Don’t take it so hard. She’s going to be all right.”
“This one,” Kurtz said. “This time. Maybe not the next time. That’s what’s really bothering me. This lunatic is still out there.”
“Yeah,” Moran said. He stared down at his notepad. “I know.” He grinned at Kurtz, a hard, mirthless grin. “He knows your name, though. I wonder if you know his.”
Henry Tolliver came to town with his wife and youngest son. The older son was a junior at Columbia, a definite plus. The family already knew the city, had a reason to bond quickly and to feel committed. From the beginning, things went well. Tolliver had read the information packet. He asked intelligent questions. He seemed eager. Within hours, he was on a first name basis with the Dean and the surgical chairs. Mrs. Tolliver, it turned out, came from Long Island and loved New York. She was a theater and opera buff.
“Okay,” the Dean said with satisfaction, and rubbed his hands together. “This is a live one.”
“Didn’t I tell you?” Marcia Cohen said. “The third time’s the charm.” She glanced at the clock. “Where are you taking them?”
“Le Bernardin. They like seafood.”
“Perfect. They’re already on the hook. Now all you have to do is reel them in.”
The Dean looked at her and grimaced. “Ouch,” he said.
“What’s the matter? You don’t like my sense of humor?”
“Forget it,” the Dean said. “I’ll do my best. We need a chairman. Peter Reinhardt is not going to wait forever.”
>
Jenny Suarez was tiny, barely five feet tall, with black hair, high cheekbones and deep brown eyes. Despite her size, she radiated confidence. “Christina told me you were going to stop by. What can I do for you?”
“Tell me about yourself,” Kurtz said.
“I’m from Dearborn, Michigan. I like my job. I’m single.” She gave Kurtz an appraising glance, which unaccountably cheered him up.
“How do you know Christina?”
“She was my Chief at Wake Forest. When she got this job, I asked to come along.”
“Why?”
“Wake Forest is in Winston-Salem, North Carolina. You ever been to Winston-Salem, North Carolina?”
“Can’t say that I have.”
“You weren’t missing much. It’s boring.”
“Christina said you wanted to live in New York.”
“Why wouldn’t I?”
Kurtz knew of a few possible reasons but decided not to mention them. “You know about the letters and the crank phone calls?”
Jenny Suarez pursed her lips and looked momentarily annoyed. “Oh, yeah,” she said.
“Any ideas?”
She frowned. “You mean who’s doing it?”
“Who’s doing it? Why they’re doing it…?” Kurtz shrugged.
“Nope.”
Helpful, Kurtz thought. Very helpful. “Does anybody not like Christina?”
“Not that I know of.”
“Does anybody not like you?”
She grinned. “A few ex-boyfriends, maybe.”
“Did you dump them or did they dump you?”
Her smile grew wider. “Generally, I’m the one doing the dumping.”
“Any of these ex-boyfriends live around here?”
“So far as I know? No.”
Lydia Cho had long, black hair, a round face, very pale skin and a white lab coat. She seemed to have a perpetually quizzical look.
“Sorry to bother you,” Kurtz said.
“That’s fine. Christina said you would come by.”
“I understand that you know about the phone calls and the letters.”
Lydia Cho nodded but said nothing.
“What do you think?”
She pursed her lips and let her eyes wander around the room. It wasn’t as if she was bored with the subject, not exactly. More like she was determined not to think about it. “Some lunatic,” she said. “It has nothing to do with me.”
Probably not, Kurtz thought, but it was way too soon to reach that conclusion. “But what do you think? You must have some ideas.”
“No, actually, I don’t. I’m a scientist. I try not to speculate when I have no data.”
Ouch, Kurtz thought. “In police work, getting the data is most of it.”
“What do you mean? Aren’t you a surgeon?”
“I am, yes, but the Dean has asked me to look into it.” He frowned. Even to his own ears, this sounded absurd. “I’ve had experience with these things,” he said. “More than I wanted to.”
She peered at him with a little more interest but still said nothing.
“Does Dr. Pirelli have any enemies that you know of?” Kurtz asked.
Lydia Cho looked taken aback. “No.”
And so it went. Lydia Cho had been pre-med, an old friend of both Christina and Christina’s sister, Elizabeth, but Lydia Cho found that she liked research. She had started out in the MD-PhD program at Northwestern but had dropped the MD part after her first year. Patients were too…she squinted and rocked her hand back and forth in a see-saw motion. “Imprecise, I guess. There’s too much in medicine that never does add up. Patients get sick. Mostly, they get better. I was shocked at how often you never do figure out exactly what’s wrong. I liked research better.” Her particular interest was in the hormonal changes affecting blood chemistry during pregnancy. She and Christina were co-investigators on three NIH grants totaling nearly five million dollars and were co-authors on over forty papers. She was happy doing what she was doing. “There’s more money in being an MD,” she said, “but then you always have a chairman hovering over you, looking at the bottom line. They like it when you publish but they also want you to take care of patients. You have to be good at both in order to be successful and I just didn’t feel like taking care of patients. This way, I can do what I want.”
Kurtz glanced at his watch. He was scheduled to be in the OR in less than twenty minutes. “Yeah,” he said, “I know what you mean. It’s nice if you get to do what you want.” He rose to his feet. “Thanks for your time.”
Lydia Cho nodded. “Don’t mention it. I’ll give you a call if I think of anything that might help.”
Not likely, thought Kurtz. “Excellent,” he said. “Please do.”
Vinnie Steinberg felt as if the walls were closing in on him. He had been Director of Anesthesiology at Easton Medical Center for a little over a month and he had already realized that this time was not going to be different. Not one iota. Patel, at least, had had experience. Patel had been Director for ten years. Patel knew how to recognize a lunatic masquerading as an administrator. Steinberg did not. Or had not, rather; he certainly did now.
“This”—Serkin waved a sheet of paper at him—“is unacceptable. I can’t have this.”
“You can’t have what?” Steinberg asked. His voice, he noted absently, was squeaking. He cleared his throat and said it again. “What?”
“You wrote a policy for discharging patients from the recovery room.”
“Yes?” Steinberg asked tentatively.
Serkin’s nostrils flared. His face was turning red. “Are you trying to deny it?”
“No, no.” Steinberg felt faint. He blinked and attempted to focus his eyes on Serkin’s face. “I mean, yes, I did. The head nurse and I wrote it together. We needed a set of standard orders. The staff had to write the orders out by hand. Now you just check off the ones you want. It saves time.”
“Did it occur to you that the Department covers three different sites? And that the staff rotates among those sites? I absolutely require that policies and procedures be identical at all of those sites. It’s the only way to be efficient. We cannot have a policy that applies to only one site. Nobody authorized you to write policies.”
“But we do things differently at all three sites now.” Speaking of efficiency. Efficiency wasn’t really the point, Steinberg had come to realize. The point was control. Serkin was the ultimate control freak, which might have been bearable if Serkin himself had realized it. As it was, he wouldn’t let you do anything and then he criticized you for supposedly not being able to make decisions. “Two of the sites already have a discharge policy,” Steinberg said.
“Yes, and now we have three discharge policies. I don’t want three. I want one discharge policy. Understand?” Serkin’s face was red. He was trembling.
“Yes,” Steinberg said. “Absolutely.”
“Get out of here,” Serkin said.
“Right,” Steinberg said. “You bet.”
“You want to do what?” the Dean asked.
“Take a sabbatical,” Peter Reinhardt said.
“A sabbatical…” The Dean had been working in administration for a very long time and he had wondered if something like this might happen. He had hoped not but hope, of course, was cheap, unlike paying a former chairman his usual very high salary while he took a sabbatical.
“I’m a full professor with tenure. I’m entitled to a sabbatical. I’ve never taken one.”
Technically, this was true. The system entitled a faculty member with tenure to take a sabbatical one year out of every seven. One year at half pay or half a year at full pay. However, you were supposed to do something with your sabbatical. Study the way they did heart surgery in Mozambique, come up with a new device for shunting blood through the brain. Something. It wasn’t supposed to be a vacation. And then you were supposed to come back to your parent institution and contribute the benefits of your new-found knowledge. You weren’t supposed to take a sabbatical and th
en retire. Unfortunately, there were already three semi-retired chairmen—urology, pediatrics and dermatology—who, rather than quietly leave when their time was up, had decided to hang around, ‘take care of a few patients,’ and draw a salary that they did almost nothing to earn. That was the problem with the tenure system. Once a man had it, you couldn’t touch him. You tried, and he sued you. “What do you plan on doing with a sabbatical?” the Dean asked.
“Write a textbook,” Reinhardt said.
“A textbook,” the Dean muttered. “Of course.” You could write a textbook while sitting at home in your study, and if somehow the textbook didn’t get written, or even if it did get written but never got published, the sabbatical would already be over, the money already spent. Clever, the Dean thought. Very clever.
“What?” Reinhardt asked.
“Nothing,” the Dean said. “Nothing at all.”
“Amazon, I’m telling you.” John Norris nodded wisely and said it again. “Amazon. It’s the investment of the decade.”
Kurtz listened quietly to the conversation but felt no urge to get involved. Norris was a neurosurgeon. Norris, like all neurosurgeons, made a lot of money. The average neurosurgeon in the United States brought in close to $500,000 per year. The average neurosurgeon in New York City made probably twice that amount. The residency for a neurosurgeon was seven years, the longest of any specialty. Neurosurgeons were highly trained, highly intelligent experts. Experts, unfortunately, have a tendency to regard their expertise as extending to all sorts of fields other than their own. Like investing.
“Amazon,” Chuck Weisberg said, “was the investment of the last decade.” Weisberg was a pediatrician. Pediatricians were at the bottom of the physicianly pecking order, averaging a mere $200,000 or so. Weisberg, however, did not seem to feel cowed by the presence of medical royalty.
John Norris reared his head back and gave him a scathing look. “Baloney,” he snorted.
Kurtz took a bite out of his sandwich and wished they would all shut up.
“If you had put ten thousand dollars into Amazon when the company first went public, you would have over a million today,” Norris said. “Think about it.”
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