“It might be too much to say that we’re on to him. We’ve figured out a little of how he’s doing it. We’re not much closer to figuring out who, or even why.”
“Henry Tolliver is not pleased,” Kurtz said. The Dean had called him as soon as he got off the phone with his newest prized recruit.
Moran shrugged. “A chairman has to be able to deal with minor frustrations.”
“Maybe the guy didn’t get tenure,” O’Brien said.
“Most don’t. It’s not usually that big a deal,” Kurtz said.
“Not for you,” Moran said. “You’re a surgeon. You can take care of patients and make a lot of money. What if the guy had nothing else to fall back on?”
“I suppose he might be pissed.”
“Something to look into,” O’Brien said.
Kurtz puffed his cheeks out in thought. “The Chairman of the Promotion and Tenure Committee is George Ryan. I’ll give him a call.”
Moran peered down into his cup. “Crappy coffee,” he said.
“Too bad,” O’Brien said. “Next time, you can bring your own.”
“Ours is worse,” Moran said.
“Penny for your thoughts?”
Lenore was wearing a dress that showed an elegant hint of cleavage, just enough to draw the eye, not enough to be slutty.
“Why am I wearing a tie?” Kurtz said.
“So, you can see and be seen?”
“I don’t think anyone can see me.” They were eating at Bouley, a dimly lit temple to fine dining in downtown Manhattan. Half of the customers wore suits and dresses. The other half looked ready to jog down the street. “Surgeons are expected to wear a tie,” Kurtz said. “It’s like a uniform, but I never actually liked wearing a tie.”
“Have you ever seen those old pictures from the 1940’s? People used to dress up all the time. They dressed up to go to baseball games.”
“Times have changed,” Kurtz said. He grinned, took off his tie, folded it and put it in the pocket of his jacket.
“Lucky you,” Lenore said. She grinned. “Maybe I should slip off my pantyhose.”
Kurtz grinned back. “Fine by me.”
“Maybe later,” Lenore said.
The waiter appeared with their appetizers, two pieces of poached lobster with lemon foam and caviar for Lenore, foie gras with cinnamon and apricot sauce for Kurtz. Both of them ate carefully, giving the food their full attention. When the waiter had taken the plates away, Kurtz said, “Has it ever occurred to you that everything is changing?”
Lenore narrowed her eyes. “Often. Do you have something specific in mind?”
“Suits and ties are vestiges from a more formal time. It might have been uncomfortable but everybody knew the rules and what they were supposed to do, and generally, they did it. Not anymore.”
Lenore nodded. “Okay…I read an article a few days ago on social disruption. Supposedly, according to this article, the French Revolution and the fall of the Soviet Union were actually decades in the making, but in the end, they took almost everybody by surprise. The system goes on and on and on, and all of a sudden, it collapses.” She smiled. “So, what’s your point, exactly?”
“I’m talking about our stalker. What motivates the guy? Did he get kicked out of a residency program? Did he think he was following the rules and the system somehow blew up in his face? What did the school ever do to him? There’s real hatred here. There’s real resentment. And when you think about it, the system is broken. The guys who want an academic career don’t have much chance of getting it, not unless they want to sacrifice a ton of money and also work hours that are inhuman and ought to be illegal. The game is rigged.”
“More wine, Madame? Monsieur, another beer?” The waiter was tall, dark and thin. He had fashionably spiky hair and a severe face and wore a tuxedo.
“Yes, please,” Lenore said.
“I’ll have another,” Kurtz said. He was drinking Duvel.
“You think he ever wears a tuxedo when he’s not at work?” Kurtz said.
“Why should he?”
“My point exactly. At least the guy has a job but they don’t give college degrees in waitering. He was probably a Sociology major, or maybe English. Bill Werth was telling me that there are openings for four assistant professors in Dina’s department. They’ve got twelve hundred applications. Why do all these kids major in English, anyway? Where do they think the jobs are?”
Lenore shrugged. “I started out as an English major with a minor in Dance. Then I switched to graphic arts.”
Kurtz made a rude noise. “What a scam. The academic beast needs an endless supply of fresh victims. Even the professions aren’t immune. I read somewhere that sixty percent of law school graduates in this country are not employed as lawyers.”
Lenore nodded and took a sip of her wine. “In the old days, college was primarily for the rich. They already had money so getting a job wasn’t a consideration. A liberal education was supposed to teach you to think, or at least, that was the claim. It was supposed to make you a better human being. The only actual job that a degree in English qualifies you for is teaching English.”
“Academic medicine has a safety net, at least. You can always say fuck it and go out and be a doctor.”
“This is true,” Lenore said, “but getting back to your original point, I think you’re jumping to conclusions that are not warranted by the evidence. The motivations of lunatics frequently make no sense to anybody but themselves and aside from generalities like ‘resentment’ and ‘hatred’ you have no real idea what motivates your stalker. And even hatred and resentment may be incorrect. Who knows, maybe the guy is just bored? Maybe this is the way he gets his kicks.” Lenore smiled gently. “Anyway, it’s Friday night,” she said. “We’re eating a nice meal and we have a nice weekend ahead of us. Why don’t we try to relax?”
Kurtz drew a deep breath. “Okay. Fine. I suppose you’re right.” He reluctantly smiled. “What do we have to complain about? Most people can’t afford to eat at Bouley.”
“Exactly,” Lenore said. “Let them eat cake.”
Kurtz winced. “Ouch.”
Chapter 16
George Ryan was the Chairman of the Appointment, Promotions and Tenure Committee, an MD, PhD in the Department of Radiation Oncology, with the rank of Professor. He was tall, middle aged and thin, with a few wisps of graying hair combed over his otherwise bald head. It was not, Kurtz thought, a good look. Nevertheless, Ryan smiled pleasantly, shook Kurtz’ hand and invited him to sit. “What can I do for you?” Ryan asked.
“I was interested in the work that your Committee does,” Kurtz said.
Ryan gave him a sharp look. “Why?” he asked.
“The Dean has asked me to look into something. I’m not at liberty to discuss the details, but the Promotions Committee may have some bearing.”
Ryan looked at him doubtfully then shrugged. “All right,” he said. “What do you want to know?”
“Anything you can tell me.”
Ryan frowned. “Well, to start with, when a new faculty member joins the institution, his Chairman proposes an academic rank. For people just out of training, or newly graduated PhD’s, the rank is always Assistant Professor. The Committee has to approve these but it’s almost always pro forma. Once we approve, the Dean signs off on it, and that’s it. The real work comes with promotion, or with bringing people on board who are already senior.” Ryan barely smiled. “That can be contentious.”
“How so?”
“There are three academic ranks, Assistant Professor, Associate Professor and Professor, with two tracks for each: tenure and non-tenure. Academics tend to be transient. Let’s say a man has built up a good reputation but he wants to move up the ranks and his own institution doesn’t have an opening. We do, and we hire him. He expects a promotion. Why leave your old job and come to a new job if there is no promotion? His Chairman has promised him a promotion, but his Chairman can’t dictate to the Committee. Sometimes he’s an Associat
e Professor and he’s expecting to be a Full Professor here, but even though the system is supposed to be pretty much the same all over the country, standards do differ. An Associate Professor here might be an Assistant at Harvard, or even a Full Professor at some place in the boonies. The guy has to meet our standard or he doesn’t get the rank.” Ryan shrugged. “Presumably his Chairman has discussed all this with the Dean before hiring the guy, and hopefully they’ve run it by me, just to make sure there won’t be any trouble, but sometimes…” Ryan shrugged. “The internal promotions work the same. A guy has been here for five or six years, he’s done some research, he’s got maybe a dozen papers, he wants to get promoted. His Chairman proposes him and then the Committee has to evaluate his CV and vote. Does he have any Service, which includes committee work, clinical work, et cetera? Does he have an administrative position? Is he a good teacher? Has he fostered any innovative programs? All this stuff comes into play.”
“How about tenure?”
“Tenure includes all of the above plus grant money. If somebody has tenure, the institution is obligated to pay his salary for as long as he wants to work and can’t fire him except for moral turpitude. It’s a lifetime commitment. You have to show that your research can generate enough money to fund at least a good part of your salary, plus pay for a lab which includes supporting the salaries of your techs and your post-docs. It’s not easy.”
“How often do you turn somebody down?”
Ryan cocked his head to the side and frowned. “Not often. If he’s smart, a chairman won’t send somebody up until he’s ready. For a physician, it’s complex. The standard is much easier to define for the basic sciences: biochemistry, physiology…the PhD’s.
“Our former Dean once described the institution as a ‘trade school.’ It wasn’t a popular comment, believe me, but there’s a kernel of truth in it. Medicine is, in its essence, the taking care of patients. We’ve grafted this profession, this trade, if you will, onto an academic system with which it is not necessarily, and certainly not entirely, compatible.”
“Research,” Kurtz said. “Advancing the science.”
“Exactly,” Ryan said. “The purpose of medical education is to train physicians. The purpose of the physician is to take care of patients. The purpose of the academic establishment is to expand and perpetuate a body of knowledge. These goals often exist in an uneasy alliance. Sometimes, they conflict.”
Kurtz barely smiled. “Actually taking care of patients doesn’t matter to your committee at all, does it?”
“Better to say that being an excellent physician is only a part of what we consider. But, there is some truth to what you’ve said; it’s entirely possible to advance up the ranks without taking care of patients.”
“Some people might consider that a kick in the teeth,” Kurtz said.
“Yes,” Ryan said, “they might.”
He sat in his chair after dinner and listened to something slow and mournful on the stereo. His campaign so far had reaped predictable benefits. Satisfying, he reflected, but he was getting a little tired of halfway measures, frustrated even. The zing that sending messages gave him, that making phone calls, that came from a little creative mayhem, was getting…old? Boring? Yes, that was it. It was getting boring.
How shall my hatred be shown? Simple. Only your blood will satisfy me.
It wasn’t a bad note, he reflected, but how many notes can a person receive before she stops taking them seriously? He sat, chewed his very expensive, very excellent steak and pondered. Yes, he decided, he would send the note. No reason not to, after all, but it was definitely time to up the ante.
“Do you like gardenias?” Lenore asked.
“Huh?” Kurtz looked up from the latest edition of JAMA that he had been trying, with minimal success, to get through. Lately, he was having a bit of difficulty in concentrating on work. Gee. Wonder why. Gardenias…they were tall, weren’t they? “Are those the ones on stalks?”
“No,” Lenore said. “You’re thinking of gladiolus. Gardenias look more like camellias.”
Kurtz sighed. “You have pictures?”
Lenore shook her head. “Flowers for the wedding. Why do I even give a damn? Am I turning into my mother?”
Lenore’s mother was five foot one, plump, with a round face and a mouth like a raisin. Lenore was almost six feet tall, with straight blonde hair and had done some modelling work during college. “No,” he said, “you’re definitely not turning into your mother.” Kurtz put down the journal and looked at her. “I thought that everything was under control.”
“I thought so, too, but somehow, picking out flowers seems to be a bridge too far.” She frowned. “It might help if you could show a little interest,” she said.
He raised an eyebrow. “I can’t help it if I don’t know the difference between a camellia and a gladiola. Anyway, the problem isn’t my lack of interest. The problem is your lack of interest.”
She gave a reluctant grin. “I thought you surgeons were supposed to be control freaks. Make some decisions. Take me away from all this.”
“The only thing I care about here is that you’re happy. You should have the sort of wedding that you want.”
She sighed again, glanced down at the catalogue in her lap and closed it. “Gardenias,” she said, and stretched out on the couch, tickling Kurtz’ thigh with her big toe. “Let’s go to bed.”
“You’re such a control freak,” Kurtz said.
She smiled. “Yeah,” she said. “In the end, none of us can deny our nature. I have big plans for you tonight.”
He sighed. “Oh, well,” he said. “Duty calls.”
“Superior mesenteric artery? Are you sure?”
Jason Lee frowned down at the cadaver and idly poked at the swollen, purple blood vessel with a metal probe. “I think so,” he said.
Linda Drake said, “It’s not supposed to look like this.”
It was not uncommon for medical students to work on their cadavers at night. There were ten classrooms that doubled as labs. Each room held four cadavers and sixteen desks, four students per cadaver, sixteen students per classroom. Dissection typically began early in September, started on the head and worked its way down. By the end of the school year, there was not much left of the cadavers. It was nine o’clock at night and the anatomy midterm was scheduled for early next week.
Kyle Stockton frowned down at a textbook propped open on the table. “I think it’s an anomaly. The inferior mesenteric is coming off the superior mesenteric. It’s supposed to come off the aorta. That’s why it looks so weird.”
“Maybe,” Jason Lee said. He sounded doubtful.
Danny Rosen, the fourth member of their anatomy group, frowned down at the offending structure but said nothing.
A small metal can flew into the classroom, bounced once on the floor and came to rest against the wall, clear liquid spraying from its opened top. The door to the classroom gently closed. All three students glanced over at the door, then down at the can. A flowery smell began to fill the room.
“What the hell?” Kyle Stockton said.
They stared at the can for a few seconds as a small puddle spread out onto the floor. “I’m getting dizzy,” Linda Drake said.
“Fuck!” Danny Rosen ran to the door and grasped the knob. It refused to turn. “It’s locked.”
Jason Lee picked up the can and ran to the sink. He turned on the water and poured the remaining liquid into the drain. By the time the can was empty, Jason was barely conscious. “Someone call the police,” he whispered, and slumped down to the floor, his head between his knees.
Danny Rosen crawled over to the air vent and took some deep breaths. Kyle Stockton fumbled with his cell phone, punched in 911 with numb fingers, and spoke into the phone. “They’re coming,” he said.
Linda Drake appeared to be unconscious, but she was breathing. Slowly, the sickly sweet smell began to dissipate.
“What was that stuff” Jason Lee asked.
Danny shook
his head. “I don’t know.”
“Ether,” Lew Barent said. “It was ether.”
Harry Moran had taken a couple of days off and was in New Jersey visiting his wife’s family. Barent was by himself.
“We don’t use ether anymore,” Patrick O’Brien said. “Where did he get it?”
“We don’t use it for surgery,” Kurtz said. “It has a tendency to explode. They still use it in the animal lab. It’s the easiest way to anesthetize small animals.”
“Yeah?” O’Brien sounded doubtful. “How do you know that?”
“When I was a student, we anesthetized a rat, then we tied off the ureter and injected it with bacteria. The rat got pyelonephritis. A week later, we killed it and examined the kidney under a microscope.” He shrugged.
“That’s a mean thing to do,” O’Brien said. He sounded offended.
“It was a rat. People don’t like rats. It’s not like it was a dog.”
Barent frowned at them both. “We’ll examine the can for prints but I doubt that we’ll find anything. This guy hasn’t been stupid so far.” He looked at Patrick O’Brien. “Let’s take a look at the tapes.” He shook his head, “Whoever it was is probably home by now, enjoying a cold one.”
The tapes showed a man with dark glasses, a light brown beard, a moustache and a baseball cap coming in the front door of the lab building. Ten minutes later, he left. He was about six feet tall and lean. He carried a small paper bag. As he passed by the camera, supposedly hidden inside a lighting frame, he held up the bag to the camera and winked.
“Well, the son of a bitch is certainly enjoying himself,” Patrick said.
Barent frowned and sat back. “The beard and maybe the moustache are probably fake.” He reached out and touched the screen. “Look at his nose.”
“What about it?” Kurtz said.
“Notice the size of his nostrils? The way they flare?” Barent shook his head. “Nose putty. His real nose will look different. This guy is no dummy.”
“We already knew that,” Kurtz said.
“His height is probably real,” O’Brien said. “Those don’t look like lifts in his shoes. Also, his body habitus. You can’t make a fat guy look lean.”
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