“My insurance company is Steadfast Health,” she said.
“I’ve done some business with them.”
Will hadn’t actually had all that much contact with the company, but he had operated on a number of patients whom they covered. From what he recalled, Steadfast Health was smaller than most of the HMOs, and for the most part more civil.
“Well, they are refusing to allow you to do my surgery.”
“When did they say that?” he asked, wondering if somehow last night’s forum and the resulting publicity could have already had some undesirable fallout.
“Yesterday. Just in case there was some clause or other like the one they have requiring preapproval for everything, I called them shortly after we got home from here to inform them about the change we wanted from Dr. Hollister to you. The woman who answered the phone checked around and then called me back to say they have a contract with Excelsius Health that includes the requirement that the referral surgeon is the only one allowed to operate on Steadfast Health patients.”
Will was stunned. Was this yet another managed-care game?
“What do you mean contract?” he asked. “What’s Excelsius Health got to do with this?”
“From what I was told when my primary-care doctor scheduled my mammogram, Steadfast Health is too small to have cancer centers the way Excelsius Health does, so their patients are X-rayed at the Excelsius mammography clinics, and if they need it, they’re treated at the Excelsius cancer centers. Then, I guess, Steadfast Health reimburses them somehow.”
“Well, this is just crazy,” Will said. “I’m on the provider panels for both Steadfast Health and Excelsius.” Even though, he chose not to add, Excelsius had tried several times in the past to have him removed from their provider list for various technicalities, including failure to get a form in on time.
“No matter what,” Grace said, “my husband and I have decided that we want you to do my biopsy, even if we have to pay for it ourselves. We have some money saved and—”
“Stop right there. This is absolute nonsense. You aren’t going to have to pay for this yourselves.”
The oversize manila folder with Grace’s mammograms in it was still propped against his desk from the previous evening. It was ironic and somewhat amusing that he had completely missed the Excelsius Health label in the upper left corner. Briefly, he scanned the films once more. The cancer was as he remembered—not huge but, in truth, indisputable. Biopsying the lesion would be technically simple, as would be its removal, provided there were no local lymph nodes with cancer in them. If the cancer had spread to the nodes—a part of the system draining foreign matter from the body—a meeting with the oncologist would be worth having to decide whether removing the lump or the upper outer quadrant of the breast would be statistically the best way to go.
Charles Newcomber was the radiologist who had read the mammogram, dictated his reading, and subsequently referred his patient to Susan. Emphasizing his title to the Excelsius Cancer Center operator, Will had no problem getting patched through to the man, who had a rather high-pitched voice and a fairly pronounced British accent.
“Dr. Newcomber,” Will said after introducing himself, “I’m here with a Mrs. Grace Davis, who had a set of mammograms that you correctly read as showing probable cancer.”
“Well, I’m certainly relieved at being deemed correct about such a thing.”
“Oops. I’m sorry, Doctor. I hope you know that’s not what I meant. I really do apologize.” Will expected the man to say something that would help ease his discomfiture, but there was only silence from the radiologist. “I . . . um . . . the problem I’m calling about is that you referred Mrs. Davis to Dr. Susan Hollister, who is one of my partners.”
“Yes?”
“Well, it turns out that Mrs. Davis and I have a history together that goes back more than ten years.”
“How sweet,” Newcomber said.
Will sensed his neck redden, but held his tongue in check. Newcomber was part of the Excelsius Health family. It was quite possible he was aware of the forum and its aftermath. Perhaps he had even been there.
“Dr. Newcomber, Mrs. Davis is here with me right now. She would like me to perform her surgery. I have spoken with Dr. Hollister, and she has no problem with the change.”
“I’m afraid that isn’t possible.”
“What?”
“Dr. Grand, first of all, this cancer center has an approved list of consultants from which we select a surgeon based on our patients’ hometown and any sexual preference. Dr. Hollister is on that list. You, sir, are not. Secondly, I have made it a point to personally get to know any surgeon to whom I make a referral. I don’t know you at all. If Mrs. Davis has a problem with that, I suggest she make an appointment to come in and share her concerns with me.”
Will could barely speak.
“Dr. Newcomber,” he managed, “who is your supervisor?”
“I am the supervisor, sir,” came the acid reply.
“Well, you’re not the boss!” Will shot. “And my name’s Grant, not Grand.”
He slammed the receiver down.
A call to information gave him the number of the headquarters of Excelsius Health. He and Boyd Halliday had mixed it up yesterday, and Will was more than ready for another go.
“There’s no way they’re going to get away with this,” he muttered as much to himself as to Grace.
“Excelsius Health, the leader in cost-effective, comprehensive health care. How may I direct your call?”
“This is Dr. Grant. Mr. Halliday’s office, please.”
“One moment.”
“Boyd Halliday’s office. May I help you?”
“This is Dr. Will Grant. May I speak with Mr. Halliday, please?”
“Dr. Willard Grant? From last evening?”
“That’s right.”
“Um . . . just a moment, please.”
For nearly two minutes, Will sat with the phone pressed to his ear, listening to a Spanish flamenco guitar piece and looking across at Grace. Her transformation, while certainly remarkable, was not the only one of its kind he had encountered. Over his years as a physician and as a volunteer at the Open Hearth, he had known a number of alcoholics and drug addicts who had failed at rehab again and again, only to suddenly get it and become straight and sober forces for good in their own lives and the lives of many others. His own dentist had survived a horrible stretch of drinking, during which he was hospitalized more than two dozen times in a ten-year period. Now, twenty years into recovery, the man was something of a saint, practicing his craft with wonderful skill, while helping countless men and women in and out of his profession to face their demons and prevail.
“Dr. Grant?”
“Yes.”
“Marshall Gold here. Mr. Halliday is at an all-day conference. Is there anything I can do to help you?”
The time spent on hold had done nothing to help Will calm down. Barely pausing to breathe, he recounted the situation with Grace Davis and his disturbing conversation with Charles Newcomber.
“I am on the provider panel for both Steadfast Health and Excelsius,” he railed, “and so there is absolutely no reason to prevent me from caring for this woman—”
“Dr. Grant—”
“I promise you, if Boyd Halliday doesn’t intercede in this case and set matters straight, he’d better be watching the news and reading the papers, because I won’t hesitate to bring Grace Davis to them and—”
“Dr. Grant,” Gold repeated calmly.
“What?”
“We’re sorry for the confusion. We have no problem honoring Mrs. Davis’s request to switch to you for her surgeon.”
“You don’t?”
“No, sir.”
“But Newcomber—”
“The arrangement we have with Steadfast Health has, from time to time, generated some confusion. I’m sorry that you, of all physicians, on the day after the Faneuil Hall forum, of all days, have been caught up in it. Hopeful
ly, in the very near future, Steadfast Health and Excelsius will be merging, and such misunderstandings will be eliminated altogether.”
The freight train of Will’s anger screeched to an immediate halt.
“You can speak for Halliday on this matter?”
“As I said, you are not the first physician to be caught up in this sort of situation. So long as you are a provider on our panel, which I most certainly know you are, you have been screened in depth by our credentialing committee and have been deemed to be a quality physician.”
“I . . . well . . . thank you, Mr. Gold. Thank you very much. Mrs. Davis will be very pleased to hear that.”
“Is there anything else?”
“No. No, I guess not.”
“Dr. Grant, I assure you, we are not the soulless, money-grubbing monsters you have worked so hard to portray us as.”
“Maybe you’re not,” Will replied distantly. He set the receiver down softly.
“So, I guess you’re my surgeon,” Grace said.
“I guess I am. I don’t know why I’m sitting here feeling like a jerk when I didn’t even do anything but stick up for our rights. The company made the offensive call, then the company took it away. It’s as simple as that.”
“It’s as simple as that, except that you have passion for your profession and your patients and don’t want to have that stolen away from you.” She stood and set copies of the morning’s Globe and Herald on his desk. “I’ll make an appointment for you to examine me and speak to me and my husband about what’s in store for us, and also to schedule the biopsy. With any luck, you’ll get to help save my life a second time. I’m not sure I subscribe to this one, but an ancient Chinese belief is that if you save someone’s life, you are responsible for that person and what she does with the rest of her life, having presumably cheated the fates out of an intended victim. If that’s really true, I would wager you have quite a number of souls on your plate.”
Before he could respond, she reached across the desk, briefly took his hand in hers, and was gone, leaving the faintest scent of something springlike swirling in the air.
Will checked the morning’s schedule once again. He still had ten precious minutes to review lab reports and dictations and to sign the stack of payment requisitions for those companies who refused to allow a rubber stamp, proxy, or any signature other than his in black ink. Two minutes into the ten, his private, direct line—the line reserved for family, close friends, and other physicians—began ringing.
“Dr. Grant?”
The voice was tinny—mechanical and robotic—the sort of distorted, disembodied, computer-generated voice that telemarketers were using more and more to announce that you had just been chosen to receive three free days and two free nights at one of Orlando’s newest resorts, or to ask you to call for the absolute lowest mortgage rates possible, even if you have been refused credit in the past. Only this call had come in on a number that none but the most dogged, resourceful telemarketing firm could ever have obtained. Will resisted the impulse simply to hang up.
“Who is this?” he asked.
“Is this Dr. Grant?” the totally creepy voice asked again.
“It is. Now, who is this? What do you want?”
“You did well last night, Dr. Grant. Very well.”
“Use your regular voice or I’m hanging up,” Will managed, though with less force than he had intended.
“All in good time. We are very proud of you, Doctor. Very proud. These companies have got to be made to pay for all those they have killed.”
Will sank back in his chair, stunned at the notion that this might be the one who had recently murdered three people. However, within just a second or two, his surgeon’s mentality kicked in and was demanding action. He snatched up a pen and wrote the caller’s words down as closely as he could remember.
“Are you responsible for the killings?” he asked, searching his thoughts for any other action he should be taking. Aside from staying focused and prolonging the conversation as long as possible, he could think of nothing. Along the margin of the paper, he wrote:
?Man?
?Woman?
Halting speech? . . . On purpose?
We . . . not I
We . . . not I
Several times . . .
“This is war,” the voice said. “In war people die. These corporations earn millions off the blood of the innocent. You implied as much last night. Now you are one of us. You are our brother in this war—a fellow soldier. If you need us, we will be there for you. If we need you, we expect your cooperation. Top drawer of your desk—back left corner. We are counting on you to deliver the message that we are engaged in a holy war to avenge the innocent.”
There was a click and, an instant later, a dial tone.
Will continued writing furiously until he was certain that most of the chilling diatribe was on paper. Finally, he scanned the transcript. His handwriting was deplorable under the best of circumstances and would have been the butt of office jokes had not Gordo Cameron’s been even worse. Carefully, he reprinted those words that were particularly illegible. Then, his palms unpleasantly damp, he pulled open the top drawer of his desk and peered down at the contents. In the back left, on top of the usual mélange of letters, articles, notepads, photographs, prescription pads, paper clips, writing implements, and scattered surgical instruments, was a plain white business-size envelope with the flap tucked in, not sealed. Inside were two pieces of white index cards, each three inches square. A C was printed on one with some kind of marker. An N was printed on the other. Aware that he had done the wrong thing by touching the envelope at all, Will carefully replaced the letters and set the envelope back where it was in his desk.
Then, with an unpleasant gnawing in his gut, he slid Patricia Moriarity’s business card to the center of his blotter and called.
CHAPTER 10
Six minutes after Will ended his conversation with Patricia Moriarity, two uniformed state policemen, sirens blaring, arrived at the Fredrickston Medical Arts Building and began the process of sealing it off. There were at least a dozen different practices of varying specialties in the building, in addition to a pharmacy, an optician, and a bagel store. Will knew that for at least the rest of the morning, there would be massive inconvenience for all of them.
Susan was doing a case in the hospital, and Jim Katz had the day off. But Gordo had arrived in his office while Will was speaking with Grace Davis. Now he was stuck there, and not at all pleased about it. Arms folded, his bulk threatening to overwhelm his desk chair, he stroked his beard and gaped over at Will in disbelief.
“Willy, now tell me again,” he said, “just what are ye doin’ consorting with a murderer?”
“Hey, you’ve got it backward, Gordo. It’s him . . . or her . . . or them . . . or it—I couldn’t even tell, for chrissakes—that’s consorting with me. Because of the things I said at the forum last night, the bastard has decided that I’m a kindred spirit of his—a brother in the war against managed care is how he put it. In fact, I had this feeling while I was listening to him that he might have actually been there last night.”
“That gives me the willies—or maybe out of deference to you I should say the creeps. How could they have gotten into this building and then into your office?”
“I was hoping you might be able to come up with a theory to explain that.”
“Well, given the crack security company that watches over this place, my guess is an entire terrorist cell could be operating here every night without being noticed.”
“You might be right. Think we ought to try and get in touch with Jim?”
“I can’t imagine something like this happening and him not wanting to know about it. In case you hadn’t noticed, he’s a wee bit of a control freak.”
“I’ll have Mimi try and find him.”
At that instant the receptionist called in over the intercom. “Dr. Cameron, would you tell Dr. Grant that Detective Moriarity is out here looki
ng for him?”
“Consider it done, lass. Do us a favor and see if ye can locate Dr. Katz.”
Her expression businesslike, Patricia Moriarity shook Will’s hand, then motioned him over to the corner of the waiting room farthest from the receptionist. She was wearing a black hip-length leather jacket over dark slacks and a light blue sweater. Will couldn’t help but notice that the only ring she wore was on the third finger of her right hand.
“Dr. Grant, the crime-scene people will be here any moment to go over your office. Is there a place we can speak in private?”
“We have two empty physician’s offices. Either one would be fine.”
“You choose.”
Will led her to Susan’s consultation room, which was on the side of the suite directly opposite Gordo’s. The size and setup of the room were nearly identical to Will’s, but the modern art on the wall and extra touches Susan had added to the basic decor—curtains with a repeating Parisian street scene and a small reading table by the bookshelf—made it quite distinctively hers. Moriarity pulled one of the patients’ chairs away from the desk and motioned Will to the other. Then she flipped open a notepad and slid a government-issue pen from the wire.
“Dr. Grant,” she began, with no pleasantries or even a mention that they had met just twelve hours before, “what on earth were you thinking when you pulled that envelope out of your desk and opened it before calling me?”
Will took a few seconds to stabilize himself.
“I . . . I think I was so bewildered and frightened by the call that I wasn’t really thinking straight.”
“And there was nothing about the caller’s voice that you recognized?”
“It was totally mechanical. In fact, whoever it was might have been typing the words into a computer that then read them over the phone.”
“That technology is available.”
Even when she was writing, Patty kept her eyes on Grant. Despite what she had learned of the man—his temper, his history of violence, his suspected though apparently never documented association with an explosion that had killed a man—he had a vulnerability and sensitivity about him that seemed real. She reminded herself that if sociopaths had a major, it was gentleness and genuineness—just ask those who knew charming Ted Bundy or John Wayne Gacy, who dressed as a clown to entertain hospitalized children. As far as she was concerned, until proven otherwise, this man was a suspect in three violent murders.
The Society Page 10