The Society

by Michael Palmer

  It was two-thirty, and always the multitasker, Will had taken advantage of his free pass into FGH by making an appointment to review Grace’s chest X-rays with Rick Pizzi, the radiologist on duty. Disappointed that there was no message from Patty waiting for him at the condo, he had called from a pay phone and spoken briefly with her.

  “That was a really nice night, thanks” was the extent of her comment on their lovemaking.

  “For me, too,” he’d replied, wanting to say much more.

  Patty, having spent much of her day on the case to which she was no longer assigned, was behind in chasing after those cases to which she was, including the wounding of a shopkeeper during a holdup. There wasn’t time for more than the brief exchange of reports of her interview with the widow of Ben Morales and his encounter with Charles Newcomber.

  “Let’s talk later if we can,” she said, “but with the shooting they just set on my plate and this next interview, I think I’ll be working most of the night.”

  The too-brief conversation had left Will with an aching emptiness in his chest. He left for the hospital reminding himself that over the past fifteen years, Maxine was the extent of his serious involvement with women. That hardly qualified him as an expert.

  Radiology was, as usual, busy. Rounding a corner, Will nearly collided with Gordon Cameron. The Scotsman was a spectacular vision in a boldly striped dress shirt, paisley tie, and deep burgundy trousers, held up by a pair of broad plaid suspenders. Each of the colors seemed to clash with every one of the others, as well as with his thick, red-orange beard.

  “Will, me boy, you’re off a couple of floors! We’re meetin’ in the conference room on three.”

  For years, any contact with Cameron raised Will’s spirits. Today, though, he had to hold his niggling concern about the man in check. It was hard to look directly at him without demanding to know if he was the one who had somehow managed to poison him with fentanyl.

  “Gordo, you have really cloaked yourself in sartorial splendor this day,” Will said. “You are positively intimidating. If Braveheart had dressed this way, I believe he’d still be charging through the heather, slicing off heads, and mooning the British.”

  “Trust me, lad, you don’t know the half of it. The hard part of pulling this outfit together was finding a set where the suspenders and thong matched.”

  “Ouch! So, do you know what this meeting is about?”

  “Just that it has to do with Jim and you. Listen, Will, I need to tell you that I’m really sorry I haven’t been in better touch. Things have been so hectic around here without you that I haven’t called to see how you were doing.”

  “Nonsense. I’ve been far too busy living the high life to make time for anyone.”

  “Well, it may not seem it, but I have been thinking about you.”

  “Duly noted and appreciated.”

  “Thanks. Now, what are you doing down here in the bowels of the hospital?”

  “I’ve run into an interesting problem with a film. Rick Pizzi’s going to go over it with me.”

  “The only suspended doctor in the history of the hospital who manages to run into an interesting problem with a film. Now, that’s what I call devotion to the profession. Want company in there? We can’t start this meeting without you anyway.”

  “Come along.”

  Pizzi, stocky and higher strung than most radiologists, had come to FGH at almost the same time as Will. However, their career paths, as least from an economic standpoint, then quickly diverged. Radiology, without much patient contact, wasn’t a specialty Will would have chosen, but it certainly had things to recommend it. An avid pilot, Pizzi now owned a pressurized Cessna, as well as a snazzy fishing boat and a Porsche. He also was still in his first marriage and spent most of his infrequent on-call nights asleep at home.

  Two sets of Grace’s chest X-rays, taken a day apart, were in place in four panels of the ten that filled the wall behind Pizzi’s desk.

  “So,” he asked, “were you able to get ahold of Mrs. Davis’s mammograms?”

  “Not yet. They’re at the mammography center of her HMO. I will, though, I can promise you that.”

  “And you feel certain there was nothing like this in any of the views?”

  “As you may have heard, Rick, I’ve been under a little stress lately, so I’m not going to claim to be one hundred percent certain about anything. But I did look at the mammograms carefully when Mrs. Davis first came to my office, and I never noticed anything like this. Her husband doesn’t remember seeing anything in her films, either. He’s a teacher, not a doc, but he claims to have an unusually sharp eye for details. The question is,” Will said, “is it possible for every one of the views of a standard mammogram series to miss this?”

  Pizzi considered the question, then shook his head.

  “I don’t believe so,” he said. “Depending on technique, it would be present in three standard views, maybe four.”

  “And if it wasn’t?”

  Rick Pizzi’s expression darkened.

  “Then,” he said, “I would have to adopt the position that the mammograms weren’t hers.”

  “Mammograms that weren’t hers. Mother of God, Will, what have you gotten yourself into?” Cameron asked as they trudged up four stories from the basement.

  “This time.”

  “Pardon?”

  “You mean what have I gotten myself into this time. This is the woman who almost died from an anaphylactic reaction to her first dose of chemotherapy.”

  “I heard about this case. The rescue-squad paramedic did a trach on her, yes?”

  “Exactly. Saved her life from all I can tell.”

  “Fascinating.”

  “Actually, she’s a patient of our practice. Susan did the biopsy and excision.”

  “So the woman really has breast cancer.”

  “Had, I hope. The cancer was about two and a half centimeters, but the sentinel lymph node Susan took was negative. The thing is, the cancer that was removed might not be the one depicted on her mammogram.”

  Cameron stopped after three floors to catch his breath.

  “Tsk, tsk, Gordo,” Will said, “too many doughnuts, not enough treadmill.”

  He was pleased with the doughnut reference even though it had been unintentional.

  “Ach, laddie, you couldn’t be more wrong. It’s nothing I do wrong, it’s just my hereditary, familial, inherited, genetic bronchitis. It acts up every year on precisely this day. There, it’s already better. So,” he went on as they headed up the last flight, “let me get this straight. The radiologist mixed up her films with someone else’s, but that person happened to have a cancer in the same quadrant of the same breast as our patient.”

  “I think that about sums it up.”

  “That’s one lucky radiologist.”

  “I should say.”

  Cameron paused outside the Sears Conference Room.

  “So what do you make of it all?” he asked.

  “Don’t know. But I do know I’m not done thinking about it.”

  Or about whether you’re the one.

  The chairs in the conference room, which were normally set up in rows, were stacked along the walls, except for those dozen or so that were spaced around a large cherry-wood table. Hospital president Sid Silverman was seated on the far side, flanked by cardiologist Dr. Hans Gehringer and an attractive, conservatively dressed brunette who just had to be a lawyer. Silverman inadvertently caught Will’s gaze and nodded a weak greeting, his expression that of a man about to be sick. To Gehringer’s left were Susan Hollister and Jim Katz. Cameron took the chair between Katz and Patty’s nemesis, Wayne Brasco.

  Occupying the two seats to Brasco’s left were bookend women in business suits—also attorneys, Will guessed. He suspected they might be connected with the Board of Registration in Medicine. He hesitated briefly, then took the middle of the three remaining empty chairs. There was no sense in even trying not to stand out in this group.

  A
pparently it had been decided that Silverman was going to run the show.

  “Well, thank you all for coming on such short notice,” he began. “I assure you we are confronting an emergency of the highest order and that every one of us needs to be here.”

  He then asked for introductions around the table.

  “Hans Gehringer, medical chief of staff here at FGH.”

  “I’m Susan Hollister, a surgeon in the same practice as Will Grant. I am also a supporter and long-standing friend of his.”

  “James Katz, also a member of the practice and the reason for this meeting.”

  “Gordon Cameron. What Susan said goes double for me. I know Will Grant is a good man and a great surgeon, and I feel we should do whatever we can to help him get through this mess.”

  “Detective Lieutenant Wayne Brasco, Massachusetts State Police. I’ve been directing the team assigned to the managed-care killings. We expect to bring this criminal to justice, and quickly.” He looked directly at Will. “His reign of terror and death will be brought to an end one way or the other.”

  Will’s dislike for the man, already fully formed, mushroomed. Brasco was arrogant, self-serving, and violent—a man to be feared. It was no wonder Patty had had such a difficult time with him.

  As he suspected, the two women to his right were both from the Board of Registration in Medicine. One, Jane Weiss, introduced herself as the chief counsel, and the other, Diana Emspak, was the head of the investigation and enforcement unit—process server Sam Rogers’s boss, Will supposed.

  “I’m Will Grant,” he said when it was his turn. “I never willingly took any drugs. I haven’t done anything wrong. I have never wanted to be anything other than a good doctor. I understand your needs to protect the patients of this hospital and the people of the state, but terrible action has been taken against me without consideration of the lack of any corroborating behavior in my past.”

  “We appreciate your feelings,” Silverman said, his tone patronizing and insincere enough to knot the muscles in Will’s neck.

  At that moment, Tom Lemm, the president of the Hippocrates Society, entered the room, wearing a navy sports coat and perfectly knotted iridescent blue bow tie. It seemed that Lemm took too long searching for a seat before he realized that both of the two available chairs were next to Will. He settled into one, shook Will’s hand uncomfortably, and accepted Silverman’s introduction.

  “Dr. Lemm, we appreciate your being able to get here on such short notice. I know it was a long drive for you. Jill?”

  “I’m Jill Leary,” the dark-haired woman on Silverman’s right said, “chief counsel for the hospital.”

  Silverman cleared his throat for transition.

  “We are here because of something that has happened involving Dr. Grant and Dr. Katz and, indirectly, all the rest of us. Dr. Katz?”

  Katz straightened some notes on the table in front of him. It was only then that Will realized the man did not look at all well. He was pale, almost ashen, and there was a slight tremor in his hands as well as the faintest tic at one corner of his mouth. Katz coughed, swept an errant wisp of thinning hair from his forehead, and poured a glass of ice water.

  “At eight o’clock this morning,” he began, “a call came for me at home on a line that is unlisted. The voice was electronically altered in the way Dr. Grant has described. Initially I thought it was a crank call of some kind, but after a few words I had no doubt it was the killer. I was in my study at the time and had a pad of paper close at hand, so I wrote down what he—what it—had to say and typed my notes out immediately afterward. I believe my recording of the incident is quite accurate. If I may:

  “Dr. Katz, listen to me and listen to me carefully. I will not repeat myself. Dr. Willard Grant is being treated poorly by those who do not understand what a martyr he is in the struggle to avenge the harm brought down on so many by those companies that control health care. In all likelihood, framing him for drugs was the work of one of those companies—retribution for his victory over them at Faneuil Hall perhaps, or more likely because we have chosen him to speak for us as he has done so eloquently for the Society. He should not be suspended from his hospital and his profession. Rather, he should be honored. You have been chosen to right the wrongs that have been done to this man, a leader in the war against managed care.

  “Dr. Willard Grant’s reputation is crucial to our mission. He must be quickly restored to the practice of medicine, to the staff of your hospital, and to his position within the Hippocrates Society, or punishment will be meted out, and you, Dr. James Katz, will be the recipient. This is no idle threat. We hope you know by this time that we are very good at what we do, and very determined to have our point driven home about the dangers of managed care. You have seven days from this noon to use your influence to see to it that our demands come to pass. In the top right drawer of your desk at work are two envelopes—one is for you, and one for Dr. Grant.

  “We have chosen Dr. Grant to present our views and grievances to the public. For him to do so effectively, the stain currently on his reputation as a physician must be removed. We want you to see to it that Dr. Grant is in the position to state our position publicly as we have written it for him. You are either with us on this, Dr. Katz, or you are against us. There is no middle ground. I hope for your sake that is clear.”

  Katz actually sloshed water from his glass trying to raise it to his lips. Even though the years had taken some toll on the man, he still was a skillful surgeon who lived his life with quiet dignity. Will ached to see him in such a state. Even though he had predicted to Patty that the killers might make some effort to restore his decimated credibility, he was stunned at the cruelty of their threat. It was quite apparent that the others were, too.

  “Nice friends you have there, Dr. Grant,” Silverman said. “Detective Brasco?”

  “One second, Doctor.”

  Brasco pulled out his cell phone, made a call, and spoke in hushed tones, nodding his head importantly.

  “As long as you’re done with the envelopes, why don’t you bring them right over,” he said, raising his voice loudly enough for all in the room to hear. “Third-floor conference room at the hospital.” He grinned in an odd, smug way. “No, the L doesn’t surprise me at all. Not at all.”

  An L. Jim Katz’s death sentence had arrived in an envelope in the form of the letter L, undoubtedly block printed on white cardboard. Brasco’s expression at that moment was as subtle as a wrecking ball. The L didn’t surprise him in the least. Why not? It had to be that he knew something, Will thought. It had to be that he and the cryptographer had solved the killer’s puzzle.

  “Sorry,” Brasco said, setting his cell phone aside. “Where were we? Ah, yes, we were starting to debate the merits of giving in to the demands of a serial killer. I would like to say here and now that our position, like that of the President, is that we don’t bargain with terrorists.”

  The knot in Will’s neck muscles tightened once again. Brasco was a cowboy—an explosive with a minuscule fuse.

  “Well, Lieutenant,” Silverman said, clearly appalled by Brasco’s insensitivity toward Jim Katz, “I would say you’ve made your position quite clear. However, I would like the rest of you to feel free to tell us what you can and would be willing to do to protect Dr. Katz, who has done so much for our hospital and community. Miss Leary?” He nodded to the hospital attorney.

  “Since we first learned of the nature of the killer’s demands,” Leary said, “we have been discussing how far we might be able to go in reinstating Dr. Grant, at least temporarily. There is some precedent in our hospital, albeit from a number of years ago, for lifting a physician’s suspension while the claims against him are being investigated. Our medical staff executive committee is willing to consider the possibility out of deference to Dr. Katz, but they would insist on a psychiatric evaluation of Dr. Grant as soon as possible by a therapist chosen by us or the Board of Registration in Medicine. They would also very much like some
other sort of mitigating evidence relative to the allegations of drug use, which Dr. Grant has so staunchly denied. They have requested at least some notarized affidavits from respected members of the medical or civic community attesting to his moral character, and they would prefer something more concrete and substantial—hard evidence that at least suggested Dr. Grant’s innocence.”

  “Ms. Weiss,” Silverman said to the board’s attorney, “is there any chance the board would agree to stay Dr. Grant’s suspension pending an investigation of the allegations against him?”

  Weiss, dark and studious, held a brief, whispered exchange with the other board attorney.

  “Ordinarily, I would say no,” she replied. “The board exists to protect the public. We take a very harsh position in disciplining physicians when there has been patient harm, as in this case, or in many instances even the possibility of patient harm. However, there are most certainly extenuating circumstances here. Dr. Katz, I was informed that you actually served as one of the members of our board.”

  “That was a few years ago, but yes,” Katz said, still quite gloomy. “Governor Wilcox appointed me. I served for two years.”

  “You have a fine reputation throughout our office.”

  “Thank you.”

  Again the board attorneys whispered to each other.

  “Given the severity of what happened with Dr. Grant in the OR, we can’t make any promises,” Weiss said finally. “But if your executive committee approves his reinstatement, it is possible the board would follow suit. Dr. Grant, have there been any new developments in your efforts to determine what happened to you?”