Geoff answered with a smile and a nod, quashing a stinging retort. Mrs. Evers reached over to the phone panel with her right hand, depressed the intercom. “Dr. Pederson, Dr. Davis has finally arrived,” she said in a tone loud enough to be heard through Pederson’s office door and probably down the hall as well. A forced smile. “You may go in now.”
Geoff thanked Evers politely, brushed quickly past her desk, and knocked softly on the dark-paneled door.
“Come in,” replied the familiar baritone voice, muffled by the door. Geoff entered the inner sanctum, treading lightly as he always did with “the Colonel” in the intimidating surroundings of what the residents referred to as “headquarters.”
Richard Pederson was an imposing man. In many ways, he reminded Geoff of his commanding officer in the navy. Tall and lanky, with thinning, reddish-brown hair strategically combed to camouflage his baldness, his large hands and long, thin fingers seemed made for gripping a basketball as much as a surgical instrument. Indeed, he had played college ball for a while, a fact he freely share with the residents when in a particularly chummy spirit, which occurred twice a year—at the departmental Christmas party and at the annual reception he hosted at his home for the new residents.
Pederson had a tremendous need to exercise control over himself and those around him. This was exemplified by his annoying habit of strategically dropping his voice so that he could barely be heard, forcing the listener to strain to hear exactly what he was saying.
Exceedingly formal, Pederson vented his perpetually bridled carnal desires by telling lewd jokes, though never in the presence of female residents. His equally stilted wife, Corinne, the only daughter of a Presbyterian Minister, played the role of officer’s wife as closely to the script as humanly possible, the only apparent paradox being her spirited interest in her husband’s base jokes. Two seeming Puritans in public, every resident that passed through over the years was convinced it was all leather, whips, and chains behind closed doors. Even if it wasn’t true, the notion made Pederson seem at least somewhat human.
At sixty-two, Pederson had been Chairman of the Department of Neurosurgery for eighteen years, having been named to the position at forty, then the youngest department chairman in the country in his field of specialty. A brilliant clinician, superb surgeon, and equally keen politician, he had honed his skills in the Army Medical Corps during the first Gulf War, attaining the rank of Colonel after only four years. He had come to NYTC—then the old City Hospital—from the Massachusetts General Hospital and immediately established himself as a force to be reckoned with at the medical center as well as on a national level.
Surgically, he had pioneered a new laser treatment for epilepsy, which complemented the powerful information provided by Balassi’s PET scanner. The two had begun collaboration on the epilepsy project while Balassi was at the NIH. They had revolutionized the surgical treatment of seizures.
Pederson’s political acumen was neatly documented on office walls replete with meticulously oak-framed certificates, diplomas and all the right photos with civilian and military VIP’s shaking hands and smiling.
Seated in a high-back, swivel chair, reading glasses resting half-way down his long nose, Pederson’s profile was silhouetted by hazy sunlight diffusing through the large window that overlooked the GW Bridge. He appeared thoroughly absorbed studying a PET scan on the light box above his side table when Geoff entered the room. Geoff approached the desk and stood for what seemed like minutes.
“Welcome, Geoff,” Pederson said. He stood reluctantly and turned his attention away from the scan. “Didn’t mean to ignore you there—just a fascinating and most significant scan.” Pederson extended his large hand. “I’m sure you’ve been dreaming about this day for seven years. I know I did when I was a resident. Come, sit down.” He gestured toward the wingback chair opposite the desk.
Geoff sat down, his posture held erect by the vertical incline of the chair’s back. The room smelled of polished leather. Geoff was reminded of the time in high school he’d been called to the principal’s office to receive a commendation but had assumed he was being summoned to answer for an offense he couldn’t remember.
“Thank you, Dr. Pederson, but I must admit I’m a bit anxious.” At that moment, the strange e-mail message played across Geoff’s mind. Obviously not to be so readily dismissed as he had thought.
“Well, I can certainly appreciate that, Geoff,” replied Pederson quite matter-of-factly. “But you have nothing to be anxious about. Your selection as chief resident was unanimous among department members. Your record at Harvard and during your residency here is beyond reproach, your surgical skills far beyond your years. Equally as important for this position—and I think you know this—you have a leadership quality, an innate gift few men have, fewer still in medicine. Whether or not you realize it, you are a future leader should you decide to stay in academic medicine. I hope you will.”
Pederson swiveled in his chair and gazed at the slightly yellowed, black and white photo of his own residency class, his full lips and hooded upper lids forming an ever-so-slight, nostalgic smile. “You remind me of myself at your age, Geoff. Top of my class, called upon by the great Dr. Bedrossian, then Chairman at the MGH, to do the same honor as yourself. I was terrified! It wasn’t until I was about halfway through my chief residency that I realized my worth. You will feel the same shift, though I don’t think it will take you as long.”
Geoff was taken aback by the flood of compliments. Pederson was a man who rarely let you know where you stood. When he did offer praise, it was usually gilded with sarcasm. Geoff was glimpsing an entirely different side of “the Colonel,” and he felt privileged.
Had Pederson forgiven the events of the last year so quickly, so easily? Geoff had to know, clear the air at the start. “I appreciate your confidence, sir, but my performance at the end of my last clinical year was far from stellar.”
“Geoffrey, Geoffrey,” Pederson said, his towering frame leaning forward over the desk. “I haven’t forgotten. We all go through major crises in our lives, emotional traumas so great we feel as if we can’t go on. The death of a loved one is the most traumatic of human experiences. Believe me, I know.”
Another glimpse beneath the armor. Pederson was human after all.
“The bottom line is, it’s over. Your life is back on track. Balassi tells me you did a superb job in the lab, and now you’re back in the saddle. Let’s forget the past and look to the future, which seems bright indeed.”
Geoff’s anxiety melted away, leaving him with a peace he had not felt in a long time. He began to feel excited about work, something he had not experienced since his early days as a resident. “Thank you, Dr. Pederson.”
Pederson stood up and removed a large three-ring binder from the top shelf of his mahogany bookcase. On the side was printed, “Manual of the Chief Resident of the Department of Neurosurgery,” and on the front the seal of the NYTC, a melding of both the new and the old: the ancient caduceus—serpents intertwined around a staff—a picture of the new medical center, and an inscription from the old one: “For of the Most High Cometh Healing.”
He handed the notebook to Geoff, the baton passed from mentor to apprentice, the same ritual repeated each of the last eighteen years. “Everything you need to know as chief is in this manual. Read it completely. I know you will do a fine job. Any questions?”
Geoff’s mind was clear, his attention focused. He felt relieved of the burden of the past, encouraged by his prospects. He felt he might as well start clean right now, get it all off his chest. “Not a question, but something you need to know from me before you hear it from someone else.”
“Oh?” said Pederson, his right brow elevated, his curiosity aroused. Obviously, he hadn’t heard yet.
“It’s Howard Kapinsky, sir. I’m not sure how it’s going to work out. We’ve had troubl
e working together in the past, and my year off doesn’t seem to have changed anything. Now I’m his boss, and I’m sure that bothers him even more.”
Pederson chuckled. “I wouldn’t lose any sleep over the situation, though I must admit you’re going to have your hands full reigning in Howard Kapinsky over the next year. He’s a smart boy, but he’s different.”
Different? Geoff couldn’t understand why Pederson had let the fool into the residency, nor why he didn’t have the guts to let him go. “That’s for sure. I’ll do my best to keep him out of trouble.”
“If anyone can do it, you can. Kapinsky respects you a great deal.”
Geoff did his best to contain his incredulity, but knew his facial expression betrayed him. “Your confidence is appreciated.” Pederson failed to detect his reaction. Something else was occupying his thoughts.
“Enough on that subject,” Pederson said. He gazed through his large window into the distance, his weighty hands in the pockets of his heavily starched white coat. “There is another, more important, matter you need to be made aware of—your first official duty as Chief Resident.”
Pederson returned to his desk chair, sat down, and removed his reading glasses. His voice dropped, barely a whisper, forcing Geoff to strain forward. “Next Monday we will be hosting an international delegation of scientists from PETronics Corporation’s headquarters in Copenhagen lead by Dr. Yuri Zelenkov. Dr. Zelenkov and his party will be spending the week here as our guests, learning firsthand the intricacies of our PET scanning program and observing in the operating room.”
“Do you know Dr. Zelenkov personally?”
“Yes, quite well, but I’d like him to get to know you, and you, him. I think you’ll find it a rather rewarding experience. There might even be a free trip to PETronics Headquarters in Copenhagen if you play your cards right.”
Geoff was perplexed. He hadn’t ever heard of Zelenkov before.
“Next to Balassi and his technician,” Pederson continued, “you know as much or more about the clinical applications of PET scanning than anyone else in this medical center. I want you to share freely whatever knowledge you have with Dr. Zelenkov and his group. By the time he leaves, he needs to feel completely comfortable with our program, particularly its applications in the diagnosis and surgical treatment of seizures. That’s his area of special interest.”
Pederson paused, as if sensing Geoff’s hesitance. He leaned forward in his chair, his voice rising just enough for Geoff to hear without straining. “Geoff, I know you feel your clinical duties are far more important, that you might view this as simply an administrative pain in the rear, but this is a potentially monumental visit for our Medical Center. I needn’t remind you of the important role PETronics has played at the NYTC. If it weren’t for their generosity, we wouldn’t be here.”
“Yes, sir,” Geoff replied. Pederson never offered choices.
“Good,” Pederson said. He stood abruptly, a broad, deep grin on his face. He patted Geoff’s still-sore shoulder. “Then get back to work. Keep your nose to the grindstone this year, and your future will be golden.”
Chapter 7
Geoff completed evening rounds in the NSICU with great swiftness, delegating most of the basic patient management work to Karen Choy and Brian Phelps, who in turn delegated the scut work to their assigned medical students.
Happily, Kapinsky was out of the way, working up a patient in the ER, his assigned med student in tow. Geoff sat in the staff workroom of the NSICU, staring at the patients’ lab values on the computer screen. He removed the three by five cards he kept on each patient from the breast pocket of his white coat and studied them one last time, checking to see if he had missed anything. He hadn’t. He glanced at his watch. Six-thirty.
The e-mail message still gnawed at him. He knew it was probably just a crank or misdirected, but it bugged him. When he had time, he’d try and track down the sender. If he couldn’t figure it out, he was sure his brother Stefan could. Geoff had promised Stefan he’d come over for dinner.
“Geoff, I think we’re okay here if you want to go home,” Karen Choy said. “I’m on call tonight anyway. My hot date is right here in the ICU.”
“Sure you’re okay?”
“Everything’s under control. Smithers ‘and little Jessica’s vitals have stabilized. Their brain stems are on autopilot. DeFranco’s coming out of his phenobarbital coma and the nurses are getting ready to ship him off to the ward. There’s nothing for me to do but babysit tonight.”
“Guess you’re right,” Geoff replied. He stood up and walked to the door. “If you run into any problems—”
“I have your cell phone number. Just don’t turn it off,” Karen replied. She smiled.
“Thanks, Karen.” Geoff turned to leave, then paused. “Good job today. See you in the morning.” Geoff grabbed his backpack and headed for the elevator. He left the hospital through the main entrance, avoiding the ER. It was never wise to leave through the ER when your goal was to get home. After this morning’s eventful sprint to the Trauma Center, he decided to take the subway instead of walk the fifteen blocks as he usually did.
The sultry, summer night smacked him in the face like a wave of steaming, stagnant water as he left the controlled environment of the medical center and descended the marble steps onto Broadway. New York in the summer was New York at its worst. People, from local shopkeepers and apartment supers to gangs of teenagers, escaped the sweltering confines of their homes, apartments, and stores and simply hung out—on the stoops of their buildings, out their windows and doors, on street corners. People hanging out meant more boozing on the sidewalks, more noise, and when the thermometer rose high enough and tempers flared, more crime. The worst of New York magnified by a factor of ten.
Geoff entered the 168th Street subway station doing his best to avoid the scraggly panhandler who stood by the entrance to the station. The fetid smell of rotting refuse nearly overwhelmed Geoff. He descended the stairs, passing beneath an overhang splattered with posters, and whisked down the long, dimly lit corridor that lead to the IRT elevator.
The subway, New York’s netherworld. Eight hundred miles of tracks spanned five boroughs, served twelve million people. A city within a city with its own unique sub-culture and population. Street people, like the tattered panhandler, lived in the subways all year round. For a buck, the subway delivered you from one end of Manhattan to the other, or if you were in the wrong place at the wrong time, swallowed you up like an insect in a Venus fly trap.
The faint but distinctive and pungent aroma of marijuana hung like a cloud in the air about mid-corridor, then it was overpowered by an acrid mixture of cheap whiskey and vomitus. Geoff’s nostrils flared at the assault on his senses. The floor was littered with evidence of last night’s events: an empty bottle of Thunderbird wrapped in a well-worn brown paper bag lay on the floor by the elevator door, next to it a used condom, a crumpled Penthouse centerfold, a half-eaten bag of Cheetos.
Geoff scanned the area. No one lingered behind the riveted steel columns or in the dark, shadowed corners of the corridor—at least no one he could see. His hand reached up to press the IRT elevator button, then he paused.
A crunching sound. Movement off to his right. Geoff’s adrenalin surged, and he spun in the direction of the sound, reached down for his knife. He knew he was as prepared as possible for whatever was coming his way. He was as skilled in hand-to-hand combat as anyone around.
Only no one was there.
His gaze was caught by the bag of Cheetos, by its movement. Geoff gave a swift kick at the bag with his right foot, and a huge grey rat squealed in pain and scurried off to some dark crevice by the stairs.
“Fucking rats,” he muttered aloud. He wiped the sweat off his brow with the back of his hand and exhaled. He shook his head from side to side and began to laugh. “Fucking rats in the go
ddamn fucking subway!”
“What’d ja expect to see down here, buddy? Cuddly little guinea pigs?” boomed a voice from behind Geoff.
Geoff turned around swiftly to see the reassuring, bulky form of a New York Transit cop.
“Never seen a rat that big,” Geoff said. “It looked more like a raccoon.”
“Then you ain’t been in the subways much,” said the officer, whose name tag read Dumbrowski. He raised his left brow, twirled his nightstick. “Where you from, Vermont or somethin’?”
“No. Connecticut. Been living in New York for the last seven years, though. I just stay out of the subways when I can.” Geoff stared at the cop’s deft handling of the stick, the large revolver strapped to his waist. A New York cowboy. A New York ranger riding the rails.
“And you ain’t seen rats before?”
“Just in the lab,” Geoff said with some embarrassment.
The officer guffawed, his protuberant, middle-aged gut twitching. He raised his heavily equipped belt over his jutting abdomen, let it slide back down to its natural resting place. He paused and looked down, then glanced thoughtfully towards Geoff.
“Well, let me give you some free advice. Dumbrowski’s rules of riding the subway. Rule number one: don’t make no eye contact. Rule number two: go about your business as quickly as possible. Rule number three: don’t take the IRT elevator. It’s the most dangerous ride in the whole goddamn city this side of the Port Authority. Patrolman Dumbrowski here’s been around this jungle and survived. I seen things down here you’d never imagine. Stick to Dumbrowski’s rules, you should make out okay.”
“Thanks for the advice.”
“So where you goin’?”
“Uptown, 181st Street.”
“Well, good thing you ran into old Dumbrowski here then, cause you’d be taking this dangerous ride for nothin’ and end up in Fort Apache.” Dumbrowski smiled widely, clicking his gum. He patted Geoff on the shoulder—the good one—with his bulky hand. “IND’s over that way, down those stairs.” Dumbrowski pointed his stick down the corridor to the left.
The Endorphin Conspiracy Page 5