by Nick Trout
The phone is answered by a recording that insists I pay particular attention because their menu has changed. I’m asked if I have an emergency, need a prescription filled, want to leave a message for a doctor, need to make an appointment. Eventually I meet the criteria of “for all other calls, press 0” and get placed on hold, forced to listen to a sycophantic female voice asking if I knew that fleas could jump up to eight inches high. Yes!
“Hey, hello, howayya, this is Healthy Paws and I’m Popcorn, how can I be of service?”
Whoa there, what kind of a greeting was that? I’m exhausted. Did she really say her name was Popcorn?
“Hello… Popcorn, this is Dr. Mills, I work at Bedside Manor, over in Eden Falls.”
There’s silence on the other end of the line, not an “Uh-huh, I know it, yes, Bedside Manor,” just total silence. I press on. “I have a dog, a black labradoodle, that answers to the name of Stash, and I wondered if it belonged to a client of yours.”
Another silence and then with her mouth she hits me with a burst of “yeah, sure, okay, please hold” and the fawning female recording comes back, telling me how vital it is for me to get my senior dog examined every six months. Where’s the elevator music?
“Looking to poach another case, Doc?”
It’s Dorkin, the question direct, not a trace of levity.
“Um, no, not at all… I picked up a dog—”
“Does it make you feel better, asking my permission? Help you sleep at night?”
“What are you talking—?”
“You as good as accuse us of malpractice with Sox Sauer, so what’s next? Animal experimentation? Operating a Ponzi scheme?”
What’s got into him? I guess the gloves are officially off.
“I’m, well, I’m simply trying to find out if a dog by the name of Stash is a patient of—”
“No. No, it’s not. Have at it. You’re desperate for business. It’s not one of ours. Knock yourself out.”
I don’t do snappy ripostes, and normally the option to hang up would trump my typical bumbling weak comeback. But when I made this call, I had Doc Honey on my mind.
“So that lecture you’ve set up in Eden Falls is… what? You feeling civic minded?”
An insolent huff hisses down the line.
“If you’re that worried, come along. In fact we’d love nothing more than to hear you defend your particular brand of veterinary medicine. I’m sure you could enlighten us about the discovery of X-rays or the benefits of a thing called”—he splits the syllables for maximal debasement—“pen-i-cill-in.”
“Brag all you like about your flashy equipment, Dorkin, but believe me, people pay attention to what lies behind the curtain.”
“Good. I’ll save you a seat, and we’ll let the pet owners of Eden Falls decide where they can get the best care and the best value. How’s that sound?”
He hangs up before I can say another word. Suddenly all I can think about is my upcoming rendezvous with Doc Honey. Like it or not, I have to come clean, to confess my sins to an enemy combatant, an enemy with a ready-made public forum in which to air my double life as the nefarious Tommy Lovelace. I’m doomed. At best, I’m a deceitful creep. More likely, around here I’m that hillbilly trying to exploit a sad and lonely doctor for kinky sex and insider information. Either way, it’s not good for me or Bedside Manor.
SITTING AT the microscope with Henry the cat’s slides, I’m reminded of the old days, simpler times, as the scientist who kept his head down, kept the rest of the world at bay, and lived his life with pain-free objectivity. The old Cyrus would have run screaming from a confrontation with Doc Honey. The old Cyrus would have been turned to stone by Amy’s heterogeneous eyes, let alone her confidence. But it’s taken Bedside Manor and less than two weeks in frigid Vermont to make me want to change. Sure, being cold and isolated (welcome to Eden Falls) ensures self-preservation and protects against humiliation, but inside, I realize now, I was as dead as most of my patients. Sometimes I think it might be easier to shake off this state of dreamy weakness, to put up my guard and retrieve a sharper, harsher focus. But for all my financial and emotional troubles, I can’t and won’t go back. These days, the comforting armor of the introvert, the second skin that fit me so well, is nowhere near as snug. And, for now, it can hang in my closet with the mothballs.
More often than not, as a pathologist, I’m given a slide, a biopsy, or a chunk of tissue, together with a note from the clinician telling me what he or she suspects I’ll find. It’s like being a wedding DJ—even if you have a great sound system, it helps to know the kind of music you’d like me to play. The thing is, if I can’t deliver a diagnosis, it’s the clinician’s problem, not mine. Blame your own crappy technique, your inability to get me a decent and representative sample, but don’t blame the pathologist. Now, forced to wear both hats, faced with this particular pair of slides, failure to make a diagnosis means another round of mortal combat with Henry, or, worse still, losing a client to Dorkin and Healthy Paws.
Though the cause of Henry’s nasal horror may lie within these greasy smudges, it needs to be cajoled, carefully deciphered, and with only two samples available, there’s no margin for error.
Calm, Cyrus, be logical. Think about what you know. I know George Simms said he tried antibiotics, antifungals, and steroids, all to no avail. Conclusion—the nasal lesion is not caused by a bacterial infection, a fungal infection, or an inflammatory process. Why? Because there’s still a big fat tumor on the end of poor Henry’s snout. Let’s prove it with a Diff Quik stain.
I hold on to the first glass slide by my fingertips and dip it in tiny vats of blue and red dyes. Quick rinse, dry, and it’s under the lens, my fingers tweaking the knobs that control the coarse and fine focus on the microscope, the prepared slide zipping back and forth, and in less than a minute I have my diagnosis—or, that is, I have no diagnosis. It’s not cancer. It’s not a tumor. All I see is cellular schmutz. That’s what you get when you’re reduced to little more than a snot-wipe sampling technique. Damn.
One down, one to go. One slide stands between me and cat scratch fever, a rabies booster, stitches, and a course of intravenous antibiotics. The mirrored-sunglasses trick will never work a second time.
There are plenty of staining options used to enhance and identify certain microbes, but pick the wrong stain and it’s over. Think. Henry had no response to antibiotics. Why? What if the bacteria were resistant?
There’s a pile of files next to me on the counter, and I dig out Henry’s, flicking my way through the pages of messy notes until I discover which antibiotics Doc Cobb used. The world is full of bacteria, but my father chose well, starting out with a sawed-off shotgun approach, hitting a broad target before working his way to a more specific antibiotic, the pharmacological equivalent of a sniper’s rifle. Still, nothing appeared to work. Why not? Common bacteria would have been wiped out. There’s only one possible reason—Henry is not afflicted by a common bacteria.
This time I go to the cupboard. Stash, now seated, keeps an eye on the action. Maybe he’s hoping for an Old Mother Hubbard moment. Instead, I’m face-to-face with remnants of my late mother’s life, in the form of her meticulously organized collection of lab equipment—rare stains, a mechanical stop-clock, and a classic piece of school chemistry memorabilia, the Bunsen burner.
It’s like following a Martha Stewart cookbook recipe. Fire up the burner, flood the last remaining slide with a crimson liquid, place in flame and steam for five minutes, take care not to flambé with the acid-alcohol and presto—feast with your eyes. Fingers twitch, the slide zips, and in less than a minute I have my diagnosis, scooching my chair back from the microscope and over to Stash.
“High five,” I say with uncharacteristic sporty machismo, and, as if we’d spent years together perfecting the trick, Stash instantly raises a black paw and we connect. Without thinking, I pull his whole body into me, up and onto my lap, like he’s a kid ready for a picture book story, and I bury my face
in the soft, sweet-smelling fur of his neck as I whisper, “Good dog.” It’s over in seconds, but I catch myself—no, we catch ourselves, like that moment in the movie Grease, where Danny Zuko and Kenickie share a spontaneous bromantic hug, realize it’s not cool, and separate like it never happened. There’s a split second of direct eye contact, the shift from mutual affection to mutual embarrassment, and Stash leaps gazelle style from my lap as I glide back to my microscope and the bright red chains of tiny bacteria floating in clouds of seafoam blue.
Henry is the victim of an uncommon bacterium, a bacterium belonging to the same family of organisms that provides us with such delights as tuberculosis and leprosy. It’s known as a mycobacterium, and it won’t respond to your typical antibiotics. You need a special Ziehl-Neelsen stain (thanks, Mom) to unmask it. Now that I know what I’m dealing with, I can even pin it down to a particular species—Mycobacterium microti—the vole bacillus. And when I say vole, I mean rodents, as in the prey of a cat regarded as an excellent mouser. Now it makes perfect sense. Where’s an infected, cornered mouse going to bite a cat? Right on the end of his nose.
There’s a Walgreens pharmacy in Patton. It turns out they carry the 2% isoniazid ointment Henry needs to treat his nose. I can pick it up, drive over to The Inn at Falls View, and deliver the Holy Grail—diagnosis and cure. I’m almost tempted to perform a self-congratulatory fist-pump while releasing a protracted “yessssss.” Almost.
“Doris, I’m just going to run over to…”
But Doris is outside, wading through a cloud of cigarette smoke, and the only person standing at the front desk is none other than the computer geek himself, Gabe.
“Hey, Doc, you got a minute?”
The Napoleon Dynamite look-alike seems pleased to see me.
“Um… sure… shouldn’t you be at school?”
“Free study time,” he says, as though I should know. He’s still wearing his gray Unabomber sweatshirt (hood down, thankfully), but strapped across his chest and shoulder, he carries a laptop bag.
“Tell me this isn’t about that dating thing again?”
“No, no way, Doc. That was Charlie, not me. This you’re going to love. But we should go somewhere private. You know that dog’s loose, right?”
Stash looks up at me, checks out Gabe, and comes back with what I might best describe as a withering stare.
“Yep. He’s with me. Come on through.”
I close the exam room door behind us, and Gabe’s already pulling out pages of computer printouts and organizing them in piles on the stainless steel table. Straight away one unifying, striking, and disturbing feature jumps out at me—at the top and center of each page sits the Healthy Paws logo.
“What have you done, Gabe?”
Somehow Gabe manages to look more confused than I do. Oh no, now I remember his email—P.S. Hoping my “covert mission” ;) will make us even.
“What you asked me to do.”
“I didn’t ask for anything.”
“Doc Lewis said you did. He said nothing dangerous, just a little creative snooping around, that’s all. Help give you a leg up with the competition.” He lovingly double pats the nearest sheet of paper.
“Hold on.” My eyes race across the pages. They’re spreadsheets, production numbers, undoubtedly confidential. “Stop right there, Gabe. This is totally illegal.”
“Maybe.”
“No, it is.”
“Maybe, but only if you got caught and only if you were stupid enough to leave an electronic footprint.”
I don’t know much about Gabe, but one thing seems clear: when it comes to computers, he is far from stupid. Dorkin’s sarcastic tone rings in my ears—Let the pet owners of Eden Falls decide where they can get the best pet care.
“Explain to me how you did this?”
“Too technical, too boring,” says Gabe, “except the password stuff, which is always cool.”
“It is?”
“Of course. It’s key. Cracking the password is the best. You like puzzles? Of course you like puzzles. See, most passwords are logical, personal, and rarely random.”
“Password,” I offer. “123456. Trustno1.”
“I said logical or personal, not stupid. It’s the only way we remember them without writing them down. I’ve been to Healthy Paws lots of times with Mom for Tallulah’s checkups. I’ve seen what kind of software and hardware they use.”
“But how do you know Dorkin, assuming he’s the one who sets the password?”
Gabe grins, loving his advantage. “I pay attention. I’ve watched the way Dorkin handles owners when they pay their bills. He plays favorites. If you’re wearing lipstick and a short skirt, he’s all, ‘Sure, we can work something out,’ otherwise, he’s hauling you off to collections. Guy’s a dick.”
Neither Stash nor I disagree.
“Normally I start with the pet name angle, but the unrestricted part of the system told me Dorkin doesn’t have any pets registered with Healthy Paws. Weird for someone running an animal hospital, right?”
This comment makes me wonder whether I’d best adopt Stash as soon as possible.
“So I get more creative. Personal dates—birthdays, his own, his kids’, wedding anniversary, that sort of thing. Dorkin’s divorced, never had kids, and his date of birth didn’t work.”
Gabe reads my alarmed expression. “Don’t ask. Anyways, next up, the man himself. What do I know? I know he loves himself. I know he wears nice clothes, nice watch. Vanity and wealth. Naturally I check with the DMV and bingo, Dorkin bought a vanity plate for his Mercedes. I type in six letters—T-O-P-D-O-G—and, open sesame, I’m in.”
I don’t know if I should be impressed or patting him down to see if he’s wired as part of an FBI sting operation.
“For a while I snoop around, mainly boring numbers, but then I think, why not check out Tallulah’s record, calculate their markup, see how badly we were being ripped off. That’s when I noticed things didn’t add up.”
Gabe has set up his evidence such that anyone with a little business savvy should be able to compare the master spreadsheet that Dorkin generates for himself with the individual monthly totals each doctor gets to see. All I can say for sure is that Doc Honey is significantly underperforming compared to her colleagues.
“I’m still not with you. Looks like rows of boring numbers to me.”
“That’s what you’re meant to see. But if, like me, you love numbers, it starts to unravel. Here,” he picks up one of Dr. Honey’s monthly Excel sheets, “the doctor gets a percentage of everything he or she does, stuff like vaccinations, dispensing medication, running blood tests. If they don’t bill, they don’t get a paycheck. Dorkin, on the other hand, is on salary, but if you notice, he takes a percentage of all the nonclinical stuff the hospital has to offer, like boarding, grooming, pet food, chew toys, dog beds, dog outfits, you name it. Nothing leaps out until you compare the monthly figure each doctor actually gets to see with the number on Dorkin’s master spreadsheet.”
Gabe’s index finger bounces between the figures for different months and different doctors and the pattern floats to the surface. He’s terribly excited, in a zone, and I notice because I know exactly how it feels. Math nerd meets science nerd.
“The doctor’s production figure is always less than they actually generate. So Dorkin’s skimming?”
“Essentially,” says Gabe. “Where he can, he’s weighting the bills in his favor. Nothing big, nothing greedy, just a steady couple of hundred here and there from every doctor, enough to make a difference, not enough for them to notice. Over a year, even after taxes, he’s got a sizeable increase in his personal revenue.”
I look back at the figures again, and this time the fraud is obvious. No one gets harder hit than Winn Honey. I can’t help but wonder whether he’s punishing her. Personal vendetta?
“How many people know about this?”
“Me, you, and Fido.”
“You didn’t say anything to Charlie, did you?”
“No.”
“Gabe?”
“Okay, yeah. But you can trust her.”
My thoughts become sidetracked by the smart, funny, but ultimately unhappy sundae-loving daughter of my online girlfriend. I deliberate, stew a little, but have to ask. “Does Charlie ever talk about her home life?”
“You mean why she’s fat?”
I’m not good at acting appalled so I don’t even try.
“Her dad moved out a couple of years ago. Went to live with a twenty-three-year-old he met online. Now they’re married, have two boys, twins. Charlie and her mom dealt with it in their own ways. The Doc went on the nerve diet, got in shape, and started dating younger men, maybe to prove a point. That left Charlie to feel abandoned by both parents. Dad’s got his new family, and Mom doesn’t want a teenage daughter cramping her dating options. I think Charlie eats to annoy as much as to forget.”
“That’s too bad. They’ve had a tough time,” I say. “But you really shouldn’t have gotten me involved.”
Gabe looks more impartial than contrite.
“And it was wrong to hack into Dorkin’s computer.”
“Ah, c’mon, Doc, this is epic.”
I hate to admit it, but he’s right (or even righteous). The best I can do is to keep quiet.
“Face it, Guy Dorkin’s totally screwed. Forget a little illicit porn or online gambling, this info can send him to the Big House. So why look so worried?”
Standing there, slack jawed, and, to be honest, a little afraid, I have what I can only describe as an out-of-body experience. It’s as though I’m watching myself in the third person as I do three unusual (for me) things. Firstly, I realize my hand has been resting on Stash’s head, and, unlike his previous master, it’s not because I need the support. Secondly, though I am equal parts grateful and furious with Lewis for commissioning this damning little project, I sweep Gabe’s proof into a pile. Lastly, and most troubling of all, I turn to Gabe and say, “I wonder if you might do one more thing for me.”