Having trained in New York, Roth was considered an outsider in the Houston medical world, and although he was highly skilled in the art of plastic surgery he was, in the early 1960s, having difficulty building a practice. Roth was not a handsome man, which is still another desirable requisite for a doctor who rebuilds damaged faces, nor did he have access to the silk stocking district through marriage or family. And he was Jewish, no advantage in the South despite Houston’s large community of merchants.
“When I saw John Hill in the training program,” Roth would say in later years, “I beheld a tall, good-looking, broad-shouldered gentile boy, married to a glamorous River Oaks beauty who knew everybody worth knowing in this town. I also learned that this fortunate young man was living in his father-in-law’s home and that the father-in-law was paying all the bills. What an arrangement!”
Roth invited the aspiring young surgeon and his wife home for dinner. He set a good table, poured vintage French wine. On his walls were the beginnings of what would become a distinguished collection of art and sculpture. His library was filled with books on history and philosophy. He seemed a man whose life was in order, whose wife Sheila was attentive, whose children were obedient. John Hill noted all this—the accouterments of the trade—while the older man scrutinized him. The evening went by on a note of pleasantness and good will. John was charming and deferential to the senior man.
“Tell me,” said Roth when the evening was nearly done. “Why did you choose plastic surgery?”
John mulled the question. He knew the answer was important. “Because I want to help people,” he said. “And because I want to make money.”
Nathan Roth nodded contentedly. The answer was what he wanted, and what he understood.
Over the next several days Roth created an imaginary ledger for the man he was considering, assets and liabilities. The former were considerable—Hill’s looks, his charm, his ties by marriage, his pair of hands (known to be quick and accomplished in surgery), his WASP air of all-American boyishness. All of these Roth relished and coveted. But he found himself troubled by John Hill’s blatant lack of interest in research and the publishing of medical papers. Many ambitious young physicians, Roth himself included, began writing articles for scientific publications while still in medical school. There was also something worrisome—a slipperiness—about John that Nathan Roth could not quite put his finger on: a glibness, a tendency to slide away from an intellectual confrontation, an ability to talk around a subject without really coming to grips with it. Roth fretted about these qualities for a time, but he rationalized that John Hill was young, eager, probably frightened of senior men, and he had years to grow.
Before he would offer John a partnership, Roth needed to discuss two touchy and intimate matters. One was the subject of John’s younger brother Julian, a year behind in his medical education and close to beginning his career as a psychiatrist. The quieter of the two brothers, the one whose world was shadowed by the accomplishments of John, Julian was as gaunt as a fence post and his face continually wore an attitude of hidden trouble. He seemed a young man who kept everything bottled up, and Roth worried that someday the cork would blow out from the pressure. And Julian was, if gossip in doctors’ lounges was to be believed, sexually confused. While Nathan Roth did not object intellectually to any man’s private life, he recognized the potential for scandal. Discreetly, he raised the subject with John Hill. He searched for a euphemism. Was Julian Hill more interested in male relationships than female?
John Hill nodded, not in affirmation, but to indicate that he understood the worth of the inquiry. He did not know this to be true, insisted John. Yes, he had heard such rumors, but as far as he knew they were simply that. Julian had many friends in the music world, he being a fine pianist, but for that matter so did John. Julian was not only his best friend, he was a highly intelligent doctor, a gifted musician, and a source of pride and comfort to the family. Of course it was true that Julian had been in analysis, still was for all John knew, but psychiatrists undergo therapy as part of their educational process. He concluded by saying that Julian was perfectly capable of coping with any flaws in his character, if there were such flaws.
Nathan Roth accepted the answer, for it seemed loving and well prepared. Now he moved to one last subject with even more tact. He began by speaking of his own Jewishness, of how much he revered a strong family life, of how vital was its harmony in the make-up of a successful professional man. There were rumors in town that the situation at Ash Robinson’s home was—and again Roth searched for euphemism—not congenial. One of Roth’s friends had heard Ash Robinson remark testily at a party, “Here comes the famous plastic surgeon John Hill, who never even bought his son a jar of baby food.” Ash was also reported to be grousing that, although John contributed nothing to the running of the household, he somehow found money enough to buy player piano rolls and old phonograph records.
Carefully, Roth chose his words. He had decided to offer John a partnership on one condition: that the young plastic surgeon move his wife and son out of his father-in-law’s home and set up his own household. “A good partner is a happy partner,” intoned Roth. “If you move away from your father-in-law, then he will be happy and you will be happy, and the rift between the two of you will be healed.”
John concurred and was indeed eager to accept the offer. But he did not have the funds to buy his own home, and he did not want to throw away rent every month. Then, said Nathan Roth, he would loan John $5,000 for a down payment on a house. It could be paid back as the practice grew.
Not surprisingly, Ash Robinson failed to rejoice when his daughter and son-in-law announced that they were finally leaving his bed and board. He had grown accustomed to having his Joan and her baby but a few feet away from him at all times. Joan hurried to reassure him. The house they were buying was just a few miles away, ten minutes at most by car, and Ash could visit every day if he wanted to, and, besides, she would be back and forth so often he would never know she was gone. And the house was located near the Texas Medical Center, where the city’s major hospitals were situated, and it would be so convenient for John.
“John’s got to be his own man,” said Joan. “I love him, too, Daddy.”
John Hill joined the practice of Nathan Roth in 1963, and to welcome his junior partner, the senior plastic surgeon gave an elaborate party, inviting various doctors, hospital administrators, and social friends of the young couple.
One of those invited to the party who did not attend was John’s brother Julian. Although he professed delight at John’s good fortune in securing such a promising partnership, a few days after the festivities, the thin and somber psychiatrist-to-be climbed to the attic of a friend’s home. There, either out of a convoluted and inexpressible jealousy over his brother’s marriage and fatherhood and advancement into the real world of medicine, or out of sorrow over a broken friendship with a young man whom he had been seeing, or acting on the command of some dark corner of his brain, Julian Hill spread out a cheap blanket, swallowed a vial of barbiturates, and killed himself.
It was the first act of the tragedy.
SEVEN
John Hill was a man in a hurry, his life a blur, a dozen brightly hued balls thrown in the air. And he was, for some time, remarkably adept at keeping them from crashing to earth.
“I never saw a young doctor work so hard,” remarked one of the city’s famous surgeons. “He was like an industry. Had he asked me to buy stock in him, I would have.” And for a time Nathan Roth was pleased, although the new man’s very first case with the partnership was troubling. A patient who had suffered a broken jaw presented himself for repair. The traditional method that every plastic surgeon learns is the routine procedure of placing splints on the upper and lower jaws and then securing them with stainless steel wires. On the lower jaw, the wires can be wound around the jaw itself but, with the upper jaw, the surgeon must drill holes on which to affix the wires.
Roth gave John the assign
ment, as mundane a task as a tyro automobile mechanic being asked to change spark plugs. The operation seemed to go well; the patient went home satisfied. But in a few weeks he returned, concerned over excessive draining from the upper jaw.
Hill was out of the office so Roth examined the patient. He found nothing apparently wrong. He assured him that the draining would cease. A few weeks later the patient had dental work, and X rays revealed that a small tip of the drilling bit had broken off during the jaw repair and was lodged in the upper jaw. The patient burst into Roth’s office steaming. “Why didn’t that young partner of yours tell me?” he demanded. Roth tried to calm him, assuring him that his life was not in jeopardy, that he could live the rest of his years with the bit in place. Or he could have a free minor operation to remove it.
Roth summoned John Hill and demanded an explanation. It simply could not have been a case of the surgeon not noticing the broken drill. The blunder was in failing to inform the patient. That left them open to a lawsuit. “My God,” thundered Roth, “it could happen to any surgeon. I’ve done the same thing. But I’ve always told the patient and …”
John Hill was abject, seemingly devastated by the scolding. “I’m so ashamed,” he said, his eyes downcast. “I was just starting out my career, and I was hesitant to mention this mistake on my very first case.”
Roth checked his temper. The mistake was minor; perhaps the patient would not sue. And there was the mitigating factor of Julian’s death. It would have been difficult for any doctor to operate on the heels of such numbing personal tragedy.
The patient did file a malpractice suit, but the fates were kind to John Hill. Even before depositions could be taken, the man blew his nose hard one morning. Out flew the drill point. Case dropped. But once more a seed of doubt was planted in Nathan Roth’s mind about the new man’s reliability.
Nathan Roth was a connoisseur of art. Indeed he resembled a Sydney Greenstreet film character who would pursue a statuette across the Far East to possess it. His office was filled with tasteful paintings and lithographs. John Hill, in emulation of his senior partner, moved quickly to decorate his own office. But his choices were poor. It was as if he said to himself, I am a successful doctor, successful doctors hang paintings on their walls, ergo, I will buy paintings. Roth was aghast to see what John’s taste had wrought—cheap oil landscapes of waves crashing against beaches, anonymous cityscapes, lifeless fruits spilling out of cornucopias—the kind of art for sale in Times Square discount houses and peddled by the thousands.
Roth also noted that the one genuinely lovely piece of art that John possessed—a framed photograph of Joan astride Beloved Belinda, a haunting picture with ominous dark clouds above her head—rested on the floor, unhung, for three years. It puzzled him that John would surround himself with atrocious paintings and leave his wife’s image on the floor to gather dust.
The average patient who visited John’s office would probably not even notice the art, so dazzling was the young doctor’s personal style. Particularly if the patient was an impressionable older woman. She would be invited to sit on the sofa while John Hill poured her a glass of wine. There would be small talk of music and perhaps of Joan’s latest accomplishment in the horse shows. Then John would move to the piano he had installed near his desk and he would play, perhaps, a soothing Chopin sonata. Finally the conversation would move to the annoying bags that had come so rudely to the woman’s eyes. With a thumb so light it seemed made of cobwebs and dusting powder, he would touch the blemishes and murmur his confidence that a quick and easy operation would banish the bags and the wrinkles.
John could perform almost everything he promised. Nathan Roth criticized him now and then for promising too much, but John Hill was not the first plastic surgeon to build a practice by catering to women’s vanity. Nor was John Hill the first plastic surgeon to insist on his fee up front, in advance of surgery—in cash. It is one of the financial rules of cosmetic surgery (normally not Blue Cross-able) that the patient is more apt to write a check in anticipation of a miracle than afterward when less than what was expected has been delivered.
He operated with style. While music in an operating theater is not unusual—Denton Cooley, the celebrated Houston heart surgeon, for example, often has a radio tuned to a country and western station—John Hill rigged up a stereo system that he could carry from hospital to hospital. Installing it in a corner, with the amplifier and speakers away from the sterile field, John inserted classical music cassettes. One patient spoke of the experience: “The last thing I remember was this gorgeous doctor bending over me, and Beethoven crashing all around me.”
He haunted the emergency rooms of hospitals all over the city, flattering the head nurses, making sure they knew he was able and available should an accident victim arrive in the middle of the night in need of his talents. He attended medical meetings, even the small and unimportant gatherings of country doctors hundreds of miles from Houston, often with his celebrated wife on his arm, shaking hands and dispensing good will and hoping for referrals. He made contact with the Texas prison system, informing the authorities that he was interested in studying criminals and perhaps performing surgery on their faces after they were paroled or pardoned. Some men steal and kill, he once said, because they think they are too ugly to do anything else. “I think I can help them, and society as well.” Nathan Roth heard this and arched his eyebrows. He did not believe his junior partner was all that consumed with altruism, but he recognized that John was shrewd enough to realize that ex-prisoners come out of jail and get jobs, jobs that provide insurance, insurance that pays for scar removals and harelip surgery if the hospitalization papers are filled out with sophistication.
Often he operated for free on the children of other doctors, or the sisters of doctors’ wives, or the brother-in-law of a scheduling nurse. Again, the practice was not unusual—a young doctor must build up his potential customers—but the zeal with which Hill pursued it was notable. His reputation in the medical community was that of a surgeon with manual dexterity, competent in face work, and particularly capable in the reconstruction of hands. One patient who was a ranked tennis player at a Houston country club suffered a horrible accident at his country house. While cutting firewood, a power saw almost severed his right hand in two. In a series of operations, John rebuilt the hand, his work so exquisite that the patient not only resumed tennis, he won his club’s singles tournament within one year of the accident. There were those who felt John Hill was pushing himself too fast, extending his ambition to the detriment of the profession. The day is not long past when nurses were openly hostile toward women who lay in hospital beds awaiting or recovering from cosmetic surgery. The feeling was that these vain patients were taking up space which should have been used by really sick people.
Years later, Nathan Roth had harsh words of criticism for John Hill. But by this time he so loathed his once promising partner that his opinion had to be measured against his bitterness. “John Hill, in my opinion, was an avaricious doctor,” Roth would say. “He operated too often. He didn’t level with his patients. He assured them, ‘Everything is going to be beautiful,’ when it most assuredly was not. If a man went through a windshield in a car accident and suffered scars, John would promise to fix them. Three months later, if the patient was not totally satisfied with the results, he would do another operation. Then he would sand the face and do still more surgery. John Hill would operate until the patient was beyond hope of further improvement.
“As long as the patient was willing to lie down on his table, then John Hill would operate—and take his money.”
Busy as he was with his practice, he was even more occupied with his music. John rose at 5 A.M., not to make hospital rounds but to practice his tuba in the quiet of his office in a medical building. A nurse who was enamored of her employer rose early as well and was there to greet him at sunrise with coffee, rolls, and just-fried bacon and eggs. His appointment book had two columns, one for medical matters, the
other for musical schedules. He devoted at least twenty hours a week to practicing, taking lessons, and playing in several groups, including the Houston Brass Quintet and the Friends of Music, an organization chiefly composed of doctors who played chamber music and sponsored cultural events. Moreover, he was a patron of both the Houston Symphony and grand opera, the principal classical FM station, and—most prestigiously, for it combined both music and medicine—the Heartbeats. This was a band composed principally of doctors (many associated with cardiac work, hence the name) which played at civic functions and at national medical conventions.
Cardiovascular surgeon Grady Hallman was the founder of the Heartbeats, its conductor, and as close a friend as John Hill had, following the death of Julian. The two men had first met when they were teenagers, in 1947, at a Texas high school band convention. Both played trombone and they stole time from the official functions to play duets together. They met again at Rush Day for fraternities at Baylor Medical School in 1952. Each was happy to discover that the other was still pursuing not only music but now medicine as well. Over the next decade or so of medical training, they remained good friends, although it was friendship in the sense of “We’ll meet next Thursday,” or “Let’s play a Respighi,” nothing more intimate. Hallman did receive one brisk letter, in 1957, when he was in the Army. “I’ve met a girl and I’m on the verge of marrying her,” John wrote. “You’d like her. She’s beautiful and she has an infectious personality.”
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