“Annette,” Franks voice crackled over the intercom, “would you please ask Dr. Iverson to come on in? And hold all calls—unless they’re regarding our fathers condition. Thank you.”
Zack walked into his brothers office, wishing he were anyplace else.
“Have a seat, Bro,” Frank said. “I was wondering when you were going to show up here again. Where’ve you been?”
“Oh, here and there. Mostly on the floor or on the toilet.”
“I know.”
Zack looked at him curiously.
“John Burris told me,” Frank explained. “Apparently he called to give you a progress report on the Judge. He says you were obviously intoxicated and totally incoherent.”
“Aw, he was just being kind.”
“Zack, this isn’t funny. Burris said something about it to one nurse, and already the whole hospital knows. Once they’re lost, reputations around hospitals don’t get found again very often. Ask Guy Beaulieu.”
“Now who’s being funny, Frank?”
“You know what I meant.”
“Well, one of the reasons I stopped by was to tell you that I was sorry for causing so much disruption around this place. I see now that I’ve got to back off a little if I’m going to get by here, even though I’ve only been doing what I thought was right.”
“Have you?”
“Dammit, Frank, you’re an excellent administrator, but that doesn’t mean you’re on top of everything that’s going on around here.”
“For instance?”
“For instance, that sleazy anesthesiologist, Pearl, and his sidekick, Mainwaring. They’re up to something, Frank. They’re using something other than what they say they are in the operating room. I swear it.”
“That’s ridiculous.”
“I have proof.”
“Do you?”
“Well, not exactly. But I have some data about recovery times that are pretty damn suggestive. And I’ve learned some things about Mainwaring’s past that even you might not be aware of. I’m telling you, there’s a connection between that poor Nelms kid’s seizures and whatever the two of them have been giving patients in the O.R. Frank, this hospital could be headed for terrible trouble. We’ve got to find out what’s going on.”
“No, we don’t, Zack-o,” Frank said simply.
“What are you talking about?”
“Well, first of all, we’re not going to find out because there’s nothing to find out. Those two men worked here for two years before you arrived, and there was not so much as a whisper of anything but praise for either of them. How do you explain that?”
“I … I can’t really. At least not yet. But I’m right, Frank. I just know I am. Mainwaring’s got a past that involves testing drugs illegally, and Pearl’s hiding something. Couldn’t you tell that from the way he behaved last night? He’s so frightened of being found out that he was willing to put that kid to sleep with anesthetics he had never used on him in the first place. Something’s going on, and dammit, I’m going to find out what.”
“No, you’re not,” Frank said again. “You’re not going to find out because you’re not going to be stirring up any more trouble around here. And you’re not going to be stirring up trouble because you’re through … finished … fired. You’re done at this hospital as of right now.”
Zack stared at him in disbelief. Frank looked back at him, smiling placidly.
“Frank, that’s crazy. I’m a physician on the staff. You can’t fire me. Only the medical staff can do that, and then only after due process.”
‘Oh, really? Here, Doctor. Here are the corporate bylaws. You don’t work for the medical staff. It’s on page seven. Check it out. You work for Ultramed. And Ultramed can fire anyone they goddamn well please. And I’m Ultramed, and you’re fired.”
He held his hands out palms up. “C’est tout, mon frère.”
Be strong.… Suzanne’s encouragement was growing hollower by the moment.
“Frank, you can’t do this.”
“I can, and I did. You see, Bro, that’s been your big mistake all along—not understanding that this is my hospital and that I can do whatever the hell I want to. I wanted Beaulieu out, and he was out. And now I want you out.”
“Frank, you forget that even though you might not have wanted Beaulieu here, you didn’t fire him. He was being systematically and deliberately driven out by—”
“By who?”
Zack hesitated, remembering his promise to Maureen Banas. Then he decided that she would simply have to understand His situation was too desperate.
“It was Ultramed, Frank. He was being driven out by Ultramed. Just look at that letter from Maureen Banas. That’s proof you don’t know everything that’s going on around here. Do you think she wrote that of her own free will? She was coerced, Frank, by that company we work for. By Ultramed.”
“Was she?”
“Yes, she received a copy of that letter along with a note that—”
“That said if she told me about receiving it, both she and I would be fired?” Frank’s gloating leer was at once disgusting and terrifying.
“Jesus,” Zack muttered.
“Nice touch, don’t you think?”
“Oh, Frank. You are really sad. Why didn’t you just fire him like you’re trying to do to me?”
“He was an obstreperous sonofabitch, that’s why. I didn’t want him making a big stink. I was just learning the ropes then, Zack-o, learning how far I could go. I know them now, and they tell me that it’s okay to fire you, so … you’re fired. God, I really love hearing that.”
“You’re crazy, Frank. Do you know that? You are absolutely nuts.”
“Maybe,” Frank said. “But I am also employed. Which is more than can be said for you.”
“I’m going to fight you.”
Frank shrugged.
“Do whatever you want. As far as the company or the medical staff is concerned, you’re a drunken, disloyal troublemaker. I doubt that even your little cardiology fluff will stick up for you.”
“Frank, Guy Beaulieu died because of what you did to him. Died! Doesn’t that mean anything to you?”
“You have a good day, now, Zack.”
“And don’t you even care that it’s possible some madmen are poisoning patients in the operating room of this hospital? What are you?”
“I’ll be speaking with the folks at Pine Bough Realty. I’m sure they’ll be more than happy to give you, oh, two or three days at least to get out of their house.”
“Jesus. I’m coming to that board meeting, Frank. I’m coming, and I’m going to tell the board and Ultramed what’s going on here. The Judge may be paralyzed, but he saw what Ultramed and its policies did to Annie. He’s had time to review Beaulieu’s evidence and to convince people how to vote. I’m going to be there to reinforce his position.”
“Well, I spoke with him earlier this morning, and he’s promised to keep hands off the whole affair.”
“Frank, that’s a fucking lie. I was just up there. The nurse told me the Judge won’t see either of us.”
Frank winked.
“Then let’s just say that if he had spoken with me, that’s what he would have promised.”
“You crazy bastard, Frank.… You crazy, crazy bastard.”
“I’ll be happy to write you a letter of recommendation, provided the place you apply to is far enough away. Now, if you’ll excuse me, I have a hospital to run.”
“I’ll be seeing you later at the meeting.”
“Try it if you want to, Zack-o. The security guards will know exactly how to handle things if you show up there. And now, little brother, how about either you leave or I remind you of how much hurt you ended up with every time we fought behind the barn. I probably would enjoy that almost as much as I’ve enjoyed firing you.… You take care, now. Y’hear?”
* * *
Numbly, Zack wandered from his brothers office and through the busy corridors of the hospital.
T
he polished linoleum, the tile, the nurses bustling from one patient to the next in their starched whites, the framed prints in every room—how clean it all appeared on the surface, how perfect. The set of a movie.
Zack smiled grimly at the thought. Davis Regional had become a gleaming, movie-set hospital—Hollywood veneer with no soul. It was a nightmare. And now, a nightmare he could do no more than walk away from. He drifted into the intensive care unit.
Suzanne, wearing surgical scrubs beneath her lab coat, was in Toby’s cubicle, moving about the heavily bandaged child in a way that could only mean trouble. At the foot of the bed, Owen Walsh, the pediatrician, watched, his perpetually cheerful expression darkened by concern.
“Hi,” she said, glancing over only momentarily. “Glad you could make it.”
She studied the monitor, and then emptied the contents of a syringe into Toby’s IV line.
“Problems?” Zack asked.
Having just been fired from the staff, he found himself strangely reluctant to approach the bedside.
“These last sixteen hours have been like a crash refresher course for me in pediatric pharmacology,” she said without looking up. “Every time his temp goes up, his rhythm goes crazy. What we’re doing here amounts to nothing more than a holding action. I sure wish we knew what was going on.”
I do know, he wanted to say. Instead, he forced himself to the head of the bed, where he made a quick check of Toby’s pupils, eye grounds, and reflexes. While there was still no definite evidence of irreversible damage, there was certainly no sign of improvement.
“We’ve got the promise of a bed for him in Boston,” Owen Walsh said. “But they can’t transfer him until late this afternoon or this evening.”
Take him away from this place, away from Jack Pearl, and you take him away from his only chance.
Again, Zack’s thought went unspoken.
“Anything I can do in the meantime?” he asked.
“You can review the steroids he’s gettine.” Suzanne checked the temperature reading from the rectal probe. “Back down to one-oh-two. And look, Zack—his rhythms stable again. Damn, what’s going on?”
“If you’re able to leave,” he said, “I’d like to talk to you for a minute.”
Suzanne checked the monitor and Toby’s chest, and then glanced over at Walsh.
“Just don’t go too far,” the pediatrician said.
“Well be right outside in the waiting room, Owen,” she replied. “Besides, you’re doing fine here.”
Walsh smiled. “She saves this child’s life at least five times in one night, and she says I’m doing fine.”
“Nonsense. I’ll be back in a little bit. Hang in there.”
As soon as the door to the ICU waiting room clicked shut, Suzanne threw her arms about Zack’s chest and buried her head against his shoulder.
“I knew you’d come back,” she said. “I’m so damn proud of you—of both of us. Listen, as soon as we get Toby off to Boston, let’s go to my place for dinner. Helenes going to take Jen for the night, and I have a batch of shrimp in the fridge and—”
“Suzanne—”
“No, listen, it’s my guilt for acting the way I did in the E.R. last night, and only shrimp sauteed in garlic butter will—”
He held her by the shoulders and moved her away.
“Suzanne, Frank just fired me.”
“He what?”
“Effective immediately.”
“He can’t do that.”
“Can and did. He even was kind enough to present me with a set of the corporate laws to prove he can.”
He held up the book for her to see. Only then did he realize how totally drained she looked. Her face was pale and drawn, her eyes reddened with strain and fatigue.
“This is crazy,” she said. “What reason did he give?”
“Actually, according to page seven here, he doesn’t need a reason. But just to be fair, he provided a couple: being drunk while on call—technically, I was, you see—being a disruptive influence. Hell, I can’t even remember everything he said. Listen, you look really wasted. Why don’t you find an empty bed and crash for an hour or two? I’ll watch Toby. Frank won’t even know I’m in the hospital. And even if he finds out, he won’t do anything about it. Owen’s too panicked about being left alone to allow that. We’ll talk later, after we get the child to Boston.”
“No, Zack. I’m fine. Really,” she said. “But Zack, we can’t let him do this.”
“You don’t understand. This isn’t a hospital the way we were trained to know one. It’s a merchandise mart that hires doctors and nurses and technicians. And Frank is the president of that company—at least here in Sterling he is. He hires, and he can fire. Except with someone like Guy Beaulieu. In Guys case, Frank didn’t want the hassle Beaulieu was threatening him with, so he just took the route of destroying the man by rumor and innuendo. He admitted being responsible for all of that.”
“To you?”
“He had already fired me. What did he have to be afraid of? He was actually boasting when he told me.”
Suzanne sank onto the sofa.
“Oh, Zack,” was all she could manage.
“Listen, Suze, this is my problem, and I’ll work it out.”
“No,” she said suddenly.
“What?”
“No, it’s not your problem—at least not yours alone. It’s all of ours. The medical staff, I mean. We’re going to fight this.”
“Suzanne, I don’t want anyone else getting hurt because—”
“No, listen to me. For years now, at least as long as I’ve been here, the doctors in this hospital have been acting like … like ostriches. This isn’t the first time there’s been a problem between Frank or Don Norman and staff doctors, Zack. It isn’t the first time one of us has clashed with the system here and then suddenly found himself out. Don’t you remember what Wil Marshfield said that first night? And I’ve been as much of an ostrich as anyone—so grateful for getting out of the trouble I was in that I’ve turned my back on any number of company decisions that might not have been in the best interests of our patients. I didn’t feel committed enough to any one issue to make waves. But dammit, I feel committed now.”
“Suzanne, I don’t want you—”
“Please. You had the guts to come back and face the music. And now, dammit, I’m going to see to it that the medical staff gets behind you. It’s time we stood up for this community-time that we stood up for our own.…”
She rose and took his hands.
“Zack, hang in here. Please. Do it for all of us. If I can just get us to present a unified front, I’m sure the medical staff can stand up to the corporation. And if we can’t get Ultramed to listen, then … then we’ll just take our case to the community.”
“You think you could pull that off?” he asked.
“I’m tougher than I look.”
He touched her cheek.
“That’s not saying much, you know.”
“Well, you just watch. Can you stand the heat?”
“Suzanne, I don’t want to leave here. I don’t want to leave you.”
“Okay, then. It’s decided. As soon as I finish with my office appointments, I’m going to start twisting some arms.”
“It’s not going to be easy.”
She kissed him lightly.
“It’s not going to be as hard as you think. Listen, I ought to get back in there. What are you going to do right now?”
“I think I’m going to try and get in to see my father. He refused to see me earlier, but I think it’s worth one more try. I was planning on putting in an appearance at that board meeting later today, but Frank has promised to have the hospital security people ready for me if I do.”
“Damn him. Zack, I think your brother and I are about due for a little meeting of the minds.”
“You would do that?”
“Would and will. I have too many friends around here, and make too much money for this place for him not t
o listen to me. You must be strong.… God, Zachary, it feels so good to realize that all of a sudden I’m not afraid anymore.”
“You were afraid of the corporation?”
“No,” she said, kissing him once again. “Of you.”
31
Brief operative note (full note dictated): … Four-inch gash over T-10, 11, and 12 debrided … hemostasis attained … wound explored.… Jagged five centimeter by three centimeter piece of rusty metal removed without difficulty … dura appears intact.… No collection of blood noted.… Wound irrigated copiously, and then closed with drain in place.… Patient sent to recovery room in stable condition, still unable to move either lower extremity.… Tetanus and antibiotic prophylaxis initiated.… Preoperative impression: foreign body, low midback; postoperative impression: same, plus paraplegia—etiology uncertain, possibly secondary to spinal cord disruption or circulatory embarrassment.…
Seated to one side of the nurses’ station, Zack read and reread the account of his father’s surgery, and confirmed through John Burris’s terse progress note and two much more detailed nurse’s notes, that there had been little change in the Judge’s condition since his surgery.
Dura intact … No collection of blood …
Zack chewed on the nub of his pen as he stared out the window at the Presidential Range. Something was off. The Judge’s symptoms seemed out of proportion to the extent of his injury—way out of proportion. The pieces of this clinical puzzle simply weren’t locking together.
Sheering forces snapping fibers in the cord, arterial spasm with enough interruption of blood supply to cause nerve damage—there were a number of logical explanations for the Judge’s paraplegia, but none of them sat just right.
At one end of the Formica counter, a small plastic tray was piled high with pens, and pencils, as well as a stethoscope and several other pieces of medical equipment. Zack slipped an ophthalmoscope, reflex hammer, and straight pin into his pocket and headed for his fathers room.
It wasn’t that he was questioning Burris’s findings and opinion, he rationalized, it was just that … that a physician was taught never to completely trust anyone’s findings or conclusions other than his own.
Flashback (1988) Page 36