by Gen LaGreca
The commissioner, wearing a beard of chocolate milkshake, slipped the Phantom’s letter into his pocket.
David Lang entered, surveying the drenched person before him. “Hey, what’s going on here?”
Nicole sighed in relief at the sound of a voice that would fix everything. “I’m so glad you’re here, Doctor! This is Mr. Wellington somebody, from an agency for the handicapped. He wants me to go to an institution for the blind to become a Braille computer operator and live with a bunch of strangers.”
“May I presume that you’re Dr. Lang?” asked Ames, wiping his face with a handkerchief and looking distastefully at David’s casual attire.
“I am. And my patient is not going to any institution. She’ll receive the training she needs in her home,” said a voice of such confidence that Nicole felt safe in lowering her food tray.
“That’s what you indicated in your note to me, didn’t you, Dr. Lang? I mean, it was you who wrote this note across the application, wasn’t it?” The commissioner smiled oddly as he showed David the form.
“Yes.”
“However, Dr. Donnelly asked me to—”
“She’s not on this case anymore.”
“But the patient needs rehabilitation.”
“As I explained in my note, she’ll receive training to make her self-sufficient in the world of the sighted, not to make her a permanent dependent in a sheltered world of the blind, which your agency creates.”
“Of all the nerve! If she doesn’t come with me, there are forms that the doctor in charge must complete. Who might that be?”
“Leave now,” said David.
“How very rude of you! I’m a CareFree commissioner!”
Nicole raised the tray again. David took it from her, the fear on her face causing his temper to rise.
“You’re upsetting my patient, and I won’t allow that!”
“No one talks to Wellington Ames that way!”
“Get out of here!”
“Dr. Lang, you will regret this incident!” With his face a casualty of Nicole’s milkshake and his hair a victim of her water pitcher, the soggy commissioner left the room.
David grabbed Nicole’s hand. “Are you okay?”
“Yes, of course.” A calm had returned to her voice.
“I don’t want him bothering you again. Let me get his forms signed, so everything is official.”
“Thank you!”
With the staccato squeeze of her hand that meant he would return, David left.
Nicole lay in bed, relieved that her intruder had been sent away. But she felt the grip of another opponent, the fatigue that was sapping her energy since the surgery. Slowly, disturbing thoughts about why the commissioner had described her doctor’s orders as invalid slid away, and she fell asleep.
* * * * *
“Nicole . . . Nicole, dear . . .”
A voice that she recognized awakened the dancer. A hand reached for hers, but Nicole instinctively pulled away.
“Nicole, I’m here to help you, dear. I know you’ll be able to make this very difficult adjustment, even to dance again in some safe way. I want to ensure that you have everything you need to get your life back on track.”
“I need the second surgery.”
“I’m afraid there isn’t going to be a second surgery.”
“What?” Nicole’s voice was a gasp.
“Dr. Lang has been suspended for performing your first surgery.”
“What?!”
“It was just a crude experiment, not ready for human trials. Dr. Lang is well intentioned, and he’s tried so hard on your behalf. But he was suspended by CareFree, which means he’s barred from performing surgery in New York State. For five days now, he’s been contacting every colleague he knows, every person of any influence, trying to get licensed somewhere else. But with the adverse publicity from this case, no other state is willing to accept him. Unfortunately, brain surgery isn’t something you can do in a garage. So you see, dear,” the voice said, softening with regret, “there’s nothing he can do for you now.”
The white sheet that was Nicole’s face stared into a black void of space. She could not find a voice to speak or a muscle able to move.
“I want to help, Nicole. That’s why I know it’s right to tell you the truth. You may have heard of Warren Lang, the head of the Bureau of Medicine. He’s David’s father.”
Another gasp of astonishment.
“You might think that his father can save him, but because Warren is expected to be chosen as the governor’s running mate, he’s under intense public scrutiny. He can’t bend the rules for his own son with the media watching him through a microscope on this case.”
Nicole felt an urgent pounding inside her head, a terrible pressure that she had experienced many times as a child, but never before with such urgency. A tunnel was collapsing on her, and she had to escape.
“I want so much to help you, Nicole. Do you want to get away? Convalesce in a place far from this unpleasantness?”
* * * * *
David Lang’s phone dangled limply from his hand. He sat in a hospital lobby with his head down and his eyes staring vacantly at a tear in the carpet. After he had completed the administrative tasks to free Nicole of Wellington Ames, his lawyer had called.
The attorney had explored every avenue but had found no way to get David reinstated as a CareFree doctor. He had contested the agency’s action against David, the lawyer explained, but to no avail. The attorney then tried to have the matter settled through the judicial system, where an impartial jury, rather than a CareFree administrator, would decide the case, but that attempt also failed. And challenging the constitutionality of CareFree’s action would take too long to be of help in Nicole Hudson’s case. His lawyer patiently discussed the issues involved.
David had attempted to get licensed elsewhere, but his difficulties with CareFree made other states unwilling to accept his application. He had even looked abroad, although the standard of medicine there had dropped in recent years. Other countries had variants of programs like CareFree, only older and in more advanced stages of budget cuts and deterioration. Nevertheless, he contacted influential medical directors abroad, but news of his problems had spread internationally. His case was a political hotcake that no one wanted to touch. His procedure was also clinically contentious, with most physicians skeptical about the feasibility of nerve regeneration. Medicine, like other lines of work, had an entrenched majority that avoided controversial issues, whether political or professional.
Thus, David could do no more than obtain a hearing within CareFree on rescinding his suspension and allowing Nicole’s second surgery. The decision that would determine his and Nicole’s future rested with the agency—and the father—he denounced.
He would have to tell Nicole the situation. But how? He walked toward the elevator, choosing his words.
He arrived at Nicole’s room to find it crowded with nurses and aides. A stout older woman approached him, her face grave.
“Dr. Lang, I’m so glad you’re here!”
“Mrs. Trimbell, what’s the matter?”
The woman, whose expression was as severe as the tight bun of black hair at her neck, pointed to the empty bed. “When I arrived, Nicole wasn’t here. We checked the restrooms, the patients’ lounge, the corridors, and the other rooms on the floor, but we can’t find her. Nicole has disappeared!”
Chapter 19
Abraham and Isaac
Morning coffee awaited the secretary of medicine as he stepped into his limousine. Exposing a starched sleeve and gold cuff link beneath an exquisitely tailored suit jacket, Warren Lang waved absently to onlookers outside his Albany residence on that first Monday in August. With the turbulent events of the past week robbing his face of its perennial smile, he looked like a statesman with weighty concerns.
“Are we going to the office, Mr. Secretary?” asked the chauffeur.
“Yes, then in the afternoon I’ll be going to the governor�
��s mansion.”
Charges against the lieutenant governor had intensified after the explosion five days earlier in Manhattan. He and other officials were accused of accepting kickbacks from construction companies awarded government contracts, including the firm believed responsible for the accident injuring Nicole Hudson and others. The faulty gas piping apparently involved in that explosion had been installed as part of a government contract, rekindling the scandal in the headlines. Although the lieutenant governor maintained his innocence, he finally withdrew from the race amid mounting pressure.
Because he was the target of a time-consuming investigation, the beleaguered official announced, he had decided not to run in the upcoming election. Publicly, Governor Mack Burrow accepted the decision with regret and expressed confidence that his second in command would be cleared of all charges. Privately, however, it was Burrow who forced his running mate off the ticket.
In speeches given across the state, the governor distanced himself from the kickback scandal. “I will select a new running mate of the highest moral character who will serve the public good,” he promised.
Now Burrow had summoned Warren for a meeting that could only concern two topics, one that the secretary wanted passionately to discuss and the other that he wanted just as fervently to avoid: the first, his running for lieutenant governor; the second, his son.
Furrows appeared like fault lines on Warren’s ashen face, a sign that a quake could rock the stately countenance. Entering a large hall in the BOM’s Albany headquarters, he brushed his concerns aside. All eyes in the packed room turned to him as he began his weekly meetings with citizens.
“An official must be accessible, not sequestered in an ivory tower,” he often said. “It’s my duty to keep my finger on the pulse of the people.” Hence, one morning a week the secretary was available to anyone wishing to discuss a health issue with him, at five minutes per person. “This is our private chat,” he would tell those who came. In actuality, the “private” interviews were conducted before a gallery of waiting people, as well as aides directing traffic, keeping time, recording the proceedings, and processing papers.
The press hailed Warren’s chats. “We commend Secretary Lang’s open-door policy. He sets a new standard for caring government that is responsive to the people,” said an editorial in a leading newspaper. A photograph of Warren sympathetically patting the hand of a distraught citizen appeared on the cover of a national magazine, accompanied by a flattering story titled “New Directions for Medicine.” A blowup of that same picture hung in the living room of the secretary’s home.
That morning a young mother approached him tentatively, as one would hesitate before nobility. Warren rose from his table, shook the woman’s hand, and offered her a seat with the magnanimity of an aristocrat opening his door to a commoner caught in the rain. The woman pleaded a case for her five-year-old son.
“You see, sir, my Willie has trouble swallowing and breathing because his tonsils are growing together. But our doctor can’t remove them because Willie hasn’t had five episodes of tonsillitis in one year. Poor Willie, who comes up shy on most things, had only four. The doctor wants to take his tonsils out, and my Willie is having a terrible time, not sleeping or eating right, but it’s something about ‘practice guidelines’ that Willie’s case doesn’t meet.” She stared reverently at Warren, her hands clasped together as if in prayer. “I was hoping you could help us, sir.”
Warren seemed to bask in her supplication. “I think we can look at the matter.”
The woman bounced in her seat. “Can you really, sir?”
“I’ll send you to Case Review, where I’ll direct a coordinator to determine if there are extenuating circumstances to warrant an exception for your Willie.”
“Oh, thank you, sir!”
An aide hovering over them made a note. All cases had the same disposition. They were sent to Case Review for a second look. Because they came from the Secretary’s Court, as the proceedings were called, the coordinators automatically honored Warren’s requests. The publicity generated from these propitious outcomes made favorable news stories for CareFree.
Warren smiled generously and shook the woman’s hand. A news photographer snapped a picture of him in his custom-tailored linen suit with the woman in her polyester dress.
“You look happy, like you just hit the jackpot, ma’am,” the photographer commented.
A sudden fear eclipsed Warren’s smile. He thought of David’s haunting words from their last meeting: What must my patient do to win a door prize, too?
The next citizen approached Warren, an older man self-consciously shifting his weight.
“Excuse me for bothering you, Mr. Secretary, sir.” He fidgeted nervously. “It’s about my bum knee.”
“It’s no bother at all.” The man’s timidity was like a splash of cool water to refresh Warren’s confidence. “Please have a seat. . . .”
For lunch, the secretary traveled by limousine to a restaurant where his favorite table, overlooking the duck pond, was reserved for him. A glass of Chardonnay was poured ten minutes prior to his arrival so that it would warm to the temperature he desired. Extra tomato wedges were placed on his salad, and his steak was cooked exactly medium rare, as he preferred, without his having to ask. The staff, honored by such an important patron, kept a careful record of his predilections.
Just as Warren was enjoying the chef’s personal visit to his table to check on the meal, a tall man with black hair entered the restaurant, giving the secretary a start. The man resembled David, triggering a sudden guilt in Warren, who felt like a child caught stealing a cookie. David’s image seemed to be following him, sprinkling salt over his sweet pleasures. The secretary was relieved to find that the man was not his son, although he could not explain why. His emotions were like lightning bolts that struck with sudden fury and vanished just as quickly.
Warren returned from lunch to perform what he considered another important duty of his office: conducting hearings against doctors who violated CareFree’s rules. A health care provider could appeal a judgment imposed by CareFree and thus obtain a hearing before an administrator. “A public official must be a role model for his staff,” Warren had said during a television interview. “I conduct the physicians’ hearings myself, as my schedule permits, to set an example of firm justice for my agency.”
Doctors privately snickered at such remarks, for Secretary Lang was known to lean far more toward firm than justice in his decisions on their cases. No doctor in the state wanted Warren as a hearing administrator. The press, however, reacted differently. “The tireless Dr. Warren Lang sets a new standard for hands-on management,” said a flattering article in a New York magazine. “He runs the huge Bureau of Medicine like a corner grocery store, rolling up his sleeves and jumping behind the counter to lead his staff, a practice more agency heads should adopt.”
Warren held the hearings in a setting resembling a courtroom. Every BOM office in the state had such a chamber. The administrator deciding the case sat at a judge’s bench. The defendant, often accompanied by a lawyer, sat at a table to the administrator’s right, with a CareFree attorney at a table to the left and a podium in between. The public observed from rows of seats behind the tables.
That afternoon Warren sat on the judge’s swivel chair in the hearing room. One aide adjusted the lighting to the level the secretary preferred. Another brought him a glass of artesian well water with two limes. Another laid the file for the first case before him. Dr. Lang scanned the document as dentist Sheldon Fein, a balding man whose direct eyes stared out of his gaunt face, approached the podium.
“Good afternoon, Dr. Fein,” said Warren with cool cordiality. Gone was the grandfatherly warmth displayed earlier in the day toward patients.
“Good afternoon, Dr. Lang.”
“The record shows you’ve been waiving the copayments that you’re supposed to collect from your patients.”
“Yes, I have.”
“Y
ou admit to the charge, so we have no dispute, Dr. Fein.”
“We have no dispute over what I did, but I have a great dispute over what your agency made of it. I mean, a ten-thousand-dollar fine! The copayments were my own fees. How can my failure to collect money owed to myself be a crime?”
“Why didn’t you collect your fees?” Warren asked sternly.
“It would cost me more to collect the fees than they’re worth. Nobody thinks they have to pay for anything anymore,” the dentist said resentfully. “Because I’m waiving fees owed to me, why should your agency care?”
“Did it ever occur to you, Dr. Fein, that the purpose of the copayments is not to embellish your income but to restrict the public’s demand for your services, and that by waiving those payments, you give patients no reason to exercise restraint on their visits to your office? Do you realize that you are encouraging extra treatment and driving up costs, which are straining the system?”
“I realize that the system is straining me!”
Warren’s eyebrows arched at the impertinence. “The judgment stands.” He closed Dr. Fein’s folder and tossed it to an aide. “Next case, please.”
The dentist’s expression oscillated between shock and anger until the latter prevailed: “I’ll speak to my lawyer about this!”
The next folder appeared before Warren, and the next body appeared before the podium—psychologist Diane Lutz, a petite woman in her fifties with gentle eyes and an intelligent face.
“Good afternoon, Dr. Lutz,” said Warren, flipping through her folder.
“How do you do, Dr. Lang?”
“It says here that you knowingly entered a false diagnosis in order to be paid for unauthorized treatment. You said you were treating a man for depression, which is covered by CareFree, but you were really conducting marriage counseling for the man and his wife, which is not covered.” Warren peered up from the papers. “The record shows that you collected thousands of dollars of taxpayers’ money under false pretenses, Dr. Lutz,” said Warren accusingly.
“But my patient’s depression has caused the problems in his marriage. Last year when I started treating the couple, CareFree paid for their marriage counseling. This year it doesn’t. But I’m still treating the same couple.”