Chapter Fourteen
When Lola Weizman entered the Berkeley Woman’s Health Clinic on Channing Way, the receptionist, Elena Ordoñez smiled. “Good morning, Lola. How’s it goin’?”
“Slow Elena, very slow. Is Kathy in yet?”
“Just got here. She’s in her office.”
Kathy Bingham directed the clinic. She was a MSW., a psychotherapist, and family counselor who came up through the county mental health system and had the scars to prove it. Kathy was a large black woman and could move from compassionate supporter to vitriolic attacker in a heartbeat.
Lola had persuaded the city to replace the program’s previous director. After twenty years, he was out of touch with the clinic’s clients and staff. Lola interviewed dozens of qualified applicants, looking for a rare constellation of talents: psychotherapeutic skills combined with street smarts and the toughness to deal with a frustrating bureaucracy. Lola remembered Kathy’s interview.
Kathy looked down at the diminutive Lola Weizman who shook her hand and, spoke with a precise Austrian accent. “Please be so kind as to have a seat.”
“Thank you.”
Kathy, nobody’s fool, knew a great deal about this unique Viennese psychotherapist, her personal and professional life, and her role in establishing the clinic.
“Tell me something.” Lola, smiled and met Kathy’s eyes, an action perfected by a years of therapeutic encounters. Lola’s face carried the wrinkles of age, cigarette smoking, and the smile lines of a lifetime. They codified her joy in helping others.
“Let me tell you what I’ve done and what I’d like to do with the clinic.”
“I read your resume. Tell me something I don’t know.”
“Where’s the couch?”
“I don’t use a couch. I do better looking at people, don’t you?”
“I don’t know what you want, Dr. Weizman.”
“Call me Lola. Everyone does.” She locked on Kathy’s eyes, and then shook her head. “Don’t fail me. I’m too old for disappointment, and I have great hope for you.”
My own analyst never made me this nervous, Kathy thought as she peered into Lola’s soft brown eyes.
“I’m good with the sort of people you see in the program, Lola. One way or the other, they’re me. We understand each other and I have the skills to help them. In addition, I have a low tolerance for bullshit. I’ve been bullshitted by the best, and that includes patients, colleagues, and functionaries of every description.”
“Why teenage girls? They’re not easy.”
“Tell me about it. I have two of my own.”
Kathy stared at Lola who remained silent. “These girls…they have no idea about the unconscious factors that motivate them, but they’re young enough to learn and become better at dealing with the realities of adult life.”
Lola rolled up the sleeve of her blouse to reveal the blurred letters of the tattoo she received at Auschwitz. “What do you feel when you see this?”
Kathy’s eyes welled with tears as she stared. “Rage and despair.”
“Good answer.”
Sarah Hughes, under constant pressure from her father, continued to attend TeenTalk meetings. She coped with the repetitive banal whining on one hand, and the religious affirmations on the other, by shutting most of it out.
Before the next meeting, Carleton Dix pulled Sarah aside.
His smile makes me want to puke, she thought.
“I’m glad you’re coming to our meetings, Sarah. Maybe it’s not so bad after all.”
Sarah said nothing.
He approached and sat on the sofa by her side.
Without thought, she slid away.
He moved closer, placed his hand on her shoulder, and stared into her eyes.
Sarah felt repulsed at once.
His eyes...his touch...he’s interested in something else, she thought.
Shuddering, she shifted her body away from his hand. “Don’t touch me. Don’t ever touch me. I’m doing this because I have no choice.”
Afterward, at the meeting, Carleton leered at Sarah. “You’ve been with us several times, Sarah, maybe it’s time to share your feelings.”
“No thanks, Padre.”
“Are you afraid? It takes courage to stand up in public, to speak your mind.”
“All this blabbering is crap. It accomplishes nothing. And the religious dogma...you can keep it.”
Several girls gasped.
Carleton reddened. “How does a girl your age reject two thousand years of truth that’s engaged the best of humanities’ minds?”
“I’m not rejecting anything. I just need a reason to believe, and so far, I haven’t discovered one.”
“If you don’t believe in the revealed word of our Lord and Savior...then you’re lost.”
Sarah bit her lip. “Lost? I don’t think so. Anyway, I don’t want to get into a philosophical debate with a man who has committed his life to a fantasy.”
“A fantasy?”
“I only have one question, Padre, and then I’ll let it go. If God is all-powerful, all knowing, and perfectly good, how can evil and suffering exist in your world? I don’t get it.”
“God allows what we consider pointless suffering for reasons we can’t comprehend.”
Sarah sneered. “Right. A typical bullshit answer. I think I’ll pass.”
Evolution must explain it, Jacob Weizman thought as he wheeled Gabriella Sago through the hallway at Brier. Men, and women too, stopped and stared at this well-proportioned, blond, blue-eyed beauty, a showgirl at the Bellagio in Las Vegas.
Mary Oakes turned to one of her nurses. “It’s as if she’s an alien species, like those air-touched models in magazines. When I look at her, I think, what’s the use...I might as well shoot myself.”
As they passed the nursing station, Jacob turned to Mary. “Give me a hand, will you?”
They wheeled Gabby to the bedside. Jacob held her arm. “Just support your weight on your good leg, Gabby, and then we’ll get you into bed.”
Mary supported Gabby’s shoulders while Jacob lifted her thickened, shiny red left leg and placed it on two pillows.
After Gabby got settled, Jacob turned to her. “This is Mary Oakes. She may be the best nurse we have around Brier.”
“It’s great to meet you, Mrs. Oakes.”
“Please call me Mary. How long have you known Dr. Weizman?”
Gabby smiled and winked. “He was the first, but not the last to smack me on the ass, thank God. He delivered me. Once Jacob delivers someone, he takes it as a lifelong obligation.”
“Get her vital signs for me, Mary, and admit her. She has a nasty infection in her leg veins, phlebitis. I’m writing the orders and starting her on anticoagulants.”
After Jacob left the room, Mary took Gabby’s temperature, pulse and blood pressure. The left leg was angry red and swollen twice normal.
Mary shook her head. “That’s nasty looking, Gabby.”
“I’m so stupid. I should have gotten on it a week ago, but you know me...Wonder Woman.”
“Don’t tell me you danced on that leg?”
“Well, it wasn’t that bad at the time...and with my costume, if you can call it that, I don’t think many people were looking at my leg.”
“You’ll be back on your feet in no time.”
“If it wasn’t so painful, I wouldn’t mind. I could use the downtime. I have so much to catch up, especially my reading.”
“You sure draw a lot of attention, Gabby.”
“I know, and I’m not complaining. It’s an occupational hazard. I don’t want to appear snobbish...I’m not, but can you do anything to protect my privacy?”
“Of course. I’ll deal with it. Meanwhile, make yourself comfortable. I’ll be back with the moist heat pad. Slip into this.” Mary handed Gabby the hospital gown.
Gabby pulled out a simple cotton lace-trimmed gown. “Is it all right if I wear this?”
“Sure, but I can hear the sighs of disappointme
nt already.”
“They’ll survive.”
After changing, Gabby lay in bed trying to find a comfortable position when she heard a knock on the door.
“Come in.”
Tommy Wells entered pushing his lab cart. “I’m Thomas Wells.” Smiling with a Dracula accent, he said, “I come for your blood.”
Gabby winced. She hated to have her blood drawn. They always had difficulty finding a vein and it often left a large black and blue mark.
Seeing her discomfort, Tommy smiled. “Not to worry. I’m the best.”
While he tied the rubber tourniquet around her upper arm, Tommy looked up into her eyes.
God, she’s gorgeous, he thought.
Gabby had seen that look thousands of times. She smiled politely, closed her eyes, then felt a tiny pinprick and it was over.
“Thanks, Thomas. That wasn’t bad at all.”
He held the site for several minutes. Way too long.
Thomas drew her blood twice each day, each time asking more personal questions until she stopped him. “Please, Thomas. You seem like a sweet man, but I’m only interested in getting well.”
Tommy reddened, and then stomped away.
When Tommy returned the next morning, he said nothing. He placed the tourniquet around her arm. Suddenly she felt the agonizing pain as he probed for a vein.
“Get out of here!” She clutched her burning arm. Tears ran down her cheeks, as her arm began swelling, and turning black and blue.
When Jacob saw the arm and heard her story, he found Tommy sitting in the coffee room. “Keep your damn hands off my patients...what’s the matter with you?”
“If you don’t like it, Weizman, take it up with my boss.”
“You can be sure I will.”
When he left, Tommy mumbled under his breath, “Fucking kike.”
“What did you say?” said Jacob as Tommy walked away.
Tommy turned. “Don’t mess with me, old man. You’ll regret it.”
Chapter Fifteen
Jack Byrnes listened as the Quality Assurance Committee (QA) discussed the complaints against Jacob Weizman. “I don’t like this one bit.”
The clock showed 12:20 p.m. The committee members finished lunch and began their meeting. The east-facing windows showed pedestrians walking to and from Brier Hospital in the bright midday sun.
“I don’t like it either,” said Warren Davidson, the chief of medicine, “but we can’t ignore the complaints lodged by the nurses and some physicians.”
Ernie Banks was a family practitioner in his early 70s. “These complaints reek of ageism. I’ve had to deal with it myself, and if you don’t mind, I hate it.”
“Age discrimination in the People’s Republic of Berkeley,” said Warren, “impossible.”
“Berkeley’s progressive, but I can’t say the same for Brier Hospital,” said Arnie Roth, the chairman of QA. “All this is beside the point. The complaints are here and we must deal with them.”
Arnie grabbed a manila folder. “This is the most recent complaint. It’s from Marion Krupp...”
“Christ,” Jack interjected. “Marion Krupp is a bitter, angry woman...you’re going to listen to her gripes?”
“This is just an example. I have several others, all with the same theme: Jacob’s reluctance to prescribe medication and his passion to get people out of the hospital as quickly as possible.”
Jack smiled. “That should make him the poster-boy for the HMO.”
“Please, Jack,” said Arnie. “We’re here to deal with practice issues only.” He paused a moment, then continued, “I asked Jacob to join us to discuss these problems.”
Jack smiled. “It’s your funeral, Arnie.”
Arnie walked to the door. “Jacob. Why don’t you join us?”
Jacob smiled and strolled to the head of the table.
The witness stand, he thought.
Jacob looked around the room. He knew these physicians well. He’d delivered a few and cared for several others and their families.
Arnie read the complaint from Marion Krupp.
“She’d have me sedate an old lady for her convenience. I won’t do it. It’s bad practice.”
“We see a pattern here, Jacob. Everyone knows you’re a therapeutic nihilist, that you resist using medication to help your patients.”
“Therapeutic nihilist...ha! You use the term as a pejorative. As I define it, it’s a compliment...thanks.”
Jacob looked around the room. “When you reach my age, and lived through the claims of wonder drug after wonder drug, eventually it forces any thoughtful physician to question our entire body of knowledge about the therapeutic properties of medications. That’s what Oliver Wendell Holmes, Sr. said in 1860: I believe that if the whole Materia Medica as now used, could be sunk to the bottom of the sea, it would be all the better for mankind, and all the worse for the fishes.”
“You’re kidding,” said Warren Davidson, “Eighteen sixty?”
“More than any of you, I appreciate the benefits of modern medications. I treated pneumonia without antibiotics, cancer without chemotherapy, and heart failure without powerful diuretics, and all of them with prayer. I recall how great we felt with each so-called advance in the treatment of pneumonia that included knowing the precise time during the course of pneumonia to open or close the windows. Imagine, treating a severe infection by the manipulation of windows!”
Jacob bit his lower lip. His eyes filled. “Don’t dare tell me I don’t appreciate modern therapeutics. Do you think I’ll ever forget standing helpless at the bedside of child after child dying with acute lymphocytic leukemia? Today, 85 percent plus, survive.
“I remember when you came to Brier, Warren, and the many problems that came with each highly touted drug. I know our intentions were honorable, but then I remember George Bernard Shaw: ‘The way to hell is paved with good intentions.’”
Jacob paused, and then continued, “The original therapeutic nihilists were early 19th-century French clinicians who decided that the therapies available then were worse than useless. Since their treatments included bleeding, purging, puking, and the use of toxic substances such as arsenic and mercury; they’re surely looking good now.”
“How can you equate what we do now with those outmoded practices?” asked Arnie Roth.
“Practices are deemed outmoded only in retrospect, Arnie. Just like us, they thought they were practicing medicine at the highest level.”
“Times have changed,” said Warren.
“You think so. Let me cite just a few statistics: Pharmaceutical drugs kill more people than die in traffic accidents each year in the United States. Studies in the late 90s show that more than two million hospitalized Americans suffered an adverse drug reaction in the study year and over one hundred thousand died as the result. That didn’t include one hundred thousand deaths from overdosage and errors in administration.”
“We know the horror stories, Jacob,” said Warren. “That’s why we have QA and pharmacy review committees.”
Jacob scanned the room. “Let me give you one more statistic, and then I’ll shut up. Public health researchers have concluded that adverse drug reactions are now the fourth leading cause of death in the United States after heart disease, cancer, and stroke.”
Jack looked around the silent room and smiled. “Therapeutic nihilists, line up on the right.”
Jacob stood beside his patient while the nurse brought in a syringe filled with clear fluid and prepared to inject it intravenously. “What’s that?”
“It’s Tobramycin, sir.”
“I wrote antibiotic orders for Gentamycin, not Tobramycin.”
She opened the chart. “Let me check the orders, Dr. Weizman.”
She flipped to the order sheets. “Dr. Spelling changed the order, sir.”
Why? Jacob thought. For this patient they’re equally effective and Gentamycin’s less expensive.
This was another minor modification of his orders by Zoe of late. H
e also noted that on several occasions, Zoe wrote orders for diagnostic tests that he’d already written.
Alteration of my orders, minor changes in dosing and writing for tests, he thought. She doesn’t trust me.
After they finished in the office later that day, Jacob sat before Zoe’s desk.
She read his discomfort. “What is it, Jacob?”
“I don’t mind if you change my orders, Zoe, especially if I make a mistake or if our patients will benefit, that is if you have good reason.”
Zoe paled. “I’m so sorry, Jacob. I was just trying too hard to help, and…” she hesitated, “to prove myself to you. Please forgive me.”
“You don’t have to prove anything to me, Zoe. You’re a great doc and I expect to benefit from your recent training. Maybe I’m getting too sensitive in my old age or perhaps I’ve practiced alone too long.”
“God no, Jacob. You’re the best. I’ll do better. I promise.”
Chapter Sixteen
Ahmad Kadir came from Nablus on the West Bank. His father Habib taught history and his mother Jasmine was a bank officer.
The family had originally lived in Gaza where Ahmad Kadir’s father thought his son had avoided the infectious militancy of the Palestinian youth that spread over the Gaza community in the years before its overt expression in the intifada.
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