Royal Pains

by D P Lyle

  After the introductions were made, Divya asked, “Is this a bad time?”

  “No worse than any other. Seems like there aren’t enough hours most days.”

  He picked up a pack of cigarettes, Marlboros, shook one up, and clenched it between his teeth. He lit it and took a deep drag, exhaling the smoke up and to his left. “I guess I shouldn’t be doing this in front of you.”

  “You shouldn’t be doing it all,” Divya said.

  “Yeah, I know. But it keeps me calm, and from chewing heads off. Even when they deserve it.”

  “I saw the article on you in Forbes,” Evan said. “I really liked the part about how you made your first billion.”

  Divya frowned Evan’s way, but he seemed to ignore it.

  “That was a long time ago now,” Nathan said. “I was young and stupid then.”

  “A billion dollars by age twenty-five seems smart to me.”

  “Or lucky,” Nathan said.

  “I’ve looked over your medical history and all of your recent tests,” Divya said. “I just have a few questions for you.”

  Nathan raised the index finger of one hand toward her and then with the other pressed the Bluetooth device.

  “No, I did not say you were fired,” Nathan said. “But if you don’t get this goddamn report to the folks in Zürich in the next couple of hours, I might reconsider.” He listened for a minute and then said, “I don’t want excuses, I just want it done. Now.”

  “See?” Evan whispered to Divya. “That’s how you run a business. Take charge. No prisoners.”

  Divya looked at him but didn’t respond.

  Nathan continued his conversation. “Put Bridget on.” He stubbed his cigarette out in an ashtray that held the remnants of a dozen others. “What kind of questions?”

  Divya stared at him for a beat before she realized he was talking to her. “About your current medical status.”

  “Didn’t Todd send you all of that?” He gave a quick glance toward Todd, who had taken a position to his left.

  Todd started to say something, but Divya jumped in. “Yes. The records were very thorough and gave me what I needed about your past, but I have a few questions about what is going on now.”

  “And why is that?”

  His response surprised her and it must have shown on her face, as Nathan raised a finger and waggled it. She realized he was back to his phone conversation.

  “I don’t care if she’s talking to the goddamned president, you tell her to get her ass on the phone right now.” He pulled another cigarette from the pack and lit it. “Ask away.” When Divya didn’t respond, he said, “That was for you.”

  Divya retrieved her pen from her purse and flipped open her notebook. “Have you had any chest pain or shortness of breath?” Divya asked.

  “No chest pain. Yes, shortness of breath.”

  “When? With exercise or does it happen at rest?”

  “When I’m riding my bike or jogging or sometimes even just climbing the stairs in the house.”

  “How long have you had this symptom?”

  “Twenty-four hours?”

  Divya began noting that in the chart, but as he continued, she realized he was back to business.

  This was getting confusing.

  “You’re telling me that you need another day to finish something you’ve been working on for a month? Is that what you’re telling me, Bridget?” He listened for maybe two minutes and then said, “How about this? If you don’t get that report out within two hours, you’ll be out walking Wall Street. You understand?” He took a long drag from his cigarette and exhaled smoke as he spoke. “Maybe six months.”

  Divya sat there waiting. Nathan opened one hand toward her.

  “The shortness of breath,” he said. “It’s been going on about six months.”

  Divya made a note and then asked, “Any coughing?”

  He shook his head. “That’s what I’m telling you. I don’t care what it takes—get the report done and get it done now.”

  It went that way for the next twenty minutes. Nathan spoke with Bridget and someone named Phil and back to Bridget and maybe a couple of other people. She couldn’t keep up with all the players and could never tell when Nathan was talking to her or to someone who she presumed was over at his Wall Street office. Ultimately, she did get the information she needed.

  Nathan finally agreed to turn his phone over to Todd long enough for Divya to give him a quick physical exam, run an EKG, and draw some blood.

  “I’m going to change your blood pressure medications,” Divya said. “And we’ve got to develop a plan for you to stop smoking.”

  Nathan nodded as he seated the Bluetooth device into his ear.

  “I want you to try either the patches or the gum first,” Divya said. “Many people find either of those to be quite successful. If not, there are other medications we can consider.”

  “What is going on there today?” Nathan said.

  He was back to his call. She wasn’t sure he had heard what she had said and was waiting for another break in his call to repeat it, but Nathan lit another cigarette, stood, and walked toward the edge of the patio, facing out toward the ocean. “Bridget, you’re responsible for all this. That’s why you’re in charge there. Remember when I hired you? Didn’t I tell you that you had my backing?” He listened for a few seconds. “If he’s not doing his job, fire him.” He walked along the edge of the patio and was soon far enough away that Divya could no longer hear what he was saying.

  The visit was obviously over.

  “As you can tell, he works a little too hard,” Todd said as he led them back into the house. “I’ll have his prescription filled and will pick up some of the patches and gum and let him decide which he wants to use.”

  “Make sure he does,” Divya said. “His blood pressure is too high and they don’t call cigarettes coffin nails by accident.”

  Todd laughed. “You’re quite charming. It has been a pleasure meeting both of you.”

  They had reached the front door and Todd pulled it open.

  “I’ll call as soon as I get the lab results,” Divya said. “And to make a follow-up appointment to see how his blood pressure responds to the new medication.”

  Once they were back in the SUV, Evan said, “Easy to see how he made all his money. Talking about large and in charge. Bet he made a few million while we were here.”

  “He might even get to enjoy it,” Divya said. “If his blood pressure and bad habits don’t kill him first.”

  Chapter 19

  The ambulance made a wide turn and backed into the receiving ramp, its red lights flashing, its siren now dead, its backup beeper sounding a rhythmic electronic warning. I had followed it from the scene. As I pulled into an empty space, I saw Jill and two nurses waiting near the pneumatic sliding doors that led into the emergency department. The ambulance’s rear doors flew open and one of the medics jumped out. The nurses helped him ease the stretcher to the pavement and then through the entry doors.

  I trailed them into the major-trauma room, where Dr. Andrew Weinberg, the ER doc on duty, waited. A nurse was setting up a surgical tray.

  “Hank,” Weinberg said. “What’s the story here?”

  I quickly ran through what had happened and what I had done in the field, while Weinberg inspected my makeshift dressing. He poked at it and then shook his head.

  “I’ve never seen anything quite like this.”

  “Neither have I,” I said. “Best I could do under the circumstances.”

  “Clever.” He ran a gloved finger around the edge of the rubber patch, checking its seal. “Looks like it’s working.” He turned to one of the nurses. “Let’s get blood for a type and cross-match, CBC, electrolytes, and then get X-ray down here for a stat chest film.”

  “BP is eighty-eight over fifty, pulse one thirty, and respirations thirty-two,” one of the nurses said. “O2 sat is eightysix.”

  “Put him on a one hundred percent rebreather,” Wein
berg said. He then asked me, “Any other injuries?”

  “Not that I saw. His abdominal and neurological exams were normal.”

  An X-ray tech rolled a portable machine into the room and began setting up to do the chest X-ray. I walked out to the nurses’ station, leaving Weinberg with his new patient. Jill was leaning against the counter, talking on her cell phone.

  “All right, Mrs. Cooper,” she said. “The doctors are with him now.” She listened for a minute and then said, “Don’t rush and get yourself in an accident. I’ll see you when you get here.” She hung up the phone.

  “His wife?” I asked.

  She nodded. “How’s he doing?”

  “Hurting but otherwise okay.”

  She took a couple steps to the left so she could see into the trauma room. “How exactly did this happen?”

  “He said he wasn’t paying attention and was going pretty fast. When he looked up and saw the road crew working on the bridge, he jerked his bike to the left and lost control. Probably hit the front brake too hard. The bike flipped and he was thrown against the abutment. Landed on a four-foot-long piece of rebar.”

  “Bizarre.”

  “That hardly does it justice.”

  The X-ray tech completed taking the films, backed his machine out of the room, and parked it against the wall. He grabbed the film cassettes, settled them under one arm, and scurried toward radiology.

  Trauma surgeon Dr. Stephen Holmes nodded to Jill as he walked by and into the trauma room.

  “Looks like they’ve got everything in control here,” Jill said. “Can I buy you a cup of coffee?”

  “Cafeteria coffee?”

  “Unless you’ve installed a cappuccino machine in your Saab.”

  “Not yet, but I’ll look into it.”

  We walked downstairs to the cafeteria and grabbed some coffee; then Jill walked me out to my car.

  “What does the rest of your day look like?” she asked.

  “I was supposed to be doing follow-up visits when this happened. Divya, being the trouper that she is, stepped in for me. I was thinking I would head home and go for a run.”

  “How about dinner tonight?”

  “You buying?”

  She laughed. “Better than that. I’m cooking.”

  “How could I say no to that? I’ll bring the wine.”

  “Make it around seven.”

  When I got home, I tugged on red jogging shorts, a white T-shirt, and my well-worn running shoes. Evan wasn’t there, so I walked over to the tennis courts and found him volleying with the automatic ball machine.

  “Want to go for a run?”

  “I’d rather hit tennis balls. It’s too hot to run.”

  “I’ll be having dinner at Jill’s tonight. What are you up to?”

  “As soon as Divya gets back, I’ll get those new accounts up to date and then I’m going to see Rachel Fleming. She has some updated sketches for me.”

  “Van girl? Try not to injure her again.”

  “It was an accident.”

  “My point exactly.”

  “Funny.”

  “And we still don’t need a van.”

  “We’ll see.”

  Evan was like a bulldog with a new chew toy. He had this van idea in his teeth and wasn’t going to let go. I admired his focus even if it was misplaced. Relentless came to mind. As did committed and persistent. And let’s not forget annoying.

  I left Evan to his ball machine and headed toward the beach road, where I turned east and ran along the shoulder. It felt good and I soon found my stride. There’s nothing quite like a peaceful run at the end of a stressful day. Just as I was turning around and heading back home, I realized that I had not slept much the night before. Maybe a shorter run would’ve made more sense. Too late now.

  I came up behind two ladies power walking, each with hand weights and exaggerated strides. As I pulled up next to them, I recognized them. Rose Maher and Amanda Brody, two of my patients. Rose owned several local boutiques and Amanda ran a thriving shipping business with her husband. I knew that they were both fitness freaks. Vegetarians and gym rats. Heavily into yoga and yogurt.

  I slowed to match their pace.

  “Dr. Lawson,” Rose said. “Good to see you out running.”

  “I didn’t think you ever had the time to do that,” Amanda said.

  “How is everything?” I asked.

  “Never better,” Rose said. “Amanda and I are on a new diet program and we’ve each lost over ten pounds.”

  “In just the last couple weeks,” Amanda added.

  “That’s a lot for two people who didn’t need to lose weight in the first place.”

  “You know us,” Rose said. “The vanity twins?”

  Both of them laughed.

  “How did you do it?” I asked. “More exercise and less carbs?”

  “We’re seeing a wonderful nutritionist,” Rose said. “Julian Morelli. Do you know him?”

  “No, but I’ve heard of him.”

  “Apparently, he’s been around for years, but we just discovered him,” Amanda said. “He practiced in the city before he moved to the Hamptons. A couple of years ago.” She looked at Rose. “Isn’t that about right?”

  “Exactly,” Rose said. “He’s got this new program that makes weight loss simple.”

  “Simple doesn’t always work,” I said.

  “It does this time,” Amanda said. “He’s got us on more fiber and more exercise as well as his own special vitamins and herbs.”

  “What vitamins and herbs?”

  “I’m not sure, but they definitely work. I’ve never felt better and the pounds are just falling away.” She lifted her shirt and pinched the very small amount of flesh around her midsection, proving that she didn’t really need to lose weight, see Julian Morelli, or swallow a bunch of mystery meds.

  “So you’re not really sure what he’s giving you?” I asked.

  Rose laughed. “I don’t really care as long as it works.”

  Chapter 20

  By the time I finished my postrun shower, Divya had arrived. She and Evan sat at the table, working quietly alongside each other, neither sniping at the other. Amazing.

  “Sorry about piling all that work on you today,” I said.

  “Not a problem,” Divya said. “How is the cyclist doing?”

  “Last I heard, very well.” I grabbed a bottle of water from the fridge. “The two new-patient visits go well?”

  Before she could answer, Evan jumped in. “I’ll say. I got to meet Nathan Zimmer.”

  I looked at Divya. “Evan went with you?”

  “Unfortunately. He has some new scheme where the CFO meets all our patients.”

  I took a swig of water. “I don’t see much good coming out of that.”

  “You’re about as funny as Divya.”

  I shrugged. “So why is meeting Nathan Zimmer such a big deal?”

  He gave an exasperated sigh. “He’s only the hottest dude on Wall Street. The guy is worth billions. Many billions. More billions than Boris.”

  “Exactly how many billions does Boris have?”

  “I don’t know, but Nathan Zimmer has more.”

  “I believe Hank is more interested in his health than his portfolio,” Divya said.

  “And?” I asked. “How is his health?”

  “Blood pressure too high and he chain-smokes. I upgraded his blood pressure meds and told him to try either the nicotine patches or gum.”

  “Sounds good.”

  Evan picked up a piece of paper and waved it toward us. “The contract he signed is even better. He’s paying us twice our normal fee.”

  “Why is that?”

  “He demanded it.”

  “He demanded to pay more? That doesn’t sound like a financial genius.”

  “He said you get what you pay for and he wanted to make sure he paid top dollar.” Evan slid the contract into his briefcase. “Someday all our patients will pay top dollar.”

&nbs
p; “I doubt it.”

  “If you leave everything to me,” Evan said, “money will be the least of your problems.”

  “I didn’t realize that spending an hour with Mr. Wall Street would rub off on you,” Divya said. “Simply being around the man has given you the Midas touch? Is that how it works?”

  “It’s not what you know—it’s who you know.”

  Divya raised an eyebrow. “I must have missed something. Exactly when did you and Mr. Zimmer become such good buddies?”

  “We will be. After I turn on the old Evan charm.”

  Divya leaned back and crossed her arms over her chest. “Modesty is such an overrated virtue.”

  Things were now back to normal.

  “As much as I enjoy listening to this argument, I have plans.” I picked up a bottle of wine from the kitchen counter and headed toward the door. “Don’t wait up for me.”

  Jill’s front door stood open to capture the evening breeze. I rapped my knuckles on the frame. She yelled for me to come in. I found her standing at the stove, glass of wine in one hand, a wooden spoon in the other.

  “Smells wonderful. What is it?”

  “Creamed corn. One of the things my mom used to make.” She raised her wineglass. “I just poured the last of the bottle, so you might want to open that.” She aimed the spoon at the wine bottle I held.

  “Anything I can do to help?”

  “Got it under control. I made that marinated chicken you like, green beans with almonds, and the corn. Too much of everything, of course, so I hope you brought an appetite.”

  “Starving.”

  I opened the wine, poured a glass, and sat at the table. Jill turned off the burner, saying that it needed to sit for a few minutes. She sat across from me.

  “I called the hospital a few minutes ago,” she said. “Mr. Cooper is already beginning to wake up. His nurse said they would have the ET tube out shortly.”