The inconceivable message confirmed, Rob clicked off the Atlantic Aviation call and switched back to Natalie.
“Natalie, Ahmed got on a plane to Cairo at nine this morning …” Rob hesitated a beat … “with Alex.”
“Oh, my God, Rob! Are you sure?”
“Honey, I called. I got them to give me the information. Even though they should not have. Confidentiality—”
“Rob, please. We have to tell Nicole. My God! What is she going to do? I’m sure she doesn’t know anything about this. She would have told me if Alex was going to Egypt with Ahmed. I just can’t believe this!”
Rob agreed. Natalie and Nicole were close. Nicole certainly would have told her sister. If only they had gone ahead with his birthday dinner. But he’d been grumpy and tired and, yes, depressed so he’d asked Natalie to cancel. Shit, he’d been so immersed in his business disaster that he’d not paid attention to the troubles of others.
“Where are you?” Natalie was asking.
“I’m closing up the Philly office.”
“Can you come here? Now? I mean, to wherever Nicole is? She’s probably at the hospital? Maybe her office?”
“I can’t believe …”
“Rob, this is going to destroy her. Alex is her world. Do you think Ahmed has actually taken him?”
“I am leaving now—traffic should be light on the Schuylkill. Call Nicole. Call me back. Tell me where you’ll be.”
“I love you, Rob.”
CHAPTER FOURTEEN
NICOLE FELT A slight weight lift as she thought of Ahmed and Alex at home having breakfast. Ahmed, always protective of his “morning time,” enjoying breakfast in the doctors’ dining room. Nice to want to spend more dad-time with Alex. Alex would be proud to have his dad drop him off at school. She did wonder about Ahmed’s motivation. Was it to make up to Alex for the unpleasant tension that had pervaded their home over the last week? Or could it be a token olive branch meant for her? Muslim men did not outwardly show emotion, and this small change in routine could be intended to signal her that he wanted to make amends. Would she accept?
Can’t think about that now. Plenty of time later. Now, I have to get through my day. I’ll get coffee and a chocolate doughnut in the hospital lobby, take it to the record room, dictate my charts—with my mouth full—get Admin off my butt. Nicole had four in-patients; she’d make rounds on them and have plenty of time to go back to the office for an hour of paperwork catch-up; then back to the hospital for a ten o’clock procedure. She and Ahmed usually coordinated their operating schedule and cross-rounded on each other’s patients, but that had come to a stop since he’d hit her, effectively ending communication. Was he on the surgical calendar today? She didn’t even know. Couldn’t have had an early patient—he’d stayed home with Alex …
By the time Nicole pulled into the doctors’ parking lot, she had gone over each step in the orbital reconstructive procedure. Orbitozygomatic fractures involved the articulation of the zygomatic bone with the frontal and temporal and sphenoid bones. Ironically, Ahmed was particularly good at these, and she wished for the old days when she’d discuss options with him. Maybe she’d call him from the record room when she finished rounds. A professional call. Doctor to doctor. Not spouse to spouse.
But she had not tried to reach him. Dictating her notes and signing her charts took longer than she planned, and if she was to get in some office-time, she’d have to jump in her car and head there right away. Hospital to office was only five minutes door to door, and if she hurried, she’d have an hour of uninterrupted time.
“Dr. Nelson, we didn’t expect you in this morning. Thought you’d go straight to the hospital.” Nicole’s secretary hustled to the coffee machine to pour her boss’ habitual cup of black coffee.
“I left the house early today,” Nicole said. “Got a few things done at the hospital. Don’t have to be back until my ten o’clock case.”
“That poor woman. I hope you can fix her face. It just looks so … collapsed.”
“I’ll do my best,” Nicole said, not wanting the conversation to veer toward domestic violence—the devastation it had caused this woman.
“If anyone can fix her, you can.” When her cheery secretary brought her coffee, Nicole almost refused. She’d had her two cups already. Too much caffeine would make her hand shake. Imperceptible to the eye, but important when using the delicate instruments of plastic surgery.
She accepted the coffee, determined to limit intake to a couple of sips. “Come get me at nine forty-five?” she said, closing her office door behind her.
She didn’t hear the casual comment, “Quiet in here today with Dr. Masud out.”
Nicole plunged into the stack of patient files on her desk. She hated paperwork and was relieved to hear the knock on her door. “Time to go, Dr. Nelson. The hospital called. Operating schedule’s running on time. They’re prepping your patient now.”
“Here.” Nicole handed off the pile of charts she’d completed. “That will keep our billing clerks busy for a while. Bet my husband isn’t up to date on his discharges.”
“Nope,” said the plump, amiable woman. “Nothing new there.” The staff often joked about Ahmed’s legion excuses for tardy charts.
Nicole smiled. Ahmed was impossible to corral when it came to documentation. She’d tried to tell him that accurate documentation was the bedrock of malpractice defense, but try to tell an Arabic man anything …
“Oh, I forgot to tell you,” her secretary called as Nicole hurried out the door. “The surgical department at Penn wanted your bio for some sort of recognition event they’re planning.”
Just what I need, Nicole thought. Something else to set Ahmed off. Will somebody please bestow an honor on my husband?
* * *
By the time Nicole scrubbed and gowned, her patient had been lightly sedated, but awake enough for Nicole to review for the patient—and for the record—her operative plan, the dangers, the possible adverse outcomes. How she would be manipulating the bones that provided the framework to the face, trying to avoid injury to the nerves and the blood vessels. She’d be using metal plates, mesh, screws, and bone cement.
She’d already reviewed this with her—the patient had signed all the surgical consent forms—but Nicole wanted to talk her through it one last time for comprehension. And she had the entire operating room staff as her witness. This was an excellent precaution in today’s world of malpractice claims. She wished that her husband took the time to do this. He considered it a waste of everybody’s time. How many lawsuits would it take to change his attitude? And what about the backlash of excess malpractice suits on their partnership?
When the anesthesiologist gave the okay, Nicole glanced at the clock. Ten twenty a.m.
“How long do you think the procedure will take, Nicole?” he asked.
“I’m hoping to be finished in six hours. Hope you’ve all had your nourishment.”
“Guess I can hold out ’til four o’clock,” he said as Nicole made the first cut.
Nicole explained her surgical strategy as she went along, telling the junior staff surgeon what he needed to do. As usual, her scrub nurse all but anticipated her needs and had the instruments in her hands before she asked for them. The circulating nurse was new to the hospital, but she seemed bright and cooperative. As soon as the patient’s bones were exposed, the team went about fixing the zygomatic arch that had snapped in two, proceeded to reposition and stabilize the eyeball socket, then planned to tackle the cracked facial sinuses. Luckily, there’d been minimal disruption of the blood supply, so the tissue, although misplaced in the facial space, was pink and healthy. Once Nicole established vascular adequacy, she sent word to the microvascular surgeon that he’d not be needed. Good. Vascular surgery could take a long time, and Nicole wanted to finish this procedure sooner rather than later.
CHAPTER FIFTEEN
NATALIE GOT NICOLE’S answering machine on her cell phone. No surprise there. Her sister would have he
r phone turned off. “Call me on my cell right away,” was her message. “It’s very important,” she added.
Next, she called Nicole’s office. Dr. Nelson was at the hospital. Natalie asked for her number there.
“She’s in surgery now, Dr. Nelson. Can I take a message?”
“It’s important that I talk to her. Now!”
“Is everything okay, Dr. Nelson?”
Natalie knew she sounded frantic. Nicole needed to know that her husband had taken Alex. She had to know now.
“Is Dr. Masud there?” Natalie had no idea why she’d asked this inane question. He was on a plane to Cairo!
“No. He canceled all his appointments today. Took the day off. Rather suddenly. I was just explaining to one of his post-op patients—”
“Give me the OR number. I must speak to her.” Natalie could feel her heart pounding.
“I can give you the number, but they have a very strict rule over there. No communication with the surgeon during a procedure. No matter what—”
“Did you see Nicole this morning? Did she come into the office?”
“Yes, she did, Dr. Nelson. What’s wrong? Did something happen to Dr. Masud? Is he ill? Is that why he’s not here?”
“Was my sister okay? I mean—”
“Yes, perfectly normal day—”
Natalie, still standing by her desk, cut the connection and speeddialed Rob.
“Did you find her?”
“She’s at the hospital. In surgery. I haven’t tried to get through yet. They don’t interrupt the surgeon, but—”
“I’ll meet you there. It’ll take you twenty minutes. I’m fifteen minutes away. When you get there, call me immediately. We’ll figure this out.”
We’ll figure this out. Rob, you are so strong. But Ahmed left the country. With Alex.
Her office door flung open and her boss roared, “Natalie, what in hell’s going on? You barge into my office. Take off like a bat outta—like I said something to hurt your feelings. And here you are cringing by your desk, wringing the daylights out of that phone.”
“God, Barney. What you said in there. In your office. About seeing my brother-in-law and my nephew. Barney, what you saw was Ahmed taking Alex.” Natalie set down the phone and reached backward, opening the closet, grabbing her coat.
“Taking. What do you mean?”
“I don’t think Nicole knows—”
“Oh shit,” Barney said. “He did look a little tense. If only I’d approached him. He was with a big man—could’ve been Middle Eastern. And the little boy looked … scared, I guess.”
“I have to find Nicole.”
“What can I do?” Barney offered.
Natalie wanted to scream. “Nothing. Just let me go.” But the disciplined corporate executive prevailed.
“Barney, I am so sorry. I have to go to my sister. But we have a problem. The company. We have a problem with Zomera. That’s what I came to tell you.”
“Zomera?” Barney repeated.
Yes, Zomera, the miracle drug. The billion-dollar moneymaker.
“Please, I have to go. Talk to Dan Booker.”
“Something to do with medical?”
Something to do with medical to a pharmaceutical CEO can mean the kiss of death.
“Dan will brief you. But don’t let him or Regulatory do anything without letting me know. Lots of harm can be done with a premature, half-assed approach.”
“Goddamn it, Natalie, you can’t run out on me know. If there’s a problem with Zomera, you have to deal with it—”
“Agreed, Barney. But not now. Urgent personal situation—” Natalie grabbed her purse and sped out of her office leaving Barney to yell after her, “Come back here—”
* * *
Nicole and Rob got to the doctors’ entrance of Bryn Mawr Hospital at the same time, communicating their arrival and meet point by cell phone. Neither had a staff ID, but a friendly middle-aged doctor seemed to recognize Natalie—thinking she was Nicole, no doubt—and let them enter. From there, they took the elevator to the operating room. Natalie had not been in an operating suite since her med school days. She tried to remember the protocol. Could she simply go through the doors, find the female lockers, change into scrubs, don a cap and mask, check the schedule on the board, find Nicole’s room, walk in, and … what? Find her sister up to her elbows in fragile facial tissue and mention that her husband had left for Egypt with her five-year-old son?
“Rob, I don’t know what to do,” she said as they stood facing the “Restricted” door.
“Lots of security cameras,” he said, his head swiveling to the junction of walls and ceiling.
“Can I help you?” A trim, fortyish woman in scrubs, a surgical cap, and a mask hanging around her neck interrupted. Then she did a double take. “Dr. Nelson? What are you …”
“Yes, I am Dr. Nelson,” Natalie said. “Natalie Nelson. I know I look a lot like my sister. I need to talk to her and—”
“Impossible. I’m the head OR nurse. We have a visitor waiting room. Very comfortable. You can wait there. We will send her in the minute she closes her case.”
“Since I’m a doctor, can I scrub and go into the operating room? I have something important to tell her. Something she’ll want to know. Right away.”
“I’m sorry, Dr. Nelson. We have a very strict rule. No interruptions of any kind during a procedure. Unless you have critical medical information about the patient.”
Natalie glanced up at the schedule. Room 8. Tempted to fake it, she shook her head. “Personal,” she said. “About her son.”
“I see,” the charge nurse said. “You need to talk to Dr. Templeton. He’s chief of surgery and he’s in his office. Follow me.”
The nurse led Natalie and Rob down a long corridor to the office at the end. Without knocking, she walked inside, past the cute young secretary, saying she needed to see the boss, and kept going.
Harold Templeton repeated the double take, though he and Natalie had met at social affairs—memorably, maybe, given that his top plastic surgeon had an identical twin—also a doctor.
“This is Dr. Nelson, our Dr. Nelson’s sister,” the nurse announced. “And I’m sorry …” She turned toward Rob.
“Natalie Nelson and my husband, Rob Johnson,” Natalie said.
“Please have a seat.” Templeton gestured to an inviting sofa opposite his desk chair. “What can I do for you?”
The nurse nodded and excused herself.
“Dr. Templeton,” Natalie said, she and Rob still standing. “We’re here because we have information of critical importance for Nicole. She needs to know about this, and she needs to know now.”
“Please,” said the rotund, gray-haired man with rectangular eyeglass frames. “Call me Harold. What is it that can’t wait until after Nicole’s finished closing?”
“Nicole has a five-year-old son …” Natalie hesitated. How much should she disclose? What if this was some big misunderstanding? A planned trip. Ahmed taking Alex on a plane ride. Perhaps there could be a reasonable explanation. Both she and Nicole had been very busy recently. They didn’t tell each other everything.
“Yes. She and Ahmed have a son. Alex. Hear about him all the time. They bring him in on weekends sometimes when Mom and Dad alternate taking care of him and rounding on their patients. Great little chap.” Templeton stopped, stood. “Has something happened to the child?”
“We’re not sure,” Rob said.
Templeton grabbed the day’s OR schedule off his desk, inspected it. “Hmm. Ahmed canceled his case. Called in last night. Gave no reason. A Mohs surgery reconstruction. We’re waiting for him to reschedule tomorrow. Still have the patient in house. Wasted hospital day. The bean counters won’t be happy.”
Canceled his case? What did that mean? But expected to reschedule tomorrow? Barney Black could have been mistaken, but not Rob’s call to Atlantic Aviation. Ahmed had boarded that plane with Alex.
“What’s going on?” Templeton looked from
Natalie to Rob. Reconstructive facial surgery was a gold mine for Bryn Mawr Hospital. Gossip about instability of his two qualified surgeons would not be healthy.
“Ahmed was seen taking off in a private plane this morning with Alex,” Natalie said. “I think Nicole has no idea about this.”
“What?” Templeton set down the schedule, removed his glasses, massaged his eyes.
“So you didn’t know he was leaving town?” Rob asked. “And you expect him back tomorrow? Not likely if he’s on a plane heading to Egypt.”
“It’s urgent that we talk to Nicole,” Natalie insisted. “She needs to know that her husband left the country with their child. Obviously. She—”
“I ignore the usual hospital scuttlebutt,” Templeton said. “But word’s going around that all’s not paradise in the Masud-Nelson partnership—professional or personal.” He replaced his glasses, picked up the schedule, and said, “Shit. She’s doing an orbitozygomatic fracture repair. She won’t be out of there for hours.”
“She needs to know,” Natalie insisted. “To take whatever measures she can, to—”
“I’ll go in. Check on the procedure. Estimate how much time—see if we have someone to step in so she can get out,” Templeton said. Again, he pointed to the sofa. “Sit here. Use my phone. My computer. I’ll be back as soon as I can.”
Natalie sat in his chair. For an instant, she thought of her mother, chief of surgery, before the fall that ended her surgical career and paved the way for her illustrious pharmaceutical research career—the model for Natalie’s own professional presence. For another minisecond, she remembered the fix she’d be in back at Keystone Pharma. She’d walked out during a critical challenge to their blockbuster drug. What would her mother have done?
“What about calling Mike?” Rob was saying as Natalie willed herself back to the present. “We need to know our legal options here.”
“Yes.” Natalie started to call her brother at his law firm, hesitating to ask Rob, “Would Nicole want us to call him? She’s such a private, independent, stubborn person. What would she want me to do?” She answered her own question and Rob nodded his agreement.
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