He took a couple of sips and decided that perhaps this was a bit better than the usual offering brewed in the lounge’s coffee maker. As he sat down, Ann strolled in, turned up her nose at the coffee pot, and took a seat on the sofa next to Caden. She sat closer than usual. Was she sending a signal?
“Doing a case this morning?” Caden asked.
Ann ran the fingers of her hand through her short blond hair and nodded. “Ulcer with perforation of the duodenum,” she said, referring to the part of the small intestine just beyond the stomach. “He came in last night. I was able to close the hole endoscopically.”
“Patient doing okay?”
“Yes, but before he’s discharged I need to have a talk with him. He’d been having belly pain going through to his back, so he treated it by gobbling ibuprofen like they were jellybeans. And, of course, that worsened his pain and eventually led to the ulcer perforating.”
“Didn’t he realize—”
Ann shook her head. “I know what you’re going to ask. It never crossed his mind he could have an ulcer. ‘I’m too busy for one,’ he said.”
Caden sipped more coffee. Either he was getting used to it, or this batch wasn’t so bad. Maybe the hospital had so many complaints they’d changed suppliers.
Ann scooted even closer to him. Now they were shoulder to shoulder—not like colleagues. More like two people in a relationship. Caden wondered how best to extricate himself from what he feared was coming.
“I want to thank you again for being there to listen to me after my aneurysm patient died. And I hope I didn’t—”
Caden stood, too uncomfortable to remain sitting beside her. He headed to the coffee pot, putting some distance between them. “Don’t worry about it, Ann. You needed comfort. I was the closest person you could lean on.”
“Actually,” she said, “You weren’t just the closest person. You were the right person.”
With that, Ann jumped to her feet and hurried out of the lounge. He ran their conversation through his head but couldn’t decide what it meant. Was Ann making a play for him? Or was she trying to divert his attention? And in either case, why?
Beth found when she walked into the office that, although she was the newest employee, she was looked upon as the person to answer all the questions. After all, she was the wife of “the boss.”
“What happened over the weekend?” asked Donna, the receptionist.
“There was a fire in the records room. Thank goodness we had switched over to electronic medical records, so only the charts that we haven’t digitized were affected. And those were primarily the ones of patients that haven’t been seen here since right after the practice opened.”
“So, our current records aren’t affected?” Mona, the other receptionist, rolled her chair closer.
“If you need a record, check your computer. It should be stored in the Cloud.” Beth looked at the others to make certain they understood. “And in case any of you are wondering, there are safeguards in place to keep hackers from accessing that information.” Which is why it makes no sense that our older records were targeted.
“What about the fire damage in that room? Is the computer still working?” Mona asked. “Dr. Russell will be in the office this afternoon.”
“Dr. Sparling is in surgery all day, but he’s got people coming in tomorrow,” Gary said.
“The computer is working fine, so you’ll be able to call up charts and send electronic prescriptions. Dr. Taggart will talk with our insurance adjustor today about getting the damage repaired.”
“So, it will be business as usual,” Mona said.
“What about the men who were here last week?” Gary asked.
“They’re gone, I guess,” Beth said. She hoped. I wonder when they’re going to wind up their investigation.
Caden was halfway through his morning when Beth tapped on the examining room door. “There’s a phone call for you, Dr. Taggart.”
He looked up from examining the man who lay on the exam table. “Can you take a message?”
“I believe it’s urgent.”
Caden frowned. “I’ll be there in a moment.” He turned back to the man. “You can sit up, button your shirt and pants, and make yourself comfortable. I don’t think this is anything serious. Let me take this call, and I’ll be back to talk about it.”
At his desk, Caden punched the blinking button. “Dr. Taggart.”
“This is Agent Neilson. I wanted you to know I contacted Detective Caruso this morning. Harwell and I are meeting with him tomorrow afternoon to fill him in. He’s agreed to keep this under his hat for a few more days.”
“Good,” Caden said.
“I’ve met your deadline to liaise with the police, and now I want to make sure you’re not going to blow my cover.”
“When and where is this meeting scheduled? I want to be there. And my attorney will probably want to come as well.”
Neilson stammered for a moment. “I don’t know—”
“Look. You guys walked into my office and took over. I lied to my staff to give you a cover story. Now you’re about to wind down the investigation, but in the meantime, there have been attempts to kill me. I think I deserve to hear what you have to say. And I believe Mr. Sewell does, as well.”
There was silence on the other end of the line for almost a full minute. Finally, the agent said, “Let me check with the detective. I’ll call back later.”
When Caden came out of his office, Beth was in the hall outside. “That sounded like Neilson. Is something up?”
“I think we’re nearing the end of this.” He paused with one hand on the knob of the exam room door. “At least, I hope we are.”
Since he’d been on his own, Henry Taggart’s morning meal generally consisted of an English muffin plus coffee or juice—at least as much of it as he could force down. On Tuesday morning, he couldn’t even tolerate the muffin. He sat at his kitchen table with a half-cup of cold coffee in front of him, waiting for the phone to ring. This morning the hands on the clock seemed stuck in quicksand, moving so slowly he wondered if it might need a new battery.
He thought back to the times when he and Nancy took advantage of the rare days when he didn’t have early morning surgery. They’d enjoy waffles and sausage together. Then they’d have a leisurely second cup of coffee before he had to leave for the office. On those days, time seemed to fly by. Now he was alone.
Surely the biopsy had been read by now. Henry had been practicing surgery long enough to know how long it took for the pathologist to review biopsy specimens after they were prepared. Once the dictated report was transcribed, the pathologist read and initialed each page to be certain there were no errors. Eventually the ordering doctor would receive the report. Total elapsed time: two or three days, but less if the pathologist felt what he found was important enough for a phone call.
Henry figured that, since he was a physician, the pathologist might pick up the phone and call Dr. Ross with his report—unless there was a problem. But what if there were a problem? Was that what was taking so long?
His mind conjured up all sorts of scenarios. How many times had a radiologist or a pathologist told him they needed more views or additional specimens to give a firm opinion? Plus, this was cancer, not a diagnosis to be given lightly. What if Dr. Ross had to repeat the endoscopy and biopsies? What if this turned out to be some rare type of tumor that would prove to be beyond the point of treatment? What if—
Henry’s phone rang. Not his landline, but his cell phone. Only a handful of people had this number, and one of them was Bradley Ross. Oh, please, let it be him. “Dr. Taggart.”
“Doctor, this is Brad Ross. I hope I’m not calling too early.”
“No, I’ve been up for quite a while. I presume you have news for me.”
“Well, it’s not what I hoped for, although it’s sort of what we expected,” Ross said. “But now we can move forward and lick this thing.”
He hadn’t heard the dreaded word “canc
er” yet, but Henry knew what Ross was saying. There was no “this is terrible.” Instead, Ross was saying that they—as a team—would “move forward and lick this thing.”
Ross continued. “I was hoping we’d get lucky and the biopsy would show a benign neuroendocrine tumor, but this one’s an adenocarcinoma. It’s definitely malignant.”
“Well, now I know for certain.”
“I’ll send a note to your internist, of course. And I notice that you originally saw Dr. Gershwin about the tumor. Do you want a copy of the report to go to him as well?”
Henry knew the question Ross was really asking was, “Will he be in charge of your treatment?”
Gershwin’s approach had been, “Yes, you have a potentially fatal disease. We’ll confirm it, then make you as comfortable as possible.” By contrast, the attitude Ross had shown was that he, in partnership with his patient, would “move forward and lick this thing.” And that was what Henry decided to do.
“You can send him a copy of your report, but if you don’t mind, Dr. Ross, I want you to direct my treatment.”
“I’ll be pleased to do so. As a surgeon, I’m sure you realize the first step is to operate. And the sooner the better.”
“Let’s talk about that,” Henry said. “Because I have someone in mind to do the procedure.”
19
Since Beth started working at the office, their dinners were sometimes catch-as-catch-can affairs, and Caden accepted the trade-off. Tuesday evening, with Beth seated across their kitchen table from him, he chewed on a cold sandwich.
Beth had made a salad for herself, but after a few bites she put down her fork. “I’m sorry you couldn’t be included in the meeting today.”
Caden shrugged his shoulders. He drank a bit of iced tea, then wiped his lips with a napkin. “When Caruso called today, he said that since this was still an active matter he didn’t want me there. He assured me I wasn’t a suspect, but I am a witness.”
“And your attorney?”
“I called to tell him. He said he’d stay in touch with Caruso, but that was okay for now.” Caden picked up his sandwich but didn’t take a bite. “Caruso told me that Neilson showed up by himself. He said Harwell had something else to do. I guess he didn’t want to tip his hand about that part of the investigation.”
“Did you get any sense that the police know who was behind the gunshots . . . ” She shook her head and didn’t finish the sentence.
“The attempt to lure me to the farmhouse and shoot me? I don’t know. Meanwhile, Neilson tells me they’ll be out of here in another day or two, and we can get back to our normal routine.”
Beth pushed her salad away. “Well, at least you came out pretty well with the insurance adjuster.”
Caden chewed and swallowed another bite of sandwich and followed it with more iced tea. “That was a relief. He assured me yesterday we could get the painters and carpenters in as soon as the fire inspector was finished with his investigation, which was signed off this morning. And since there was no equipment damage, it shouldn’t take long to get things back to normal.”
“By the way, I had a thought when I was explaining this to the staff yesterday morning. If our records are mainly electronic—”
Caden stopped her when their landline rang. He pushed back from the table. “Maybe it’s my dad.” He looked at the caller ID and nodded to Beth, who’d followed him into the living room.
“I’ll pick up the extension in our bedroom,” she whispered.
“Dad, it’s good to hear from you,” Caden said.
“Is this a good time?”
“Of course.”
There was a click, followed by Beth’s voice. “And I’m on the extension, so you have both of us.”
“Any news, Dad?” Caden asked.
“I had the biopsy last Friday. Dr. Ross called me earlier today with the results. He found about what we expected—adenocarcinoma of the pancreas. I’d hoped it might be something other than that, but it’s not.”
Caden had trained at Parkland Hospital, and the UT Southwestern Medical Center had some of the best doctors around. But he wasn’t certain he should mention the name he had in mind of the doctor his father should consult. Not yet. “So, what are you going to do?”
“I see Dr. Ross in a couple of days to plan this out, but you and I both know the first step is surgery to remove the cancerous mass. This is still a small tumor. There’s a chance that a good surgeon can get it out intact. If it hasn’t invaded blood vessels or spread to nearby structures, surgical resection gives me the best chance. Then we use chemotherapy and radiation to follow up.”
Caden couldn’t see Beth, but he could visualize her. She’d have her head bowed, her eyes closed, no doubt praying at that moment for his dad. Include me, sweetheart, because I know what’s coming.
Sure enough, his father’s next words were what Caden expected—and feared. “I want you to do the operation.”
Caden had heard the expression “mixed emotions,” but he’d never experienced it quite so vividly as now. “Dad, I’m glad to hear you talk about doing what’s needed to beat this. But do you really think I’m the person to do the next stage—the surgery?”
“I know. Surgeons aren’t supposed to operate on family and friends. Their judgment is affected by the relationship, and the surgeon has to be able to assess things unemotionally.”
Caden found himself nodding, although he knew his father couldn’t see him. “What if I got in and found the tumor to be beyond resection? What if the surgery was technically beyond my capabilities? Or what if I made a mistake? What if—”
“I know all the arguments. I’ve used them myself. Remember when you were in your early teens? You and Scott McElroy were scuffling, and you hit the table edge. I could have sewed up that laceration, but instead I got hold of the best plastic surgeon I knew.”
Caden ran a finger over his left cheek. The scar had long since become almost invisible. He hadn’t thought about that incident in years, but now that his dad mentioned it, the major emotion he remembered was fear. He wanted his father to sew up the cut. The man who eventually did it was a stranger to him. When the emergency room nurse tried to place a draping sheet around the wound, he’d cried out for his father. He didn’t stop until he felt a hand grab his, and he held onto his dad throughout the entire procedure. “I understand.”
“Will you do it? I can arrange temporary operating privileges at the hospital where my gastroenterologist works. One of the surgeons there can assist. He’ll even do the post-op care. But I want you to do the case.”
That evening, when Dr. Claude Horner arrived home, his wife was talking on the phone. He waited patiently for her to finish, although what he really wanted to do was snatch the instrument from her and share his news. While he waited, he went into the kitchen, opened the refrigerator, and treated himself to one of the two bottles of beer almost hidden in the back. He rarely indulged, but today was special.
His wife found him there, sitting at the kitchen table and gazing at the corner of the room. The bottle in his hand was half-empty.
“Sorry, that was my sister on the phone, and you know how she can talk.”
Claude patted the chair next to him, and Nelda sat down. “I was at the hospital this afternoon and saw Jim Ketchersid as we were both walking out.”
“Do I know him?”
“Not sure. He’s a pathologist. He reads biopsy samples from all over town, and he told me he was sorry to hear about my partner.”
Nelda’s eyebrows went up. “Henry?”
“Yes. Jim had read the specimens Dr. Ross sent over . . . biopsy specimens from Henry.” Claude drank deeply, emptying the bottle. “Adenocarcinoma of the pancreas.”
“You’ve suspected that all along.”
“Yes, but now it’s confirmed. And that means there’s an extremely good chance that Henry won’t be around much longer. In turn, that means I’ll be collecting the proceeds of his life insurance policy and can replace the
money I’ve taken from the practice.”
“But it’s not a sure thing, is it?”
“The diagnosis—yes. The survival—it’s only a matter of time.”
Nelda frowned. “But the presence of pancreatic cancer isn’t a 100 percent death sentence, right?”
“No, but time is on my side. This is going to happen.”
The next day, Beth realized something was bothering Caden. He never shortchanged his patients, but between cases he seemed distracted. She was pretty sure what was occupying his attention, but it wasn’t until lunchtime she had a chance to talk with him about it.
“Want to go out together and grab a bite?” she asked.
“I’m not hungry. Why don’t you go with the other staff?”
“Bring you back something?”
“No . . . Well, maybe a sandwich. I’ll nibble on it if I get hungry later this afternoon. I want to spend some time at my desk, checking things on the computer.”
“Why?” Beth asked.
“Because I need to call Dad this evening, and I want to be able to talk with him intelligently. The only way to get him to go along with my plan is to have the facts at my fingertips.”
Seeing Beth’s puzzled expression, Caden continued. “I called Dr. Ross about mid-morning. He and I agree that my old professor of surgery at the med center, Dr. Markham, is the best person to do the operation on Dad. He’s done a lot of them, and this procedure should be handled by the person with the most experience. I’ve seen maybe three of these Whipple procedures, but I’ve never done one myself. Markham’s performed at least fifty, maybe more.”
“And you don’t think your father knows that already?” Beth asked. “He’s an experienced surgeon. He won’t be unfamiliar with Markham’s reputation. Surely he’ll see that’s the best man to do the procedure on him.”
“You know how stubborn my father can be. Once he gets an idea in his head, sometimes you can’t get it out.”
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