by David Carnoy
Klein laughed. “You’re shittin’ me. She’ll laugh.”
“You think she’ll laugh ’cause we’re sitting here in this godforsaken cafeteria in the early morning hours after a sleep-deprived night. But in the heat of the moment, there is no laughter, only respect. You need to take command of your sexual situation—as limited as it may be. You’ll sleep better at night, and more importantly, so will she.”
“That’s what you got for me? That’s your solution to all my problems?”
“That’s what I got.”
Klein yawned again then took a sip of coffee. After a short silence, he said, “You on the market?”
“Why?”
“Trish has this new friend. She’s looking to get fixed up. Thirty-six, recently divorced, works in the PR department at Sun Microsystems. Smart.”
Cogan said he appreciated the offer but he’d already had his fill of smart, recently “liberated” divorcées. They had worn him out, both mentally and physically.
“What if I said she’s got the body of a twenty-six-year-old?”
“I’d say I know a twenty-six-year-old with the body of an eighteen-year-old.”
“Really?”
“Smart, too. And not always in a hurry, on some mission to make up for lost time.”
“Just have a drink with her,” Klein said. “An hour. It’s no big deal.”
“I know.”
“She’s not looking for any big, involved thing, if that’s what you’re afraid of. You know, she just wants to dip her toe back in the water. Have some fun.”
Three months ago, he would have gladly taken Klein up on the offer. But he’d had a real run of late, dating a different woman every couple of weeks, looking for someone he wanted to stick with for a while but not quite finding her. He told himself he was looking for someone who could just hold his interest. But sometimes he was afraid he was looking for perfection. Whatever the case, he’d pushed hard for a while, and come away feeling he’d failed. Now he was tired of the feeling.
He explained this all to Klein but Klein really didn’t get it, which Cogan had expected. It was hard for a married man to understand how a single man, with all the freedom in the world, could turn down a date with a woman the married man thought was attractive, because if the married man was in the single man’s position he’d jump at the opportunity. The only explanation Klein could come up with was that there must be something truly wrong with Cogan.
“Must be nice,” Klein said wistfully, picking up a small piece of paper next to his tray that noted the cafeteria’s upcoming lunch specials. “To pick and choose like that from a new menu with new items every day. And if you’re not hungry, well, you go light. Me, I’m looking at the same menu every day, rain or shine. Meatloaf.”
“Come on, Trish is better than meatloaf. She’s at least a cutlet.”
“Yeah, when she feels like it. Hell, she can be filet mignon when she wants. But it’s not like I can put in a request with the maitre d’ and it shows up.”
They ate in silence for a minute. Then Cogan said, “I went to see a patient this morning. A kid, twenty-six. Some dot-com dick-head. Pudgy face. Ponytail. Says he’s worth ten million. Thinks he’s big shit. But the thing is, he keeps crashing his bike. Second time in two years he’s been through trauma. And we’re not talking little crashes. We’re talking about this guy really fucking himself up. We’re talking twelve hours in the OR. I mean, this last time, he barely made it. And he treats me like it’s my job in life to put him back together. So today I told him, hey, maybe it was time he laid off the bike. And he says to me, ‘Do they pay you to give advice, too?’ And I’m thinking, Why did I save this motherfucker’s life? To take this abuse?”
“Hey, we’ve all been there, Ted. We all get crappy patients every day. Between them, the administrators, and my wife, it’s enough to put a guy over the edge.”
“I know.”
“Try coming home at seven o’clock after dealing with some of these schmucks and now your three-year-old boy needs to be entertained and watched and put to sleep. And you don’t want to give any more because you’ve given all day. Trish is the same way. There’s no give. If I say to her I’m getting hammered at the hospital, she’s going to say, ‘Hey, I’ve got the same story.’”
Everybody had it worse, Cogan thought. It wasn’t supposed to be this way. He wasn’t supposed to be sitting here each morning, complaining. He should have been exhilarated. He should have been talking about how he’d saved that girl’s life last night. But instead he was complaining about some asshole he shouldn’t have saved. The good things somehow got lost. Overwhelmed. Outweighed.
Lowering his voice, he said: “This is between you and me. It doesn’t leave this table, OK?”
He waited for Klein to agree to the terms, then quietly told him he’d been thinking more and more about splitting Parkview.
“And going where?” Klein asked.
“I don’t know. To start my own business.”
“Private practice? It’s a haul, too, man. There isn’t the kind of money there used to be in it.”
“No. I mean a completely different business.”
“Give up fixing people?”
“Yeah. Shit, between the Internet and the venture-capital firms looking at biotech companies, there’s gotta be a ton of consulting out there.”
“You mean, like Teddy Cogan, cyber-M.D.?” Klein said, laughing. He made it sound as if Cogan would be starring in his own new sitcom.
“I’m not kidding.”
Klein considered it. He took a contemplative sip of coffee, then said, “Give up patient care. Sure, I’ve thought about it. I thought about going to B-school. Trish and I talked about it when Richard-son left last year.”
“Really?” It was the first Cogan had heard about it.
“But I don’t want to be a regulator, Teddy. I don’t want to be the director of some health plan. Even if there is more money in it and you have more control, none of the business-side stuff appeals to me. I didn’t grow up wanting to be a bean counter.”
“Me neither.”
“We both know we’re in too deep to let it go,” Klein went on, seeming to relish his resignation. “We spent a third of our lives getting a degree to do what we do. So they changed the rules on us. We’ve still got too much time invested. To make it at something else would take . . . what? Five, ten years? Who knows? We’d both be pushing fifty by then.”
“If I had to do it over again, Bob, I wouldn’t do this. God, I wish I could start over.”
“And that bothers you?”
“Sure.”
“Welcome to midlife, pal.”
They both sat in silence for a little while, then Cogan heard himself say unexpectedly: “I had this dream a couple of nights ago.”
He was back in college, going out for the baseball team, he told Klein. It was tryouts, his senior year. The only thing was, he was the age he was now: forty-three. He’d just never graduated. He had one more year left of eligibility. And the coach introduced him to the players. He said, “This is Teddy Cogan, he played with the team a while back, then decided to take some time off. Now he’s back and will be trying out with the rest of you.”
He started doing the drills and the conditioning work. And he found himself running well, keeping up with everybody. He felt good. Then it was his turn on the mound—he was a pitcher—and he started to throw, and he realized he didn’t have the velocity he used to. He couldn’t strike anybody out. But he was craftier. He was getting guys to ground and fly out. And he made it through a couple of innings without allowing any runs. Walking off the mound, he thought, Hey, maybe I have a shot here.
After the last day of tryouts, they posted a list of the people who made the team. Cogan put his things away, all his equipment, then went over to where they’d posted the list—right next to the coach’s office—and looked for his name. He went down the list. Down, down, he was looking at the names. Then, right near the end, he saw his.
It said: Cogan T. But next to his name there was another name. And next to that it said: Chest Wall Mass. Suddenly, he realized he was reading a schedule for surgery. And that he was due in the OR in a few minutes.
Klein smiled. “I have the same dream. Only there’s no team. It’s just me and a couple of cheerleaders. And my beeper goes off.”
“I’m telling you I was good,” Cogan said. “I was pitching well.”
“I’m sure you were. Bring your mitt to the OR next time and we’ll toss a mass around after an operation. We’ll see what you’ve got.”
“I’d love to.”
12/ EMERGENCY VISIT
April 1, 2007—12:12 p.m.
MADDEN PRESSES THE RECORD BUTTON ON THE MICROCASSETTE recorder. It’s the second time he’s had to stop and restart the tape.
“That night. You went to a party. It was a college party?”Carrie doesn’t answer at first. She’s still wrestling with the fear that people will think she could have prevented her friend’s death. A few seconds pass. Then, finally, she says: “Yeah. My brother goes to Stanford. He’s in a frat there and they were having a big party.”
“How’d you get in?”
“What do you mean?”
“Were they carding at the door or did you just walk right in?”
“Well, we were there early. We went over to watch some basketball game.”
“And you were drinking?”
“Yeah.”
“What were you drinking?”
“I had a couple punches. I think it was rum punch. But I wasn’t really drinking. That was sort of a deal we had. That one of us could drink and the other couldn’t. I mean, it’s not like we drank a lot. I don’t even like to drink.”
“But Kristen was drinking?”
“Yeah, you know, I guess she just sort of felt like it. She kind of had a bad week at school and she just wanted to have a good time.”
“So then you’re at the party.”
“Yeah. It was fun. We were dancing and stuff. Then all of a sudden Kristen was gone. She went upstairs to the bathroom and threw up. I guess she’d also had a couple of beers during the party. You know, someone handed her a beer and she took it and after the punch she said it didn’t seem strong at all. But that’s what gets you sick. Mixing.”
“Then what happened?”
“Then she was in pretty bad shape. They had to take her to Jim’s friend’s room. That’s my brother, Jim. And she was pretty out of it. We were slapping her and putting cold water on her face but she wasn’t responding. So it got pretty scary. And that’s when we decided to take her to Dr. Cogan’s house. Because we didn’t want to take her to the emergency room. Our parents would have killed us if they’d found out. And because Jim thought the frat might get in trouble because she was underage. So I suggested we drive over to Dr. Cogan’s house and see if he was home before we went to the hospital.”
“And how did you know where Dr. Cogan’s house was?”
“Because we’d followed him a few times. I kind of had a crush on him. I think—”
He waits for her to finish the sentence, but she doesn’t. So he says: “You think what?”
“It doesn’t matter.”
“Maybe it does.”
“I was just going to say that I think she wrote about that—about how I had a crush. She told me she did.”
Madden allows himself a smile. Kristen had written about it. Nice and consistent, he thinks.
“OK,” he says, “then what happened?”
“Well, he was home. At first he didn’t want to let us in, but we kind of begged him.”
“So he did?”
“Yeah. He checked her out. He was mainly concerned she’d taken something else. You know, some drug or something.”
“And she hadn’t.”
“I didn’t think she had. And she said she hadn’t. And so we mainly just started walking her around and trying to get her to drink water.”
“Who was we?”
“Me, Dr. Cogan, and Gwen Dayton, who goes to the U. I think she’s a junior.”
“Do you remember how long that was?”
“Maybe an hour.”
“And what time was it?”
“When we were walking her around?”
“When you finished.”
“I think around one. Maybe a little later. At some point I know Jim called my mom to tell her I was staying in his room at school. My curfew was midnight.”
“And what time was Kristen’s curfew?”
“Hers was usually eleven. But she was going to stay over at my house.”
“But she didn’t?”
“No, because my mom always waits up for me. And she would have freaked if she’d seen her. I mean, she might not have freaked that bad, but she would have told Kristen’s parents and they definitely would have freaked. Jim told mom that we were driving Kristen home and that I was going to stay with him. She was OK with that.”
“And then you just stayed at Dr. Cogan’s?”
“Yeah. I mean, Kristen was crashed out in his guest room. So we asked him if she could stay. He didn’t want her to at first. But then I promised I’d get her out of there early—by eight. My brother would come back and get us.”
“And where’d you go?”
“I went to sleep in the living room. On the couch.”
“And then what happened?”
She’s silent.
“I think you already know,” she says. “That’s part of the reason why you’re here, isn’t it?”
“Yes, but I’d rather hear you say it.”
“I’m not sure I should. I’m not sure that’s what Kristen would have wanted.”
“I don’t think it’s a question of what Kristen wanted at this point,” he says.
She looks away. Then down at the ground.
“Carrie, did Kristen have sex with Dr. Cogan?”
13/ DICK-NAR
November 10, 2006—10:04 a.m.
AFTER BREAKFAST, COGAN WENT BACK UP TO THE OR. HE HAD two minor operations scheduled that morning, both bronchoscopies, which he could do in an hour with any luck. They were really pre-op ops: You ran a tube down the patient’s trachea, then you ran a camera and biopsy tools down the tube and took a sample of a suspected lung cancer. No cuts on the outside. And no anesthesia. The patient was awake during the whole operation, though heavily sedated.
He eased into what he expected to be a fairly standard day. Once, he’d been asked to describe a typical day at the hospital to a group of high school students who’d come for a tour of the emergency department. At first, he hadn’t been sure how to answer. Part of the problem was that his day—and he said this—was really a night and a day. He was almost always in the hospital for a twenty-four-hour shift. In the daylight hours, his work was very structured. He had operations scheduled, usually in the morning, and appointments to see patients. But at night, he never knew what to expect. He could sleep through the whole night without having to go to work. Or he could be up the whole night, treating one victim after another. Unfortunately, he didn’t get to choose when people hurt themselves. But if he had his choice, everybody would hurt themselves between six and ten in the evening. He’d make it a law, if he were president.
The students laughed. Then one girl asked, “If you don’t sleep at night, how do you stay awake during the day?”
“Coffee,” he said. “Lots o’ coffee.”
And it was true. Cogan was a regular customer at the coffee cart out in the courtyard. On warm days, he’d go outside and sit at one of the half dozen or so umbrella-covered tables. It was almost like sitting at an outdoor café. He’d drink a latteé, kibitz with other doctors, and flirt with nurses, who took as many cigarette breaks as he took coffee breaks. His fifteen minutes there were some of the most cherished moments of his job.
He didn’t tell the high school students that, though. Nor did he talk about the petty squabbles that forever seemed to dog him. These kids didn’t want to hear about office poli
tics. They wanted to hear about blood and guts. How could he tell them that working in a hospital was just as much about stroking people’s egos and gossiping behind their backs as it was about saving lives? Sometimes, he thought the problem was that during the years doctors were supposed to be developing personalities, they were holed up in libraries and labs. Too often, the result was a fully developed adult male or female of the species, performing the duties of a highly skilled profession with the social skills of a teenager.
Anne Beckler was just such a person. That morning, he didn’t see her coming, he just heard her voice bearing down on him from behind.
“Hold up a minute, Cogan, I want to speak to you.”
Her voice had an emotionless, authoritative tone to it, the kind a police officer uses when he asks you to step out of your car and show him your driver’s license and registration. Cogan turned around slowly and faced her with a gracious, if somewhat phony, smile. He’d just come out of the OR after finishing the second bronchoscopy.
“What’s up, Anne?”
“I notice you’ve managed to successfully avoid me the whole morning.”
“It’s ten o’clock. I don’t think that qualifies as the whole morning. But I’ll take it as a compliment. Successfully avoiding a blood-hound such as yourself for even an hour is an accomplishment.”
“Why are you such a dick, Cogan?”
“Well, I’ve given it some thought,” he said. “And this is what I’ve come up with. Really, I’m more of an ephemeral dick than a permanent dick. See, I’m only a dick when I sense someone is about to be a dick to me. I make a preemptive dick strike, so to speak.”
“And what leads you to assume that someone is going to be a dick?”
“I have dick-nar.”
“Dick-nar?”
“Dick sonar.”
“Interesting. It’s a shame that you don’t also possess the ability to sense when your opinion is not needed in an operating room.”
“That is a matter of opinion.”
“For the record, I was just about to put the scope in when you dropped by. I would have gotten through the operation fine alone. I don’t appreciate you making my surgical decisions in front of my resident.”