Noble Vision

by LaGreca, Gen

  But after a life of duty, was he happy? he sometimes wondered. He had married a woman, since deceased, whose social aplomb was an asset to his career. Although he had felt many positive emotions toward her, passion was not one of them. He had bought a house suitable for entertaining, but it lacked the grounds needed for his favorite hobby, gardening. He played golf with the influential, but he really enjoyed fishing. He worked as a bureaucrat, but he loved medicine. He basked in the glory of his position; however, on the rare occasions when he was alone, he was gripped by an inexplicable sadness. His life seemed colorless in his kaleidoscope.

  There was, however, one bright spot on the gray landscape of his inner life. He had two children, and although he loved them both, he favored one of them, who idolized him and shared his interest in the same field of medicine from an early age. Watching that child grow up was the thrill of his life. The child’s first words, first trip to school, first graduation were the golden milestones of contentment etched in his memories. These remembrances formed a locked room in the open house that was his life, a place not to be shared with the world but cherished in privacy.

  “This way, Mr. Secretary,” said the escort, opening the double doors to a meeting room whose antique mahogany table, tapestried walls, and old paintings were reminiscent of a time when colonial statesmen met to adopt a new government. The formality of the room seemed to clash with the rolled sleeves, crumpled shirts, and loosened ties of the people gathering there.

  With the air of an executive whose boardroom was the world, the secretary greeted his colleagues. His linen suit, custom-made by a London tailor, his well-styled white hair, and his Italian leather attaché case added dignity to the gathering. When all had assembled, twelve advisors sat around the oblong conference table, with the governor and the secretary at opposite ends. The table resembled a boat with oarsmen lining the sides and officers at the bow and stern.

  Burrow drank from a coffee mug bearing his picture and the inscription Back Mack for governor. The governor’s actual face showed no trace of the smile dominating the mug. He often seemed to shift masks from comedy to tragedy, with the former reserved for public consumption and the latter, more natural, face for private.

  “Good morning, Warren. You look awfully starched today, considering the heat and humidity,” said the governor, with a faint tinge of mockery in his tone.

  “Good morning, Governor. I’m pleased if my appearance matches the dignity of the meeting I’m honored to attend,” said the secretary, feeling complimented.

  A thump of Burrow’s feet was the only response as he put them on the antique table, leaving the secretary to gape at a hole forming on the sole of one shoe. Malcolm Burrow knew that he and the man whom he might choose for his running mate were different. The media described his secretary of medicine as “respectable,” “honorable,” and “a pillar of the community,” but it characterized him as “cagey,” “crafty,” and “shrewd.” The governor’s staff expunged the expletives from their language in the presence of the secretary but allowed their speech to flow uncensored before their boss. And Malcolm Burrow knew—not as a conscious identification but more as a hound sniffs food—that somehow these differences made the secretary suitable to be both his running mate and the object of his gibes.

  “What time is your press conference, Warren?” Burrow asked.

  “It’s at three.”

  “Then let’s get busy, folks. In three hours Warren’s giving the media his report on CareFree, so we’ve got to figure out how he’ll answer the rumors. We’ve got tough problems to face and big decisions to make, so let’s focus on the important things: the polls and the media.” He turned to one of his advisors, a young, energetic man sitting at the edge of his chair.

  “You’ve been dropping in the polls since the kickback scandal broke. Yesterday you dipped two points behind your opponent, Governor,” said the young man. “The people think they’re worse off now than four years ago, and the program they’re griping about is CareFree.”

  “The press next,” said the governor irritably.

  An attractive female advisor held a newspaper. “This morning the Globe ran an editorial with the headline ‘CareFree or CareLess?’ ” She lowered the eyeglasses resting atop her head and read aloud: “ ‘Barely two years after its ceremonious beginning, the governor’s pet project, CareFree, is rumored to be bankrupt. Reliable sources say that the demand for health care, which was expected to increase slightly when the state took over medicine, has actually doubled and is still climbing.

  “ ‘While the public clamors for care, there’s a growing scarcity of providers. This year a record number of doctors quit, enrollment in medical schools dropped, and long-established hospitals closed their doors.

  “ ‘We suspect that CareFree may cause the governor’s demise on election day, unless a tonic is administered now to treat the ailing program. In his news conference this afternoon, will the secretary of medicine announce an elixir for CareFree? Or is it too late for remedies? Will we be wise to break our legs and have our strokes before CareFree’s budget springs a fatal leak? Perhaps the time has come for someone new to steer the ship of state.’ ”

  When the advisor dropped the paper and looked up, the only smile she saw in the room was imprinted on a coffee mug.

  “Those reports are vicious lies spread by my enemies,” said the governor, springing to his feet and pacing. “CareFree bankrupt? That’s preposterous!”

  “It’s absurd!” said an advisor.

  “It’s ridiculous!” said another.

  “It’s outrageous!” said a third.

  “It’s true,” said the white-haired man with the starched shirt.

  All heads turned to him.

  “The situation is worse than the media guessed. Our budget is going to run out,” said the secretary.

  “After the election?” the governor asked hopefully.

  “Before.”

  No one disputed the secretary’s words—or seemed surprised.

  Burrow’s voice shrieked. “Something’s gone wrong, and we’ve got to fix it.”

  “I prepared a financial report on our expenditures,” said the secretary, reaching into his briefcase for a stack of spiral-bound documents and distributing copies to everyone.

  The governor rolled up his copy and slapped it against the table. “CareFree can’t go belly-up!”

  “Let’s hit Washington,” someone said. “They bailed us out before.”

  “Forget it. They contributed all they’re going to. We’re making history with a landmark program, and Washington’s leaving us to rot,” griped Burrow. He paced restlessly, waving his rolled copy of the report at the group. “Let’s analyze this baby line by line and throw out everything unessential.”

  Twelve heads bowed to study the report.

  “We mustn’t allow anything new,” said someone to Burrow’s right. “No new hospitals, wings, pavilions, or treatment centers. More facilities mean more billings, and we can’t pay them.”

  The others nodded in agreement.

  “Here’s something for the scrap heap,” declared the woman who had read the newspaper column. “On page two, I see that one district is adding two thousand hospital beds, but they already have more beds per capita than any other district in the state. Let’s ax this now.”

  “But that’s Waterbee’s district,” said the governor, glancing at his report. “Don’t anybody scratch that!”

  “Oh, right, I forgot.”

  Bill Waterbee was an influential congressman who had broken ranks with the opposing party to back CareFree.

  “Keep looking,” Burrow said, tapping a finger on the table. “Watch for expensive equipment like scanners. No facility can buy one without our authorization, and we’re not giving it.”

  “Page seven shows that Nassau County is getting two new scanners,” said a woman who had been a business consultant. “This report indicates it already has more scanners per capita than any other county. Let
’s scrap that acquisition.”

  “Sure, Helen! Scrap Louie Marcone and watch me end up on the trash heap, too.”

  “Sorry, Mack, I forgot about Louie.”

  Nassau County was home to the largest manufacturing plant in the state and the seat of a powerful union headed by Louis Marcone, a man Burrow wooed the way a casino courts a high roller.

  “Keep looking, folks,” the governor continued. “We’ve gotta trim the residency programs, so we limit the number of new surgeons. They cost a fortune, and only a small percentage of people need them.”

  “Here on page eight, the budgets of Galen College of Medicine and its residency program were increased. Let’s cut them,” said another aide.

  “But remember last March?” someone replied. “We were free-falling in the ratings over Galen.”

  “Oh, of course,” the first aide said apologetically.

  The previous March, the community served by Galen College Hospital staged a massive demonstration to protest the state’s rejection of their plan for a new cancer facility, and the governor’s approval rating plummeted until the BOM finally consented.

  “Keep looking! Let’s curb medical research,” Burrow continued. “That’s the easiest thing to cut. Because people don’t have the benefit of it yet, they don’t know what they’re missing.”

  “Governor,” remarked an advisor, “page ten shows we’re shelling out millions on research to cure baldness. Let’s cut this.”

  “Are you crazy, Chuck?” replied a voice from across the room. “Last week in Manhattan the applause meters jumped off the scale when the governor announced CareFree’s research project to cure baldness.”

  “Oh, that’s right. Damn!” Chuck responded, leafing through the report to find something else.

  “You people want to cut things that are necessary! Let’s look for something we don’t need,” said Burrow.

  “What about the ten million dollars for education? Let’s scratch that.”

  “CareFree needs education, Norma. We need seminars, videos, booklets, TV spots, and counselors to explain to people what the new system is and why it’s good,” said the governor.

  “And we always gain in the polls after we blitz a community with an education program,” someone added.

  “Then let’s get rid of the fluff—the free checkups, free contact lenses, free nutritional counseling, and free vitamins. These programs bleed us dry, and they couldn’t be essential,” said another aide.

  “They’re more essential than anything else. The majority of folks are healthy. They need some benefit from the taxes they pump into CareFree, something to remember on election day. I need to increase what you’re calling fluff,” said the governor.

  “Besides, those programs are Buddy’s turf,” another voice added.

  Buddy Terkins, New York City’s director of community affairs, was an outspoken supporter of Burrow, and Buddy had a following.

  “Maybe we can eliminate some bureaucrats, Governor,” said another aide. “We now have as many bureaucrats as we do doctors.”

  “Then where’s the progress?” asked Burrow, as he stopped pacing to stare at the aide. “We need the bureaucrats to run things because they’re unselfish and impervious to personal gain.”

  “Then let’s raise taxes,” said a young advisor just out of college.

  The governor laughed. “Glen here thinks it’s simple. All I have to do is raise taxes . . . when I promised for four years to cut them? When I’m committed to cutting them? When my opponent smears me every day for not cutting them—and you’re telling me to raise them?” the governor bellowed.

  The young man fidgeted. “It was just a thought,” he whispered.

  “Keep looking!” Burrow ordered. But no one replied. Glen’s flushed face seemed to silence the rest. “How much time do we have, Warren, before things get . . . out of hand?”

  “If we continue spending the way we have been, CareFree won’t be able to meet its payroll in three weeks.”

  “Three weeks!” gasped the governor, his forehead wet, his face white. “Our employees will strike. The doctors will join them. We’ll have demonstrations, violence, chaos! The media will cremate me. It’ll be the end of my political career!” Burrow sagged into his chair with a thump, his shoulders slouched, his jaw dropped. “We’re in a goddamn fix. I can’t cut the programs; I promised to expand them. I can’t raise taxes; I promised to lower them. What am I going to do?” “Warren, help me,” he pleaded. “Do you know what to do?”

  Everyone turned to the white-haired man who had been silent through the discussion.

  “Yes, Mack, I do.” The secretary’s calm voice was a cool salve on the governor’s frazzled nerves. “But first I want to explain some actions of my agency that were mentioned here, actions that would be embarrassing to me if they were misconstrued,” said the secretary. “Some of you may wonder why my agency seems to have dispensed favors and given preferential treatment to some people over others for political gain.”

  “Nobody wonders about that, Warren. Everybody here knows how politics works,” said Burrow.

  “Two years ago when I became head of the BOM, I vowed to place no concern over the public interest, so I want to explain, as a matter of principle, why my agency seems to be acting arbitrarily and playing favorites left and right.”

  The governor glanced at his watch. “Let’s not waste time, Warren. Everybody knows we have to scratch a few backs to get ours scratched.”

  The secretary continued. “I assure you that I am still dedicated to upholding my sacred trust to serve the public. However, I realize that for CareFree to survive, our party must win in November. Therefore, any measures we take to win votes are noble actions for a worthy cause, rather than arbitrary abuses of power for political gain. A noble end sometimes requires, well . . . practical means.”

  Burrow snickered. “Folks, I think you’ll find that Warren hits the ball just like everybody else, only he does it from his high horse.”

  The advisors silently turned their heads back and forth, from the governor to the secretary, as if watching a tennis match.

  “I blame the doctors for our troubles,” the secretary continued. “They want the old way back. They don’t follow the rules. They drive up the costs. They give us a hundred excuses why they can’t comply and why we should make exceptions. Their stubbornness requires continually more inspectors and rules to police them. Regulators and red tape consume half the budget. But if the doctors cooperated, we wouldn’t need any bureaucrats. If the doctors complied voluntarily, because they were just as enlightened as we are, we wouldn’t need the inspectors and paper trails to keep them in line. Can we permit this subversive behavior by a group privileged to serve the public?”

  “No, Warren, we can’t!” cried the governor, galvanized. The anger building inside him like an overheating radiator seemed to find a vent. “You’ve put your hands on the problem. We’ve got our great program threatened, my political future collapsing, and the people thrown into a crisis—by what? A few individuals with special skills who think they can hold the rest of us hostage. And for what? So they can have a few fancy cars in their garages? Is that why the people have to go without the services they need?” He snarled. “I won’t stand for it. We need to hit the doctors over the head.”

  “Forgive me, Governor, but while we agree on the cause of the problem, I must reject your solution as, well, barbaric.”

  “Just what do you mean by that?” snapped the governor.

  “We need to impress on the doctors their social responsibility,” said the secretary.

  “We need to show the doctors who’s boss,” said the governor.

  “We need to enlighten them about their moral obligations.”

  “We need to rein them in.”

  “We need to tell them to stop breaching our rules. We need to tell them emphatically.”

  “Emphatically?” the governor asked, puzzled.

  “Yes, emphatically.”

/>   A coffee-mug grin was forming on the governor’s face as he studied the secretary.

  “We’ve been too lenient, Mack. When the doctors disregard the rules, we fine them a few thousand dollars, which for many of them isn’t enough of a deterrent. The arrogant ones pay the fines and commit the same offenses again. We have the power to be tougher. We can suspend them, revoke their licenses,”—his voice lowered—“or even throw some of them in jail.”

  The governor clasped his hands behind his head and leaned back in his chair, as if basking in the noonday sun. “Perhaps I was too quick to question your approach, Warren.”

  “I disagree with you, Mack, when you say that we have to hit the doctors over the head. With all due respect, I loathe such uncivilized behavior, if you will forgive me.”

  “Oh, I do, Warren, I do.”

  “Rather than instill fear in the providers by resorting to the force of the state, we must raise their consciousness so that they look beyond their personal interests to the common good. The cooperation and compliance of the doctors will save us millions of dollars and will save the soul of CareFree. I believe that the only thing that can save us is the doctors’ acceptance.”

  “Warren, I now see your point,” said the governor, his face beaming. He looked like someone pleased to be getting what he wanted, even if under a different name.

  “At my press conference this afternoon, I’ll tell the doctors that they must meet their social obligations, which means they must cooperate, sacrifice . . . and obey.”

  All signs of suspicion vanished from the governor’s face. He smiled at the white-haired gentleman with the regal bearing. “Warren, I think you have the perfect solution.”

  * * * * *

  The tall shade trees on the lawn of the state capitol strained to resist the gusts bending them to the breaking point. The secretary of medicine faced reporters at the steps of the stone building, his well-groomed white hair being jostled by the wind. The state and national flags draping his outdoor podium flapped loudly in the turbulent air. The secretary eyed the mounting storm clouds, for he had planned not only to hold his press conference outdoors but also to travel afterward from Albany to New York City for an important dinner engagement.