"How long since you first felt this? " he asked. He ached for what he now realized she was going through. If, at that moment, the lump were offered as an exam question with only one correct answer, he would have to call it trouble, all the way down the line. And so, he knew, would she. "A month. Six weeks now, I guess, " she said. "There's been no change over that time. Mammograms were equivocal. A needle biopsy came back normal breast tissue, and rather than go through that procedure a second time, I elected to go ahead with an excision, and, if necessary, a modified radical."
"When?"
"I'm going in tomorrow evening. Surgery's scheduled for Friday morning.
And in case you couldn't tell, I'm scared stiff."
He held her tightly. "I'm just grateful you didn't send me away tonight, that's all. You've made arrangements for Jennifer?"
"My partner in the gallery is going to take her. She has a son two years older than Jen."
"Good. It's going to be okay, you know."
Suzanne nodded grimly. "Just keep reminding me. I tell you, being a physician, I just know too goddamn much. And I'll tell you something else, no matter how much you read, no matter how many Donahue shows you watch, the prospect of what might happen just doesn't compute."
"It's going to be okay, " he said again, forcing conviction into his voice. "You've got a friend who's going to be with you all night tomorrow. Will they be doing the excision under local?"
She shook her head. "No, " she said. "The anesthesiologist and surgeon both recommended general. And frankly, I was relieved."
"Who's the anesthesiologist?"
"Pearl. Jack Pearl."
"Good. He did my case this morning. He's a little on the weird side, I think, sort of like a character out of a Gothic horror novel. But he sure as hell knows what he's doing in the O. R. And the surgeon?
" Suzanne sighed. "It's your friend from this morning, " she said.
"Jason Mainwaring. Whatever you might think of him, Zack, he's by far the best technician around."
"So I've heard. Well, I only hope his skill in the O. R. is more highly advanced than his skills in interpersonal relations."
"Oh, it is."
"In that case, " Zack said, "we've only got one thing to worry about, right?"
CHAPTER SIX
Frank Iverson's office was a spacious two-room suite on the ground floor of the west wing-the newest addition to the hospital. From his spot in one of three leather easy chairs, Zachary watched his brother's two secretaries go about their business with prim efficiency. One of the women was dark, with an air of sophistication and polish. The other was blond and wholesome. Both were young, well built, and remarkably good-looking-far beyond the run-of the-mill in any setting, but near goddesses by Sterling's standards. Gorgeous secretaries, a plush office, big-money business deals, a Porsche 911, a spectacular hillside A-frame-the man certainly had style, Zack mused. And while that particular style was not one Zack had ever really wished for himself, Frank had clearly come a hell of a long way from fraternity beer blasts.
Fifty percent identical. With each passing year, it seemed, the two of them were becoming less and less a validation of that genetic truth.
Still, there was a time, Zack knew, when their drives and their goals were not nearly so divergent, a time when the two brothers careened through their world along virtually parallel tracks, guided only by the beacons of early success, trophies, ribbons, medallions, and adulation.
It had become something of a game for him-a recurring daydream — to imagine his life had he not fallen that winter day, had the ligaments of his young knee not shredded. Accidents. Illness. The violent, uncaring acts of others. The daydream, as always, led him to acknowledging how fragile life was-how totaily beyond control. A patch of ice, the fraction of an inch, and suddenly, in one agonizing instant, the blinders were stripped away from his protected view of life, his unswerving track was transformed into a twisting, rutted path negotiable only one uncertain step at a time. Zack's eyes closed as he drifted back to that day. He was in a perfect spot, racing after Frank. Three seconds was a lot, but nothing he couldn't have made up-especially with his brother being so uncharacteristically cautious on his second run. And he wanted it. He wanted it more than he would ever admit to anyone-even, he reflected, to himself. The colors, the packed snow, the sudden disappearance of the steady crosswind that had been blowing all day-it was a moment frozen forever in his memory. The conditions were perfect for an upset, for a demonstration to all that Zachary Iverson had suddenly come into his own. The Judge, their mother, and most of the town, it seemed, were gathered along the slope, anticipating his run.
Waiting beyond the red and blue pennants marking the slalom course was a wonderful trophy, a savings bond, a trip to the Junior Olympics, and a huge piece of the praise and newsprint that he had watched being heaped on his older brother over the years. It was time. It was, at last, his moment, his run. He checked the course below. No problems. A few final seconds to mentally chart his line, and he lowered his goggles and glided to the electronic starting gate. Then, suddenly, he stopped.
Something was wrong. Something simply didn't feel right. His boot?
The wax? No, he realized at the last possible second, it was his ski-his right ski. Somehow, the binding on it had come loose. He backed away and made the necessary adjustment on the screw, cursing himself for not being more meticulous in his preparation in the first place. The oversight could have been ruinous. But now there was nothing to stop him. It was his run, and there was nothing but two minutes of skiing between him and Colorado. Nothing, that was, except a small patch of ice. Zack shuddered and sensed his body recoil and stiffen as he relived some of the pain and helplessness of that fall, the bouncing and tumbling over and over again down the matted slope. The loose binding, while never a factor, had certainly been an omen. "Dr. Iverson, can I get you something? Some coffee? " It was one of Frank's bookend secretaries-the blonde, scrubbed and sensual. The prototypical farmer's daughter. The impotence and anguish lingered for a moment, and then drifted away. Unconsciously, Zack rubbed at the still-hypersensitive scar that ran along his knee. "No, " he said hoarsely. "No, thanks."
He checked the time. Just four o'clock. Three forty-five, Frank had said, he had been quite specific about the time. Zack had a consultation waiting and a small stack of paperwork in his office. Suzanne was due to sign herself into the hospital in less than two hours. The last thing in the world he needed at that moment was a meeting with Frank. However, the invitation had been couched in words that made it difficult for him tobeg off, even for a day. The fifteen-minute wait, while very annoying, was hardly surprising. Frank had never been one to pay too much attention to the schedules of others. "Excuse me, " Zack said to the secretary, "do you have any idea how much longer he's going to be?"
The woman smiled blandly. "No, Dr. Iverson, I'm sorry, I don't. But it shouldn't be too much longer. Mr. Iverson is on the line with the Ultramed mainframe computer in Boston. He talks to it every day." She sounded very proud to be working for someone who regularly talked to a mainframe computer. "Are you sure you wouldn't like a cup of coffee? Or a Coke?"
Zack shook his head. "What I'd like, " he said, standing, "is to reschedule this appointment for a time when he's able to keep it. Just tell my brother to have me paged when he's through, okay?"
"That won't be necessary, old shoe, " Frank's voice boomed from the intercom on the blonde's desk. "I was just calling Annette to have her send you in. The door's open."
No explanations, no apologies. Zack wondered how long the intercom had been turned on. The notion of being eavesdropped on did not sit well with him at all. "Sit down, sit down, " Frank sang as Zack closed the door behind him. "Are you sure you don't want the girls to get you something?
A drink? Something to eat?"
"No, thanks, but go ahead if you want to."
The office was richly paneled. A floor-to-ceiling bookcase, complete with a built-in bar and sound system, covere
d one wall, and a huge aerial photo of Ultramed-Davis filled much of another. A computer keyboard and screen occupied only a portion of the massive mahogany desk that Frank had once proudly described to him as "a one-of-a-kind honey."
Frank himself, seated in a high-backed, brown leather chair, and dressed in a tan linen suit, silk tie, and custom-tailored shirt, looked as if he had just stepped off a page of Gentleman's Quarterly. "So, " he said, sliding a box of slim cigars across the desk, "how goes Zack slid the box back. "It goes fine, Frank."
"The office okay?"
"Perfect."
Zack's office, supplied and paid for by Ultramed for one year ("With the strong possibility of a second year, if all goes well"), was a neat, three-room space on the top floor of the Ultramed-Davis Physieians and Surgeons Clinic. "Word has it you've been doing a hell of a job in the operating "That's nice to hear."
"Nice for both of us. It's not too many hospitals the size of this one that can claim a full-time, Harvard-trained neurosurgeon. And, of course, I come off looking like some sort of health-care Iacocca for recruiting you."
"Frank, you didn't exactly beat down my door to get me to come."
"Nonsense. I just had some… some early misgivings, that's all. But the Judge and the Ultramed people helped me see the light, and now I'm really happy with the way things are turning out. You've been a real shot in the arm for the morale in this place."
"I haven't encountered any morale problems, " Zack said, sensing the word was something of an introduction to the real business at hand.
"Well, we do our best to see that there are none, " Frank replied.
"And as you say, we do pretty well at it. But every once in a while, something or someone pops up that threatens to polarize our Ultramed-Davis family-turn brother against brother, as it were. And you know what they say about a house divided, right?"
"Right, Frank."
"So, Zack-o… Speaking of houses, how's your place?"
Oh, for crying out loud, Zack wanted to shout, this isn't some sleazeball business adversary you have to play cat and mouse with. This is your brother. Just say what in the hell it is you want, and let's get it over with. Instead, he folded his hands together, crossed his legs, and settled back in his chair. It was Frank's show. "The house is beautiful, Frank, " he said mechanically. "I don't know how you stumbled onto the place, but I'm certainly glad you did."
He wondered where Suzanne was at that moment, what she was doing, how she was feeling. "Great, " Frank said. "Remember what I said about the basement full of extra furniture we have. Just come by and take what you want until you get your own stuff, okay?"
"Sure."
Zack reminded himself that his brother, for all of his straight-up the-middle-with-power athletic skill, had always been an expert at hidden agendas. It was an art he had studied at the feet of a master, their father. If Frank was operating true to form, this small talk was anything but casual. "The rent's pretty decent for a place like that, yes?"
Zack laughed. Decent was far too tame a word. The rent for his tiny apartment in Boston had been three times what it was for the house, which had a huge, wooded lot, two fireplaces, and several times as much space as the apartment. "Don't tell the realty company that owns it,"
Zack said, "but they're getting killed on this deal. I sleep with my lease under my pillow for fear someone will sneak in and take it away."
"Oh, we won't, " Frank said calmly. "We?"
Zack realized that the hidden agenda was about to surface.
"Ultramed-Davis, Zack. You see, Pine Bough Realty Trust is a sort Of, well, convenient way for the hospital to administer some property it owns hereabouts. We're your landlord."
Frank beamed, obviously delighted with the way he had delivered the news. "You know, " Zack said, now consciously working to keep his cynicism in check, "somehow that little piece of information doesn't altogether surprise me. Not that it would have made any difference, Frank, but you could have told me when I rented the place that in addition to my salary, my office, my equipment, and my insurance, Ultramed was providing the roof over my head."
Frank shrugged. "This seemed like a more appropriate time."
"Tell me, is it customary for a hospital to have such a-how should I say-proprietary role in a community?"
"I would use the word progressive." Frank smiled and winked. "You see, Zack, the bottom line of this or any other business is money. Dinero.
The big D." As he became immersed in his rhetoric, he grew more excited and animated, his gestures more professorial. "That's what the administrators and boards of directors of hospitals all over the country are just beginning to realize. Fortunately, Ultramed recognized it years ago. Eliminate nonprofitable programs and deadwood, increase receivables and collections. Change the red ink to black, no matter how, and the rest takes care of itself. If it's real estate, then it's real estate.
If it's other investments, then it's other investments. Colleges like Harvard and Dartmouth have some of the biggest stock portfolios and real estate holdings around. Why shouldn't hospitals follow their example?"
"I… I don't know why they shouldn't, " Zack said. But give me time, he was thinking, and I'm sure I can come up with something.
The wedding of business and medicine was one with which he was simply not comfortable-at least not yet. He reflected on the new CT scanner..
the incredible opportunity he had been given by Ultramed to set up a private practice. The marriage, he acknowledged, deserved, if not his blessing, at least his open mind. Perhaps that was what his brother needed to hear. "You know, Frank, " he went on, "if I seem uncomfortable with some of this corporate-medicine stuff, you've got to remember that I've spent the last eight years in a hospital where everything was always in incredibly short supply. Everything, that is, except for the dedication of the nurses and the doctors, and the love-I guess there really isn't any better word for it-that they had for their patients.
"I'm grateful to be in a situation like this. Believe me, I am. But there are some parts of those years I spent at Muni that are hard to get out of my system. Frank, I tell you, there was something so pure about the kind of caring that went on in that grimy old place, something so..
I don't know, holy, that many times patients seemed to get better when every medical fact-all the odds-said they shouldn't. Does that make any sense?" Frank held up his hands. "Hey, Zack-o, " he said, "that makes all the sense in the world. That's what makes you such a valuable addition to the staff here. So, you just do the doctoring and let me worry about the politics and the CT scanners and such. That way everyone benefits, right?"
Dignity, Zack was thinking, still immersed in his years at Boston Muni.
That's what it all boiled down to. The dignity that came from being cared for with love and respect, from being treated as something more than a credit or debit on a balance sheet. He flashed on the tears glistening in the eyes of Chris Gow at the realization that someone cared enough to stand up for him, regardless of the cost. "Right?" Frank asked again. "Huh? Oh, yes, exactly."
"Good, " Frank said. "Then I can assume you'll leave this Beaulieu business to me?"
"What? " Again, Zack warned himself not to drop his guard too low. Frank was, and probably always would be, the fiercest of competitors.
"Beaulieu, sport. Hey, are we on the same wavelength or not?"
"Frank, you haven't said one word about-"
"Well, what in the hell else do you think we've been talking about?
I've let that business with the old man and Wil Marshfield slide by because I knew that you hadn't had time to learn the system around here.
But Beaulieu is another story. Zack, that man is on a vendetta because he thinks the hospital's to blame for his inability to maintain a surgical practice. Have you heard that kind of paranoid talk from anyone else around here?"
"No, but-"
"Every time someone new has come on the staff over the last few years, Beaulieu buttonholes him with wild claims
and stories about how we're railroading him out of business and how we forced Richard Coulombe to sell his pharmacy in order to pay his hospital bills. Christ, I'm surprised he hasn't tried to tie us in with the fucking famine in Ethiopia. Let me tell you something, Zack. No one has to try and force Guy Beaulieu into retirement. He's doing a perfectly adequate job of that all by himself. "And as for that Coulombe crap of his, ours wasn't the only debt the man had, believe me. He was in it up to here with everyone in town. Check it out yourself. Coulombe either sold that store or he spent the rest of his days in a courtroom."
"But-" Zack stopped himself at the last moment from breaking his promise to Beaulieu by bringing up the connection between Ultramed-Davis and Eagle Pharmaceuticals and Surgical Supply. He also found himself wondering if the former owner of the house he was Ig renting had ever been a patient at the hospital. "But what? " Frank demanded. There was a sudden hardness in his eyes, an edge to his voice. "Nothing, " Zack said. "Forget it."
With his thoughts focused on Suzanne and on problems at the office, he was willing to do almost anything to avoid a clash. "Forget it."
Frank shook his head. "You're holding out on me, Zack-o. It's written all over your face. Now, what's going on?"
"I said, nothing" Zack felt the skin tighten across the back of his neck. Some of what is happening is simply wrong Some of it is evil…
Guy Beaulieu's words, his anger and his sadness, took hold. Your old friend Beaulieu is a little short of allies in this place "All right, Frank, " Zack suddenly heard himself saying. "You want to know what's wrong? I'll tell you what. I believe Guy, that's what. I listened to him, and I looked in his eyes, and I know he's telling the truth. That's what's wrong. I don't know if it's Ultramed, or that pompous ass Mainwaring, or what. And I sure as hell don't know why. But I think Beaulieu is being railroaded out of practice, just like he says. And if that's true, then it pisses me off. It pisses me off a lot, and it makes me want to do whatever I can to help the man out. There, is that what i you wanted to hear?"
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