Flashback

by Michael Palmer

  Frank laughed out loud. Then he lit up a cigar and sent a smoke ring swirling toward the ceiling. "Let's just say it's what I expected to hear, " he said. "You always were something of a bleeding heart, Zack-a sucker for anybody's cause. Vietnam, Timmy Goyette's supposedly-stolen Junior Olympics entry fee, women's rights, not enough mashed potatoes in the school lunches. Give the boy a sob story, and he gives you his guts … and his allowance. Remember all that? I sure do. So why should Guy Beaulieu and his paranoid stories be any different, right?"

  "Frank, you can really be a bastard, do you know that?"

  "Careful, boy, " Frank said, launching another perfect ring. "That's your mother you're talking about. Besides, this time you're wrong. Dead wrong."

  "What?"

  "This is one cause you'd best steer clear of, brother. Beaulieu's on his way off the plank, and if you're hanging onto him when he goes, then you're going to get awfully wet. I promise you that."

  He opened his desk drawer, withdrew an envelope, and slid it across.

  "I've been keeping this letter quiet because I still hoped Beaulieu would back off. Now, I'm afraid, I have no choice but to present it to the ethics committee. There are people on the staff who wanted to do something months ago to limit or cut off his privileges, but I kept putting them off. Like the Judge said, the old guy did save my life.

  Here, have a read."

  The letter was handwritten and carried no heading other than the date, June 17. Dear Mr. Iverson, I am writing to share with you some allegations against Dr. Guy Beaulieu by myself and several other nurses on the emergency ward. Over the past several months, he has become increasingly inconsistent and indecisive in his dealings with patients.

  He has been quite forgetful, at times issuing the same set of orders more than once, and at other times, neglecting to order certain studies which we would consider routine and basic. In addition, on more than one occasion his speech has been slurred and his manner inconsistent enough to raise the question of drugs, alcohol, small strokes, or some combination of the three. Fortunately, his case load has been small enough so that no one has been harmed-at least no one that we know of.

  Still, we feel some sort of investigation and action is called for. I would welcome the chance to meet with you and discuss this matter further. Meanwhile, I feel you should have a talk with Dr. Beaulieu.

  Sincerely yours, Maureen Banas, R. N. Head Nurse Zack read and reread the letter in stunned silence, trying to match the charges with the eloquent, dedicated man he had listened to at the staff meeting and, later, over lunch. There was nothing in Beaulieu's manner, speech, or the content of his words that bore out the nurse's claims. Still, there was no way such charges could be dismissed. Across the desk from him, Frank sat in smug silence, obviously savoring the moment. "This is terrible, " Zack murmured, trying, as he read the letter for a third time, to get a fix on the nurse, Maureen Banas… colorless, but efficient… distant… knowledgeable… he simply hadn't spent enough time around her yet to have any real handle. "Terrible, but true,

  " Frank said. "I had hoped to spare the old duffer any more humiliation, but after hearing his little speech the other morning, and seeing the way he's gotten to you, well, it seems I have no-"

  "Frank, does anything about this letter strike you as strange?"

  Frank set his cigar aside and leaned forward. "What are you talking about?"

  Zack slid the letter back across the desk. "Well, for one thing, this woman doesn't substantiate her charges with one specific example."

  "Well, there's no doubt she has them. Zack, don't you think you're grasping at straws?"

  "And for another, the whole damn thing is just too… too sterile."

  "What?"

  "Just look at it, Frank. Not one bit of sensitivity or poignancy.

  Not one indication that she understands the charges she's making could quite possibly send a man's life down the drain-a man who has practiced surgery in this town for thirty years. Christ, for all the awareness she's showing, she might just as well be writing to complain that a neighbor's poodle is shitting in her flower bed. The more I think about it, the more this letter smells. I think that woman should be spoken with, face to face."

  "You don't think I've done that?"

  "Well, then, I want to. It's the only way I'm going to even begin to believe all this."

  "You go to her or anyone else about this business, " Frank said, jabbing a finger at him, "and you'll be out on your ass quicker than you can say scalpel. This is my affair-mine and Ultramed's. You really have it in your mind to fuck things up for me around here, don't you?"

  "Frank, that's nonsense."

  "Is it?"

  For several frozen moments, Zack couldsonly sit and stare at his brother. Despite his tan, Frank looked pallid, his expression a disconcerting amalgam of anger and-what? Fear? They had had their differences over the years, true, and from time to time, some magnificent arguments. But Zack sensed something far more powerful at work here. "Frank, please, " he managed. "Stop sounding like I'm your goddamn enemy. I'm not. I just care about Beaulieu and I want to see that he gets a fair shake, okay?"

  A margin of color returned to Frank's cheeks. "Okay? " Zack asked again.

  Frank smiled. "Sure, sport, " he said, far too amicably. "I understand.

  I'll tell you what, why don't we just leave it that I'll keep you posted and you'll keep an eye on things… from a distance. That way I get to do what I'm paid to do, and you get to keep from taking a fall. I promise you, Beaulieu will get every break that's coming to him. Yes?"

  Zack gauged the intensity in his brother's eyes, and then nodded. Their session had gone far enough. "So, that's taken care of, " Frank said, tilting back in his chair and folding his hands in his lap. His tone and expression gave no hint of their disagreement. "Listen, how about we have dinner sometime this weekend? I'll have Lisette give you a call."

  "Sure, Frank. That'd be fine."

  "Excellent. Oh, and by the way, " he added, getting up from his chair as Zack stood to go, "tell that new squeeze of yours that we're all praying everything goes well for her tomorrow."

  Now Zack felt the color drain from his face. "How did you-" His brother patted him on the shoulder. "Sport, if someone who works for me so much as farts anywhere in this hospital, sooner or later I get a whiff.

  That's worth remembering. Trust me on that one and you'll be doing both of us a favor. She's a terrific lady. I'm glad she's finally coming out of her shell. I hope things work out between you."

  With that, he shook Zack's hand and ushered him out the door.

  CHAPTER SEVEN

  Disturbed by a cart clattering past the door of her hospital room, Suzanne Cole rolled onto her back, floating in the twilight world between sleep and wakefulness. For a time, she struggled to complete a dream she had been having — a romantic, storybook dream, in which Jason Mainwaring, dressed head to foot in ebony armor, sitting astride a coal-black stallion, was jousting with a knight clad equally spectacularly in gold. Again and again, the men sped past one another, their lances exploding off their opponent's shield. With each encounter, one or the other came close to falling from his mount, but each time, the stricken knight recovered and swung about for another pass. Suzanne herself was seated in the grandstand, wearing a flowing gown of pink silk and clutching a single white rose. Who are you? she called again and again to the gold knight. Who are you? What do you want from me?

  As the dream faded, the knight turned toward her and lifted the visor of his golden helmet. Like flashing neon, the face of the man kept changing. One moment it was Zachary Iverson, and the next, Paul Cole — the pathologically self-possessed physiology professor who had picked her out of a crowded lecture hall during her second year in medical school and had swept her up in a whirlwind of flowers and parties and romantic weekends in the country. Less than a year later they were married. If there were signs of the man's sickness during those months, she had missed them completely. Later, when the r
ecreational drugs, and the erratic behavior, and the lies-"misunderstandings, " Paul had called them-began to surface, she had chosen to ignore them, to rationalize them away. By the time she knew that her efforts to hold their marriage together had been a mistake, there was Jennifer. The years she spent trying to accommodate Paul for her daughter's sake had nearly cost Suzanne her career, and perhaps even more than that. Why? she pleaded again. What do you want from me?

  "Dr. Cole, it's morning."

  Why?… "Dr. Cole?"

  The nurse's gentle voice, and the touch of her hand, began to dispel what remained of the dream. The colors began fading into a sea of white.

  How long had it been since Paul had last forced his way into one of her dreams? The arguments, the guilt trips, the hang-ups when she answered the phone, the missing prescription pads, the visits from the glib, condescending drug enforcement agents… Why had she given the man so goddamn many benefits of the doubt?

  "Dr. Cole…"

  Suzanne opened her eyes a slit. "Hi, " she murmured. Instinctively, she reached up and touched her breast, dreading the thick bandages she expected to find there. "It's seven-fifteen, " the nurse said. "Time for your pre-op meds." Pre-op. Damn, she thought. It was not over at all. It was just starting. Why was this happening? Life in Sterling had been everything she had hoped it would be-so peaceful, so uncomplicated, so good for Jen. Now, suddenly, everything seemed to be unraveling at once.

  Why?

  She opened her eyes fully. "Seven-fifteen?"

  "Uh-huh. You're on call for twenty minutes from now. This is some atropine and Demerol."

  Atropine… Demerol. One to dry up secretions, and the other to help one not give a damn about the prospect of being disfigured, or worse.

  What wonderful potions we doctors have at our fingertips, she thought acidly. What wonderful potions, indeed. She turned onto her side and winced as the needle pierced her buttock. Then she rolled onto her back and smiled up weakly at the nurse. "Nicely done, " she murmured. The nurse, a kind, elderly woman named Carrie Adams, patted her hand.

  "You're going to do fine, " she said. "I've had a couple of cysts removed, and so has my daughter. The hardest part is the waiting to get it over with."

  "I'll try to remember that."

  Once again, this time in spite of herself, Suzanne reached up and touched her breast. It was all so crazy. This sort of thing happened to other people-to patients. She was trained to help them through their medical crises, not to go through one herself. She had bounced back so far, put so many pieces of her shattered world back together. Now this.

  Helplessness… panic… rage… her emotions, held in check over the weeks since that terrifying moment of discovery, swirled about like windblown snow. Where in the hell was the acceptance that the textbooks all wrote about?

  "That Demerol should start to work in just a few minutes, " the woman said, as if reading her thoughts. "Good."

  "And here are your earphones."

  "Oh, yes, " Suzanne said, taking the set and placing it on the bed beside her. "What's on today?"

  "I don't know, " the woman replied, "but Dr. Mainwaring's on channel..

  " She took a three-by-five card from her uniform pocket."… three."

  The system-tapes picked by the surgeons to be played in the operating rooms and broadcast to earphone receivers-was designed to reduce patient anxiety levels. Over the few years it had been in place, the innovation had received high marks from surgeons and patients alike.

  Suzanne flipped the dial on the phones to 3, and held one up against her ear. "Greensleeves, " she said. "Pardon?"

  " Greensleeves. That's the music. A really beautiful version of it.

  Here, listen."

  She passed the earphones up. The nurse politely listened for a few seconds, and then returned them. "Very pretty, " she said. "Well, I'll be back in a little while. Meanwhile, you just relax. Oh, by the way, there's an envelope for you on the bedside table. Perhaps you'd better read whatever's inside it before that medicine I gave you takes effect."

  Suzanne thanked the woman, and then waited until she had left the room.

  The envelope, with the Ultramed-Davis heading and logo, read, Dr.

  Suzanne Cole. She peeled it open, knowing it was from Zack. Throughout much of the evening, he had sat there with her, reading out loud from magazines and newspapers, laughing, sharing stories of his life, and, when there was nothing to say, just holding her hand. He had been as open, as tender, and as understanding as any man she had ever met. She wondered if he realized the resentment she was feeling at his intrusion into her life. Silently, she cursed herself for using him the way she had. She had no intention of allowing a man close enough to ruin her life again-not now, at least. Possibly not ever. Zack had said they could make love with no strings attached, but she knew damn well that there were always strings. When the operation was over, regardless of the outcome, she would do what she must to put distance between them.

  For a moment, the fear of what might be growing within her breast seemed pale next to the fear that she might never again be able to trust. Dear Doc-It's now 2 a. m. The sleeper they gave you seems to have worked, because you've been out fairly solidly for about an hour. I'm going to leave now, and hope that you don't wake up until a minute or two before they bring you down to the O. R. I just wanted to thank you for Wednesday night, and even more, for letting me share this evening here with you. I don't know if my being here helped you, but it has surely helped me. It's not much of a secret that I think you're pretty special.

  I know how frustrating and frightening this is for you-partly because it's frustrating and frightening for me, too. Just know that whatever happens, I'll be with you as much and as closely as you want me to be.

  If there's a good, working definition of "friend, " maybe it's someone who helps us find the tools to get through this kind of shit when we can't seem to find them for ourselves. Regardless of what happens, you've got one in me. It's going to be benign. That's all I can say.

  It's going to be benign, and everything's going to be okay. Be strong.

  You have an appointment on my mountain as soon as this is over. Zack "I'm sorry, Zack, " Suzanne whispered as she slipped the note back into its envelope, tucking it between the pages of the novel she had been reading for the past two weeks. "I'm sorry I wasn't stronger…"

  She settled back onto her pillow and slipped on the earphones. Her mouth had become uncomfortably dry from the atropine, but the Demerol, too, was having its effect, so she did not really care.

  Carrie Adams and an orderly wheeled a stretcher into the room and helped her slide onto it. Please, God, Suzanne whispered to herself as the fluorescent lights flashed overhead, let it be nothing. Let it be benign. Jason Mainwaring met her in the operating room, his blue-gray eyes intent from between his aqua mask and hair cover. Suzanne pulled off her earphones. The same lovely piece she had been listening to filled the operating room. "Welcome to my world, Suzanne, " he said.

  Suzanne smiled weakly. "I wish I could say I was pleased to be here."

  "I understand." He patted her arm reassuringly. "We'll take good care of you. Don't you worry."

  "Thanks."

  "How do y'all like my music?"

  "It… it's beautiful."

  "The most beautiful music ever written, I think. It's called Fantasia on Greensleeves, an' it's by an English composer named Ralph Vaughan Williams. I begin every single case with it, an' then go on to some other pieces of his. If you want, I'll make a tape of it for you."

  "That would be very nice, " she managed. Jack Pearl, the anesthesiologist, appeared at Mainwaring's side. Together with a nurse, they helped her from the litter onto the chilly operating table. Then, in a maneuver so quick and painless she barely realized it was happening, Pearl slipped an intravenous line into a vein at her left wrist. Next, a broad strap was pulled across her abdomen and tightened.

  A final pleasantry or two from Mainwaring, and they were ready to begin.<
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  Jack Pearl came into Suzanne's field of vision, held up the rubber stopper of her intravenous line, and slipped in a needle attached to a syringe full of anesthetic. Please, God, she prayed once again, let Zack be right. Let it be okuy. "All right, Suzanne, " Jack Pearl said. "This is just some Pentothal."

  He depressed the plunger, emptying the contents of the syringe into her intravenous line. "All you have to do now is count back from one hundred."

  From the speakers overhead, Ralph Vaughan Williams's flowing fantasy filled the room. "One hundred, " she said thickly."… ninety-nine… ninetyeight…"

  Above her, the huge, saucerlike operating light flashed on. "Ready," she heard someone say. Takashi Yoshimura was one of seven Orientals living in Sterling, New Hampshire. The other six were his wife and five children. Though Japanese by birth, and, in fact, by birthplace, he had been raised and educated in lower Manhattan, and spoke both English and Japanese with a pronounced New York accent. Like a number of the new Ultramed physicians Zack had met since his return to Sterling, Yoshimura, a pathologist who insisted on being called Kash, was young, well trained, and exceedingly capable. It was just after eight in the morning. Yoshimura, diminutive, with close-cropped hair and Ben Franklin glasses, sat at his desk, with Zack peering over his shoulder. Before them, in a stainless-steel pan, was the fleshy, silver-dollar-sized mass that had just been removed from Suzanne Cole's right breast. Zack watched in tense silence as the man maneuvered the tissue about beneath a bright light and magnifying glass. A floor above them lay Suzanne, adrift in the dreamless netherworld of general anesthesia. In minutes, the unimposing little pathologist would send word to the O. R. of his interpretation of the cells in the frozen sections of the specimen, and Suzanne would either have her incision sewn up, or a large portion of her breast and the surrounding Lymph nodes removed. If Kash Yoshimura was the least bit nervous about the awesome implications of this facet of his work, it certainly did not show in his face. He hummed a soft, almost tuneless melody as he scanned the surface of the mass, searching for any telltale dimpling or discoloration. Then, with a final, satisfied arpeggio, he used a scalpel to produce a thin slice from the core, and handed the pan with the exposed specimen to the histologist.