Flashback

by Michael Palmer

  "You didn't keep a tight enough rein on that doctor of yours, Frank.

  You're in charge. It's your hospital, just like this is my courtroom."

  Oh, give me a fucking break, Frank thought. "You're right, Judge," he said. "Your point's well taken. I've spoken to Don, and he knows his behind is on the griddle from now on. Also, he's making arrangements to pay for any expenses Annie runs up in getting home care after her surgery."

  "Excellent, son. That's an excellent move."

  "Our hospital's come a long way since Ultramed took over, Judge. I'll do anything I have to to keep it on the right track." Clayton Iverson loosened his tie and ran his thumbs beneath the black suspenders that had always been part of his courtroom dress. "I assume, " he said, "that statement of purpose is your roundabout way of asking me to withdraw the notice I dispatched to your friend, Ms. Baron."

  Damn, but the man was tough. "Well, as long as you brought it up The Judge swiveled in his seat, lifted the picture of Frank from the wall, and appraised it thoughtfully. "Remember when this was taken? " he asked. "It was right before the state championship game against Bloomfield. The best game you ever played, I think. Six touchdown passes against the team people were calling the toughest ever in the state."

  "Five, " Frank corrected. The Judge smiled. "You're forgetting the thirty yarder in the third quarter that was called back for a holding penalty. On the very next play, you threw that forty-five-yard bomb to Brian Cullen. Three men hanging all over you, and you heaved that ball downfield like… like you were playing in the backyard."

  "That was a long time ago, Judge."

  Frank was genuinely surprised and touched by the detail in the man's recollection. "You have quite a memory."

  "Son, " Clayton Iverson said, "you'd be amazed at how much I remember from those days."

  His tone was uncharacteristically wistful. "There was a toughness to you then, Frank-a determination to be the best. You had the whole world right in the palm of your hand. Somewhere along the line, though, you started backing off, making bad choices. No, not bad," he corrected,

  "terrible. Somewhere along the line, you lost that edge."

  "But-"

  "I'm not through. The worst part of it all is that the more you struggled, the less willing you became to listen to advice. You ran up against problems, and instead of plowing through them like you used to do, you tried to run around them. "I want you to succeed here, Frank. I want that very much. But I'm not going to make it easy for you. I'm going through with that letter, and I'm going to try and find out just what went on with Guy."

  "I've told you before, Judge. Nothing went on with Guy."

  "I hope not, Frank. Don't you see? I want you to show up at that board meeting with a case for Ultramed that's so strong and so polished, no one on the board would even think about voting against you. This is one problem you're going to meet head on, son. And I pray to God you roll right over me."

  Frank held up his hands in frustration. "Judge, you're just making a mess of everything. Checking up on me and the hospital, auditing our books. The people at Ultramed are watching. If they see that I can't even reason with my own father, everything I've gained these past four years will be headed down the drain. Just the fact that I was the last one to know about your letter has already made me look like an idiot."

  "Well, when Ms. Baron and her associates see the case you put together for their corporation, you will be a hero."

  "But-, "That's the way it is, Frank."

  He swung back and replaced the photograph. Frank felt an all-too-familiar anger and frustration begin to well up. He cautioned himself against any outburst, and reminded himself to meet strength with strength. "Okay, Judge, " he said. "You obviously have your mind set on this thing."

  "I do."

  "Well, then. I'd like you at least to compromise on one thing-the audit.

  We weren't scheduled for our general audit until next February. It will take me days to put everything together as it is, and it will throw my staff into chaos. Either cancel it or… or at least postpone it until next month."

  The Judge shook his head. "Farley Berger says it's got to be done in the next day or two in order for his team to have all the figures checked over by the meeting on Friday."

  "But there's nothing in the contract that says the audit has to be done by the board meeting. Make it two weeks."

  Clayton Iverson thought for a minute. "Okay, Frank, " he relented, "you want two weeks, you've got two weeks."

  That's it, Judge, Frank thought exultantly. That's it, that's all I need. "I'm going to beat you, you know, " he said. "I hope so, son," the Judge responded. "I truly do."

  CHAPTER SIXTEEN

  For Zack, the day had resembled some of those during his residency. Two consults on the floors, assisting one of the orthopedists with a back case, admitting a three-year-old who had fallen off a swing, hit her head, and then had a seizure, and finally, seeing half a dozen patients in the office. It was the sort of pace on which, ordinarily, he thrived.

  This day, it was all he could do to maintain his concentration. Six days had passed since his initial contact with Toby Nelms, and he was still unable to put together the pieces of the child's diagnosis. For a time after his abortive interview with Jack Pearl, he had tried, as an exercise, to give the anesthesiologist the beiiefit of the doubt-to concoct another explanation that would jibe with the facts. He had cancelled his schedule for the day and driven to Boston for consultations with several anesthesiologists at Muni. He had also spent four hours in the county Medical Library at Harvard, reviewing every article he could find on Pentothal, isoflurane, and their complications.

  By the end of his search, he considered himself qualified as one of the experts in the field. Always, though, his efforts brought him back to his original hypothesis, and back to a single word, Metzenbaums. Now, in a few days, he would meet again with the boy and his mother. This time, Zack knew, Barbara Nelms would not settle for evasions and half-truths.

  The woman was desperate. She had every right to be. It was just after four in the afternoon. From the west, dusky mountain shadows inched up the valley toward Sterling. Zack had just finished a detailed discussion of Meni amp;re's disease with the last of his office patients. "I know exactly what you have, " he had told the elderly man, who had come because of intermittent dizziness and a persistent, most unpleasant hum in his ears. "Unfortunately, I also know there is very little we are going to be able to do beyond teaching you how to live with it."

  He had ordered some tests in hopes of coming upon one of the rare, treatable causes of the condition, had passed on the address of the national society dealing with Meniere's, and had expressed his regret at not being able to do more. The man's disappointment was predictable and understandable, but it was nonetheless painful for Zack. It's not going to get you, Toby, Zack vowed as he watched his crestfallen patient shuffle from the office. The practice of medicine provided more than enough of the frustration and heartache that came from having no answers. In Toby Nelms's case, the answers were there. And somehow, someone was going to supply them. Just hang in there, kid. natever's going on, whatever they've done to you, it's not going to get you. Zack sent his office nurse home early, alerted the answering service that he would be on his beeper, and spread the boy's folder on his desk. Most of what he was rereading he knew by heart. After just a few minutes, he snatched up the phone and called Frank's office. There was no alternative but to share his suspicions with his brother and try to enlist his help in another confrontation with Pearl. Frank was gone for the day, and his secretary had no idea where he was or when he would be back. A call to Mainwaring's office gave him only the answering service, and the information he already had, that the surgeon was out of the state until the following Monday and was being covered by Greg Ormesby.

  "Answers, " he canted, drumming a pen on the edge of his desk. "There have got to be answers… Where are you, Jason?… Who are you?…

  What do you know
?"

  On an impulse, he checked his hospital directory and dialed the pathology department. Takashi Yoshimura answered on the first ring.

  "Kash, " he said, "if you can do it, and if it wouldn't put you on the spot, I need a name…"

  Ten minutes later, Zack was on the line with a Dr. Darryl Tarberry at Johns Hopkins. "Dr. Tarberry, " he said after explaining how he had come by the man's name, and after listening patiently to ebullient praise of Kash Yoshimura and his work, "I am calling for a recommendation, but not for Dr. Yoshimura. Fortunately, we already have him on our staff. The man I'm interested in is Dr. Jason Mainwaring. Kash said you might have worked with him when he was at Hopkins."

  For a few seconds there was only silence. "Who did you say you were?"

  Darryl Tarberry asked finally. From his recollection of the man, Yoshimura had guessed that Tarberry was in his mid-sixties by now. But from the harsh crackle in his voice, Zack wondered if he might be years older than that. "My name's Iverson. Zachary Iverson, " he repeated.

  "I'm a neurosurgeon, and I'm on the credentials committee here."

  Again there was a pause. "Mainwaring's applying for surgical privileges at your place?"

  "That's right."

  "Well, I'll be," Tarberry said. "Where did you say that hospital of yours was?"

  "New Hampshire, sir. Listen, I don't want to put you on the spot, Dr.

  Tarberry, but we would certainly appreciate any information you can give us."

  "This call being recorded?"

  Zack groaned. "No, I promise you it isn't."

  "I'm not putting anything on paper, now."

  "That's fine."

  "Mainwaring and his lawyers had this place tied up in knots for I don't know how long. Damn lawyers. Ended up costing the hospital a small fortune to settle even though we were one hundred percent in the right as far as I'm concerned. One of my colleagues got ulcers from it. I swear he did. I don't want that happening to me. I'm too damn old for that kind of nonsense."

  "You have my word."

  "Your word… Iverson, huh. That Swedish?"

  "English. It's English, " Zack said, staring upward for some sort of celestial help. "Well, Iverson, I don't know all the details."

  "That's okay."

  "And as far as I'm concerned, we never had this conversation."

  "Promise."

  "Well, " the man said, drawing out every letter of the word, "let me tell you first that Mainwaring may be the most ambitious sonofabitch God ever put in a mask and gown, but he is one fine surgeon. Maybe the best I've seen, and I've seen plenty."

  "Go on, " Zack said… After fifteen minutes of prodding and cajoling, Zack felt he had extracted as much from Darryl Tarberry as he was likely to-at least over the phone. There was more to the story, he knew.

  Probably much more. But even so, a huge piece had fallen into place in the puzzle of Toby Nelms. Zack was just finishing writing a synopsis of the interrogation when the door to his waiting room opened and closed.

  "I'm here," he called out. "What a coincidence. So am I" Suzanne appeared at his office door, wearing a lab coat over an ivory blouse and ankle-length, madras skirt. "Got a minute? " she asked. "For you?

  Years." He set the Tarberry notes in Toby Nelms's folder and pushed it to one side of the desk. "Trouble with Annie?

  "

  "No, no. Nothing like that. She's doing amazingly well. I think Sam Christian's going to do her hip tomorrow."

  "Excellent. I'm so pissed off about what's happened to her. Every time I think about what Don Norman did, I want to hunt him down and flatten that pudgy little nose of his."

  "Zack, I'm as upset as you are about Annie, but I don't see how you can lay all the blame on Don. He didn't do anything with malicious intent."

  "That depends on your definition of malicious. He was sedating her so that she wouldn't object to being sent to a nursing home, so that Ultramed could continue to rake in profits from her care. If that's not malicious, I don't know what is."

  "Hey, easy does it, okay?"

  "What do you mean?"

  "that's your opinion. But it happens not to be everyone's. Couldn't YOU just let up on this place a bit?"

  "Huh?"

  "Zack, Frank just left my office."

  "So, that's where he's been. I've been trying to reach him."

  "He's really upset with you."

  "I know. Is that why he went to see you?"

  "As a matter of fact, it is. He… he wanted me to talk to you-to ask you to let up on your criticism of this place."

  "He could have come and asked me himself."

  "He says he tried."

  "He was drunk. He threatened me. That's not what I would call the Optimal approach… So, now he's chosen to involve you. I can't believe this place."

  "Zachary, I didn't come up here to pick a fight. I just wanted to do what I could to smooth things over between you two. I owe Frank a lot. I thought you understood that from all I told you of what happened to me."

  "Sorry, " Zack mumbled. "If I'm touchy, I guess it's that I just wish things were different between me and Frank."

  "Well?"

  "Suzanne, I can't help it if Frank thinks it's my fault that the Judge is pushing the board of trustees to buy back the hospital from Ultramed."

  It was clearly the first she had heard of that development. "My God, Zack, you can't let him do that."

  "First of all, " he said.

  "I have no more control over that man than Frank or anybody else does.

  And second, why not?"

  "Well… well because, " she stammered. "If the board threw Ultramed out, Frank would be ruined."

  "Nonsense. He knows his job. He could do it just as well for a community corporation as he could for an operation like Ultramed. Better, probably. Suzanne, listen to me. Something's wrong around here.

  Something's terribly wrong."

  "Dammit, Zachary, what is the matter with you? Don't you have regard for anyone but yourself? I come here to ask you to let up on a man who is partly responsible for saving my career, to say nothing of his being your brother, and all you can do is… is tear down his hospital."

  "It's not his hospital. Look, I don't want to get into a fight. I have too much on my mind."

  "Like what?"

  Every instinct was clamoring for him to change the subject, to keep his theories to himself-at least as long as they were no more than that. He stared down at his hands. Darryl Tarberry's revelations about Jason Mainwaring were too fresh in his mind. "Suzanne, " he said slowly. "I have reason-good reason-to believe that human experimentation is being conducted at this hospital."

  "Now that is the wildest-"

  "And, " he cut in, "I have just as much reason to believe that you might have been one of the subjects."

  Suzanne listened in wide-eyed disbelief as he recounted his experiences with Toby Nelms and Jack Pearl, his brief study of the gallbladder surgery performed by Mainwaring and Greg Ormesby, and finally, his conversation with Tarberry. "Apparently, a woman died of an anaphylactic reaction to a local anesthe ic she received in Mainwaring's office.

  Mainwaring claimed it was Xylocaine, but there was plenty of documentation that the woman had received that drug on numerous occasions with no problems. A nurse of his, who was very upset with what happened, charged that Mainwaring had been testing something out that wasn't Xylocaine. Although investigators could never prove that was true, they did apparently discover that our friend Jason was part owner of a pharmaceutical house somewhere in the South."

  "This is crazy!" Suzanne said. "Did that man you talked to at Hopkins happen to know what company this might have been?"

  Te couldn't remember." He… couldn't… remember… Zack, this is exactly the sort of thing Frank was protesting. These are terrible, disruptive charges you're making on very little hard evidence."

  "I'm not making any charges, " he said, feeling his composure beginning to slip. "I'm sharing a disturbing theory with a friend whos
e clinical judgment I value and trust. I would think you'd be frantic at the thought that someone might have been fooling around with your body while you were asleep."

  "Well, I'm not frantic, I'm worried-about you. Zack, you've only been here a couple of weeks.

  In that time, you've clashed with Wil Marshfield, had words with Jason, fought with Don Norman, upset your brother, fostered a move to buy back the hospital, and now, on nothing more than the flimsiest circumstantial evidence, you're accusing the finest surgeon and anesthesiologist on the staff of a terrible crime."

  Zack pushed back his chair. "Suzanne, listen to ine-"

  "No, you listen. How do you explain the fact that there hasn't been one other case like Toby Nelins's?"

  "I… I don't know. Maybe it's a rare complication of whatever it is they're using. Maybe people have had episodes like his but they've happened in other places, or haven't been brought to a doctor's attention. Maybe there's some sort of sensory trigger involved that Just doesn't happen to everyone. You told me yourself that you hadn't been feeling right since your operation."

  "I've been tired. That's a far cry from having a psychotic seizure."

  "What about that episode in the field?"

  "What are you talking about?"

  "You went blank."

  "I did nothing of the sort."

  "You did. It was as if someone threw a switch, and all of a sudden you weren't there."

  "Zack, this is crazy. You've got to back off. You've hit this place like an earthquake."

  "Suzanne, that child is dying."

  "Maybe so. But it's not from something Jason or Jack Pearl did to him.

  One other case, Zachary. Just find me one other case like Toby Nelms and I'll listen. Even then I may not believe you, but I'll listen. In the meantime, I think you owe your brother, and all the rest of us for that matter, a little breathing room." She stood up. "Back off, Zack. Please.