by Aiden Bates
"Hot damn," Allan whispered into Carter's ear.
Carter's body agreed with Allan. He met the alpha's eyes and wondered what it might be like to have a few less people in the room. Then again, Carter wasn't exactly in the market for an alpha. He delivered babies. He didn't make them. "Are you kidding me?" he whispered back. "Did you see that suit?"
"It will look lovely on the floor." Allan nudged Carter with his shoulder.
The icy alpha stood up, and all conversations came to an abrupt halt. "Good afternoon. My name is Finn Riley, and I'm the new Chief Executive Officer here at Silver Oak. As you're all aware, Silver Oak joined the Regent Healthcare Alliance last month. Part of my job is to bring Silver Oak into the Regent family."
The lights dimmed, but didn't completely darken. "I'm sure you're all wondering, 'What does this mean for me?'"
Carter frowned and glanced around at the rest of his colleagues. They were all looking at each other, too, and not with approval. Sure, the self would intrude, but none of them had gone into healthcare because they thought about themselves first. They worried about their patients first. Their prior CEO had understood that.
Images appeared on a screen. Carter hadn't noticed the screen behind Riley, but now he did. He noticed it because of the graphs that were on it. The graphs that were on the screen showed expenses rising, year over year. There was no corresponding graph for income, or for patient outcomes. Carter pressed his lips together and crossed his arms over his chest.
"As you can see, the hospital's expenses have been rising year over year for the past ten years. This is especially concerning given the current environment. Obviously, Regent would prefer to keep their employees fully employed, but we need to cut back on the waste. Overtime, shown here in red, is one of the most egregious expenses we have, and it's especially overblown in your department as you can see here."
Carter raised his hand.
Riley narrowed his eyes. "What is it?"
"Dr. Idoni." Carter stood up and met the alpha's eyes. "I noticed that there's no corresponding graph that shows patient outcomes over the same period. I have one on my laptop, in my office, that I would be happy to send you. It shows parental mortality rates declining by over twenty percent and paternal mortality rates, in cases of parturient omegas, declining by more than fifty percent. Maybe that would provide some context to your graph."
A murmur ran through the crowd, and a few of the nurses nodded their heads.
"I don't see how that's relevant to expenses." Riley's voice dripped venom.
"It's relevant in that more is being spent to ensure that these patients, who would otherwise have died, survive. That is what we actually do here. When you take our department to task for overtime, I also notice that you don't take the seasons into account. Fortunately, I happen to have a breakdown of exactly that on my laptop as well."
"Why do you even have that?" asked a balding man with a pink tie.
"Because something we were doing, as a department, before the merger was addressing quality of life issues within the department. Something that we found was that we tend to incur overtime costs in the winter, for two reasons. One is weather related. If the next shift can't get to the hospital, the earlier shift has to stay on, and they have to be paid. There are laws about that. Lots of laws about that," he added, with a grim smile. "The other issue is cold and flu season. Our staff, and our nursing staff in particular, is dealing with a highly vulnerable population. Half of our patients do not have functioning immune systems yet. They cannot come to work if they are sick. Their colleagues pick up the slack, which also causes overtime."
Riley's face went white with rage, and he gripped the podium so hard that it cracked. "We can discuss these issues at a later point. Nevertheless, we need for all employees to be extra conscious of expenses and of costs as they go about their daily tasks. I'm sure that there will be many changes as the merger is completed. Any transaction of this nature tends to involve some culture shock; behaviors that were tolerated by one administration may not be welcome in the next." He met Carter's eyes, and his threat was clear. "Enjoy your day." He stormed out of the room, ridiculous jacket flowing behind him.
Allen turned his head to look at Carter, his face ashen. "Dude. You just challenged not only an alpha, but the new CEO, in public. Your ass is grass around here."
Carter did not want to think about Riley and his ass in the same context. Maybe someone who looked like Riley, and who smelled like Riley, but the man himself was an ass. He curled his lip. "I'm the only one in the next three counties who's licensed to do a C-section on an omega." He grimaced. "That's why I said it, instead of expecting someone else to do it. I've got job security."
"He can make you quit, and then what would you do?" Allan shook his head. "Don't poke the bear with a stick, okay?"
Carter headed back to his office. Lord, what a day this was turning out to be. When he'd gotten to work this morning, he'd been looking forward to a fairly routine day of simply hanging around and working with parents to be. Now he had a case with a possible serious birth defect and a budding war with the hospital's new CEO.
The hot alpha CEO.
Allan stuck his head into the room. "Don't get comfortable. We just got an omega in from Emergency, no prenatal care and he's having a rough time. It looks like he's going to need you."
Carter chugged down the cold remains of his coffee. It looked like it was going to be a long night. Fortunately for him, and for Finn Riley's hideous graphs, he wasn't paid by the hour.
***
Finn burned with rage after he left the introductory meeting. He'd intended—no, he'd needed—to impress his new employees with his importance. He'd walked right in and things had been going well, until he met that omega's eyes. Those chestnut brown eyes that just stared back. They didn't look away, they didn't give way, they didn't submit.
Maybe he'd mistaken the omega's scent? He'd been sitting beside another omega. Maybe there had only been one omega.
When he'd gotten back to his own office, and pulled up this "Dr. Idoni's" personnel file, though, it had confirmed what he'd scented in the conference room. That wood-smoke scent had been his, and it had been beautiful.
Too bad the personality was more "firebrand' than "campfire."
The obnoxious doctor had a damn fine track record, too. Finn scoured his file, looking for anything that he could use to fire the man for, but there was nothing. He'd taken the job at Silver Oak once he'd finished his residency because there weren't enough obstetricians in Syracuse and there weren't nearly enough obstetricians who were certified to handle the number of omegas living in Central and Northern New York.
He'd agreed to work there for two years, to pay off the rest of his schooling. He was still here, years later.
Okay. So, what Finn was dealing with here was a True Believer. That wasn't exactly a shock. Dr. Idoni clearly had some kind of lofty ideals when it came to the work that he did, and if he was the kind of guy who signed on to get sent to an "underserved" location then that was no surprise. Finn had dealt with True Believers before. All that he had to do was to show them that their behavior was hurting their cause, and they would cut the crap and get with the program.
Finn massaged his temples. He didn't need this crap. He'd done the lunch thing with four other departments so far. Those meetings had gone fine. Everyone had been suitably impressed by the necessity of cutting costs, and no one gave him any grief. For crying out loud, it wasn't as though Finn was telling them to execute patients or anything like that. He just needed them to bring their expenses in line.
Silver Oak was a nice hospital. It was the best hospital in Syracuse. It was also, unfortunately, a money pit. Regent hadn't understood that when they'd acquired the place. They figured that they could get the place to break even if they managed to achieve some kind of economies of scale, but clearly they hadn't been informed about the true state of the hospital's finances. If he couldn't get the place to stop bleeding money, some thing
s were going to have to go.
If the Obstetrics, Gynecology, and Omega Medicine department was going to play host to a mouthy jackass like Dr. Idoni, who couldn't figure out the power structure around here, then maybe that was what needed to be on the chopping block.
He signed some papers in his office for a while, trying to calm down. Whatever the mouthy omega might think, say, or do, Finn was the one in charge around here. He was the authority. All that he had to do was to assert his authority, and everything would work out. Maybe he hadn't been the chief executive at a hospital before, but he'd worked his way up the chain just fine. He knew what he was doing.
After a couple of hours, when his rage faded but his anger lingered, he made his way down to Dr. Idoni's office. Maybe he could focus once he'd set this omega straight. It had nothing to do with his omega status, of course. Finn was above that sort of thing. It had everything to do with establishing his position as the head of this hospital.
The department receptionist turned pale when she saw him, and Finn hated himself a little bit. He didn't want all of the employees to be afraid of him, for crying out loud.
Just Idoni.
"I want Dr. Idoni and I want him now."
"Dr. Idoni's in with a patient, sir." The receptionist wouldn't meet his eyes.
"So, pull him out!" Finn leaned forward. "I'm his boss!"
Another doctor, a woman in a pencil skirt and a lab coat, happened to be passing by. She carried a tablet in her arms, but she turned to face Finn and frowned. "You don't 'pull someone out' of a high-risk delivery." She curled her lip. "I mean that's how infections are spread. You have worked in healthcare before, right?"
Finn sucked in his cheeks and counted to ten. "She didn't tell me that he was in Labor and Delivery. She told me that he was with a patient."
The doctor, whose nametag identified her as Dr. Indah Glover, curled her lip a little. "Do you honestly think that we do anything in this department, Mr. Riley, that anyone can simply be pulled away from? A patient would be on the phone to the state medical board right there on the table, and they would be right." She shifted her weight. "Is there something that I can help you with, or are you here to try to intimidate Dr. Idoni?"
"Is this entire department insubordinate?" he barked.
"You're from out of town, aren't you?" She rolled her eyes. "I'm sure you'll be able to find the coffee station. He usually comes back to his office after a delivery; he'll be back when the baby's here." She walked off toward the doctors' offices.
"Would you like to have a seat? You can wait there for Dr. Idoni." The receptionist's voice was bland but calm.
"Thank you, no. I'll wait for him in his office."
The receptionist opened her mouth, and then she shut it again. "Yes, sir. Right this way."
At least someone around here knew how to follow orders. He followed her down the hallway that led to the doctors' offices and sat down in one of Dr. Idoni's office chairs to wait.
The office was in the older part of the building. Finn was going to have to come up with the cash to renovate it soon. He couldn't be positive, but he thought that those windows might be original. No wonder the heating costs and the cooling costs were so astronomical.
If his office was any indication, Dr. Idoni spent most of his salary on books. Finn could barely tell what color the walls were because they were hidden by shelves and all of the shelves were full. The books were full of information, too. There were anatomy books. There were how-to manuals. There were pathology tomes as big as a man's head and bound volumes of medical journals that surely must have cost a fortune. Finn hoped that this jackass wasn't spending department money on the damn things.
There were a few personal items. Idoni's degrees hung on the wall. He'd gone to Brown for undergrad, and then to Stanford for med school. Not too shabby. He'd had prestigious residencies, and then he'd finally ended up right here in Syracuse where he'd stayed. Apparently, he liked it here. Well, good. That was some good leverage to hold over him.
He sat back down to wait, and to wait, and to wait some more. Had someone managed to get down there and warn him?
Finally, after the sun had gone chasing the Greyhound bus to Ohio or wherever it went, Finn heard that wretched doctor's voice. "I wish we could do more for him."
"Carter, man, we did everything we could." The second man was a local, if his accent was anything to go by. "You saved his life, and you saved his baby. That's literally all you can do. You even referred him to Social Services."
"Yeah, well, that was before I found out that the Social Services department is running a skeleton crew right now." Idoni's voice was so bitter that Finn's mouth puckered just from the sound. "They told me that they could get to the poor guy in two weeks. By which point he'll be out on the street, with a new baby." The doorknob rattled. "I'll look for some other resources, I guess."
"Don't stay up too late." The other voice faded as its owner moved on down the hall.
The doorknob rattled again, and Finn's breath caught in his throat. He'd be livid if he caught someone eavesdropping on his private conversation, and it sounded like that one was definitely meant to be private. When he caught a whiff of Idoni's wood-smoke scent though, he remembered why he was here. His anger returned.
"I suppose you're going to blame me for the social service cutbacks too," he said, in as cold a voice as he could muster.
Idoni, damn the man, didn't have the good grace to jump. Finn wasn't sure that he could have jumped. The man looked absolutely beat. His previously neat dark hair was now disheveled, and a little line had appeared between his eyes. An omega shouldn't look that distressed. He should have someone to wrap him up in his arms and kiss him better.
Finn blinked in surprise. Where had that thought come from?
"Well," Idoni drawled out. His voice had more of a rasp to it than it had this afternoon. "I could point out that since you are the CEO, and they're gone, that yes, it's your fault. But since it doesn't matter whose fault it is, as long as no one's going to help that young man with the new baby, I'll just get to solving the problem." He sat down at his desk and opened up the laptop.
"For the record, those staff members resigned when they found out about the acquisition. They were not laid off." Finn leaned forward. "They haven't been replaced because that department was bloated and underutilized."
"That department was running well over the recommended number of cases per worker according to most standards. I know, because we're the department that refers to them more often than any department other than Geriatrics." Idoni started typing.
Finn shook his head. "The man in charge of the entire hospital comes to your office and you ignore him to play on the computer."
"I'm not 'playing on the computer.’ I'm supplementing the deficiency you created and looking for resources for the guy who gave birth in my OR." He glared. "I get that it's all just numbers to you."
"Those numbers are where your salary comes from."
"Actually, the reimbursement from Medicare, and from the state, is where the payment for what I did today will come from. So will the grants and donations that cover this hospital. No one sits here and spends money for the hell of it. At any rate, what I was saying was that it may be just numbers to you, but these are actual human lives. Silver Oak is the top of the line when it comes to patient care and patient outcomes, in all of Upstate New York. When you start to lose sight of the human beings involved, patient care suffers. At that point the grant money starts to dry up, and so do the donations." He grinned, deadly and wickedly. "And your name is going to be all over it."
"You have no respect for authority, do you?" Finn stood up, incensed beyond his own ability to keep cool.
Idoni pretended to consider it. "Nah. Not really. Not arbitrary authority. You gotta do better than waltz in and say, 'Hey, look at me and my charts, now be afraid of me!'" He wrinkled his nose. "If you want to fire me, you're going to fire me. But that's not going to change anything that I just said. Yo
u're still going to take this entire hospital down with you. I'll just be long gone by that point."
"But you don't want that. You stuck around in Syracuse for a reason." Finn leaned on Idoni's desk. "You could have left after two years. You didn't. You're a believer. You like it here."
"I reckon I'd like it just fine at any of the other hospitals around here. Or, you know, in Manhattan. I wonder how a Tennessee boy would do in Manhattan?"
"You'd melt. Hospital administrators in New York actually expect their employees to do what they're told." Finn sneered. "Look, you're already on thin ice. Don't contradict me in front of people again. Don't contradict me at all. If you have a suggestion, use the suggestion box."
"I've got a laundry list of suggestions for you, Riley. And believe you me, the first time we lose a patient because of something you did, I'm going to make damn sure the entire city knows about it." He gestured at the door. "Now, if you don't mind, I've got a patient to save."