by Allen Wyler
This inability to maintain a predictable schedule was the biggest obstacle of developing any sort of elective private practice at a trauma center. It sucked.
When leaving Philadelphia to take this job as chief of neurosurgery, Wyse had dreamed of developing a high-end, lucrative, elective service in addition to his research. He envisioned a practice competitive with those nose-in-the-air carriage-trade clowns at the premier downtown Seattle hospital, Doctors Medical Center. And the concept had sounded so good, the Lakeview search committee bought it hook, line, and sinker. After all, most of those old geezers over at DMC were just a few heartbeats away from retirement or the grave. Why not make a serious play for their territory?
The problem he and the administration had overlooked was a very basic business principle—cater to your customers. And the customers of a regional trauma center like Lakeview are all unscheduled trauma victims. Usually major thrashes. Well, duh. Severe burns, major vehicular crunches, multiple UZI wounds couldn’t wait for an operating room to open up after a long day of elective cases. So, of course, elective surgeries were delayed until all emergent cases had been accommodated. Which could take forever. Hence, the problem: Mr. Moneybags wasn’t about to lie on a rock-hard gurney for twelve hours in a surrounding that held about as much charm as the county lockup. The trauma center’s meat-house ambience simply didn’t compete with DMC’s Architectural Digest interior of muted colors and whisper-soft carpet.
On the bright side, a trauma center did offer him a perfect opportunity for clinical research. Especially if you had enough chutzpah to take advantage of it. Which Bertram Wyse did.
Even as a child he always saw the bright side of a situation, believing that being a pessimist sentenced you to a life filled only with depression.
WYSE SWEPT FROM bay to bay through the trauma ICU, an entourage of residents and med students in his wake. He stopped at the head of the next bed and waited for his eager audience to crowd around him. And in the hard-ass drill-sergeant tradition of neurosurgery, he taught. Everyone—from nursing students to the first-year general surgery residents forced to suffer through three-month stints on his service—became fair game. He despised the general surgery residents, seeing their short tour through neurosurgery as a waste of time for all involved. Three lousy months wasn’t enough to teach them anything about the specialty. He settled, instead, for beating into them a distinction between high-priest neurosurgeons and, say, knuckle-dragging orthopods.
He pointed at a med student, a cute little Hispanic number (Boy, I’d love to fuck her.) with black hair in a ponytail and a dark brown mole to the right of her pert little nose, and asked, “Look at the patient and tell me his diagnosis.”
She glanced at the resident standing to her left, but apparently realized all eyes were now on her. “I, ah …” She glanced again at a resident for help.
“No. No passing this off. I want you to tell me. Diagnosis, please.” Wyse drilled the first-year resident with an admonishing look, warning him to not take pity on her by giving away the answer.
The student’s face reddened as she shifted weight to the other leg and fiddled with the new stethoscope draped around her neck. Finally, with a helpless shrug, she said, “I don’t know.”
“You don’t know?” Wyse’s words dripped shock. Slowly, he scanned the group. The chief resident—an eight-year veteran of Wyse’s boot-camp mentality—had his hands clasped serenely behind his back and an impassive look in his eyes.
Wyse’s gaze drifted back to the student. “Look at his eyes, Gonzales. What do you see?”
Her blush intensified. “They … they’re swollen.”
“Come on, come on.” He checked the wall clock to see how much time remained before he could leave to deal with the phone messages he knew were piling up on his desk. Important people received important calls.
“I … don’t know.”
“Oh yes you do. Look at the damn patient, girl.” He felt himself losing patience with her. All she had to do was tell him what everyone could see. “His eyes are swollen and …”
“They’re black-and-blue?” she offered meekly.
“Yes!” He paused. “Swollen and black-and-blue. What does this tell us?”
She looked up at him, those big brown eyes surrendering. Ha! That vulnerable doe routine might work on others. Not him. She was going to learn this, goddamn it.
“I don’t know.”
He nodded at his chief resident to explain a bit of knowledge anyone entering a neurosurgery residency would know by the end of the first day.
The resident snapped back from his short mental vacation. “The term is raccoon eyes because the bruising resembles a raccoon’s mask. The bruising results from fractures around the base of the orbit. Hence, this pattern is diagnostic for a basal skull fracture. That’s the diagnosis Dr. Wyse was asking for, but in this patient, that’s not the only neurologic diagnosis.”
Wyse decided to salvage the remains of his schedule by cutting rounds short. His chief resident’s answer filled him with pride. As a first-year trainee that clown had choked every time he was placed in a similar situation as Gonzales. Now look at him. He had been turned into a good teacher. The ability to express clinical information clearly and succinctly was the most fundament skill needed to pass the oral board exam. And Wyse made damn sure none of his graduates ever flunked their orals.
Wyse gave the resident a fatherly pat on the shoulder. “You’re doing such a fine job; why don’t you finish up for me? I’ll catch up with you later.”
Wyse pushed through the ICU doors intent on dealing with the two most important issues of the day: McCarthy and Cunningham’s meeting with the CIA analysts.
7
STILL IN SCRUBS, Wyse climbed the stairs from the thirteenth to fourteenth floor. His newly formed start-up company, RegenBiologic, was on thirteen, and the Neurological Surgery Unit occupied the top floor. Wyse smiled at how he’d won the hard-fought battle against orthopedics for this space. Ortho and neuro, the top two moneymakers for a typically cash-strapped trauma center. Although he chaired the smaller department, he’d single-handedly won the David and Goliath fight for the space. He pushed open the metal fire door separating the bare concrete stairwell from his magnificent reception lobby. The walnut panels, plush carpet, and hushed voices served as sharp contrast to the third-world marketplace ambience everywhere else in the hospital.
“Good afternoon, Dr. Wyse.”
He smiled at the knockout behind the sleek glass and stainless steel reception counter. “Afternoon, Ginger.” She was a straight-spine, hair-in-a-bun, dress-for-success woman who preferred stylish glasses to contacts. Probably her assertion of individuality, he figured. He fantasized her with her hair down, glasses off, sipping a martini as a prelude to an evening of sex.
His private secretary had taken the day off to extend the three-day weekend into four, so Cunningham’s call would’ve come through Ginger. Had he called? The answer, of course, would be scrawled on one of those pink callback memos on his desk. But he’d have to weed through the stack to find it. He asked, “Did Colonel Cunningham call?”
“Yes, Doctor. A few minutes ago. I said you were running behind. He asked for you to return his call.”
Nodding, as if it were nothing more than another hassle in a typically busy day, he mumbled thank you and continued into his office.
His corner space featured two magnificent views. One across Lake Washington to the multimillion-dollar homes choking the east shore, the Bellevue office buildings, and the breath-stopping Cascade Mountain peaks. The other, a northerly panorama of the downtown business district, Lake Union, and Queen Anne Hill. It didn’t get much better than this, far as hospitals went.
He shut the door, went straight to the desk, picked up the slips, and found Cunningham’s call second from the top. According to Ginger, it came in ten minutes ago. Gut churning with anticipation, he eyed the phone. Did the agency buy the concept?
Sure they did. They had to.
Why wouldn’t they?
Well, because there were certain, ah, issues. But hell, those were relatively minor compared to the benefits.
He dropped into his chair, ran trembling fingers over his scalp, and squinted at the ridiculously expensive silver frame that held a portrait of his wife and two children. His family. What a joke. Twenty-one years shackled with Samantha the Clotheshorse, the frigging Imelda Marcos of Nordstrom. Pissed him off every time he looked around her closet at the piles of clothes. The guest room closet was overflowing too.
And Rachael, his daughter. A high school senior who dressed like a two-buck hooker from the projects. It’d be a godsend if a fraction of her mother’s tastes rubbed off on her. But he knew they wouldn’t.
To say nothing of Aaron, the fucking disaster. A ski bum shacked up in Vail. Or was it Whistler? Couldn’t keep those places straight. Leaching off older women like a damned gigolo in Gucci. Christ, was that a cliché or what?
To say nothing of Samantha’s social-climbing charity events. Queen of the spend-big-so-the-program-committee-will-seat-you-close-to-the-stage-to-be-noticed philosophy. At the moment she chaired both the Pinnacle Club Women’s Advisory Board and the Woman’s Auxiliary. Both bloodsucking tentacles of the Lakeview Foundation, the group of parasites tasked with encouraging philanthropic giving by making prospective donors feel exclusive. All last week Sam had pressed him to accept the co-chair for this year’s Celebrate Lakeview event, claiming the honorary position required little to no work. Far as he was concerned it put you in the knee-to-chest position to get boned up the ass. The bare minimum financial outlay would be to purchase a table for ten guests at five hundred a pop. Her hunger for social notoriety was killing him.
But it all wouldn’t be such a bad deal if Samantha weren’t so prudish in bed. More and more he wondered why put up with her?
The answer was simple: Divorce would be too expensive. But not in the obvious way. Fact was, he couldn’t risk the audit that would result. So, for the time being it would be far better to just roll with it.
He’d considered having an affair as one way to satisfy his unfulfilled sexual needs, but he couldn’t figure out where to find a candidate. Nurses or residents like Gonzales would be the easiest to hit on. But the residents were his surrogate children. And good fathers don’t screw their daughters. Unless, of course, you live in east Tennessee.
He gazed across the room to a wall of pictures of every graduate from his program. All doing well. The majority of them in academics, pursuing significant research and teaching—a part of him remained embedded in each one and would subsequently be passed on to every student they taught. The sight of all the past trainees filled him with deep pride. No, he couldn’t even think of hitting on Gonzales.
With a sigh he picked up the callback note and started to reach for the phone just as his back line rang. Interesting, only a limited number of people knew the number. The caller ID showed restricted, so it couldn’t be Cunningham. He answered, “Yes?” preferring to not announce himself.
“Bertram, Harold Glant.”
Fuck! Hang up? A voice in a small recess of his brain warned not to. In his best schmoozing voice he said, “Harry, how nice to hear your voice. I just got out of surgery and was intending to call. How you doing?” As if he gave a shit. The shark.
“My health is good, but my sleep will be a lot better when I start seeing some of the money you owe me. You know what Monday is?”
Monday? What the fuck was Monday supposed to be? Nothing came to mind so he didn’t answer.
Glant answered for him. “At the start of business Monday, the interest rate bumps up two hundred basis points, Bertram. Understand what that means? That’s a two percent increase.”
Wyse started to yell, “Fuck you!” but realized it probably wasn’t a smart thing to say to the broker to whom he owed 1.6 million dollars. When gold prices were going straight up he’d loaded up on GLD, a stock indexed to the price of gold. It was a good call and his position became profitable. But then he got greedy and leveraged the position, buying the maximum amount his account would allow on margin. Turned out, he margined at the very peak of gold prices, and when the market turned south he was caught in a meat grinder. Sure, he could walk away from the account, but the broker’s lawyers would come after other assets. He was forced into a classic rob Peter to pay Paul situation. His solution had been to “borrow” the money from his company, RegenBiologic. Cunningham’s money.
“Harry, you’ll get the money. You have my word on it. But at the moment I’m on another call.” Wyse disconnected, then sat watching his hand shake from his anger.
Where was he? Oh yeah, Cunningham and the Pentagon meeting. The outcome of which would determine his entire future. A future now threatened by Tom McCarthy. Talk about bad luck. Of all the doctors in Seattle, why had those two patients picked McCarthy for a second opinion? First Russell, then that Baker woman. What were the odds of that?
Maybe he should’ve done something—although he wasn’t sure what—when Russell started to complain about the memories. But no, he’d blown Russell off, figuring the problem would simply go away. It didn’t. Then, two months ago, a request for a copy of Russell’s medical records landed on his desk to be sent to McCarthy’s office. He blew that off too. Two weeks later another request arrived. Again he ignored it, figuring fuck McCarthy.
A request for Baker’s files followed.
Meaning McCarthy was working up both patients. Christ, both of them!
Any other doctor evaluating those two patients would’ve thrown up his hands and figured they were loony. But to stumble across two patients with the same bizarre symptoms would surely pique McCarthy’s interest. If you see one patient with strange symptoms, it’s an undiagnosed oddity. But then another patient comes along with similar symptoms, it’s a fucking syndrome. He knew McCarthy well enough to expect the self-righteous prick to dig until he put it together. Once he did that, he’d blow the whistle. So Wyse wasn’t going to let that happen.
Again, he started to dial but hesitated. Calm down. Don’t let Cunningham hear you like this.
At the wet bar, he flicked on the black Krups coffeemaker that his secretary readied each morning with his special Starbucks blend, then entered his private bathroom of ebony granite and brushed nickel fixtures.
After showering, he donned a clean set of scrubs. Considering there was no other surgery scheduled until Monday morning, wearing scrubs was unnecessary. But he believed they portrayed the right image to the residents, making him appear more like “one of them” instead of a white-shirts-andtie professor.
Armed with coffee and a PowerBar he settled into his desk and eyed the phone and the message beside it, rubbed his forehead, drummed his fingers. Had Cunningham sold the concept? Why wouldn’t they leap at the opportunity? Well, because … Jesus, he didn’t want to even think about it. He swiveled around to the magnificent view of Queen Anne Hill.
How in the hell had it come to this? A distinguished career now at the mercy of a handpicked group of CIA nerds and a two-bit army colonel. He hated Cunningham about as much as he hated the DARPA money. Initially, it seemed like pot of gold at the end of the rainbow, a mother lode to be mined without fear of tapping out. To realize how naive he’d been initially now doubly pissed him off. Even the village idiot knows there’s no such thing as a free lunch. So how had he been so stupid to not see the downside to the deal? Cunningham now controlled him the way heroin controls the junky. Shaking his head in disgust at himself, he dialed.
A moment later: “Cunningham.”
“It’s me. What happened?”
“Let me call you back on a secure line.”
Fuck! A secure line? That couldn’t be good news. He kept the phone in hand and connected before the first ring finished. “What happened?”
Cunningham said, “We ran into some snags.”
Wyse swallowed. “Snags? What kind of snags?” An ice cube crystallized in his gut.
“They love
the idea, but they see a few problems.”
The ice cube grew. “What problems?”
“They’re not stupid, Bert. The same reason you want out is the same reason they don’t want in.”
The gut cube grew so cold it was now burning. “They’re the agency, for Christ’s sake. They can do the work anywhere they damn well please, Afghanistan or fucking Antarctica, doesn’t matter, anywhere where they can make the rules. I can’t.” He realized the last words had come out as whiney and blamed Cunningham for making him sound like that.
“There’s the ethics issue.”
They’d discussed this particular point multiple times during rehearsals. “Ethics? Are you fucking kidding me? What about the ethics of flying a plane of innocent people into the World Trade Center to kill three thousand more innocent people? Don’t talk to me about ethics. Can’t they see the good this will do?”
“Bert, get off your soapbox. It’s me you’re talking to. It all boils down to the potential for blowback. Nothing more.”
Cunningham’s tone verged on condescending, Wyse thought. But instead of the snide comment on the tip of his tongue, he said, “Blowback? Tell me you’re joking.”
“Don’t give me that ‘I’m amazed’ routine. We discussed this, what, a couple hundred times already? These guys are affected by the political winds just as much as any other government bureaucrat. No one within fifty miles of the Lincoln Memorial wants to risk getting their ass fried. You know damn well there’s a huge leap between PTSD and the war on terror. Ever since the whole water boarding brouhaha, there’s been increased sensitivity in, shall we say, interrogation techniques.”
What was he talking about? As long as his implants yielded a bulletproof way of obtaining pristine intelligence why should anyone give a rat’s ass? So what if the present subjects didn’t know they’d been implanted? Other than a few harmless memories, they came though the procedure totally intact. Besides, how could Wyse and Cunningham be expected to do classified research if the subject knew the all details? Fucking ridiculous to say there were issues.