by Robin Cook
“Until later,” Dr. London said. “I hope to see you tonight.” She handed over the sheet of paper before disappearing into the women’s locker room.
For the very first time since Noah had been fretting about the upcoming M&M Conference, he felt a glimmer of hope that he might possibly be able to survive his presentation with minimal fallout. At least now he had a BMH attending who was on his side, even possibly a collaborator of sorts, willing to counter Dr. Mason’s interpretation and his apparent desire to divert the conversation away from the real issues. Vaguely, he wondered why she believed Dr. Mason did not like her and whether he’d find out that evening, provided, of course, he could leave the hospital. At least her house was close to the BMH if he had to get back in a hurry.
After checking his watch to be sure he had enough time before afternoon work rounds, he headed back into the OR. His intention was to find the two anesthesia residents, Wiley and Chung. What he wanted to learn was the inside, “resident” scoop on the Vincent case, and whether the general feeling of the anesthesia residents corroborated Dr. London’s beliefs about her performance. There was always a resident grapevine that was invariably more truthful than the involved attending’s interpretation.
8
FRIDAY, JULY 7, 8:15 P.M.
It was still light outside when Noah exited his apartment building on his way to Louisburg Square, one of the tonier sections of Beacon Hill and sharply different from his much more modest Revere Street environs. When he’d finally gotten out of the hospital, he had decided to dash back to his apartment to get out of his hospital whites and take a quick shower. After all, it had been fifteen hours he’d been on the go.
Noah had put on a pair of jeans and a polo shirt that were reasonably clean. He chose them because he thought they were flattering. He’d considered wearing his only jacket and a tie but had dismissed the idea as too old-fashioned and proper. As he was dressing he admitted to himself that he was energized but nervous about the upcoming visit with Dr. Ava London above and beyond the need to prepare for the damn M&M. She had unnerved him at their little tête-à-tête in the surgical lounge, and now that he was actually en route he felt the same way. Instead of trying to understand his reaction, he concentrated on the destination. Over the five years he had been in Boston, he had walked through Louisburg Square innumerable times and had wondered what the houses were like on the inside. Now he was going to find out. He was also curious about Dr. London and how she would act in her home environment.
Noah had hoped to be out of the hospital much earlier, and he had become progressively worried Dr. London might have evening plans and change her mind about seeing him. The problem had been a surgical consult that had gone bad, requiring Noah to smooth the feathers of one of the internal medicine chief residents who had requested the consult. It ended up being more of a personality clash than anything else, but it took time for Noah to resolve the issue without causing anyone to lose face. For Noah, it was yet another learning experience to emphasize that diplomacy was one of the major jobs of a super chief resident, a skill that he knew was going to be sorely tested at the M&M.
As Noah walked up Pinckney Street, he thought about what the two anesthesia residents had told him that afternoon when he’d cornered them in the anesthesia office. They said that the case had been a widespread topic of conversation right after the incident, and everyone without exception backed Dr. London’s interpretation. For the most part, they blamed the debacle on Dr. Mason’s cavalier attitude and willingness to have three patients under anesthesia at the same time while he flitted back and forth from room to room. As Noah trudged up the hill, he briefly wondered if he should mention what he’d learned to Dr. London, as it was certainly supportive, but almost immediately he decided against the idea. Since he was just getting to know her, he reasoned it would not be diplomatic to admit he was spying on her behind her back.
Reaching the square that was actually a rectangle, Noah stopped long enough to appreciate its suddenness as an unexpected oasis in the middle of a warren of brick tenements, brick sidewalks, and black macadam pavement that made up the rest of Beacon Hill. With its soaring elms, it was a true hideaway of lush greenery surrounded by an imposing wrought-iron fence. There were a few children playing on the enclosed lawn, and their shouts reverberated off the brick façades of the surrounding town houses.
Number 16 was on the downhill side of the square, whose long axis was oriented perpendicular to the rise of the hill. After climbing a half-dozen granite steps, Noah faced an imposing mahogany door. Searching for a doorbell and not finding one, he entered the foyer. There he found a bell. He pushed it. When nothing seemed to happen, he was tempted to try it again while suppressing a sudden worry that he was going to be stood up. After all, he’d not provided his mobile number. He’d thought about texting Dr. London earlier to say he would be late but had decided against it, at least partially for superstitious reasons.
Suddenly the door was pulled open fast enough to create a mild breeze that ruffled his hair. Standing in front of him at the base of an elegant carpeted staircase was Dr. London, who appeared far different than he was accustomed to seeing her. Instead of baggy scrubs, bouffant cap, and face mask, she had on form-fitting black yoga pants and an athletic tank top. For fear of making a fool of himself, he glued his attention to the woman’s blue eyes to avoid staring elsewhere.
“Welcome, Doctor,” Dr. London said with a gracious sweep of her hand, gesturing through an archway immediately to her right. “Please come in!” In sharp contrast to her professional froideur in the hospital, she seemed remarkably hospitable. There was not a speck of staff-versus-resident condescension.
“Thank you, Dr. London,” Noah managed, glad to be able to redirect his eyes into the room. He found himself in a large, high-ceilinged living room that extended from ten-foot-tall double-hung windows in the home’s bow front all the way to the rear of the house, where there were French doors. The decor was restrained Georgian with period moldings. To Noah’s eyes everything seemed new, as if it had just been constructed. On the south wall were a pair of period black-marble fireplaces. Partially dividing the room into two spaces were several fluted Corinthian columns. In the section of the room facing the square were two large, dark green sofas facing each other. Between them was a marble coffee table with several stacks of large, colorful books. On the walls were a collection of gilt-framed oil paintings. In the back section of the room beyond the columns stood a grand piano. The air was cooled and dehumidified.
“First and foremost,” Dr. London said as she followed Noah, “let’s dispense with the formalities. Please call me Ava, and I presume I can call you Noah.”
“By all means,” Noah said. He allowed his eyes to look back at his hostess, but he immediately redirected them to the surroundings. It was going to take a few minutes for him to adjust to her outfit, which he jokingly thought could have come from a spray can. He had sensed she had an athletic figure. Now he was sure of it. The definition of the muscles of her legs was all too apparent. Same with her arms but slightly less so. Sudden movement on the staircase captured his attention. Two sizable cats streaked down the stairs to race into the room. Both stopped and cautiously sniffed Noah’s leg.
“I hope you aren’t allergic to cats,” Ava said.
“No, not at all,” Noah said. He bent down and let each cat smell his outstretched hand. One was grayish-blue with striking yellow eyes, the other gray-and-white striped with blue eyes. “Beautiful cats.”
“Thank you,” Ava said. “They are my buddies. Yellow eyes is Oxi, short for oxygen, and blue eyes is Carbi, short for carbon dioxide.”
“Very clever,” Noah said. “Have you had them for a long time?”
“Relatively,” Ava said. “I got them from the animal shelter.”
“Well, they certainly lucked out,” Noah said.
“I think I got the better end of the bargain,” Ava said. “Can
I get you anything to drink? There is a bar off to the right as part of the library.”
“You have a library?” Noah questioned. He didn’t know if she was joking or not. Having a library was not part of his vocabulary.
“Of course. This is a rather big house, even though from the front it appears modest. The building’s footprint has what is called an L off the back.”
“Modest is not the adjective I would choose.”
Ava laughed in a sincere, crystalline manner. “Everything is relative.”
“Do you live in the whole house?”
“As opposed to what?”
“Are there apartments?”
“I see what you mean,” Ava said with another laugh. “No, there are no rental units. It is a single-family house. I just happen to be a family of one with two cats.”
“How many floors?”
“Six.”
“Not bad!” Noah said. “It’s very impressive. I like the period decor.” The house was far bigger than he would have guessed from seeing its façade, which made it look as if it were three stories, not six. He wondered what it would be like to occupy such a place, thinking his entire apartment probably would fit in the room he was standing in.
“Are you interested in architecture and design?”
“I suppose,” Noah said, even though he had never given the idea much thought, as evidenced by his apartment.
“Would you like to see the house?” Ava asked. “I would be happy to give you a quick tour. Creating it has been a labor of love for me. Since I spend a lot of time in the house when I am in Boston, I wanted it to reflect me and my lifestyle as kind of a homebody. The renovation has only been finished for less than a year.”
“I’d love to see the house,” Noah said.
They started on the first, or basement, floor, which was level with the garden in the back. Noah was shown a full guest studio with its own kitchen. Next was a full workout room with several stationary bikes, a treadmill, a half-dozen weight machines, and a rack of free weights. “Here’s where I spend six-thirty to seven-thirty every evening I’m in town,” Ava said. “Just like I did today. That’s why I’m still in my workout clothes. I was afraid to get into the shower, for fear you would arrive the moment I did.”
“Do you travel out of town frequently?” Noah asked.
“I do,” Ava said. “As often as I can. In fact, almost every weekend. I take full advantage of my freedom. It’s one of the benefits of anesthesia as a medical specialty. When I’m off, I am really off.”
“Good point,” Noah said. “What do you do about your cats?”
“My housekeeper, Maria, comes every day when I’m out of town. She loves Oxi and Carbi.”
“Where do you usually go?”
“It depends if it is business or pleasure,” Ava said.
“What do you mean ‘business’?” Noah asked. The question popped out before he even thought of whether it was appropriate. “Are you on an anesthesia staff at another hospital as well?”
“Not at all,” Ava said without offense. “I couldn’t do that. Dr. Kumar wouldn’t tolerate it. I do consulting.”
“Interesting,” Noah responded. He wanted to ask more but felt it too probing, and Ava was already climbing the stairs to the next level.
The second floor, which was half underground on the Louisburg Square or front side of the building, housed a large, modern kitchen with all the usual appliances, a dining room, and a full maid’s apartment.
“I don’t have a maid,” Ava said in response to Noah’s shocked expression. “When I did the design for the renovation I was thinking of resale as well as my own needs.”
“Interesting,” Noah repeated. He was more than impressed. Knowing a little about real estate values, he doubted Ava could afford such a manse even on anesthesiologist’s salary. Her consulting business had to be extremely profitable. It was either that or she had inherited a fortune.
The third floor was where Noah had entered when he’d come in through the front door, so they continued up the main stairs to the fourth. It was here that Noah was most impressed. The main portion of the house without the back L comprised two rooms. The front and slightly larger room was an inviting, dark green study with several desks, a floor-to-ceiling bookcase, a sitting area with comfortable overstuffed club chairs with ottomans, an expansive coffee table with a number of colorful coffee table books, a collection of framed photographs of Ava in various athletic venues, and lots of light streaming through large windows. Noah could imagine spending a lot of time in such a space.
“Do you mind if I check out your photos?” Noah said.
“Not at all,” Ava said. She laughed with pleasure at Noah’s interest.
Noah’s eyes ran over the entire lot, one more interesting than the last. He could tell most were selfies taken with a selfie stick. There were a few group shots, but the others were solo, with Ava smiling into the camera as if she were as happy as a lark. She seemed to have the same expression in all of them and her hair was always perfect. There was something oddly impersonal about them. “I guess you’re quite a sports enthusiast,” Noah commented.
“I like sports and travel,” Ava said. “Now let me show you another room.” She gestured back out into the hallway.
In contrast, the rear room was dark and uninviting until Ava turned on the light. Then Noah’s face lit up like a child’s at Christmas seeing the decorated tree for the first time. The entire room was devoted to a computer setup the likes of which Noah had never seen except in his dreams. “I’m so jealous,” he said as he stepped over the threshold. There were three monitors sitting on a broad desk against the far wall and angled so all three could be seen by someone at the desk with just a minor turn of the head. A bank of electronics, including a server, were on open shelving to Noah’s left. Large speakers stood on either side of the desk. Several of the latest virtual-reality headsets sat on top of it. The windows at the rear of the house were shuttered to keep out the light. The ceiling was covered with acoustical tile.
“This is my favorite room in the house,” Ava said with pride as she noted Noah’s reaction. “I spend every evening in here when I am in Boston, sometimes as much as four hours. I lose track of time.”
“I can see why it’s your favorite room,” Noah said. “I think it would be mine, too, if I had the time. Are you a gamer?”
“Not as much as I used to be as a teenager,” Ava said. “But I still play once in a blue moon, mostly League of Legends, despite the misogyny involved. From your reaction, I guess you’re a gamer, too.”
“I used to be,” Noah said. “I played League of Legends when it first came out while I was in medical school, but not since becoming a resident. No time.”
“I didn’t play when I was a resident, either,” Ava said.
“This setup certainly suggests you play more than occasionally,” Noah said. “What level did you get to?”
“Silver Two, but I haven’t kept it up. Instead, I’m into virtual reality. I also use the system every day for MOCA. Are you familiar with MOCA, Maintenance of Certification for Anesthesia?”
“Of course,” Noah said. He knew that the various specialty boards in medicine, such as the American Board of Anesthesia, require its diplomats to recertify every ten years. One way to do it was online, but Noah was aware most people put it off until the last few months and then binged. The fact that Ava was doing it every day was a sign of true commitment. “And you really do it every day?” Noah asked, just to be sure.
“Every day without fail,” Ava said. “Even when I’m traveling. I have to be up on all the latest trends. Plain and simple, I make a real effort to be the very best anesthesiologist possible.”
“I hear you,” Noah said. “I feel the same about surgery. Seems that we are equally committed to our specialties, like two peas in a pod.”
Ava
laughed in her unique fashion. “Two peas in a pod! I love that metaphor. We share a definite similarity, knowing your reputation. But to be completely honest, the MOCA only takes me about a half-hour a day. What I mostly use this setup for nowadays is social media, which I do most every day. I know it’s a bit of overkill for just social media, but what can I say.”
“What do you mean by ‘social media’? Like Facebook?”
“The entire gamut: Facebook, my YouTube channel, Snapchat, Twitter, Instagram, Tumblr, Pinterest . . . you name it. But mostly Facebook, which certainly dates me. To tell you the truth, social media has become my game of choice. When I was a teenager in the late nineties I got addicted to SixDegrees and AOL Instant Messenger for social reasons to manage my reputation, or so I thought, which in retrospect was a disaster, as it truly took over my life in a bad way. Now I’m addicted to it as entertainment and to stay connected. I’m fascinated by it like a lot of people. It is certainly driving our culture.”
“You mean you go on it every day?”
“Usually,” Ava said. “And even at the hospital, I occasionally sneak a peek on my mobile in between cases to respond to snaps and tweets. When I’m here in the house, I’m either working out, doing MOCA, eating, or doing social media. What can I say? I’m addicted, I admit, but I tell you, I have learned more about myself doing social media than I would have if I’d spent years doing psychoanalysis.”
“Really?” Noah questioned with skepticism. “I think you’d have to explain that to me. I mean, I use Facebook and Snapchat a bit, but I don’t think I have learned anything about myself from doing it.”
“I’d be happy to explain,” Ava said. “But that will take some time. I think we should stick to the M&M problem for now.”