Charlatans

by Robin Cook

  “She also has a history of having been emotionally injured,” Noah said. “She was abandoned by a new husband who was a surgical resident from Serbia who needed a green card. I’ve never been married, but I think I can relate to that.”

  There was a pause in the conversation, with the issue of abandonment hanging in the air.

  “Is there anything you can do to prepare for the Advisory Board hearing?” Leslie said to change the subject.

  “The hospital has assigned me a lawyer,” Noah said. “I haven’t called him yet. I’ll do that on Monday. I suppose it will be interesting to get his take. But it scares me the hospital thought I needed a lawyer. It certainly suggests they are taking this seriously. They even have me under surveillance.”

  “What do you mean?”

  “Every time I go out there’s a guy in a suit following me. There’s two of them and they trade off.”

  “Are you sure they’re following you?”

  “I’m pretty sure,” Noah said.

  “You think it is the hospital?”

  “I do. Who else would it be? The only problem is that I think it might have started before my suspension.”

  “That doesn’t make any sense.”

  “Tell me something I don’t know.”

  “But why would they be watching you?”

  “Your guess is as good as mine,” Noah said. “I guess they want to keep tabs on me to make sure I don’t sneak back into the hospital. It’s true that I considered doing it. I can’t imagine what my patients are thinking. I don’t know what they have been told. Maybe there are some serious legal issues I don’t understand.”

  “I’m so sorry all this is happening to you,” Leslie said. “You don’t deserve it. I still think it will work itself out, at least in respect to the hospital. I’m afraid your girlfriend might be another story.”

  “I appreciate your listening to me,” Noah said.

  “Call me whenever,” Leslie said. “And good luck. I hope everything turns out okay. I really do.”

  After appropriate goodbyes, Noah disconnected the call. For a moment, he sat staring at the blank wall. His calling Leslie had been a toss-up emotionally. He appreciated her sympathy and support, but she’d aggravated his concern for Ava’s possible involvement in his suspension.

  Thinking about his thesis got him up from the couch. He went into the surprisingly large walk-in closet where he kept several heavy cardboard storage boxes. He rummaged through them until he found the large portfolio with an elastic closure containing all the material relating to his thesis—all his notes and copies of the various drafts. He brought it out into the living room and began to go through it to refresh his memory. He hadn’t opened the file for more than ten years.

  30

  MONDAY, AUGUST 14, 3:34 P.M.

  The lawyer that the hospital had retained for Noah was not the warm-and-fuzzy person Noah had hoped for. His name was John Cavendish, a thin, young man with gaunt features and lank blond hair who Noah guessed was in his late twenties. He was not particularly personable. Although he was a member of a large law firm housed on the fiftieth floor in an elegant high-rise building on State Street, he had only junior status. His office was an interior one without a window and was as small as Noah’s living room.

  Noah’s appointment had been for 3:00, but as eager as he was, he’d arrived around 2:30 and had been kept waiting for forty-five minutes. John had come out to the waiting room when he was ready to see Noah and had stiffly introduced himself. The lawyer was now going through Noah’s Ph.D. file page by page, his expression neutral.

  Taking a deep breath, Noah settled back into his chair. It was the first time he’d ventured out of his apartment since going to Whole Foods Saturday afternoon. He was still depressed and anxious, hoping the visit to the lawyer might buoy his mood. So far it didn’t seem promising.

  The weather was as hot as it had been on Saturday, and Noah felt it more acutely, because he was now dressed in his only jacket and tie. As he had expected, he’d been followed, this time by the Caucasian, who was significantly more subtle in his surveillance technique than his African American colleague.

  “Thank you for bringing in this material,” John said as he slid the papers back into their folder. “Unfortunately, there doesn’t seem to be anything of particular value in the present circumstance.

  “Let me ask you again, just to be sure. It is my understanding that you stated in front of witnesses that the bound volume of your thesis contained falsified information. Is that correct?”

  “It is,” Noah said. He then went over the entire problem for the second time to make sure the lawyer knew all the details. Watching the man’s expression as he talked made Noah feel he was trying to go up a down escalator.

  “I can appreciate what you are saying,” John said when Noah finished, “but you did admit to falsifying data. It would have been far better if you hadn’t done that.

  “Just so I am not blindsided, have there been any other similar ethical lapses in your academic career that if revealed would influence this current problem?”

  “Only one,” Noah admitted. “Once while I was a freshman at Columbia University, I bought a paper off the Internet and handed it in as my own work.”

  “Was there any fallout at all at the time?”

  “No,” Noah said.

  “Does anyone know of this incident?” John asked.

  “No,” Noah said. “I don’t believe I’ve ever mentioned it to anyone other than you.”

  “Good,” John said. “If the question of other ethical lapses comes up during the Advisory Board meeting, I don’t want you to answer. I will answer for you. Understand?”

  “I suppose,” Noah said. The meeting with the lawyer was not helping his anxiety.

  “All right,” John said, standing up behind his desk. “I will do my best. Thank you for coming in. If you think of anything else germane, please let me know. Otherwise, I will see you on the twenty-third of August.”

  A few minutes later Noah walked out into the August heat onto State Street. He felt so depressed he didn’t even bother to look for his tail until Court Street. He wasn’t sure what prompted him to look back over his shoulder, but he was surprised not to see the Caucasian, so he stopped to look more carefully. When he still didn’t see him, he felt somehow let down, like his life was in such dire straits that even his mysterious followers were abandoning him.

  Thinking the man was being more subtle than usual, Noah continued at a slower pace to the northeastern end of the Boston Common. The route required a number of uniquely Boston twists and turns, due to the city having been designed more for horseback than cars. On each corner, Noah checked behind him, expecting to see his follower, but he was nowhere to be seen.

  Suddenly feeling relieved rather than abandoned, Noah wondered what he should do to take advantage. Since he had no idea why he was being followed, it wasn’t a totally rational thought. Nonetheless, the idea of visiting Louisburg Square occurred to him, maybe even ringing Ava’s doorbell. What could he lose? Since his conversation with Leslie Saturday afternoon, his confusion about Ava had weighed on him. Although he had thought about trying to contact her again, he hadn’t. The idea of confronting her seemed appropriate, although there was the question if she would even talk to him. He decided it was worth the risk.

  Arriving outside her house, Noah climbed the half-dozen stairs of her stoop and entered her foyer. Since he knew she had a camera at her front door as part of her security system, he purposefully stood to the side to avoid being seen. He rang the bell. Staying perfectly still, he could hear a phone ring in the distance. When she didn’t respond, he tried again. This time he heard her voice from a hidden speaker asking who was there.

  “FedEx,” Noah said in a falsetto, making him cringe at the absurdity of it all.

  “Just leave it,” Ava’s voice said.


  “I need a signature,” Noah said in the same falsetto. He was embarrassed for himself and suppressed a nervous chuckle about the antics he was capable.

  A moment later the door swung open. Ava was back to her yoga pants and tank top, presumably in anticipation of her afternoon workout. Within a fraction of a second her expression morphed from ennui to irritation when she caught sight of Noah. She started to close the door, but Noah inserted his foot like an old-fashioned door-to-door salesman.

  “I need to talk to you,” he said.

  “I’m still angry with you,” Ava said. She pushed the door against him, but not with much resolve.

  “That’s obvious. I want to know if you’re aware that I have been suspended from the hospital.”

  “Of course I know,” Ava said. “Everybody in the hospital knows, and no one can figure it out. You are a popular person. I give you that.”

  “Can I come in for a moment?”

  Ava reluctantly opened the door, leaving it ajar. It was apparent she expected it was to be a short visit. Both cats appeared and sniffed Noah’s leg.

  Noah and Ava eyed each other. Finally, Noah spoke: “Knowing my commitment to surgery, I thought I would hear from you. I could have used some sympathy. I’m devastated, and I’m having trouble coping.”

  “As I said, I’m still really, really mad at you.”

  “But I apologized sincerely about violating your trust. I’m so sorry, Ava. I admitted my mistake of going on your computer. I thought you could forgive me and be supportive, considering how close we’ve become. If the tables were turned, I guarantee I’d be on your side.”

  “I’m not so sure about that,” Ava said.

  “Why not? Why would I lie to you?”

  “You betrayed me. Not only did you go into my computer because you had misgivings about my anesthesia training, you went to my boss, Dr. Kumar, questioning my competence in regard to the three deaths. And you did it behind my back. You know how I know? He told me. He has that much confidence in me. How dare you?”

  Noah felt his mouth go dry as he realized she was partially right. He had betrayed her in both circumstances. “I felt it was my ethical responsibility as the super chief resident to voice my concerns to the proper person. You weren’t willing to talk to me about them. I’m not an anesthesiologist. In retrospect, it was a mistake to go to your chief. I should have gone to mine and let him talk to Dr. Kumar. I’m sorry for that, too.”

  “It seems that your ethics function selectively,” Ava snapped. “The rumor is that you were suspended from the hospital for falsifying data on a thesis that helped get you into medical school.”

  “How did you know that?”

  “Dr. Mason told Janet Spaulding, which is a sure way to get it all around the OR.”

  Noah knew there was no way Dr. Mason would have told the whole story. He worried how such rumors might affect the people on the Advisory Board.

  “Dr. Kumar advised me to break off our relationship,” Ava said. “He strongly suggested I avoid fraternizing with you.”

  For almost a full minute Noah and Ava stared at each other. Both were overwrought. Noah broke the silence: “So is this the end of our little romance?”

  “I don’t know,” Ava said. “I’m trying to digest it all.”

  “If it is the end of our relationship,” Noah said irritably, “there is one thing that I’d like to know. Were you the one who raised the Ph.D. thesis with Dr. Mason and got the damn thing from MIT?”

  Ava threw her head back and laughed derisively. “Hell, no. I can’t stand the blowhard. There’s no way I would want to help him. Why would you even think such a thing?”

  “Because you were the only person I’ve talked with about my thesis for years. And you are certainly the only person I’ve said anything to about ‘fudging.’ Dr. Mason wouldn’t have come up with the idea on his own.”

  “It wasn’t me,” Ava snapped. “Maybe it was your old girlfriend who you ignored. Maybe she wanted to get back at you.”

  “It wasn’t Leslie,” Noah snapped back.

  “Then I don’t know who the hell it was,” Ava said. “Now I want to work out. So if you don’t mind, I’d like you to leave.”

  His emotions in turmoil, Noah walked out of Ava’s house. When he’d entered, he’d felt perplexed, depressed, and anxious. Now he felt perplexed, depressed, and angry. Despite Ava’s protestations to the contrary, she had to be the one who brought the stupid thesis issue to Dr. Mason’s attention. Yet her suggestion about Leslie ate at him even though he was sure she could not be involved. She’d never acted angry when she left. If anyone had been angry, it had been Noah, but even he had been angry at himself not Leslie.

  He pulled out his mobile phone as he headed up Revere Street toward his building and called her. He had no idea if she’d answer, but at least it was after 5:00, so he was reasonably confident he wouldn’t be disturbing her at work.

  “What’s up?” Leslie responded after only two rings. “Are you okay?”

  Noah assured her he was okay and explained that the reason for his call was just to ask her if, by any chance, she had ever said anything to anybody about his Ph.D. thesis, particularly recently.

  “Absolutely not,” Leslie said. “To tell you the honest truth, I completely forgot the whole story about your thesis until you brought it up on Saturday. I’d never given it any significance that you’d had to estimate some figures to get it in on time since you made the effort to replace them with the real ones when they were available. Besides, I’d never say anything to anybody about your thesis. I don’t even remember the name.”

  “Okay, good,” Noah said. “I just wanted to be sure.”

  “I’ve been thinking about your situation ever since we hung up on Saturday,” Leslie said. “Are you interested in what I’ve been thinking?”

  “I guess,” Noah said.

  “The more I think about it, the more certain I am that your erstwhile friend Ava has to be responsible for raising the thesis issue.”

  “I thought the same thing, since you and she were the only two people I’d ever confided in about it. Five minutes ago, I asked her point blank whether she’d done it, and she denied it.”

  “So she finally contacted you?” Leslie said.

  “No, I went to her house and rang the bell.” He was too embarrassed to mention the FedEx ruse.

  “Was she at least friendly?”

  “No. She said she was still angry at me.”

  “Did you believe her denial?”

  “To some degree,” Noah said. “She didn’t hesitate in the slightest. She even mocked me for suggesting such a thing.”

  “Well, I certainly didn’t do it,” Leslie said. “And if she was the only other person who knew about this thesis issue, it would have had to have been her who spilled the beans. Yet it does seem out of keeping with how you described your relationship and certainly out of proportion to your going on her computer without permission.”

  “I did something else that I didn’t tell you about,” Noah said. He went on to admit that he’d gone to her boss behind her back with minor but nagging concerns about her professional performance in a couple critical situations.

  “Ouch,” Leslie said. “To my way of thinking, that could be interpreted as betrayal more than accessing her computer, especially if she is as dedicated to her work as you say. How did she find out you went to her chief? Do you know?”

  “He told her.”

  “Double ouch,” Leslie said. “Now all this is making more sense. If she did blow the horn on your thesis, it could be a kind of sick tit-for-tat by forcing the surgery department to question your ethical competence.”

  “That’s gone through my mind,” Noah said.

  “Is there a reason to question her competence?” Leslie asked.

  “No,” Noah said, “no
t really. She’s a well-trained anesthesiologist who is religious about keeping up with her specialty. She’s done thousands of cases at the BMH over the last five years. I’ve been told she passed her written and oral anesthesia boards with flying colors, which is no mean accomplishment. And to be hired by the BMH, she had to be seriously vetted. There is no doubt about her general competence.”

  Noah reached his building but hesitated going inside. He was afraid he’d cut Leslie off.

  “Did you see the lawyer today?” Leslie asked.

  “I did, but it was a bust. He must have just graduated from law school and got assigned all the crap cases. I can’t imagine he’ll be any help.”

  “I’m sorry.”

  “Thank you.”

  After saying goodbye, Noah hung up. Once inside his building he began to slowly climb the stairs. His legs felt strangely heavy again, as if they didn’t want to return to his apartment any more than he did.

  31

  MONDAY, AUGUST 14, 7:15 P.M.

  After getting into his apartment, Noah peeled off his damp shirt and tie, turned on the window air conditioner in the bedroom, and collapsed on his couch. It had been a discouraging day. Even the phone call with Leslie hadn’t cheered him. Instead it had increased the anxiety and irritation he felt about Ava. And Ava’s continued overtly defensive reactions whenever he tried to voice his misgivings about her three anesthesia deaths only heightened the concerns he had about her anesthesia training. It could have been so easy for Ava to reassure him, and if she had, he never would have even considered the misguided idea of going to Dr. Kumar, which ended up aggravating the situation. One way or another, Noah thought that the issue of Ava’s sensitivity to questions about her professional training and competence demanded more attention if for no other reason than to take his mind off his own problems. It was also a type of therapy for his smoldering resentment in how Ava was treating him.