Troy looked up. He resembled a lost puppy. “Look, I didn’t come to intrude on your life, but I will not leave Long Island until this is all settled and these people can no longer threaten you. I can check into a hotel, but I am going to spend every night and every day making sure you are safe. It would be easier to protect you if I could use your couch for the time being. But I understand that’s a lot to ask.”
Tobi vacillated. She hadn’t wanted him to come back into her life, but now that he was here, she was torn. Truth was, she was now terrified of Ismar and no longer had confidence in getting help from the police, Steve Chagall, or B. Healthy. Maybe Reuben had been right, and these people were entrenched everywhere. Having Troy nearby did make her feel safe—or at least, safer.
Pantelaymin wandered into the kitchen and regarded Troy with the sassy attitude unparalleled by anyone except a feline. She walked up to him, sniffed at his socks, and after a glance at Tobi, rubbed against him. She circled his legs in a figure eight and started purring loudly. Troy flashed a mischievous smile and looked up at Tobi. He shrugged his shoulders and nodded at the cat, trying to look innocent.
“Change of heart, Panni?” Tobi quipped at the cat. Then she gave up. “Okay, okay,” Tobi said. “Only since Pantelaymin approves. But you’re staying in the study and using Ben’s bathroom. Stay out of my room!”
“Scout’s honor!” Troy held up his fingers.
“How is Benny? What’s he up to? I missed him too.”
“For one thing, no one calls him ‘Benny’ anymore. He was terribly hurt when you left, as much as I was.”
“I never in a million years wanted to hurt him ….”
“Well, you did. You hurt us both. But we both survived. He’s in medical school now, at Columbia. He has a serious girlfriend, and she’s delicious. It’s looking like they might get married one of these days.”
“Wow, little Benny—or what does he go by now?”
“Ben. Or sometimes Benjamin.”
“Ben. A doctor and getting married. I missed it all, didn’t I?”
“Yup, you did.”
“And what about you, Tob? Would it be out of line to ask if you were with anyone?”
“Nope, Troy, you cured me.” He had the good graces to wince, at least.
There was another awkward moment. “What about you?” she asked. “I hear your foundation is a huge success. I even looked you up once on charitynavigator.org; you got four stars.”
Troy’s face colored. “You know I never did it for money, Tob. It’s all for the Earth. And in case you were wondering, no, there’s been no one serious in my life since you.”
“Guess I cured you too, then.” Tobi couldn’t seem to keep the acerbic tone from her voice. It was her only defense.
“Well, I need to dive in and talk to my medical director, but the way he sounded on the phone yesterday, I don’t think he’ll be particularly helpful. There’s granola, and yogurt and fresh strawberries are in the fridge, if you want. Don’t worry, it’s all organic.”
Troy’s posture changed, and his muscles tightened. “Why do you think he won’t be helpful?”
“I don’t know. I spoke to him yesterday morning and I told him Ismar was caught using other providers’ logins and could access charts and he told me not to worry about Ismar, that I should ‘just worry about myself.’ It isn’t like him to be dismissive like that. And he acted like he’d never said anything to me about my login being used to ‘snoop’ in charts that aren’t mine.”
“Wait, so this has been happening in your organization?”
“It’s starting to look like it,” Tobi said.
“Is there anyone else you can call, besides this medical director?”
“Well, there’s Daniel Comet … he was the previous director, but he left. I think he couldn’t stand the direction B. Healthy was going in. So much emphasis on profit and no consideration of quality of care. Did you know, Troy, that we don’t treat patients anymore, they are now consumers of medical services? And our number one goal is to keep them ‘happy customers,’ so they’ll keep coming back and we’ll keep making money, even if what it takes to make them happy is not the appropriate treatment.”
Troy raised his hands in the air. “The whole damn world is doing that, why should medicine be any different? They’re not selling value anymore, just volume. It’s all about greed. The abuses of nature that I’ve seen, Tobi, it makes me want to cry sometimes. All so some multimillionaire—or multibillionaire—can pad his pockets even more. I wonder if he thinks he’ll be able to buy clean air and clean water for his grandchildren when it all runs out.”
Tobi was quiet. Of course, Troy understood without even being told. He was the same Troy he’d always been.
Troy pushed his hair back on the sides of his head, and flinched when he touched his swollen, purple forehead. “Where is this Daniel Comet now? How well do you know him, and can you trust him? Because I think we have to choose our confidants carefully.”
Tobi heard the “we” and relaxed a little. Maybe she wasn’t all alone in this snake pit after all.
“Daniel is vice president at Hospitals for Health, which is the system B. Healthy is trying to affiliate with. Yes, I think I can trust him. He used to be my boss, but he’s more of a kindred spirit. Like, I feel as if I’ve known him for centuries.”
Troy cocked his head at her.
“No—not like that. He’s married, and anyway, I haven’t been interested in that with anyone. He’s just a friend.”
“So, who are you going to call first?”
“I guess I should call Steve first. That would be the appropriate channel. And Daniel if that doesn’t go well.”
Chapter 48
The first time Tobi called Steve, it went to voicemail, so she sent him an urgent text. When there was no answer after three hours, she called him again.
“Yes, hi, what’s up?” Steve’s voice was tense and detached.
“Hey. I need your help. Ismar followed me home last night and tried to break into my house. He needs to stay the hell away from me, like in the office too.”
“Did you call the police?” Steve’s voice was flat.
“Yes, of course, but his wife lied and told them he was with her all night. We’re sure it was him, it was his car. How many short, three hundred pound guys with dark brown facial hair drive a Mercedes GLS?”
“Well, if the police say it wasn’t him, it’s out of my hands. You actually saw him?”
“A friend of mine did, and he picked him out of a Facebook photo.”
“I don’t know what I can do, Dr. Lister, these are matters best left to the police. My hands are tied. Literally. Okay? I have to run. Be well.”
“But—”
The phone went dead.
Tobi felt like she’d been sucker punched. She stood there feeling completely vulnerable. Steve had always been so collegial and friendly. Dr. Lister? Really? I’m in deep trouble, she thought. He had said his hands were tied, “literally.” He might have been trying to let her know, they’d gotten to him. She called Ellie.
“Hey, Ell, is it busy there?”
“We caught a three-minute break, good timing. What’s going on? Wait, let me go in the back and shut the door. Okay, I’m in the x-ray room. I heard you accused Rufini of trying to attack you! What happened?”
“Where did you hear that?” Tobi was astonished. “How did it end up all over B. Healthy already? I just called Steve five minutes ago.”
“I don’t know, but you know me. I heard from Monica in the south shore office. He’s been hanging out there recently, and she overheard a conversation. Also, he seems to have hurt his knee, he could barely walk. He said it just gave out on him yesterday, and he wanted to get an x-ray, and then he didn’t want anyone to look at the image. He wouldn’t make himself a chart, either. Of course, she looked at i
t after he left, and he has a fracture of the head of the fibula. You don’t get that with your knee just buckling. Hey, don’t tell anyone I told you, okay? HIPAA and all that. But he doesn’t seem to care about looking in other peoples’ charts, or using our logins, so ….”
“But how did that get connected to me?” Tobi asked.
“Oh, yeah, he was cursing you under his breath, told Monica you were giving him a hard time, and then Monica overheard him in the kitchen denying he had anything to do with you being assaulted—he mentioned you by name and said his wife had already explained he was home last night. Were you assaulted? What happened? I was going to call you later anyway.”
“Ellie, this is all a big mess, and I’m really scared. I tried to talk to Steve, and he was bizarre. He called me ‘Dr. Lister.’ I think he’s wrapped up in it too.”
“That’s weird. Wrapped up in what? Monica tried to talk to him yesterday about him using her tablets and he was, like, clueless. Didn’t he ask you once if you were snooping?”
“Yeah, he did, last month. Now he acts like he doesn’t know what I’m talking about. Something bad is happening at work, Ellie. Do you know anything about an insurance called Kordec?”
“Umm, yeah, it’s for really sick people. I think they’re all like end-stage something or other. A couple of my hospice patients were on that plan where I moonlight. It’s super expensive. Why?” Ellie asked.
“I don’t know, but Ismar and the tablet issue have something to do with them, I’m pretty sure. Pretty convenient that Monica manages to ‘overhear’ all these conversations. What does she do, put her stethoscope to the door to listen?”
Ellie cackled. “Yeah, well, she feels like she’s getting shafted by this place, so nothing is out of reach to her. I’ll call you later, a bunch of patients just came in.”
Chapter 49
After three postponements, the subcommittee finally convened. The meeting was dull and cumbersome, and the room was stuffy. Kavandor was sweating. He still had not heard back from his Russian albatross. He kept glancing at Wiseman out of the corner of his eye and praying the newbie really did want to make a career mark.
He drawled, trying to sound bored with the topic. “So, our next matter is this insurance company called Kordec. The AMA has been receiving anonymous emails for years, begging them to look into it. They disregarded the correspondence at first, since no one would take responsibility for sending them. But after about the fiftieth email, they started questioning. The medical association thinks the insurance is costly and provides no realizable gains for the consumer, since the insureds seem to die before they can benefit. They want us to evaluate and possibly shut it down.”
There was an outburst from the newbie. “Kordec? The FBI was looking into Kordec a bunch of years ago, and so was Interpol. I was just reading about it!”
Atta boy, Wiseman, Kavandor thought. Come through for me, bro!
“What else did the AMA say?” Senator Hank Hasbrow asked. “Did they find the source of the emails?”
“Apparently not,” Kavandor said. “The previous chair, Andrew Corbet, had been receiving them for years but dismissed them. He just retired, and the file was inherited by Zack Pryor. Pryor thought they should be looked at, but he hasn’t been able to get past the firewalls that are hiding the source and is looking for help. He also found that several state medical societies have Kordec on their radar, but not with the kind of detail these emails provide. He’s asked for an investigation into this company. If what the emails claim is true, then at the very least, these people are making a lot of money preying on disadvantaged patients.”
Wiseman spoke up. “I might be able to get some FBI support for that, at least to track the sender. The trail went cold for us years ago. A surgeon in London reported his patients were dying before they got to the OR, but then he died—or was maybe killed—Scotland Yard never did get to the bottom of that. Why is this email person being so underhanded? If there’s a problem, why don’t they come out and talk to us? We would protect them.”
“Maybe they’re worried about HIPAA violations,” Hasbrow offered. “Or retribution. Who knows why people feel they need to be anonymous. How many patients are we talking about? Is it worth our time?”
“Not sure, but if, as Pryor thinks, it’s a multistate action, possibly thousands,” Kavandor said.
“Wow. Sure,” Hasbrow said. “Let’s check into it, then, and see what’s going on. If something is fishy and we don’t act on it, we could lose votes in next year’s elections, especially if the liberals get wind of it and say we ignored it. We can only look good by investigating.”
“Okay, Hank, I’m putting you on it. Al, please facilitate with some of your FBI resources.” Kavandor felt an odd mix of relief and anxious anticipation.
“Sure thing,” Wiseman said. “We can usually break through those firewalls.”
Chapter 50
Mannfort sat in first class on Ukraine International, sipping his vodka, lime, and ginger beer. He was sweating under a skin-tight facial mask. He’d had them made up for him and Kazi before boarding. He was sure either of them could set off facial recognition alerts at the airports. He didn’t think the Americans were sophisticated enough to spot them unless they were actively looking for them, but Interpol was more thorough, which was why he’d sent Kazi on Air France through Europe and he flew direct to New York.
They had disassembled their weapons and distributed the parts between both sets of suitcases, so no one could find a complete weapon on either of them or even on the same flight. Kazimir had been an arms specialist in the Georgian Civil War and could break down and reassemble firearms from their bare bones. He loved guns and all things that blew up, and he was also an excellent marksman with a knife. It made him a tremendous asset to the Project. The plan was for Mannfort to rent a car at JFK Airport, and Kazi would take the Air Train, so they’d meet up at Jamaica station in Queens.
Kazi had already picked out a hotel on Long Island not far from Lister’s office. It was much less glamorous than his usual digs, but it would attract less attention. That part of Long Island appeared to be a sleepy stretch where not much happened; no one was going to suspect them in “suburbia.” Americans took their peaceful way of life completely for granted.
First order of business would be to “persuade” the Turkish toad to be more cooperative. Kazi had supplied Mannfort with some in-flight reading about the fool, Rufini, and how he had been acquired, and what buttons they could push to terrify him. Rufini had failed to neutralize the lady doctor, but it seemed he had been quite useful in getting potential clients for Kordec, so Mannfort would hate to waste him if it wasn’t necessary. Mannfort scratched at his face, wishing he could get under the mask.
Chapter 51
The next morning, Troy pulled the Jeep into the parking lot behind the office. Tobi felt irascible; seeing patients right now was not where her attention was, and her mind kept straying. She also felt vulnerable leaving the car back here, but she hated going in the office through the front, and at least the Jeep wasn’t recognizable as hers. There were already patients waiting on line outside that she would have had to push past and then explain to them why she wasn’t opening up the doors yet. It was 7:50 a.m., and she still wanted a few minutes to get her bearings before putting on her professional face. At least Ismar’s Mercedes was nowhere in sight.
Troy walked her in to make sure the place was secure and Tobi introduced him to Esther and Mandy and explained he would be hanging out in the break room for the day. Then he went around the building to the bagel place next door to get breakfast. It had been a long time since he’d had a real New York bagel. They’d both agreed she was pretty safe in the morning at the start of the work day.
Her work email pinged and she reluctantly checked it. The frequency of Emergency Department transfers was being evaluated, and apparently, she was one standard deviation above the mark
et mean, but the notice said no action was indicated unless she were two standard deviations above the mean. That would actually be a huge difference. The email recommended discussing cases with colleagues before sending to the ED to see if there were a way to treat them outpatient. Lovely, she thought. Did they think she turfed to the hospital if she was busy in the office?
The only people she sent to the ED who could reasonably be treated outpatient were those whose insurance did not allow her to get outpatient studies because they needed a referral from their primary care doctor. Waiting for that referral could take weeks, and often the patient could not safely wait that long. Sometimes she sent patients due to dehydration, and sure, she could give IV fluids in the office, but it would mean tying up a room for several hours, which would increase wait time, decrease her Press Ganey scores from all her other patients, and she wouldn’t be able to get stat blood work on them like the ED could.
Why was B. Healthy emailing her about this, anyway? Oh, she suddenly got it. They were trying to cut the costs for the emergency departments, now that they were part of Hospitals for Health, especially since if they discharged someone who bounced back in a few days, they’d get penalized on their compensation. The hospitals were in a bind too. If they admitted too many people, the insurance companies balked and threatened to deny payment, and if they discharged a patient who later had to come back, they were fined. Their answer was to try to keep people from coming to the emergency department in the first place. America was no place to get sick.
Well, maybe if B. Healthy staffed their sites adequately, Tobi could hydrate some of those patients in the office, but as for those who needed treatment that only the hospital could provide, that’s where she was going to send them, period.
Tobi walked into room two. She recognized Peter, who was sitting on the exam table.
“Hey, Dr. Lister. My favorite doctor!”
“Aw, thanks, Peter.”
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