by Maren Cooper
She took a sip of her drink and rolled her eyes. “Why does this not surprise me?” She chuckled ruefully. “But for the sake of my children, I’d like him to be happy. They don’t need him to add drama to their lives. And for my sake, I’d like him to be happy so I don’t have to think about him anymore. Does that make sense to you?”
“Yes, Jess, it does. I think it would be a good thing for you to be able to go ahead with your own life.” He moved the flowers to the edge of the table and leaned back in his chair. “So, may I ask if you are seeing anyone special?”
“Ah, that’s an interesting question.” She smiled. “I don’t know. I’m not sure about what I’m doing right now, beyond having a great vacation with my kids and enjoying your hospitality.” The server brought them a small plate of prosciutto and melon.
“Hey, this reminds me. What are you doing, inviting my Tom over for the summer to learn to cook?” She took a bite of the appetizer.
“He sought out my advice. How could I refuse?” He looked down quickly.
Jess squinted at him. “Is it more than that? Tell me.”
“Well, I’ve actually had quite a few conversations with Tom over the past several months. He was devastated by his father’s duplicity and couldn’t bear to burden you, so he turned to me.” He looked at Jess as her eyes welled up. “I hope you’re not angry with me for not telling you. I tried to provide some comfort and guidance, and I thought you had enough to deal with.” He took her hand. “I’m sorry if I took liberties . . .”
“Dear Vincente. Of course I’m not angry. I’m humbled by your generous spirit. What a friend you’ve been to me.” Tears streamed down her face. “I can’t thank you enough for being there for my son.”
He handed her his handkerchief and waited as she dabbed her eyes.
“Did you know Arthur wasn’t coming?”
“Yes. I saw him at the Barcelona meetings last month and knew it was unlikely. But he called me just before the wedding with his final no.” He suddenly took an interest in the street scene beyond Jess.
“Vincente, what aren’t you telling me?”
“I feel torn. Arthur is my friend. You are my friend. I feel terrible about what has happened. I believe he has made some poor decisions.”
“I can see this is difficult for you,” she said. “Don’t betray your friendship with him for me. But if you could help me understand anything that might upset my children as they try to cope, I’d appreciate it.”
He pulled the flowers toward him again. “In Barcelona, Arthur confided in me that his relationship with Rebecca is falling apart and that he is filled with regret for having left his family. When he called a week ago, he was desperate to come but in the midst of chaos.”
“So, it was chaos in his personal life that caused him to bail on this trip, not conflicting work obligations?”
“I’m not sure they aren’t connected. I think the chaos in his personal life has caused him to retreat into work more than he should. That, and . . .” He looked up at her, as if wondering how much to share. “I’m not sure he felt he could cope emotionally with this family event—seeing you all and realizing what he’s lost.”
Jess felt her eyes fill again. Despite herself, she empathized with Arthur’s delayed pain and tried not to relapse into her own.
“Vincente, I know there have been other women for a long time, but I don’t know much about his current relationship, other than that she’s in Portland. Tell me about Rebecca.”
“Yes. She was his research protégée and then his lover. Then that wasn’t enough. He thinks she’s been obsessed with convincing him to marry her since she visited the lake house. And now she wants a baby, and, well, he’s done with that phase of his life. He realizes he misjudged the situation—”
Jess’s mouth fell open, and she cut in, “Wait, what? A baby? Wow, that’s a surprise.”
“Evidently to Arthur as well. He didn’t expect her to want that. And he’s not prepared to parent another child.”
“And what did you say a second before that? What do you mean, she’s been obsessed with marrying him since she visited the lake house? Arthur took her to the lake house for New Year’s—actually, the kids joined them. What happened then that provoked her obsession with getting married?” Her mind leaped to how rough that trip had been for the kids and what they may have seen or heard, beyond Rebecca’s interest in having their father sell the lake house.
“Oh, no, evidently it was last year when she visited the lake house, before the Portland move.”
Jess could only acknowledge this news with a shudder. Rebecca had visited the lake house before New Year’s, before Jess and Arthur’s marriage had imploded. She wondered how Arthur could have taken a woman there without Jess’s knowledge. There was so much she had missed. She looked away, her empathy for Arthur gone. She willed herself not to allow her mind to revisit the ups and downs of the prior year and smiled wistfully at Vicente.
“Jess, this is too much for you. I don’t know how Arthur could have treated you so badly.”
“It was hurtful for the kids that he didn’t come.”
“And you, Jess?”
She gave him a bittersweet smile. “Arthur’s the father of my children and always will be. But the kids are my priority. I want what’s best for them, which is why I’ll always welcome him whenever he wants to join us. That’s his choice. If he’s dealing with poor choices now, perhaps he’ll be more thoughtful in the future.”
It took her the rest of the evening, but she finally realized that she didn’t care about Arthur’s personal problems anymore. Perhaps she had graduated.
Chapter 39
“So, are your parents absolutely delighted? I wish I could have been there when you told them. Tell me all about it.” Jess spoke to Diane in bursts as she jumped over puddles, navigating their run in Forest Park after a hard rain. She was determined for Diane to shine over these next few months before her wedding.
“Oh, they were so cute. They admitted to hoping but not wanting to put pressure on me. They love George and are so happy for me. Dad is so excited about walking me down the aisle, and Mom is already planning to come down here to go wedding-dress shopping with me. They want the whole experience, and I’m going to oblige.” Diane was breathless, both from the run and with excitement.
Jess prodded her. “Isn’t it wonderful that they’re still around for this? And you know that the ‘whole experience’ includes a shower. Can I do the honors? Maybe we can do one in Goodrich for your mom’s friends and family. And then let’s do another one, here in town, for city friends.”
“Really?” Diane looked at Jess in mock horror. “Bridal showers, plural. Do I really have to do that?”
“Of course—the first one for your mom, the city one for fabulous you! It’ll be fun! Just say yes!”
“OK, OK. But I’m not going to let you do too much work on this. We’ll go simple. Promise?”
“Promise. No ice sculptures or male strippers, I swear!” Jess smiled slyly as they paused to drink from the water fountain near the St. Louis Zoo entrance.
“By the way, your wonderful son sent me a postcard from Italy. He must have been raised very well indeed!” Diane teased, then hesitated a beat before asking, “How was it seeing Arthur?”
“Oh, he didn’t show. He claimed he had schedule issues, but Vincente tells me there’s trouble in paradise with the new love. The kids were hurt, of course. But we made the best of it and still had a great time.”
“Do you hear from Arthur much?”
“Not much, which is fine with me. Thank God for e-mail. That’s how we’ve communicated since the divorce. I know it’s impersonal, but that saves me.” Jess looked away a minute, surprised she had teared up. “And I have very little to communicate about with him, now that both kids are away at college.”
They had reached their cars and caught their breath in the cool evening breeze.
“Hey, Jessica,” Diane said, reaching out to touch Jes
s’s arm. “If this wedding stuff is hard on you, let’s not have you do all this.”
“No, Diane, I really want to. This is real life, the ups and downs, and if you don’t mind that I still feel bad sometimes, I want to feel the good stuff with you, without your feeling bad. OK?”
Sweaty as they were, they locked arms and held on for a big, wet hug, adding tears to the mix.
“Are you saying that Personne and Ramsey were the ones who went on these trips?”
“Yes. We couldn’t find any other trips that any other doctors took, and it looks like this was a regular practice over a several-year period; it ended this past year, after Floyd’s death.”
Jess pushed her plate aside and sighed. “This is getting pretty obvious. First, overbilling looks to be a systemic, not a special, issue. Second, there’s the medical directorship kept alive even when there’s no doctor providing services. And now we find out about these drug company–funded junkets to warm climates, with no educational component even hinted at.” Jess pushed her chair back from the table in her office and took a turn around the room. “What’s left to complete on our assessment? Is the quality review done?”
“Yes.” Cindy reached into her folder to hand it to Jess. “It just came in as a draft, but I did discuss it earlier this morning with Dr. Moody. He made it clear that there was nothing in it to make him anxious.”
Jess scanned it briefly, continued her walk around, and then stood with her hands on the table and leaned toward Cindy. “OK, this is what I’m thinking: poke holes in it.” She waited for a nod from Cindy and then folded her arms, walked the length of her office, and turned to face Cindy again.
“Floyd is the bad actor. Maybe he started things that nobody knew about, just to prime the pump as he came in to juice up the practice years ago. Maybe Personne didn’t know about any of it for a long time. Then Personne finds out, maybe by accident, and Ramsey persuades him that any change to their billing practices at that point will bring unwanted attention from the feds and lead to a large-scale investigation implicating him, as well as Personne, for current and past abuses. I don’t know how much persuading it took, but let’s say Personne becomes complicit and totally reliant on Ramsey, who continues to flout the rules. He makes sure nobody in the office stays long enough to get suspicious. He intimidates Alice out of the practice . . .” Jess paused to check Cindy’s reaction.
Cindy’s brow was furrowed, but she nodded and took the theory further: “And then Ramsey up and dies, leaving Personne in a bad place, alone. The other physicians are clueless, and Personne is stuck in his role as enabler. What a mess he’s in! And when Ramsey dies, what can he do?”
Jess’s turn: “He looks to Midwest Health to bail them out.” Just then, with an involuntary shudder, she remembered that Jim was the one who had recommended Midwest Health to Larry Personne.
Jess’s phone alarm went off. “Oh, gotta go to my interview with Dr. Sloane. He’s the last of them, right?” Cindy nodded, and Jess continued, “OK, let’s both think about this more on our own. We don’t want to push it out too far until we’re sure. And you were supposed to poke holes, not continue my thoughts.” She winked at Cindy as she grabbed her suit jacket and grabbed the last bite of their shared cinnamon roll.
“Then you shouldn’t have been so right!” Cindy returned the wink. “And before you leave, you might want to wipe the remaining frosting from your top lip—doesn’t go with the image!”
Jess checked her theory as she drove. Was she pointing the finger at Floyd Ramsey because he was a convenient scapegoat? Was she being too easy on Larry Personne? And Jim: What role had he played?
“Keep an open mind,” she said aloud. But crowding her rational thoughts like a storm cloud on the horizon was the anticipation of the pain that would result if she was right.
Jess was breathless as she ran into the coffee shop amid a late-afternoon thunderstorm. Shaking out her coat and hair, she saw Dr. Keith Sloane sitting in the back of the nearly empty shop, reading from a tablet and drinking coffee from a steaming mug.
“I’m sorry to be late. I miscalculated the time in this traffic, given the weather. Will you give me a quick minute to get something hot? I’ll be right with you.” He nodded and went back to his reading.
When she rejoined him, he put the tablet away, sat up straight, and smiled, giving her his full attention. “What can I do for you, Ms. Lawson? What do you wish to know?”
His warmth and friendliness caught her by surprise. He had seemed to freeze the group with his flat delivery at the initial meeting, but now he was anything but detached.
“Tell me a bit about yourself: How long have you been at Goodmoor, and how did you get there?” She looked at his tablet and added, “And what are you reading?”
He grinned at her. “Grew up in California, came to St. Louis for a girl and to Goodmoor for a job. Reading Oliver Sacks because I have an interest in neurology, even though I haven’t studied it formally.”
“Ah, a man who keeps on learning. So, tell me what I don’t know yet about Goodmoor.”
“Have you interviewed everyone?” he asked coyly. He took his glasses off and looked at her with penetrating blue eyes. She noted his coal-black, curly hair, slicked back but still unruly, his late-day stubble just the right amount of dangerous.
“Yes, you are our last interview.” She smiled. This wasn’t supposed to be so pleasant. She took a swallow of her latte and let him talk.
“My interview will be different from the others.” He paused briefly. “I’ll assume you’ve learned nothing of great interest. It’s a high-quality medical group made up of good doctors.” His voice darkened. “But there’s something rotten there. And I got too close for comfort.” His smile didn’t lose its warmth, but his eyes lost their gleam.
“A year ago, I challenged Floyd’s interpretation of the rules regarding Medicare billing. I approached him directly, thought we could have a dialogue about it. I’d picked up some information at a medical meeting in Chicago. I’m always picking up stray bits of information.” Again, that warm smile. “Anyway, I’d just gotten back from the meeting and asked for a minute at the end of the workday to talk to him. Nobody else around. He listened attentively and calmly told me my interpretation was wrong, but not to worry about it—he knew his way around Medicare rules.
“Two days later, Floyd told Personne that I’d been stealing narcotics from the supply closet and that I would have to go. Personne was about to fire me and report me to the National Practitioner Data Bank, when the missing narcotics were discovered in a file drawer in the chart room.”
He looked away for a full minute. Jess held her breath. Finally, he continued.
“I suppose you’re wondering why I didn’t protest, fight, pull in reinforcements, et cetera.” He paused again, then spoke softly. “I had a problem with substance abuse in my youth. That background, of which both Personne and Floyd were aware from my personnel file, would have made my stealing the drugs plausible. And, as you know, once you’ve been reported, you lose your livelihood.”
“So, what happened?” Jess helped him get there.
“Well”—he regained his focus, and his warm smile and direct eye contact returned—“Personne offered me a break, I took it, and it was never spoken of again. And I knew what it required. So I’m biding my time until the Midwest Health deal either happens or doesn’t, and then I’ll leave.”
Jess gave him another minute, as he took a swallow of his drink and exhaled with relief.
“So, you’re saying that you were told to remain silent about the Medicare billing in return for the ‘break’ of keeping your job and not being reported?”
“It was never laid out in so many words, but yes, that’s what I’m saying. Those two were covering something up. I still don’t know exactly what, but clearly I needed to back away. I’m not proud of it, but that’s what I did.”
“Did anyone else in the practice know about this?”
“No, Floyd and Personne
were careful about that. They isolated me by insinuation. They put my past drug abuse out on the rumor mill with a lingering question about a possible current problem, so I got a lot of cold stares and stilted conversations from my partners. Actually, Adam Bright was the only one to approach me about that. He’s a good guy. I never told anyone about the incident and didn’t try to explain away the rumor about my past, since it was a fact. It did distance me from the rest of the group, though. So there you are. I’m playing a waiting game.” He smiled again, sat back in his chair, and finished his coffee.
Then he leaned forward with a serious expression and almost whispered, “I’m hoping, Ms. Lawson, that your firm does what’s right. At the appropriate time, I’ll be willing to help, but for now, I’m keeping a low profile. The ‘girl’ I mentioned earlier is now my wife. We have a child and a life here that I need to protect. And”—he grinned and stood—“it’s my night to cook dinner, so I’ve got to get going.”
Jess stood, they shook hands, and Dr. Sloane left. Jess sat and stared at the door, sipping her drink absently for several minutes before she could rouse herself. One thing she knew for sure: she no longer felt bad for Larry Personne.
Chapter 40
Twinkly lights in the trees surrounding Jim’s patio were just coming on, replacing the intense pink and orange colors of the sunset. Jim took orders for grilling. Jess sat with his friends around the table.
“Jim was a jock in high school. He was a three-letter man and always bested me—always.” Jay, Jim’s longtime best friend, was telling tales. “I recall I skipped football practice once and Jim here covered for me. Remember that?”
Jim looked up from his grilling. “You were always getting into trouble, Jay. Hard to remember all the times I covered for you!”
“At least I could challenge him academically, but not for long. He surpassed my intelligence and ambition when he went to medical school, and then kept on going.”