The Patient Page 10

  “But Alice says you’ve been scheduling them for yourself.”

  “Some of them. Some just hang up when I tell them you’re not available.”

  “I hope none of those hang-ups were HCs.”

  “HCs?”

  “Highly connecteds. You know, senators, big businessmen, celebrities, foreign diplomats—the kind of people who can pump prestige into a program like ours just by walking through the doors.”

  Jessie felt nauseated and had to remind herself for the thousandth time that nothing she could ever say or do was going to change Carl Gilbride.

  “You mean like Marci,” she said.

  “Precisely. Those are the ones who need to be referred directly to me. Teamwork.”

  “Yeah, sure, teamwork.”

  Gilbride simply steamrolled over her sarcasm.

  “What about that guy from the MacIntosh Foundation?” he asked. “Any word from him?”

  “Not yet.”

  “Well, let me know as soon as you hear anything about that.”

  “Three million. I remember. Carl, I can do this for a little while, but not indefinitely.”

  “I assure you, once Marci’s out of the hospital, all this will begin to die down.”

  “I certainly hope so.”

  “Remember, HCs should be referred to my office right away. Alice is doing her best to work them into my schedule as quickly as possible.”

  “HCs to CG,” Jessie said acidly. “I just noted it down.”

  FOLLOWING THE AGENCY attempt to ambush him in his apartment, Alex stopped going anywhere unarmed—opting for his .38 revolver holstered beneath his left pant leg. It was ten o’clock, and as he had done the evening before, he had left his assigned area to wander through Surgical Seven, taking note of any new patients and targeting any male between thirty and fifty-five for further investigation and observation. This time, though, he had a guide. Jessie Copeland had met him in the cafeteria for the second evening in a row, but they had been together for less than ten minutes when she was called back to the floor to check on a patient. Unaware that he had already been there several times, she had invited him to come along to get a firsthand look at where she worked and what she did.

  While she was in with her patient, Bishop wandered down the hall a few doors, glancing into the rooms. The hospital computer had already told him that there were currently forty-four patients on the neurosurgical service—only seven of them possibles. After a brief check, he was fairly certain that none of them was Malloche. Still, he managed to obtain fingerprints from the rooms of five of the men to send to Paris. Interpol had two sets of prints on file they felt might be Malloche’s. With Malloche it was always might be.

  Jessie came out of room 713 and hurried down to him. She wasn’t exactly a knockout, he was thinking, but she was certainly good looking in a bookish sort of way, even when she was harried and overtired, which seemed to be most of the time. It bothered Bishop to have lied to her about himself, but in truth, not that much. In his job, the ability to lie seamlessly was a survival skill—one he had perfected over years of practice. When he had his man, he would set things straight with her. Meanwhile, he had no intention of trusting her or anyone else any more than he had to.

  It made things easier that she seemed attracted to him. The more they talked, the more he learned about Gilbride and the rest of the service. Perhaps under other circumstances, he would have been open to exploring the possibilities between the two of them. But this wasn’t other circumstances. He had bet the ranch on nothing more than a hunch, and he had less than two weeks to amend five years of failure. If he was wrong about Malloche coming to EMMC, or if the Mist eluded him in some way, not even a surgeon like Jessie Copeland would be able to put Humpty together again.

  “Hi,” she said. “Sorry to take so long.”

  “No problem.”

  “Actually, there is. The guy I just went over needs a spinal tap, and he’s got so much arthritis in his spine that the resident just can’t get the needle into the right space.”

  “So you’re going to do it?”

  “I’m going to try. From the time I was a medical student, no matter what happened in the hospital, I could always look over my shoulder and know there was someone with more experience watching out for me. Now that I’m the attending surgeon, when I look over my shoulder, no one’s there.”

  “I think I’d faint.”

  “I doubt it. You don’t look like a fainter. Besides, I don’t think you made it through the Marines by passing out.”

  “Actually, you’re right. I hold it all in and then get sick later when no one’s around. Listen, you just go ahead and tap that guy’s spine. I’d better get back on my loop or I’ll get sacked before I even get my first paycheck.”

  “It was great talking with you again, even if it was just for a little while. You’re kind of funny. I like that in a security guard.”

  Bishop sensed she wanted plans to be made for them to see each other again, but she had already gone more than halfway in that regard.

  “So what do you think?” he asked. “Would you like to try and get together outside the hospital sometime?”

  “Wait. You mean there’s an ‘outside the hospital’?”

  “I can prove it.”

  “Then let’s. The night after tomorrow is a definite possibility for me.”

  “Oops, I’m on the schedule. How about the night after that?”

  “Um, I’m on call.”

  “Lunch. Lunch tomorrow,” he said.

  “Maybe. Just call first. Gilbride’s celebrity has come at a price, only I’m the one who’s paying it. This dating stuff is easy, huh?”

  “Don’t worry. Not much that’s worthwhile is.”

  Bishop left the neurosurgical floor and headed down the long corridor past Jessie’s office and the others. There was something about her that unsettled him. Maybe it was her unassuming confidence, maybe her eyes and the way she smiled at him. In spite of himself, he knew he was wondering what it would feel like to hold her. His love life over the five years he had been after Malloche had consisted of nothing more intense than scattered one-night stands, some with professionals. That was the way he wanted it. Not once over that time had he become emotionally entangled with a woman. Jessie Copeland was one to beware of.

  Distracted, he hurried around the corner, and nearly collided with an elderly, stoop-shouldered janitor who was mopping the floor outside Carl Gilbride’s office.

  “Oh, excuse me,” he muttered, barely looking at the man as he passed.

  “Have a good night, Officer,” the old man said.

  Claude Malloche, his hair and fake mustache snow white, continued his mopping until he was certain the security guard was gone. Then he pulled a device from his pocket, opened the door to Gilbride’s suite in less than fifteen seconds, and dragged his mop and bucket inside. Quickly, he crossed the receptionist’s office, entered Gilbride’s, and closed the door behind him. The high-powered light and camera he took from his pocket were espionage quality. He spread out all the papers on Gilbride’s desk and rapidly photographed each one. Next he turned to the file cabinet.

  Twenty minutes and three rolls of film later, Malloche was back in the hallway, humming the melody of a French folk tune as he nonchalantly worked his way toward the exit.

  CHAPTER 12

  IT SEEMED HARDLY POSSIBLE TO JESSIE, BUT OVER the next few days, life for her at the hospital became even more hectic and exhausting. In addition to her thirteen inpatients, she was covering Gilbride’s large service as well, while the chief continued to stump for publicity, new patients, and grant money like a manic politician. More than once, Jessie had to rein in her anger by remembering that harboring resentment was like drinking poison and then waiting for the other guy to die.

  In the office, the calls, referrals, inquiries, letters, donations, and requests for interviews, personal appearances, and patient appointments made life a whirlwind, second-to-second affair. Even Gilbri
de’s unflappable secretary Alice Twitchell seemed to be fraying at the edges.

  Then there were Jessie’s inpatients. She visited Sara in the NICU three or four times a day. Although Sara remained comatose, she was breathing on her own and showing other very soft signs that the coma was getting lighter. Not exactly startling improvement, but certainly no setback either. Jessie had resigned herself to being encouraged by anything even slightly positive. But she also knew her objectivity in Sara’s case had flown south. It was wrenching to see the expressions on Barry’s and the kids’ faces as they tried to come to grips with the reality that this might be all they got back of their wife and mother.

  Dave Scolari was a different story. He was moving both arms fairly easily now, and even showing some action in his legs. Jessie’s quadriplegic patient, Luis Velasco, had become something of a fixture in Dave’s room—a cheerleader who saw in the linebacker the chance for a level of recovery that he, himself, would never be able to achieve.

  After more than a week, Elsa Davidoff had finally managed a bowel movement and had been shipped off to a rehab center. Jessie wondered what the insurance utilization review people would say when they got a look at the reason for six additional hospital days. Actually, she didn’t care whether the UR people approved or not. If nothing else, she was striking a blow for pre-managed-care kindness and patients’ rights by honoring the elderly woman’s demand that she not be sent out to rehab until her colon had proven it could function.

  Marci Sheprow was out of the NICU and, in fact, only a day or two from being out of the hospital altogether. Her family and Gilbride held twice-daily press conferences in the hospital auditorium, and late this afternoon, Marci herself would be wheeled down to participate for the first time.

  Jessie had tried to take advantage of the gymnast’s celebrity by wheeling her into Tamika Bing’s room. Marci was charming and patient, but her visit evoked nothing from the mute teenager. Tamika, her laptop still open but untouched on her tray table, looked as if she knew who her visitor was, but she reacted no more than that. Soon, the utilization folks would be nipping at the department’s heels about her hospitalization, and plans would have to be made for her discharge. Jessie was pulling out all the stops to keep her as an inpatient because the therapists and psychiatrist were still hopeful and still pushing. She knew there was no way she would get approval to cover an in-hospital stay at a rehab center, and it was certain Tamika’s mother, who was holding down a factory job, wouldn’t be able to take her for daily outpatient therapy.

  Alex Bishop continued to be a pleasurable island in the madness. Although they had yet to manage any extended time together outside the hospital, they had walked around the neighborhood for half an hour last night, and he had visited her on Surgical Seven a number of times. He continued to be a source of little surprises, including a better than passing knowledge of opera and, once she had given him instructions and turned over her Game Boy, a deft hand at Tetris. With her demanding on-call schedule, and his assignment to the evening shift, she feared they might be doomed to an unending in-hospital courtship. The drastic initial measure she opted for was to meet him tomorrow at noon in the North End—Little Italy—for lunch and two hours of strolling the shops and uninterrupted conversation. If the neurosurgical service managed to survive when she was tied up in emergency surgery, it could manage while she was tied up in veal scallopini.

  Jessie’s aneurysm case, which she had done in the regular neurosurgical OR, had gone beautifully, but in the MRI-OR, the post-Marci deluge of patients had intensified an already existing problem—no available time. Marci’s three-and-a-half-hour case notwithstanding, the usual MRI-guided operation took anywhere from five to seven hours. Adding prep and clean-up time, that meant each of the two specially trained teams could do one case a day. A third team could be assembled from parts of the other two when absolutely necessary, but to try to do more than two cases a day was to ask for burnout and shaky judgment from the staff.

  Already, the MRI-OR schedule was booked solid for more than three weeks. A number of those cases were appropriate for ARTIE, although Jessie was still uncertain whether she or the robot were ready. Patients with brain tumors were being reassured, as much as Jessie and Emily could justify, that waiting around at home for a few weeks would not lessen their chances of a successful operation … unless, of course, there was a sudden complication like bleeding into the tumor or rapid pressure buildup from the unanticipated obstruction of spinal fluid flow.

  Although Jessie did most of the preliminary patient evaluations, a number of the MRI cases were going to be Gilbride’s—all of them high visibility. Some of the new patients Gilbride dashed by and met on the fly, while the more important ones he would see in an evening office session. The lowest-level HCs he would not meet in person until they had been checked into the hospital the morning of their operation. Jessie knew that at this pace, with all Gilbride’s distractions and his marginal surgical skills, disaster was just a cut away.

  It was six in the evening when the intensity of the day finally began to ebb. There were enough patients for Jessie still to see, and enough paperwork to catch up on, to keep her in the hospital until ten, but the way things had been going since the operation, home by ten-thirty was tantamount to a vacation day. Her first stop would be the NICU to check on her post-op aneurysm patient, and also on Sara. Not surprisingly, though, before she could leave her office, the phone was ringing again. Also, not surprisingly, the caller was her department chief with more work for her.

  “Jessie, hi,” he began. “Sorry to be calling you so late about this, but I’m in the middle of taping Talk of the City for Channel Five, and I didn’t check in for messages until a few minutes ago.”

  “That’s okay,” Jessie replied dully. “What do you need?”

  “Do you remember me reading you a cable from a guy named Tolliver at the MacIntosh Foundation?”

  “Yes, I remember. It’s hard to forget three million dollars.”

  “Well, I just got word that he’s coming to check out our setup personally.”

  “That’s terrific,” Jessie responded with little enthusiasm.

  She sensed what was coming next.

  “There’s just one problem. I’ve been invited to do a phone interview on the Imus in the Morning radio show at nine tomorrow, then I’m meeting with the hospital administration to discuss some extra lab space for the department. So I’ve arranged to have Tolliver contact you when he arrives at the hospital. Just show him around and be your usual charming self. Whatever he wants to see or do is fine.”

  “But—”

  “Take him out somewhere for lunch if I’m not back. Maybe that Sandpiper place. Just turn in your expenses to Alice and the department’ll take care of reimbursing you. She’s a real peach, isn’t she? Listen, the producer’s waving at me for something. I’ve got to go. Keep up the good work, Jess. Three million will buy a helluva lot of research.”

  Before Jessie could insert a word, she was listening to a dial tone.

  “All bleeding eventually stops,” she muttered, picturing Alex Bishop marching off into the sunset with a plate of veal scallopini. “All bleeding eventually stops.”

  Jessie’s post-op aneurysm patient, a thirty-eight-year-old, high-powered businessman named Gary Garrison, was awake and lucid.

  “Any stock tips?” she asked.

  “McNeil. They make Tylenol. If this headache of mine doesn’t let up soon, I’m going to push their stock up all by myself.”

  Jessie had him describe the pain and location. Then she checked his neurologic status and used an ophthalmoscope to examine the arteries, veins, and optic nerves on the back surface of his retinas, searching for the changes that warned of brain swelling.

  “Not serious,” she proclaimed, finally. “Between your initial hemorrhage and what I did in getting that artery clipped, the structures in your skull have had quite a bit of trauma. They’re allowed to hurt. One more day, I suspect, and you’ll start t
o feel much better. Feel like leaving the unit?”

  “Not really.”

  “Good enough. That’s all I have to hear. I’ll explain things to your HMO in a way they’ll understand.”

  “You’re the best, Doc.”

  Jessie wrote out some orders and passed them to one of the nurses. Then she headed into Sara’s room. A candy striper stood at the bedside, massaging cream into Sara’s hands. The volunteer, whom Jessie had never seen on Surgical Seven before, was a waiflike brunette, maybe in her late teens, with wide, dark eyes and close-cropped hair.

  “Hi,” said Jessie, startling the girl, who was engrossed in her work. “I’m Dr. Copeland.”

  “Oh … hi. I’m Lisa. I just started here.”

  “Welcome to Oz. It looks like you’ve caught on quickly. I’m sure Sara appreciates the hand massage.”

  “Thank you. I did a lot of volunteer work in hospitals when I was in high school. Now, I’m taking a semester off from college, but I wanted to do something that mattered while I was figuring out what comes next.”

  “I thought you looked a little old to be a candy striper.”

  “My mother says I’m a little old to be taking time off from college,” the girl said, grinning.

  “Hey, I’m a neurosurgeon, and I still don’t know what I want to do when I grow up. Have you thought about medicine?”

  Lisa blushed.

  “I … I don’t do very well in the sciences,” she said. “I’m considering working with kids—probably because I think I’m destined to always look like one. Do you want me to leave?”

  “No. Of course not. I want you to keep at it. Sara Devereau is very important to me. And I believe that things like hand massages play a significant role in a patient’s recovery. I’ll be back a little later. Thanks for what you’re doing here.”

  “Thanks for talking with me,” Lisa said. “Most of the doctors I’ve dealt with seem too stressed to stop and talk to anyone.”

  CHAPTER 13

  LATE THE NEXT MORNING, EASTMAN TOLLIVER, THE three-million-dollar man, arrived at Eastern Mass Medical on schedule. Jessie had returned to the hospital at six feeling irritable and frustrated. Instead of spending a few relaxing hours away from the hospital with the first man in whom she had been interested in a couple of years, she would be baby-sitting a foundation bureaucrat.