F Wilson - Implant

Well, he'd pretend not to recognize Marsden and see how the consultation played out.

"Mr. Marsden, " he said, entering and extending his hand. "Dr. Lathram." Marsden's handshake was firm. And he didn't correct Duncan's failure to address him as Senator.

"Glad to meet you, Doctor. You come highly recommended."

"That's always good to hear." He pretended to glance through the medical history on the intake form he'd already perused outside the door.

"Looks like you've been in pretty good health. What can we do for you here? " Marsden turned his head and touched the top of the auricle of his left ear. "I have it on good authority that this needs attending to." Duncan stepped closer and saw the pink nodule in question He touched it, smooth, firm. He pulled an illuminated magnifying glass from a drawer and bent for a closer look. Fine capillaries crisscrossed the opalescent surface. A positive Tyndall effect with the light. He palpated it again, pressing around the edges. It was bigger than he'd initially thought.

"Your authority is a good one. You've got a basal cell carcinoma there.

No risk of distant spread, but if left to its own devices it will continue to grow and eventually ulcerate and bleed. My advice is to have it out now, while it's small."

"That's why I'm here." Duncan placed the magnifier on the counter.

"Sorry. I don't do therapeutic surgery, only cosmetic work. But I can recommend, " "You were recommended."

"I won't argue with that, but I don't do what you need . , , crone.

"But I do need a cosmetic repair. I don't want a notch out of my ear.

" "I appreciate that, but, " 'I Dr. Panzella told me you're the best.

" "Gin? She sent you to me? " Why? he wondered, irritably. She should know better.

"Not really. It. seems we have something in common, She works for each of us. She spotted this thing on my ear, called it a lesion', and told me to have it looked at. Since many of my colleagues on the Hill speak highly of you, and since Gin seems devoted to you, I figure you're the man." Duncan's mind raced. He felt awkward. But this explained Marsden's presence, the Gin connection.

All right. Maybe it was time to stop playing completely dumb and move to slightly dumb.

"Marsden . . . " he said slowly. "Good Lord, you must be Senator Marsden. Forgive me for not making the connection. Of course. You're chairing the", he snapped his fingers, "the . . .

"The Guidelines committee. ' "Right! The Joint Committee on Medical Ethics and Practice Guidelines." Marsden smiled. "You know the full title. So few people do." '"I read a lot. You're group has had some trouble recently, , & , , s. seems.

"Yes. Poor Harold. He's quite ill, I'm afraid. ' "Any idea as to if or when he'll be back? " "No. No definite word yet." Marsden was playing it close to the vest. Not revealing anything. As he should do. Duncan was trying to sort out his feelings for this man. He had nothing personal against him. If he weren't chairing a committee that had no right to exist, he might even like him.

"A bit of bad luck, wouldn't you say? " "Quite a lot more than a bit.

It's almost as if some sort of curse was hanging over this committee.

" "You don't know if any of your members went poking into a pharaoh's tomb, do you? " Marsden's smile was wan. "You'd almost think so, wouldn't you? " "Does that mean you're now out of the Guidelines business? " "Only for a little while. I'm doing my damnedest to fill those empty seats. We should be rolling again in no time"

"Will you now? " Duncan said, feeling his jaw muscles bunch. "How interesting.

" '"But back to the matter at hand, " Marsden said. "I'd like you to do the surgery. And the reason is, quite frankly, cosmetic. I understand you have a method that heals many times faster than regular surgery. I need that. ' "Do you? " '"Yes. Depending on the president, the hearings could be up and running again in a matter of weeks. I don't want to be there on national TV with a cauliflower ear, or an ear that looks like someone took a bite out of it. You know the press. There'll be speculation about it, and once they find out, there'll be story after story on my skin cancer, then TV specials on the prevalence of skin cancer and how to avoid it."

"Nothing wrong with that."

"No. But I don't want the press to center on me and my minor skin disorder. They should focus on the Guidelines committee and what we're trying to do." Just what are you trying to do? Duncan wanted to ask.

Marsden continued, "With your reputed skill and accelerated healing methods, I believe you're just the man for the job." Oh, I am, Senator, Duncan thought. I am that.

'"Very well, Senator. Because of your connection with Dr. Panzella, who speaks very highly of you, by the way, I'll make an exception. But I will not make an exception about not dealing with any insurance company. You pay my outrageous fee up front. In return you will get the finest cosmetic surgery in the world, with absolute discretion.

Ours is a doctor-patient relationship. It does not involve Medicate, Medicaid, Blue Cross, HMOs, PPOs, IPAs, or any of the rest of the alphabet soup.

I do not fill out forms, talk to utilization committees or quality assurance coordinators or nurse-bureaucrats insisting on a second or third opinion. I speak to you, you speak to me. No other parties involved." Marsden's expression reflected fascination rather than consternation.

'"I take it then that you're not a participant in any of the managed-care systems."

"You're looking at an endangered species, Senator." '"If you want, I can have you put on the Department of the Interior's protected list. ' '"Too late for that, I think."

"Well, the sale of my company left me with a bit of money. I can afford to spend some of it on my ear."

"Good. I'll turn you over to my secretary, who'll arrange all the releases. How does next week sound?

" "Thursday would be the best for me."

"I'll sc-e what we can arrange. But if you want me to use the accelerated healing procedures, you'll have to watch a videotape and sign a stack of release forms.

The implants I employ are still considered investigational at this point."

"Whatever you say."

"Excellent." As Duncan led him out into the hall, he spotted Gin passing by.

She glanced his way, then did a double take.

"Senator Marsdent" Something flickered across her face. Somewhere in the moment between her surprise of recognition and smile of greeting her features twisted with an odd expression. Was it fear, concern, or consternation?

Whatever, it was plain that Gin was anything but happy to see the senator here.

Why?

She'd seen nothing but good results, excellent results, during her time here. Why on earth should she have the slightest concern about her senator's having surgery here?

Unless . . .

No. How could she suspect? How could she even guc-ss? It had to be something else. Maybe he'd misinterpreted her expression.

But he didn't think so. Something there, something very much like fear.

Duncan tried to shrug off the feeling but it wouldn't let go. Why on earth should the sight of him with Senator Marsden strike terror into Gin?

Unsettling thoughts whirled through Gin's mind as she watched Senator Marsden sign the consent forms, thoughts about three members of Marsden's committee, all Lathram patients, all either dead, damaged, or demented . . .

She did her best to keep calm.

"What a surprise to see you here, " she said after Duncan was gone.

He tapped the tip of his ear with his finger. "Well, it seems it's unanimous that this has got to go. And didn't you say he was the best?

" "Yes, but I never meant you should come here. . . I mean, he doesn't take cases like yours."

"He said he'd make an exception in my case." Gin felt a cold lump form in her stomach. Duncan never made exceptions.