Peter Clement: The Inquisitor

Earl spotted the chief of surgery, Sean Carrington, a giant of a man seated in the front row, and slid in beside him. He wielded enormous influence in the hospital and more than once had used it to save Earl's hide politically. But Earl appreciated him most for his zany sense of humor. Sean could cut through the suffocating bureaucracy of academic medicine like a blast of oxygen. And his bushy red eyebrows, highlighted by his mask, whipped up a laugh all by themselves when his jokes failed.

He nodded to Earl, leaned over, and whispered, "Stewart must be in anger management classes again. You know, the ones where they chant, 'Teach it, and the shit you spout will come true.'"

Earl swallowed a chuckle. "Did he brief them about SARS yet?"

The fun went out of Sean's eyes. "Yeah."

"Who's left to speak?"

"Just you, Dr. Vice President, Medical, sir, and chief poo-bah, or whatever it is we get to call you these days."

"Now don't you start. I get razzed enough by my department."

Sean reached over and pretended to knuckle-rub the top of his head. "Hey, what are old friends for but to keep you from getting too high and mighty up there among the ruling class?"

Earl knew that Sean took the epidemic as seriously as anyone, but apart from the mandatory discussions about it at meetings, he never dwelled on it, let alone voiced his personal fears. If anything, his joking had increased as the hospital hunkered down to meet the crisis. What with the general atmosphere of gloom, they could do with more like him. And Earl read this latest tease as a hint to lighten up himself. "High and mighty, with the bellyfull of problems you bums dump on me every day? Fat chance."

The vice president, medical held authority over all doctors in their practice of medicine at St. Paul's Hospital. Only the CEO had more power. The position also meant a mountain of trouble for whoever filled it, especially in times such as these. Yet two weeks ago, under pressure from most of the other chiefs, Earl had accepted the appointment. Why? "Because it's a responsibility I can't refuse," he'd told most people who asked. And he hadn't lied, just dressed up the real reason: it would be easier to run ER with himself in charge rather than some of the other bozos who might get the job.

"How's Janet taking you being named boss of bosses around here?"

"Cutting me down to size, as usual. I don't think she got the memo-"

A gentle cuff to the back of his head cut him off. "Hey, quit bad-mouthing your superiors," Janet whispered, loud enough for people two rows away to hear, as she slipped into a seat behind him. She whipped off her surgical cap, setting a sunburst of blond hair free with a shake. Then, quickly replacing the headgear, she gave him a masked kiss on his masked cheek. "And no memo's going to make me treat you differently."

Earl heard a few snickers.

Dr. Janet Graceton, obstetrician and recently named director of the hospital case room, held command over him as friend, lover, and wife. Some in the hospital eagerly awaited an issue where the VP, medical would have to confront the case room director over something or other. According to the rumor mill, odds of that matchup stood at eight to five for Janet.

"Hey, you look great," Sean told her.

"That's because OR greens and gowns make perfect maternity wear, don't you think?" She molded the layers of material over her abdomen, accentuating the swell of her stomach. Even with her in her thirty-fourth week of pregnancy, operating room garb hung so loosely on her tall and normally slim frame that nobody believed her due date could be six weeks away. Nor would her workload tip them off. Some women might have cut back their time on the job by now. But Janet would have gone nuts staying home at this stage under any circumstances. She relaxed through work, finding a contentment in it that her colleagues, male and female, envied. "And a happy mom usually means a contented fetus," she'd told thousands of women, helping them discover their own unique needs during pregnancy. Little wonder she gave herself the same right to decide what would be best for her baby. While carrying their first son, Brendan, now six, she'd done her last delivery a mere twenty-four hours before going into labor herself.

Not that her bravado didn't worry Earl.

"Now a word as to your night schedule," Stewart droned, and flipped open his laptop computer, where he kept house staff duty rosters. On the screen behind him a barely decipherable set of lists came into view. "As in last year, only second- and third-year residents will be on for ICU, the intensive care unit, CCU, the coronary care unit, and SICU, the surgical intensive care unit. If you learn nothing else, you'll at least be able to impress family and friends with all these neat acronyms."

A third of the audience laughed. The remainder groaned. Stewart made this same joke every year.

"And if you lose your handouts, feel free to make yourself floppies. This laptop is at your disposal, and the password is Tocco, T-o-c-c-o, my dog's name…"

Earl tuned it all out, mentally preparing what he would say to sum up the session. The SARS outbreak had catapulted doctors into a level of risk that hadn't existed in North America since the 1918 flu epidemic, and forced them to adopt protective measures unprecedented in modern hospitals. No one in this room had planned to take on that kind of danger when they chose medicine as a career. How the hell did he address that?

"… and while during the day you may be internists, surgeons, gynecologists, et cetera, residency cutbacks necessitate that at night you will cover a multitude of services, again like last year…"

This time Stewart got a howl of disapproval from the newcomers. High up in the back row a kid who had black Brillo pads for eyebrows and who looked lost in his voluminous OR gown leapt to his feet, teetering over the similarly attired confreres sitting in front of him. "What if we need help?" he yelled.

Equally youthful looking colleagues joined in.

"… yeah…"

"… a lack of supervision…"

"… violates our contract…"

Earl marveled at how they could get so exercised over such a traditional complaint as the on-call roster when the new normal they faced loomed so large. Odds were that the first-year people, with so much to learn, would slip up more than anyone else when it came to all the protective measures they must practice. As a consequence, no other group in the room stood a greater chance of ending up sick, maybe even dead.

Stewart waved them quiet with the palms of his hands. "Easy, people, easy. We'll also have full-time staff doctors in the critical care areas I mentioned. That frees the R-twos and R-threes on duty there to come and assist you on the floors when you call them. It's a system that's worked well."

A few of the rookies continued to mutter, and some rolled their eyes in exasperation. The second- and third-year people remained silent and slumped in their chairs. They were all too aware that scheduling arrangements didn't matter much against an unseen threat ready to get you on any shift, at any time.

"What about ER?" a lone voice inquired from somewhere behind and above. "Will R-two and R-three people there be expected to back up arrests on the floors as in the past, or did you finally get that note from my mother saying we needed our sleep?"

This brought a much-needed laugh from everyone.

Earl smiled, recognizing the easy drawl of Dr. Thomas Biggs, his own emergency medicine protege. He looked around and saw the lanky Tennessee native sprawled in his seat a few rows from the top with the laid-back air that he had made his trademark. Even with his mask on, the bottom margin of his black beard could be seen under his chin. On either side of him sat the other men and women in the ER program. Thomas, in his last year of training as an emergency medicine specialist, would serve as Earl's chief resident and supervise teaching during the next three months. After that he'd begin a final rotation through all the other critical care areas Stewart had just mentioned. Judging by his performance so far, he had the potential to be a real star and would undoubtedly make a major contribution wherever he ended up.