Robin Cook - Crisis

"That is a heartrending story," Randolph said, "and stirring because of your immediate compassionate impulse and the fact that it motivated you to follow what was to be a difficult path. Becoming a doctor was not easy for you, Dr. Bowman, and that al-truistic urge you so eloquently described had to be strong indeed to propel you over the obstacles you faced. Could you tell the court something of your inspiring Horatio Alger story?"

Craig perceptively straightened in the witness chair.

"Objection," Tony shouted, getting to his feet. "Immaterial."

Judge Davidson took off his reading glasses. "Counsels, approach the bench."

Dutifully, Randolph and Tony congregated to the judge's right.

"Listen!" Judge Davidson said, pointing his glasses at Tony. "You made character a centerpiece of the plaintiff's case. I allowed that, over Mr. Bingham's objection, with the proviso you established foundation, which I believe you did. What's good for the goose is good for the gander. The jury has every right to hear about Dr. Bowman's motivations and training. Do I make myself clear?"

"Yes, Your Honor," Tony said.

"And furthermore, I don't want to hear a flurry of objections in this regard."

"I understand, Your Honor," Tony said.

Tony and Randolph retreated to their original spots, with Tony at the plaintiff's table and Randolph at the podium.

"Objection overruled," Judge Davidson called out for the court recorder's benefit. "Witness may proceed to answer the question."

"Do you recall the question?" Randolph asked.

"I should hope so," Craig said. "Where should I begin?"

"At the beginning would be appropriate," Randolph said. "I understand you did not get parental support."

"At least not from my father, and he ruled the house with an iron fist. He was resentful of us kids, particularly me, since I wasn't the football or hockey prodigy like my older brother, Leonard Junior. My father thought I was a 'candy ass,' and told me so on multiple occasions. When my browbeaten mother let it slip that I wanted to be a doctor, he said it would be over his dead body."

"Did he use those exact terms?"

"Absolutely! My father was a plumber who was dismissive of all professionals, which he labeled as a collective bunch of thieves. There was no way he wanted a son of his to become part of such a world, especially since he never finished high school. In fact, to the best of my knowledge, no one in my family on either side went to college, including my own brother, who ended up taking over my father's plumbing business."

"So your father wasn't supportive of your academic interests."

Craig laughed mirthlessly. "I was a closet reader as a youngster. I had to be. There were occasions on which my father whacked me around when he caught me reading instead of doing things around the house. When I got report cards, I had to hide them from my father and have my mother sign them secretly because I got all A's. With most of my friends, it was the other way around."

"Was it easier when you got to college?"

"In some ways yes and some ways no. He was disgusted with me, and instead of calling me a 'candy ass,' I became a 'highfalutin' ass'. He was embarrassed to talk about me to his friends. The biggest problem was that he refused to fill out the financial forms necessary to apply for a scholarship and, of course, refused to contribute a cent."

"How were you able to pay for college?"

"I relied on a combination of loans, scholastic awards, and every type of job I could manage to get and still keep a four-point-oh grade point average. The first couple of years it was mostly restaurant work, washing dishes and waiting tables. During the last two I was able to work in a variety of science labs. During summers I worked in the hospital at any job they would give me. Also, my brother helped me a little, although he couldn't do much, since he'd already started a family."

"Did your goal of medicine and your desire to help people support you during these difficult years?"

"Absolutely, especially the summer work in the hospital. I worshipped the doctors and the nurses, particularly the residents. I could not wait to become one of them."

"What happened when you got to medical school? Were your financial difficulties worse or less severe?"

"Much worse. The expenses were greater and the curriculum required more hours, essentially all day every day in contrast to college."

"How did you manage?"

"I borrowed as much as I was allowed; the rest I had to earn with a myriad of jobs all around the medical center. Luckily, jobs abounded."

"How did you find the time? Medical school is considered a full-time occupation and then some."

"I went without sleep. Well, not totally, since that is physically impossible. I learned to sleep in short snatches even during the day. It was difficult, but at least in medical school the goal was in sight, which made it easier to endure."

"What kind of jobs did you do?"

"All the usual medical center jobs like drawing blood, type and cross-matching blood, cleaning animal cages: anything and everything that could be done at night. I even worked in the medical center kitchen. Then, during the second year, I landed a terrific job with a researcher studying sodium ion channels in nerve and muscle cells. I've even kept up that work today."

"With such a busy schedule in medical school, how were your grades?"

"Excellent. I was in the top ten percent of my class and a member of the Alpha Omega Alpha honorary scholastic society."

"What do you consider your biggest sacrifice? Was it the chronic lack of sleep?"

"No! It was the lack of any time for social contact. My classmates had time to interact and discuss the experience. Medical school is quite intense. During my third year, I was conflicted about whether to go into academic/basic-science medicine or clinical medicine. I would have loved to debate the pros and cons and have the benefit of others' opinions. I had to make the decision myself."

"And how did you make the decision?"

"I realized I liked taking care of people. There was an immediate gratification that I savored."

"So it was the contact with individuals that you found enjoyable and rewarding."

"Yes, and the challenge of coming up with the differential diagnoses, as well as the paradigm for narrowing the field."

"But it was the contact with the people and helping them that you cherished."

"Objection," Tony said. He had been progressively fidgeting. "Repetitious."

"Sustained," Judge Davidson said with a tired voice. "No need to belabor the point, Mr. Bingham. I am confident the jury has gotten it."

"Tell us about your residency training," Randolph said.

"That was a joy," Craig said. He was now sitting up straight, with his shoulders back. "Because of my grade point average, I was accepted to train at the prestigious Boston Memorial Hospital. It was a wonderful learning environment, and suddenly I was being paid, not a lot of money, but some. Equally important, I was no longer paying tuition, so I could begin to pay off the shocking debt I'd assumed from college and medical school."

"Did you continue to enjoy the necessarily close bonds that had to form between you and your patients?"

"Absolutely. That was by far the most rewarding part."

"Now tell us about your practice. I understand there were some disappointments."

"Not at first! Initially, my practice was everything I had dreamed it would be. I was busy and stimulated. I enjoyed going in each and every day. My patients were challenging intellectually and appreciative. But then the insurance companies began to withhold payments, often needlessly challenging certain charges, making it progressively difficult to do what was best for my patients. Receipts began to fall while costs continued to rise. In order to keep the doors open, I had to increase productivity, which is a euphemism for seeing more patients per hour. I was able to do this, but as it continued, I became progressively concerned about quality."