Robin Cook - Fatal Cure

The buzz of the intercom surprised them all, especially Beaton who'd left explicit instructions there were to be no interruptions.

"Some bad news," she said once she hung up. "Tom Baringer has died."

The three fell silent. Traynor was the first to speak: "Nothing like a death to remind us that for all the red and black ink, a hospital really is a very different kind of business."

"It's true," Beaton said. "The burden of the work is that the whole town, even the whole region, becomes like an extended family. And as in any large family, someone is always dying."

"What is our death rate here at Bartlet Community Hospital?" Traynor asked. "It's never occurred to me to ask."

"We're just about in the middle of the road," Beaton said. "Plus or minus a percentage point. In fact, our rate is better than most of the inner-city teaching hospitals."

"That's a relief," Traynor said. "For a moment I was afraid there was something else I had to worry about."

"Enough of this morbid talk," Caldwell said. "I have some good news. The husband-and-wife team that we and CMV have been recruiting so actively has decided to come to Bartlet. So we'll be getting a superbly trained pathologist."

"I'm glad to hear it," Traynor said. "That brings pathology up to speed."

"They've even purchased the old Hodges house," Caldwell added.

"No kidding!" Traynor said. "I like that. There's something wonderfully ironic about it."

Charles Kelley slipped into his Ferrari coupe, started the engine, and gave it some gas. It responded like the engineering marvel it was, pressing him against the seat as he accelerated out of the hospital parking lot. He loved to drive the car, especially in the mountains. The way it hugged the road and cornered was a true delight.

After the meeting with the Bartlet Hospital people Kelley had phoned Duncan Mitchell directly, thinking it was a good opportunity to make his presence known to the man at the pinnacle of power. Duncan Mitchell was the CEO of CMV, as well as of several other HMOs and hospital management companies in the South. Conveniently the home office was in Vermont where Mr. Mitchell had a farm.

Kelley had not known what to expect and had been nervous when he called, but the CEO turned out to be gracious. Although Kelley had caught the man preparing to go to Washington, he had generously agreed to meet with Kelley outside the Burlington Airport general aviation building.

With CMV's Learjet in its final stages of fueling, Mitchell invited Kelley into the back of his limousine. He offered Kelley a drink from the limo's bar. Kelley politely refused.

Duncan Mitchell was an impressive man. He wasn't as tall as Kelley, yet he emanated a sense of power. He was meticulously dressed in a conservative business suit with a silk tie and gold cufflinks. His Italian loafers were dark brown crocodile.

Kelley introduced himself and gave a brief history of his association with CMV, mentioning that he was the regional director for the area centered around Bartlet Community Hospital, just in case Mitchell didn't know. But Mitchell seemed acquainted with Kelley's position.

"We eventually want to buy that facility," he said.

"I assumed as much," Kelley said. "And that's why I wanted to come to talk with you directly."

Mr. Mitchell slipped a gold cigarette case from his vest pocket and took out a cigarette. He tapped it thoughtfully against the case's flat front surface. "There's a lot of profit to be squeezed out of these rural hospitals," Mitchell said. "But it takes careful management."

"I couldn't agree more," Kelley said.

"What is it you wanted to talk about?" Mr. Mitchell asked.

"Two issues," Kelley said. "The first involves a bonus program the hospital wants to initiate similar to our own with our hospitals. They want to cut down on hospitalization."

"And what's the other?" Mitchell asked. He blew smoke up toward the ceiling of the car.

"One of our CMV physicians has begun acting bizarrely in response to post-operative complications in his patients," Kelley said. "He's saying things like he's not to blame and there's something wrong with the hospital."

"Does he have a psychiatric history?" Mr. Mitchell asked.

"Not that we can determine," Kelley said.

"Regarding the first issue, let them have their bonus program. At this point it doesn't matter about their balance sheet."

"What about the doctor?" Kelley asked.

"Obviously you'll have to do something," Mitchell said. "We can't let that type of behavior go on."

"Any suggestions?" Kelley asked.

"Do what you need to do," Mitchell said. "I'll leave the details up to you. Part of the skill of running a large organization like ours is knowing when to delegate responsibility. This is one of those times."

"Thank you, Mr. Mitchell," Kelley said. He was pleased. It was obvious to him that he was being given a vote of confidence.

Elated, Kelley climbed out of the limousine and got back into his Ferrari. As he was pulling out of the airport he caught a glimpse of Mitchell walking from his car to the CMV jet.

"Someday," Kelley vowed, "it'll be me using that plane."

Both the internal medicine department and the pathology department had small, informal ceremonies for that year's group of graduates, marking the end of their residencies. After collecting their diplomas, David and Angela passed up the parties scheduled for that afternoon and hurried home. This was the day they would leave Boston for their new home and careers in Bartlet, Vermont.

"Are you excited?" David asked Nikki.

"I'm excited to see Rusty," Nikki announced.

They'd rented a U-Haul truck to help make the move. It took quite a few trips up and down the stairs to get their possessions in the two vehicles. Once they were finally packed, Angela got in their station wagon and David got in the U-Haul. For the first half of the trip, Nikki elected to ride with her dad.

David used the time to talk with Nikki about starting at a new school and ask her if she'd miss her friends.

"Some of them I'll miss," Nikki said, "but others I won't. Anyway, I think I'll cope."

David smiled, promising himself that he would remember to tell Angela about Nikki's precocious comment.

Just south of the New Hampshire border, they stopped for lunch. Eager to arrive at their new home, they ate quickly.

"I feel wonderful about leaving the frantic, crime-filled city behind," Angela said as they left the restaurant and approached their vehicles. "At this point I don't care if I ever go back."

"I don't know," David joked. "I'm going to miss hearing sirens, gunshots, breaking glass, and cries for help. Country life is going to be so boring."

Both Nikki and Angela pummeled him in mock anger.

For the rest of the trip Nikki joined Angela in the station wagon.

As they drove north the weather improved. In Boston it had been hot, muggy, and hazy. By the time they crossed into Vermont it was still warm but clear and much less humid.

Bartlet appeared serene in the early summer heat. Flower-filled window boxes adorned almost every sill. Slowing down, the Wilsons' two-vehicle caravan crept through the lazy town. Few people were on the streets. It was as if everyone were napping.

"Can we stop and get Rusty?" Nikki asked as they neared Staley's Hardware Store.

"Let's get a bit settled first," Angela said. "We'll have to build something to keep him in until he gets housebroken."

David and Angela pulled into their driveway and parked side by side. Now that the house was officially theirs they felt even more awed than they had on their initial visit.

David climbed out of the truck, his eyes glued to the house. "The place is lovely," he said. "But it looks like it needs more attention than I realized."