Robin Cook - Marker

ROGER LEANED BACK AND stretched his arms up toward the ceiling. They felt cramped after the hours he'd spent leaning over the library table in the conference room of the human resources department of St. Francis Hospital. Stacked around the table in little individual piles were numerous pages of computer printouts, plus a recently burned CD. Sitting across from him was the department head, Rosalyn Leonard. She was a serious-appearing, tall, striking woman with inky black hair and porcelain skin who had initially intimidated Roger since she seemed immune to his charm, which Roger took personally. It was inordinately important for him to think of himself as attractive to women he thought were attractive. But persistence had paid off, and as the hours had passed, he had finally prevailed. Ever so slowly at first, she had begun to warm. During the last hour, he felt she was flirting in return. The fact that she was not wearing a wedding band was not lost on Roger, and as the day melded into evening, he had tactfully inquired about her social status. When he learned that she was single and currently between relationships, he even considered taking the risk of asking her for a dinner date, especially if things didn't work out with Laurie.

When Roger had come out to Queens from Manhattan earlier that afternoon it had been a little like going home, since the hospital was located in the East Side of Rego Park, which was a stone's throw away from the section of Forest Hills where he had grown up. Although both of his parents had passed away, he had several aunts and an uncle who still lived close to his boyhood home. As he'd peered out of the taxi window while cruising along Queens Boulevard, he'd even entertained the idea to pass by the old homestead when he was finished with his errand.

Roger had made significant progress. His meeting with Bruce Martin, who headed up the Manhattan General Hospital 's department of human resources, had been quite fruitful, although not at the outset. When Roger had initially asked straight-out for employee records, Bruce had told him that there were all sorts of federal rules that restricted access to such information. That forced Roger to be creative in his request, by contending that in his role as the chief of the medical staff, he was starting a study about the interaction between the doctors and all the support and custodial staff, particularly in regard to new employees and particularly during the night shift, when the hospital was on, in his words, "cruise control." Roger assiduously avoided mentioning even a hint of his true goal.

By the time Roger had left Bruce's office, he'd been promised a list of all employees at the Manhattan General Hospital and a list of new employees since mid-November, with a particular emphasis on people who worked the eleven-to-seven night shift. There had been a slight worry in Roger's mind when he had proposed such a seemingly arbitrary commencement date for the new employees that Bruce would have become suspicious in some form or fashion, but Bruce had merely written it down without any reaction. He promised Roger he'd have the list before he left work that very afternoon, and would have it placed on Roger's desk.

The second thing Bruce had done was call Rosalyn Leonard, his counterpart at St. Francis Hospital, to tell her that Roger would be coming over and to give her an idea of what Roger needed. At the time, Roger didn't appreciate how helpful that had been. Had Roger walked in off the street with his requests, which was his initial plan, he wouldn't have gotten anywhere with Rosalyn. There was no doubt in Roger's mind that she would have been dismissive and unhelpful. Thanks to Bruce's call, she had already done some of the preliminary work before Roger arrived. It turned out that getting the kind of lists Roger wanted required accessing a number of different sources. Roger had been surprised that the various departments in AmeriCare hospitals more or less functioned as individual fiefdoms within the constraints of their centrally dictated budgets.

The other thing Roger had accomplished before leaving the Manhattan General was to get Caroline started on amassing the professional staff list, with particular interest in those physicians who had admitting privileges for both the Manhattan General and St. Francis. Roger had taken the time to see if that information was generally available by calling up a few individual doctor's records. Unfortunately, it was spotty. Caroline had promised him she would do what she could, as it wasn't specifically coded. She had said that she was hopeful, since she was personally friendly with one of the computer whizzes employed by the hospital, who could often figure out how to do the impossible.

"Well, there you have it," Rosalyn said, pushing a final, thin stack of papers in Roger's direction across the library table's varnished surface. She patted the top with the palm of her hand. "Here's a complete list of all Saint Francis employees as of mid-November, with a notation of those working the night shift; a list of St. Francis employees who either quit or were terminated between mid-November and mid-January; a list of our full-time professional staff, also as of mid-November; and finally, a list of our professional staff with admitting privileges. Is that all you want for your study? What about new employees since mid-November?"

"No need," Roger said. "I think this should do it for what I have in mind." He glanced through the pages containing all the hospital employees as of mid-November and shook his head in amazement. "I had no idea so many people were required to run an American hospital." He wanted to divert the conversation away from his putative study. As sharp as Rosalyn was, he guessed she'd see through his ruse rather quickly if he was forced to say too much.

"Like all AmeriCare hospitals, we're actually on the lower slope of the bell curve," Rosalyn said. "As with all managed-care organizations, one of the first things AmeriCare does when it takes over a hospital is reduce the personnel in most every department. I should know, since the unenviable task fell to me. I was responsible for a sizable number of pink slips."

"That must have been difficult," Roger offered in an unconsciously preoccupied tone. He put the full list aside and glanced at the list of the employees that had left St. Francis. Even that was much longer than he had anticipated. It also wasn't as detailed as he had hoped, particularly in respect to which particular shift individual employees worked, whether they were terminated or left on their own accord, and where they went. "I'm surprised there is as much turnover as this. Is this representative?"

"Generally speaking, yes, but it might be slightly on the high side, because the period you are interested in encompasses the holidays. If people are thinking of moving to a new job, and want to take a little time off in between, the holidays are a popular and predictable time."

"And it seems like it's mostly nurses."

"Unfortunately, that's the reality. There's a serious nursing shortage, which puts them in the driver's seat. We're constantly recruiting nurses, and other hospitals are recruiting ours like a tug-of-war. We're even being reduced to seeking prospective candidates abroad."

"Really?" Roger questioned. He knew the United States drained doctors from developing countries who came to America, presumably to train, but then stayed, but he wasn't aware that nurses were being recruited as well. Considering the health needs of the developing world, it seemed ethically questionable at best. "The list doesn't say where the individuals went."

Rosalyn shook her head. "That information isn't put into the main employee data bank. It might be in the individual record if the individual requested a recommendation be sent to another institution or if an inquiry came in from another institution. But we have to be very chary with those records, as you well know. There's always the threat of litigation unless the individual authorizes access. "