Robin Cook - Godplayer

George Sherman was one of the few unmarried surgeons. What put him in a unique class was that at age forty he’d never been married. The other bachelors were either separated or divorced. And George was a particular favorite among the younger nurses. They loved to tease him about his errant bachelor’s life, offering help in various ways. George’s intelligence and humor took all this in stride, and he milked it for all it was worth. Thomas found it all exceedingly irritating.

“The poor woman was pretty upset,” said Thomas. Once again he had to refrain from making some comment concerning the advisability of bringing such a case into the hospital. Instead he raised his paper.

“It was an unexpected complication,” said George, undeterred. “I understand that good-looking chick in the waiting room was your patient’s daughter.”

Thomas slowly lowered his paper again.

“I didn’t notice she was particularly attractive,” Thomas said shortly.

“Then how about sharing her name and phone number?” said George with a chuckle. When Thomas failed to respond, George tactfully changed the subject. “Did you hear that one of Ballantine’s patients arrested and died during the night?”

“I was aware of it,” said Thomas.

“The guy was an admitted homosexual,” said George.

“That I didn’t know,” said Thomas with disinterest. “I also didn’t know that the presence or absence of homosexuality was part of a routine cardiac surgical work-up.”

“It should be,” said George.

“And why do you think so?” asked Thomas.

“You’ll find out,” said George, raising an eyebrow. “Tomorrow in Grand Rounds.”

“I can’t wait,” said Thomas.

“See you in conference this afternoon, sport,” said George, giving Thomas a playful thump on the shoulder.

Thomas watched the man saunter away from him. It annoyed him to be touched and pummeled like that. It seemed so juvenile. While he watched, George joined a group of residents and scrub nurses slumped over several chairs near the window. Laughter and raised voices drifted across the room. The truth was that Thomas could not stand George Sherman. He was convinced George was a man bent on accumulating the trappings of success to cover a basic mediocrity in surgical skill. It was all too familiar to Thomas. One of the seemingly inadvertent evils of the academic medical center was that appointments were more political than anything else. And George was political. He was quick-witted, a good conversationalist, and socialized easily. Most important, he thrived within the bureaucratic committee system of hospital politics. He’d learned early that for success it was more important to study Machiavelli than Halstead.

Thomas knew that the root of the problem was an antagonism between the doctors on the teaching staff like himself, who had private practices and earned their incomes by billing their patients, and the doctors like George Sherman, who were full-time employees of the medical school and received salaries instead of fees for service. The private doctors had substantially higher incomes and more freedom. They did not have to submit to a higher authority. The full-time doctors had more impressive titles and easier schedules, but there was always someone over them to tell them what to do.

The hospital was caught in the middle. It liked the high census and money brought in by the private doctors, and, at the same time, it enjoyed the credibility and status of being part of the university medical school.

“Campbell’s chest is closed,” said Larry, interrupting Thomas’s thoughts. “The residents are closing the skin. All signs are stable and normal.”

Tossing the newspaper aside, Thomas got up from the chair and followed Larry toward the dressing room. As he passed behind George, Thomas could hear him talking about forming some kind of new teaching committee. It never stopped! Nor did the pressure that George, as head of the teaching service, and Ballantine, as head of the department, applied to Thomas, trying to convince him to give up his practice and join the full-time staff. They tried to entice him by offering him a full professorship, and although there’d been a time when that might have interested Thomas, now it held no appeal whatsoever. He’d keep his practice, his autonomy, his income, and his sanity. Thomas knew if he went fulltime it would only be a matter of time before he was told who he could and who he could not operate on. Before long he’d be assigned ridiculous cases like the poor mentally retarded kid in the cath room.

Tense and angry, Thomas went into the dressing area and opened his locker. As he pulled off his scrub clothes and tossed them into the hamper, he recalled Laura Campbell’s pliant body pressed against his own. It was a welcome and pleasant image and had the effect of mollifying his frazzled nerves. Ever since he’d left the OR, his pleasure in operating had dissipated, leaving him increasingly tense.

“As usual, you did a superb job today,” said Larry, noting Thomas’s grim face and hoping to please him.

Thomas didn’t respond. In the past he would have loved such a compliment, but now it didn’t seem to make any difference.

“It’s too bad that people can’t appreciate the details,” said Larry, buttoning his shirt. “They’d have a totally different idea of surgery if they did. They’d also be more careful who they let operate on them.”

Thomas still did not say anything, although he nodded at the truth of the comment. As he pulled on his own shirt, he thought of Norman Ballantine, that white-haired, friendly old doc whom everyone loved and applauded. The fact of the matter was that Ballantine probably shouldn’t still be operating, although no one had the nerve to tell him. It was common knowledge in the department that one of the chief thoracic resident’s jobs was to assign himself to all of Ballantine’s cases so that he could help the chief when he blundered. So much for academic medicine, thought Thomas. Ballantine, thanks to the residents, got reasonable results, and his patients and their families worshipped him despite what went on when the patient was anesthetized.

Thomas had to agree with Larry’s comment. He also thought that it would be infinitely more appropriate if he, Dr. Thomas Kingsley, was chief. After all, he did most of the surgery, for God’s sake. It was he, more than any other single person, who had made Boston Memorial the place to have any cardiac surgery. Even Time magazine had said as much.

Yet Thomas did not know if he wanted to be chief any longer. At one time it was all he could think about. It had been one of his driving forces, pushing him on to greater efforts and more personal sacrifice. It had seemed part of a natural progression, and colleagues had started talking about it while he was still a fellow. But that was quite a few years ago, before all the administrative bullshit had reared its ugly head and showed just how much it could interfere in his practice.

Thomas stopped dressing and stared ahead into the distance. He felt an emptiness inside of him. Comprehending that one of his long sought-after goals was potentially no longer attractive was depressing, especially when the goal was finally within his grasp. Maybe there was no place to go… maybe he’d reached his apogee. God, what an awful thought!

“I’m awfully sorry to hear about your wife,” said Larry as he sat down to put on his shoes. “It really is a shame.”

“What do you mean?” asked Thomas, pronouncing each word with deliberate precision. He took immediate offense that a subordinate like Larry would presume to be so familiar.

Larry, oblivious to Thomas’s response, bent to tie his shoes. “I mean about her diabetes and her eye problem. I heard she’s got to have a vitrectomy. That’s terrible.”