Robin Cook - Godplayer

As Jeoffry was wheeled back out, Thomas’s and Jeoffry’s eyes happened to meet. Jeoffry nodded and smiled. Thomas returned the gesture. Thomas couldn’t help feeling sorry for the young man. Yet as tragic as his story was it was also quite common. Thomas had personally operated on hundreds of patients with similar histories.

With Jeoffry gone, George returned to the podium. “Mr. Washington has been scheduled to have a mitral valve replacement, but during the work-up an interesting fact was uncovered. Mr. Washington had an episode of pneumocystic carini pneumonia one year ago.”

An excited murmur rippled through the audience.

“I suppose,” called George over the babble of voices, “that it is not necessary to remind you that such an illness suggested AIDS, or Acquired Immune Deficiency Syndrome, which was indeed found in this patient. As it turns out, Jeoffry Washington’s sexual preferences have placed him in that group of homosexual men whose life-style has apparently led to immuno-suppression.”

Thomas now knew what George had meant by his comment in the surgical lounge the previous afternoon. He closed his eyes and tried to control his rising anger. Obviously Jeoffry Washington was an example of the kind of case that was taking OR slots and cardiac surgical beds away from Thomas’s patients. Thomas was not alone in his reservations concerning operating on Jeoffry. One of the internists raised his hand and George recognized him. “I would seriously question the rationale for elective heart surgery in light of the patient’s having AIDS,” said the internist.

“That’s a good point,” said George. “I can say that Mr. Washington’s immunological picture is not grossly abnormal at present. He’s scheduled for surgery next week, but we will be following his helper T-cell and cytotoxic T-cell populations for any sudden decline. Dr. Sorenson of the department of immunology does not think the AIDS is an absolute contraindication for surgery at this time.”

A number of hands popped up in the audience, and George began to call on them. The animated discussion took the conference over its normal time, and even after it was officially over, groups of people stood in clumps to continue talking.

Thomas tried to leave immediately, but Ballantine had gotten up and blocked his way. “Good conference,” he beamed.

Thomas nodded. All he wanted to do was get away. His head felt as if it were in a vise.

George Sherman came up behind Thomas and clapped him on the back. “You and I really entertained them this morning. We should have charged admission.”

Thomas slowly turned to face George’s smiling, self-satisfied face. “To tell you the honest truth, I think the conference was a goddamn farce.”

There was an uncomfortable silence as the two men eyed one another in the midst of the crowd.

“Okay,” said George at length. “I suppose you are entitled to your opinion.”

“Tell me. Is this poor fellow, Jeoffry Washington, whom you paraded out here like some freak, occupying a cardiac surgical bed?”

“Of course,” said George, his own ire rising. “Where do you think he’d be, in the cafeteria?”

“All right, you two,” said Ballantine.

“I’ll tell you where he should be,” snapped Thomas while he jabbed George in the chest with his index finger. “He should be on the medical floor in case something can be done about his immunological problem. Having already had pneumocystic carini pneumonia there’s a good chance he’ll be dead before he ever gets into a life-threatening cardiac state.”

George knocked Thomas’s hand aside. “As I said, you’re entitled to your opinion. I happen to think Mr. Jeoffry Washington is a good teaching case.”

“Good teaching case,” scoffed Thomas. “The man is medically ill. He should not be taking up a scarce cardiac surgical bed. The bed is needed for others. Can’t you understand that? It’s for this kind of nonsense that I have to keep my patients waiting, patients with no medical problems, patients who will be making real contributions to society.”

George again knocked Thomas’s hand away. “Don’t touch me like that,” he snapped.

“Gentlemen,” said Ballantine, stepping between them.

“I’m not sure Thomas knows what the word means,” said George.

“Listen, you little shithead,” snarled Thomas, reaching around Ballantine and grabbing a handful of George’s shirt. “You’re making a mockery of our program with the cases you’re dredging up just to keep the so-called teaching schedule full.”

“You’d better let go of my shirt,” warned George, his face suffused with color.

“Enough,” shouted Ballantine, pulling Thomas’s hand away.

“Our job is to save lives,” said George through gritted teeth, “not make judgments about who is more worthy. That’s up to God to decide.”

“That’s just it,” said Thomas. “You’re so stupid you don’t even realize that you are making judgments about who should live. The trouble is your judgment stinks. Every time you deny me OR space another potentially healthy patient is condemned to death.”

Thomas spun on his heels and strode from the room.

George took a deep breath, then adjusted his disheveled shirt.

“God! Kingsley is such a prig.”

“He is arrogant,” agreed Ballantine. “But he is such a damn good surgeon. Are you all right?”

“I’m fine,” said George. “I must admit I came close to slugging him. You know, I think he’s going to be trouble. I hope he doesn’t get suspicious.”

“In that sense his arrogance will be a help.”

“We’ve been lucky. By the way, have you ever noticed Thomas’s tremor?”

“No,” said Ballantine with surprise. “What tremor?”

“It’s on and off,” said George. “I’ve noticed it for about a month, mainly because he was always so steady. I even noticed it today when he was doing his presentation.”

“Lots of people are nervous in front of groups.”

“Yeah,” said George, “but it was the same as when I was talking to him about the Wilkinson death.”

“I’d rather not talk about Wilkinson,” said Ballantine, glancing around at the slowly emptying amphitheater. He smiled at an acquaintance. “Thomas is probably just tense.”

“Maybe,” said George, not convinced. “I still think he’s going to be trouble.”

Cassi dressed for her visit to Patricia as if it were the first time they were to meet. With great care she chose a dark blue wool skirt with a matching jacket to go over one of her high-necked white blouses. Just as she was about to leave, she noticed the atrocious state of her nails and thankfully postponed the visit while she removed her old polish and applied a new coat. When that was dry, she decided she didn’t like her hair, so she took it down and put it back up again.

Finally having run out of reasons to delay, she crossed the courtyard between the house and the garage. It was freezing out. Ringing Patricia’s bell, Cassi could see her breath in the crisp air. There was no answer. Standing on tiptoes, she looked through a small window in the door, but all she could see was a flight of stairs. She tried the bell again, and this time saw her mother-in-law slowly descend the stairs and peer out through the glass. “What is it, Cassandra?” she called.

Nonplussed that Patricia didn’t open the door, Cassi was silent for a minute. Under the circumstances she didn’t feel like shouting her reason for visiting. Finally she said: “I want to talk to you about Thomas.”

Even with that explanation there was a long enough pause for Cassi to wonder if Patricia had heard her. Then several bolts snapped aside and the door opened. For a moment the two women eyed each other.