Robin Cook - Godplayer

Yet Larry had weathered this kind of abuse before. What was making him crazy was Thomas’s operative performance. It had been obvious from the moment he began work on his first patient that the surgeon was exhausted. His usually flawless coordination was off and his judgment faulty. And worst of all, Thomas had an uncontrollable tremor. It almost gave Larry heart failure to watch Thomas bend over the heart with a razor-sharp needle and try to direct the instrument to the dainty piece of saphenous vein he was attempting to sew to the minute coronary vessel.

Vainly Larry had hoped the tremor would lessen as the morning progressed. Instead it got worse.

“Would you like me to sew this one on?” asked Larry on several occasions. “I think I can see a bit better from my position.”

“If I want your help, I’ll ask for it,” was Thomas’s only reply.

Somehow they got through the first two cases with the bypasses sewn reasonably in place and the patients off the heart-lung machine. But Larry was not looking forward to the third case, a thirty-eight-year-old married man with two little children. Larry had opened the patient’s chest and was waiting for Kingsley to return from the lounge. The resident’s pulse was racing, and he had begun sweating heavily. When Thomas finally burst through the OR door, Larry felt his stomach knot with fear.

At first, things went reasonably well, although Thomas’s shaking was no better and his frustration level seemed even lower. But the open-heart team, wary after the first two cases, was careful not to cross him in any way. The hardest job fell to Larry, who tried to anticipate Kingsley’s erratic movements and do as much of the actual work as Thomas would allow him. The real trouble didn’t begin until they’d started sewing the bypasses in place. Larry couldn’t watch and turned his head away as Thomas’s needle holder approached the heart.

“Goddammit,” shouted Thomas.

Larry felt his stomach churn as he saw Thomas yank his hand from the operative site, the needle buried in his own index finger. Inadvertently Thomas also pulled out one of the large catheters that took blood from the patient to the heart-lung machine. As if a faucet had been turned on, the wound filled with blood and in seconds began soaking the sterile drapes and dripping onto the floor.

Desperately Larry plunged his hand into the wound and groped blindly for the clamp holding the suture around the vena cava. Luckily his hand hit it immediately. Deftly he pulled up on the tape and the blood loss slowed.

“If I had decent exposure this kind of problem wouldn’t happen,” raged Thomas, pulling the needle out of his finger and dropping it on the floor. He stepped back from the table nursing his injured hand.

Larry managed to suck out the blood from the wound. As he reinserted the catheter from the heart-lung machine, he tried to think what he should do. Thomas wasn’t fit to operate anymore that day, yet to say anything risked professional suicide. In the end Larry decided that he could no longer stand the tension. When he’d secured the operative site, he stepped away from the table and joined Thomas, who was being regloved by Miss Goldberg.

“Excuse me, Dr. Kingsley,” said Larry with as much authority as he could muster. “This has been a trying day for you. I’m sorry we haven’t been more on the ball. The fact of the matter is that you are exhausted. I’ll take over from here. You needn’t reglove.”

For a moment Larry thought Thomas was going to slug him, but he forced himself to continue. “You’ve done thousands of these operations, Dr. Kingsley. No one is going to fault you for being too tired to finish one of them.”

Thomas began to shake. Then, to Larry’s astonishment and relief, he snapped off his gloves and left.

Larry sighed and exchanged glances with Miss Goldberg.

“I’ll be right back,” said Larry to the team. With his gloves and gown still on, Larry left the OR. He hoped that one of the other staff cardiac surgeons would be available and was relieved when he saw Dr. George Sherman coming out of OR No. 6. Larry took him aside and quietly related what had happened.

“Let’s go,” said George. “And I don’t want to hear a word about this outside of the OR, understand? It could happen to any one of us, and if the public learned about the incident it would be disastrous, not just for Dr. Kingsley, but for the hospital.”

“I know,” said Larry.

Thomas was angrier than he had ever been. How dare Larry suggest he was too tired to proceed? The scene had been a nightmare. It was the haunting fear of such disaster that had originally forced him to take an occasional pill to sleep. He’d been perfectly capable of finishing the operation, and if he hadn’t been so upset over Cassi’s infidelity, he certainly would not have left. Furiously he stomped into the surgical lounge and used the phone by the coffee machine. He called Doris to make sure there were no emergencies and asked her to reschedule his afternoon patients for another day. He was already late, and he didn’t think he could stand to see patients. Doris was about to hang up when she remembered that Ballantine had called, asking if Thomas would stop by his office.

“What did he want?” asked Thomas.

“He didn’t say,” said Doris. “I asked him what it was in reference to, in case you’d need a patient folder. But he said he’d just like to see you.”

Thomas told the nurse at the main desk that he’d be in Dr. Ballantine’s office in case there was a call. To steady himself and relieve his headache, which had gotten steadily worse, he took another Percodan from his locker. Then he donned a white lab coat and left the lounge wondering what the meeting could be about. He did not think the chief would call him in to discuss the scene at the party with George Sherman, and it certainly couldn’t have anything to do with the episode with Larry Owen. It must have something to do with the department in general. He remembered the trustee’s odd comment the night before and decided Ballantine was finally going to let Thomas in on his plans. There was always the chance that Ballantine was thinking about retiring and wanted to discuss turning over the department to Thomas.

“Thanks for coming in to see me,” said Dr. Ballantine, as soon as Thomas was seated in his office. He seemed somewhat ill at ease, and Thomas shifted in his chair.

“Thomas,” Ballantine finally began. “I think we should speak frankly. I assure you that whatever we say will not leave this room.”

Thomas rested an ankle on his knee, steadying it with his hands while his foot began to pump rhythmically.

“It’s been brought to my attention that you might be abusing drugs.”

Thomas’s foot stopped its nervous movement. The low-grade headache became a pounding agony. Although anger flooded his consciousness, his expression stayed the same.

“I want you to know,” said Dr. Ballantine, “that this is not an uncommon problem.”

“What kind of drugs am I supposed to be taking?” asked Thomas, making a supreme effort to rein in his emotions.

“Dexedrine, Percodan, and Talwin,” said Dr. Ballantine. “Not uncommon choices.”

With narrowed eyes, Thomas studied Dr. Ballantine’s face. He hated the older man’s patronizing expression. The irony of being judged by this inept buffoon drove Thomas to the brink of frenzy. It was lucky that the Percodan he’d taken in the lounge was beginning to work.

“I’d like to know who brought this ridiculous lie to your attention,” he managed to ask quietly.

“That is not important. What matters…”

“It’s important to me,” said Thomas. “When someone starts this kind of vicious rumor, they should be held accountable. Let me guess: George Sherman.”