Робин Кук - Charlatans

The welcoming ceremony had started precisely at 8:30 A.M. as scheduled. Noah had entered from the second floor prior to its commencement with several minutes to spare and looked down into the pit to see Dr. Hernandez waiting at the lectern for 8:30 to arrive. The chief was a compulsive man, especially about time. The room was built as a typical half-circle medical-school amphitheater, with tiers of seats rising from the half-circle pit or arena a full story below, making it look like an ancient Greek or Roman theater. The room was nearly full, with the twenty-four newly minted and obviously eager first-year residents sitting front and center in the first row. They all had on glaringly white, highly starched coats similar to Noah’s. Over the whole scene was a surprisingly loud buzz of conversation as a testament to the room’s fine acoustics.

As Noah had begun to descend one of the amphitheater’s two rather steep stairways that divided the seating into thirds, his arrival caught the attention of the chief of surgery, who waved up to him and gestured toward the only empty chair in the pit. Noah had quickly signaled that he preferred to sit in the audience. It had been a snap decision predicated on his seeing that the empty chair was next to Dr. Mason. As nervous as he was about speaking in front of the packed amphitheater, Noah had no interest in compounding his anxiety by having to relate to his least favorite attending, so he took an aisle seat in the twelfth row. The fact that the empty chair was also next to Cantor’s also played a role. After the man had threatened to dismiss him for spending too much time in the hospital as a junior resident, Noah had never felt at ease in his presence.

The program progressed just as Noah had predicted. Dr. Hernandez carried on for almost a half-hour, letting Noah’s mind wander to all his newly acquired responsibilities. Unable to avoid observing Mason down in the pit, wearing one of his typical expressions of disdainful disinterest when he was not the center of attention, Noah had found himself mostly worrying about the damn M&M Conference and how the hell he was going to navigate the minefield he knew it represented. He had successfully avoided thinking about it all morning, until Mason’s presence made it impossible.

After the chief of surgery had spoken, the program director followed suit in an equally predictable fashion, enough to make Noah marvel that no one in the audience fell asleep. He could tell that Dr. Mason was not finding the program particularly stimulating, either, as he was constantly fidgeting in his seat and crossing and uncrossing his heavy legs.

The moment Dr. Cantor had taken his seat, Dr. Hernandez got up and returned to the lectern. After adjusting the microphone down to accommodate his height, he cleared his throat and said: “Now I want to introduce to you our brand-new super chief resident, Dr. Noah Rothauser.” With that he gestured up toward Noah.

As Noah got to his feet and began descending the steep stairs that lead down into the pit, he could feel the hairs on the back of his neck stand up, as well as his pulse begin to hammer in his temples. There was a smattering of applause and a few teasing catcalls and some playful laughter in the audience. Noah was popular not only with the nursing staff but also with his fellow residents. One of the reasons was practical: If ever anyone needed someone to cover for whatever reason, everyone knew Noah never turned anyone down regardless of the hour or the day of the week.

Noah kept his eyes down and concentrated on avoiding a fall, as that would be a scene he’d never live down. Not only were the amphitheater’s stairs abnormally steep, there was no handrail. Once in the pit, he walked directly to the lectern, feeling himself blush. Dr. Hernandez had returned to his seat.

After adjusting the microphone up, he still hunched over, then raised his eyes to gaze directly at the twenty-four brand-new first-year residents. He started to speak, but his voice came out in an otherworldly squeak, making him clear his throat. When he began again, he sounded relatively normal, at least to himself.

“I would like to add a welcome to you all,” he said while he made eye contact with each new resident in turn and gained confidence as he did so. “I had planned on giving a long, detailed speech about the history of surgery, but I believe that has been adequately covered by our own esteemed surgical professors, who are giants in their respective fields.” Noah briefly turned and nodded toward Hernandez and Cantor, both of whom smiled contentedly as the audience tittered in relief. Noah avoided looking at Drs. Mason and Hiroshi, although he had nothing against Hiroshi, with whom he never had much interaction.

“Instead I would just like to say you are about to begin the most exciting and demanding part of your extensive training, and leave it at that. I would like to add that I wish I could say my office door is always open for whatever reason you might have to pay me a visit, but unfortunately, I do not have an office.”

A few chuckles rapidly grew to a round of real laughter as a reaction to the pomposity of the previous speeches. Noah found himself smiling, too, although he worried that his off-the-cuff attempt at humor might offend Dr. Hernandez. A quick glance reassured him when he saw the chief was at least smiling.

“Office or not,” Noah continued, “I will always be available for whatever reason. Don’t be shy! I’m easy to find. Surgery here at the BMH is a team effort, and we expect everyone to be a team player. You all got your initial rotation assignments, so after the coffee and doughnuts served next door in the Broomfield Hall, we are off to the races. Thank you! And let’s have a fabulous year.”

Noah turned and faced Dr. Hernandez, who had risen to his feet. He was a square-built man, in some ways similar to Dr. Mason but a smaller version, with darker, thicker hair, an olive complexion, and a heavy mustache. In contrast to Dr. Mason’s bluster, he exuded an air of quiet confidence, which he maintained no matter the challenge in either the operating room or the boardroom. “I hope you didn’t take my attempt at humor as a complaint,” Noah said.

“Not at all,” Dr. Hernandez said. “It was unexpected, which made it funny. But you do have an office...”

“I have a desk,” Noah corrected. “Not an office.”

“I see,” Dr. Hernandez said, before his attention was hijacked by an attending surgeon who pulled him aside for a quick consult.

Noah noticed several of the new residents, including Lynn Pierce, coming down into the pit and heading in his direction. He couldn’t help but notice Lynn was wearing a very striking yellow summer dress under her white coat. With a minor wave of panic, Noah glanced back at the exit, but before he could beat a retreat, he felt a tap on his shoulder. He turned to face a nurse dressed in scrubs whom he had seen on occasion but with whom he had never spoken.

“Dr. Rothauser, I’m Helen Moran.”

“Hello, Helen,” Noah said.

“I don’t want to take much of your time,” Helen said. “I know you are busy, but I wanted to speak to you briefly about the Bruce Vincent case. I am one of the few people who didn’t personally know him, but I participated in getting him admitted. Rumor has it that he was a victim of the concurrent-surgery process. Is that true?”

Taking a deep breath, Noah tried desperately to organize his thoughts and figure out what to say. In truth, he didn’t want to say anything, as he had been trying to avoid even thinking about Bruce Vincent, but now, gazing into the indignant eyes of Helen Moran, that clearly wasn’t an option. Obviously, he was already being drawn into the minefield he was dreading. There had even been a few unflattering articles about concurrent surgery in the lay press.