Робин Кук: Charlatans

Over the years, Bruce had enjoyed persistent advancement in the security department, thanks to his unabashed commitment to the hospital combined with his outgoing personality. He loved his work, and because of his attitude and the fact that he seemed to know everyone by name, everyone loved Bruce Vincent in return. They also liked that he was a family man who had married another outgoing and popular BMH employee from the food-service department. Together they had had four children, one of whom was an infant. Since the Vincent kids’ pictures continuously graced the cafeteria bulletin board, it seemed to the entire medical center community that they were the quintessential hospital family.

Although Bruce’s popularity ratings had been high from day one, they soared when he had been elevated to take over the hospital’s problematic parking division. Due to his efforts, the seemingly intractable difficulties had melted away, especially after he convinced the hospital board to build a third multistory garage specifically for doctors and nurses as part of the Stanhope project. On top of that, Bruce was never one to hide out in his “parking czar” cubicle. Instead, he was always available in the trenches, anticipating problems from the crack of dawn to late afternoon with a smile and personalized comment. By his example, all the other parking employees were similarly dedicated and personable. And it was in this capacity as a hands-on supervisor that Bruce had managed to befriend the otherwise rather aloof Dr. William Mason.

The whole hospital knew when Dr. Mason got his red Ferrari four years ago. There were some jokes behind his back about a mid-life crisis, because along with the flashy sports car he had become overtly flirtatious with several of the OR department’s younger and attractive women, mostly nurses, but also one of the female surgical residents. Bruce heard the buzz about Dr. Mason’s behavior and off-color comments but dismissed them as envy. And as far as the Ferrari was concerned, instead of thinking of it as inappropriate and out of place among the tamer and more conservative Volvos, Lexuses, BMWs, and Mercedes, Bruce lavished it with praise and even offered daily to personally park the car in a special protected place to avoid door dings. So when Bruce learned from his Charlestown GP that he had to have his hernia repaired, a problem he had had for some time but which was now giving him mild intermittent problems, particularly with his digestive system, he simply asked Dr. Mason if he would do it. Bruce popped the question on the spur of the moment one morning when he took the Ferrari’s keys. To everyone’s surprise — even Bruce’s, as he later confided — Dr. Mason agreed on the spot, promising to squeeze Bruce into his jam-packed schedule of celebrities, business mavens, European aristocrats, and Arab sheiks whenever Bruce wanted.

Despite being scheduled for surgery that very morning, Bruce had still appeared at his parking office at five as if it were a normal day. And just as he had done for years, he greeted the staff as they arrived. He even parked Dr. Mason’s Ferrari. Dr. Mason was a bit taken aback to see him and said as much, wondering if his own memory was failing him.

“I’m a to-follow case, so I don’t have to be at Surgical Admitting until eight fifteen” was Bruce’s simple explanation.

Yet Bruce’s dedication to his job wasn’t without consequence on this particular morning. After handling a problem generated by an employee who had failed to show up or call, Bruce was late getting to Surgical Admitting on Stanhope 4.

“Bruce, you are almost forty minutes late,” Martha Stanley said anxiously. She was head of Day-Surgery Admitting. She didn’t usually do intakes herself, but she had been waiting for Bruce to show up. “You were supposed to be here at eight fifteen. We’ve already heard from the OR, wondering where the hell you were.”

“Sorry, Miss Stanley,” Bruce said sheepishly. “I got held up by a staff problem in the garage.”

“Maybe you shouldn’t have worked this morning,” Martha said with a disapproving shake of her head. She had been surprised to see him in his usual uniform when she pulled into the garage early that day, as she was aware he was scheduled for an inguinal repair. She opened the folder and riffled through its contents, checking that the history and physical were there, along with the most recent blood work and an ECG. She turned her attention to the computer screen to be sure all the same material was there. “In case you don’t know, Dr. Mason is a bear about waiting, and he has two other big VIP pancreatic cancer cases this morning.”

Bruce flashed a remorseful, almost pained expression. “Sorry! I’m sure he hates to wait. Maybe we can speed this admitting process up a bit. My operation is no big deal. It’s just a hernia repair.”

“Every case is important and has to be done by the book,” Martha mumbled as she made an entry into the EMR, the electronic medical record, “but we do have to get you up there sooner rather than later. You haven’t eaten anything, have you?”

“I’m having spinal anesthesia,” Bruce said. “Dr. Mason’s fellow, Dr. Kolganov, told me I was to have spinal when he did the history and physical.”

“It doesn’t matter what kind of anesthesia you’re scheduled to have. Have you eaten anything? You were told not to eat after midnight. That is the same for everyone.”

“No, I’m fine. Let’s get the show on the road.” Bruce glanced at his watch as his heart skipped a beat. A sudden fear swept over him that Dr. Mason might change his mind and refuse to operate on him. That was the last thing Bruce wanted.

“Okay,” Martha said with a touch of reluctance. “You have a negative history and physical by Dr. Mason’s fellow, so maybe we can leapfrog the junior surgical resident going over it and adding his two cents. There has been a kind of rush here over the last half hour, so I know he’s got his hands full, meaning it would take quite a while for him to get to you. Which side is to be operated on?”

“Right side,” Bruce said.

“Do you have any allergies?”

“No. None.”

“Have you ever had anesthesia?”

“No. I’ve never been a hospital patient.”

“Excellent.” Then Martha called out to one of the attendants tasked to take patients into the changing area where they would get out of their clothes and put on hospital gowns. She handed Bruce’s folder to him. “Good luck,” she added to Bruce. “And next time be on time!”

Bruce gave her a thumbs-up and a guilty smile, and followed the attendant.

After getting out of his clothes and struggling into the hospital gown, Bruce lay down on a gurney and pulled a sheet up under his armpits. Another nurse appeared, dressed in surgical garb, one of the few nurses he didn’t know. She introduced herself as Helen Moran and asked the same questions Martha had asked. Then she marked Bruce’s right hip with an indelible marker after confirming with him the side to be operated on. “My orders are to move you along at top speed,” she said. “I’ll let anesthesia know you are on your way over. They have been looking for you.”

Bruce nodded. He felt progressively embarrassed at having been late to Admitting and appreciative of the extra attention he was getting because of it. He figured it was due to a large degree that Dr. Mason was his surgeon. An orderly appeared just after Helen left, unlocked the gurney, and then maneuvered it out into the hallway. His name was Calvin Wiley. Bruce didn’t know him, but he knew Bruce. “You are a VIP,” Calvin said as he wheeled the gurney along the tortuous route toward the operating suite. “I was told you were one of Dr. Mason’s patients and I was to get you up to the surgical holding area on the double.”