Робин Кук - Charlatans

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Charlatans: краткое содержание, описание и аннотация

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Newly minted chief resident at Boston Memorial Hospital Noah Rothauser is swamped in his new position, from managing the surgical schedules to dealing with the fallouts from patient deaths. Known for its medical advances, the famed teaching hospital has fitted several ORs as “hybrid operating rooms of the future” — an improvement that seems positive until an anesthesia error during a routine procedure results in the death of an otherwise healthy man. Noah suspects Dr. William Mason, an egotistical, world-class surgeon, of an error during the operation and of tampering with the patient’s record afterward. But Mason is quick to blame anesthesiologist, Dr. Ava London.
When more anesthesia-related deaths start to occur, Noah is forced to question all of the residents on his staff, including Ava, and he quickly realizes there’s more to her than what he sees. A social-media junkie, Ava has created multiple alternate personas for herself on the Internet. With his own job and credibility now in jeopardy, Noah must decide which doctor is at fault and who he can believe — before any more lives are lost.

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“I don’t think I can do what you are asking,” Noah said. “As a real doctor, I’m afraid that I will feel an ethical responsibility to expose you as the charlatan you are. I’m sorry. Maybe you are right about medical education. Perhaps it is behind the times as you say, but I don’t think I can be the judge and jury.”

“I’m sorry to hear you say this,” Ava said. “If you do out me, then I will feel equally obligated to do the same for you.”

“What do you mean?” Noah asked hesitantly. The fears he’d felt earlier came back in a rush.

“I mentioned a few minutes ago that Keyon and George, using the investigative powers of ABC Security, came up with a few secrets of yours that are certainly more prejudicial than some temporal data fudging on a Ph.D. thesis. Would you like to hear what they discovered?”

Noah nodded reluctantly.

“First and foremost, it was determined that your father did not die of a heart attack but rather is in prison and will be there for a long, long time, possibly for life for drug trafficking, attempted murder, money laundering, and a few other odds and ends amounting to an impressive felonious résumé. His name is Peter Forrester, and your name was Peter Forrester Jr. until it was legally changed to Noah Rothauser, with Rothauser being your mother’s maiden name. I like the choice of Noah, with its biblical connection. Should I go on?”

Noah didn’t move, nor did he even blink, yet perspiration appeared on his forehead as evidence of his inner turmoil.

“I’ll take your silence as a yes,” Ava said. “It was confirmed that you, too, were arrested with your father when you were fourteen for abetting some of your father’s activities, and you too went to prison in South Carolina for a time, but as a juvenile offender, since it had been judged that there had been an element of coercion involved. It was also confirmed that you were released at age eighteen and your felony record was sealed. Unfortunately for you but fortunately for us, nothing disappears in the digital age. In the old days, a page was literally torn out of a court log and thrown away. Today, there is no way to make a record such as yours vanish, and the ABC Security investigators, mostly Keyon and George, found all of it. Now, there were some commendable aspects to your backstory, such as you getting your high school diploma with some AP credits while in prison as evidence to your rehabilitation, to the delight of the prison officials. It is also impressive that the warden, hearing of your desire to become a doctor, made great efforts to get you accepted into Columbia University.”

“My record is officially sealed,” Noah said, finding his voice. “It can’t be used against me.”

“That is correct, to an extent,” Ava said, as the corners of her mouth turned up in a slight but knowing smile. “However, there is the sticky point about the expectation of being truthful. When you filled out the form for your DEA license and there was a place for you to respond to the question of whether you had been convicted of any felonies, you should have marked the box for yes and then on the back of the form in the space provided, you should have explained about having been a juvenile offender and the record sealed. It will be interesting to talk with the DEA about this issue, and see what they say, particularly because your felony involved drug trafficking. The legal opinion is that you will lose your DEA license and thereby make practicing as a doctor all but impossible. It is also interesting to consider how the Residency Advisory Board, which will be ruling on your suspension, will react when they learn that you had lied on your DEA application, which is far more serious than temporarily fudging data on a Ph.D. thesis.”

“They cannot use a sealed record against me,” Noah repeated, but his voice lacked conviction.

“The Residency Advisory Board is tasked with making a value judgment about ethics,” Ava said. “But let’s not get into an argument about details, because there is more to your story. It was confirmed that your mother is in an Alzheimer’s facility. It was also discovered you have a sister with a chromosomal abnormality who is also institutionalized. It was also confirmed that you were forced to spread your medical school career over six years because of financial difficulties involving supporting your mother, your sister, and yourself, which was all very noble. But since you worked for the medical school administration, it was obvious to me that you would have had special access to the medical school’s computer similar to my access to the Brazos University computer. And since we share computer proficiency as part of being ‘two peas in a pod,’ I recommended that Keyon and George use some IT forensics to look at your record. What was found was not pathognomonic but suggestive there had been some alterations. What I am saying is that at this stage it is not known for certain if you had made any changes to your record to help your application to your BMH residency, and further study would be needed to ascertain it. But here is yet another major area where you are vulnerable.”

Ava paused and took a deep breath, watching Noah. She was hoping for more of a reaction, but he just stared back at her, breathing shallowly.

“I can see you are distressed, and for good reason,” Ava continued. “So let’s talk about a resolution. You want to be one of the world’s premier surgeons and have worked stupendously hard to that end. I want to do the same in anesthesia and have worked equally as hard but on a different trajectory. The reason I had you brought back here and have made you privy to all these secrets that no one else knows is that I see our similarities more than our differences, and I like you. I told you all this because there is a solution. What I have intentionally created is a true Mexican standoff, meaning there are three entities pointing guns at each other: you, me, and the NSC. The only way for this to be resolved and we all win is for all of us to agree to the status quo and lay down our weapons. If not, we all lose.”

“Every time you say something, it is another surprise,” Noah said. “Why do you think the NSC is holding a gun on you? You are their darling.”

“If you make an issue about me being a charlatan, I will no longer be their darling but their enemy.”

“So the NSC has no idea you are a charlatan?” Noah said, shocked yet again.

“Absolutely not,” Ava said.

“And how are you holding a gun against the NSC?”

“That’s easy,” Ava said. “I could disrupt what I have already accomplished about keeping the 1994 DSHEA from being amended. Also, over the years I have learned enough about the supplement industry to seriously discredit it.”

Another silence ensued as Noah struggled to put everything he’d learned over the last half-hour into context. Finally, he said in a subdued voice: “What would you have me do?”

“Nothing,” Ava said with a smile. It was clear to her she was making progress. “It is key that you do nothing, but you have to be convincing you are going to do nothing. The NSC has to be absolutely certain that you are not going to try to discredit me in any way at all. As you’ve guessed, they are enamored of me, which is obvious when you consider this house, my Mercedes, my computer, and all my toys and lifestyle I enjoy. Of course, it would be even better and more convincing if you were willing to help the cause.”

“I hope you don’t mean me supporting the nutritional-supplement industry,” Noah said.

“That’s exactly what I mean,” Ava said with a chuckle. “Get down off your high horse, Dr. Rothauser! The industry is trying in some ways to clean up its act. Not all companies are bad; it’s like everything else, including hospitals and doctors, there’s good and bad. The bad ones are really bad, especially the ones who get all their products from China and India, go overboard on their health claims, and really don’t give a damn. But with your participation you could be an effective positive force on the inside, trying to get the bad companies to mend their ways by toning down their absurd claims and making them feel responsible for the poisonous crap that’s in the bottles they advertise and sell. I can tell you that the good companies, the ones which care about their products and are selling legitimate vitamins and such, are very aware of those companies responsible for all the harm and bad publicity. The reality is that you could do a lot more good on the inside than tilting at windmills from the outside.”

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