Робин Кук: Charlatans

Ava paused, aware she was getting carried away. “So what are your thoughts?” she said finally, in a calmer voice.

“I have to think about being supportive,” Noah said.

“Okay, you do that,” Ava said. “But if you feel as strongly as you say about the nutritional-supplement industry, this could be an opportunity for you to do something positive. The industry is not going to change on its own. The problem is, just like the rest of healthcare, there is too much money involved and the industry has a lot of politicians in their pocket. And as a final note, I imagine the potential remuneration you would receive with your Ivy League credentials from the NSC could easily take care of your educational debt and your mother’s and sister’s ongoing care. How bad is that?”

THURSDAY, AUGUST 24, 1:53 P.M.

Dressed in his only jacket and tie, Noah pushed through the revolving door at the entrance to the Stanhope Building. Finally, after several weeks of torment, worrying that his surgical residency was going to be prematurely ended, he felt confident he was going to be reinstated. The day before had been the feared Surgical Residency Advisory Board meeting, but it had gone as well as could be expected. There had been eight members present, which included the program director, Dr. Cantor, and the two assistant program directors, Dr. Mason and Dr. Hiroshi, as well as five surgical residents who had been elected to represent each of the five years of the program. Noah’s seat had been empty for obvious reasons. He had served on the board every year he’d been a resident.

Although Noah had been nervous at the outset, it soon became clear to him by the questions asked that his lawyer, John Cavendish, had made it abundantly clear Noah had not fabricated data on his thesis but rather had conservatively estimated results of the final concluding experiment and then replaced them with the real data as soon as it was available, with the motivation being to have his Ph.D. be considered as part of his medical school application. At the end of the meeting, Noah had been told that the board would vote on his case and that he should return in twenty-four hours for the result.

The only surprise for Noah had been Dr. Mason’s total silence during the hour-long proceedings. Although Noah had been told by Keyon and George that they had uncovered some potentially compromising information about Dr. Mason, which had been communicated to him, Noah had suspected the worst from his long-time antagonist. He hadn’t known why it hadn’t happened until last night at Ava’s.

As they had eaten their dinner overlooking her garden, she’d explained that Keyon and George had discovered that Dr. Mason had made it a habit over the years to insist that Arab sheiks from the Emirates and Saudi Arabia provide progressively extravagant gifts for the privilege of being seen in a timely fashion, which was important for pancreatic cancer patients. At first these gifts had been mainly in the form of large contributions to his research efforts or to hospital building projects, but then about seven years previously, they became more personal, including his beloved, flamboyant red Ferrari.

After consulting with several knowledgeable tax attorneys, Keyon and George had ascertained that from the IRS’s point of view, these gifts had to be considered income, since they were required to secure an appointment and were therefore fee-for-service and not voluntary. Since the amount of money involved was more than 25 percent of Dr. Mason’s academic salary, there was the specter of statutory fraud, meaning possible prison time. This information had been provided to Dr. Mason with the advice that it would be best for him to curtail his ongoing harassment of Dr. Noah Rothauser.

Noah took the Stanhope’s elevators up to the third floor. Once there, he walked across the sumptuous carpeting toward the double mahogany doors leading into the hospital boardroom where the Advisory Board meeting had been held the day before. He told the hospital president’s secretary whose desk was nearby that he was there and then took a seat in the administrative waiting area. It was 1:58 P.M. He had wanted to be exactly on time, not too early and certainly not late, and he could congratulate himself on his timing. Although he’d been optimistic about the upcoming meeting, now that he was waiting to be seen, he felt the old anxiety he’d always felt when forced to confront authority figures. There was always the chance his life could once again be upended. Nervously, he flipped through a magazine that he’d picked up from the low table in front of him.

After the previous night’s dinner and following the revelations about Dr. Mason’s tax fraud, Noah and Ava had retreated up to her study. He’d been staying with her the whole week, and each night they had gone to the study to continue their conversations. Last night, just when they were ready to call it a night, Noah had said he had a condition he wanted to run by her that involved her babysitters. After explaining what he had in mind, Ava’s response had been she’d think about it although a half-hour later she’d reluctantly agreed.

“They are ready for you now,” the secretary called out to Noah five minutes later, interrupting his musing.

Getting to his feet, Noah straightened his tie, took a deep breath, and walked over to the imposing, oversized doors of the boardroom. After another slight pause to take yet another deep breath, he entered. He was moderately surprised that only Dr. Cantor, Dr. Mason, and Dr. Hiroshi were seated at the expansive table. None of Noah’s resident colleagues were present. Noah’s heart skipped a beat. Maybe his optimism had been premature. He closed the door behind him and walked to the near end of the long, boardroom table. The three faculty members representing the executive committee of the Advisory Board were at the opposite end.

“Thank you for returning,” Dr. Cantor said. “Sit if you’d like.”

“I’ll stand,” Noah said. He looked at each of the men in turn. Dr. Mason refused to make eye contact, staring at his hands clasped on the table in front of him.

“By a unanimous vote of the Advisory Board with one abstention,” Dr. Cantor said formally, “it has been decided that you will be reinstated as the super chief resident.”

Relief spread through Noah with such suddenness he had to support himself by grabbing the back of the chair in front of him and leaning on it.

“However,” Dr. Cantor continued, “we want to make sure you understand how important we as medical educators feel about the central role ethics play in our profession. We want to make certain that you don’t feel that expediency can justify ethical lapses, and furthermore...”

Noah was no longer listening to Dr. Cantor. He was already absorbed in thinking about getting himself up to surgery to go over the surgical schedule for the morning to make sure the residents were appropriately assigned as assistants. Then he was going to tour the surgical intensive-care unit to familiarize himself with all the cases. Following that he was going to go to the surgical floor to do the same. The reality was that he had an enormous amount of work to do just to get acclimated back into the system...

“Dr. Rothauser,” Dr. Cantor said. “We’d like an answer to our question.”

“I’m sorry,” Noah said clearly flustered. “I’m so pleased to be reinstated that I am already thinking about all that I have to do to get up to speed. I didn’t hear the question. Could you repeat it?”

“The question is: Is there anything else of an ethical nature that you would like to reveal to the board? This current problem with your thesis surprised all of us coming out of the blue, and we don’t like surprises, especially involving our super chief, who we are considering offering a staff position.”