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CENTURY PLAZA HOTEL

CENTURY CITY, LOS ANGELES, CALIFORNIA

MONDAY, JUNE 30, 2014, 10:14 A.M.

George glanced around the room at the other attendees. No one spoke. No one coughed. No one moved. The only sound was that of the faint Celtic choir in the background.

George redirected his gaze toward the dais. Thorn was still twisted around, staring up at images of the smartphones like a proud father. When he turned back the crowd burst into applause.

“Hold your excitement,” Thorn said. “There’s more. Shortly you are going to hear brief presentations from our three other speakers this morning. First will be Dr. Paula Stonebrenner.” He gestured toward Paula, and George looked over at her. She stood briefly and nodded to the audience. If she was nervous, it didn’t show. There was a smattering of applause.

Thorn continued. “Dr. Stonebrenner, I know, doesn’t look old enough to be an MD, but I assure you that she is. She will be giving a very short overview of iDoc and its capabilities. She is the best person for this task, as she is the individual who gets the credit for the idea of a smartphone functioning as a twenty-first-century primary-care physician. There have been multiple apps for smartphones configured to do various and sundry medical functions, but it was Dr. Stonebrenner who came up with the brilliant concept of putting them all together in a purposeful algorithm to create a true ersatz physician on duty twenty-four-seven for a particular individual, truly personalized medicine.”

“Holy shit!” George whispered to himself. He felt a surge of color suffusing his face. He couldn’t believe what he’d just heard and didn’t know whether to be angry or flattered. Suddenly George realized why Paula had invited him to the presentation. They’d had a conversation about this years before. She hadn’t come up with the concept. She’d gotten the idea for a smartphone primary-care physician from him!

When George had first come out to L.A. for his residency, he’d known that Paula was coming, too, not for a residency but rather for a job with Amalgamated Healthcare. They’d talked about being in the same city before graduation. She’d been in the MD-MBA program during medical school, a fact that they’d argued about on occasion. It had been George’s opinion that she shouldn’t have taken a slot to become an MD if she had no intention of ever practicing medicine. There were too many people who really wanted to be doctors who couldn’t get a spot in medical school, and that was leading to a shortage of primary-care doctors. Paula, of course, had seen the issue differently. It had been her contention that the business of medicine was so important there had to be people who understood all sides of it. Neither convinced the other.

When George arrived in L.A. he tried to contact Paula a few times, but she never returned his calls. He didn’t have her home number or address, so he’d only left messages at Amalgamated’s main number. He never knew if she got them or not. But then, after an emotionally draining trip back home for Thanksgiving 2011, he made a more determined effort to track her down. His mother, Harriet, had died unexpectedly while he was home and, coming back to L.A., he had never felt more alone. He hadn’t been particularly close to his mother, but watching her die was one of the most painful episodes of his life.

George’s father had died when he was three and his mother remarried when George was four, but George never got along with his stepfather. On top of that, his stepfather had a son three years older than George. Then his mother and his stepfather had a daughter, and George ended up the odd man out, spending his high school years living with his grandmother, with whom he had a close relationship. During medical school his stepfather died, and his mother developed a series of health issues from smoking and obesity, which turned out to be deadly just four days short of her sixty-seventh birthday.

The day had started out routinely, but by early afternoon Harriet began wheezing and then developed chest pain. When George suggested that they call her doctor, she said she didn’t have one. Her primary-care physician had changed his practice to the concierge model, which Harriet had refused to join because she thought the yearly payment way too steep. When Harriet turned sixty-five, she tried but failed to find a doctor who would accept Medicare.

So on that fateful Thanksgiving Day there was no doctor to call or see. And she refused to go to the hospital. George pleaded with her to go but was accused of meddling. He tried to call a few of the local physicians that he could find online but wasn’t able to get anyone on the phone. He needed someone either to see her or tell her to go to the hospital. While he was making the calls, his mother became short of breath and began to perspire. He called 911. The dispatcher said the local ambulances were all occupied but that one from a distant town would be there ASAP but couldn’t give an ETA.

With growing consternation George watched his mother turn ashen. Realizing he couldn’t wait any longer, he managed to get her into the backseat of her car despite her reluctance, and rushed her to the local hospital. When he pulled up to the ER, he discovered it had been closed. “Consolidation” was what the corporation that bought the facility had called it. George drove as fast as he could to the next closest hospital, which was owned by the same corporation. It was located a half hour away, and by the time George pulled in, jumped out of the car, and opened the back door, his mother was dead. The sheer frustration of it all nearly drove George mad. He had never cried much, even as a child, but on that cold, dreary day he sat in that car and wept.

CENTURY PLAZA HOTEL

CENTURY CITY, LOS ANGELES, CALIFORNIA

MONDAY, JUNE 30, 2014, 10:18 A.M.

George reached up with both hands and rubbed his eyes to get himself under control. It always bothered him to think about his mother’s passing, and since Kasey’s death the unwelcome remembrance of the episode had become more frequent. The two episodes shared a similarity: Both had occurred in his presence.

Blinking his eyes open, George looked back at the dais. Paula had sat down and Thorn was saying, “I am also pleased to introduce to you Dr. Clayton Hanson.” Thorn pointed over to Clayton, who, like Paula, rose to his feet to acknowledge a bit of applause. From the standpoint of appearances, Clayton looked as good as Thorn, decked out in equally expensive gentlemen’s finery. Where he surpassed Thorn was his overly tanned face, accentuated by his carefully coiffed silver hair. He was old enough to appear learned and young enough to attract women of any age.

“Dr. Hanson, vice chair of academic affairs for the L.A. University Medical Center’s department of radiology, will be giving us an overview of iDoc’s advanced imaging capabilities, but before Dr. Hanson, I would like you to hear from Lewis Langley. He’ll be saying a few technical words about the unique character of the iDoc algorithm.”

Langley nodded slowly at the mention of his name but didn’t stand. He didn’t look anything like the typical software guy and was miles away from the other two men with whom he was sharing the dais, wearing shit-kicker boots with black jeans that were topped off with a huge, silver-plated Texas longhorn belt buckle. To round out the outfit, he wore a black sport jacket over an open-collared black shirt.

For the next few minutes George found it hard to concentrate on Thorn’s words. His unexpected trip down memory lane of that awful Thanksgiving Day and his mother’s death had him freaked out. On the flight back to L.A. after the funeral, he had found himself agonizing over the way the lack of primary-care physicians had contributed to the nightmare.