Робин Кук - Cell

“Well, we doctors should have been for it, but we were too afraid of losing control of the profession, which now is going to happen via the digital revolution. Maybe we deserve it, having tried to support the fee-for-service paradigm for so long.”

“I couldn’t agree more,” Paula said. “Doctors certainly have been dragging their feet about informational technology in general. It is just another reason why iDoc is going to be a huge plus.”

“It’s not going to be a huge plus if, as you say, it murders people.”

“Let’s put that behind us for a few minutes,” Paula said. “I’m inclined to do as they wish. I committed the last three years to developing iDoc. Maybe you should feel the same, since it was your germ of an idea that started it all.” With raised eyebrows she looked over at him and studied his face.

George was taken aback. “I hope you are not suggesting that you and I bear some of the responsibility for these deaths.”

“Hardly. But I am beginning to think that they are, as Thorn has suggested, an unfortunate consequence or growing pain of a new and improved system that is going to have an enormous positive effect on the health of the public. A few people die in all sorts of medical studies, particularly drug trials. As long as the unintended killing has stopped, I think I can live with keeping quiet about this glitch, at least in the short run. What about you?”

George sighed. “You know, I have a real problem because one of these murdered souls was someone I loved, and another was one I cared about as a friend. That makes it hard to think of them as unfortunate ‘growing pains’ or statistics. What would I have paid to have had six more months with my fiancée. But maybe she would have wanted to avoid the pain and suffering. Still, I would much rather that the decision had been hers and not an algorithm’s... Jeez!” George lifted his hands in a gesture of frustration and confusion.

“These issues are a thousand times more troublesome when they are imbued with emotion. I can understand. And I’m sorry.” She touched his hand again, this time leaving her hand resting on his.

George glanced at the attendants, then leaned closer to Paula. “Thorn also said that the government doesn’t want the glitch to go away.”

“But the killing has stopped.”

“But it is only a click away if the glitch, as they euphemistically call it, remains.”

Paula removed her hand from George’s. “I see your point.”

“This Independent Payment Advisory Board is a scary behind-the-scenes organization. Its members are appointed, not elected, and this Universal Resource Initiative is even more of an enigma.”

“Agreed. But Thorn said that what the government does with the glitch is an open question and that our input will be respected.”

“True. But the secrecy worries me. And when you get down to it, the federal government is going to do what the federal government wants to do. If our input doesn’t line up with their intentions, who do you think wins?”

“Well, we can agree not to let it remain a secret. Meanwhile, I think we should get out of this place. We can tell Thorn that we agree in principle to what he’s asking, meaning we won’t go running off to the media. That will get us out of here, and we can continue talking at my place, which will be a hell of a lot more pleasant.”

“Do you think Thorn will buy it?”

“I do! I’m taking him at his word. We have no other choice if we want to walk out of here.”

“Letting the glitch persist makes me feel I have taken the first step on a slippery slope. It’s like the beginning of herding up the weakest among us for a future cull.”

“That may be, but as long as no more people are murdered, we can afford to continue thinking about it. I have to get the hell out of here. And you need to finish your residency instead of going to prison.”

“Okay!” George said. “Okay!”

“Okay what?” Paula asked.

“Okay, I guess it is worth a try. I hope I can make it sound convincing.”

“All we are promising is not to go to the media right now. We can sound convincing because that is exactly what we are doing, and for the moment at least, it’s all they’re asking.”

MENTAL HEALTH FACILITY

HOLLYWOOD HILLS, LOS ANGELES, CALIFORNIA

MONDAY, JULY 7, 2014, 2:30 P.M.

Just when Paula and George were beginning to despair that Thorn might not return that day after they had sent word that they had agreed to his offer and wished to see him, he walked into the common room. They had returned there following their lunch. They had been the only people in the dining room, and the isolation of the place, its pervading silence, and its vintage fifties decor were beginning to wear on them.

Thorn dismissed the attendants and brought a chair over to where Paula and George were sitting.

“I must tell you that I was ecstatic to hear the good news!” Thorn said. He was clearly pleased that his speech had had the desired result.

As George and Paula had decided prior to Thorn’s arrival, Paula spoke while George stayed silent. It had been her idea because she knew Thorn best and was also more confident she and George were making the right decision. She didn’t waste words: “We have talked it over and agree that the iDoc program should not be held up by the glitch, which we understand would occur if the media happened to get ahold of the story. So we will not be alerting the media, or anyone else, for that matter, despite, should we say, our continued misgivings.”

“I’m pleased to hear this,” Thorn said with a contented smile. “Can I ask what your misgivings are, specifically?”

Paula glanced briefly at George in the hope that he would indeed stay silent and let her answer. “Our biggest concern is that the glitch has not been eliminated, or should we say dismantled, from the iDoc program.”

Thorn looked at George. “I trust that these are your feelings as well.”

George nodded.

Paula added, “We would also like to impress upon you our desire to be included in the ongoing discussions vis-à-vis CMS’s response.”

“Excellent! I can assure you of that. In fact, we welcome your input.” Thorn turned back to George. “I want to be absolutely certain that Ms. Stonebrenner is speaking for you.”

George nodded. “She is.”

“Excellent,” Thorn repeated, slapping his thighs. “I consider this welcome news, as you can well imagine. Now, you can leave this facility, but we feel it would be best if neither of you goes back to your work routines for, let’s say, at least a week. I would also prefer that you stay together during the upcoming week so that you can continue your discussions. We would be happy to put you up in a hotel.”

“I don’t think that’s necessary,” Paula said. “Our plan is to stay in Santa Monica.”

“You wouldn’t prefer, say, the Four Seasons in Maui?”

Paula turned to George with a questioning expression. The idea had some merits.

He shrugged. “I think Santa Monica will be just fine.” He was not interested in becoming beholden to Amalgamated, which he thought would be the case if they accepted a paid vacation in Hawaii.

“Excellent,” Thorn said yet again. He turned to George. “Just so you are aware, I’ll be telling Clayton to reinstate you at the medical center. As for the stock options, I will bring them up at our next board meeting.”

“I think I’ll pass on the options,” George said.

Thorn gave him a look, suggesting that was not what he wanted to hear. “I will put in the request just the same,” he said, standing. “I will make the arrangements for you folks to leave. If you change your minds about Maui, let us know.”