Arthur Hailey - Strong Medicine

If he closed his eyes, Andrew thought, he might well imagine he was at a PTA meeting at the children's school, or perhaps in the boardroom of a nuts-and-bolts industrial company making everyday, routine decisions. The words flowed past him. "May I have a resolution on that?" - "Mr. Chairman, I propose "Is there a seconder?" second that.”

been proposed and seconded... Those in favor of the res- olution...” A chorus of "aye. "Against?" Silence. “.

...declare the resolution carried By unanimous decision the hospital privileges of Dr. Noah Townsend are suspended...” Could this truly be the way it happened? This prosaic, formal, minor-key accompaniment to deepest tragedy. Were these petty, pecksnifflan phrases the best that could be found to signal the sudden, grievous ending of a lifetime's work, a once dedicated man's career? Andrew was not ashamed to find that tears were coursing down his face. Aware that others seated around the hospital boardroom table were watching, he made no attempt to hide them.

"Dr. Jordan," the chairman of the medical board executive committee said considerately, "please believe me that the rest of us share your great sadness. Noah was, and is, our friend and colleague too. We respect you for doing what you have, which we are well aware was difficult. What we have done was equally difficult, but equally necessary.”

Andrew nodded, unable to speak. The chairman was Dr. Ezra Gould. He was a neurologist and the chief of medicine, having succeeded Noah Townsend in that office three years earlier. Gould was small and soft-spoken, but quietly strong and greatly respected at St. Bede's. The others on the committee were heads of services--surgery, obstetrics and gynecology, pathology, pediatrics, radiology, several more. Andrew knew most of them fairly well. They were decent, sensitive, caring people, but doing what they had to, even though, in Andrew's view, their action had been delayed too long.

"Mr. Chairman," Leonard Sweeting said, "I should inform the committee that in anticipation of its decision I prepared a notice which will go immediately to the entire hospital-nursing stations, admitting office, pharmacy, and so on. In it I took the liberty of describing Dr. Townsend's suspension as being 'because of health reasons.' I believe that's more discreet than anything specific. Is that agreeable?" Gould glanced inquiringly at the others. There were murmurs of assent. "It's agreeable," Gould said. "I would also urge," the administrator continued, "that the details of what has passed here be discussed outside this room as little as possible.”

Leonard Sweeting had guided the committee on procedure from the moment the meeting's purpose had been made known-to ' the shock and consternation of the senior doctors summoned here so hurriedly. Sweeting had also, before the meeting began, had a hurried telephone consultation with the hospital chairman, a veteran local lawyer, Fergus McNair, whose practice was in Morristown. The conversation had been in Andrew's presence and, while hearing only one side of it, Andrew did catch the chairman's emphatic final words which rattled in the phone receiver, "Protect the hospital.”

"I'll do my best," the administrator had said. After that Sweeting had gone into the boardroom, which adjoined his office, closing the door behind him and leaving Andrew alone. In a few minutes the door reopened and Andrew was summoned in. All faces around the boardroom table were deadly serious. "Dr. Jordan," the chairman, Dr. Gould, had said, "we have been informed of the nature of your charges. Please tell us what you know.”

Andrew had repeated what he had told the administrator earlier, at times referring to his notes. Following his statement there were a few questions and some discussion, but not much. Leonard Sweeting then produced the hotspital's file on the deceased Kurt Wyrazik, which was passed around and the patient's chart, with its damning entries, examined amid doleful head shaking. Andrew had the clear impression that although members of the committee had not expected today's disclosures to unfold as they had, the subject itself was no surprise to them. The formal resolution had come next, stripping Noah Townsend of his long-held status at St. Bede's. Now the chief of pediatrics, a gaunt, slow-speaking New Englander, said, "Something we haven't discussed is what's to happen concerning the young man who died.”

"Knowing what we do," the administrator answered, "it's essential that an autopsy be performed. Just before this meeting I spoke by telephone with the deceased's father in Kansas-a sister is on the way here--and the father has given the necessary permission. So the autopsy will be done today.”

Sweeting glanced at the head of pathology, who signified assent. "All right," the pediatrics chief persisted, "but what do we tell his family?" "Quite frankly," Sweeting said, "because of the legal issues involved, that is a delicate, potentially volatile subject. I suggest you leave a decision on it to Dr. Gould, to me, and to Mr. McNair who will be here shortly and who will also advise us legally.”

He added, "Perhaps, later on, we will report back to this committee.”

Dr. Gould asked the others, "Is that all right?" There were nods of agreement and also, it seemed, a sense of relief. Perhaps. Andrew thought: it was the operative word. Perhaps... we will report back to this committee. And perhaps we won’t. What the hospital, in the persons of Leonard Sweeting and his boss Fergus McNair, would undoubtedly like was for everything to be hushed up, and for young Kurt Wyrazik, the innocent victim, to be cremated and forgotten. In a way, Andrew supposed, you couldn't blame Sweeting or McNair. They had their responsibilities. And if all this came to a malpractice case in court, a jury award or financial settlement could be horrendous. Whether insurance would cover it, Andrew had no idea and didn't care. The only thing he was sure of was that he would not be part of a cover-up himself. There had been a buzz of conversation and the chairman rapped a gavel for attention. "Now," Dr. Gould said, "we come to the hardest part.”

He glanced around the room.”I will have to go to Noah Townsend and tell him what has been decided here. I understand he is still in the hospital. Is there anyone who chooses to come with me?" Andrew said, "I'll come with you.”

It was, he thought, the very least that he could do. He owed that much to Noah. "Thank you, Andrew.”

Gould nodded his appreciation.

In the calm of later, quiet reflection, and despite the pathetic, strident scene that followed, Andrew had an instinct that Noah Townsend had been waiting for them and was relieved to see them come. As Dr. Ezra Gould and Andrew stepped out of an elevator on the medical floor, to their right were a busy corridor, patients' rooms and a nursing station. At the end of the corridor Townsend was standing, doing nothing, appearing to be looking into space. As the two of them approached, he moved his head and then, observing them, seemed to shrink into himself. He turned away, but a moment later abruptly changed his mind. Swinging back, his features twisted in the parody of a smile, he held out his wrists, both close together. "Did you bring handcuffs?" Townsend asked. Gould seemed non-plused, then said, "Noah, I have to talk to you. Let's go somewhere private.”

"Why bother with privacy?" The response was close to a shout and it appeared as if Townsend had raised his voice deliberately; a nurse and several patients turned their heads in curiosity.”Isn't the whole hospital going to know before the day is out?" "Very well," Gould said quietly.”If you insist, we'll do it here. It is my duty to tell you, Noah, that the medical board executive committee has held a meeting. With the greatest regret it was decided to suspend your hospital privileges.”