William Kienzle - Deathbed

Same with the whores who were forever getting pregnant. Too dumb to stay on the Pill. Just as likely to pull out their IUDs as their tampons. Counseling was a waste of time. Far easier to scrape out their prematurely tired uteruses, and the fetuses in there as well. The dumber ones you could always badger into agreeing to a hysterectomy. And while that could be time-consuming, it was good practice.

Time was better spent being in the right places, being seen by the right people, talking to the movers and shakers of the local medicine scene, brown-nosing them. The big thing is to get St. Vincent’s behind you. Get into the real world of the Caddies, country clubs, influential patients. And get there yesterday. Time was an enemy.

The other enemy, perhaps even more threatening than time, was sitting across from him. Sister Eileen Monahan. He knew she had her suspicions. He was also pretty sure that she had no proof. Without proof, she would never bring him up on charges. Which didn’t mean she didn’t want to get him. Only that, for now, she couldn’t.

But he also knew that the very instant she could, she would get rid of him. And then where would he be? Dismissed from St. Vincent’s! Who would consider him after such degradation?

That was why he was in such inner turmoil. He had no way of telling what she knew. He would soon find out. Meanwhile, it was crucial that he present a calm and tranquil exterior.

They sat across from each other for several moments in silence, each measuring the other.

Eileen opened a file folder and began paging through it. Kim shifted in his chair. It was increasingly difficult to retain an unruffled exterior.

“Dr. Kim,” she said at length, “is all going well for you here at St. Vincent’s?”

“As well as can be expected.” He was pleased to use the bromide response traditionally given in hospitals to almost any question.

Eileen smiled tightly. “And how ‘well’ may we expect that to be?”

“I have no complaints.” Pause. “Have you?”

Pause. “Doctor, when you came here from Chicago last year, we had a long talk.”

“I remember it well.”

“Good. Then you’ll recall that I spoke at considerable length about the spirit here at St. Vincent’s.”

He did remember it well. At the time, he had thought her a bit over-age to be a cheerleader. “May I again remind you,” Eileen continued, “that this is only a small health-care facility, in precarious financial balance at best. So much so that, in order to survive, we must work together in a spirit of trust unequaled in most similar institutions. We lack the numerical strength to carve out a niche for ourselves and bury ourselves in some specialty. But, most of all, among the capabilities we lack—and I wish we could afford—is we have no ‘watchdog’ committee to police our operation. So, to a greater extent than most health-care facilities, we must function on an honor system. We must police ourselves.”

“I remember all of that very well, Sister.”

“As you complete your first year of residency, Doctor, I thought it would be good to evaluate your position here.”

“Have there been complaints? Has not my work been satisfactory?”

“Satisfactory? Technically, yes. Every evaluation of your work has been more than satisfactory. In emergency situations and particularly in the OR, you are reported to be calm under fire and a gifted surgeon.”

“Then all is well.”

“Not quite. And this is not merely hearsay. It’s your attitude toward people. Toward patients and their families.”

“Attitude?”

“I know that’s difficult to define. For one thing, among our patients, an unusually high percentage of those on life-support systems are yours.”

“Without the systems, they’d be dead now.”

“With the systems, they are already dead now, for all practical purposes.”

“If it is the cost of maintenance—”

“Of course it isn’t the cost. No more than it would be in any other hospital. If someone’s life can be prolonged for any positive purpose, then of course we must do everything we can. But many of your patients are vegetating. Many have reached a terminal state even as you order procedures to begin.”

“If the wishes of the family—”

“I know all about the wishes of the family. And I’ve heard about your routine in getting their consent to put the patients on the machines.”

“Is there anything medically improper in all this?”

“Not technically. But one tends to wonder why so high a percentage of the families you talk to decide that we must, in your phrase, ‘do everything.’ One wonders if you are doing this just to save yourself the time it would take to sit down with the families and explain the options available to them.”

“Sister, do you not think your conclusion is a bit farfetched and rather unsubstantiated?”

“All by itself, perhaps. But then we have your rather cavalier attitude towards D & Cs.”

“What do you mean by that?” He knew she was coming close to pay dirt.

“The word I get—”

“From whom, may I ask?”

“We won’t get into that just now. These are not formal charges.”

He breathed a bit more easily.

“I’ve heard that you frequently don’t even order a pregnancy test when it is called for, before going right into a D & C,” she continued, “and there are times that you’ve removed a fetus.”

“That is not unique.”

“It isn’t unique unless it happens again and again. Then it’s another name for abortion.”

“Do you not think that is a bit strong, Sister?”

“No, I don’t. And you well know our policy on abortion at St. Vincent’s.”

“I see.

“Is there anything else on your mind, Sister, before I reply to all this?”

“No. And I am eager to hear your reply.”

Kim relaxed measurably. She hadn’t mentioned all those unnecessary hysterectomies. Was it possible she hadn’t heard about them? In any case, she wasn’t going to bring them up. So much the better.

“Since you want to know what I think,” Kim began, “I think it is easy for you as a Caucasian American to apply a racial stereotype to one such as I.”

“Racial stereotype!”

“Yes. It is very easy for you Americans to group us Asians into one category and claim that we have no respect for life.”

“That has nothing to do with this!”

“Is that so? Do you have any documentation for the charge that I perform a D & C merely in order to abort?”

“I told you I am not concerned at this time with formal charges or documentation. I can only tell you that I have heard about it from more than one source. Sources, I might add, who are most trustworthy.”

“I cannot allow my life, my professional conduct, to be affected by innuendo and rumor—and that is what I consider these unsubstantiated charges to be based on.” Kim realized he was moving into dangerous ground, almost challenging Eileen to bring formal charges. He decided to turn the tables. “And, as to the allegations regarding my handling of the terminally ill, does that not argue just the reverse of the first charge—that I have no regard for life? How very un Asian of me to want to prolong someone’s life, do you not think?”

“Dr. Kim, one look at your patients while they are being mechanically sustained will tell anyone worlds about the quality of life to which they’ve been relegated.

“Besides, you have twisted and jumbled everything I’ve said with your gratuitous reference to an Asian prejudice. There may be some in our society who feel that Asians prize life less than do we in the West. But I am very definitely not in that number. I am too well aware that we in the United States have less than an enviable record when it comes to racism. So I am conscious of our own failings. But being conscious of racism does not necessarily mean being guilty of it.