Robin Cook - Foreign Body

But that was not going to happen this morning. He was much too keyed up about the previous night’s activities for more sleep. He stared up at the high ceiling and thought about what had transpired the evening before.

What bothered him was how close Veena’s suicide attempt had come to bringing his whole project down. If he hadn’t gone in to check on her when he did, she would have died, and there was little doubt that her death would have resulted in an inquest, and an inquest would have been a disaster. It would certainly have closed Nurses International, and in the process, at the very least, slowed his progress toward his ultimate goal of becoming truly wealthy as the CEO of SuperiorCare Hospital Corporation.

Cal hadn’t been interested in healthcare initially, and he still wasn’t interested in taking care of patients or nurses, for that matter. He just liked the money involved, two trillion per year in the United States alone, and the field’s record of sustained growth. Back when he was in high school, advertising had been his first career choice, and he had gone through UCLA and the Rhode Island School of Design in preparation. But briefly working in the field caused him to recognize its limitations, especially financially. Giving up on advertising, but not its principles of deception, he sailed through Harvard Business School, where he was introduced to the mind-boggling money involved in healthcare. When he finished business school he sought and got an entry-level job at the SuperiorCare Hospital Corporation, which was one of the biggest players in the field. The company owned hospitals, feeder clinics, and healthcare plans in almost every state and major city in the United States.

To best utilize his creative bent, Cal entered the company via the public relations department, where he saw the best opportunity to make a name for himself and thereby attract the attention of the company’s officers. On his first day he boasted he would lead the company in ten years, and after two it appeared as if his prophecy might have merit. Along with a striking woman five years his senior and an inch taller than his six feet named Petra Danderoff, who’d been part of PR when he joined, he found himself co-running the entire department thanks to a series of extremely successful ad campaigns the two had contrived that had nearly doubled the enrollment in several of the company’s healthcare plans.

Some people had been surprised at his meteoric rise, but not Cal. He was accustomed to success from an early age, partly as a self-fulfilling prophecy of the confidence and competitiveness that was part of his genetic makeup, and which had been honed to an obsession by his equally competitive father. From early childhood he’d wanted to win at everything, especially in competition with his two older brothers. From board games like Monopoly to school grades, from athletics to the presents he gave his parents at Christmas, Cal insisted on being number one with a kind of single-mindedness few could match. And success only reinforced his appetite for more success, to the extent that over the years he lost all vestiges of the need for moral principles. In his mind cheating, which he didn’t refer to as such, and ignoring ethics, which he considered mere limitations for the faint of heart, were simply tools to advance one’s agenda.

SuperiorCare Hospital Corporation officers were not aware of these details of Cal’s background and personality. But they were very aware of his contributions to the company and were eager to reward him, particularly the CEO, Raymond Housman. By coincidence this recognition had materialized more or less at the same time a mounting financial problem had been brought to the CEO’s attention by his CFO, Clyde English. To their collective horror, accounting had determined that the company had lost, in 2006, about twenty-seven million dollars from its bottom line because India’s growing medical tourism industry had caused a disturbing number of American patients to shun SuperiorCare hospitals and wing off to the Asian subcontinent for their surgeries.

Linking the two issues, Raymond Housman had invited Cal to a secret meeting in his office. He’d explained the medical tourism issue and the need to somehow turn it around. He’d then offered Cal an unparalleled opportunity. He said SuperiorCare was looking to lavishly fund through a secretive bank in Lugano, Switzerland, a company with the express purpose of seriously diminishing demand for patients to go to India for surgery, if he would agree to form it. Raymond was very clear that SuperiorCare Hospital Corporation wanted no ostensible connection with such a company and would strenuously deny there was a connection if asked, nor did they want to know how the company accomplished its goal. What Raymond didn’t say but what Cal definitely heard was that his termination at SuperiorCare Hospital Corporation was temporary and that his success in the current venture would be a cause for him to be welcomed back into the corporate fold with open arms at an extremely high level, essentially leapfrogging the corporate ladder.

Despite having no idea how he was going to engineer the new company’s objective, Cal had accepted immediately with the proviso that Petra Danderoff, then his co-director of the public relations department, would be included in the deal. At first Housman had balked with no one to run SuperiorCare’s PR, but after being reminded of the seriousness of the medical tourism problem, he relented.

Two weeks later, Cal and Petra were back in Cal’s hometown of Los Angeles, brainstorming their company-to-be’s modus operandi. To help, each had hired a gifted friend: Cal had chosen Durell Williams, an African-American whom he had befriended at UCLA and who had gone on to specialize in computer security; and Petra had asked Santana Ramos, a Ph.D. in psychology who had joined CNN after she’d worked in private practice for a half-dozen years.

Most important, all four people were equally competitive, equally dismissive of ethics as a limiting weakness, and equally convinced that their current challenge of curtailing medical tourism for a Fortune 500 company was an opportunity of a lifetime, and each vowed that they would do whatever it took to denigrate medical tourism. Quite expeditiously, the group had settled on a company plan of promoting patients’ fears as the best way to lower demand. Until patients were subjected to propaganda to the contrary, everyone facing surgery had strong reflex reservations about going to India or another developing country for an easily understandable complex of reasons. First was the concern of the country’s general lack of cleanliness, raising the specter of wound infection and catching any one of a number of dreaded infectious diseases. Next there was an obvious question of the skill of the surgeons and the other personnel, including nurses. In addition, there was the question of the quality of the hospitals and whether the necessary high-tech equipment was available. And finally there was the question of whether the operations that were performed were generally successful.

When the group looked into the propaganda the India Tourist Office was actively putting out, they discovered the office was clearly addressing these specific issues. Consequently, it was decided that Cal’s new company would create ad campaigns to do the opposite and take advantage of people’s fears. Everyone was certain this plan would be successful, since ad campaigns are always easier when the goal is the support of people’s existing beliefs and prejudices.

Unfortunately, no sooner had they settled on a strategy and begun trading ideas when they ran into a serious problem. They had realized that with India spending serious money and effort promoting their medical tourism, the Indian government would surely investigate if someone started doing the opposite, and an investigation of any sort would invariably cause significant problems if ad campaign claims could not be substantiated.