Authors: Gen LaGreca
“Good evening, my fellow New Yorkers. I sincerely appreciate your generous support for my campaign. I see many among you who backed me four years ago in my first race for governor. I hope you all realize that your contributions helped us make history.
“My administration launched CareFree, the greatest public entitlement program ever attempted in New York. We’re the first state to guarantee health care to all citizens. The president of the United States himself hailed CareFree as a model system. So now every other state in the nation is scrambling to copy what we’ve already accomplished here in New York!”
The audience cheered.
“Now, I’m going to ask you to make history with me again,” continued the governor. “I have only one campaign promise this time, but accomplishing it will be another milestone. First, let me say that I was as shocked as everyone by the recent . . . questions . . . concerning one of our colleagues.”
Burrow’s tone softened. The lieutenant governor, conspicuously absent from the evening’s event, was under investigation for accepting gifts and payments from construction companies awarded government contracts, and many voices were urging Burrow to choose a new running mate.
“We are thoroughly investigating the matter involving the lieutenant governor. Once the facts are known, I will act accordingly.”
Burrow waved his hand as if to shoo away the scandal blackening the front pages of every newspaper in the state in recent weeks. Cameras panned to the secretary of medicine, the leading contender for the governor’s running mate should the lieutenant governor be forced off the ticket. Prominent citizens lauded the secretary as a “man of honor,” “pillar of morality,” “impassioned servant of the people.”
“This brings me to my promise to you and to all New Yorkers,” Burrow continued. “I pledge that my administration will serve no cause other than the people’s welfare. We will make history again, this time by having the most honorable government ever to serve the people. The public interest will be our only beacon!”
The governor’s voice was a distant drone to alcohol-mellowed Marie Lang, sipping cognac and watching the waiter pour coffee.
“This coffee’s stale,” said the partner who managed Reliant Care’s clinical staff, the tinge of petulance in his manner becoming more pronounced after the evening’s drinks. He raised his hand to signal the waiter, and then lowered it. “Aw, what’s the use complaining? Nobody listens.”
The financial officer tasted his coffee, and then glanced around the room. “It’s stale, but no one else is complaining. Who are we to go against the majority?”
“This is typical,” said the head of marketing, tasting the contents of his cup disapprovingly. “The hotel makes a killing on the banquet, then serves us these dregs. There ought to be a law.”
“I have just the thing,” said Marie. She poured some of her cognac into the complaining partner’s coffee. “How’s that?”
“Actually, very good!” said the partner, sipping the brew.
Paul Eastman smiled. “That’s a fifty-year-old cognac you just poured into stale coffee, my dear. One could say you ruined the cognac.”
“Or one could say I improved the coffee.”
“I’d say Marie’s bent on making things work, even if it takes a little defiling,” said the head of the clinical staff approvingly.
“The way Reliant’s growing, we’ll need to take on another partner.” Eastman tapped Marie’s hand. “Let’s talk.”
“Let’s do, Paul,” she replied.
Marie’s silky hair bounced as she tossed her head back in enjoyment of the moment. Affixed to the thin strap of her gown was a gold pin. In the creamy light of the chandelier, one could read the engraving:
Dr. Marie Lang, Distinguished Caregiver
.
*
*
*
*
*
Disinfectants and sweat hung in the heavy air of the OR. Fluids that had been sucked out of Eileen Miller’s brain filled a plastic container. Bloody gauze pads lay in neat rows on a blue cloth after a nurse triple-checked that every one put into the patient’s brain had been retrieved. Bentley finished bandaging the patient’s head. While David Lang shed a surgical gown resembling a butcher’s apron after a day’s work, the anesthesiologist removed the respiratory tube. David’s eyes froze on Eileen Miller’s still body. What would her lungs do? Within moments, her chest rose and fell in even breaths, an auspicious sign! Smile lines, the first of the evening, livened David’s face.
He accompanied Eileen into the recovery room. Standing over her listless form, he waited for her to awaken. Would she? No device existed to spare him the anguished moments after surgery when only the limp body before him knew whether his best effort had been good enough. He waited for Eileen’s body to confide in him its secret. Interminable minutes passed. Then Eileen Miller opened her eyes.
“Good evening, Eileen! Squeeze my hand.”
Five frail fingers made the journey around the summoning hand. David felt a weak but discernible pressure.
“Good! Now squeeze my other hand. . . . Wiggle your toes. . . . Very good! . . . Now follow my finger with your eyes. . . . What year is it, Eileen?”
Although groggy and confused, Eileen responded normally to his various neurological tests. David laughed in exhaustion, relief, and triumph. But his laughter died when Bentley entered the room.
David stepped away from the bed and whispered to the resident: “Was a brain scan done on this patient before tonight?”
“No, Doctor.”
“Do you know that a patient taking anticoagulants is predisposed to hemorrhage after trauma?”
“Yes, Doctor.”
“Do you also know that persistent headaches after a head injury are a neurological sign to take seriously?”
“Of course,” Bentley replied, confused.
“What has been done all week to treat this woman?”
“She was given a painkiller for migraines.”
“Do you know the difference between a migraine and an intracranial hemorrhage?”
“Why, yes.”
“Is this what I’m teaching you to do, Bentley?”
“Oh,” Bentley said in sudden understanding. “But—”
“To observe symptoms and not to test?”
“But Dr. Lang—”
“To send a patient home to die! Is that what you’re learning here?” David’s fists tightened.
“But Doctor, I—”
“Excuse me, Dr. Lang.” A nurse had approached them, pointing to a man and two children standing at the doorway. “The Millers made their way back here. Shall I ask them to wait?”
David saw six desperate eyes staring at him.
“No, I’ll talk to them right away.” Glancing at Bentley, he added coolly, “I’ll be back.”
Despite the exhaustion apparent in his puffy eyes, David’s handshake was firm. “Hello, Mr. Miller. I’m David Lang. I just operated on Eileen.”
“You’re smiling, Dr. Lang. Does that mean we . . . have reason . . . to . . . hope?”
“I think Eileen is going to be fine.”
His words transformed three despondent figures into human beings. Mr. Miller jubilantly embraced his daughter. He paused to look for a small presence standing apart, watching them.
“Come here, son. Everything’s going to be all right.”
Billy tentatively walked toward them. The father and sister threw their arms around the little bundle, clutching him until the biting sadness lifted its grip on his small face.
David allowed them to talk to Eileen. He watched with a quiet thrill as they kissed the limp form with the bandaged head. He stood apart, allowing them intimacy, yet he could not avert his eyes, knowing he was part of that moment.
“Dr. Lang, forgive me—I haven’t thanked you yet,” Mr. Miller said when they left the patient. “You see, I’m still stunned. Eileen seemed fine. She complained of headaches earlier in the week, but they weren’t bad at first.”
“These conditions sometimes worsen, even though she might have seemed okay when you brought her to the hospital earlier this week.”
“We never brought her to the hospital.”
“You didn’t come to the ER?”
“Why, no, we didn’t think there was an emergency—until tonight when we couldn’t arouse her from a nap.”
“I guess I assumed you brought her here.”
“We’ve never been to Riverview Hospital before tonight, except when Eileen gave birth.”
“I was napping when Dr. Bentley called me this evening. I thought he treated her earlier this week.”
“We never met Dr. Bentley until tonight.”
“Oh, I see!” David said, relieved to owe Bentley an apology. He liked the resident. Then the fuse within him reignited, searching for the proper target to strike. “Who treated your wife?”
“She saw our general practitioner at the office as soon as the headaches started, the same physician who has been treating her varicose veins. We also telephoned our doctor when the headaches were worsening. We were told they were migraines and nothing to worry about.”
“Who is this doctor?”
“Well, that’s what we were wondering.”
“What do you mean?”
“We were curious.”
“About what?”
“Your name. We wondered if you were related. You see, our general doctor is Marie Lang. . . . Doctor, are you okay? . . . Is anything wrong?”
Chapter 4
The New Frontier
To serve the public interest above all other concerns—this is the noble work of medicine.
David Lang read the gold inscription over the entrance to the Manhattan offices of the Bureau of Medicine. His eyes dropped contemptuously to the name under the quotation—that of the secretary of medicine.
In the serpentine lobby of the old brick building, he passed a mural of Antoni van Leeuwenhoek peering through his magnifying lens in a moment of discovery. Leaning against the picture was the ladder of a maintenance man who was changing a lightbulb. In the center of the lobby stood a statue of Joseph Lister gazing into a test tube. Propped against its legs was a makeshift sign with directions to the information desk. A white marble tablet in the floor displayed the etching
To the independent mind that is the wellspring of science
. The mural, the statue, and the tablet were the remains of a bygone era when the building was home to a distinguished medical school. David recalled hearing of students being required to walk around the tablet, with the placement of one foot on the inlay being grounds for punishment. Despite the building’s history, countless shoe prints now scuffed the inscription, the letters rounded from wear. As was his practice, David walked around the tablet. Riding the elevator to the Department of Medical Research, the man who spent more time in the OR than at home felt that it was
he
who was now out of step in this building dedicated to medicine.
He arrived at a small, austere conference room whose gray walls and fluorescent lighting were as cold as the seven people sitting around its oval table. They comprised the committee that would determine the future of his research—and of his life, he thought uneasily.
Rising to greet him was the head of the committee, a petite, businesslike woman in her forties, Dr. Alice Cook, the director of medical research for the BOM. The shorthaired and long-waisted Dr. Cook, fashionably clad in a blue suit, introduced David to the other members. With sweeping hand gestures and a measured voice, she seemed to enjoy lingering in the moment of having control over the fate of another. In an effort to establish what she liked to call a partnership with the community, she included in her group laypeople as well as health care professionals. Thus, she presented David to a research scientist, a public-health administrator, a retired gynecologist, a minister, a manufacturer, and a homemaker.
When everyone was seated, Dr. Cook walked to the podium at the head of the table and read from David’s curriculum vitae: “Dr. David Lang is a practicing neurosurgeon and a professor at West Side University Medical School. He has published dozens of papers and lectured internationally. He seeks permission to complete a research project he started years ago.” She turned to him cordially. “Dr. Lang, please tell us about your project.”
The man who approached the podium looked too young to possess the lengthy vita before Dr. Cook, except for an air of quiet confidence in his bearing. The aesthetic lines of his face made him seem too pure to deal with blood and death, but a ruthlessness in his eyes suggested that he could absorb such shocks. The silk suit he wore appeared too elegant for the grisly work of a surgeon, yet its tailored lines implied a laser-sharp focus on business.
“Thank you, Dr. Cook. Good afternoon, ladies and gentlemen.” On a small table beside the podium, David rested a soft leather briefcase that he had brought. Eyeing the laypeople in the group, he decided to explain his work in simple terms. “My research centers around the thing that makes humans the supreme creatures of the world, characterized by remarkable feats and endless progress, from the cave to the skyscraper, from the wheel to the rocket, from the campfire to the power plant, from the stone tool to the computer. This thing makes humans superior to other animals because we alone can understand the world and harness the powers of nature to control our destiny. This thing is the most exquisitely complex object known, housing the massive power of two hundred billion cells engaged in countless electrochemical reactions, yet it is nothing more than a three-pound gelatinous mass that fits in the palm of your hand. It is, of course, the human brain.