Authors: Robin Cook
Rounding a sad-looking palm tree, George started toward his door. Besides Sal, George was friendly with only one other tenant. His name was Zee, and George really didn't know him all that well. He wasn't even sure if Zee was his real name or not. He was in his mid-twenties and used to work for a computer gaming company. He had gotten laid off when a major new product bombed upon its release. According to Zee, he had nothing to do with that particular product, but since he was the low man on the totem pole, he was one of the employees who got their walking papers. Now he supported himself playing poker on the Internet, a career choice George never knew existed until Zee gave him the 411 on it.
George knew Zee to be incredibly computer savvy and capable of fixing anything and everything associated with hardware and software. That talent had come in handy on occasion. Zee had helped George with a number of iPad and iPhone issues. George was also aware that Zee was an accomplished hacker since he had regaled George with hacking stories while fixing whatever computer device wasn't working. It seemed to George that Zee hacked secure sites just for the fun of it. Zee bragged that he could hack into anything.
Slamming the door behind him as he entered his apartment, George was in a strange mood. iDoc had invaded his world without his even having been aware of it. And it was an idea he had supplied to one of its creators! He wasn't sure if he was depressed or just pissed off about the whole thing. The distinction probably didn't matter.
“Shit!” George shouted while glancing at the bare shelves in his refrigerator. He had forgotten to stop at Ralph's grocery on his way home. The empty fridge underscored how sad and devoid of pleasure his life was.
He looked around the room. He had no pictures on the walls and no photos. There had been a few of Kasey, but after she died he put them away. They were too painful to look at every day. His only addition to the furniture that had come with the apartment was the flat-screen TV and a bunch of radiology textbooks. Sad. Very sad indeed.
L.A. UNIVERSITY MEDICAL CENTER
WESTWOOD, LOS ANGELES, CALIFORNIA
TUESDAY, JULY 1, 2014, 7:30
A.M.
G
eorge entered the radiology main conference room, checking messages on his phone while balancing a cup of coffee on his iPad. For a small gaggle of first-year residents it was the first day of residency. He was still in a blue funk from the previous day and still couldn't decide how he felt about Paula and iDoc.
Feeling decidedly antisocial, George took a seat in the very last row. He liked a lot of his fellow residents and some of them were very accomplished, but he wasn't close to any of them. For the most part, they were married, some with kids and living a completely different life from George's. In truth he felt envious, and it made him miss Kasey that much more.
George sipped his coffee and tuned out the welcoming speeches. He had heard them all, ranging from the warm to the threatening. George stifled a yawn as he eyed the first-year residents. There were more women than men this time around, and all appeared eager to go. They were scrubbed up in crisp, freshly laundered and pressed white coats. He had made it a point to look over the list of the first-year residents a few days before and noticed they were all married.
George's mind wandered as the meeting droned on. Over the last few months he was supposed to have been dreaming up some sort of research project for his fourth year, but he hadn't given it much serious thought. He wondered about the possibility of doing a year of subspecialty radiology as a way of putting off the decision about what he was going to do after he graduated from the program. After the previous day's presentation at Amalgamated, he wasn't as sanguine about his professional future as he had been prior to it. Would he end up working for Amalgamated or its equivalent? Unfortunately he thought the chances were depressingly possible.
At the conclusion of the department's welcoming conference there was a modest spread of doughnuts and coffee to encourage mingling. George watched it all from the periphery, feeling disassociated. Just then Clayton caught sight of him and sidled over before George could escape.
“The women are getting better looking every year,” Clayton whispered.
“It's just that we're getting older,” George replied. “Plus they're all married, so it doesn't matter.”
Clayton glanced over at George. “Someone got up on the glass-half-empty side of the bed this morning. What's your first rotation this year?”
“Supervising emergency imaging in the ER.”
“Good!” Clayton said, pleased. “I had told scheduling to assign you there, but you never know. Can't count on anyone anymore. Listen: I heard through the grapevine that there's a knockout first-year ER resident from Stanford. Single, since that seems to be a prerequisite for you. Her name is Kelley something or other. Check her out. I'm always thinking about you, buddy.”
“Okay,” George said. He wasn't interested, but he didn't want to get into it with Clayton; better to let him think all was well with his clumsy efforts to fix George up. George definitely wanted to stay on the man's good side. George saw Carlos Sanchez, the first-year that he was scheduled to supervise. It was an excellent opportunity to ditch Clayton. “Excuse me, that's my newbie over there. Better go get him situated.”
“Go to it.” Clayton smacked George on the butt with his folder. He had once confided that carrying a folder around always made you appear busy, and even better, you could end any conversation instantly just by waving it and saying you had to go. The guy was a superb radiologist and a great teacher, George thought, but he had his fair share of idiosyncrasies.
George approached Carlos, a bright, eager Mexican American whose record George had perused when he'd gotten the assignment. Carlos had breezed through UCLA Medical School with stellar grades. With radiology being one of the more desirable specialties, all of the department's residents had done extremely well in medical school, George included. When George first met the young man a few days earlier he'd been impressed with his eagerness. He had already read several of the main texts written about emergency imaging, but reading textbooks about what to do was one thing, actually doing it was another.
“Hey, Carlos!” George said, offering his hand.
“Dr. Wilson,” Carlos replied, grabbing George's hand and giving it an eager pump.
“Just George will be fine. I'm about to head out but wanted to let you know I'll see you over in the ER after the reception.”
“I'll go with you,” Carlos said, setting down his coffee.
“No! Stay and try to meet as many of the staff members as you can! It's important for you to get the lay of the land. See you in a few!” George headed for the exit, waving over his shoulder in a fair imitation of Clayton.
“Okay, boss,” Carlos called after him.
EMERGENCY DEPARTMENT
L.A. UNIVERSITY MEDICAL CENTER
WESTWOOD, LOS ANGELES, CALIFORNIA
TUESDAY, JULY 1, 2014, 10:17
A.M.
G
eorge leaned back and stretched in his chair. Carlos did likewise in unconscious imitation. George glanced at him, making sure Carlos wasn't messing with him. Apparently not. They were in the ER's radiology reading room, where most of the light came from the viewing monitors. They had just finished going over all the X-rays taken the night before in preparation for their conference with the ER staff. George had found three X-ray cases that had been misread by the emergency medicine residents in the current batch.
“Would you like to present the details?” George asked.
“No!” Carlos replied, shocked. “It's my first day. I'd make a fool of myself.”
“You would do fine. But I'll leave that up to you. If you change your mind, let me know,” George said, remembering his own reluctance to speak when he was a first-year resident.
The door opened and a shaft of daylight pierced the reading room.
“Dr. Wilson?” one of the ER secretaries called out. “Dr. Hanson is at the main ER desk and wants to see you.”
George rolled his eyes and pushed himself out of his chair. “Start going through this morning's X-rays,” he said to Carlos.
George stood outside the reading room, waiting for his eyes to adjust to the sunlight streaming through the floor-to-ceiling windows. The place was packed with patients who had not been deemed true emergencies, illustrating the chronic problem caused when the general public used the ER as primary care.
George spotted Clayton chatting up Debbie Waters, the charge nurse known for being a no-nonsense taskmaster and for her excellent work keeping the ER running smoothly. On seeing George, Clayton immediately broke off and walked over to him.
“Did you meet that first-year ER babe yet?” he asked, seemingly unconcerned about being overheard. “You know, the one I mentioned earlier, from Stanford.”
“That's why you pulled me out of the reading room?” George's tone of mild admonishment had no effect on Clayton.
“Someone has to look out for you, my friend,” Clayton said. “It's time you left the past behind you, where it belongs. Tell me! Have you at least laid eyes on her?”
“No, I don't believe I have. It was a busy night last night. Lots of films.”
Extending a hand, Clayton motioned for George to be quiet and nodded toward a young woman who had just come out of one of the enclosed cubicles. She was fashion-model tall and seriously attractive in a healthy, vibrant way. Even in scrubs it was obvious to George that she had a rocking-hot body. She walked past them, tapping away on her tablet.
“Now you have,” Clayton whispered. “What a sight. Agreed?”
George turned away from Clayton and rolled his eyes. Dutifully he watched the first-year ER resident approach the main desk to drop off paperwork before taking the next clipboard from the to-be-seen rack.
“They don't get much better than that,” Clayton said.
“She's definitely attractive,” George admitted, although at this point he was watching Clayton, not Kelley. The man was shameless.
Clayton watched as she stopped to go over a chart. “You better get busy before some surgical resident gets all up in that. But if it doesn't work out, I can put in a good word for you with Debbie Waters.”
“The Queen of Mean?” George was shocked. He could feel his face redden as he briefly glanced over at Debbie.
“Hey, she said she was interested in getting together with you,” Clayton protested. “And you need to get out more. I'm worried about you. You have to have some balance in your life. You work too hard. Seriously. Invite her to have a drink at the W Hotel! She likes it there. I happen to know.”
George stole another glance at her. Luckily Waters's attention was directed elsewhere. He had always admired how well she kept the ER on an even keel even when all hell was breaking loose.
“She's a lot of fun, even though she can be a bit bossy,” Clayton said. “She's very entertaining when she is taken out of her element here in the ER trenches. Believe me! Work is work. Fun is fun. She's a pistol. Don't judge a book by its cover!”
George knew everybody was intimidated by Debbie Waters. He had seen her give more than one tongue-lashing to unprepared surgeons all the way down to janitors. She didn't discriminate.
“Debbie would be perfect for you,” Clayton persisted. “Hell, you don't have to marry her. Come on! I'll break the ice.”
“No way. It's not that I don't find her attractive. It's just that she's so damn . . . domineering.” He realized Clayton wasn't about to drop the subject. George added, “I'll talk to her when she isn't quite so busy.”
Clayton shrugged. “It's your call.” He glanced down at his watch. “I have to get back to work. I hope to hear you made some progress on one of these young fillies soon. You need to be entertained to pull you out of your funk.”
George shook his head in disbelief as Clayton walked off. In a way it was touching that Clayton was concerned about him. He had also heard rumors that Clayton and Debbie had been more than good friends.
Despite his misgivings George was intrigued. If Debbie Waters really had said she'd like to get together, he'd be a fool to not follow up. When you worked in the ER it was best to have her in your corner.
Reaching the main desk, George pretended to look through the to-be-seen charts while watching Debbie out of the corner of his eye. As usual she was juggling about ten different tasks. As George waited to see if she would even acknowledge him, one of the orderlies dropped a sheaf of paperwork on the countertop in front of him.
“The patient in Trauma Room Six is dead on arrival,” the orderly stated.
“And do you have a name, or are you going to make me weed through all of this to find out?” Debbie demanded. She aimed her pen toward the clipboard in front of her.
“Tarkington,” the orderly replied.
George's head shot up.
“Thank you. That wasn't so hard, was it?” Debbie said dismissively as she crossed out a name on the master sheet in front of her.
George edged along the countertop, angling for a look at the paperwork, though he wasn't sure he wanted to know that his patient had died. He glimpsed the given name Gregory before Debbie snatched away the chart. As her eyes met his there wasn't an ounce of recognition.
So much for Clayton's good word
, George thought. He turned and headed down to Trauma Room 6. The dead patient was lying on a gurney, his clothes torn open, revealing a bare chest. An ER doctor was off to the side typing on a tablet. A male nurse was busy detaching the EKG leads from the individual's chest. A crash cart with a defibrillator stood off to the side.
George looked at the dead man's face. He just wanted to be sure it was the Tarkington whose MRI George had supervised the day before.
“What was the cause of death?” George asked the ER doctor.
The resident glanced up and shrugged. “Don't know. If I had to guess, probably a heart attack. Whatever it was, he was long gone by the time he got here. He was as cold as an ice cube.”
“Was there a resuscitation attempt?” George asked, looking over at the defibrillator.
“No. Like I said, the guy was already cold.” He gave George a look of “what can you do” and left.
“Are you okay, Doctor?” one of the orderlies asked as he came in to retrieve the crash cart.
“Yeah, I'm fine. Thanks,” George mumbled. Yesterday he had assumed Tarkington was in for a rough time, but he didn't think the man would be dead within twenty-four hours! George couldn't shake the feeling that the episode was directed at him to remind him yet again that life was fragile, unpredictable, and unfair, and that he better squeeze what he could out of it while he was able. Worse yet, he felt a strange and irrational complicity, as if he were somehow responsible. Had it not been for him, the lesions in the man's liver might have been overlooked, and had they been overlooked, the man might be alive, happy, and unsuspecting while enjoying life with his family.
George wondered again if medicine had been an appropriate career choice. Maybe he didn't have the emotional strength necessary.
Just then an orderly poked his head into the trauma room. “Excuse me? Are you Dr. Wilson?”
“Yes?”
“Dr. Sanchez asks that you return to the image-reading room to view a possible hip fracture.”
“Okay, thanks,” George said. He looked back at Tarkington's lifeless body, then began walking back to Carlos. Passing the central desk, he paused to take another look at Debbie Waters. She was still at it, barking out orders. It might be interesting to find out what made her tick. And he did need to get out of his rut.