Charlatans

Epilogue

THURSDAY, AUGUST 24, 1:53 P.M.

Dressed in his only jacket and tie, Noah pushed through the revolving door at the entrance to the Stanhope Building. Finally, after several weeks of torment, worrying that his surgical residency was going to be prematurely ended, he felt confident he was going to be reinstated. The day before had been the feared Surgical Residency Advisory Board meeting, but it had gone as well as could be expected. There had been eight members present, which included the program director, Dr. Cantor, and the two assistant program directors, Dr. Mason and Dr. Hiroshi, as well as five surgical residents who had been elected to represent each of the five years of the program. Noah’s seat had been empty for obvious reasons. He had served on the board every year he’d been a resident.

Although Noah had been nervous at the outset, it soon became clear to him by the questions asked that his lawyer, John Cavendish, had made it abundantly clear Noah had not fabricated data on his thesis but rather had conservatively estimated results of the final concluding experiment and then replaced them with the real data as soon as it was available, with the motivation being to have his Ph.D. be considered as part of his medical school application. At the end of the meeting, Noah had been told that the board would vote on his case and that he should return in twenty-four hours for the result.

The only surprise for Noah had been Dr. Mason’s total silence during the hour-long proceedings. Although Noah had been told by Keyon and George that they had uncovered some potentially compromising information about Dr. Mason, which had been communicated to him, Noah had suspected the worst from his long-time antagonist. He hadn’t known why it hadn’t happened until last night at Ava’s.

As they had eaten their dinner overlooking her garden, she’d explained that Keyon and George had discovered that Dr. Mason had made it a habit over the years to insist that Arab sheiks from the Emirates and Saudi Arabia provide progressively extravagant gifts for the privilege of being seen in a timely fashion, which was important for pancreatic cancer patients. At first these gifts had been mainly in the form of large contributions to his research efforts or to hospital building projects, but then about seven years previously, they became more personal, including his beloved, flamboyant red Ferrari.

After consulting with several knowledgeable tax attorneys, Keyon and George had ascertained that from the IRS’s point of view, these gifts had to be considered income, since they were required to secure an appointment and were therefore fee-for-service and not voluntary. Since the amount of money involved was more than 25 percent of Dr. Mason’s academic salary, there was the specter of statutory fraud, meaning possible prison time. This information had been provided to Dr. Mason with the advice that it would be best for him to curtail his ongoing harassment of Dr. Noah Rothauser.

Noah took the Stanhope’s elevators up to the third floor. Once there, he walked across the sumptuous carpeting toward the double mahogany doors leading into the hospital boardroom where the Advisory Board meeting had been held the day before. He told the hospital president’s secretary whose desk was nearby that he was there and then took a seat in the administrative waiting area. It was 1:58 P.M. He had wanted to be exactly on time, not too early and certainly not late, and he could congratulate himself on his timing. Although he’d been optimistic about the upcoming meeting, now that he was waiting to be seen, he felt the old anxiety he’d always felt when forced to confront authority figures. There was always the chance his life could once again be upended. Nervously, he flipped through a magazine that he’d picked up from the low table in front of him.

After the previous night’s dinner and following the revelations about Dr. Mason’s tax fraud, Noah and Ava had retreated up to her study. He’d been staying with her the whole week, and each night they had gone to the study to continue their conversations. Last night, just when they were ready to call it a night, Noah had said he had a condition he wanted to run by her that involved her babysitters. After explaining what he had in mind, Ava’s response had been she’d think about it although a half-hour later she’d reluctantly agreed.

“They are ready for you now,” the secretary called out to Noah five minutes later, interrupting his musing.

Getting to his feet, Noah straightened his tie, took a deep breath, and walked over to the imposing, oversized doors of the boardroom. After another slight pause to take yet another deep breath, he entered. He was moderately surprised that only Dr. Cantor, Dr. Mason, and Dr. Hiroshi were seated at the expansive table. None of Noah’s resident colleagues were present. Noah’s heart skipped a beat. Maybe his optimism had been premature. He closed the door behind him and walked to the near end of the long, boardroom table. The three faculty members representing the executive committee of the Advisory Board were at the opposite end.

“Thank you for returning,” Dr. Cantor said. “Sit if you’d like.”

“I’ll stand,” Noah said. He looked at each of the men in turn. Dr. Mason refused to make eye contact, staring at his hands clasped on the table in front of him.

“By a unanimous vote of the Advisory Board with one abstention,” Dr. Cantor said formally, “it has been decided that you will be reinstated as the super chief resident.”

Relief spread through Noah with such suddenness he had to support himself by grabbing the back of the chair in front of him and leaning on it.

“However,” Dr. Cantor continued, “we want to make sure you understand how important we as medical educators feel about the central role ethics play in our profession. We want to make certain that you don’t feel that expediency can justify ethical lapses, and furthermore...”

Noah was no longer listening to Dr. Cantor. He was already absorbed in thinking about getting himself up to surgery to go over the surgical schedule for the morning to make sure the residents were appropriately assigned as assistants. Then he was going to tour the surgical intensive-care unit to familiarize himself with all the cases. Following that he was going to go to the surgical floor to do the same. The reality was that he had an enormous amount of work to do just to get acclimated back into the system...

“Dr. Rothauser,” Dr. Cantor said. “We’d like an answer to our question.”

“I’m sorry,” Noah said clearly flustered. “I’m so pleased to be reinstated that I am already thinking about all that I have to do to get up to speed. I didn’t hear the question. Could you repeat it?”

“The question is: Is there anything else of an ethical nature that you would like to reveal to the board? This current problem with your thesis surprised all of us coming out of the blue, and we don’t like surprises, especially involving our super chief, who we are considering offering a staff position.”

Noah stared back at the program director with his mind in a sudden turmoil. He wanted to say a lot, but how could he? He wanted to explain how difficult it was to be caught in a standoff with an industry he despised and a woman he thought he loved. The truth was that he was caught between the past and the future, between old-school ethics and the new reality of an ever-expanding technological and connected world where the real and the virtual were fusing.

“Well?” Dr. Cantor persisted.

“I don’t know,” Noah said, stumbling over his words.

“Dr. Rothauser!” Dr. Cantor said sharply. “That is hardly the answer we are looking for. What do you mean you don’t know?”

Noah audibly sighed, sounding like a balloon deflating. “Maybe I should sit down,” he said. Suddenly his legs felt weak. He pulled out the director’s chair directly in front of him and sat heavily. After a deep breath, he looked up, noticing that Dr. Mason was staring at him as intently as the others but with a slight smile of anticipation. Noah was painfully aware that time was passing, and each second was making the situation worse. He should have said “no” immediately and be done with it, but he couldn’t. The question had caught him completely unawares, upsetting the unsteady balance he’d been trying to maintain in his mind, sending it into tumult.

“Dr. Rothauser!” Dr. Cantor snapped. “Explain yourself!”

Noah cleared his throat as he struggled to regain control as an idea emerged from the fog of his addled brain. “This thesis situation surprised me as well,” he said haltingly but gaining confidence, “and it awakened an old fear that has dogged me since I was a teenager that something unexpected would happen to prevent me from becoming the best academic surgeon my abilities would allow. I had never thought about what I did with my thesis as an ethical issue, but now I can see that it could be considered as such, and I apologize for not having cleared the air on my own accord. But with that thought in mind, there is something else that is more clearly an ethical issue that I believe I should reveal to clear the air.”

“By all means,” Dr. Cantor said hesitantly with building concern and dismay. He’d never expected a positive answer to what he thought was a pro forma question.

“Once I bought a paper off the Internet, and after doctoring it, I presented it as my own work. I knew it wasn’t right, but it was in the very beginning of my freshman year of college, and I was under a lot of pressure to perform.”

Dr. Cantor’s face, which had hardened considerably from expecting the worst, suddenly softened. He was ostensibly relieved by Noah’s benign mea culpa. “That’s it?” he questioned with relief. “Early in your college career you bought a paper online?”

“That’s correct,” Noah admitted. “Others were doing it, too, but I know that is no excuse.”

After a quick reassuring glance at his colleagues, whom he judged were as relieved as he, Dr. Cantor assumed a knowing yet condescending smile. “Thank you for your forthrightness, Dr. Rothauser. Although we surely cannot condone plagiarism on any level, I believe we can all relate to the competitiveness we all had to experience early in our lengthy education.” He again glanced at his fellow board members to make sure he was speaking for them. Dr. Hiroshi nodded his head in obvious agreement.

“Any other issues besides this freshman-year paper, Dr. Rothauser?” Dr. Cantor asked, redirecting his attention at Noah.

“That’s the extent of it,” Noah said.

“Okay, fine!” Dr. Cantor said. With a satisfied expression, he sat back, extended his arms, and pressed his palms against the table. “It is good to clear the air. Thank you and welcome back! I know I can say with support of my colleagues, your services have been sorely missed.”

“Thank you, Dr. Cantor,” Noah said as he got unsteadily to his feet. For a split second, he allowed his eyes to dart in Dr. Mason’s direction. He could immediately tell that his erstwhile antagonist didn’t share Dr. Cantor’s contentment, yet under the circumstances he stayed thankfully silent.

Without another word or even a glance back at the residency program directors, Noah headed for the door on rubbery legs. He felt as if he had dodged a speeding train but needed to do something to control the anxiety that Dr. Cantor’s unexpected and open-ended ethical question had unleashed. Luckily, he had just the right antidote. He’d head up to the operating room as he planned and dive back into work.

3:10 P.M.

An eight-ton, intimidating, black Lenco BearCat armored truck with BOSTON POLICE stenciled on its rear panel lurched up onto the curb on School Street in downtown Boston and screeched to a halt. To the shock of several dozen tourists milling about the plaza in front of the refurbished, Old City Hall building, six heavily armed Boston Police SWAT officers, some carrying Colt CAR-15 submachine guns, leaped from the vehicle in a highly rehearsed and synchronized fashion and ran toward the entrance of the ornamental Victorian building. Despite the August heat, they were in long-sleeved black combat gear with military helmets and ballistic vests festooned with additional ammunition clips, flash bang grenades, and Tasers. All but one member of the team were wearing black balaclavas, making them even more sinister.

There was no hesitation or conversation among the group. There didn’t need to be. The operation had been planned to the T, with each knowing their position and exactly what was expected. The first officer to reach the building’s outer door pulled it open as the others dashed within. He followed immediately on their tail.

Since they had already remotely shut down the elevators, they ran toward the main staircase and entered it on the run. Once inside, they rapidly climbed the stairs in step like a precision dance troop. They exited the stairwell one after the other on the fourth floor and stacked up single-file at the entrance of the ABC Security office. Instantly, the second officer in the line removed a door-breaching Thor Hammer strapped to the back of the first officer who then moved out of the way. The officer with the Thor Hammer stepped to the side and without a second’s hesitation swung the heavy hammer so that it hit the door adjacent to the doorknob with as much force as he could muster. With a shockingly loud splintering noise, the door burst open, allowing the next two men in the stack to rush into the room, sighting along their Colt submachine guns with fingers curled about the triggers as they shouted “police arrest warrant.” The first man took the right side of the room as his area of concentration, the second man the left as they executed a classic SWAT dynamic entry. Two more officers followed immediately on the tail of the first two while holding Glock automatic pistols out in front of them in both hands.

There were three totally stunned people in the room. George Marlowe was sitting on a couch to the right of the entrance, using a PC laptop. Keyon Dexter was standing at the window, gazing out over the Kings Chapel Burying Ground with his hands in his pockets. Both had removed their suit jackets and had their sleeves rolled up. Charlene Washington, a temp, was at a desk to the left.

“Down!” yelled the first officer into the room, keeping his Colt trained on George. He knew the second man into the room was doing the same for Keyon. “On the floor, now! All of you! Hands extended!”

George and Keyon recovered quickly, their highly trained military minds rushing through the OODA loop of “observing, orienting, deciding, and acting.” But it was to no avail. In the split second it took to recover their senses, there was no time to act. Resignedly raising their hands, they obeyed the repeated shouts to lie on the floor. It was different for Charlene, who was frozen in place, paralyzed by fear as she stared into the barrel of a Glock pistol.

The two officers who had been responsible for breaching the door and the last to enter the room now came forward and quickly handcuffed Keyon and George as they lay facedown. Once the prisoners’ hands were secure, the same two policemen removed the weapons from the prisoners’ shoulder holsters and their mobile phones and fake FBI badges from their pockets. Once that was accomplished, they hauled the two men to their feet. No one said a word. Only then did the officers with the Colt submachine guns remove their fingers from the triggers and lower their weapons.

The commander of the high-risk-warrant service team and the first person to enter the room stepped forward. He was also the only one not wearing a black balaclava. After handing off his Colt rifle to a colleague, he proceeded to pull out a tattered 3x5 card inscribed with the Miranda Rights. Stepping up to Keyon Dexter, he addressed him with his full name, and informed him that he was being arrested for the murder of Roberta Hinkle of Lubbock, Texas, kidnapping, and for impersonating a federal officer. Moving on to George Marlowe, he repeated the charges. When he was done with the arrests, he read both men their Miranda Rights.

Stepping back from the prisoners, the SWAT team leader purposefully fell silent while eyeing the two handcuffed men. As was often the case during an arrest, prisoners frequently said incriminating things as a normal reaction to the stress of the situation even after being informed of their rights to remain silent. But it wasn’t to be. Keyon and George were professionals and trained to remain silent, knowing full well that ABC Security would have formidable lawyers on the case within hours of learning of their arrest. They were not intimidated by being arrested, since they were certain they would be quickly out on bail.