Critical

12

Angela hurried out onto Fifth Avenue from the commercial entrance to the Trump Tower, and merged into the heavy pedestrian traffic heading south. She had to wait for the light at 56th Street, and glanced at her watch. She was already late for her scheduled seven-fifteen dinner with Chet McGovern. It seemed that lately she was always running and always late. The pressure was unrelenting. She knew she shouldn't be taking the time to dine formally, but the coincidence of having had a confrontation of sorts with Dr. Laurie Montgomery and being persistently asked to dinner by one of the medical examiner's colleagues on the same day was too much not to take advantage of. Angela was concerned that Laurie Montgomery could be the biggest current threat to the secrecy Angels Healthcare had managed vis-a-vis the MRSA problem and its cash-flow consequence. Angela needed to know how big a threat.

When the light changed, Angela's mind went back to her other problems. Paul Yang still had not returned, and just before leaving the office, Angela had checked with Bob. She thought he would have called if the accountant had contacted him, but Angela wanted to be sure. It would have been nice to be able to cross off one of her concerns. At the same time Angela was checking with Bob about Paul Yang, she had asked him if all had been arranged with Michael about the extra fifty thousand. Bob had said everything had been taken care of except the money itself, which he hoped would be wired in the morning.

The last thing Angela had had to take care of before she left the office was a blowup between Cynthia Sarpoulus and Herman Straus, the president of Angels Orthopedic Hospital. Cynthia demanded to keep David Jeffries's OR closed for another twenty-four hours, while Herman wanted it available. It was his contention that there had been four operations after Jeffries, which had had no infections, and the OR had been fastidiously cleaned. Cynthia, on the other hand, wanted to wait a day to check it again before giving it a green light. Under normal circumstances the chief operating officer, Carl Palanco, would have handled the problem, but mercurial Cynthia had threatened to quit, meaning Angela had to step in to mediate. Angela did not want to lose their infection-control professional with MRSA still a potential threat.

At 54th Street, Angela turned left and hurried her step. Despite all the current problems and pressures, she resigned herself to at least enjoy the meal even if it was, like everything else she was doing, in the line of work. After all, on the positive side, it was one of her favorite restaurants.

Coming through the front door and then the inner door, she peeled off her coat and gave it to the coat check person. Approaching the hostess desk, she expected to see one of the owners, of which there were two. Although she didn't know for certain, she suspected they were brothers. The one whom she expected to see, since he acted as the maitre d', was the elegant Italian male with the omnipresent and superbly fitted Italian suit, crisp white shirt, bold Italian silk tie with matching pocket square, and luxuriously dark, rather long and flowing hair. The other was the tough, no-nonsense Italian male exuding testosterone, who could have played the part of a mobster. He dressed considerably more casually yet commanded significant respect tinged with a touch of fear. He usually hung out behind the small bar, and when Angela stepped farther into the room, she caught sight of him in his usual location. When he caught sight of her, he waved and greeted her by name. Prior to the disastrous MRSA problem, Angela had patronized the restaurant nearly on a weekly basis, but it had been for lunch, not dinner. She quickly surmised the brothers probably rotated evenings, since the power lunch was the establishment's forte.

One of the waiters recognized her as well. He was a youthful-appearing Italian with a pervasive smile, who also greeted her by name. With a grand gesture he pointed her toward the front corner table and said, "Your guest has already arrived."

Standing behind the table, Chet waved and smiled a greeting.

As Angela approached, she sized him up. She'd forgotten his engaging, nonchalant smile as well as his boyish appeal. She never would have suspected he was a physician, and certainly not a medical examiner. During her medical training, pathology had not been her favorite course. She couldn't help but wonder why anyone would choose to make a career of it.

When she reached the table, Chet surprised her by stepping out and giving her a hug. She limply hugged back. After all, this was business, even if he didn't know it.

"Thanks for coming out, knowing how busy you are."

"Thanks for having me. I'm not sure I would have gotten much dinner had you not been so persistent."

"As I said, you have to eat."

They sat down.

"First things first," Chet said. "This is my treat."

"I think I'm going to get the best of this exchange," Angela said. She knew that in keeping with its quality, San Pietro was not inexpensive.

They engaged in superficial banter for a time, after which Angela signaled for the waiter. She was committed to having a short evening.

The youthful, smiling waiter came over and rattled off an impressive description of more than a dozen appetizer specials and more than a dozen entree specials. Then he handed out the menus.

"That was incredible," Chet whispered to Angela. "How does he remember all that?"

After they had made their selections, including a bottle of 1995 Brunello, they went back to their conversation. As had been the case the night before, Angela found Chet an extremely facile conversationalist, and she couldn't help but enjoy his humor and refreshing candor. He was, as he openly admitted, an irrepressible lothario. Yet by admitting it so freely, it seemed to erase its usual tawdry shallowness. Once again, as was the case the previous evening and in spite of all the pressure she was under, she began to enjoy herself. Of course, the wine significantly helped, as it was truly delicious to the point of making her feel a bit guilty: She imagined the bottle was pricey.

As the conversation proceeded, and not wanting to be rude by essentially delving into her true interest for coming out to dinner namely, to find out about Laurie Montgomery, she took advantage of Chet's openness by asking him why he chose medicine and why forensics.

"You want the expurgated version or the truth?" Chet said, flashing one of his playful smiles.

"The truth!" Angela said with exaggerated forcefulness. She took another sip of the heavenly wine.

"Most people, like ninety-eight percent, go into medicine because they are truly motivated to help people. Not me. I had no idea what I wanted to be until about the eighth grade."

"What happened?"

"One of my friends, whom I thought of as somewhat of a nerd – I mean, he was the chairman of the chess club – suddenly decided he truly wanted to be a doctor, and for the standard reason. And do you know what happened?"

"I cannot wait to hear."

"Overnight, he became really popular with the girls. I couldn't believe it. It was like a metamorphosis. Even the girl I was trying to date, Stacey Cockburn, suddenly wanted to date Herbie Dick. Really, those were the names. I'm not joking."

Angela suppressed a laugh.

"So, suddenly I wanted to be a doctor," Chet continued. "And it worked. Two weeks later, I took Stacey to the Saturday-night dance."

"But was the motivation enough to make you actually study medicine?"

"It was for me. I'd always liked biology so medicine wasn't generally contrary to my interests. And having a real sense of direction at that age was somehow reassuring. And my parents and sisters were wild about me being a doctor, because in a small midwestern town, the doctor is still considered a rather respectable individual."

"Okay," Angela said. "But why forensics?"

"I suppose because I like puzzles and I like to learn new things. For me, that's what forensics is all about. Also, in medical school I sensed I wasn't all that good with patients, especially when they were alive."

Angela smiled and nodded. She could understand to a degree philosophically what he was saying, but not the part about having to do the autopsy itself.

"Okay, it's your turn," Chet said. "Why did you choose business?"

Angela hesitated for a moment, thinking how she cared to answer. Her first inclination was to brush the question off by offering some pat answer, but a combination of Chet's forthrightness, her recent misgivings about her motivations, and even perhaps the wine made her want to be frank. "I guess I should ask you the same question you asked me," she said. "Do you want the stereotypical version or the honest one?"

"The honest one for sure."

"Actually, I never wanted to be a businesswoman, at least not until about five years ago."

"What did you want to be?"

"I wanted to be a doctor."

"No shit?" Chet questioned, as a wry, uncertain smile appeared on his face.

"No shit," Angela echoed. "And I was part of the herd. I was part of the ninety-eight percent you mentioned. I truly wanted to take care of and hopefully cure people. It might sound overly sappy, but I even had it in mind to bring medicine into the inner city like a kind of modern-day Dr. Livingstone."

"How come you didn't do it?"

"I did do it," Angela said. "I went the whole nine yards. I did a residency in internal medicine, got my boards, and opened a practice in Harlem."

Chet sat back and put his fork down. He was momentarily at a loss for words. He'd sensed from the moment he'd begun talking with Angela at the health club that there was something special about her, but he never would have guessed she was a doctor. The shocking news challenged his self-esteem, since being an M.D. and a high-level businesswoman certainly trumped his being only a doctor. But at the same time, the news fanned his interest in Angela.

"Are you surprised?" Angela asked. Chet looked as if a cannon had gone off next to him.

"I'm flabbergasted."

"Why?"

"I don't really know," Chet stammered.

"I'm surprised myself," Angela admitted. "But perhaps my motivations for medicine weren't quite as altruistic as I've always believed."

"Oh?" Chet voiced. He leaned forward. "Why not?"

"Part of the reason I wanted to go to medical school, and I suppose to take care of people, because that's generally what you do after you graduate, was to get back at my father."

"Really?"

"Really!" Angela repeated. In truth of fact, she was as surprised by her statement about her father as Chet was. It wasn't that the idea hadn't vaguely occurred to her in rare moments over the years, but rather because she'd never truly visited the issue.

"Forgive me if I'm being too personal," Chet said, readjusting himself in his seat. "Why would you want to get back at your father? For some reason, I guess I just assumed you experienced an idyllic childhood."

"In all outward appearances, it was," Angela said. She was again surprised at herself. As a private person, she was admitting things she'd admitted only to a few close girlfriends while in college. "And it was important for my father that it appeared that way. But our perfect little family had its secrets." Angela paused, unsure if she wanted to go on. "I hope I'm not boring you. Are you sure you want to hear this?"

"Oh, come on!" Chet complained. "I'm fascinated. And if it is a concern for you, I give you my word that whatever you feel comfortable telling me will go no further."

"I appreciate that," Angela said. She took a sip of wine, thought for a moment, and then said, "Regrettably, my father abused me, not in any sexual sense but rather in an emotional sense. Of course, I had no idea of this as a child. It was only after I'd matured to whatever degree I have. When I was very young, I was the apple of my father's eye. I remember it very well, and I was crazy about him. But with my father's guarded emotions and reliance on appearances, the cost for me, and for my mother, for that matter, was absolute, pet-like allegiance. As long as I was his little automaton darling doll, everything was picture-perfect. The problem was that I was slowly growing up, and the moment I expressed any autonomy by being my own person, he turned away from me and dropped small comments about me abandoning him, which made me feel horribly guilty. For a time, I tried desperately to please him, but invariably I'd disappoint him as my interests turned progressively away from home and more toward my friends and school. My poor mom, who had remained entirely allegiant, perhaps suffered the most, because he seemed to become bored with her and had the stereotypic midlife crisis, complete with affairs and alcohol. Of course, he never took responsibility. He blamed both my mother and myself for his need to act out, claiming no one cared about him. For some reason, which I'll never understand, my poor mom stayed with him until he divorced her for a younger woman."

"I'm sorry for you," Chet said. "It's tragic that people like your father can be their own worst enemies. Obviously, your father should have been proud of your accomplishments, not feel threatened by them. But how did this influence your wanting to go to medical school?"

"My father was a dentist, quite a successful and good one, actually, but he had in one of his rare flashes of honesty admitted he'd wanted to be a doctor but had been unable to get into medical school. To please him, back when I was only ten or eleven I told him I would go to medical school, which wasn't entirely a surprise, since one of my favorite child games was being a nurse or a doctor, which at the time I thought was the same thing."

"You were just being clairvoyant. Year by year, the two fields are coming closer and closer. The major difference now is nurses work harder and doctors are paid more."

Angela smiled but was preoccupied by her own story. She had never before expressed it even to herself quite so succinctly.

"So part of your motivation to go to medical school was to spite your father?" Chet asked.

"I think it was a part. It was like a personally rewarding way to get a kind of revenge. My getting an M.D. challenged him to the extent he skipped my graduation."

"I don't know if I can quite buy this theory in its entirety," Chet remarked.

"Why?"

"The fact that you subsequently did an internal-medicine residency, one of the most demanding, took a lot of commitment."

"I'm still not practicing."

"And why is that?"

"Actually, because my practice literally went bankrupt. I ran up a considerable debt because the Medicaid reimbursement was either slow or nonexistent, and the Medicare too low to cover the shortfall."

"Wow," Chet said. "My life in comparison with yours has been a walk in the park. As a child growing up, my most emotionally draining moment was when some older kids kicked in the face of my Halloween pumpkin. My folks are still together, my father came to every athletic event and graduation I ever had from kindergarten on up."

"With that kind of stable background, how come you're such a Casanova? I hope you don't mind me asking, especially since I don't know it's true. You seemed so at ease when you approached me last night, and your repartee seems so polished."

Chet laughed. "It's all an act. I'm always nervous on the inside and worried about being rejected. Calling me Casanova gives me more credit than I deserve. Casanova was successful; I'm usually not, although once I do go out with a woman a half a dozen times or so, I find myself yearning for the chase. Whether it represents a problem or not, I don't know. It started in medical school, when I had to work as well as go to school. I didn't have time for a real relationship, because a real relationship takes time." Chet shrugged. "So the seeds were planted back then."

"Well, that sounds honest."

"Honest, yes; admirable, probably not. I'd like to say I just haven't met the right woman, but I can't because I usually don't hang around long enough to find out."

"Have you ever had a long-term relationship?"

"Oh, yeah! Practically all the way through college. My girlfriend and I had plans for her to follow me to Chicago where I went to medical school, but at the last minute she ditched me for somebody here in New York."

"I'm sorry."

"All's fair in love and war."

"Maybe that episode affected you more than you give it credit for."

"Maybe," Chet said. Then, to change the subject back to her, he said, "You mentioned you were divorced. Do you want to talk about that?"

Angela hesitated. Normally, she avoided talking about her divorce, not only because she was by nature a private person but because the whole sad affair could still infuriate her even after six years. Yet, since Chet had been so open and she herself had already related even more private matters, she suppressed her usual reticence and said, "At the very end of medical school I was, like a teenage girl, swept off my feet by a man who I thought was the antithesis of my father. Sadly, that was not the case. He too was ultimately threatened by my medical degree. He also had affairs and, worst of all, developed a penchant for hitting me."

"Ouch," Chet said with a wince. "Domestic violence is intolerable and inexcusable. Unfortunately, we see more of it in the morgue than people realize."

The waiter suddenly appeared and whisked away their plates, then asked if they cared for dessert. Chet looked across at Angela.

"I'm not a big dessert person," she confessed.

"Nor I," said Chet. "But a cappuccino would hit the spot."

"I'll finish the wine," Angela said, pointing to the bottle. The waiter happily poured it and took the empty bottle away.

"Okay," Chet said, sitting back in his chair. "Your inner-city practice went bankrupt. When was that?"

"Two thousand one," Angela said. "Hopefully, that year will be my nadir. I mean, it couldn't get much worse. My medical practice went bankrupt and I got divorced, two ugly experiences that I don't recommend for anyone. It's the one year I would not like to live over again."

"I can well imagine. So, how did you make the transition from private medical practice to a company executive? By the way, what is your position, some sort of medical adviser?"

"I'm the founder and the CEO."

Chet's wry smile reappeared, and he shook his head in disbelief. "You are a trip! Founder and CEO!. I'm awestruck. How did that happen?"

"The bankruptcy was a humiliating disaster, but it did have one saving grace. It impressed upon me the detrimental power that economics plays in medicine. I mean, I was somewhat aware before my bankruptcy, but not the extent I was after. Anyway, I had an idea to try to do something about it, but medical school taught me nothing about medical economics. In fact, I knew nothing about economics or business, which medical care has unfortunately become a slave to, so I went back to school and got an MBA at Columbia."

Chet put his head back and slapped a hand to his forehead. "That's enough," he pleaded. "I can't take any more. You're making me feel too blasted inadequate."

"You're kidding, of course?"

"I suppose," he admitted. "But, lady, you have one hell of a CV."

The waiter came and served Chet's cappuccino.

"I have a question for you," Angela said, suddenly realizing she'd been so engrossed in their conversation that she'd not yet touched on the issue that had brought her out to dine.

"Shoot," Chet responded.

"I wanted to ask you about Dr. Laurie Montgomery."

"What would you like to know?"

"Would you characterize her as a persistent, get-the-job-done person, or would you think of her as laid-back?"

"The former for sure. In fact, I'd characterize her as one of the most persistent people I know, both she and her husband. A few of the other MEs think of them as such compulsive workers that they make the rest of us look like slackers."

Angela felt the muscles in her gut tighten. She had hoped and expected Chet would say something to mitigate her worries, not fan them. "I actually met her today. It wasn't under the best of circumstances. We have had an outbreak of postoperative methicillin-resistant staph that has bedeviled us for a month or so and which has required us to go to extraordinary effort to control, even to the point of hiring a full-time epidemiologist and infection-control specialist."

"Laurie mentioned the problem," Chet said. "She also reminded me that I had posted one of your cases."

"Oh, she did?"

"Yes. She came by my office to pick up the case, which I'd done a number of weeks ago, and was still waiting for some lab results. She had just done a similar one this morning. I guess both cases came from one of your hospitals."

"Did she say what she was going to do about it, if anything? I mean, we are already doing everything in our power. I personally have authorized our infection-control person free rein."

"Well, you can relax, because Laurie specifically said she was going to solve your problem if it kills her."

Angela's throat went dry. She took a sip of wine. "Did she use those exact words?"

"Absolutely."

Suddenly Angela wanted the evening to be over. Although she had enjoyed herself more than she would have imagined prior to talking about Laurie Montgomery she now had a problem that could not wait. Without concern of its precipitousness, she put down her glass, folded her napkin, and placed it on the table. She then made a show of looking at her watch.

"How is it I sense our most delightful evening is over?" Chet said, with a touch of melancholy. "I was hoping you'd be willing to walk one block north for a drink at the elegant Saint Regis King Cole Bar."

"Not tonight. Duty calls," Angela said. "Let's get the check, and how about we split it?"

"Oh, no!" Chet said. "This is my treat. I made that clear at the beginning."

"Okay, if you insist, and if you'll pardon me, I have to get back to the office. There's a call I must make." Angela pushed back her chair and stood. Chet did the same. The unexpectedly precipitous end to such an enjoyable evening flummoxed him.

"We'll talk soon," Angela said, extending her hand, which Chet shook.

"I hope so," Chet said.

With a final smile, Angela threaded her way across the room, got her coat from the coat check, and after casting a final glance and wave toward Chet, hurried out of the restaurant.

Chet slowly sat down. His eyes caught those of the waiter, who shrugged in sympathy.