Flashback

CHAPTER EIGHT

Over the more than thirteen years that Zack had spent as a medical student and surgeon, Suzanne represented, without doubt, the most striking recovery from general anesthesia he had ever encountered. He was already in the recovery room, waiting by the nurse's station, when she was wheeled in from the surgical suite. She was awake, smiling, and totally alert. Her jubilant thumbs-up sign to him made clear that she was also well aware of the results of her operation. "That is the most amazing wake-up I've ever seen, " Zack commented to one of the recovery room nurses as Suzanne, with very little help, transferred herself from the litter to her hospital bed. "It's hard to believe she was ever really asleep."

The nurse, an animated young redhead whom Zack knew only as Kara, beamed with pride. "Oh, she was out, all right, " she said. "Isn't it wonderful?

Almost all of Dr. Pearl's cases come out of the operating room looking like that."

"Mine didn't, " Zack said, recalling the prolonged, but quite typical recovery of his cervical disc case. "Pardon?"

"Nothing. I'm just really impressed, that's all."

"Every one around here is, " the woman said. "Part of it may be Dr.

Mainwaring, too. He demands that his patients be anesthetized just so, and Dr. Pearl is the only one he'll allow to work with him. I used to scrub before I got the job in here, and I tell you, they are quite a pair. Things have really taken a turn for the better at this place since they teamed up."

Across the recovery room, Zack saw Jack Pearl peering through an ophthalmoscope, examining the nerves and vessels on Suzanne's retinae while one of the nurses checked her vital signs. He was a slight, sallow man with a pencil-thin moustache and a broad, high forehead that dominated his nondescript eyes. "What do you mean, a turn for the better'? " Zack asked, knowing he was fishing for some opinion on Guy Beaulieu. "I grew up in Sterling and then did an externship here. I always thought we were pretty fortunate with the surgeons we had."

The nurse eyed him warily, suddenly uncertain as to whether she might have said too much to a virtual stranger. Zack tried his best to appear only marginally interested in her response. After a beat or two, she shrugged and brushed a wisp of hair from her brow. "Ormesby's okay," she said, "at least for routine things. But I think it might be time for Dr.

Beaulieu to retire, especially with all the trouble he's been having, and with someone as good as Dr. Mainwaring around."

"Is that the general feeling of the nurses? " Zack ventured. Again, she appraised him. "Dunno, " she said finally, although her eyes told him otherwise. "But they like you. I can tell you that much. And we all like having a neurosurgeon on the staff. It makes Ultramed-Davis seem more-I don't know-special."

"Thanks, Kara. Thanks for telling me that."

The young nurse blushed. "Well, I've got to get back to work, " she said. "See you."

"See you."

Zack watched as the woman returned to her patient. Her opinion of Guy Beaulieu was, he suspected, typical of what he would encounter from most of the other nurses on the staff. Whether justifiably or not, the man's reputation at Ultramed-Davis was shot. And Zack knew that given the nature of medicine, gossip, and the intense microcosm of hospitals, there was probably nothing on God's earth that Beaulieu could do to reverse the situation. Still, despite all the rumors and innuendoes, despite Frank's vehemence and the damning letter from Maureen Banas, Zack could not shake the belief that Guy was the victim of some sort of calculated effort to drive him from practice. The thought was so sad, so pathetic, that it almost defied comprehension. On some level, Zack realized, he was half hoping the charges against Beaulieu would prove true. At least then he could make some sense of it all. Jack Pearl had finished his evaluation of Suzanne and was headed back toward the operating room when he noticed Zack. "Morning, Iverson, " he said.

"Jack." Zack nodded. "How goes it?"

"No. I just stopped by to see how Suzanne was making out. She looks great."

Pearl glanced back at her. "Pretty routine business, " he said. "What did you use?"

For the fraction of a second, the anesthesiologist's expression seemed to tighten. Then, just as quickly, it relaxed. "The usual, " he said. "A little Pentothal, a little gas. Mainwaring likes his patients really light."

"I guess. She doesn't look as if she's even been asleep."

Again, tension flickered across Pearl's face. "Well, she was, " he said simply. He glanced at the clock over the nurse's station. "Got to go, Iverson. You have a good day, now."

"Yeah, Jack. You, too."

As the taciturn little man shuffled away, Zack realized that during this and all their previous encounters, Pearl had not once made direct eye contact with him. The trait was not that surprising, he acknowledged, given the nature of the breed. Although the exceptions were far too numerous for any generalization, many of the anesthesiologists he had known were introspective loners, skilled more in biochemistry and physiology than in the more subjective arts of clinical medicine, and committed to one of the specialties where conversation and interaction with patients-awake patients at least-was at a minimum. Still, there was something unusual about Jack Pearl, something furtive and arcane, that Zack found both curious and disconcerting. He wondered if perhaps the man had a past-trouble somewhere along the line-and he made a mental note to ask Frank about him sometime. Then he turned and headed to Suzanne's bedside. Though a bit pale, she was still smiling, radiant and wide awake.

"Hi, lady, " he said. "What's new?"

"Oh, nothing." She feigned a yawn. "A little this, a little that. You know. Just another routine, humdrum day."

"Yeah, my day, too."

"That's quite obvious from those dark circles around your eyes," she said. "Hey, before I forget to mention it, thanks for your note. It meant a lot."

"You look fine. Are you in any pain?"

"Not really. At least not compared to what I would have been in if that biopsy had been positive."

"It does seem a bit easier to deal with this way, " Zack said. "I thought I'd have the chance to break the good news to you, or at least to remind you of it, but you came out of the O. R. as if you'd never been asleep. It's absolutely incredible how light you are so soon after general anesthesia."

"I know. Jason said I would be. It's wonderful. I had my appendix out when I was seventeen, and I remember being totally out of it for a day.

Jack Pearl said that if it was okay with Jason, I could go home this afternoon."

"That's great."

"Zack, God bless every woman who has to go through this madness. I know we're supposed to believe that there's some sort of grand, cosmic scheme operating in life, but cancer-especially breast cancer-just doesn't lend itself very easily to any philosophizing. I tell you, I'm so relieved, all I want to do is cry."

"Well, go ahead and do it. In fact, I'm pretty relieved myself, so if you're free tomorrow night, I could come over with a bottle of wine and a box of Kleenex."

Her eyes darkened. "Zack, I…"

"Go ahead, " he said. "I really owe you for staying with me the way you did last night…"

"There's a but' coming. I can feel it."

"Zack, Wednesday night was wonderful, " she whispered. "I really mean that. But it's just not like me to start things in the middle that way.

Do you understand?"

"I guess so."

"For weeks I've been so consumed with my damn lump, then suddenly you show up in my life and… Zack, I just need some time and a little space to sort some things out. You said the other night that you had no expectations. I hope you meant it."

Zack swallowed hard. "I hope so, too, " he said. She smiled thinly and squeezed his hand. "Thanks at least for trying. Listen, I have the next week off. I owe Jen some quality time with her mother and my partner a few days of help in the gallery. I'll call you toward the middle of the week, okay?"

"Middle meaning like Tuesday?"

"Zack, please."

"Okay, sorry, sorry. Middle of the week is fine. Can I at least drive you home later?"

"I'll be fine. Besides, I don't even know if I'll be going home later.

Zack, there'll be time. If it's supposed to be, there'll be plenty of time."

There was a sadness in her eyes that helped keep him from pushing matters any further. "Sure thing, " he said. "Hey, for what it's worth, I just ran into your replacement in Annie's room."

Suzanne smiled broadly, obviously relieved at the change in subject.

"Don Norman? Is he overwhelmed yet?"

"Hardly. Norman doesn't seem like the type to be overwhelmed very easily-at least not as long as there are guidelines and policies for him to follow. And Ultramed seems to have provided all the guidelines and policies he could ever want, so not to worry."

"I won't, " she said. "And I agree totally. The man is conscientious as hell, but he is a little medical robot. Julia Childs with a stethoscope-strictly cookbook. Annie okay?"

Zack nodded. "When I stopped by, she was fighting with Norman about her sodium restriction, so I guess that's about as good a sign as any. Oh, get this, right in the middle of their little altercation he puffs himself up like he loves to do-you know, like this-and he says, "Mrs.

Doucette, pull-eese. Whether you know it or not, I am the Chief of Staff at this hospital. I certainly know what is best for my patients."

"Good imitation. Excellent. And what did Annie say?"

"Nothing too inflammatory. She just eyed him with this great Annie look, called him Tubby, and suggested that he should lose weight so that he would be a better example for his patients."

"Oh, no."

"It was great. Norman turned ten shades of red, and looked for a moment as if he might haul off and pop her in the nose. Having been brought up by the woman, I can say that it's lucky for him he didn't. Even after cardiac arrest, my money would have been on Annie. Well, listen, I've got to go play doctor. If you change your mind about that ride home, give me a page."

"Sure."

"You know, I still can't get over it."

"What? " she asked. "How light you are. The nurse I was talking to said all of Mainwaring's patients come out of the O. R. like that. I've got to ask him his secret."

"No secret, Doctor. Just good technique."

Jason Mainwaring, sans mask and haircover, appraised them from the foot of the bed. "Well, " Zack said casually, trying not to appear as startled by the intrusion as he was, "whatever it is, it's impressive.

I'd like to scrub with you sometime to learn firsthand how it's done."

"My goodness, " Mainwaring mused, "a neurosurgeon who doesn't know everything. What will the gods send us next?"

"Now just a minute, " Zack countered, again feeling his hackles stiffen at the man's superciliousness. "I don't know if you're like this with everyone, or just with me, but I-"

"Hey, fellas, " Suzanne cut in, "remember me? The patient?"

Mainwaring smiled down at her as if Zack were no longer there. "Is everything still all right, my friend? " he asked. "Perfect, Jason. I can't tell you how pleased I am."

"That's fine. Just fine, " he drawled. Zack, arms folded tightly, stood back from the bed a step, wondering if he should say good-bye or simply leave. It was obvious that Jason Mainwaring, for all of his glistening reputation and surgical skills, was too threatened by him to let up even for a moment. Unless he could find some way of reassuring the man that they were playing for the same team-and his experience with similar egos told him that possibility was highly unlikely-the two of them seemed destined to be enemies. Well, so be it, Zack thought. It would only make things that much easier if, in fact, Mainwaring did prove in any way responsible for Guy's difficulties. "Can I go home this afternoon? " Suzanne asked. Mainwaring smiled, walked to the bedside opposite Zack and took her hand. "If there's no major bleeding from that incision, " he said, "and you still feel the way you do right now, I don't see why not. Listen, I've got an emergency exploratory in just a few minutes, and a gall bladder at two. Why don't I stop by after that-say, four-thirty? Then, I'll not only discharge you, but I'll even drive you home. Your place isn't very far out of my way."

Suzanne's eyes flicked toward Zack. "Oh, Jason, I wouldn't think of-"

"No, no. It's settled."

Don't you think driving your post-op patients home is carrying bedside manner a bit too far, Doctor?

Zack barely kept the snide rebuke in check. He was already irritated with the man and his ways, and now he realized he was jealous of him as well. Suzanne had made no secret that she and her surgeon had a friendship that, at times, went beyond the hospital. But she had also been careful to add that Mainwaring had a wife and children living somewhere in the South, who were, for whatever reason, as yet unable to follow him to New England. There was, Zack reminded himself angrily, never a valid excuse for jealousy. Nevertheless, jealous he was. His reaction also reminded him that it was far more pleasant being threatening than feeling threatened. "Well, " he said, clearing his throat, but still unable to fully expunge the hurt from his voice, "you two seem to have everything pretty much under control, so I'll just get along. See you later, Suze. Nice job, Mainwaring."

Before either of them could respond, a nurse whom Zack recognized as one of the emergency crew rushed across the recovery room to Mainwaring.

"Doctor, " she said breathlessly, "there's some trouble in the emergency ward. It's Dr. Beaulieu. He's-" She glanced at Zack and Suzanne, and stopped in mid-sentence, obviously unsure of how much more to say."… um… Mr. Iverson would like you to come down right away if you can."

"Of course, Sandy, " Mainwaring responded with urbane calm. "Tell Mr.

Iverson I'll be right along."

"Thank you, Doctor. Hi, Dr. Iverson. Hi, Suzanne. Are you okay?"

"I'm fine, Sandy, thanks, " Suzanne said. "Everything's all right."

"That's wonderful. I'll tell everyone downstairs the good news." She hurried off. "So, " said Mainwaring, "I'll see y'all at four-thirty, yes?"

He gave Suzanne's hand a final squeeze and then strode out of the recovery room. "Are you going down there? " she asked Zack. "Uh-huh."

"Let me know what's going on, okay?"

"Sure." He made no move to touch her. "Zack? " she said softly. "What?"

"I'm sorry I didn't handle that situation better. Jason comes on a little strong sometimes. He caught me off balance. He's really a decent guy. Just don't let him get to you, okay?"

"Sure."

"Talk to you later in the week?"

"Right."

He turned to go. "I hope the trouble with Guy is nothing big, " she called. "You and me, both, " he muttered. But as he headed for the emergency ward, feeling not a little deflated, Zack could not shake an ugly sense of foreboding. Nothing that Zack had imagined about what was transpiring in the emergency ward prepared him for the reality. There was commotion bordering on chaos. The hospital's threeman security force was there, as were the director of nursing, Mainwaring, Chief of Staff Donald Norman, and half a dozen embarrassed patients and their families.

The epicenter of the turmoil was behind the closed door of the family quiet room, where brief periods of strained silence separated angry, easily audible outbursts in English and in French from Guy Beaulieu.

"Damn you, Frank, get out of my way before I strike you, " were the first words Zack heard. "That woman is my patient, and I have every right to care for her. Now, out of my way!"

"Guy, sit down and quiet down, or I swear I'll have the guards come in here and tie you down. I will not have you making a scene like this in my hospital."

"Your hospital! If it's your hospital, Mr. High and Mighty, then why don't you see that this is all a plot to take my practice away?

You're in on it, aren't you? That's why. You're one of them!"

"Dammit, Guy, shut up. There are patients out there."

"I know there are. My patients! Now let me pass!"

Zack crossed to where Jason Mainwaring stood, leaning against a wall near the quiet room. "What gives? " he asked. Mainwaring glanced over at him and then looked back toward the source of the commotion. "The old quack has gone beserk, that's what, " he said coolly. "He's been unbalanced for some time, but at least he's had the presence and intelligence to limit his outbursts and paranoia to the staff meetings.

This is disgraceful."

"Do you know what happened?"

Mainwaring's response was preempted by yet another outburst from Beaulieu, followed by still another, though more constrained, response from Frank. Moments later, the door to the quiet room opened and Frank slipped out. He appeared a bit more ruffled than usual, but was still impeccably dressed, with not a hair out of place. "Stay with him, Henry,

" he said to one of the security guards-a broad, reckless man with bad skin and close-cut hair, who looked to Zack like a mammoth fireplug. "If he starts yelling again, cuff him to the chair and shove a rag in his mouth."

"Mr. Iverson, I don't hurt people unless they hurt me. I told them that when I started working here."

"Look, Henry, if you want to keep on working here, you'll do as I say and keep that nutcase quiet until Chief Clifford and his men get here.

Now get in there and do your job."

Shaking his massive head, the guard entered the quiet room and closed the door behind him. There were no shouts of protest from Beaulieu.

Frank scanned the cubicles filled with patients. "Christ, " he muttered.

Spotting Zack and Mainwaring, he approached them, shaking his head.

"This is fucking insane, " he said, keeping his voice low. "And you know what? It's my fault. I should have done something about him way back when his craziness started. Well, Zack-o, if there's one good thing to come out of all this, it's that at least you get to see him in action firsthand."

"Exactly what's going on? " Zack asked. "What tipped him over?"

Frank laughed sardonically. "I keep telling you, brother, Guy Beaulieu tipped over a long time ago. This is just an example of how far. See that woman over there in bed five? Well, she's got some sort of bowel problem."

"Probably a ruptured diverticulum, " Mainwaring interjected. "Well,"

Frank went on, "Beaulieu's done some surgery on her in the past. On her husband, too, I think. This time, though, the woman and her internist apparently talked things over and decided that she might be better off with Jason, here, doing the surgery."

"I evaluated her right before I did Suzanne, " Mainwaring explained,

"and had her scheduled to follow in the O. R."

"Meanwhile, Beaulieu, the lunatic, comes strolling through the emergency ward, spots the woman, and without a word to anyone, begins examining her and issuing orders to the nurses. Needless to say, the poor lady, who's not too swift to begin with, was totally confused and absolutely terrified." Frank looked impatiently toward the ambulance bay. "Where in the hell are the goddamn cops? When you don't want them they're all over the place."

"Frank, you don't need the police, " Zack said. "Let me talk to him.

Can't you see where this might be upsetting and humiliating for him?

I'll just get him out of the hospital and he'll calm down."

"He's out of the hospital anyway, " Frank said acidly. "For good."

"What?"

"This was the last fucking straw. I told him about the latest series of complaints, and about that letter from Maureen Banas. And I suspended his privileges."

Zack's heart sank. "Frank, is that when he went nuts?"

"What difference does it make? " Frank said. "Nuts is nuts. Just listen to him."

From within the quiet room, Beaulieu had again begun to shout. "You ape, let go of me! Take your hands off me, goddamn it!

Take your hands-" Suddenly, the surgeon's words were cut short. Without waiting for Frank's permission, Zack bounded across to the quiet room and threw open the door. The guard, Henry, had balled a red bandanna in his fist, preparing to use it as a gag. Beaulieu was sitting, handcuffed to the arm of his chair. He was staring in wide-eyed terror, not at his tormentor, but at a vacant spot on one wall. The right side of his face was starting to droop. "Oh, Jesus, " Zack said as he knelt by the man.

"Guy, can you talk?"

Beaulieu turned to him slowly. His eyes were glassy and filled with tears. "Head… hurts, " he moaned. His speech was thick and slurred.

His tongue seemed bunched at the corner of his mouth. "Did you hit him?

" Zack demanded of the guard. "Not even a tap. I swear I didn't."

"Undo these, " Zack snapped, jiggling the handcuffs. The man hesitated.

"Dammit, do as I say!"

"Do it, Henry, " Frank said from the doorway. "What's happening, Zack?"

Zack turned slowly and looked up at his brother. "He's having a stroke, Frank, " he said hoarsely. "That's what. A cerebral hemorrhage, I would guess. I need a litter, a nurse, and an IV setup. And I want the CT scanner warmed up." He turned to the guard. "Tell me again, did you touch this man's head? " His voice was ice, his eyes fire. "I didn't touch nothin' except his wrists, " the man said defensively. "I swear, I don't hurt people unless they hurt me."

"Undo these. Quickly now!"

The guard did as he was told, and instantly, as if made of rags, Guy Beaulieu's right arm flopped off the chair and dangled down. Zack lowered him to the floor and cradled his head in his lap. "I need that litter, please, " he said, barely able to contain his anguish. He bent close to Beaulieu. "Easy does it, old friend, " he whispered. "Easy does it."

Beaulieu's eyes opened, and Zack noted with horror and despair that the pupil of the right one had already begun to dilate. "Okay, Guy, " he whispered, stroking the older man's forehead and cheek, "the litter will be here in a second. Just hang on. You're going to be okay."

Suddenly, for a few frozen seconds, Beaulieu's eyes stopped their random drifting and focused on Zack's face. "No… I'm… not, " he said, forming each word with the most excruciating effort. "God… help… me… I'm… not."

Slowly, his eyes closed. "Damn you, " Zack hissed, looking first at the guard and then at Frank, Mainwaring, and Don Norman, who were clustered in the doorway. "God damn you all."