Godplayer

Eight

In the morning Cassi was up and dressed before she heard the alarm go off in the study. It kept ringing and ringing. Concerned, she ran down the hall and opened the door. Thomas was sprawled in his chair exactly as she had left him the night before.

“Thomas,” she said, shaking him.

“Wha-what?” he whispered.

“It’s quarter to six. Don’t you have surgery this morning?”

“I thought we were going to Ballantine’s party,” he muttered.

“Thomas, that was last night. Oh God, maybe you should call in sick. You never take a day off. Let me call Doris and see if she can postpone your operations.”

Thomas struggled to his feet. He swayed and steadied himself against the arm of the chair.

“No, I’m fine.” His voice was still slightly slurred. “And with the cutback on my OR time, I won’t be able to reschedule for weeks. Some of the patients this month have already waited too long.”

“Then let someone else…” Thomas raised his hand so quickly Cassi thought he was going to hit her, but instead he lunged into the bathroom, slamming the door. A few moments later she heard him turn on the shower. When he came downstairs he seemed in better shape. Probably because he had taken a couple of Dexedrines, thought Cassi.

He quickly drank juice and a cup of coffee and then headed for the garage.

“Even if I can get home tonight, I’ll be very late, so you better take your own car,” he said over his shoulder.

Cassi remained sitting at the kitchen table for a long time before she, too, began the long trip to the hospital. “For the first time,” she thought, “it’s not just Thomas I’m worried about. It’s his patients. I don’t know if it’s safe for him to operate anymore.”

By the time she reached Boston Memorial, Cassi had made up her mind to do three things the minute she was finished with team meeting. She would make an appointment to have her eye surgery, arrange to take the necessary time off, and she would see Dr. Ballantine and confide her fears about Thomas. After all, the problem affected the hospital as well as her marriage.

Joan noted Cassi’s preoccupation, but before she had a chance to ask any questions, at the end of the meeting Cassi said something about seeing her ophthalmologist and hurried off the floor.

Dr. Obermeyer interrupted his schedule the moment he heard Cassi had appeared. He came out of his inner office with his minerlike light still strapped to the top of his head.

“I trust you’ve come to the right decision?” he said.

Cassi nodded. “I’d like to be scheduled as soon as possible. In fact, the sooner the better before I have a chance to change my mind.”

“I was hoping you’d say that,” said Dr. Obermeyer. “In fact, I took the liberty of scheduling you as a semi-emergency for the day after tomorrow. Is that all right with you?”

Cassi’s mouth went dry, but she nodded obediently.

“Perfect,” said Dr. Obermeyer with a smile. “Don’t you worry about a thing. We’ll take care of all the arrangements. You’ll be admitted to the hospital tomorrow.” Dr. Obermeyer buzzed for a secretary.

“How long will I be unable to work?” said Cassi softly. “I will have to say something to the chief of psychiatry.”

“That depends on what we find, but I’d guess a week to ten days.”

“That long?” said Cassi. She wondered what would happen to her patients.

Walking slowly back from the Professional Building, Cassi decided to phone Dr. Ballantine before her courage failed her. He answered the phone himself and assured her he had no surgery and could see her in half an hour.

After arranging to take sick leave, Cassi decided to kill the rest of the time before her interview with Ballantine by visiting pathology. She could tell Robert about her surgery, and just seeing him always gave her confidence. But when she reached his office, it was empty. One of the technicians told her that Robert was not due in at all. He was being admitted early that afternoon for oral surgery, and he’d decided to go out to eat what would probably be his last real meal for a week.

Cassi was back out at the elevator when she remembered Jeoffry Washington. Turning back into the lab, she asked the technician for the slides. The woman located Jeoffry Washington’s tray without difficulty but explained that only half the slides were finished. She said it took at least two days to do a case and suggested that Cassi come back the next day for the full set. Cassi said she understood, but was interested only in the H amp; E mounts of the vein, which were probably ready.

The slides Cassi wanted were available and, in fact, were the first slides she saw when she opened the tray. There were six in all, labeled LEFT BASILIC VEIN, H amp; E STAIN, followed by Jeoffry Washington’s autopsy number.

Cassi sat down at Robert’s microscope and, adjusting the eyepieces, focused on the first of the slides. There was a small collapsed ringed structure inside a smudge of pink tissue. Even under low power Cassi saw something strange. Looking closer, she identified multiple small white precipitates ringing the interior of the vein. Cassi then examined the walls of the vein. They looked completely normal. There was no infiltrate of inflammatory cells. Cassi wondered if the small white flakes had been introduced in the mounting process. There was no way to tell. She checked the rest of the slides and found the same precipitate in all but one.

Taking them back to the lab, Cassi showed them to the technician, who was also perplexed. Cassi decided to tell Robert the moment she found out his room number. Glancing at her watch, she realized it was time to see Ballantine.

He was having a sandwich at his desk and asked Cassi if his secretary could bring her something from the cafeteria. She shook her head. Given what she had to say, she wasn’t sure if she would ever want to eat again.

She began by apologizing for the scene Thomas had caused, but Dr. Ballantine cut her off and assured her that the party had been a great success and he doubted if anyone even remembered the incident. Cassi wished she could believe that; unfortunately she knew it was just the kind of scandalous scene that stayed in peoples’ minds.

“I’ve talked with Thomas several times this morning,” said Dr. Ballantine. “I happened to see him before surgery.”

“How did he seem?” asked Cassi. In her mind’s eye she could see Thomas unconscious in the leather armchair, then stumbling into the bathroom.

“Perfectly fine. Seemed to be in a good mood. I was pleased that everything was back to normal.”

To her dismay Cassi’s eyes filled with tears. She’d promised herself it wouldn’t happen.

“Now, now,” said Dr. Ballantine. “Everyone occasionally blows up under stress. Don’t place too much importance on last night’s incident. The way he’s been working, it’s entirely understandable. Maybe not excusable, but understandable. The house staff have even commented that he’s spending an unusual number of nights in the hospital. Tell me, my dear, has Thomas been acting normally at home?”

“No,” said Cassi, dropping her line of sight to her hands that lay immobile in her lap. Once she started talking, the words came out easily. She told Dr. Ballantine Thomas’s reaction to her proposed operation and confessed that their relationship had been strained for some time, but she didn’t think the cause was really her illness. Thomas had known she had diabetes before they were married, and, except for the eye problem, her condition had not changed. She didn’t think her medical complications explained Thomas’s anger.

She paused, beginning to perspire with anxiety.

“I think the real problem is that Thomas has been taking too many pills. I mean lots of people take an occasional Dexedrine or sleeping pill, but Thomas may be overdoing it.” She paused again, looking up at Ballantine.

“I have heard one or two things,” mused Ballantine. “One of the residents commented on a tremor. He didn’t realize I was behind him in the hall. What exactly has Thomas been taking?”

“Dexedrine to keep awake and Percodan or Talwin to calm down.”

Dr. Ballantine strode over to the window and stared into the surgical lounge directly opposite. Turning back to Cassi, he cleared his throat. His voice had not lost any of its warmth.

“The availability of drugs can be a severe temptation for a doctor, particularly if he is as severely overworked as Thomas.” Ballantine moved back to his desk and eased into his chair.

“But availability is only part of the story. Many physicians also have a sense of entitlement. They take care of people all day and feel they deserve a little aid themselves if they need it. Drugs or alcohol. It’s an all-too-common story. And since they have been trained to be self-sufficient, instead of talking to another doctor, they medicate themselves.”

Cassi was enormously relieved that Dr. Ballantine absorbed the news about Thomas with such composure. For the first time in days she felt optimistic.

“I think the most important thing is that we keep this to ourselves,” said Dr. Ballantine. “Gossip could be detrimental to both your husband and the hospital. What I will do is have a diplomatic talk with Thomas and see if we can’t take care of the problem before it gets out of hand. Having seen this kind of thing before, I can assure you, Cassi, that Thomas’s difficulties are minor. He has been carrying his usual surgical load.”

“You’re not worried about his patients?” asked Cassi. “I mean, have you seen him operate recently?”

“No,” admitted Dr. Ballantine. “But I would be the first to hear if something were amiss.”

Cassi wondered.

“I’ve known Thomas for seventeen years,” Ballantine said reassuringly. “I’d know if there was something seriously wrong.”

“How will you bring up the subject?” asked Cassi.

Dr. Ballantine shrugged. “I’ll play it by ear.”

“You won’t mention that I spoke with you, will you?” asked Cassi.

“Absolutely not,” said Dr. Ballantine.

Carrying a handful of irises that she’d purchased in the hospital flower shop, Cassi walked down the eighteenth floor corridor to room 1847. The door was open about halfway. She rapped and peeked in. A figure was lying in the single bed holding a sheet up to his eyes. He was shaking in apparent terror.

“Robert!” laughed Cassi. “What on earth…”

Robert bounced out of the bed dressed in his own pajamas and robe. “I happened to see you coming,” he said. Eyeing the flowers, he asked, “Are those for me?”

Cassi surrendered the small bouquet. Robert took the time to arrange them carefully in his water pitcher before placing them on the nightstand.

Glancing around the room, Cassi could see she wasn’t the first. There were a dozen bouquets blooming on every surface.

“Kinda looks like a funeral,” said Robert.

“I don’t want to hear that kind of humor,” said Cassi, giving him a hug. “There is no such thing as too many flowers. It means you have a lot of friends.” She settled down on the foot of the bed.

“I’ve never been a patient in a hospital,” said Robert, pulling up a chair as if he were the visitor. “I don’t like it. I feel so vulnerable.”

“You get used to it,” said Cassi. “Believe me, I’m a pro.”

“The real problem is that I know too much,” said Robert. “I can tell you, I’m terrified. I’ve convinced the anesthesiologist to double up on my sleep meds. Otherwise I know I’ll be up all night.”

“In a couple of days you’ll wonder why you were nervous.”

“It’s easy for you to say, dressed in street clothes.” Robert held up his wrist with its plastic name tag. “I’ve become a statistic.”

“Maybe it will make you feel better to know that your courage has prodded me into action. I’m being admitted tomorrow.”

Robert’s expression changed to one of compassion. “Now I feel foolish. Here I am worried sick over a couple of teeth while you face eye surgery.”

“Anesthesia is anesthesia,” said Cassi.

“I think you are doing the right thing,” said Robert. “And I have a feeling that your operation is going to be a hundred percent successful.”

“What about your own chances,” teased Cassi.

“Um… fifty-fifty,” said Robert, laughing. “Hey, I got something to show you.”

Robert stood up and went over to the nightstand. Picking up a folder, he joined Cassi on the edge of the bed. “With the help of the computer, I collated the data we have on the SSD cases. I found some interesting things. First of all, as you suggested, all of the patients were on IVs. In addition, over the past two years, the cases increasingly involved patients who were in stable physical condition. In other words, the deaths have become more unexpected.”

“Oh God,” said Cassi. “What else?”

“I played around for a while with the data, punching in all the parameters for our study except surgery. The computer spat out some other cases, including a patient by the name of Sam Stevens. He died unexpectedly during cardiac catheterization. He was retarded but in excellent physical condition.”

“Was he on IV?” asked Cassi.

“Yup,” said Robert.

They stared at each other for several minutes.

“Finally,” said Robert, “the computer indicated that there was a preponderance of males. Curiously enough, where the information was available, the computer pointed out an unusually high number of homosexuals!”

Cassi looked up from the papers to Robert’s friendly gaze. Homosexuality had never been mentioned between them, and Cassi felt a reluctance to discuss it.

“I went to pathology to visit you this morning,” she said, changing the subject. “I missed you, but I did find some of Jeoffry Washington’s slides. When I looked at the sections taken from the IV site, I found white precipitate along the inside of the vein. At first I thought it was artifact, but they were present on all but one of the sections. Do you think they might be significant?”

Robert pursed his lips. “No,” he said finally. “Doesn’t ring any bells. The only thing I can think of is that when calcium is inadvertently added to a bicarbonate solution, it causes a precipitation, but that would be in the IV bottle, not the vein. I suppose the precipitation could run into the vein, but it would be so apparent in the bottle that everyone would see it. Maybe I’ll have an idea when I look at the section. Meanwhile, enough of this morbid stuff. Tell me about the party last night. What did you wear?”

Cassi glossed over the evening. There was a chance Robert would hear what had happened on the hospital grapevine, but she didn’t want to bring it up. In many ways Cassi was surprised Robert hadn’t noticed her reddened eyes. He was usually so observant. She decided he was understandably preoccupied with his admission to the hospital. Promising to visit the next day, Cassi left before she was tempted to burden him with her own troubles.

Larry Owen felt like a piano wire drawn out to its limit, ready to snap at the slightest increase in tension. Thomas Kingsley had arrived late that morning and was furious that Larry had waited for him to physically appear before beginning to open the first patient’s chest. Even though Larry completed the procedure with record speed, Thomas’s foul mood had not changed. Nothing pleased the surgeon. Not only had Larry done a piss-poor job, but the scrub nurses weren’t handing him the instruments properly; the residents weren’t giving him adequate exposure, and the anesthesiologist was an incompetent son of a bitch. As chance would have it, Thomas was given a faulty needle holder, which he’d thrown against the wall with such force it had snapped in two.

Yet Larry had weathered this kind of abuse before. What was making him crazy was Thomas’s operative performance. It had been obvious from the moment he began work on his first patient that the surgeon was exhausted. His usually flawless coordination was off and his judgment faulty. And worst of all, Thomas had an uncontrollable tremor. It almost gave Larry heart failure to watch Thomas bend over the heart with a razor-sharp needle and try to direct the instrument to the dainty piece of saphenous vein he was attempting to sew to the minute coronary vessel.

Vainly Larry had hoped the tremor would lessen as the morning progressed. Instead it got worse.

“Would you like me to sew this one on?” asked Larry on several occasions. “I think I can see a bit better from my position.”

“If I want your help, I’ll ask for it,” was Thomas’s only reply.

Somehow they got through the first two cases with the bypasses sewn reasonably in place and the patients off the heart-lung machine. But Larry was not looking forward to the third case, a thirty-eight-year-old married man with two little children. Larry had opened the patient’s chest and was waiting for Kingsley to return from the lounge. The resident’s pulse was racing, and he had begun sweating heavily. When Thomas finally burst through the OR door, Larry felt his stomach knot with fear.

At first, things went reasonably well, although Thomas’s shaking was no better and his frustration level seemed even lower. But the open-heart team, wary after the first two cases, was careful not to cross him in any way. The hardest job fell to Larry, who tried to anticipate Kingsley’s erratic movements and do as much of the actual work as Thomas would allow him. The real trouble didn’t begin until they’d started sewing the bypasses in place. Larry couldn’t watch and turned his head away as Thomas’s needle holder approached the heart.

“Goddammit,” shouted Thomas.

Larry felt his stomach churn as he saw Thomas yank his hand from the operative site, the needle buried in his own index finger. Inadvertently Thomas also pulled out one of the large catheters that took blood from the patient to the heart-lung machine. As if a faucet had been turned on, the wound filled with blood and in seconds began soaking the sterile drapes and dripping onto the floor.

Desperately Larry plunged his hand into the wound and groped blindly for the clamp holding the suture around the vena cava. Luckily his hand hit it immediately. Deftly he pulled up on the tape and the blood loss slowed.

“If I had decent exposure this kind of problem wouldn’t happen,” raged Thomas, pulling the needle out of his finger and dropping it on the floor. He stepped back from the table nursing his injured hand.

Larry managed to suck out the blood from the wound. As he reinserted the catheter from the heart-lung machine, he tried to think what he should do. Thomas wasn’t fit to operate anymore that day, yet to say anything risked professional suicide. In the end Larry decided that he could no longer stand the tension. When he’d secured the operative site, he stepped away from the table and joined Thomas, who was being regloved by Miss Goldberg.

“Excuse me, Dr. Kingsley,” said Larry with as much authority as he could muster. “This has been a trying day for you. I’m sorry we haven’t been more on the ball. The fact of the matter is that you are exhausted. I’ll take over from here. You needn’t reglove.”

For a moment Larry thought Thomas was going to slug him, but he forced himself to continue. “You’ve done thousands of these operations, Dr. Kingsley. No one is going to fault you for being too tired to finish one of them.”

Thomas began to shake. Then, to Larry’s astonishment and relief, he snapped off his gloves and left.

Larry sighed and exchanged glances with Miss Goldberg.

“I’ll be right back,” said Larry to the team. With his gloves and gown still on, Larry left the OR. He hoped that one of the other staff cardiac surgeons would be available and was relieved when he saw Dr. George Sherman coming out of OR No. 6. Larry took him aside and quietly related what had happened.

“Let’s go,” said George. “And I don’t want to hear a word about this outside of the OR, understand? It could happen to any one of us, and if the public learned about the incident it would be disastrous, not just for Dr. Kingsley, but for the hospital.”

“I know,” said Larry.

Thomas was angrier than he had ever been. How dare Larry suggest he was too tired to proceed? The scene had been a nightmare. It was the haunting fear of such disaster that had originally forced him to take an occasional pill to sleep. He’d been perfectly capable of finishing the operation, and if he hadn’t been so upset over Cassi’s infidelity, he certainly would not have left. Furiously he stomped into the surgical lounge and used the phone by the coffee machine. He called Doris to make sure there were no emergencies and asked her to reschedule his afternoon patients for another day. He was already late, and he didn’t think he could stand to see patients. Doris was about to hang up when she remembered that Ballantine had called, asking if Thomas would stop by his office.

“What did he want?” asked Thomas.

“He didn’t say,” said Doris. “I asked him what it was in reference to, in case you’d need a patient folder. But he said he’d just like to see you.”

Thomas told the nurse at the main desk that he’d be in Dr. Ballantine’s office in case there was a call. To steady himself and relieve his headache, which had gotten steadily worse, he took another Percodan from his locker. Then he donned a white lab coat and left the lounge wondering what the meeting could be about. He did not think the chief would call him in to discuss the scene at the party with George Sherman, and it certainly couldn’t have anything to do with the episode with Larry Owen. It must have something to do with the department in general. He remembered the trustee’s odd comment the night before and decided Ballantine was finally going to let Thomas in on his plans. There was always the chance that Ballantine was thinking about retiring and wanted to discuss turning over the department to Thomas.

“Thanks for coming in to see me,” said Dr. Ballantine, as soon as Thomas was seated in his office. He seemed somewhat ill at ease, and Thomas shifted in his chair.

“Thomas,” Ballantine finally began. “I think we should speak frankly. I assure you that whatever we say will not leave this room.”

Thomas rested an ankle on his knee, steadying it with his hands while his foot began to pump rhythmically.

“It’s been brought to my attention that you might be abusing drugs.”

Thomas’s foot stopped its nervous movement. The low-grade headache became a pounding agony. Although anger flooded his consciousness, his expression stayed the same.

“I want you to know,” said Dr. Ballantine, “that this is not an uncommon problem.”

“What kind of drugs am I supposed to be taking?” asked Thomas, making a supreme effort to rein in his emotions.

“Dexedrine, Percodan, and Talwin,” said Dr. Ballantine. “Not uncommon choices.”

With narrowed eyes, Thomas studied Dr. Ballantine’s face. He hated the older man’s patronizing expression. The irony of being judged by this inept buffoon drove Thomas to the brink of frenzy. It was lucky that the Percodan he’d taken in the lounge was beginning to work.

“I’d like to know who brought this ridiculous lie to your attention,” he managed to ask quietly.

“That is not important. What matters…”

“It’s important to me,” said Thomas. “When someone starts this kind of vicious rumor, they should be held accountable. Let me guess: George Sherman.”

“Absolutely not,” said Dr. Ballantine. “Which reminds me. I spoke to George about the regrettable incident last night. He was mystified by your accusation.”

“I’ll bet,” snapped Thomas. “It’s common knowledge that George tried unsuccessfully to marry Cassi before I met her. Then I gave them the opportunity by working so many nights…”

Dr. Ballantine interrupted. “That doesn’t sound like much solid evidence, Thomas. Don’t you think that you might be overreacting?”

“Absolutely not,” said Thomas, uncrossing his legs and letting his foot down with a bang. “You saw them together yourself at your party.”

“All I saw was a very beautiful girl who seemed only interested in her husband. You’re a lucky man, Thomas. I hope you know that. Cassi is a special person.”

Thomas was tempted to stand up and leave, but Ballantine was still talking.

“I believe that you have been driving yourself too hard, Thomas. You’re trying to do too much. My God, man, what are you trying to prove? I can’t even remember the last time you took a day off.”

Thomas started to interrupt, but Dr. Ballantine cut him off.

“Everyone needs to get away. Besides, you have some responsibility to your wife. I happen to know Cassi needs eye surgery. Shouldn’t she be getting some of your time?”

Thomas was now reasonably certain that Ballantine had talked with Cassi. As incredible as it sounded, she must have come to him with her wild stories about drug addiction. It wasn’t enough, thought Thomas with anger, that she went to his mother. She also had to see his chief of service. Thomas suddenly realized that Cassi could destroy him. She could ruin the career that he’d spent his whole life constructing.

Luckily for Thomas, his sense of preservation was stronger than his anger. He forced himself to think with cold, hard logic as Ballantine finished.

“I’d like to suggest that you take some well-earned vacation.”

Thomas knew that the chief would love to have him out of the hospital while the teaching staff whittled away at his OR time, but he managed to smile.

“Look, this whole thing has gotten out of hand,” Thomas said calmly. “Maybe I have been working too hard, but that’s because there has been so much to do. As far as Cassandra’s eye problem is concerned, of course I’m planning to spend time with her when she’s laid up. But it really is up to Obermeyer to tell her how best to handle her retinal problems.”

Ballantine started to speak, but Thomas interrupted him.

“I listened to you, now hear me,” said Thomas. “About this idea that I’m abusing drugs. You know that I don’t drink coffee. It’s never agreed with me. So it’s true that I occasionally take a Dexedrine. But it has no more effect than coffee. You just can’t dilute it with milk or cream. I admit it has different social implications, especially if someone takes it to escape from life, but I only use it on occasion to work more efficiently. And as far as the Percodan and Talwin are concerned: yes, I’ve taken them at times. I’ve had a propensity for migraines since I was young. I don’t get them often, but when I do, the only thing that helps is Percodan or Talwin. Sometimes the one, sometimes the other. And I’ll tell you something. I’ll be happy to have you or anyone else audit my prescribing habits. You’d see in an instant the amount of these drugs that I prescribe and for whom.”

Thomas sat back and folded his arms. He was still trembling and did not want Ballantine to notice.

“Well,” said Ballantine with obvious relief. “That certainly seems reasonable.”

“You know as well as I,” said Thomas, “that all of us take a pill now and then.”

“True,” said Dr. Ballantine. “The trouble comes when a physician loses control of the number he takes.”

“But then they’re abusing the drug,” said Thomas. “I’ve never taken more than two in twenty-four hours, and that’s only with a migraine.”

“I must tell you that I feel relieved,” said Dr. Ballantine. “Frankly, I was worried. You do work too hard. I still mean what I said about your taking some vacation.”

I’m sure you do, thought Thomas.

“And I want you to know,” continued Ballantine, “that the whole department only wants the best for you. Even if we see some changes down the line, you will always be the keystone of our service.”

“That’s reassuring,” said Thomas. “I suppose it was Cassandra who came to you about the pills.” Thomas’s voice was matter of fact.

“It really doesn’t matter who called it to my attention,” said Dr. Ballantine, standing up. “Especially since you’ve laid my fears to rest.”

Thomas was now positive it had been Cassi. She must have looked in his desk and found bottles. He was swept by another wave of anger.

He stood up, his fists tightly clenched. He knew he had to be alone for a while. Saying good-bye and forcing himself to thank Ballantine for his concern, Thomas hastily made his way out of the office.

Ballantine stared after him for a moment. He felt better about Thomas, but not completely reassured. The scene at the party nagged him, and there were those persistent rumors that had cropped up recently among the house staff. He didn’t want trouble with Thomas. Not now. That could ruin everything.

When the door to the waiting room opened, Doris quickly dropped the novel she was reading into a drawer and closed it with one smooth, practiced motion. Seeing Thomas, she picked up the telephone messages and came around from behind the desk. After being alone in the office all afternoon, she was happy to see another human being.

Thomas behaved as if she were part of the furniture. To her surprise, he went past her without the slightest acknowledgment. She reached out to grasp his arm, but she missed, and Thomas continued into his office as if he were sleepwalking. Doris followed.

“Thomas, Dr. Obermeyer called and…”

“I don’t want to hear about anything,” he snapped, starting to close his door.

In commendable saleswoman fashion, Doris got a foot over the threshold. She was intent on giving Thomas his messages.

“Get out of here,” screamed Thomas. Doris stepped back in fright as the door slammed in her face with jarring force.

The fury that he’d suppressed during the harrowing interview with Ballantine engulfed him. His eyes searched for some object on which he could vent his anger. He grabbed up a bud vase Cassi had given him when they were engaged and smashed it on the floor. Looking at the shattered pieces, he felt a little better. He went over to his desk, pulled out the second drawer, and grabbed a bottle of Percodan, spilling several of the tablets onto his desk. He took one, putting the rest back, then went into the washroom for a glass of water.

Returning to his desk, he put away the pill container and closed the drawer. He began to feel more in control, but he still could not get over Cassi’s treachery. Didn’t she understand that all he really cared about was his surgery? How could she be so cruel as to try to jeopardize his career? First going to his mother, the one person who really had the power to upset him, then George, and now the head of his department. He would not tolerate this. He had loved her so much when they were first married. She had been so sweet, so delicate, so devoted. Why was she trying to destroy him? He would not let her. He would…

Suddenly Thomas wondered if Ballantine was glad about all this. For some time he had the nagging feeling that something strange was going on with Ballantine and Sherman. Maybe it was all an elaborate play to undermine him.

Thomas again felt a thrill of fear. He had to do something… but what?

Slowly at first, and then more rapidly, ideas began to form. All at once he knew what he could do. He knew what he had to do.

Still troubled by his meeting with Thomas, Ballantine decided to drop down to OR to see if he could find George. Sherman may have lacked Thomas’s genius, but he was a consistently excellent surgeon and an evenhanded and unflappable administrator. The house staff admired him, and Ballantine was increasingly considering backing George as chief when he himself stepped down. For a long time, the trustees had pushed to get Thomas to switch to full-time so he would be eligible for the post, but now Ballantine had doubts even if Kingsley would agree.

Unfortunately George was still in surgery. Ballantine was surprised and hoped there was no trouble. He knew George had had only one seven-thirty case that morning. The fact that he was still in the OR in the middle of the afternoon was not auspicious.

Ballantine decided to use the time to visit Cassi on Clarkson Two. Even if he wasn’t totally sanguine about her husband’s future, Ballantine wanted to offer what reassurance he could. Despite the years Dr. Ballantine had been on the staff of the Boston Memorial, he’d never once set foot on Clarkson Two, and when he pushed through the heavy fire door, he felt as if he’d entered another world.

In a lot of ways it did not seem like a hospital at all. It had more the feeling of a second-class hotel. As he passed the main lounge, he could hear someone plunking atonally on the piano, as well as some mindless television game show. There were none of the sounds that he traditionally associated with the hospital, like the hiss of a cycling respirator or the characteristic clink of IV bottles. Perhaps the thing that made him the most uncomfortable was that everyone was dressed in street clothes. Dr. Ballantine could not be sure who was a patient and who was on staff. He wanted to find Cassi but was afraid of approaching the wrong person.

The only place he could be sure of knowing who was who was the nurses’ station. Dr. Ballantine walked to the counter.

“Can I help you?” asked a tall, elegant black woman whose name tag said simply, Roxane.

“I’m looking for Dr. Cassidy,” said Dr. Ballantine self-consciously.

Before Roxane could respond, Cassi’s head appeared around the door to the chart room.

“Dr. Ballantine. What a surprise!” Cassi stood up.

Ballantine joined her, again admiring her fragile beauty. Thomas must be crazy to spend so many nights in the hospital, he mused.

“Can I talk to you for a moment?” asked Ballantine.

“Of course. Would you like to go to my office?”

“Here’s fine,” said Ballantine, indicating the empty room.

Cassi pushed some of the charts away. “I’ve been writing summary notes on my patients for the other doctors to use while I’m in for my eye surgery.”

Ballantine nodded. “The reason I stopped down was to tell you in person that I’ve already spoken with Thomas. We had a very good talk. I feel he’s been pushing it a bit, and he admitted a small reliance on Dexedrine to keep him awake, but he pretty well convinced me that he only took the pain-killers for his migraine headaches.”

Cassi didn’t reply. She was certain Thomas hadn’t had a migraine since he was in his teens.

“Well,” said Ballantine with forced joviality. “You get your eye taken care of and don’t worry anymore about your husband. He’s even offered to have his prescription roster audited.” He stood up and patted Cassi on the shoulder.

Cassi wanted desperately to share Dr. Ballantine’s optimism. But he had not seen Thomas’s pupils or his staggering gait. And the chief was not the recipient of his unpredictable moods.

“I hope you’re right,” said Cassi with a sigh.

“Of course I’m right,” said Dr. Ballantine, annoyed that his pep talk hadn’t worked. He started to leave.

“And you didn’t mention our conversation,” Cassi added, seeing Ballantine was becoming impatient.

“Of course not. Anyway, Thomas’s jealousy makes it obvious he adores you. And with good reason.” Ballantine smiled.

“Thanks for coming down,” said Cassi.

“Don’t mention it,” said Ballantine, waving. He headed down toward the fire door, glad to be leaving Clarkson Two. He had never understood why anybody would take up psychiatry.

Getting on the elevator, Ballantine shook his head. He hated getting mixed up with family problems. Here he had been trying to help both Kingsleys. He’d sought out Cassi in order to put her mind at ease. But she hadn’t seemed willing to listen. For the first time he began to question Cassi’s objectivity.

Getting off the elevator, Ballantine decided to see if George was out of the OR.

He found Sherman surrounded by house staff in the recovery room. When George caught the chief’s eye, he excused himself and followed Ballantine out into the hall.

“I had a disturbing conversation with Kingsley’s wife this morning,” Ballantine said, getting straight to the point. “I thought she had wanted to see me to apologize about the incident last night. But that wasn’t it. She was worried that Thomas might be abusing drugs.”

George opened his mouth to reply, then hesitated. The residents had just been describing Kingsley’s behavior in the OR that morning before George himself had taken over. If he told the chief that would mean real trouble for Kingsley. And it was always possible that Thomas had just drunk too much the night before, upset as he obviously was after the fight. George decided to keep his thoughts to himself for the time being.

“Did you believe Cassi?” he asked.

“I’m not sure. I spoke with Thomas, who had some very good answers, but even I have found his temper unusually erratic.” Ballantine sighed. “You always said you didn’t care about being chief of service, but even if Kingsley agrees to come full-time, he may not be right for the department when we are done reorganizing. He certainly opposes the new patients we’re scheduling on the teaching service.”

“Yes,” said George. “And I can’t see Thomas accepting the idea of free surgery for the mentally retarded in order to train new teams of vascular surgeons.”

“His point of view isn’t necessarily wrong. These new expensive procedures should be made available first to the patients with the best chances for long-term survival. But practically speaking, the residents rarely get such cases. And as far as the hospital favoring patients most valuable to society, who’s to judge? As you said, George, we’re just physicians, not God.”

“Maybe he’ll calm down,” said George. “If our plans go through, we certainly will be needing him on the teaching staff.”

“Let’s hope,” said Ballantine. “I’ve suggested he take a vacation with his wife. By the way, I assume his accusations were pure paranoia as far as you’re concerned.”

“Unfortunately yes. But I’ll tell you, if she ever gave me a chance, I’d still fight for her. Aside from those amazing looks, she’s one of the most caring women I’ve ever met.”

“Just don’t upset our genius any more than you have to,” said Ballantine with a laugh. “In the meantime, do you think I should review Thomas’s prescriptions?”

“How can it hurt? But there are other ways doctors can get hold of drugs,” said George, thinking of Thomas’s collapse in the OR.

“Let’s just hope he takes his vacation soon and comes back his old self.”

“Right,” said George, though he personally had not been that fond of Thomas in happier days.