Mercy

CHAPTER 34

Roman Janowski walked alongside Allyson Brock as they headed from the main entrance of Suburban West to the rehabilitation unit. Her strides equaled two of his, and he had a feeling Allyson hurried to make it as uncomfortable for him as possible.

White Memorial had gobbled up Suburban West like a great white shark snatching a meal in a single bite. The biggest obstacle to the takeover had always been the board of directors, but the numbers Romey put forward were so favorable his negotiation skill could have been second-rate and would have still closed the deal. Romey’s lawyers had the papers drafted and the details ironed out well in advance of that meeting. Based on projections, West’s chairman of the board, Vince Hanke, was doing everything in his power to speed up the process.

Brilliant.

The full transition would take time, but there already were some tangible benefits in bringing Suburban West into White’s accountable care organization. The benefits could be even greater, but Romey had heard from the other CEO that Allyson kept her foot too heavy on the brake. Romey had come here to force that foot over to the gas.

ACOs were the media darlings of the moment, with almost daily news reports of savings to Medicare projected in the billions. With ACOs, the average spending per patient was expected to plunge forty to fifty dollars per month in the coming years. Multiply that by millions of patients, and the trend was worth some attention.

The media could write whatever stories they saw fit, but Romey’s accountability was to his board, which mandated he deliver profits and patients. Before Romey took over White Memorial, those were thought to be mutually exclusive objectives. Allyson would learn the hard way they were not.

The looming takeover left Romey little time for exercise, or for screwing around with either of his two mistresses. It had been all work and no play, and indeed that made Romey a dull boy. His suit pants did not fit as well, and his notoriously slow metabolism probably had something to do with how snug his blazer felt across his chest.

The stress of the merger did not seem to bother Allyson any. Her weight had not fluctuated one iota. She still looked fine in her business suit, her rear end filling out her black slacks to perfection. Who said walking golf courses wasn’t exercise? Romey lamented not getting a chance to bed her. It could have happened, too, but Romey always put business before pleasure.

“How are things with Knox Singer going?” Romey asked.

Allyson’s counterpart had come from Boston Community Health, better known as BCH. Knox had already given Romey an earful on how things were going.

“I think we’re making progress,” Allyson said in a voice too sweet, too saccharine.

“Any trouble spots?” Romey was much better at lying.

“Nothing we can’t handle,” Allyson said.

“Good,” Romey said. “I read the report from Dr. Lucy Abruzzo. It seems you two had a good meeting.”

“We did. She’s a very directed person, not much small talk with her. It was an extremely productive working session, and I’m sure there are efficiencies we can gain by leveraging the resources of her pathology department.”

“Dr. Abruzzo may have a certain way about her, but she’s supremely competent. I’m sure whatever ideas she’s come up with will benefit our respective hospitals and our patients.”

When they reached the rehab unit Romey walked the floor, checking in on the rooms.

“No available beds,” he noted.

“We’ve been busy,” Allyson said. “It’s good for the hospital and the patients. They have to go somewhere.”

“Shouldn’t some of them have gone to White? You’ve seen the numbers, or have you forgotten?”

Romey led Allyson beyond the nurses station, out of earshot of the staff. A few patients were out on guided walks around the floor. Most got around with the aid of a walker.

“I hadn’t forgotten, Romey,” Allyson said. “But it’s a lot easier to move these patients on paper than it is in real life. They have families nearby and don’t see the benefit of going to White.”

“Because you haven’t made them see the benefit.”

“I thought my job was to run this hospital,” Allyson said with some bite.

Romey returned a half smile.

“The staff is a reflection of their leadership, is all I’m saying. If the staff believes it’s better for their care, the patients will believe it, too.”

Romey put his hands behind his back and walked with an exaggerated tilt from side to side, like he was out on a leisurely stroll. He popped into a unit where a frail, thin man could barely be seen beneath all the tubing connected to his body. Romey went to the patient’s bedside after Allyson introduced him to the nurse.

“Hello, I’m Roman Janowski, CEO of White Memorial and the newest member of the board here at Suburban West. And who do I have the pleasure of meeting?”

A nose cannula supplied oxygen to this patient, but Roman knew for a fact he had been on mechanical ventilation not too long ago. He also knew this patient had chronic COPD and no hope of ever living anywhere but at Suburban West or some other long-term-care facility.

The man spoke in a whispered voice, weak with disease, and introduced himself as Albert Cunningham. Albert was a Vietnam War veteran, and onetime public address announcer for the Boston Red Sox.

Romey was patient with Albert, who got winded easily as he recounted his bio. The young nurse seemed taken by Romey’s attentiveness and evident compassion. Suits rarely mingled with the guests. Romey might not have been blessed with six-pack abs, but he made up for it in other ways. At the end of their brief conversation, Romey took hold of Albert’s hand to shake good-bye and commented on the substantial scarring there.

“Is that from the war?” Romey asked.

Albert explained it was a leftover from a bad case of hives.

“Seems like something’s trying to get me at every turn,” Albert said. “My lungs might be crap, but at least the ticker’s still going strong.”

Romey wished him well. Then he and Allyson were back in the corridor.

“Nice fellow,” Romey said. “What the hell is he doing here?”

Allyson returned a blank stare. She had no idea how to respond. “Um, he’s sick and needs to get better. I’m sorry, but I thought that’s what a hospital was for.”

“He’s not going to get better, and he’s eating your profit. He doesn’t belong at White-or here, for that matter. He belongs at a long-term-care facility or a nursing home.”

“He refuses to go there. He thinks that’s where you go to die.”

“So you send him home, and then he comes back here again.”

“What would you like me to do, Roman? Put him on an ice floe with old and sick Eskimos?”

“I guess what I’d like is to go to your office so we can talk in private.”

ALLYSON SAT behind her expansive desk in a spacious top-floor office. Romey stood and gazed out the window at the parking lot below. Not a great view, not great furniture or carpeting, but what could be expected from a suburban hospital bleeding red ink?

Allyson did not want her pro golf career to eclipse her accomplishments as a businessperson with a passion for health care. She had an open-door policy, and was happy to meet any doctor or nurse who had ideas on how to improve Suburban West’s operation. She was loved here. Knox Singer was Romey’s guy, and a perceived threat. Something had to give.

“Allyson, you’ve done a great job here at West.”

“You’re firing me, aren’t you?”

Romey turned to face her, with arms behind his back, and his eyes momentarily to the floor. He paused before finally meeting her harsh gaze.

“The board agrees that this pond isn’t big enough for two fish to swim.”

“Oh, are you setting me free? Is that it?”

“I like the visual.”

“It’s better than the truth.”

“And what’s that?”

“I’ve been gutted, flayed, and served for dinner.”

“We all have our perspectives.”

Romey took a folder from his Tumi carrying case and set it on Allyson’s desk.

“You’ll find the terms are quite favorable. And of course I’ll be an unqualified reference.”

“That fills me with such warmth, I can’t tell you.”

“Just be grateful I’ve given you a graceful exit. I could have buried you, Allyson, and taken Suburban West over in the same day.”

Allyson sent an icy smile. “Forever in your debt, Roman.” She opened the folder and perused the three-page document within. “I’ll have my lawyer look this over and get back to you.”

“Have it signed by tomorrow,” Roman said. “Or I’ll make it ugly for you.”

With that parting salvo, Romey strolled out of Allyson’s former office.