Hospital (6 page)

The chairman was part of a platoon of people from Maimonides who made the 150-mile drive upstate. Joseph Cunningham arrived first—with Lili Fraidkin, who insisted on going with him. Brier could drive her crazy, but Fraidkin couldn’t bear the thought of her dying.

Dr. Joseph N. Cunningham Jr. was head of strategic initiatives, chair of surgery, and a significant force in the hospital. He was also chief of cardiothoracic surgery. Twenty-one years earlier, in 1982, he had left a promising career at New York University Hospital to go to Brooklyn, where he helped bring national prominence to the Maimonides cardiac surgery department. He remained striking at sixty-three, tall and still sexy, though his frame was slightly stooped and his shock of hair was gray and white. Smooth and courtly, he had star power, though he was in danger of self-parody, wearing cowboy boots to surgery and—senior citizenship be damned!—still generating rumors because he liked the company of attractive nurses.

In Brooklyn he was a novelty, with his accent doused in the syrup of his southern boyhood and his apparent identification with the Swamp Fox, Brigadier General Francis Marion, the daring Revolutionary War commander. The connection? Cunningham grew up in Marion, Alabama, and admired rugged men. A print of Ernest Hemingway hung on his wall, standing beside a boat called the
Swamp Fox.
Cunningham, too, liked to deep-sea fish in dangerous waters and named all his boats
Swamp Fox.
Even the mugs in his office carried the “Swamp Fox” logo.

In Steve Brier’s recollection, though, it was Douglas Jablon who dominated. Jablon was conspicuous wherever he was: six feet two inches tall and broad, a yarmulke always perched on his head, looking like an Orthodox fullback who had softened into middle age. He always dressed the same way, ready for a funeral, in a black suit and white shirt. His official title was “special assistant to the president,” but Steve Brier called him the “Mitzvah Man” (
mitzvah
means “good deed” in Hebrew). Jablon ran the patient-representative department at the hospital, meaning he took care of the VIPs—the Very Important Patients—a category that for Jablon encompassed anyone who asked him for help. Jablon managed to be simultaneously unflappable and on the verge of hysterics. He was in Albany because he loved (and feared) Brier and because his job—he would say—was to handle
tsuris
(“troubles”). If the situation in Albany didn’t represent
tsuris,
what did?

Sondra Olendorf, head of nursing and hospital operations, went to the upstate hospital and so did a contingent of physicians besides Cunningham, including the chairs of plastic surgery, obstetrics, and orthopedics. Some were there to oversee the medical care; others went simply to provide support. Brier’s assistant, Annette Cruz, accompanied a Hatzolah ambulance driver when it came time to bring Brier home; Aschkenasy would again be airlifted by helicopter, to New York University Medical Center.

Thinking about who could manage Maimonides right then, Payson turned to Fraidkin, hospital chief of staff, a nurse by training who had become personal manager for the hospital’s physicians and who had been a favorite of Brezenoff. Fraidkin had been at Maimonides for more than twenty years and had everyone’s respect. (No one would dare to disrespect her; Fraidkin knew where all the bodies were buried.) Still fabulous at sixty-something, she was known for her ability to get things done, her toughness, her streetwise swagger, her love of riding Harley-Davidsons in leather chaps, her cadre of loyal physicians.

Fraidkin had been shaking things up at Maimonides from the moment she got there. She found conditions at the Brooklyn hospital to be about a decade behind the Manhattan hospitals; she had previously worked at Beth Israel. To convince the board that the staff had no idea how to deal with an emergency cardiac arrest, she started doing mock codes, filming the physicians’ and nurses’ responses. She had put a dummy equipped to simulate human response in a room, called a Code-3, and videotaped the reaction of the medical staff.

She took the evidence to the department chairs and said, “Your physicians are killing our patients.” Within a few months of arriving at Maimonides, Fraidkin had forced mandatory CPR courses on doctors and nurses, reorganized the operating-room schedule so half of them were no longer sitting idle during lunch break, and made sure the surgeons, nurses, and anesthesiologists got to the OR on time. They couldn’t lie to her. She was at the hospital by 6:30 A.M., her presence marked by her silver Infiniti sports car, always parked in the same space. By 6:35 it wasn’t unusual to find a physician in her office, wheedling and cajoling. Cunningham dryly referred to her as their “mommy.”

Fraidkin, born Lilia Maria Escobar, was of Puerto Rican descent, having become Jewish and a Fraidkin via a marriage that ended after twenty-five years. (She said she stopped using Lilia because “gringos” always mispronounced it.) She wore three-inch heels and short skirts that emphasized her famous (at Maimonides) legs. She was loyal to her physicians and, as she put it, had no trouble boxing their ears when she thought it was necessary.

Brezenoff recognized Fraidkin’s talents; when he and Brier took charge, Fraidkin became chief of staff. She was also given the task of outreach, beginning in Bay Ridge, an Italian and Irish enclave that viewed Maimonides as “the Jewish hospital.” Fraidkin joined organizations, went to community meetings, ate unidentifiable food at banquets, and froze to death watching endless parades with local politicians.

When she discovered that nearby Lutheran Hospital, a major competitor, won Italian patients not just by attending the Ragamuffin Parade—an annual costume parade for kids in Bay Ridge—but by entering a float, she went to Brezenoff. “I want a Maimonides float. I want it to be the
Wizard of Oz
.”

“I’ll pay for it if you’ll be the witch,” he replied. Thus began a tradition: Fraidkin as bad guy. The Wicked Witch of the West one year, Cruella de Vil the next. It was a role she relished. More than once, Brier told Fraidkin she was scared of her. Everyone knew that it was not wise to cross Lili.

Payson also relied on Joe Cunningham, Dr. Cowboy Boots, the Hemingway man. In recent years new nonsurgical procedures had taken the shine off cardiac surgery, and this, along with personal problems, had in turn taken their toll on Cunningham. But he remained a powerful force, not least because he had won Payson’s loyalty.

Cunningham and Fraidkin were old friends; they had arrived at the hospital around the same time, in the early eighties. They had both thrived under Brezenoff’s leadership. Brier and Cunningham, on the other hand, were not natural allies. He found her quirkiness irritating and thought she was a snob. Now, Stanley Brezenoff, he would say, Stanley had a “presidential air,” whereas he described Brier as a “micromanager.” Brezenoff was someone he could relate to—and Brezenoff admired him as well. They recognized in each other a particular catalytic force; they were alpha males. As for Brier, her feelings were complicated: appreciating Cunningham’s history with the hospital, cognizant of the loyalty Payson felt was owed him, but wary of the old-boy network he represented. Now she would have to add gratitude to an already thick gumbo of feeling.

In Albany, however, she was a patient, not a hospital administrator, and Cunningham was by her side. Whether he was there as a friend or to take charge of the hospital that had become part of his identity would later be a matter of speculation. But what Brier subsequently remembered from the painkiller fog that sheltered her the first days in the intensive care unit was a critical conversation with Cunningham. She asked him whether her husband was going to live (the answer was yes) and whether he was going to walk again (the answer was maybe, probably). From then on, no matter what her frustrations with Cunningham, she would remember that he had provided comfort for her, in the way she needed, at a crucial time.

Brier refused to be treated as an invalid. For the first several weeks after the accident, Hatzolah medics took her to work and back home by ambulance because she couldn’t get in and out of a car. For months she needed a wheelchair but insisted on having the Hatzolah driver park around the corner from the entrance so she would not have to be pushed through the front door. She would rather limp in on her own.

The effects of the accident would linger.

Two years later, when I was trying to convince the hospital’s management to let me hang around, I met with Brier several times. The second of those early conversations took place in a hospital room at Maimonides. The patient was Brier, recovering from yet another round of surgery, this one a knee operation to repair damage from accident aftershocks. Her blond hair was carefully combed (she made weekly visits to the Tribeca branch of Privé, the Beverly Hills salon), the nails on her delicate hands were well manicured. She wore an Issey Miyake jacket over a pair of sweatpants. Despite the attempt at gloss, she seemed tiny and frail—a first impression she soon dispelled by issuing a series of quick orders to Lili Fraidkin, who had delivered me to the room.

I had already heard about Brier’s idiosyncrasies. People remarked that Brezenoff’s meetings were electric; Brier’s were often chaotic. She would get up while someone was talking, walk to a cabinet, pull out a bag of popcorn, and pour it into bowls. Her gaze was always wandering, landing on curtains that were crooked, which would compel her to leave her chair to adjust them. “She cannot sit still for a full meeting,” Fraidkin had told me. “At first when she gets up and straightens out the window shades we went, ‘Oh, my God! This lady’s nuts!’ We just couldn’t believe it.”

As Brier talked to me from her hospital bed, it was obvious she recognized and enjoyed her own foibles. “I was in the hospital for back surgery and was doing rounds just for exercise,” she told me. “Peter was with me. It’s boring to go to the same floors, so we went to pediatrics. I was in my night-gown and came across a family there, really obnoxious, and the nurse very politely asking them to leave—I thought very politely, and the family was being very disrespectful. I went up to them and said, ‘Excuse me.’ And this person totally blew me off! And I said, ‘Excuse me, I am the executive vice president of this hospital,’ and Peter was saying, ‘Not now, Pam,’ but I ignored him and said to this family, ‘You’ve been most impolite here, and I would like to see you listen to this nurse, and I would like you to go. Go now!’ And they did.”

She grinned as she remembered the spectacle. “I don’t know what I thought, wearing my bathrobe, that I could draw myself up like a pooh-bah!”

Pooh-Bah.
The character from
The Mikado
also known as Lord-High-Everything-Else. I would come to see this as vintage Brier, relishing the incongruous, invoking the light comic opera of Gilbert and Sullivan in Borough Park, the Orthodox Jewish heartland. Yet it was also no joke. She wanted to be a pooh-bah, defined by Webster’s as “an official or leader who maintains full control.”

Less than six weeks later, I saw her in full pooh-bah mode, at the official opening of the Maimonides Cancer Center, the same cancer center that had drawn Alan Astrow—and then me—to Brooklyn, Borough Park.

The opening was the kind of event that Brier approved of: a tasteful gathering attended by important people paying attention. A white party tent had been set up in the parking lot adjacent to the brand-new building—so new, in fact, that the first floor was still under construction.

For the opening she again wore clothes from her favorite designer, Issey Miyake, this time a yellow-gold jacket, worn over an orange Miyake dress. But she was quite different than she’d been the last time I’d seen her, when she appeared to be helpless, the way patients tend to appear, even those who are hospital presidents. Now she was wispy but authoritative, apparently comfortable in her role as chief executive of a large, complex institution. She surveyed the crowd of three hundred well-dressed people crammed together on folding chairs. One group had the side curls and beards required by Orthodox Judaism; nearby sat a Pakistani imam accompanied by a small entourage; a few seats away she could see the leader of the local Caribbean community and a Roman Catholic monsignor. Young men and women wearing doctors’ jackets shivered in the unseasonably sharp wind. The sky above the tent was alternately cloudy and sunny.

Mayor Michael Bloomberg sat on a makeshift stage, wedged between a Brooklyn selectman and Martin Payson, the chairman of Maimonides. Bloomberg looked tired. He was running for reelection and would stay at the Maimonides opening for forty-five minutes. Before the mayor left, he listened politely to a series of speeches, glanced once at his PalmPilot, and gamely exchanged whispered jokes with Marty Markowitz, the exuberant borough president, who frequently and publicly expressed his desire to have Brooklyn secede from the City of New York. It was Markowitz who was responsible for the amusing highway signs about to appear on the Manhattan-bound side of the Williamsburg Bridge: LEAVING BROOKLYN— OY VEY.

Walking to the microphone with a hesitant, awkward gait, Brier presided over the proceedings with her official blend of hominess and hauteur. She spoke warmly of the public and private partnership that had allowed for the creation of the center but couldn’t resist interrupting herself to scold a local politician who showed up late. Her patrician diction could have an imperious overtone, most pronounced when she thought people weren’t behaving as she thought they should. “I know the mayor has to leave before the program is over to celebrate Cinco de Mayo in another part of the city,” she said, peering at the crowd through narrow, black-rimmed glasses. “Not through lack of interest, I’m sure.”

As she talked, she glanced for reassurance at a robust-looking man situated near the back of the tent, sitting in a wheelchair with a woman’s Prada bag on his lap. He smiled and nodded. That was Peter Aschkenasy, her husband. He remained an amiable man—even though he would never regain full physical functioning after the accident—the kind who didn’t mind holding his wife’s pocketbook while she presided over important public business.