Authors: David Farris
“And this comes on the heels, within three weeks, anyway, of a reported discrepancy in the drug count in the OR
lockbox. Two 10-cc vials of 10 percent cocaine have been reported missing.”
That was staggering. I mouthed to myself, “Oh fuck.” I had not heard about that little heist, the perfect coincidence of bad timing. Without mentally calculating it out I knew each vial would have been worth thousands of dollars on the street.
“What say you, Dr. Ishmail?” he said, feigning a smile.
“Complete falsehood.” I said, trying to find a tone of voice neither too vehement nor quavering.
“Is that it?” he asked.
“Dr. Kerlin, I didn’t steal the OR’s cocaine and I never offered drugs to Dr. Lyle. If there’s some other evidence, something more than an accusation . . .” I held up my hands.
Dr. Kerlin frowned at Dr. Montoya. She sighed a bit.
“By the way,” I said, “Dr. Hebert said he was going to send a letter to the committee.”
“Yes, we each have a copy,” Dr. Montoya said.
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“Good. I appreciate Dr. Hebert’s support. Anyway, it’s easy for me to imagine being on Dr. Lyle’s hit list. I reported my concerns to Dr. Bullock. I presume she knows about that.”
Another of the ensemble spoke, a nerdy-looking man with a sparse mustache and a squinting face. “But you and Dr.
Lyle have not spoken about this, had any confrontation, say, about your having . . . ‘turned her in,’ for lack of a better term?”
“No. It certainly became clear to me, though, when Dr.
Goodbout came around for a specimen.”
“Yes, yes, I suppose so,” he said.
“But, if I may add something,” I said, looking at Dr. Montoya. She nodded. “I realized that other neurosurgeons have seen what I’ve been talking about. When Dr. Lyle is struggling to find her way, she usually calls Ed Adams to assist her. He helped on the Coles case. I wanted to get his thoughts on this, but he’s been out of the country.
“Dr. Lyle did share with me, though, that one time, some years ago, when Dr. Adams was also unavailable, she had called in Dr. Steven White. Dr. White is—has been—practicing primarily in Scottsdale. He came in late one Friday to help with another aneurysm and, according to Dr. Lyle, had little difficulty getting it clipped.
“I met with Dr. White, a few days ago, at his home. He shared his opinion that Mimi is in the wrong specialty. He gave me this note.” I pulled the card, still in its envelope, from my folder. “He referred to it as ‘confessional.’ In it she describes her own inabilities.” I passed my stack of copies to Dr. Montoya, then waited.
Several nodded as they read. The nerdy man said, “Have you shown this to anyone else?”
“I got it a week ago. I sent copies to Dr. Bullock and Dr.
Kellogg.”
The stout woman said, “You, a resident, seem to want to sit in judgment of your professor.”
“No.”
“You want her to be, what?
Error-free?
”
“No. That’s not it. I thought the thing about mistakes in 198
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medicine was, whether they’re bad judgment or lack of information or lack of experience or whatever, that you’re supposed to learn from them. Not hurt somebody the same way twice.”
They were staring at me.
A wiry-haired woman said, “And how did the patient do?
The young woman with the adenoma?”
“Okay. She woke up a little slow, I guess, but she was grossly intact when I saw her.”
“So, do you think you were wrong to have worried?”
“Not at all. I’d be just as worried about the next one.”
“Did you speak with Dr. Lyle about your concerns?”
“Like I said, I asked her about getting help. When the case was booked. She made it very clear she didn’t want to hear suggestions from me. I just went off service a few days after that, started my vascular rotation, and next thing I know, this.”
“And you contend that her letter is . . . what? A complete fabrication? Pure lies? For some sort of retribution?”
“Apparently so. Yes. I think she is—obviously—trying to disgrace me. Make it seem that what I told Dr. Bullock was a stupid attempt at revenge for having been spurned.”
Dr. Kerlin spoke: “Okay, perhaps so. But let us go through her allegations.” He looked at Dr. Montoya. “I think we need to do that.” She nodded. To me: “Did you do the things in her letter?”
I looked blankly at my notepad. This was expected. “I may have made mistakes, sir. Certainly. In my residency. In my life.” I looked up. “Fortunately I can say with a clear conscience—and I was once an altar boy—that not one of them is in that letter.” Two of them smiled.
“Okay. You never asked Dr. Lyle for a date?”
I hesitated. “No. Certainly not as she describes it.”
Dr. Kelin sat forward. “What do you mean by that?”
“Just that. I did not ask Dr. Lyle for a date.”
Dr. Kerlin looked at Dr. Montoya. He said to me with obvious frustration, “Did you seek dates? Seek sex? Other than asking for a date?”
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My ground was shaking. I looked at my notes. They held no solace. “I’m not trying to be cute with the wording. Dr.
Lyle and I had a relationship.” I felt my face burn. “It never involved any of the kinds of things she says in her letter.”
A pause. Dr. Kerlin: “You—you and Dr. Lyle—you had ‘a relationship.’ But you did not ask her for a date.”
“Yes, sir. That’s a fair statement.”
“Will you care to elaborate for us? Help us understand . . . ?”
“Sir, with all due respect, the particulars of our relationship are not really germane.”
“Are we to understand that you two are, or were, lovers?
And this letter is, according to you, part of a lovers’ spat?”
“No, sir. I mean, we are not lovers. Whether we were or not is irrelevant. And the letter is her retaliation for participating in the process of trying to ensure good patient care.”
“But you were lovers.”
I hesitated. I took an involuntary sigh. “Yes, sir. Were.”
He looked about as if he were resting his case, victorious.
“For how long?” asked Dr. Wiry Hair.
“Well, of my six-week rotation there, take out the first week or so and most of the last two weeks,” I said.
“But you never asked her for a date?”
“No, ma’am. I acquiesced. I said yes.”
“She initiated it?”
“Yes, ma’am.”
“When did this happen?”
“Middle of the second week of my rotation. We hit it off.
But really, how it began, how it ended, none of that is important. What is important is that she told me why she has so much trouble. I acted on my obligation to patient care.
She is apparently seeking revenge.”
“And no one knew of this? You did not tell Dr. Bullock?”
“It’s really irrelevant. It obscures the real issue.” A pause.
I said, “I think—I guess I’m sure—she feels betrayed.”
Dr. Kerlin: “She initiated this affair.”
“Yes, she did.”
Two were shuffling their folders. One said, “How did you manage to keep this a secret for—what—a month?”
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“She had it pretty well thought through. How to put down cover and hide tracks.”
They were all staring. “Had she done this before?”
“You mean with a resident? I have no idea. You’ll have to ask Dr. Lyle.” They continued to stare. Dr. Montoya nodded.
“And just to be completely explicit: Yours was a . . . sexual relationship?” The questioner was a nearly child-sized man with a thick beard and a bow tie.
“Entirely so.”
“Did you, at any time, make any objections?” The haughty expressions I’m sure were meant to convey profes-sorial disgust, but it was not difficult to imagine a tinge of fascination behind the Victorian veneer.
I hesitated. I had trouble believing any of them really expected a young man to put very obscure academic scruples in front of a very tangible erection. Besides, the professor’s ethical obligation in such a case was much the greater. “No,”
I said, “why would I?” Several of them smiled.
“You would have, Doctor, because it was the right thing to do,” said Dr. Kerlin.
“By some standards that may be true, sir,” I said. “But the ethical problem arises from the power one holds over the other. And I believed from the start she would never abuse that power. She never did. I was no victim here. That was something between consenting adults.”
“You’re not here to lecture us on ethics.”
“No, sir. But my relationship really is not the issue.”
“You’re here to answer allegations of drug abuse,” he went on. “And harassment.”
“Yes, sir.”
“You deny offering drugs to Dr. Lyle, but say she was your lover?”
“Yes, sir.”
“Were there drugs involved in your alleged relationship?”
“That’s not Dr. Lyle’s allegation.”
“No, she alleges that you repeatedly offered her cocaine.”
“I did not offer her cocaine.”
“But were there drugs involved in your relationship?”
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I sat silently. I knew dodging to be a virtual admission, but better than an outright declaration.
“Other drugs? What . . . marijuana? Opiates? Pills?”
I sat quietly, trying to convince myself the obvious logic of the greater issues would prevail.
“Cocaine?”
Still, I sat quietly.
“You will not answer whether or not there was cocaine involved in your relationship.”
Every movement I made, every blink, swallow, glance, weight shift, or roll of a finger hurt. I felt like crying. I said only, “No.”
“Then, were there or were there not drugs used between you two?”
A long pause. “I think,” I said as calmly as I could, “I am entitled to withhold certain answers.”
The nerd said, “Well, I think we have an answer.”
Another pause. “Your urine test was entirely clean,” Dr.
Montoya said. She was apparently the ever-compassionate doctor, giving me a bit more rope that I might not hang myself.
I only nodded, pointlessly clinging to the strategic notion of seeming to know all along that it would be. Another pause.
“How could you satisfy us,” said Dr. Kerlin, “that you have never used drugs?”
“Well, Doctor”—I took a deep breath—“no disrespect intended, but I could no more prove that than you could prove you’ve never molested small boys.”
He snorted, “That is outrageous.”
“I mean, sir, in a purely logical way of looking at it, it’s awfully hard to prove you’ve never done something.”
“Have you ever used drugs?” asked Dr. Nerdly.
“If I smoked a joint in college, would that bother you?”
“Did you?”
“Does it matter?”
“Yes. I want to know if you smoke marijuana. I want to know if you ever did.”
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“I do not. I don’t like marijuana. On the question of my past, I suppose I should again decline to answer. It’s a self-incriminating question. And irrelevant to the issue.”
Another pause. Dr. Montoya: “You paint a somewhat suggestive picture in the way you answer some questions and not others.”
“I’m being as honest as I can.”
“Do you know anything about the cocaine missing from the OR?” the nerdish one asked.
“What I know, sir, is that drugs come up missing around here with some regularity. In the Medical ICU, about six months ago, they found that someone had slit with a razor blade, or maybe a scalpel, the cellophane at the back of two boxes of Demerol injectable vials, put a needle through all the little rubber stoppers in the backs of the amps, and sucked out ten 100-milligram doses of Demerol. He—or she—then put the boxes back at the bottom of the stack with the intact sides facing outward. Those boxes were counted as ‘full and correct’ at every change of shift for days or maybe weeks.
But to answer the question directly, no, I know nothing about the missing cocaine. This was the first I heard about it.”
“How do you know so much about the Demerol?”
“I work here. Stories like that usually go around faster than cold viruses. I guess the missing cocaine was too mundane.”
Another pause for breath.
Dr. Nerdy: “So. You were . . . intimate.” He was struggling.
I pictured us in her bed. “Yes.”
“And your . . . relationship . . . was ongoing, consensual, mutual.”
“Absolutely.”
“And how are we to believe you? You said yourself some things are impossible to prove.”
I felt myself shrinking. I looked through my folder at my pages of notes about our time together. I read down the myr-iad intimate details. Clinging to the top was the credit card receipt from a jeweler’s store bearing Mimi’s signature. At LIE STILL
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this, the obvious point to pull it out, to bolster my case, I hesitated. I drew a breath. Her gift to me had been the single moment of honest romance between us. In my mind I focused on the bear’s face, my shamanistic guide. For the second time it occurred to me I might not want to be a surgeon.
In that pause Dr. Kerlin spoke. “It hardly matters. We have a, a, a confession of grossly inappropriate behavior.
And probably, use of illicit drugs.” The others looked un-convinced but I was still silent, shaking slightly, skewered by my incurable clinging to one last hopeless intimacy.
I heard little else. Voices went on, back and forth at each other, like gunfire across a killing field. It seemed nothing further was required of me. Soon enough they thanked me, then sat in silence, awaiting my departure so they could decide my fate. I trudged back to vascular surgery.
To their slight credit, they did not dismiss me on the spot, nor, technically, ever. Of course, they didn’t have to. They just did not renew me for the next year. Years ago all surgery residencies used a pyramid structure. They would take in six or eight or ten interns, then choose, each year, selectively fewer from among them to advance to the next level, until they had only two or three to graduate each year.
In theory, this left only the cream to be full-fledged surgeons, but in the reality of ass-kissing academic politics, it left only those who stayed the farthest from trouble. Precisely because many promising young doctors were abandoned after one to four years of dedicated service, most training programs had dropped their pyramid structures. At the time, though, Maricopa, to prove they were a serious residency, still did some pruning after the first and second years. A perfect way to be rid of a young doctor of questionable character, never mind his talents for surgery.