Monday Mornings: A Novel (23 page)

His own father, Mayhew, was a doctor who had seen the rise of lawsuits and hung up his white lab coat for a pin-striped suit and started selling malpractice insurance. He made a killing, amassing a fortune in the years after World War II. Hooten had three bothers, and they now shared the family summer estate on Mackinac Island, an enormous white clapboard affair on the water, with a wraparound porch and gabled windows on the third floor.

Martha met her future husband while he was still in residency in New York in the late 1960s. At some point, he had invited her to spend a long weekend at the family estate. The weekend marked a rare respite from the grind of residency and the first time Martha had met Hooten’s parents.

Hooten purchased the airline tickets, and they had flown Pan Am from Kennedy International Airport, which had been renamed recently enough that some people still called it Idlewild. They landed in Detroit, and a car was waiting for them. When Hardy didn’t raise an eyebrow, Martha realized there was more to this earnest, diligent, honorable man she had fallen for than his bow ties and the tender way he touched her cheek when they kissed.

Rolling up to the sprawling family mansion, Martha realized that what drove Hooten had nothing to do with money. As the country convulsed around them after the Martin Luther King assassination and riots, Robert Kennedy’s assassination, the Vietnam War protests, Chicago’s violent Democratic convention, Hooten remained focused on his training. His only diversions were Martha and his growing expertise in birding. He almost never slept.

Martha learned quickly that Hardy’s work ethic was undiminished by family money and unmoved by the pot-and-protest-stoked ethos around the Columbia University campus not far from his apartment. That he maintained this feverish schedule into his fifties and sixties was a testament to his drive and his love of medicine.

Four decades after they’d met, Martha knew the hospital was still the center of Hardy’s life. She feared he would die of boredom if he retired, like his friend. Having him only part of the day beat that alternative, she reminded herself when she was home alone.

“I’ve got a piece of unpleasant business to attend to,” he said at the threshold as his wife straightened his bow tie.

At the hospital, he had the paging operator send a message to Michelle Robidaux, asking her to come to the twelfth floor. She arrived, still ebullient from her recent back-from-the-dead experience. Michelle wondered if a journal would be interested in Earl Jasper as a case study. She’d seen case studies in the
New England Journal of Medicine
. The thought of her byline in the
New England Journal
made her almost giddy. She’d already started thinking of a title: “Failure of Glasgow Metrics to Ascertain Minimum Brain Consciousness—A Case Study.” The title needed work, for sure, but she saw career-advancing possibilities in the racist killer. He might just be the break she needed.

Hooten’s admin waved Michelle through, and moments later she was standing in front of the great man himself. She had only formally met him once, at orientation,
And now he knows my name
, Michelle thought.
I am the resident who kept a conscious man from being cut up like a catfish
. The thought of noodlers grabbing for organs made her smirk despite herself.

“Dr. Robidaux, thanks for coming up,” Hooten said.

“Sure,” Michelle said. She bounced on the balls of her feet, almost giddy with anticipation. She hadn’t yet realized that his grave expression and grim tone were not in line with her vision of the meeting. This was not the look of a man congratulating a junior colleague. Michelle had no idea what was coming.

“I’m not sure if you’re aware of the reason I called you up here.”

“I think so, sir. Earl Jasper?”

Hooten looked perplexed for a moment. “No, I asked you to see me because of the meningioma resection you performed on a patient named Mary Cash.”

It was Michelle’s turn to look perplexed. The name was such a departure from what she expected, the young doctor was lost for a moment. “You may recall,” Hooten continued, “Ms. Cash had a serious complication. Lost her olfaction. As a chef, this was a life-altering event for her.”

Michelle’s elation evaporated. The embarrassment of remembering the case caused a tightening of her stomach muscles and the blood vessels below the surface of her skin to dilate and become suffused with blood. Michelle’s cheeks reddened.

“Yes, yes, I do remember the case. Yes, sir.” Now Michelle realized she had not been called to the legendary Harding Hooten’s office to be congratulated for saving the hospital the horrible embarrassment of killing a conscious man. She had been summoned about an operation that had gone badly. Her operation. Michelle felt as though someone had squeezed the air out of her.

“As you know, the young woman is suing the hospital. That in and of itself is not unusual. In this case, however, we are going to have to respond aggressively, and as the hospital legal counsel sees fit.” Hooten paused. This was a distasteful business. “It is with regret that I am terminating your employment at this hospital, effective immediately.”

Again, the words did not sink in right away. Michelle felt as though she were at the bottom of a pool, and the words were reaching her one at a time.

“Terminate?”

Before Hooten could answer the question, a harried woman in a pantsuit entered his office carrying a legal pad and a sheaf of papers. She looked from the stunned Michelle Robidaux to Hooten. The woman’s eyes widened in surprise and then her cheeks flushed with anger.

“Dr. Hooten? I thought we agreed that you would wait for me.”

“You said two o’clock. It is now two ten.”

The woman took a deep breath and quietly muttered, “On a Sunday? Really, Dr. Hooten?” She turned her attention to Michelle.

“Michelle Robidaux. My name is Nancy Lowenstein. I work in human resources here at the hospital. I’m here to make your transition as smooth as possible.”

“Transition?” Michelle asked. “That’s what you call it?”

Michelle was now gulping for air, trying to hold back the sobs, trying not to think of what she would tell her parents, Mrs. Truex the librarian, and her brother, Michelle’s benefactor.

Hooten stood up.

“Ms. Lowenstein. I will leave you to it.”

With that, he stood up, grabbing his white lab coat on the way out the door.

CHAPTER 27

A

t precisely 6 am, Dr. Harding Hooten stood before the assemblage of bleary-eyed surgeons in Room 311.

“Before we get to the business of the day, I want to let you know that our colleague Dr. Sung Park is doing as well as can be expected. He’s moved from neurological intensive care to a private room here in the hospital. I know you share my wishes that his recovery be swift and lasting.”

Hooten paused and then nodded to Villanueva, who sat in the front row like an oversize schoolboy at the principal’s office.

“And now my colleague George Villanueva will present the case of Earl Jasper.”

Hooten returned to his seat next to Sydney, among the few who looked wide awake. Truth be told, Sydney had already run eight miles that morning. She was on call and knew she wouldn’t get another chance to exercise that day.

Villanueva stood up and walked to the front of the room. His plan was to come clean, admit wrongdoing, and move on. That was the way things worked in Monday Mornings. Spell out your shortcomings in painful detail, submit to the questioning of the assembled surgeons, and put the episode behind you. You might even learn something through this Socratic
mea culpa
. This Earl Jasper case just rubbed Villanueva the wrong way. He could see nothing redeeming about this racist SOB at all. Like a mosquito, Earl Jasper had done nothing to justify his place in the world.

A couple of decades earlier, Villanueva had raised his right hand in Hill Auditorium, looking up at the beautiful, arched, art deco stage, and taken an oath. Swelled with pride—and the doughnuts that fueled his late nights—the Big Cat had sworn he would “prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.” Clearly, not allowing the neurologist to see Jasper in the Emergency Department was not the correct regimen for this patient. Yet the scumbag had made it. No harm, no foul.

Easy
, Villanueva told himself. Submit to the proceedings. Take his lumps. It was no different from Mondays in the NFL. If you missed a blocking assignment, the coach was going to rewind and play and rewind the film of that mistake over and over and over. Fire out of the stance, miss the block, jump back to the three-point stance, fire out again, and so on. Missed assignments could be dangerous. The quarterback or running back could take a serious hit. But no one died from a missed blocking assignment. Not yet, anyway.

Monday Mornings were sacred. They were there to save lives. To learn from mistakes. To allow the participants to rededicate themselves to practicing the best medicine humanly possible. Villanueva knew this. Still, he couldn’t put the vision of Jasper’s grandmother out of his head. An old woman torn up by a shotgun blast at close range. Why couldn’t she have been the one to survive? He’d read in the newspaper that Jasper’s grandmother had raised him, and that he’d gone into a rage and shot her when she wouldn’t give him twenty bucks.

“Dr. Villanueva, we’re ready for the your presentation,” Hooten said.

Grandma never stood a chance
, Villanueva thought, and then began.

“Let me give it to you in a nutshell. This neo-Nazi dirtbag who had just killed his grandmother showed up in my ER.”

Hooten interrupted, “Dr. Villanueva, Morbidity and Mortality is a time-honored medical proceeding. I expect the appropriate decorum.”

Ty Wilson nudged Tina Ridgeway, who sat next to him. “That’s the Gato we know and love,” he said.

“That’s the Hooten we know and love,” Tina answered.

Chastened, Villanueva continued, his voice not quite as combative.

“Mr. Earl Jasper presented in the ER with a single gunshot wound to the head, with the wound penetrating his hard palate, inferior turbinate, middle turbinate, superior turbinate, ethmoid bone, entering his frontal lobe and exiting through the skull above his right eye. By all appearances, this dirtbag—excuse me, Mr. Jasper—had died of lead poisoning—”

“Dr. Villanueva,” Hooten cautioned. His tone was now cold and biting. He was losing his patience.

“How did you know that? How did you know he died?” a surgeon called from the back of the room.

Villanueva took another deep breath. When he was pushed, Villanueva liked to push back—hard. When he was challenged, he liked to destroy the challenger. If someone gave him a cheap shot on the football field, he did his best to take that person’s head off the next chance he got. Villanueva fought the impulse to say something about the large hole in Jasper’s skull, but he knew he was wrong, and he decided to come clean. He held his hands up in submission.

“All right, you win.”

“It’s not about winning,” Hooten scolded. Villanueva paid no attention to him and plowed ahead, looking at his shoes and feeling every bit like a chastened schoolboy.

“I let my emotions cloud my judgment. I was too busy looking at that damn swastika to pay attention to the patient.”

“Since when do we need to judge people worthy before we treat them?” called one surgeon from the back of the room.

“Tell me about it,” an ER doctor added. “All the noncompliant, abusive alcoholics I see.”

“I admit it, I was wrong,” Villanueva said. “I. Was. Wrong.” The room was completely silent. This was a monumental moment, even given the history of Monday Mornings. Villanueva hung his head, and was about to continue when he heard a noise.

A smattering of applause started in the back of the room and began building. Confused, Villanueva looked up. He’d never heard his fellow surgeons applauding an admission like his. He saw the doctors standing now, cheering. He was bewildered for a moment, and even started to raise his hands in acknowledgment. Then he realized they weren’t applauding his public admission. They were looking toward the back of the room. Villanueva followed their gaze. There, his arm intertwined with his wife’s, was Dr. Sung Park taking a seat. His head was bandaged, and he looked weak and pale, but he was smiling.

Villanueva began clapping along with his colleagues.

Hooten now stood and turned to find the source of the commotion. When he saw Park, he raised his fists as a boxer might.

“Bravo, Sung!” Hooten called. “Bravo.”

Doctors were now leaving their seats to crowd around Park, shake his hand. Park looked almost shy, surrounded by his peers. Next to him, Pat Park beamed, tears streaming down her cheeks.

A
fter M&M, Park’s wife took him back to his room at the hospital. Ty and a number of other surgeons went to the cafeteria in search of a few calories before their days began. The cafeteria was an enormous rectangular room that had undergone a makeover in recent years designed to give the illusion that it wasn’t an enormous rectangular room.

Stations for omelets, cold cereal, and coffee sprouted away from the long, stainless-steel line serving up eggs, grits, pancakes, hash browns, bacon, and other foods most cardiologists forbid their patients from eating. There were also the calorie-laden cinnamon pastries and doughnuts that led to many of the medical problems being treated in the hospital. Cloth banners hung from the ceiling at the midpoint of the room, near the cashiers, to divide the space and muffle the noise. Still, the overall impression was something between a Picadilly Cafeteria and a medium-security prison.

Ty sat down in a far corner of the room with a bowl of cereal and a cup of green tea. Park’s entrance had given him a charge. He hadn’t expected it; nor would he have guessed that his groggy and cynical colleagues would give the oddball neurosurgeon such a rousing welcome. The scene left him feeling somehow lighter than he’d felt in a while. On a whim, he’d bought the single-serving bowl of Froot Loops, a cereal he hadn’t eaten since grade school.