Noble Vision (16 page)

“Medicine is tainted by the profit motive. The public must be protected from doctors lining their pockets at the expense of the sick,” was the battle cry of ambitious politicians who enacted laws claiming to revamp medicine to serve the public good.

The secretary was caught off guard when the climate for medicine changed. His profession was somehow in crisis, and he had caused it. People no longer paid him homage. He felt a growing sense of guilt about his work. When a patient, Bob Martin, whose life he had saved, bought a new sports car instead of paying for his medical treatment, the secretary hired a collection agency. Bob Martin, adopting a helpless air and claiming poverty as an excuse, contacted the press to complain about his doctor’s bill collector. To the secretary’s dismay, the local newspaper, hungry for a cause célèbre, ran Martin’s story as a Sunday feature. It portrayed the secretary as a villain who gouged the disadvantaged while he lived in luxury. This started a biting public attack that the secretary found unbearable. The curious stares by colleagues, the questioning eyes of patients, and the lowered heads of neighbors avoiding him had the dark power of an impending storm. Thus, he ran for cover. He thought that somehow he was wrong, so he stopped trying to collect his fee, and the waters of his life calmed.

When a local agitator, Charles Fox, and his group, Earthlings for a Simple Planet, vandalized the secretary’s experimental laboratory, alleging that his research was polluting the environment with noxious chemicals, the secretary sued them. But he did not fight for long. The press depicted him as a monster whose self-serving experiments recklessly introduced hazardous material into the air and water. People reading the media accounts shunned him. His alma mater withdrew a speaking invitation that it had extended to him; friends excluded him from a golf meet; patients cancelled appointments. Although the Earthlings’ accusations were false, the secretary, capitulating to public pressure, dropped the lawsuit and abandoned his research. He was afraid to oppose people claiming to protect the planet.

Events like these changed the secretary. He came to believe that he was too selfish in loving medicine and profiting from it. Over the years, the topsoil of his life eroded, leading him to plant a new crop. The kinds of mementos that he collected changed. They no longer marked achievements from his medical practice but from other activities gaining in importance to him: a hat from a charity fair at which he manned a hot dog stand, a newspaper clipping about him giving money to a poor person, a photo of him sweeping trash from the street in a campaign to help the city’s garbage collectors. The secretary included among his new souvenirs a framed thank-you note from a family whose dog he had rescued from a ditch, while he omitted an impassioned letter of gratitude from an executive whose life he had saved in the hospital—and who had paid a handsome fee.

He sold his luxury car for a jeep, asked his wife to wear a wool coat instead of a mink, and canceled a major remodeling of his house. He gave up his medical practice for what he considered a more public-spirited role. He became president of the state’s medical association, where he made political contacts. Ultimately, he was appointed to head the state’s Bureau of Medicine and to administer the governor’s new program, CareFree. The post of secretary of medicine lifted his guilt. CareFree was a kind of atonement.

When asked to describe his job, the secretary would say humbly, “I work for the people.” Gradually, the luxury car, the mink coat, and the home remodeling returned to his life, along with an arsenal of new treats: the limousine, the extravagant parties he threw, the hobnobbing with the prestigious, the entourage of press, the celebrity status. No one seemed critical of his posh lifestyle now, because he worked for the people.

One morning a week, he opened his office to any citizens wanting to discuss their medical problems and their difficulties with the system. One afternoon a week, he conducted hearings against those whom he called “medical delinquents,” the doctors who broke the rules. The press hailed him as medicine’s savior.

With the lieutenant governor and other officials under investigation for accepting costly gifts from contractors awarded government projects, the governor’s administration was wounded. Burrow needed a running mate untouched by political scandal. Should the heat on the lieutenant governor increase, the secretary would likely be chosen. As he approached the meeting room, the secretary’s ready grin, authoritative gait, and impeccable grooming suggested that he could win the public’s confidence for the office he so ardently sought.

But after a life of duty, was he happy? he sometimes wondered. He had married a woman, since deceased, whose social aplomb was an asset to his career. Although he had felt many positive emotions toward her, passion was not one of them. He had bought a house suitable for entertaining, but it lacked the grounds needed for his favorite hobby, gardening. He played golf with the influential, but he really enjoyed fishing. He worked as a bureaucrat, but he loved medicine. He basked in the glory of his position; however, on the rare occasions when he was alone, he was gripped by an inexplicable sadness. His life seemed colorless in his kaleidoscope.

There was, however, one bright spot on the gray landscape of his inner life. He had two children, and although he loved them both, he favored one of them, who idolized him and shared his interest in the same field of medicine from an early age. Watching that child grow up was the thrill of his life. The child’s first words, first trip to school, first graduation were the golden milestones of contentment etched in his memories. These remembrances formed a locked room in the open house that was his life, a place not to be shared with the world but cherished in privacy.

“This way, Mr. Secretary,” said the escort, opening the double doors to a meeting room whose antique mahogany table, tapestried walls, and old paintings were reminiscent of a time when colonial statesmen met to adopt a new government. The formality of the room seemed to clash with the rolled sleeves, crumpled shirts, and loosened ties of the people gathering there.

With the air of an executive whose boardroom was the world, the secretary greeted his colleagues. His linen suit, custom-made by a London tailor, his well-styled white hair, and his Italian leather attaché case added dignity to the gathering. When all had assembled, twelve advisors sat around the oblong conference table, with the governor and the secretary at opposite ends. The table resembled a boat with oarsmen lining the sides and officers at the bow and stern.

Burrow drank from a coffee mug bearing his picture and the inscription
Back Mack for governor
. The governor’s actual face showed no trace of the smile dominating the mug. He often seemed to shift masks from comedy to tragedy, with the former reserved for public consumption and the latter, more natural, face for private.

“Good morning, Warren. You look awfully starched today, considering the heat and humidity,” said the governor, with a faint tinge of mockery in his tone.

“Good morning, Governor. I’m pleased if my appearance matches the dignity of the meeting I’m honored to attend,” said the secretary, feeling complimented.

A thump of Burrow’s feet was the only response as he put them on the antique table, leaving the secretary to gape at a hole forming on the sole of one shoe. Malcolm Burrow knew that he and the man whom he might choose for his running mate were different. The media described his secretary of medicine as “respectable,” “honorable,” and “a pillar of the community,” but it characterized him as “cagey,” “crafty,” and “shrewd.” The governor’s staff expunged the expletives from their language in the presence of the secretary but allowed their speech to flow uncensored before their boss. And Malcolm Burrow knew—not as a conscious identification but more as a hound sniffs food—that somehow these differences made the secretary suitable to be both his running mate and the object of his gibes.

“What time is your press conference, Warren?” Burrow asked.

“It’s at three.”

“Then let’s get busy, folks. In three hours Warren’s giving the media his report on CareFree, so we’ve got to figure out how he’ll answer the rumors. We’ve got tough problems to face and big decisions to make, so let’s focus on the important things: the polls and the media.” He turned to one of his advisors, a young, energetic man sitting at the edge of his chair.

“You’ve been dropping in the polls since the kickback scandal broke. Yesterday you dipped two points behind your opponent, Governor,” said the young man. “The people think they’re worse off now than four years ago, and the program they’re griping about is CareFree.”

“The press next,” said the governor irritably.

An attractive female advisor held a newspaper. “This morning the
Globe
ran an editorial with the headline ‘
CareFree or CareLess?’
” She lowered the eyeglasses resting atop her head and read aloud: “ ‘Barely two years after its ceremonious beginning, the governor’s pet project, CareFree, is rumored to be bankrupt. Reliable sources say that the demand for health care, which was expected to increase slightly when the state took over medicine, has actually doubled and is still climbing.

“ ‘While the public clamors for care, there’s a growing scarcity of providers. This year a record number of doctors quit, enrollment in medical schools dropped, and long-established hospitals closed their doors.

“ ‘We suspect that CareFree may cause the governor’s demise on election day, unless a tonic is administered now to treat the ailing program. In his news conference this afternoon, will the secretary of medicine announce an elixir for CareFree? Or is it too late for remedies? Will we be wise to break our legs and have our strokes before CareFree’s budget springs a fatal leak? Perhaps the time has come for someone new to steer the ship of state.’ ”

When the advisor dropped the paper and looked up, the only smile she saw in the room was imprinted on a coffee mug.

“Those reports are vicious lies spread by my enemies,” said the governor, springing to his feet and pacing. “CareFree bankrupt? That’s preposterous!”

“It’s absurd!” said an advisor.

“It’s ridiculous!” said another.

“It’s outrageous!” said a third.

“It’s true,” said the white-haired man with the starched shirt.

All heads turned to him.

“The situation is worse than the media guessed. Our budget
is
going to run out,” said the secretary.

“
After
the election?” the governor asked hopefully.

“Before.”

No one disputed the secretary’s words—or seemed surprised.

Burrow’s voice shrieked. “Something’s gone wrong, and we’ve got to fix it.”

“I prepared a financial report on our expenditures,” said the secretary, reaching into his briefcase for a stack of spiral-bound documents and distributing copies to everyone.

The governor rolled up his copy and slapped it against the table. “CareFree can’t go belly-up!”

“Let’s hit Washington,” someone said. “They bailed us out before.”

“Forget it. They contributed all they’re going to. We’re making history with a landmark program, and Washington’s leaving us to rot,” griped Burrow. He paced restlessly, waving his rolled copy of the report at the group. “Let’s analyze this baby line by line and throw out everything unessential.”

Twelve heads bowed to study the report.

“We mustn’t allow anything new,” said someone to Burrow’s right. “No new hospitals, wings, pavilions, or treatment centers. More facilities mean more billings, and we can’t pay them.”

The others nodded in agreement.

“Here’s something for the scrap heap,” declared the woman who had read the newspaper column. “On page two, I see that one district is adding two thousand hospital beds, but they already have more beds per capita than any other district in the state. Let’s ax this now.”

“But that’s Waterbee’s district,” said the governor, glancing at his report. “Don’t anybody scratch that!”

“Oh, right, I forgot.”

Bill Waterbee was an influential congressman who had broken ranks with the opposing party to back CareFree.

“Keep looking,” Burrow said, tapping a finger on the table. “Watch for expensive equipment like scanners. No facility can buy one without our authorization, and we’re not giving it.”

“Page seven shows that Nassau County is getting two new scanners,” said a woman who had been a business consultant. “This report indicates it already has more scanners per capita than any other county. Let’s scrap that acquisition.”

“Sure, Helen! Scrap Louie Marcone and watch me end up on the trash heap, too.”

“Sorry, Mack, I forgot about Louie.”

Nassau County was home to the largest manufacturing plant in the state and the seat of a powerful union headed by Louis Marcone, a man Burrow wooed the way a casino courts a high roller.

“Keep looking, folks,” the governor continued. “We’ve gotta trim the residency programs, so we limit the number of new surgeons. They cost a fortune, and only a small percentage of people need them.”

“Here on page eight, the budgets of Galen College of Medicine and its residency program were increased. Let’s cut them,” said another aide.

“But remember last March?” someone replied. “We were free-falling in the ratings over Galen.”

“Oh, of course,” the first aide said apologetically.