Noble Vision (17 page)

The previous March, the community served by Galen College Hospital staged a massive demonstration to protest the state’s rejection of their plan for a new cancer facility, and the governor’s approval rating plummeted until the BOM finally consented.

“Keep looking! Let’s curb medical research,” Burrow continued. “That’s the easiest thing to cut. Because people don’t have the benefit of it yet, they don’t know what they’re missing.”

“Governor,” remarked an advisor, “page ten shows we’re shelling out millions on research to cure baldness. Let’s cut this.”

“Are you crazy, Chuck?” replied a voice from across the room. “Last week in Manhattan the applause meters jumped off the scale when the governor announced CareFree’s research project to cure baldness.”

“Oh, that’s right. Damn!” Chuck responded, leafing through the report to find something else.

“You people want to cut things that are necessary! Let’s look for something we don’t need,” said Burrow.

“What about the ten million dollars for education? Let’s scratch that.”

“CareFree needs education, Norma. We need seminars, videos, booklets, TV spots, and counselors to explain to people what the new system is and why it’s good,” said the governor.

“And we always gain in the polls after we blitz a community with an education program,” someone added.

“Then let’s get rid of the fluff—the free checkups, free contact lenses, free nutritional counseling, and free vitamins. These programs bleed us dry, and they couldn’t be essential,” said another aide.

“They’re more essential than anything else. The majority of folks are healthy. They need some benefit from the taxes they pump into CareFree, something to remember on election day. I need to
increase
what you’re calling fluff,” said the governor.

“Besides, those programs are Buddy’s turf,” another voice added.

Buddy Terkins, New York City’s director of community affairs, was an outspoken supporter of Burrow, and Buddy had a following.

“Maybe we can eliminate some bureaucrats, Governor,” said another aide. “We now have as many bureaucrats as we do doctors.”

“Then where’s the progress?” asked Burrow, as he stopped pacing to stare at the aide. “We need the bureaucrats to run things because they’re unselfish and impervious to personal gain.”

“Then let’s raise taxes,” said a young advisor just out of college.

The governor laughed. “Glen here thinks it’s simple. All I have to do is raise taxes . . . when I promised for four years to cut them? When I’m committed to cutting them? When my opponent smears me every day for not cutting them—and you’re telling me to
raise
them?” the governor bellowed.

The young man fidgeted. “It was just a thought,” he whispered.

“Keep looking!” Burrow ordered. But no one replied. Glen’s flushed face seemed to silence the rest. “How much time do we have, Warren, before things get . . . out of hand?”

“If we continue spending the way we have been, CareFree won’t be able to meet its payroll in three weeks.”

“Three weeks!” gasped the governor, his forehead wet, his face white. “Our employees will strike. The doctors will join them. We’ll have demonstrations, violence, chaos! The media will cremate me. It’ll be the end of my political career!” Burrow sagged into his chair with a thump, his shoulders slouched, his jaw dropped. “We’re in a goddamn fix. I can’t cut the programs; I promised to expand them. I can’t raise taxes; I promised to lower them. What am I going to do?” “Warren, help me,” he pleaded. “Do you know what to do?”

Everyone turned to the white-haired man who had been silent through the discussion.

“Yes, Mack, I do.” The secretary’s calm voice was a cool salve on the governor’s frazzled nerves. “But first I want to explain some actions of my agency that were mentioned here, actions that would be embarrassing to me if they were misconstrued,” said the secretary. “Some of you may wonder why my agency seems to have dispensed favors and given preferential treatment to some people over others for political gain.”

“Nobody wonders about that, Warren. Everybody here knows how politics works,” said Burrow.

“Two years ago when I became head of the BOM, I vowed to place no concern over the public interest, so I want to explain, as a matter of principle, why my agency seems to be acting arbitrarily and playing favorites left and right.”

The governor glanced at his watch. “Let’s not waste time, Warren. Everybody knows we have to scratch a few backs to get ours scratched.”

The secretary continued. “I assure you that I am still dedicated to upholding my sacred trust to serve the public. However, I realize that for CareFree to survive, our party must win in November. Therefore, any measures we take to win votes are noble actions for a worthy cause, rather than arbitrary abuses of power for political gain. A noble end sometimes requires, well . . . practical means.”

Burrow snickered. “Folks, I think you’ll find that Warren hits the ball just like everybody else, only he does it from his high horse.”

The advisors silently turned their heads back and forth, from the governor to the secretary, as if watching a tennis match.

“I blame the doctors for our troubles,” the secretary continued. “They want the old way back. They don’t follow the rules. They drive up the costs. They give us a hundred excuses why they can’t comply and why we should make exceptions. Their stubbornness requires continually more inspectors and rules to police them. Regulators and red tape consume
half
the budget. But if the doctors cooperated, we wouldn’t need
any
bureaucrats. If the doctors complied voluntarily, because they were just as enlightened as we are, we wouldn’t need the inspectors and paper trails to keep them in line. Can we permit this subversive behavior by a group privileged to serve the public?”

“No, Warren, we can’t!” cried the governor, galvanized. The anger building inside him like an overheating radiator seemed to find a vent. “You’ve put your hands on the problem. We’ve got our great program threatened, my political future collapsing, and the people thrown into a crisis—by what? A few individuals with special skills who think they can hold the rest of us hostage. And for what? So they can have a few fancy cars in their garages? Is that why the people have to go without the services they need?” He snarled. “I won’t stand for it. We need to hit the doctors over the head.”

“Forgive me, Governor, but while we agree on the cause of the problem, I must reject your solution as, well, barbaric.”

“Just what do you mean by that?” snapped the governor.

“We need to impress on the doctors their social responsibility,” said the secretary.

“We need to show the doctors who’s boss,” said the governor.

“We need to enlighten them about their moral obligations.”

“We need to rein them in.”

“We need to tell them to stop breaching our rules. We need to tell them
emphatically
.”

“
Emphatically?
” the governor asked, puzzled.

“Yes, emphatically.”

A coffee-mug grin was forming on the governor’s face as he studied the secretary.

“We’ve been too lenient, Mack. When the doctors disregard the rules, we fine them a few thousand dollars, which for many of them isn’t enough of a deterrent. The arrogant ones pay the fines and commit the same offenses again. We have the power to be tougher. We can suspend them, revoke their licenses,”—his voice lowered—“or even throw some of them in jail.”

The governor clasped his hands behind his head and leaned back in his chair, as if basking in the noonday sun. “Perhaps I was too quick to question your approach, Warren.”

“I disagree with you, Mack, when you say that we have to hit the doctors over the head. With all due respect, I loathe such uncivilized behavior, if you will forgive me.”

“Oh, I do, Warren, I do.”

“Rather than instill fear in the providers by resorting to the force of the state, we must raise their consciousness so that they look beyond their personal interests to the common good. The cooperation and compliance of the doctors will save us millions of dollars and will save the soul of CareFree. I believe that the only thing that can save us is the doctors’ acceptance.”

“Warren, I now see your point,” said the governor, his face beaming. He looked like someone pleased to be getting what he wanted, even if under a different name.

“At my press conference this afternoon, I’ll tell the doctors that they must meet their social obligations, which means they must cooperate, sacrifice . . . and obey.”

All signs of suspicion vanished from the governor’s face. He smiled at the white-haired gentleman with the regal bearing. “Warren, I think you have the
perfect
solution.”

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The tall shade trees on the lawn of the state capitol strained to resist the gusts bending them to the breaking point. The secretary of medicine faced reporters at the steps of the stone building, his well-groomed white hair being jostled by the wind. The state and national flags draping his outdoor podium flapped loudly in the turbulent air. The secretary eyed the mounting storm clouds, for he had planned not only to hold his press conference outdoors but also to travel afterward from Albany to New York City for an important dinner engagement.

“Mr. Secretary, would you like to move the conference indoors?” an aide asked.

“Why, no. We shouldn’t let a few dark clouds scare us.”

The secretary reassured New Yorkers that CareFree would triumph because it was a noble plan. His thick white hair brightened the darkening scene like a beacon atop a lighthouse. His impassioned voice sparked hope.

After his introductory remarks, the secretary delivered his message: “Fees paid to hospitals and doctors will be reduced by fifteen percent in order to meet CareFree’s temporary financial challenges, which the providers themselves have caused with actions that were self-serving rather than public-spirited.”

He felt a sudden jolt at the sight of a young man joining the crowd that had gathered. The man, who was a wearing a doctor’s white coat, had probably wandered over from a nearby hospital. A disturbing image of himself as a young doctor under siege flashed through the secretary’s mind. Was he now the Bob Martin and Charles Fox in the life of the physician before him, making unfair accusations that everyone would believe and that the doctor would be helpless to combat? His mind slammed a door on the unwelcome thought before it could gain a foothold. Another, more comforting idea hurried to replace it: He reminded himself that he was working for a noble cause—the good of the people. Thus, his actions were justified.

He continued his speech with added vigor. “CareFree guarantees everyone the right to medical care. The doctors have a duty to provide that care, and I have an obligation to see that they do. If any doctor flagrantly and willfully violates the law, I will personally impose stringent consequences. We cannot permit lawlessness. I will uphold the rules so that the public can receive all the benefits of CareFree.”

Lightning flashed in the distance. It was soon to strike closer.

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The same dismal sky blanketed Manhattan that afternoon, subduing its glorious cityscape to a cluster of black shadows in gray space. Inside the executive offices of Riverview Hospital, the board of directors was meeting to elect a chief of neurosurgery. The group had invited David Lang to address them prior to their private deliberations and vote. In their pinstriped suits, they sat on swivel chairs around a glass-topped conference table, listening to hospital administrator Randall Lang enumerate David’s credentials. To the board, the surgeon, who sat beside his brother, appeared calm. Only Randy could detect the troubled look in David’s eyes, which made him decide that it would be better if his brother spoke as little as possible.

David reminded himself of how close he was to unveiling the secret of healing that the nervous system had so cleverly hidden. In time, he would heal, too. He warned himself that if he gave his word, he would have to honor it. For as long as he could remember, he had viewed a promise as a sacred commandment never to be broken. He reassured himself that there was no reason to feel uneasy. Hadn’t he already taken the necessary steps to keep his vow? He had begun to curtail his practice. He had hired an additional secretary whose sole job was to ensure his compliance with CareFree. He had resolved to enter and leave his office from a back door that bypassed the waiting room, to avoid contact with unauthorized patients attempting to see him. And he had cleared his desk! He had taken steps to bring himself closer to CareFree and to distance himself from the growing number of desperate patients who somehow managed to find him.

He wished the meeting were over. His head was beginning to ache. He wanted to be happy at the prospect of completing his research, but he could feel nothing. The vision of a young dancer swept across his memory, and with it the special joy of a free spirit. But he must not think of that particular image—of a free spirit—at this meeting. He forced his mind to concentrate on the simple task at hand. He would be asked to give his word, and he would do so. Then he would steadfastly stick to his plan and keep his promise. By virtue of this one vow, he could complete his years of research and resolve questions left unanswered through the centuries.