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To Dr. David Neubert,
who is everything a doctor should be.
CONTENTS
CHAPTER 1
CHAPTER 2
CHAPTER 3
CHAPTER 4
CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
CHAPTER 10
CHAPTER 11
CHAPTER 12
CHAPTER 13
CHAPTER 14
CHAPTER 15
CHAPTER 16
CHAPTER 17
CHAPTER 18
CHAPTER 19
CHAPTER 20
CHAPTER 21
CHAPTER 22
CHAPTER 23
CHAPTER 24
CHAPTER 25
CHAPTER 26
CHAPTER 27
CHAPTER 28
CHAPTER 29
CHAPTER 30
CHAPTER 31
CHAPTER 32
CHAPTER 33
CHAPTER 34
CHAPTER 35
CHAPTER 36
CHAPTER 37
CHAPTER 38
CHAPTER 39
CHAPTER 40
CHAPTER 41
CHAPTER 42
CHAPTER 1
Dr. Ivan Munro liked saving lives, liked making a difference in those lives. It was people he didn’t care for.
People with their endless complaining. People with endless details about their humdrum lives that he had absolutely no interest in. If he possessed so much as a thimbleful of mild curiosity regarding his patients, he would have gone into a medical discipline that required contact with those patients on a fairly regular basis.
But such contact would have necessitated feigning interest on his part and he had never been one to lie or even seen the need to lie. Ever. For any reason whatsoever. The truth, any truth, was what it was and needed to be faced. No sugarcoating, no beating around the proverbial bush. Just shooting straight from the hip.
He’d chosen neurosurgery as much as it had chosen him and he’d selected it for three reasons. The first was to heal, to pit himself against the power that delivered such a low blow to the individual on his operating table. The second was that it was the only way he could possibly make it up to Scott, even though Scott was no longer around to see the results.
The last reason was distance. Neurosurgery afforded him distance. Once he tackled a condition, he could distance himself from the recovering patient and thus move on, leaving the chore of hand-holding to the patient’s friends, relatives and/or referring physician, all people who were far better suited to the tedious chore than he. They were the ones who either wanted or felt compelled to establish and maintain a rapport with the patient.
He’d been told, more than once, that he had the bedside manner of an anaconda. He took it as a compliment. Ivan could not, would not, allow emotions to get in the way of his making a judgment call.
Unfortunately, emotions or some sort of cursory display of them, was what most patients thought they both needed and were entitled to. His chief of staff, Harold Bennett, a man he grudgingly admired and respected, told him that was the way patients knew that they were in capable hands. They measured capability by the physician’s capacity to act as if he or she cared.
Ivan cared, all right, cared that he successfully eliminated the tumor, or reconnected the nerve endings, cared that he did no harm and only accomplished what he’d set out to accomplish: to make the patient better than he or she had been when they’d first laid down on his operating table.
But as for verbally talking the patient through the steps of the surgery before it transpired to set to rest any fears that patient might have, well, that just was not why he got up each morning to come to Blair Memorial Hospital.
Being “patient with patients” wasn’t something he was any good at and he saw no reason to pretend that he was. He wasn’t in medicine to forge friendships, only to save lives.
“They call you Ivan the Terrible, you know,” Harold told him over the lunch he’d insisted that his chief neurosurgeon share with him in his office.
There was an ulterior motive for the invitation. It was that most painful time of year again. January. Time for the annual review where budgets were wrestled with and unpleasant decisions had to be made. It was a time to lightly sprinkle praise and to make a sincere call for improvement. This meant even from a man who clearly did have the ability to walk on water, but did not, to any and all who took note, possess so much as a single drop of humility.
“I know,” Ivan replied, his attention appearing to focus on his sandwich. “It’s my name. Good sandwich,” he commented in the next breath, infusing as much interest and feeling in the last sentence as he had in the first two he’d uttered.
After almost a dozen years, Harold was skilled at tiptoeing into conversations with his chief neurosurgeon. “Funny, I don’t remember seeing ‘the Terrible’ on your application form.”
“I didn’t want to brag,” Ivan replied in the semi-raspy voice that was his trademark. As far as anyone knew, it had been awarded him courtesy of a near-crushed larynx he’s sustained from an incident in his late teens. An incident that he never talked about. Rumor had it he’d offended someone and they’d tried to hang him. The rumor tickled Ivan and he never bothered correcting it.
Harold tried again. “Ivan, I know that you’re good at your job—”
Dark eyebrows rose on a relatively unlined forty-six-year-old forehead as Ivan looked up at the man across the desk. He stopped eating.
“‘Good’ is a very mediocre word, reserved for things like pudding or foodstuffs chosen for breakfast and touted in mindless television commercials. It also can be used to praise a child for mastering accomplishments society requires, like potty training. ‘Good boy, good job,’” Ivan added for emphasis and as examples. “It also blandly shows up in greetings. ‘Good morning. Good afternoon.’ Or in partings. Such as good night or goodbye. Equally as bland and in no way descriptive of what I do when someone comes to your illustrious hospital holding a severed hand and expecting to be reunited with it so that it’s of some use to them.”
The chief of staff closed his eyes for a moment, searching for strength. He and Ivan had known one another for twelve years now. He had been the one to hire him and he was as close to a friend as he imagined Ivan Munro had. But there were times when the man’s personality was a little hard to take. Specifically the hours between dawn and midnight.
To get to his point, Harold acquiesced. “All right, you’re magnificent at your job—”
“Better,” Ivan allowed charitably, nodding his head and once again focusing on his pastrami on rye.
It was getting late. He had a meeting scheduled at one, Harold thought. At this rate, he was never going to get to his point. “Look, I didn’t call you here to praise you—”
There was a hint of a smile as Ivan looked at him. “Good—see how I worked in your word?—because you’re doing not that excellent a job of it.”
Abandoning finesse, Harold blurted, “Ivan, you need to learn humility.”
Ivan cocked his head, as if he were deliberating over the request. He obviously found it wanting. “Why, Harold? Will it make me a better neurosurgeon?”
Harold blew out a breath. “It’ll make you easier to get along with.”
Ivan laughed shortly. He paused to take a sip of the iced coffee—he required and consumed all forms of caffeine whenever possible—before commenting on what he felt was the absurdity of the last statement.
“I’m not here to get along with people, I’m here to put together people’s pieces, remember? You want someone easy to get along with, hire some clown in big, floppy shoes and a red rubber nose. I don’t do floppy shoes or red rubber noses, Harold.”
Harold looked at him over the half glasses that were perched on the tip of his nose. He wasn’t about to be dissuaded or diverted from the path he was determined to take. “We have classes now.”
Wide, rangy shoulders that could have belonged to a one-time football guard rose and fell carelessly at Harold’s words. “You’ve always had classes, Harold. This is a teaching hospital.” Holding his sandwich with both hands now, the pastrami overflowing at the nether end, he fixed Harold with a penetrating look. “The question is, do you have hot mustard?”
Harold sighed. Reaching for a packet of the requested condiment that was on his side of the tray, he pushed it across the desk toward his irritating neurosurgeon. “Classes that teach interns bedside manner,” he doggedly continued.
To his surprise, Ivan nodded his approval. “Excellent.”
Harold squelched the urge to pinch himself. His association with Ivan had taught him never to jump to an obvious conclusion even if it was shimmying before him. “You mean that?”
“Of course,” Ivan attested with feeling. “The more of those little buggers who come out knowing how to coo and make it ‘all better’ for Sally or Bobby or whoever, the less likely we’ll be having this annoying conversation again.”
Harold sighed. “How is it your parents never drowned you?”
“I was too fast for them,” Ivan deadpanned, then nodded toward the chief of staff’s plate. “You going to eat that pickle?”
“Why?” Harold asked. “You’re not sour enough?”
“Touché.” Not standing on ceremony and aware that the older man didn’t really care for pickles, Ivan commandeered it and dropped it on his own paper plate. A tiny yellow-green pool of pickle juice formed. Ivan played along with the chief’s quip. “Let’s just say I don’t need any input in that category.”
“No, by God, you don’t.” It was more of a lament than an evaluation. “All right, I can’t force you to take that class.”
“Glad you see that.”
Harold wasn’t finished. “But I can assign you a resident.”
Ivan’s expression was deceptively bland, but his eyes locked on the other man. “Not if you know what’s ‘good’ for you—see, there’s that word again—or for the resident.”
And then Harold said the unthinkable to him as he shook his head. “This is not negotiable, Ivan. You refuse and you’re gone.”
CHAPTER 2
Silence hung in the book-lined office, mingling with the smell of pastrami and the faint odor of lemon-scented furniture polish. Outside, the sky was appropriately gray, nursing a Southern California January that had been fraught with rain for most of the month. The fluorescent lighting seemed somber and dim.
“You’re not serious,” Ivan finally said.
Harold was relieved. He’d half expected Ivan to continue his silence—by leaving the room. Dialogue gave him hope. “Very.”
Ivan frowned. “I don’t respond well to threats, Harold.”
“This isn’t a threat, Ivan, it’s reality.” It wearied him to have to go over this, but the alternative—to lose Munro—was unthinkable. “As you probably already know, the board is not exactly crazy about you. You’ve alienated over half of them.”
Ivan pretended to look both aghast and saddened. “And here I was, getting ready to ask them to go to the prom with me.” He shook his head. “You just never know, do you?”
Like a full-on game of doubles played across an extra-wide tennis court, meetings with Ivan always exhausted him. Didn’t the man understand that he was on his side? That he was one of the very few who actually were? “Ivan, this isn’t a joke.”
“Isn’t it?” Ivan scowled at the very thought of having to nurture a fledgling surgeon. “How am I supposed to do my work with some wet-behind-the-ears lower life-form following my every move, sucking up to me and trying to absorb everything like a nondiscriminate sponge?”
Maybe the man wasn’t aware of the way he sounded. Maybe he should have brought in a video camera so that he could play this all back for Munro and let the neurosurgeon witness firsthand just how abrasive he came across. “Now that’s what I’m talking about. You’ve got to change your attitude.”
Unblinking, cold brown eyes fixed on him. Ivan’s face remained expressionless as he asked, “Why?”
The answer, Harold thought, was very simple. He smoothed out the edges of his bow tie with his thumb and index finger. A sign to those who knew him that he was nervous. “Because people hate working with you.”
Ivan shrugged again. “Easy enough solution. Get new people.”
The man just didn’t get it, did he? For the sake of a tenuous friendship and because Munro was the best neurosurgeon he had ever known in his thirty-year career, Harold persisted. “Ivan, if you don’t change, you can’t operate.”
Something resembling a smirk crossed Ivan’s lips. But when he spoke, he was deadly serious. No quips, no sarcasm. “I don’t operate with my attitude. I operate with my skill. Everything else is secondary and unimportant.”
Some people preferred to be nonconfrontational. Sadly for him, Harold thought, the chief neurosurgeon of Blair Memorial did not number among them. Arguing appeared to be something Ivan both enjoyed and keenly relished, sharpening his wit as if it were a sword in need of constant honing. So rather than continue on a field of battle where he was hopelessly out-matched, Harold moved aside what was left of his ham-and-Swiss sandwich and pushed forward a dark blue eight-by-eleven folder.
Ivan perused the cover with a smattering of interest, but made no effort to open the folder. “If that contains a bribe, Harold, I’m afraid you’re out of luck. I only take bribes on Fridays. Today is Monday.” With a nod of his head, he indicated the calendar on the chief’s desk. “Try me again at the end of the week.”
Harold pressed his thin lips together. He could almost hear his wife’s voice in his head. Rachel had been after him for years to retire. If he’d listened five years ago, his hair might still be black instead of completely gray. Ivan, he noted, still didn’t have so much as a single gray hair.
“I’m perfectly aware what day it is, Ivan,” he replied tersely. “And no, it’s not a bribe in the folder. It’s your career.”
Ivan glanced down at it, then back at the chief. “The folder should be bigger, then.”
“Open it,” Harold instructed.
To his surprise, Ivan smiled. Patiently. As if he were humoring someone not entirely in possession of his faculties. A few more sessions like this, Harold thought, and Munro might be right.
“Is it me,” Ivan asked, “or are you getting testier in your old age?”
“Oh, it’s definitely you,” Harold told him with feeling, his meaning clear. “All you. Now open the damn folder, Ivan.”
“Well, since you asked so nicely.” Ivan set aside the last of his sandwich and carefully wiped his fingers on the stiff napkins that had been provided along with lunch. Crumpling the napkin, he tossed it on the tray and then opened the folder.
Inside was an application for residency at Blair Memorial. The obligatory two-by-two photograph was glued in the space provided in the application’s upper left-hand corner. Ivan glanced at the photograph, ignored the application and allowed the cover to fall back into place.
Raising his chin, he looked the chief of staff in the eyes. “Turn her down.”
About to take a drink of his bottled water, Harold nearly choked. He stared at Munro in openmouthed disbelief. “Excuse me?”
“Turn her down,” Ivan repeated, enunciating every word as if the man had suddenly been struck deaf and born slow.
It took Harold less than a heartbeat to find his voice. “On what basis?”
“She’s too pretty,” Ivan told him matter-of-factly. He turned his attention back to the last of his sandwich and his iced coffee.
“What?” The single word fairly vibrated with incredulity.
“Pretty,” Ivan repeated. “Attractive, comely. I believe the term ‘handsome woman’ would have been applied to her a century ago.” His eyes narrowed as he looked across the desk at the chief. “That might be more your style, anyway.”
He had to know Ivan’s reasoning here. “And since when do looks even remotely figure into the selection process?”
“A woman who looks like that—” Ivan pushed the closed folder even farther away from him “—is not going to keep her mind on her work. She’ll be too busy flirting with all the eligible doctors and would-be doctors.” He rolled his shoulders, mimicking the exaggerated movements of a femme fatale. “And they’ll all be buzzing around her like so many bees who’ve lost their way to the hive.” Wrists pointed down, he wiggled his fingers in the air to illustrate. “Want my advice.” It really wasn’t a question, merely a declaration. “Nip this in the bud before it even starts. Tell her ‘thank you but no thank you.’ Better yet—” his eyes glinted as a thought came to him “—refer her to Sloan Memorial,” he said, referring to another teaching hospital in the area. “Let them deal with her and the chaos that she’ll leave in her wake.”
Harold had leaned back in his chair, waiting the neurosurgeon out. When the silence finally came, he seized it. “Are you through?”
Ivan looked down at the paper that had held his sandwich. A dollop of the spicy mustard was all that bore witness to the pastrami extravaganza that had been his lunch. He smiled as he crumpled the paper and placed it and the paper plate onto the tray. “I guess I am.” He pushed back his chair, ready to leave.
“I didn’t mean lunch,” Harold informed him. “I meant with your tirade.”
The choice of words amused Ivan. There were obviously holes in Harold’s education. “That wasn’t a tirade, Harold. When I have a tirade, there’s much rising of hair at the back of the neck. Usually involving the necks of the people I’m tirading against. Believe me, you’ll know when I deliver a tirade.”
“I’m not considering hiring her at Blair Memorial,” Harold said evenly.
“That’s good to know.” Ivan began to rise to his feet. “Now, I’m afraid that I have to—”
His next words had Ivan sitting down again. “I’ve already hired her.”
The surprise on Ivan’s face melted away a moment after it appeared. He shook his head sadly. “Big mistake.”
Harold wasn’t through. “She is your surgical resident.”
“Bigger mistake,” Ivan declared. When Harold made no attempt to rescind his words, Ivan grew serious. And annoyed. “Haven’t you been listening to a word I’ve said?”
“I’ve listened,” Harold informed him succinctly. “And like you’ve done so many times before, I’ve chosen to ignore what I’ve heard.” He leaned forward, trying to appeal to Ivan’s charitable nature—if such a thing existed. “There’s no leeway here, Ivan. She has an excellent grade point average—”
Biting back a choice expletive, Ivan waved a hand in disgust at the words. “Oh well, an excellent grade point average, that’ll save lives.”
“And she comes highly recommended.”
“By who?” he demanded, getting to his feet again. He shoved his hands deep into his lab coat as he began to pace the length of the overcrowded office. A stack of folders piled up in one corner toppled, sliding down like gleeful children on a sled sampled the first snows of winter in the mountains. “Some online dating service?”
“By professors at John Hopkins University,” Harold countered, turning in his chair to watch Ivan stride around the room on legs that had always struck him as being too long. “Professors for whom I have the utmost respect. She’s impressed every one of them.”
Ivan’s expression was nothing short of sour. He snorted as if he’d expected nothing less. “I won’t ask how.”
“Don’t be insulting, Ivan.”
“Insulting?” Ivan echoed. “You call this insulting? I haven’t even begun to be insulting.”
One of the reasons Harold Bennett had risen to his present position of chief of staff of one of the best hospitals in the Southwest was that he kept both his head and his temper during times of crisis. To see him angry was as rare as viewing the tail end of Halley’s comet. It was visible, but not very often.
But at the moment his expression was serious, closely bordering on angry. “If you do anything to make her leave, anything that will make her time here at Blair anything but informative and well-spent, I promise you, Ivan, there will be consequences. Consequences that you won’t like.”
Ivan looked at him, utterly unaffected by the prediction. “In other words, there’ll be no change from now.”
CHAPTER 3
“Do your worst, Harold.” Ivan drew himself up to his full six-three height, which was quite a bit taller than his chief of staff. His imposing personality made him seem even taller. “I can’t be expected to do my job while babysitting your latest project. And why is she your latest project?” he asked suddenly, skillfully turning the tables as he mounted his offensive. The best defense was a strong offense did not just apply to football, but to life, as well. Ivan continued to fire questions at him, just quickly enough so that Harold couldn’t answer. “Did you lose a bet? Is she your goddaughter? Or perhaps Rachel’s grandniece?”
Harold pursed his lips. When it came to Ivan, he hated admitting anything. The neurosurgeon always managed to turn the information into a rapier that he skillfully wielded.
“Not that it has any bearing on this,” the chief of staff began grudgingly.
Ivan’s well-shaped eyebrows rose as if to coax the rest from him. “Yes?”
Harold knew that somehow, some way, Ivan would discover this on his own. It blunted the edge if he admitted it first. “I know the young woman’s uncle.”
Crossing his arms before his chest, Ivan leaned a shoulder against the doorjamb. “Aha.”
“No ‘aha,’” Harold replied tersely. “That just happens to be an extraneous fact, one I know you with your unrelenting capacity to dig and burrow would unearth on your own in short order. I just want you to know that it doesn’t mean anything.” He saw the smirk on Ivan’s lips and felt compelled to defend his decision further. “I want only the best people working here at Blair.” He did his best to sound formidable and knew in his heart he fell short of the mark. “Which is why I’ve gone to bat for you so many times. If I hadn’t, you and I both know that your head would have been on a pike somewhere near the entrance of the hospital years ago.”
“Very medieval imagery, Harold. I had no idea you had it in you,” Ivan congratulated him, then paused at the threshold, the integrity that was his foundation keeping him from his exit. “So, in other words, I owe you.”
Harold snorted. “In any words you owe me.”
Ivan blew out a breath, a condemned man resigning himself to his firing squad. “And there’s no other way to repay the debt? Shine your shoes, take you to Disneyland? Wear a hair shirt for a week?”
Harold smiled, anticipating a truce. “The hair shirt has possibilities, but we can explore that at another time. I told the board that you were taking an active part in training our residents—”
Ivan allowed himself a smug moment. “In other words, you, Dr. Harold Bennett, chief of staff, our standard bearer of the truth, lied.”
Harold’s faded gray eyebrows drew together in one tufted, ragged line. “I don’t lie, Ivan. And in order for you to remain in the board’s good graces, you are going to have to at least appear to be involved with the residents.”
A fate, Ivan thought, only slightly less worse than death. Or maybe it was a tie. “Couldn’t I just drink hemlock?”
Harold spread his hands out. They were wide hands, capable hands, but not the hands of a skilled surgeon. He’d always envied Ivan that. But then, he was not at the top of people’s hate list, either. People liked him. In the long run, that balanced things out.
“Fresh out, Ivan. Now—” sitting up, he straightened the files on his desk and moved the tray aside “—you have the rest of the day to bemoan your fate. Report to my office tomorrow morning at eight.”