After Hatsumi went to sleep, I cleaned up a day’s clutter in the galley, retracing the steps of the dishwashing ballet that I would perform twice a day: wet the dishes with a little water from the foot pump, squirt soap onto a cloth, scrub and rinse with another few foot-strokes of precious water. Then drain, dry, and refile everything in rack and drawer. The battery problem Hatsumi had discovered didn’t seem to extend to our dedicated engine-starting battery, so I poached enough electricity from that one to light the sink. Outside, the moon was pallid behind a veil of cloud. The axe murderer’s generator droned on.
Already our boat was changed, the tangle of tools and wire and grease guns that filled Vera in the weeks before departure had miraculously transformed itself into books, dog toys, basil plants, and laundry dangling from the clever Japanese drying racks Hatsumi hung from the cabin ceiling. But I couldn’t relax; tomorrow would take us through an unavoidable section of Johnstone Strait and then to the town of Port McNeil, the second last settlement of any size before we took the irrevocable step of crossing the Nahwitti Bar. I needed something to take my mind off it all, so I dug out my father’s file on malpractice suits. An hour of legal nuts and bolts, that would put me to sleep.
The first thing I found was this quotation, from the Nicene Creed of the Anglican church: “We have left undone those things which we ought to have done, and we have done those things which we ought not to have done, and there is no health in us.” The words introduced the chapter on “Malpractice and Negligence,” which my father had photocopied from a book called The Doctor and the Law: A Practical Guide for the Canadian Physician. The adversarial system, its author felt, should not be the only way of dealing with problems in medical practice because there will be times in a surgeon’s life — many times — when the right thing to do and the wrong thing to do are equally risky. Medicine was full of Catch-22s.
The author of The Doctor and the Law also wasn’t much in favour of contingency fees, which removed the objectivity of lawyers by giving them a financial interest in the outcome. Contingency fees incensed my father, as might be expected of someone who had just watched more than $400,000 go to the lawyers who had bargained a settlement against him. Doctors and lawyers are never likely to see eye to eye on this subject. Doctors say, “We have to treat everyone who comes through the door. We can’t cherry-pick and take only the ones we’re most likely to get a good result with. So why should a lawyer be allowed to?”
At the time of my father’s malpractice case, anguished commentary abounded: on the rapid increase in awards, on the cost of insurance literally driving doctors away from their practices, on the unseemly profits made by lawyers. Even back in the 1980s, most malpractice suits didn’t go to trial; if they did, the courts would have been hopelessly tied up. For a case to go to trial, either the issues were highly contentious, or one side would rather fight than flee. That was my father. I shouldn’t have been surprised; as a boy, he’d taken on all comers. “You helped your friends,” he wrote in his memoir. “Fighting was as natural as breathing.”
And so, after spending a few hours trying to understand the legal process, I found myself back at my Big Question: When the result of his obstinacy came crashing down on his head, why couldn’t he get over it? Why couldn’t he say, as my wife and 167 million other Japanese say every day, shikata ga nai? (“It can’t be helped”).
Before we left, I’d called up his last family doctor, a man about my age who I’d come to know and like. We’d met for lunch at a Polish delicatessen, taking our glistening mounds of artery-clogging food to an out-of-the-way table.
“I don’t eat like this that often,” he said, forking a sausage. If he did, he must burn it off somehow; he was lanky and fit-looking. I asked my question before he’d even stopped chewing; I couldn’t wait. He swallowed and said, “His ego, of course,” as though I’d asked him one of those skill-testing questions to which nobody could fail to know the answer. “Just couldn’t take it.”
“Yeah, but don’t other doctors have egos? Don’t lots of them get sued?”
“Sure we do,” he said. “I did, along with a couple of other doctors, just like your dad.”
“And?”
“We lost.”
“And?”
“I got over it. Part of being in practice. I acted to the best of my ability with the information I had.”
I couldn’t imagine my father leaving it at that.
“We get these newsletters from the Medical Protective Association. You know what they keep reminding us? The ones who get sued the most are the ones that don’t communicate well with patients. The godly ones.”
“Like my dad?”
“I never saw him in practice. You know what else they tell us? Don’t be defensive. Don’t ignore people. If something goes wrong, apologize. It reduces the number of suits.”
“Never happen,” I said. A big ego could get you a long way, I was beginning to realize, but once it was conclusively deflated, especially late in life, there was no recovery. I’d heard the same message from another physician, Charley Brown.
Charley Brown was a little younger than my father. He appeared often in family photo albums, sailing, playing Ping-Pong, mugging in a lawn chair. In my father’s last months, Charley came faithfully to the care home, cajoling him outside, mediating in disputes about the best way to care for a crotchety and still-imperious retired neurosurgeon.
I went to Charley’s townhouse shortly after my lunch in the Polish deli. Outside, sunglassed retirees crept past pastel house fronts. Inside, Charley’s place was tidy and dark. His wife had died a year earlier, from cancer; like all doctors, he was able to provide a dispassionate description of her condition while clearly still reeling from the loss. A large grey cat wandered through the empty house, tinkling.
“He was crushed,” Charley told me. “Those headlines, terrible, his reputation. Some of the other doctors . . . they backed off.”
“I thought you were supposed to close ranks,” I said.
“They didn’t. He didn’t make it easy on himself.”
“No kidding. What was he like, professionally?”
Charley considered. “Crusty,” he finally said. “Fantastic training, but there was always something. I had him and two of the neurologists at my kitchen table once, trying to get them to get along. It didn’t work out.”
Charley had arrived in Victoria in 1952, the year after we did. He’d been mediating ever since.
“The funny thing was, he didn’t like operating. He told me once he wished he’d become an internist like me, where you could do the detective work, and others could do the surgery. That he’d gotten to the point where he just didn’t want to cut anyone anymore. He was dedicated, though. In the early days, he flew up north in a private plane to see a young woman who’d gone over her horse’s head. He brought her back to Victoria; we both worked on her. She never came out of the coma.”
I remembered that case; it was one of the ones he’d talked to us about. The woman’s family tried a faith healer brought in from England. When that failed, they took her off life support. It never stopped nagging at him. Very Harvey Cushing.
“But he was definitely different. You know about the concerts, in the pediatric ward?”
“Concerts?”
“He used to play his violin for the sick kids at the old General Hospital. I never forgot that he did that.”
“You’re kidding,” I said. “When was that?”
“Back in the mid-seventies, I guess.” Exactly the time he operated on Billy.
***
I shoved the stowaway’s legal file back under the seat, tried a few pages of that incomprehensible book on Buddhism that my father had been trying to get through when he died, and finally crawled into bed with my wife and dog. Charley was on my side of the pizza slice–shaped berth, so maybe Brent was right: he was coming between us. The wind moaned in the rigging, Vera snatched nervously at her mooring lines, and I thought about the axe murderer next door. Or wherever he was. What if he really did have to deliver five boats a hundred miles to Egmont, alone and at night, piloting a daisy chain of derelicts through the rapids? What if he was just a loner trying to make a living, instead of the ogre my wife was probably having nightmares about already?
Finally, I fell into an unsatisfying sleep. I dreamed I was eight years old again, trapped in the middle of Haro Strait. This time, though, I was sitting on Zero Rock with the seals, watching my father struggle past.