Four
Since it was Saturday morning, Matt slept in. He had stayed at the Taub until about four, observing the two surgical residents who took over after Strickland and Mathis went off duty.
At three in the morning, Matt called one of the residents into the coffee room and shut the door. He had seen something in the way the young doctor treated his team, and his patients, that he didn’t care for. He was developing something Matt called “staff patient syndrome.” Staff patient was the name given to people who utilized the charity hospitals for their medical care. They were usually poor, minority, and somewhat overwhelmed by both life and the system. Residents spent a great deal of their time working on staff patients who couldn’t afford their own private doctors. Unfortunately, some of the residents began to treat those patients as a lower form of life, put on earth mainly to help train them in their specialty. They became derogatory and condescending to the patients and dismissive of their relatives and their feelings.
Matt gave his “compassionate doctor” speech, followed by his “the nurses and other technicians will save your ass more than once so be nice to them” speech. The resident seemed to listen, but Matt had seen too many young surgeons fail to get over the arrogance and egotism they learned in their training.
By the time he left the hospital to walk across the darkness of the medical center to the parking garage, he had almost forgotten the strange feeling that had affected him while working on the woman who had died. He shuffled through the night without so much as looking over his shoulder, dead tired after a full night’s work. Once home, he tumbled into bed and fell immediately into a deep, dreamless sleep.
The next morning, Matt called the morgue to find out when the Jane Doe from last night was going to be autopsied. They were stacked up and running behind as usual so it was going to be close to noon before they got to her. He told the autopsy assistant he intended to be there, thinking perhaps he would find some answers to the questions her death had raised, not the least of which was why she had affected him in the way she had. In all his years of practicing medicine, he had never felt such horror, such unrelenting terror as he had in the young patient the previous night. Maybe the autopsy would shed some light on the puzzle.
He poured himself some coffee as he thought about his schedule for the day, then went into the garage and fired up his Stingray. Unlike the night before, there were no rain clouds to soften the August heat and it lay on the city like a malevolent fog. Matt put the top up on the ’Vette and turned on the air conditioner. This made the engine overheat, the short-block 327s being notorious for that. Classic cars look good, but lack the comforts of new technology. Finally, to keep the engine from exploding, he turned off the air conditioner and sweated like a warthog on the way to the Taub, wondering, as he did every summer, if the thrill of driving a muscle car was worth the trade-off in comfort.
After crawling through the terrible early-morning Houston traffic to the medical center, Matt parked his ’Vette and again walked to the Taub. While waiting for the elevator to take him to the basement morgue, he saw an old friend walking down the hall. Dr. Sheldon Silver was, as usual, making rounds in white jeans and a red-flowered Hawaiian shirt. His only concession to hospital protocol was a rather wrinkled white clinic jacket. In spite of the heat and his size, he managed to look crisp and cool.
Dr. Silver—Shelly to friend and foe alike—was a rotund six feet tall, solid and muscular. He had a springy, quick walk and, like so many big men, he moved with no wasted motion. His hair was dark, shot through with gray, and he had blue eyes that students swore twinkled when he caught them in a mistake.
“Hi, Shelly,” Matt called, waving.
Shelly looked up, saw Matt, and broke out in a smile. That’s one of the things Matt liked best about Shelly. His smile was frequent and open and his face held no secrets. If he liked you, you knew it. He had no patience for hypocrisy, so if he didn’t like you, you knew that too. Everyone knew where they stood with Shelly.
“Hey, Matt. What are you doing here on a Saturday?” He took a handkerchief out of his pocket and wiped his forehead. “Especially on a day as hot as this one.”
Matt grinned. Shelly had a well-known aversion to heat, which everyone teased him about. His secretaries had been known to show up for work in the summer with coats on to protest the coldness of his office. “I’m here to watch an autopsy on one of the patients I had in the ER last night. How about you? You’re a little out of your territory, aren’t you?” Matt asked.
Shelly was chief of pathology at Methodist Hospital, and Matt couldn’t imagine why he would be at the Taub.
Shelly shrugged. “Just doing a favor for a friend. Dr. Chow, the medical examiner, had a heart attack. . .”
Matt interrupted, “Oh no. I hadn’t heard. Is he going to be all right?”
“Yes, fortunately it was a mild one with very little damage. They did an angioplasty Friday and say he’ll be good as new in three or four weeks. Meanwhile, I’ve taken a leave of absence from Methodist to cover his job.”
It was just like Shelly to take time off his job to help a friend. Rumor had it he began his career in internal medicine, but was too honest for his patients. He finally became cross-trained in pathology, where the patients didn’t care what you thought about them.
Suddenly what he said dawned on Matt. “Are you doing the postmortem on the Jane Doe from last night?”
“Yep. Looks like I’m finally gonna get you in one of my lectures.”
He was teasing Matt, who had often told him he needed to come and listen to Shelly lecture to see how to maintain students’ interest. Shelly was an enormously popular lecturer, and his monthly clinical-pathological conferences were always well attended by students, nurses, and staff doctors.
“I’m looking forward to it,” Matt said.
As the two doctors stood there, waiting for the elevator, they looked out the window at the smog, which managed to dim even the white-hot heat of the summer day. Shelly frowned, saying, “You know, Matt, I remember how Houston used to be before the smog came to irritate our eyes and noses and make breathing a chore.” He smirked and turned as the elevator dinged. “You realize how old that makes me?”
Just before the door opened, Shelly said, “Hold the door for me, Matt. I see somebody I need to talk to.” He walked rapidly toward a tall man, calling, “Roger, hey, Roger, wait up a minute, will ya?”
A moment later, Shelly brought the man over to the elevator and introduced him. “Matt Carter, this is Roger Niemann, hematologist.”
Matt sized the doctor up. It was a game he often played with himself. He had a theory that a lot could be deduced about people the first time you met them by the way they dressed, their mannerisms, and their handshakes. Niemann was nearly six feet tall, wore a three-piece suit, had graying hair and gold-rimmed glasses. He was as distinguished looking as Shelly was casual.
Niemann stuck out his hand and grinned. “Glad to meet you, Dr. Carter. I’ve heard about you from some of my students that you made their rotations in the ER fun. Quite an accomplishment considering the hours you made them put in.”
Matt smiled back, liking the man immediately. “Thanks, Dr. Niemann.”
“Call me Roger,” Niemann said easily. “Only my patients call me Dr. Niemann.”
Shelly put his hand on Niemann’s back and ushered him into the elevator, along with Matt. “Roger,” he said, “a case came in last night that I thought you might be able to give us a hand with.”
Niemann took off his glasses and began to clean them on a spotless linen handkerchief. “Shelly,” he said without looking up, “you know I’ll do anything I can to help the chief of pathology, but what kind of case could cause you to ask me for help?” He slipped the glasses back on, hooking the earpieces around his ears. “Hell, I’ve never known you to admit there was anything you didn’t know.”
Shelly took it in stride. “Now, Roger, you know I’m not that bad. Why, just two years ago we had that case of African Hemorrhagic fever and I admitted there was one man at Harvard who might know as much about it as me.”
Matt noticed again how cool and crisp Niemann looked, in spite of the heat. He pulled his sticky shirt away from his skin and fanned himself with his hand, thinking the man probably drove to work in an air-conditioned luxury car, as he would if he had any sense.
The doors closed and Niemann leaned back against the wall, arms folded. “Now, tell me about this case.”
Shelly began to fan his face with a manila folder. “I’m having a little trouble with the COD on this case.”
Niemann held up his hands. “Whoa, wait a minute. Just what is a COD?”
Matt broke in, “COD means cause of death.” He grinned at his new friend. “You know how pathologists hate to say anything in plain English.”
Niemann looked at Matt and nodded his agreement. “My patients tell me all doctors are guilty of that, Matt.” He glanced back at Shelly. “Go on, Shelly.”
Shelly held up his folder and said, “Anyway, last night a young woman was found in a vacant lot with part of her throat ripped out . . .”
Before Shelly had time to say more, the elevator doors slid open. Shelly and Matt stepped out and walked a few feet down the hall before they realized Niemann hadn’t moved. They turned to find him standing there, holding the doors open.
Niemann shook his head, frowning. “I’m sorry, Shelly, but I just realized I’m late for a lecture to the sophomore class on anemia. Could you check with me later?”
Shelly started back toward the elevator. “Roger, wait a minute, it won’t take long . . .” Then the doors closed and the elevator was gone.
Shelly turned back to Matt, eyebrows raised. “Well, guess we’ll just have to figure it out by ourselves.”
“That shouldn’t present a problem, for an expert pathologist like you,” Matt teased, “unless you’ve grown rusty with that cushy job over at Methodist where the most exciting thing you see is a slide of cirrhosis of the liver from too many three-martini lunches.”
“Hey, rich people get sick too,” Shelly countered. “Don’t be such a snob, Matt.”
They started down the hall toward the morgue. Matt noticed a very attractive young woman in a clinic jacket, looking at her watch and tapping her foot.
He whistled under his breath and Shelly nudged him. “Nice, huh? She’s my new associate professor of pathology.” As he saw her look at her watch again, then frown at them, Shelly said, “Uh-oh, she’s pissed. Never keep a woman waiting, Matt, or there’ll be hell to pay.”
She called out, “Yo, Shelly! You coming to this party, or are we gonna have to call an outside caterer?”
As they walked up to her, she stuck the metal chart she was holding under her arm and put her pencil behind her ear. She was a good-looking woman, and Matt wondered how she could have worked around the medical center without him hearing about her.
Matt stuck his hand out. “Hi, I’m Matt Carter.”
She took it and her face became a little more guarded. Probably used to being hit on by every male she meets, thought Matt, who tried to keep his admiration for her looks out of his expression and his eyes firmly on her face and not her chest.
“Hello, Dr. Carter. I’m Samantha Scott, but I usually answer to Sam.”
She was about five and a half feet tall and had auburn, almost red hair worn in a page boy style. Her eyes were a bright green and were deep enough to get lost in. Even in a clinic jacket, her figure was obvious, with larger than average breasts, a tiny waist, and well-rounded hips. She was one of those women who wear no makeup, but unlike most of them, didn’t need any.
“Do you have the woman brought in last night set up and ready?” Shelly asked.
“Yes, sir, I do. I’ve even got some medical students and a couple of internal medicine residents in attendance.”
Matt stared at her in disbelief. “How did you manage that?” He looked at his watch, noting it was almost lunchtime, a time when residents traditionally disappeared. “Did the cafeteria catch on fire or are you serving a buffet down here?”
She grinned. “No, Dr. Hunt brought them down. He said he thought they should see an autopsy as part of their training in medicine.”
Shelly shook his head. “You are talking about Dr. David Hunt, the famous internist and skeptic?” he asked, with heavy sarcasm. When Sam nodded, he continued, “And Hunt said they should see an autopsy as part of their training in internal medicine?”
Sam nodded again. “Yeah. In fact, he said, ‘In order to gain an appreciation of the body in health, one must first see the ravages of disease.’ ”
Shelly and Matt both began to laugh out loud, while Sam tried to shush them. Between laughs, Shelly said, “Why, that old fraud. He just wants to come down here and show off his knowledge to those residents.” He winked.
As Sam turned to see if the door to the morgue was open and they could be overheard, Shelly said, “I’ll bet before the residents got here he asked to see the chart, didn’t he?” Sam nodded again. “That schmuck was trying to find out the COD from the chart so he could look like a big shot in front of his residents.” Shelly’s lips turned down in disgust. “Well, we’ll just have to see how much he really knows about the ‘ravages of disease.’ ” He started through the door.