“You’re building quite a reputation,” Linda Brown, Garrison’s nurse, told Alex as they rounded the corner onto 7 West, the neurology and neurosurgery floor.
“Reputation?” Alex asked, unsure if this was good or bad. “What? With whom?”
“Among the residents,” she replied with a good-natured lilt.
He stopped. “Hold on. You can’t just say something like that and not explain it. This good or bad?”
She smiled at his obvious concern. “They say you like to teach and seem pretty good at it, too.” She hesitated, as if there was more to say but wasn’t sure how to phrase it.
“Go on, spit it out.”
“For them it’s good, of course. But you might oughta be a tad cautious.”
Cautious? Why? “What do you mean? This is a teaching program; that’s my job. I’m glad they regard me in that way. It’s what I’m supposed to do.”
She glanced down the hall, as if checking who might overhear their conversation. “Keep in mind there are other egos involved. Other faculty. Some of them might see you as a threat. Understand what I’m saying?” Linda was born and raised in Kentucky and spoke with an accent Alex now recognized as noticeably different from those who were natives here. When he first arrived, all accents seemed similar—people saying Ah for I, for example—but he’d since started to develop an ear for the numerous variations. It had so many more nuances than the generic West Coast accent that seemed so normal to him. He wondered if his accent grated on southern ears as much as theirs did on his.
“Faculty?” Huh. “A threat?”
“I’m sure you know your coming here had a few negative repercussions on a couple of them. Resident coverage, for one. Reynolds cut Harry Rosen loose. He’s not your greatest fan now. In fact, you might say he’s a tad pissed over it. Once people start talking, feelings become polarized. There might be some clinic members who come to resent your hold over the residents.”
Alex massaged the back of his neck and exhaled a long, deep breath. He knew this might happen, at least in theory. Having Linda confirm it made him nervous. Then again, what could Rosen do to him? Probably not much. Unless he had some juice with people like Garrison. But other clinic members? Well, that could become a problem. But Garrison should be on his side, right?
“Let me ask you, what kind of political pull does Rosen have?”
“Not much. Fact is, he’s not well liked.”
Comforting. But still … He glanced up at the acoustic ceiling tiles. Linda had become a trusted source of medical center gossip. On the other hand, he suspected her ears were wired directly to Garrison’s. The ghosts of paranoia seeded by Weiner rose again. Part of him sensed Garrison could be trusted. Another part warned to trust no one. He hated the ambiguity.
“Thanks for the advice. Now let’s finish rounds.”
Alex had been back in the office for about a half hour when Garrison knocked at his door. “Got a minute?”
“Sure. What’s up?”
Instead of ambling into the office, Garrison remained at the door. “I’m assigning you to cover Tuesday out-clinics. Understand how that works?”
Alex shook his head. He’d heard the term from the nurses but hadn’t asked for any details. Now, with a practice developing, he was being assigned fewer Any Doctors while simultaneously being integrated into other clinic responsibilities.
“Two days a week we fly out to towns about a hundred miles or so away. See folks in another doc’s office during their day off. Helps them meet overhead while it gives us a place to see patients. Any patient needs a work-up, we schedule it back here at Baptist or the clinic. Helps drum up business and hold on to our referrals. Also gives those towns some neurosurgical coverage. Everybody wins. Starting tomorrow, you’re scheduled for Tuesdays. Two Clinic Tuesdays, we call ’em ’cause we see patients in one town in the morning and another in the afternoon, then fly back on home. Meet us out at the commercial aviation terminal by 6:30 a.m. That’s the commercial terminal, not the one folks fly in and out of. Know where that is?”
“At the airport, I suppose.”
“Yep, except instead of going to the main terminal, you take the side road away from it. There’s signs to help you find it.”
Alex wasn’t a big fan of small airplanes. “Who’s flying?”
Garrison smiled. “That would be me. That’s the Cessna I told you about. My partner and I lease it back to the clinic for these out-clinic trips. Say, long as we’re on the subject, you might oughta come out to the Arlington airfield Saturday. I’m flying in an aerobatics competition. Might just get you interested in taking it up. Would love to teach you a few things while we’re in the cockpit Tuesdays. Might as well be doing something during those flights other than mashing hemorrhoids.”
Fuck!
Alex opened the chart on his next patient and immediately recognized the name: Bart Jorgensen, the man with the B12 deficiency neuropathy. He’d been practicing long enough now to be seeing long-term return patients, and Bart was one he really looked forward to following. He pushed open the door and stepped in the exam room.
“Hey, Bart, how you doing?”
The man grinned broadly. “Just fine, Doc, just fine. Tingling in my feet’s all gone now, and I reckon the sensation’s a hundred percent.” He sounded as happy as his smile was broad.
Minutes later, exam finished and the patient discharged from his care, Alex dictated a letter summarizing the diagnosis and treatment plan to Bart’s physician. He recommended Bart see him every couple weeks for vitamin B injections. The gastroenterologist had diagnosed and treated chronic gastritis as the cause of the vitamin deficiency, so the case had been amazingly textbook. Four months ago he never would have believed such personal satisfaction could come from diagnosing and treating medical neurological problems outside of surgery. In retrospect, becoming a doctor had always been his only motivation for working so damn hard to enter and graduate med school. As a youngster he’d never considered research as a calling. But all that had changed once his mother’s illness became apparent. No one knew anything about those awful tumors other than they were universally fatal and untreatable. As pleased as he was to be honing his clinical skills, he also yearned to be back working in the lab. He took some satisfaction with the small amount of research he was managing in collaboration with Cell Biology, but it was not nearly what he would prefer. Every day now, it seemed his clinic responsibilities increased, making it more difficult to eke out any time at all in the lab.
10:12 p.m. Instead of watching television with Lisa, Alex holed up in his study putting finishing touches on his NIH grant application. Tomorrow he’d have Claude FedEx it to Bethesda to make the deadline for the next round of evaluations. Getting his research back on track would be the one missing facet of having the perfect practice: clinical activities, teaching, and research. As more time passed, he also worried about his work becoming trumped by other labs. The previous week, a competitor lab had published a paper in Science claiming two of Alex’s prior findings were valid. If Alex didn’t get his research back on track soon, other researchers would leave him in the scientific dust. He sat back in the chair to massage his aching neck muscles. Although he couldn’t see how, there had to be a way to carve out more lab time.