“Best way to deal with those rag-heads is to just nuke the hell out of Baghdad,” Brett Johnson said. “Drop a big one and turn that damn place into glass. Launch a hundred cruise missiles, that ought to do it.”
Alex stopped operating to look at the young man. “Don’t joke about that.”
Johnson recoiled. “Hell, I ain’t joking. I’m serious as a damn heart attack. The Koran tells the Arabs to slaughter all infidels—meaning anyone who’s not Muslim. We just need to wipe out all them rag-heads before they get the chance and settle the issue.”
Alex handed Chuck his instruments and turned to look at the resident. “Where’d you come up with that business about the Koran?” Alex glanced over the surgical drape at Cole. Cole looked up from the latest issue of Car and Driver he was reading and nodded, letting him know he was listening.
“Everybody knows that,” Brett said dismissively.
“News to me. Then again, I guess I’m not everybody. So tell me, did you personally read those words in the Koran, or is this something you heard from a friend?” The only sounds in the room now were the soft hiss of the suction and the wheeze of the anesthesia machine. The circulator, Chuck, and Cole were all listening. Cole turned down the cardiac monitor to a barely perceptible volume.
Johnson dropped his eyes to the surgical field. “You mean me personally? No, I don’t read that Arab shit. But I have it on good authority.”
Alex seldom stopped a case to talk, but he wasn’t going to let the remark pass unchallenged. “What good authority?”
“Have you read any of the Koran?”
Johnson gave a derisive snort. “Hell no. Why should I do something like that?”
“Doctor Johnson?” A circulating nurse stuck her head in the door. “You on call today?”
“I am.” He sounded relieved to have a distraction.
“Just got called by the ER. They need a resident to come see a patient.”
Johnson waved her away. “Tell them I’m busy. Call someone else.”
Alex jumped on it. “Wait, don’t do that.” He looked at Johnson. “You’re not really doing much at the moment, and this dissection’s going to take me”—he glanced at the wall clock—“another couple hours. Go ahead, scrub out. I’ll muddle on without you.”
Johnson slapped his sucker onto the overhead table in a snit. “Whatever.”
“Doctor Cutter,” the circulator said, breaking his concentration, “we just got called again by the ER. Seems they’re still waiting on a resident to come see the patient.”
Alex handed off the Malis—a forceps capable of cauterizing tissue—to Chuck and rocked his neck side to side, working out kinks. He stood up from the rolling stool and backed away from the microscope so he could flex and extend his spine in an attempt to loosen up the tight, aching muscles. The clock showed him he’d been sitting in the same position for three straight hours.
“Bob, Chuck, please note the time.” Then he told the circulator, “Call the lounge and find out which resident is free at the moment. Ask him to come see me. If we don’t have one available, find one who’s scrubbed.”
“You call, Boss?”
Ah, Steve Stein. Perfect. “I did. There’s a patient in the ER who needs to be seen. Pop on down there, take care of it, and report back as soon as you’re done. Got it?” If Johnson was lying to him—which he strongly suspected—this might be the perfect opportunity to document it.
“Note the time?” he asked the moment Stein was out of the room.
Both Cole and Chuck said they had.
“Routine migraine,” Stein explained thirty minutes later. “Took care of it and discharged her with instructions to schedule a follow-up with you next week. Anything else?”
Alex thought about it a moment and decided he needed to keep a lid on this incident until he had a chance to sort out all the facts. “Yes. Keep this just between us. Understood?”
After a questioning look, Stein nodded and pushed through the heavy OR doors into the hall.
“Bob, please note the time.”
Thirty minutes later Johnson sauntered in, tying his mask in place. “All taken care of.”
Alex handed his instruments to Chuck and stood, grateful for another excuse to stretch. This should be interesting. “What was the problem?” He tried to sound neutral.
“Routine rear-end collision. Driver was complaining of neck pain. The only reason I needed to be gone so long was I had to get X-rays, and Radiology was backed up as usual. I’ll scrub back in.” He turned toward the door to the scrub sinks.
“Hold on. Before you do, jot down the patient’s name so I can sign the chart when I finish up here.”
Johnson appeared at a loss for words. “Uh … that’s not necessary.”
“Oh? Why not? You signed the chart as my resident, right?” If so, Alex would be required to countersign.
Johnson shuffled his feet. “Not exactly. Thing is, uh, Friedman came in about the time I was finishing up, so I asked if he’d sign the orders. I know he’s not on the rotation but thought I’d save you the hassle. So you see, there’s no need to bother.”
A wave of sadness descended over Alex. Why lie? What could he possibly think he’d gain? Didn’t he realize he’d eventually be caught? “It’s no bother because I do want to review the chart. Consider it part of resident quality control.”
Johnson nodded agreement. “Okay. I’ll do it after the case is over.”
Alex caught Chuck rolling his eyes. “No, Brett, write down the patient’s name now. I’m closing anyway. It’ll be done before you can finish a scrub. Leave the name on my loupes case. Okay?”
Johnson shrugged. “Whatever.”
Alex watched the circulator hand him a progress note to write on. Johnson glanced back over his shoulder at Alex, shrugged again, and wrote something on the paper before slinking out the door.
“Hey, Johnson,” Alex called after him. “Two things.”
“What?”
“First of all, leave the paper.”
“Oh.” Johnson reluctantly handed the sheet to the circulator. “What else?”
“What would you say if I told you Humpty Dumpty was pushed?”
As Johnson shouldered his way out the door, he called over his shoulder, “He was probably an asshole and deserved it.”
With Johnson gone, Alex asked Cole and Chuck, “You guys catch all this?”
“Hard to miss,” Cole said.
“Good. I’d appreciate it if none of this leaves this room. At some later time it may be necessary for you to verify what just happened.”
“Uh, uh, uh, Lord have mercy,” Chuck muttered. “That boy’s in a world of hurt.”
With the wound dressed and the patient on his way to the recovery room, Alex—still wearing scrubs—dropped down three flights of stairs to the Emergency Room. Luckily, the nurse who initially called for the consult was finishing up his end-of-shift paperwork.
“The patient you called about, which resident took it?”
“Just a second, let me have a look.” The nurse began thumbing through a handful of charts in the “Out” bin. A moment later he slid one from the stack. “Here we go. Let’s see … a migraine. Looks like your man Stein took care of it. Why?”
“Brett Johnson show up to see anyone?”
The nurse reached for a log of all the patients seen during the day and by whom, and ran a finger down the list. “Nope. Doesn’t look like Johnson’s been here today. The list runs from midnight till now. Want me to check yesterday’s records?”
“No, that’s not necessary. Has a whiplash patient been seen today?”
He checked the log again. “Doesn’t look like it.”
“Friedman been here to see anyone in the past two to three hours?”
This time he didn’t need to check. “Nope.”
“Final question: Know of any problems getting Johnson to respond to calls?”
With a sigh, the nurse glanced away, perhaps searching for a diplomatic answer. “Let me put it this way: we’ve had our issues.”
“What sort of issues?”
“Pretty much exactly what we’re discussing. Not answering pages. And when he does, he doesn’t always come in. Which obviously puts us in a bind, because we then have to turn around and call around for someone else to come see the patient. There’ve been times when your boys are tied up over at the trauma center so we had to call in one of the private surgeons. They’re not thrilled about the idea of backstopping your guys.”
Alex closed his eyes and squeezed the bridge of his nose, trying to lessen an impending headache. “Why am I just hearing about this?”
“Supposedly Doctor Reynolds was told about it a while ago, but nothing’s been done. Least nothing we’ve been able to see.”
Reynolds was probably too busy at the time and simply forgot. Alex jotted down the nurse’s name and other particulars about the incident. “I may need to have you recount this conversation under more formal conditions. Any problem with that?”
The nurse seemed relieved to have the story out. “None at all.”