1

AN APPOINTMENT

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R.J. woke.

As long as she lived, from time to time in the middle of the night she would open her eyes and search the darkness in the tense certainty that she was still an overworked resident physician at the Lemuel Grace Hospital in Boston, grasping at a nap in an empty patient room in the middle of a thirty-six-hour shift.

She yawned while the present flooded into her consciousness and she knew with great relief that the residency was years behind her. But she closed her mind to reality because the luminous hands of the clock told her she had two hours left and she had learned in that long-ago residency to milk every moment of sleep.

She emerged again two hours later to graying light and no panic and reached over and killed the alarm. Invariably she awoke just before it rang, but she always set it the night before anyway, just in case. The special shower head thrummed the water into her scalp not quite bruisingly, as reviving as an extra hour of sleep. The soap slid over a body ampler than she thought desirable, and she wished there were time for a run, but there wasn’t.

As she used the dryer on her short black hair, still thick and good, she appraised her face. Her skin was fair and clear, her nose narrow and somewhat long, her mouth wide and full. Sensual? Wide, full, and unkissed for a long time. There were bags under her eyes.

“So, what do you want, R.J.?” she demanded rudely to the woman in the mirror.

Not Tom Kendricks any longer, she told herself. Of that she was certain.

She had selected her clothing before she went to bed, and it waited at one side of the closet, a blouse and tailored slacks, attractive but comfortable shoes. In the hallway she saw through the open door to Tom’s bedroom that the suit he had worn yesterday was still on the floor where he had dropped it the night before. He had been up earlier than she and was long gone from the house, needing to be scrubbed and in the operating room by 6:45.

Downstairs, she poured a glass of orange juice and forced herself to drink it slowly. Then she put on her coat, picked up her briefcase, and went through the unused kitchen and out to the garage. The little red BMW was her indulgence, as the grand antique house was Tom’s. She enjoyed the purr of the engine, the responsiveness of the wheel.

It had snowed lightly during the night, but the Cambridge road crews did a good job removing snow, and she had no trouble once she was past Harvard Square and JFK Boulevard. She turned on the radio and listened to Mozart while drifting with the tide of traffic moving down Memorial Drive, then she took the Boston University Bridge across the Charles River to the Boston side.

Early as it was, at the hospital the staff parking lot was almost full. She slid the BMW into a space next to a wall, to minimize the chance of damage from a neighbor’s carelessly opened door, and then walked briskly into the building.

The security guard nodded. “Mornin’, Dockuh Cole.”

“Hi, Louie.”

At the elevator she said hello to several people. She got out at the third floor and walked quickly into Room 308. She always got to work very hungry in the morning. She and Tom rarely had lunch or dinner at home, and never breakfast; the refrigerator was empty except for juice, beer and soft drinks. For four years R.J. had stopped at the crowded cafeteria every morning, but then Tessa Martula had become her secretary and insisted on doing for her what she doubtless wouldn’t have agreed to do for a man.

“I go there to get my own coffee, so it doesn’t make sense not to get yours,” Tessa had insisted. So now R.J. put on a fresh white coat and began to review the case histories that had been left on her desk, and seven minutes later she was rewarded by the sight of Tessa bearing a tray containing a toasted bagel and cream cheese, and coffee black and strong.

While she made short work of the food, Tessa came in again with the appointment schedule, and they reviewed it.

“Dr. Ringgold called. Wants to see you before you start your day.”

The chief of medicine had a corner office on the fourth floor. “Go right in, Dr. Cole. He’s expecting you,” his secretary said.

In the inner office, Dr. Ringgold nodded, pointed at a chair, and closed the door firmly.

“Max Roseman had a stroke yesterday while he was attending the communicable diseases meeting at Columbia. He’s a patient at New York Hospital.”

“Oh, Sidney! Poor Max. How is he?”

He shrugged. “Surviving, but he could be better. Profound paralysis and sensory impairment of the contralateral face, arm and leg, for starters. We’ll see what the next few hours bring. I just got a courtesy call from Jim Jeffers in New York. He said he’ll keep me informed, but it’s going to be a long time before Max returns to work. Matter of fact, given his age, I doubt he’ll ever be back.”

R.J. nodded, suddenly watchful. Max Roseman was associate chief of medicine.

“Someone like you, a good female physician and with your background in law, would bring new dimensions to the department as Max’s successor.”

She had no desire to be associate chief, a job of many responsibilities and limited power.

It was as if Sidney Ringgold could read her mind. “In three years I reach sixty-five, the age of compulsory retirement. The associate chief of medicine will have a tremendous advantage over other candidates to succeed me.”

“Sidney, are you offering me the job?”

“No, I’m not, R.J. Matter of fact, I’m going to talk with several other people about the appointment. But you would be a strong candidate.”

R.J. nodded. “Fair enough. Thanks for filling me in.”

But his glance held her in her chair. “One other thing,” he said. “I’ve been thinking for a long time that we should have a publications committee to encourage staff physicians to write and publish more. I’d like you to set it up and chair it.”

She shook her head. “I simply can’t,” she said flatly. “I’m already stretching to handle my schedule.” It was true; he should know that, she thought with resentment. Mondays, Tuesdays, Wednesdays, and Fridays, she dealt with patients at her hospital office. Tuesday mornings she went across the street to give a two-hour class at the Massachusetts College of Physicians and Surgeons on the prevention of iatrogenic illness, sickness or injury caused by a doctor or a hospital. Wednesday afternoons she lectured at the medical school on the avoidance and survival of malpractice suits. Thursdays she performed first-trimester abortions at the Family Planning Clinic of Jamaica Plain. Friday afternoons she worked at a PMS clinic which, like the iatrogenic illness course, had been established because of her persistence and over the objections of some of the hospital’s more conservative doctors.

Both she and Sidney Ringgold were conscious of her debt to him. The chief of medicine had sponsored her projects and promotions despite political opposition. At first he had looked upon her warily—a lawyer turned physician, an expert on illnesses caused by the mistakes of physicians and hospitals, someone who did peer review work and judged her fellow physicians, often costing them money. In the beginning, some of her colleagues had referred to her as “Dr. Snitch,” an appellation she wore proudly. The chief of medicine had watched Dr. Snitch survive and prosper and become Dr. Cole, accepted because she was honest and tough. Now both her lectures and her clinics had become politically correct, assets so prized that Sidney Ringgold often took credit for them.

“Perhaps you can trim some other activity?” Both of them knew he was talking about Thursdays at the Family Planning clinic.

He leaned forward. “I’d like you to do this, R.J.”

“I’ll give it serious thought, Sidney.”

This time she made it out of the chair. On the way out, she was annoyed with herself, realizing she was already trying to guess the other names on his list.