CHAPTER TWO

In the predawn darkness, Jack eased out of his driveway and headed toward the distant lights of New Canterbury down in the valley, coasting much of the way. He crossed over the Seneca River Bridge, where the countryside ended and the city began. Reaching his fifth-floor office at the medical center by six o’clock, he brewed himself a mug of coffee and took it to a window from which he could look out over the sprawling complex—the two clinical towers, the nursing school, the medical school, and the original hospital building. The original hospital building was three stories tall with granite front steps, limestone pillars, and a cupola on top, and it now housed the library, boardroom, research labs, and classrooms. A helicopter was approaching the brightly lit helipad above the new emergency department, and he could hear the muted whopping of rotor blades.

His pulse quickened at the sound. There was a time not long ago when he’d have been in the critical care bay awaiting its arrival, poised to do whatever was needed to save a life. After graduating from medical school here at New Canterbury, he’d completed an emergency medicine residency in California, then returned and soon became the ER director, even managing to convince most people to stop calling it the ER and use the more comprehensive term “ED.” Within a few years, he had done what few thought possible, jumping through a myriad of hoops to start an accredited emergency medicine residency program. He’d worked hard, treated people well, taught enthusiastically, and never refused taking on more responsibilities. His rise through the ranks had been swift. Several years ago when in his early forties, a few months before his wife’s fatal accident, he’d accepted the post of medical center dean. Early on, he’d continued to pull occasional shifts in the ED, but there were not enough hours in the day nor days in the week, and after Zellie’s death, needing to spend as much time as possible with his daughter, he’d taken himself off the clinical schedule.

The medivac chopper landed, its whirling blades shimmering in the lights. He knew that the patient on board would be well cared for by his former colleagues in the ED. There were times, though, when he missed simply caring for patients. It was a more black-and-white life. You identify the problem in front of you, then act. Period. His only patient now, however, was the medical center itself—a demanding beast with countless moving parts. Despite the frustrations, he loved the work he was doing now, and he loved this place. It was home, and it helped keep him whole.

So, what in God’s name was Jan Cummings talking about—a crisis at the medical center? He had his finger on the center’s pulse as good as anyone and was unaware of any brewing critical situations. Finishing the coffee, he went to his computer and scanned his inbox for suggestions of something awry.

Nothing. No clues. He would have to wait.

At eleven fifteen, Jack slipped out of a meeting and headed outside, taking the footbridge over Bracken Avenue to the main campus of New Canterbury University, a sprawl of neo-Georgian buildings nestled in a curve of the Seneca River. Dodging undergraduates on skateboards and bicycles, he passed through the main quad, the lawns and brick paths thick with fallen leaves still soggy from last night’s rain. The sky was gray, the air cold. At the Hawthorne Building, he rode the elevator to the fourth floor and opened the door to Jan Cummings’s conference room. It was 11:25. He was five minutes early.

The only person there was Martin F. Bentley, the university provost, seated at the long cherrywood table and fixated on his phone. Bentley glanced up, wearing his usual stone-faced expression. “You’re in the right place, Forester,” he said. “She’s running late.” He returned to his phone.

A stocky man with sagging jowls, the provost was one of the few senior figures across the university with whom Jack had never been able to strike a cordial relationship over the years. Bentley made no bones about the fact he didn’t think physicians made good administrators, and on a personal level, he hadn’t been in favor of Jack becoming the med center dean at such a relatively young age.

“Morning, Martin,” Jack said, as he pulled out a chair.

Bentley responded with a grunt and a shrug of his eyebrows. The room was warm, but the provost was wearing a tweed jacket over a shirt, tie, and yellow waistcoat. Beads of perspiration glinted through his thin reddish comb-over.

“What exactly is going on?” Jack said. “Jan mentioned a crisis.”

Bentley sighed and set his phone on the table. “What’s going on is a shitstorm, Forester. A category five shitstorm.”

“Involving the medical center?”

“Yes.”

“For how long?”

“For the past several days.”

“Several days?” Jack felt his face growing warm. “Why am I just hearing about it?”

“There was no need to involve you.”

“What?”

“You know, Forester, we haven’t seen much of you on the main campus lately. You’ve missed the last few board meetings.”

Jack’s jaws tightened. “If this concerns the med center, where’s Jason?” he shot back. Jason Everts was the medical center CEO, the business counterpart to Jack’s academic role as dean.

“It hasn’t been announced yet, so this is between you and me, but Everts walked the plank this morning. He was suspended.”

Jack stared, a tingle spreading over his scalp. “Suspended? Why?”

Bentley held up his hand. “I’m deferring any further explanation till the boss arrives. If it were up to me, you wouldn’t be at this meeting. This is top-layer decision-making territory. You’re an academic.”

“You know what I think?” Jack said, swallowing. Don’t do it, Jack, he said to himself.

“No,” said Bentley. “What do you think?”

“That I’m tired of your condescending bullshit.”

Bentley’s eyebrows levitated toward his receding hairline.

At that moment the door sprang open, and Jan Cummings strode in carrying a coffee cup and a folder. Closing the door with a backward jab of her foot, she halted, looking at them. “Am I interrupting something?” she said.

Bentley cleared his throat. “Nothing of consequence. Dr. Forester was just exercising his First Amendment rights.”

Obviously deciding not to pursue the matter, she dropped the folder on the table, took a sip of coffee, and glanced out the windows. “Nothing but clouds,” she said. “Every damn day. Western New York is the dreariest place on the planet.” She sagged rather than slid into the chair at the head of the table.

Ever since Jan Cummings had assumed the leadership role at New Canterbury University last year, Jack had never seen her anything but relaxed and elegant, always ready for a publicity photo or a press conference. Today she looked like someone who’d spent the night in her office. “Your years in California spoiled you, Jan,” Bentley said, unctuously. “But you bring an inner sunshine with you.”

“I’m in no mood,” she said, cutting him off. “Have you given Jack any information yet?”

“Just about Everts’s suspension. I thought that everything else best come from you.”

She fixed Jack with a stare, her hazel eyes intense and bloodshot. Then she looked away and drew in a deep breath. “I’ve been in many unexpected situations. But nothing like this before. What I’m about to tell you needs to stay confidential until I say otherwise. Do you understand?”

He folded his hands and nodded.

She leaned forward. “Okay. Five days ago, I received a call from J.P. Morgan telling me that the hospital’s primary disbursement account was overdrawn. Which made absolutely no sense. Last week’s financial report showed the medical center having over ninety days of operating cash on hand.”

Jack frowned. “Sounds like a mistake on the bank’s end.”

“Not hardly,” said Bentley. “They’ve got the best—”

“I thought you wanted me to talk,” she snapped, interrupting the provost.

“Please go on,” Bentley said, reddening.

“Thank you,” she said, looking back at Jack. “So I reached out to our comptroller, Judy Marsh, who was equally perplexed, to put it mildly. I could hear her jaw drop from the other side of the campus. Obviously, something very weird was going on, so we immediately called in a team of forensic accountants from Manhattan and they’re still sorting through the mess. But so far it looks like a perfect storm of accounting errors has accumulated undetected over the past several years.”

“Several years?” said Jack, his heart pounding. “What sort of errors?”

“There’s quite a laundry list. They include overreporting of collections, underreporting of accounts payable, and worst of all, a failure to properly bill and collect hundreds of thousands of patient accounts. Hundreds of fucking thousands of patient accounts.” She paused and took another sip of coffee. “Excuse my goddamn French.”

Jack sagged back. “And no one noticed this until now?”

The provost hooked a finger in his shirt collar and twisted his neck. “We all trusted Ms. Marsh’s reports, Forester. Obviously, we were getting corrupted information.”

Jan set down her coffee cup with a bang. “And to be fair, she may have been getting corrupted information too. Our accounting software is ancient. The only thing we know for certain is that the med center is on the verge of bankruptcy.”

Jack looked up at the ceiling and shook his head. This was some kind of joke.

“May I speak?” said Bentley.

Jan sighed. “Knock yourself out.”

“That’s why Jason Everts isn’t here, Forester,” he said. “The financials of the medical center were within his and Judy Marsh’s sphere of responsibility. Both were put on administrative leave this morning.”

Jack straightened. “They’re taking a fall even before you know why this happened?”

“Don’t look so surprised,” Bentley replied. “It’s standard procedure. This is what happens when a fecal typhoon makes landfall.”

There came a loud knocking on the door. It opened and Jan’s administrative assistant, a black-haired woman named Tulip, peered in.

Jan pushed back and rose to her feet. “This had better be important.”

The assistant met her halfway and whispered in Jan’s ear. Jan went visibly rigid and swung around to Jack and Bentley. “Back in a minute. Stay exactly where you are.”

Swiveling his chair toward the window, Bentley made an exaggerated sigh. “What now? Listen, Forester, you’re lucky your bailiwick is academics. You’ll likely escape the scaffold.”

Jack swallowed against the dryness in his throat. “What about you? Isn’t this within your sphere of responsibility as provost?”

Bentley sniffed. “The plane I fly goes above the storm clouds. And I’m an old shitstorm survivor.”

“This whole thing seems crazy,” Jack said. “Why would a series of mistakes go unnoticed? Could the software have been tampered with externally?”

“The accountants say no. We may have old accounting software, but our firewall is first-rate. State-of-the-art. No evidence it was breached. Whatever happened came from inside. The real question of whether it was accidental or intentional remains to be seen.”

Jack didn’t know Judy Marsh well, but she seemed like a good person. The door swished open and Jan reentered. Her face had gone pale and her eyes were glistening. Lowering herself into the chair in slow motion, she reached for a tissue.

“Jan?” said Bentley.

She blew her nose and shook her head.

Jack leaned toward her, the back of his neck tingling. “What’s happened?”

Jan took up another tissue. “Judy Marsh is dead. She was in a car crash. Less than an hour ago.”

Bentley made a whistling sound. Jack closed his eyes, battered by a wave of shock. News of accidents reawakened memories.

“Her car went through a guardrail on the Seneca River Bridge,” Jan said in a thin voice. “She was on the way home after leaving here.” She paused and swallowed. “A witness told police that it looked like she kept swerving until her car rolled over the edge. It’s seventy-five feet down.”

“I hate to seem callous,” said Bentley. “One must wonder if this might be an admission of responsibility.”

Jan turned to him, her eyes widening. “Or it could have been the horror of seeing her reputation destroyed. Or a seizure or something. The least we can do is withhold judgment until we know more.”

“Of course. I agree,” Bentley mumbled.

“I put in a call to Jason Everts to let him know and make sure he’s all right,” she added. “He is, but this brings up another issue.” She turned to Jack and frowned. “Are you all right, Jack?”

He folded his hands and cleared his throat. “Yes.”

She went on. “With Jason gone, we need an interim med center CEO for the time being. I know you’ve got the confidence of the medical staff, Jack. That will be crucial for morale in the coming days. Would you be willing?”

He released a breath. “Would I be willing to be both dean and CEO?”

“Only the interim CEO,” said Bentley. “You’d be a placeholder, a figurehead. Consider it a little window dressing on your CV.”

“You don’t have to be so cynical about it,” Jan said, turning to Jack again. “It would be one less thing I have to worry about. We’d appreciate your help. Martin will give you any support you need.”

I’d rather do without that, Jack thought, then he said, “If it helps, I’ll accept.”

Jan glanced away and dabbed at her eyes again. “Thank you. Sorry. I keep seeing her car on that ridiculous bridge. But we must put our heads down and keep moving forward or this debacle will drown the entire university in a sea of red ink.”

She gathered herself. Opening the folder in front of her, she removed two sheets of paper and slid one each to Jack and Bentley. “Here’s the latest interim report from Brink and Waterborne, the forensic accountants. The medical center is 226 million underwater and it’s likely to get worse. That’s over a quarter of the hospital’s entire annual gross revenue. As you both know, the university’s endowment never recovered from the recession of ’08. We can only draw operating cash from it for several weeks. Building it up was one of the reasons they recruited me in the first place. But that takes time.”

“Obviously, we’ll need to begin searching for outside help,” said Bentley. “As soon as possible.”

She sniffed. “What the hell do you think I’ve been doing these past three days? Practicing the cello? I’ve pleaded with the governor twice, and I’ve spoken with every contact I could find at the federal level. I’ve called several dozen commercial lenders. So far the only thing I’ve received is some guarded sympathy. Everyone is appalled that we let something like this happen. We look like imbeciles.”

“I might have an idea,” said Jack.

Bentley snorted. “Know some good loan sharks, Forester?”

Jan Cummings glanced nervously at her watch. “It’s almost time,” she said.

“Time for what?” Bentley said.

“To explore what may be our only viable remaining option.”

“Which is?” said Bentley.

She folded her hands and eyed each of them in turn. “That the university sell the medical center.”

Jack stared back, his neck tightening.

“Hmmm,” said Bentley, thoughtfully. “You’re suggesting we divest ourselves of the whole kit and caboodle—the hospital, the medical school, the labs, the training programs?”

“Yes, as a single package,” she said, drawing in a deep breath before continuing. “I have made inquiries.”

Jack shook his head. He felt as if his chair was sitting on a trapdoor that might suddenly open.

Jan leaned forward and jabbed the table with her red-nailed index finger. “There are four healthcare consortiums in the nation with sufficient resources, but only one is interested. I assume you both are familiar with Health Wealth Associates?”

This could not be. Jack inwardly groaned. The very thought was like fingernails on a blackboard.

“Of course,” said Bentley. “In point of fact, HWA expressed interest in buying the medical center a few years before you arrived, Jan. They’d love a foothold in the Northeast. But we declined at the time. I believe, Forester, you were one of the naysayers.”

“I definitely was.” He turned to Jan. “HWA bragged about us being one of their targeted acquisitions in the Journal of Health Economics without bothering to tell us first.”

“They’re aggressive,” she said. “I’ll give them that.”

“Cutthroat is the word,” said Jack.

“So, they’re still in the market?” Bentley asked.

“Very definitely.” She glanced at her watch again. “Martin, I apologize for not letting you in on this aspect of the situation yet, but things have been moving very fast. After I spoke to you last evening, I had a long conversation with Dr. Lawrence Haines, the CEO of HWA, and he agreed to fly up this morning from North Carolina.” She leaned back and folded her arms across her chest. “He’s in the next room waiting to talk.”

“Jesus no,” Jack said.

She shot him a hard look. “Don’t Jesus no, me. Nothing is worse than the university going bankrupt and the hospital closing.”

“Jan, this is brilliant,” Bentley said, beaming. “I’m glad you jumped ahead.”

“We’re going to at least hear his proposal. And Jack, despite your obviously negative feelings, I’m counting on you to be a good team player. If this goes through, I’m sure he will want you to stay as dean. That’s already been discussed.”

Jack took a deep breath and felt the trapdoor crack open.