Charlatans

But being an employee and thereby accustomed to the hospital environment was not the only reason for his comparative sangfroid that morning. What truly made him calm was that he had, over the twenty-six years of employment, befriended almost everyone, including doctors, nurses, administrators, and support staff. In the process, he had learned a lot about medicine, particularly hospital-based medicine, to the point that it was a common joke among the staff that he was a graduate of the nonexistent BMH medical school. Bruce could discuss surgical technique with orthopedic surgeons, malpractice concerns with administrators, and staffing problems with RNs, and he did all of this on a regular basis.

When Bruce had been told he was to have spinal anesthesia for his upcoming hernia repair that was going to take maybe an hour at most, he knew exactly what spinal anesthesia was and why it was safer than general anesthesia. For him there was no mystery involved. And on top of that, he was extremely confident of his surgeon, the legendary Dr. William Mason. Bruce was well aware that the mercurial Dr. Mason, who was known behind his back as “Wild Bill,” was one of the most famous surgeons at the hospital. Dr. Mason himself saw to it, making sure that it was common knowledge that patients came from around the world on a weekly basis to take advantage of his skilled hands and incredible statistics. Dr. Mason was a full Harvard professor of surgery, chief of the Department of Gastrointestinal Surgery, and one of the associate program directors of the hospital’s famed surgical residency program. His subspecialty was the very demanding surgery of the pancreas, an organ tucked away in the very back of the abdomen that was notoriously hard to operate on because of its peculiar consistency, digestive function, and location.

When Bruce told people that Dr. Mason was going to do his hernia repair, everyone was shocked. It was common knowledge that Dr. Mason hadn’t done a hernia repair since he had been a surgical resident more than thirty years ago. The professor prided himself on doing only the most complex and difficult cases involving the pancreas. Some had been mystified enough to ask Bruce how he had managed the impossible, getting Mason to do what he certainly considered a piddling operation fit for a surgical neophyte and well below his dignity. Bruce had been happy to explain.

Over the years, Bruce had enjoyed persistent advancement in the security department, thanks to his unabashed commitment to the hospital combined with his outgoing personality. He loved his work, and because of his attitude and the fact that he seemed to know everyone by name, everyone loved Bruce Vincent in return. They also liked that he was a family man who had married another outgoing and popular BMH employee from the food-service department. Together they had had four children, one of whom was an infant. Since the Vincent kids’ pictures continuously graced the cafeteria bulletin board, it seemed to the entire medical center community that they were the quintessential hospital family.

Although Bruce’s popularity ratings had been high from day one, they soared when he had been elevated to take over the hospital’s problematic parking division. Due to his efforts, the seemingly intractable difficulties had melted away, especially after he convinced the hospital board to build a third multistory garage specifically for doctors and nurses as part of the Stanhope project. On top of that, Bruce was never one to hide out in his “parking czar” cubicle. Instead, he was always available in the trenches, anticipating problems from the crack of dawn to late afternoon with a smile and personalized comment. By his example, all the other parking employees were similarly dedicated and personable. And it was in this capacity as a hands-on supervisor that Bruce had managed to befriend the otherwise rather aloof Dr. William Mason.

The whole hospital knew when Dr. Mason got his red Ferrari four years ago. There were some jokes behind his back about a mid-life crisis, because along with the flashy sports car he had become overtly flirtatious with several of the OR department’s younger and attractive women, mostly nurses, but also one of the female surgical residents. Bruce heard the buzz about Dr. Mason’s behavior and off-color comments but dismissed them as envy. And as far as the Ferrari was concerned, instead of thinking of it as inappropriate and out of place among the tamer and more conservative Volvos, Lexuses, BMWs, and Mercedes, Bruce lavished it with praise and even offered daily to personally park the car in a special protected place to avoid door dings. So when Bruce learned from his Charlestown GP that he had to have his hernia repaired, a problem he had had for some time but which was now giving him mild intermittent problems, particularly with his digestive system, he simply asked Dr. Mason if he would do it. Bruce popped the question on the spur of the moment one morning when he took the Ferrari’s keys. To everyone’s surprise—even Bruce’s, as he later confided—Dr. Mason agreed on the spot, promising to squeeze Bruce into his jam-packed schedule of celebrities, business mavens, European aristocrats, and Arab sheiks whenever Bruce wanted.

Despite being scheduled for surgery that very morning, Bruce had still appeared at his parking office at five as if it were a normal day. And just as he had done for years, he greeted the staff as they arrived. He even parked Dr. Mason’s Ferrari. Dr. Mason was a bit taken aback to see him and said as much, wondering if his own memory was failing him.

“I’m a to-follow case, so I don’t have to be at Surgical Admitting until eight fifteen” was Bruce’s simple explanation.

Yet Bruce’s dedication to his job wasn’t without consequence on this particular morning. After handling a problem generated by an employee who had failed to show up or call, Bruce was late getting to Surgical Admitting on Stanhope 4.

“Bruce, you are almost forty minutes late,” Martha Stanley said anxiously. She was head of Day-Surgery Admitting. She didn’t usually do intakes herself, but she had been waiting for Bruce to show up. “You were supposed to be here at eight fifteen. We’ve already heard from the OR, wondering where the hell you were.”

“Sorry, Miss Stanley,” Bruce said sheepishly. “I got held up by a staff problem in the garage.”

“Maybe you shouldn’t have worked this morning,” Martha said with a disapproving shake of her head. She had been surprised to see him in his usual uniform when she pulled into the garage early that day, as she was aware he was scheduled for an inguinal repair. She opened the folder and riffled through its contents, checking that the history and physical were there, along with the most recent blood work and an ECG. She turned her attention to the computer screen to be sure all the same material was there. “In case you don’t know, Dr. Mason is a bear about waiting, and he has two other big VIP pancreatic cancer cases this morning.”

Bruce flashed a remorseful, almost pained expression. “Sorry! I’m sure he hates to wait. Maybe we can speed this admitting process up a bit. My operation is no big deal. It’s just a hernia repair.”

“Every case is important and has to be done by the book,” Martha mumbled as she made an entry into the EMR, the electronic medical record, “but we do have to get you up there sooner rather than later. You haven’t eaten anything, have you?”

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