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Authors: Michael Palmer

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BOOK: Silent Treatment
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There was a silent, tense exchange between the two men, which Kevin was in a perfect spot to observe. Clearly Percivale, the man from Comprehensive Neighborhood Health Care, did not enjoy being singled out. This was Tristram’s eighth Roundtable session, but he was only now getting a handle on the various knights. The one most respected, and perhaps most feared, was Galahad, an officer with a managed care company. Percivale, on the other hand, seemed to have less influence and carry less responsibility than the rest.

If there was a clique, the insiders seemed to be Galahad, Lancelot, Merlin, and possibly Kay, a wizard with numbers who was the group’s actuarial expert. Tristram and Gawaine, still under microscopic scrutiny, were regarded as fraternity pledges. And Percivale, though tolerated, seemed like an outsider. Kevin had once asked his sponsor, Burt Dreiser, whether or not there was an inner circle of knights on The Roundtable. Dreiser’s reply had been a reassuring pat on the back and an enigmatic reminder that total trust takes time.

“I’ve put the figures together from the past two months,” Lancelot went on. “They are excellent, as you’ll see for yourselves. Perhaps the most significant statistic, provided courtesy of Sir Kay, is that the average age of our companies’ subscribers now is four point one years
below
the average for the rest of the companies doing business in the metropolitan area.”

The knights acknowledged approval of the information by tapping their pens on the table. Kevin did not know the exact figure, but he did know that each of those years translated into tens of millions of dollars in payout savings annually. The trick was to avoid group subscribers who were slow to terminate their older employees, or worse, those who actually hired people over forty. Weeding .out such groups was a skill The Roundtable had mastered.

One by one, the other knights made their reports. Gawaine
was applauded for obtaining the names of at least 80 percent of the women in southern New York State who had had abnormal PAP tests in the past year. The tests, even those showing only minimal inflammation and no suspicious precancerous cells, would be used to label as a preexisting condition any cervical cancer occurring within the twelve months allowed by state law, or to exclude those women from coverage altogether. Other insurers, or perhaps Medicaid, might take them on, but that was their problem.

Percivale distributed a printout giving updated information on the benefits managers of the largest 250 businesses and unions in the area—not only such data as income, marital status, education, automobile make, home value, and religious affiliation, but also hobbies, alcohol consumption, cocaine and marijuana use, sexual preferences, and a grade on a one-to-ten scale of “approachability.” The knights voted to court seven of the managers aggressively.

Merlin called on Sir Tristram next. Kevin, still self-conscious in the spotlight, felt he stammered far too much in his presentation. His area of responsibility, political action, had been Burt Dreiser’s. The insurance industry already had strong lobbies in both Washington, D.C., and Albany, so Dreiser had concentrated his efforts on a few key state legislators, the insurance commissioner, and one of his deputies. In most cases, the only leverage needed was money. But the commissioner had been a harder nut to crack. It took Dreiser’s private investigator nearly six months to get decent photos of the man—videos, actually—sharing his hunting cabin with a seventeen-year-old summer intern from Oneonta.

“The information Merlin presented at the last meeting proved correct,” Kevin reported now. “The commissioner
had
spoken with some aides about retiring. I have contacted him through our channels and made it clear that this would be an unwise decision at the present time. At the moment, he is reconsidering. I think he will see things clearly.”

Kevin had no idea how The Roundtable would handle
matters if the commissioner decided to call their bluff. According to Burt Dreiser, such a situation had never arisen. The secret, he said, was meticulous research and preparation—that and never making a request that was too far beyond the previous one.

There were nods of approval from around the table. Kevin tried for the matter-of-fact expression with which the older knights acknowledged success. Despite the Desiree debacle, their regard for him was clearly on the rise. And he loved it. Next to Nancy’s saying she’d marry him, Dreiser’s offer of a seat at The Roundtable was the most significant event in Kevin’s life. The fact that the group was breaking the law meant little to him. In a highly competitive industry, the strong grew stronger, and the weak were doomed. Collaboration among corporations, while technically illegal, made perfect business sense.

“Okay, brethren,” Merlin said. “Any other comments on Tristram’s information? Suggestions? Good enough. Excellent job, Tristram. Excellent. Now, if there’s no further business, let’s have an update from Galahad.”

The security chief cleared his throat, set a portable tape player on the table, and took over the meeting. Kevin hoped that his expression at that moment did not reflect the anxiety he was feeling at having the subject of Desiree come up again.

“Let me bring all of you up to speed on our mysterious escort. Lancelot has spent a good deal of time interviewing Page Proctor, the woman who runs the escort service. My own man has spoken with several of Proctor’s employees. We’ve been trying to identify this Desiree, but so far with no luck. She never gave Proctor a phone number. Instead, she called in on certain nights to see if work was available for her. Somehow, she learned that Proctor had found out she was a reporter. She didn’t call in for almost a month. Then, last week, she called to see if Proctor would grant her an exclusive interview. Unfortunately, Page lost her cool completely and cost us a chance to find out who Desiree is. The only thing she did right was to record the conversation. Here’s a portion of it.”

He switched on the tape player.

“… I’ve got to know why you’ve done this to me.”

“I did nothing to you.”

“My clients are very upset. I’ve lost an account that was paying over ten thousand dollars a month. Some very angry and anxious people are still after me to find out what you have learned, and what you intend to do with the information.”

“Page, I told you. I’m working on a story about upscale escort services. Yours was just one of several I worked for .”

“What are you going to do with the story?”

“I can’t tell you that just yet.”

“Those people want to know.”

“Then tell me who they all are, and I’ll invite them to come and ask me.”

“You’re a very selfish person.”

“Do you have any other questions?…”

“She goes on,” Galahad said, “but that’s the gist of it. All the woman ever admits is that she’s working on a story about escort services. She didn’t mention us or the insurance industry once to Page. We’ve checked with people at the local TV stations, newspapers and magazines, and even a friend at
60 Minutes
. No one knows anything about an escort service story.”

“I was certain you would have found out who she is by now,” Percivale said nervously. “Do you think we’re safe?”

“What options do we have?” Lancelot chimed in, “How can we buy her off if we can’t find her?”

“First of all,” Kay said, “we don’t have any idea whether she even knows about us. Second, we’re not going to allow anyone to blackmail us. That is inevitably a losing proposition.”

Kay had aristocratic features and a gentle but persuasive voice. From the expressions around the table, it was clear his opinion carried weight.

Galahad shrugged. “Tristram and Gawaine swear she didn’t ask more than a few passing questions about their line of work. But neither of them has recordings of their sessions, and you can bet this woman does. My sense is that
she’s probably telling the truth when she says she’s working on an escort service story and nothing more. But obviously I can’t be certain.”

“So?”
Percivale said.

“I don’t see how she could have any hard data on us,” Kay said, before Galahad could answer. “My guess is the whole thing’s a coincidence.”

“Even so, maybe we should hold off meeting for a while,” Percivale offered. “In fact, I move we suspend operations for two months.”

No one bothered commenting on the motion. Merlin handled the vote, which was initially six to zero in favor of continuing on the second and fourth Tuesdays. Percivale at first abstained and then made the decision unanimous.

“So, we’re done, then,” Merlin said. “Galahad, do you intend to keep trying to find out who this reporter is?”

“I do. We’ve come too far to allow anyone to threaten our work.”

“Just don’t do anything too rash,” Merlin said. He smiled and added, “At least, not until you’re certain none of our companies is carrying a policy on her.”

CHAPTER 6

Harry had seen and experienced enough of what could go wrong in hospitals to fear ever being a patient in one. Each day, every day, thousands of patients were cared for at hospitals in and around Manhattan. Most physicians, nurses, aides, and technicians were dedicated, competent, and focused. But invariably, on any given day, some weren’t. There were simply too many patients, too many illnesses, and too many caregivers with human frailties for the system ever to be perfect.

Over his twenty-five years in medicine, Harry had confronted or heard about all manner of disasters, many of them beyond anything he could have imagined. Orange juice given intravenously by a nurse who had misunderstood a physician’s telephoned orders and was too intimidated to call back and question them. A lethal dose of medication administered to a child because a harried physician omitted a decimal point. B-positive blood inadvertently finding its way into the bloodstream of an A-negative
patient. Then there were the countless IVs that emptied far more rapidly than they were supposed to, the bedrails carelessly left down, and the unanticipated psychoses in response to tranquilizers or sleeping medication.

Along with the preventable disasters were the so-called complications—the documented
and accepted
1 percent, or 0.1 percent, or 0.01 percent adverse reactions to medications and invasive procedures that were enumerated in the textbooks,
PDR
, and package inserts, and were only of concern if they happened to happen to you.

With such thoughts refusing relegation to the back of his mind, Harry made his way through the corridors of MMC to the neurosurgical unit on Alexander 9. It was five past eight in the evening. Visitors were streaming toward the exits. He had hoped to make it up to the floor earlier, but a long-standing patient of his had been brought to the ER vomiting blood. Now, having stabilized the man’s bleeding ulcer, he had finally been able to sign out to the doc on call.

Earlier in the day, he had met Evie at the main lobby and walked with her to the admissions office. He offered to stay with her during the pre-admission ritual, but she declined. She seemed preoccupied and distracted, just as she had the night before. Certainly the surgery was on her mind. But there was something else. Harry felt certain of it.

The evening before, they had walked from their, apartment to the SeaGrill in virtual silence. Although they talked some during dinner, only one topic of substance was discussed. Evie made him promise to fight any attempt to prolong her life if there was brain damage of any kind. And as they were walking back to the co-op, she apologized for not having put the energy into their marriage that she might have. There was a bittersweet finality to the way she said it. Harry acknowledged the apology, but could not read its significance.

Alexander 9, an “L” with fifteen rooms on each arm, was in transition from evening to night. The corridors were empty except for a nurse’s aide wheeling a patient back from the lounge and a janitor readying his large, metal-enclosed
floor buffer. The nurse’s station was midway between the elevators and Evie’s room. An attractive, redheaded nurse, with high-gloss crimson nail polish was seated behind the counter writing notes. Harry had never seen her before.

“Hi, I’m Dr. Corbett,” he said.

“I know,” the woman said. “Your wife’s doing fine.”

“That’s great. I spoke to her on the phone a while ago and she sounded okay, except she was a little distressed about her roommate.”

The nurse’s face wrinkled in distaste. “She’s not the only one. We’ve all just about had it up to here with Maura Hughes. I really think there ought to be a hefty tax on alcohol to pay for the medical treatment of people like her. Don’t you?”

“I don’t understand.”

“Alcoholics. Oh, I thought your wife told you. Her roommate, Maura’s, in the DTs. Unfortunately, there are no other empty beds on the floor.”

“Evie said she wasn’t too bad.”

“As long as the Librium is working she isn’t. She came to the floor from the OR three days ago. She was on a big bender and fell down the stairs of her building and fractured her skull. The CT scan showed a collection of subdural blood, so she had to have it drained. She did great until yesterday when she suddenly began complaining about the spiders crawling along the ceiling and the ants under her sheet.”

“That certainly sounds like the DTs.”

“Oh, it is. Believe me. She’s disrupted the whole floor. Those people are so self-centered and inconsiderate. They never stop to think of the consequences of their drinking, if you know what I mean.”

Harry had heard enough. Where had this woman been for the last fifteen years?

“Sorry to get here after visitors’ hours,” he said, “but I had a man in the ER with a GI bleed. Is it okay if I visit with Evie for a while?”

“Sure. If Maura-the-moaner gets to be too much for
you, we’ll just tighten her restraints and move her into the hall. As a matter of fact, she’s due to have a visitor soon, too. Her brother called a little while ago. He’s a policeman, of all things. He doesn’t get off duty for a while and he wanted to see her. I almost told him to bring in a whip and a chair.”

BOOK: Silent Treatment
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