Dead Certain (6 page)

It took Jeff under twenty minutes to find one of the pinball machines on an Internet auction site that could be, by paying an obscene premium, delivered to Chicago by afternoon. I knew it didn’t qualify as a great idea, but it was the only one I had, so I handed Jeff my American Express card and sat down to draft a letter to Hurt. Taping the interview to the bottom of my computer screen, I found myself looking at the photograph of Hurt that had run with the article. I knew he had to be in his twenties when it was taken, but he still looked like a little kid, the nerdy kind who accumulates a little cloud of spittle at the corner of his mouth and never gets picked to play baseball even though he knows every box score. Perhaps because he looked so goofy, I decided to go with an oddball approach. In less than an hour I’d composed a poem in iambic pentameter equating Delirium’s quest for a joint venture with Icon to the quest of the hero of the Dark Invader game.

“No guts, no glory,” I said out loud to myself as I typed in the command that sent it to the printer. “Now if only I could find something to rhyme with
orange.”

While Cheryl and Jeff tried to figure out the logistics of wrapping a pinball machine and having it delivered to the Four Seasons, I slipped out for lunch. After all, partnership
does
have its privileges. Besides, Joan Bornstein never asked me out to lunch without an ulterior motive, and as usual, I was dying to find out what it was.

Joan was a litigator, a high-priced, high-profile medical-malpractice attorney whose skill at defending prominent physicians and hospitals accused of wrongdoing was surpassed only by her talent for promoting herself. Joan had picked Nick’s Fishmarket, a see-and-be-seen power-lunch spot whose deep, secluded booths have long been favored by LaSalle Street deal makers. It was the kind of place that Joan liked, a place where everybody from the busboy to the maitre d’ knew her by name and treated her like a celebrity. As I expected, by the time I arrived, I found her at the best table, holding court with a bunch of insurance types who’d stopped on their way out the door. At the sight of me they moved on, and she made a half-hearted effort to get to her feet, offering up air kisses and exclamations of pleasure at seeing me.

Joan always looked like she was about to step in front of the cameras. With her dark hair and telegenic red suit, she was less pretty than handsome, but struck a memorable figure nonetheless. She was also one of those people who somehow manages to look better on television than in person. Her strong features were somehow softened by the intervention of the camera, and as fond as I was of her, even I had to admit that hers was a personality best appreciated in sound bites. Today she was, as always, impeccably made up and expensively dressed. She was also, by the look of things, about seven months pregnant.

“Long time no see,” I remarked, sliding into the booth across from her. “It looks like you and Ada
m
have both been keeping busy.” Adam was Joan’s husband, a North Shore obstetrician with a gilded practice.

Joan patted her stomach. “I think this is going to be one of the hazards of being Adam’s wife. He always tells people we’re going to keep on having kids because the delivery room is the only place where I’ll let him tell me what to do.”

“So how does little Jared feel about all of this?” I asked.

“Oh, he’s excited about having a little brother to push around,” she replied. “But I didn’t ask you out to lunch to talk about babies and potty training. That’s what I go to the office to get away from.” She leaned across the table conspiratorially. “I wanted to talk about the sale of Prescott Memorial to HCC.”

I was so surprised I practically choked on my ice water.

“Oh, come on,” she continued. “Don’t pretend you don’t know that the board of trustees signed a letter of intent yesterday.”

“If they did, then Pm sure they also signed a confidentiality agreement,” I pointed out. “You wouldn’t be telling me this as if it’s an accomplished fact, hoping to trick me into confirming it’s true?” I asked, being all too familiar with Joan’s courtroom wiles.

“Believe me, Kate. Being a mother has made me a much better lawyer. After all, medicine is a lot like nursery school. No matter what, somebody
always
tells.”

“So what makes you think I’d want to talk about it?” I asked.

“Because your mother has been publicly associated with raising funds for the hospital her entire adult life. Because your family is the biggest single financial supporter of the hospital.”

“And?”

“And if they knew what I know about HCC, they would turn and run the other way.”

“In that case I think you’d better tell me what you know about HCC,” I suggested.

“For one thing, they’re evil.”

“Oh, well, I’ll just go right ahead and take that to the board,” I said, helping myself to rolls and butter. “I’m sure that’ll persuade them.”

“Okay, Miss Smarty Pants, why don’t you tell me what it is that you know about HCC?”

“Not much,” I replied truthfully, “only what I managed to read last night.”

“In that case, let me test the limits of your knowledge. Question one. Why does HCC have its headquarters in Atlanta?”

“I have no idea, but I’m sure you’ll tell me.”

“I’ll give you a hint. They don’t own any hospitals there, but it’s where Quickie-Mart, Circle Seven, and French’s New Orleans Style Fried Chicken all happen to have their national headquarters.”

“I still don’t get it. What does any of that have to do with HCC?”

“You really weren’t kidding when you said you don’t know much, were you? Those are all the companies that Gerald Packman worked for before he decided to strike out on his own and start Health Care Corporation. It only seems natural, doesn’t it, that having conquered the world of convenience markets and fried-chicken franchises that he’d want to share his unique vision with the health care industry?”

“What vision is that?”

“Oh, you know, the usual. Cost cutting, consolidation, taking the paper clips off your memos before you throw them in the trash—all the stuff that gives accountants hard-ons and is pretty much meaningless when it comes to medicine.”

“What makes you so sure it’s meaningless?” I demanded.

“Because in health care what is ultimately at stake is lives, not dollars.”

“A business is a business,” I countered, not at all happy with the direction this conversation was taking. “It doesn’t matter whether it delivers bagels or babies.“

“Tell that to Adam’s patient, the one whose baby was born with a heart defect last night. Her insurance company refuses to cover the cost of a new, less invasive surgery to correct it because it costs too much.”

“Okay, I grant you the difference between babies and bagels, but that still doesn’t mean that health care isn’t a business.”

“Then I guess it’s time for quiz question number two. In one sentence or less, describe the mission of Prescott Memorial Hospital.”

“To deliver high-quality health care to patients in need, regardless of their ability to pay,” I answered, repeating the catechism without hesitation.

“Very good. So now tell me, what’s HCC’s mission? „

“I don’t know,” I replied, growing weary of this interrogation. “To deliver cost-effective health care to people who
can
pay?”

“Wrong answer. You just said it a minute ago. A business is a business. HCC’s mission is to maximize profits for their shareholders. Period.”

“So?”

“So that’s what makes them evil,” declared Joan passionately. “Medicine may be a business, but it’s not like any other business. If you walk into Saks to buy a dress and you don’t like the way they treat you, you can always walk down the street to Neiman Marcus. But when you’re sick and helpless, you’re in no position to go down the street. That’s why, whether you can pay for it or not, you pray you’re in a place like Prescott Memorial where everyone is working their butt off to give you the best possible care instead of an HCC hospital where all they’re worried about is squeezing the maximum profit out of you in the shortest amount of time.”

Suddenly I thought about Claudia, who attacked her job with a selfless dedication approaching mania.

“The doctors I know wouldn’t have anything to do with a place that treated patients like that,” I protested. I “You’d be surprised,” said Joan in a tone of voice that told me she’d long ago been stripped of such illusions. “Doctors have their price just like anybody else. If they didn’t, HCC wouldn’t have been able to do what they’ve done. Everywhere they’ve gone, the company has made it worthwhile for the docs to roll over for them.”

“In what way worth their while?”

“Kickbacks and insider contracts. Everyone knows that HCC gives bonuses to the doctors who perform more of the procedures that provide the highest profit margins and to the administrators who have the fewest empty beds. I That’s why HCC hospitals take more X-rays, do more MRIs, and perform more hysterectomies on average than other hospitals. Conversely, they see fewer emergency patients and have a policy of shunting off the indigent to noncompany facilities.”

“Then what on earth could they possibly want with Prescott Memorial?” I demanded. “All they have is indigent patients.”

“Oh, HCC isn’t looking to make money from Prescott Memorial,” answered Joan, “at least not in the short run.”

“Okay, now you’ve really got me confused,” I protested, “Just a second ago you had me convinced that all HCC was interested in was making money.”

“They are. You’re just not looking at the big picture. Don’t you see? Acquiring Prescott Memorial is just the ) first part of a much larger plan.”

“Which is?”

“To buy the company a foothold in Chicago. Think about it. HCC may be a $16 billion company, but they’re doing all their business in places like Omaha and Dubuque. By buying Prescott Memorial, HCC is making their first move into a major metropolitan market.”

“Why? What does it matter where they make their money?”

“You want to know why? Because Gerald Packman is an arrogant son of a bitch who actually believes that he’s found a better way, and like every other arrogant son of a bitch who’s come before him, he wants to shove it down everybody else’s throat whether they like it or not.”

After lunch I took the long way back to the office, pausing to admire the Chagall mural on the First National Bank Building as I tried to sift through everything that Joan Bornstein had just told me. The trouble was that Joan was a partisan by profession, a well-known and outspoken opponent of the constraints placed on the traditional freedoms enjoyed by physicians. Just like my mother, she had her own agenda.

When I finally got back to my office, I was surprised to find my door shut and the sound of voices coming from within. Puzzled, I shucked off my raincoat and ventured toward the door. Turning the handle slowly, I pushed it open to reveal a vaguely disturbing tableau—Cheryl, dressed in a dark blue suit that had once been mine, looking very much at home behind my desk. From the looks of things, she appeared to be conducting an interview with a very animated young woman whose hair looked like it had been cut by a poodle groomer.

I caught my secretary’s eye and offered up an inquisitive glance. In response she shot me one of her don’t-even-ask looks and promptly turned her attention back to the fascinating young woman with the strange hair. “Now, were there any other questions I can answer for you about the kinds of work involved?” she asked in an obvious effort to draw the interview to a close.

“Well...,” began the young woman rather tentatively, but it was too late. Cheryl was already on her feet and moving toward the door.

“It’s been a pleasure meeting you,” continued Cheryl, shepherding her toward the door.

“It’s been really neat meeting you, Ms. Millholland,” gushed the young woman, ignoring me and speaking to my secretary. “I just want you to know that if I
do
get the job, I know it would, like, work out to be super for both of us, you know?”

“I’m so sorry I’m late coming back from lunch, Ms. Millholland,” I piped in, my voice dripping with contrition. “I promise it won’t happen again. Would you like me to show the job candidate out?”

“That would be very nice of you,” replied Cheryl, struggling valiantly to control her face.

I took my time showing the hapless young woman to the door, ducking through the library and taking a detour through the trusts and estate department to give us time to chat. As we walked I managed to learn that her name was Amber and that she wanted to work as a legal secretary only until she’d saved enough money to pay for electrolysis school. I must confess, I entertained myself further by regaling her with stories about what a harridan “Ms. Millholland” really was to work for, complete with anecdotes about temper tantrums and punitive overtime.

By the time I got back to my office, I found that my secretary had not only resumed her usual seat but also fetched fresh coffee for the both of us.

“It would almost be worth hiring her just to see her face on the first day,” I announced as I settled in behind my desk.

“No, it wouldn’t,” replied Cheryl. “I guarantee you you’d strangle her inside of a week. The woman has the IQ of a rutabaga. I hope you don’t mind what I did, but you still weren’t back from lunch and you’re already on Mrs. Goodlow’s shit list.”