Noble Vision (10 page)

Because violent groups of simple vandals or political activists were common, David was not a glaring suspect. Because he had released all of the animals posing no danger, the action did not seem targeted at the rats. And because most of the animals had declined liberation to remain inside the heated facility on such a forbidding night, many of the rats were found there the next morning, lending more credence to David’s innocence.

After completing his experiments, David incinerated the rats he’d taken back, destroying the incriminating evidence. With the storm officially closing the laboratory building, no one was present to notice David’s activities. He was questioned but not charged with the break-in.

David thought that he should feel relieved to be out of danger—but was he? A greater threat seemed to appear, one that he would have to guard against constantly, for when he’d smashed the windows at the animal center, he’d done so with more . . . diligence . . . than was necessary—with more blows, more shattered glass, and far more ardor than required. Standing amidst the havoc he had created, David Lang had laughed in exultation and deliverance. He had laughed so heartily that he almost forgot to escape.

The next day, through the marvels of horticulture, while the ground lay covered with snow, David sent Nicole daffodils. “Pandora sprinkled me with hope,” he wrote in the first of many unsigned letters.

After that night, he would attend Nicole’s show whenever his discouragement returned with such tenacity that he could find no other remedy. He always saw her performance alone, as if she were his special secret. The next day he would send flowers accompanied by an unsigned letter. The more he wrote, the more he needed to write. He could not burden his wife, Marie, with his problems when she . . . did not seem to understand. Thus, Nicole became his confidante. He welcomed anonymity; it freed him to express his greatest desires and deepest anguish. To be unknown was to be unencumbered.

He never intended to meet Nicole. He disliked the frivolity of the artists he had met, so he did not expect to like Nicole. He thought his fascination with her was a fantasy. But that was before he saw the thing that astonished him—the solemnity of her face gazing at him from across the street.

Stop it!
he ordered himself. Nicole was dangerous. The perverse inspiration with which she imbued him would lead to his demise. He took his worst chances after seeing her show. And most disturbing of all, he did his most brilliant work when he flirted with the impossible, when he attempted to rewrite his fate his own way, and to hell with any one else’s script.

Stop it!
he ordered himself again. He opened a desk drawer and removed a playbill he kept with Nicole’s radiant face on the cover. He tore the pages in half and tossed them in the trash.

Then he heard a knock on his door.

“Yes?”

“Doctor, your first patient has arrived.”

“Thank you,” he said cheerlessly, rising to begin work.

*
  
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*
  
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*

In a nearby building that was a landmark of the Broadway stage, Tony from Regal Flowers delivered a package to Nicole Hudson’s dressing room and collected his bounty. She found the expected envelope tucked in the wrapping, tore it open, and read:

Dear Nicole,

Did you know that the most exotic orchid grows only on top of the tallest tree in the rain forest? From that height, its petals are nourished by the sun, never bruised by the dirt or swallowed by the weeds. Is it wrong to want to reach the brightest flower in the jungle? Is it wrong to climb higher and higher, lured by its unusual beauty?

It wasn’t the dizzying height, the searing heat, or the jagged bark that could make me turn back, not when the treasure was so rare. But when creatures too base to seek their own prizes shoot poisoned darts at me, I begin to lose my footing and I can feel myself slipping.

I once believed that the race was to the swift and the battle to the strong. But that was long ago. Now I know that the race is to the turtle and the battle to the sloth. Why is it that weeds can overrun flowers? Yesterday I couldn’t break loose from the underbrush that entangled me.

But that was before I saw your show last night, before I saw your body leaping through the air, celebrating the supreme glory of your own existence. That was before I felt the warm wave of your laughter flowing from the stage and lifting me in its crest. Last night you poured before me a different world, a cloudless kingdom where one could climb clear up to the sun. The bright vision of you splashed against my tarnished dreams until they shined again.

For a few magic hours last night, your vibrant spirit lured me away from my despair until I rose so high I could smell the orchids.

She looked for a signature but knew she would find none.

Under the gift-wrapping was a crystal bowl containing two dozen of the most exotic orchids she had ever seen. Their translucent velvet petals soaked the room with color and fragrance. Nicole closed her eyes, inhaled a symphony of sweet perfumes, and envisioned the Phantom’s face.

Soon she took her place onstage, waiting for the curtain to rise.
Will he be watching?
she wondered.
This is for you,
she told the lingering presence in her mind.
Today I’ll dance especially for you.
Later, when climbing to Prometheus on the desolate cliff, she thought of the proud, lonely figure outside the flower shop. Was he chained, too, and could she set him free?

Chapter 6

Unnecessary Treatment

A headlamp beamed on a hole being drilled. Although the tool’s deafening noise seemed suitable for riveting bolts into concrete, the user’s sensitive hands were boring a hole into the base of a young woman’s skull so that she could become pregnant and lead a normal life. A desire for children had brought her and her husband to David, who discovered that a tumor on the woman’s pituitary gland was causing a hormonal imbalance and preventing conception.

The pressure building inside David’s own skull that week—the burning anger after his meeting with Dr. Cook and her research committee, followed by wild thoughts of quitting medicine—subsided when he entered Riverview Hospital’s surgical suite. The OR was both the tranquilizer that calmed him and the stimulant that excited him. With unblinking eyes, he began an absorbing task within a unique brain.

 
In a complex, interlocking chain—from the surgeon who operated to the resident who assisted to the scrub nurse who supplied the instruments to the circulating nurse who tended the patient to the anesthesiologist who kept the patient breathing to the scalpel making the incision to the drill cutting the bone to the microscope enlarging a tiny work field to the instruments removing the tumor to the stitches closing the incision—every person and object would play a vital role in removing a pea-size tumor on a grape-size gland so that a young woman could bear children and be healthy.

David had decided to reach the little structure at the base of the brain that was known as the master gland by operating through the patient’s upper lip and sinuses. This approach, which penetrated the base of the skull, spared the patient a craniotomy and pulling on delicate brain tissue; however, operating through the sinuses shrank the surgeon’s area of vision from a large cavern atop the skull to a long, narrow passageway through the mouth.

In choosing his route, David counted on a device called a mobile scanner, which could be wheeled into the operating room to provide instant, sophisticated images of the body. The mobile scanner was particularly valuable to neurosurgeons in checking their positions and progress and in ensuring the complete removal of tumors in spots difficult to see. The tumor David tackled that morning would normally have required an intracranial operation. With the mobile scanner, however, David could do the job via the sinus route. At a critical point in the procedure, he ordered the device
to be brought in
.

A technician wheeled the equipment into the OR. With movements as routinized as brushing their teeth, the operating team silently stepped back from the patient to accommodate the instrument.

A voice broke the calm: “One minute, please.” It belonged to a man wearing small glasses above his surgical mask and holding a large clipboard against his scrubs. The man had followed the technician in. “I’m Inspector Norwood of CareFree. A request to use the mobile scanner in this surgery was denied. It was found to be unnecessary treatment.”

On hearing this, the technician backed his machine away from the patient while the OR team returned to the operating table, again in silence, as if this, too, were the expected.

David’s headlamp crossed the room to shine impolitely on the eyeglasses of the inspector. “There
will
be a scan done, now,” said the surgeon.

Again the technician moved the machine toward the patient and the OR team backed away.

“Dr. Lang, let’s not have any unpleasantness this morning. You know that as an inspector of surgery for CareFree, I must ensure compliance. Whenever I observe you surgeons directly, costs drop and the hospital meets its budget. I’m here for your benefit, Doctor, so you won’t have a hard time later with the review board,” Inspector Norwood said with strained politeness.

“So I’ll have a hard time later,” replied David. “Right now, I’ll have the scan.”

“Preauthorization was denied. As the inspector, I say the scanner will not be used.”

Like a movie reel played in forward and reverse, the technician and machine backed away from the patient while the OR team moved toward her once again.

“As the surgeon, I say the scanner
will
be used.”

The players finally stopped and waited, freezing the scene in a still frame.

“And I say it will not be!” Inspector Norwood’s voice puffed from his mask, steaming the lenses above it.

“When did you go to medical school?”

“That’s irrelevant.”

“Shall I wake the patient and see if she thinks it’s irrelevant?”

“CareFree hasn’t authorized the mobile scanner.” Inspector Norwood squinted in the spotlight still rudely hitting his eyes.

“CareFree isn’t doing the surgery—I am.”

“Studies show that using expensive technology is often just a frivolous indulgence of the doctor.”

“So I’m frivolous. The scan will be done.”

“The scan is unnecessary!”

“Something in here is unnecessary, but it’s not the scan.”

The two argued across the operating table, whereas the limp body between them had no comment.

“Excuse me,” resident Tom Bentley interjected. “Two weeks ago, a patient skipped town before a postop brain scan could be taken that CareFree approved.” He glanced at the inspector hopefully. “Maybe we could swap that one for this one.”

“Or the ER patient who died this morning before we ran images,” said one of the nurses. “Those pictures would have been for the cervical spine, but maybe that’s close enough—”

“I’m not making any bargains.” Inspector Norwood raised his hand for silence. “The technician must leave, and the operation must resume without the pictures.”

“And without the surgeon. Are you prepared to finish the job, Inspector?” asked David.

“Are you threatening a strike, Doctor? You know that’s illegal. Doesn’t your conscience tell you to stay and work?”

“As the state orders me to? Isn’t there a name for that?”

The inspector sighed tolerantly, waving his hand to dismiss the matter. “Whoever said anything about ordering anybody? Really! The other surgeons are cooperating voluntarily, without any unpleasantness.”

“You mean after you threatened to slap them with fines?” David asked.

“Of course, if you’ve gotten yourself into a bind and can’t see where you are without a film, perhaps your resident can help.” Inspector Norwood glanced at Bentley.

David’s eyes glazed past the official to a vision of their own. The surgeon observed himself clinically, as if he were the patient. He noted pressure building as his blood seemed to hit a clogged artery, the same pressure that he had felt when he struggled to save Eileen Miller, when he faced the committee halting his research, when many other blockages occurred.
The condition seems incurable; the patient should learn to live with it
, he thought.
Or should he?

“Think of how much you’re costing the system, Doctor. We need to conserve medical resources by eliminating unnecessary things we’re better off without,” said the inspector.

“Do you know what a surgeon does to unnecessary things we’re better off without?” David replied.

The headlight went dark, its cord pulled from its power source, as David grabbed a scalpel from the equipment tray and lunged toward the inspector. A collective gasp was heard from the others. Clutching the inspector’s shirt, the surgeon pushed him through the swinging doors of the OR and into the hallway, the knife aimed at the man’s throat.