Chapter 47: Fourteen Dirty Words

August 13, 1990, McKinley, Ohio

I returned to Doctor Wernher's office, and he motioned for me to close the door, which I did.

"Do we have anything to worry about?" he asked as I sat down.

"I'm going to call him Ron because that's the name we know and the name on all the charts. He was, as far as I was concerned, an average student on his second clinical rotation. He performed adequately, and my interim take was that he'd receive 'meets expectations' without any additional endorsements."

"Please tell me he only did procedures appropriate to a Third Year."

"He did. Someone would have to be as good as Mary Anderson before I'd allow anything more than that."

"Or you?"

"I'll leave that question for the doctors who trained me," I replied.

Dutch laughed, "Very smooth, Doctor. Do you have any concerns about Ron Oaks?"

"Given anyone can sue for anything, yes, but my concerns are minimal. No patient had a bad outcome related to anything he did, which was limited to hooking up monitors and EKGs, drawing blood, and inserting a pair of Foley catheters. He was not involved in treating any patient who had a bad outcome in the ED."

"Good. I'll speak to Owen about how we handle this, but I don't have an extra Third Year to give you."

"I called Doctor Mertens to let her know," I replied. "I can make do, so long as a nurse is available."

"I'll speak to Nurse Green about that. You can return to work unless you have something for me."

"Nothing besides a racist «мудак» (mudak) who refused to allow Doctor Jefferson to treat his son." ("asshole")

"I infer that term is on my banned list?"

"Yes. One of the fourteen dirty words you can't say in the ED," I replied with a grin.

"I didn't think I needed to publish it in multiple languages," Dutch said with a wry smile. "Why am I not surprised you're a George Carlin fan?"

"Zappa, too," I replied. "My mom didn't approve of either of them. I didn't care."

"Mine didn't approve of Jimi Hendrix; I didn't care, either."

"If I could play guitar like Hendrix, I'm not sure I'd be a doctor."

"NOBODY can play guitar like Hendrix could. And yes, you would."

"OK, you're right, I would."

"What happened with the patient?"

"Letitia decided that the patient's health was more important than her righteous anger at having a guy with '88' and a pair of lightning bolts tattooed on his neck call her a 'jigaboo'."

"You're not joking?"

"I am not. I offered to allow him to sign his son out AMA, but Letitia felt that was a bad idea."

"Please tell me you were bluffing."

"I'd have offered him Doctor Varma as his second choice if he insisted on either leaving or having a new doctor."

"I understand your point, and I agree with you philosophically, but please do not do that again. Just ask a different physician to handle it, and don't try to tweak the patient or their parent if it's a minor. You know as well as I do that a neo-Nazi is going to call that bluff, even if he doesn't know it's a bluff. It's a fact of life here, just as it was in Chicago when the Nazis won the right to march in Skokie."

"The ACLU set a perfect example for all of us when they defended the Illinois Nazis' right to march on First Amendment grounds. The Blues Brothers response would have been far more popular. And wrong."

"What was the diagnosis for that patient?" Doctor Wernher asked.

"Admitted to neuro for overnight observation due to a moderate concussion."

"Is Doctor Jefferson OK?"

"Yes. She and her cousin — my friend and roommate at Taft, Clark — are used to dealing with that kind of crap. They shouldn't have to be, but they are."

"Sadly. Dismissed, Doctor."

I left his office and went to find Gabby to get a report on the patients, all of whom were doing fine.

"What happens now?" she asked.

"Doctor Wernher will speak with Doctor Roth, but it's not likely we'll have a replacement. We can make use of nurses and student nurses when necessary."

"Do you know when he changed his identity?"

"I don't know for sure, but I'd speculate around 1983. From the little I know, he assumed the identity of someone born in 1965, so '83 would be about the time the real Ron Oaks graduated from High School. Our Ron Oaks was allegedly born in 1960, so he'd have graduated from High School in 1978. That would have left him five years to do whatever it is they're accusing him of doing, then adopt the new identity, enroll in college, and eventually medical school."

"How did the background check miss that?" Gabby asked.

"What showed up on your background check?"

"Nothing, because I've never been in trouble with the law. My credit report showed my student loans, and that's it."

"And they asked for a copy of your diploma and High School transcript, right?"

"Yes."

"Any pictures or description other than 'female' and your name?"

"Only the one I submitted with my application; I'm pretty sure they didn't compare it to a Yearbook picture or anything like that. I'm confused about how he obtained ID?"

"Birth certificates are public records. He could have easily gone to the county and asked for a certified copy, saying he'd lost his ID. Once he has the birth certificate, the rest would be trivial, especially if no fingerprints were ever on file."

"It's that easy?"

"Tell me how you would catch someone like that and how you would prove they weren't who they say they were?"

"DNA testing, I guess, and compare it to family members."

"In 1983?"

"No. What about using yearbook pictures? The police would do that, I'm sure."

"I agree they would. Perhaps he chose someone who looks vaguely like him. Enough teens die every year for someone to be close enough, and he ended up selecting someone five years younger to achieve that goal."

"It's really that easy to get a birth certificate?"

"When my dad needed a copy of his, he had his father send him a request form from Illinois. My dad filled it out, sent it in with a check, and they sent him back a certified copy of his birth certificate. That was in the mid-70s."

"Mike?" Nate called out. "EMS three minutes out with an MI."

I acknowledged him and walked over to the nurses' station, where Ellie was working.

"I'll need a pair of nurses, please. Ron is not coming back."

"What just happened?" Ellie asked.

"He was arrested. Which nurses?"

"Julie and Becky. Arrested for what?"

"A bunch of fraud charges and using an assumed identity. That's all I know."

I gathered the nurses, then they, Gabby, and I went to the ambulance bay to await the paramedics.

"What happened?" Becky asked.

"Ron Oaks was arrested by a Deputy US Marshal and a McKinley PD detective on a list of fraud charges. He appears to have been using an assumed identity for at least seven years. I don't know anything more."

"I've never seen anything like that before," Becky observed. "And I've worked here from before the medical school opened in 1972."

The EMS squad turned into the driveway, and a few seconds later, pulled up in front of us. As soon as Roy gave the bullet, I knew it was probably hopeless, as a fireman was performing CPR, and the patient had registered no pulse when they arrived on scene. Twenty minutes of futility later, I called 'time of death' and asked Isabella to sign off. She asked about Ron, and I told her exactly the same thing I'd told everyone else.

"Mike?" Nate called out as I exited the trauma room. "Wife is in chairs."

"Thanks. Gabby, bring her to the consultation room. Doctor Mastriano and I will come in shortly."

"Chafing under Wernher's rules about Attendings supervising Residents?" Isabella asked as I reluctantly put on my medical coat.

"I'm positive that bothers you more than it bothers me!" I declared. "You sign my charts without any grief, and I don't mind having backup when I tell someone their loved one has died."

"True, but YOU get to tell them. I just have to sit there and look the part of a senior physician."

"Good luck," I chuckled. "You're only three years older than I am!"

Once I saw Gabby take the patient's wife into the room, Isabella and I joined them.

"Good morning, Mrs. Baxter," I said. "I'm Doctor Mike, and this is Doctor Mastriano, one of our senior physicians, and the young woman behind me is Gabby, a trainee physician."

"How is my husband?"

"He was brought to us by the paramedics in full cardiac arrest — that means his heart was not beating. The paramedics performed CPR, and once your husband was brought here, we continued CPR while we evaluated him. We used all our capabilities and all our skills, but we were unable to restart his heart, and he died."

She looked grim, "I was sure that was true when the paramedics checked him, and I saw their faces. May I see him?"

"Yes, of course. Gabby will take you to see him. You'll see all the equipment we used, as well as wrappers and other items. Is there anyone we can call for you?"

"No. I called my pastor before I left home, and he's on his way here."

"We'll make sure he's brought to you. You're welcome to stay with your husband as long as you wish."