Chapter 22: My Work Here Is Finished

October 18, 1994, Mayo Clinic, Rochester, Minnesota

“So, was that all a big waste of time, Doctor Ross?”

We were sitting in his office on Tuesday afternoon after the complete battery of tests.

“It’s never a waste of time. Even if we don’t find anything, we can rule things out.”

“I feel like a pincushion. And I swear, Dracula couldn’t get blood out of me at this point.”

“Unfortunately, that’s the only way we can understand the chemistry. The total amount we took is less than you would have given if you donated blood.”

“Yeah, but that’s ONE stick!” I chuckled.

“True. I can’t really tell you much until the blood chemistry work comes back and we line it up with all the other stuff, including the nearly continuous EKG and EEG tapes.”

“How many spools of paper did THAT take?”

Doctor Ross laughed, “Quite a few. Thanks for allowing Mary to follow the case the whole way through.”

“I remember Jess bitching about not getting to do anything during some of her clinical rotations. I wasn’t going to contribute to that problem. She seems like a good kid.”

“She is. If she doesn’t Match here, Doctor Alston and I are going to be VERY put off. What time is your flight?”

“8:00pm. I wasn’t sure when we’d be done. Why?”

“Want to come to the conference and listen to the team go over what we know so far?”

“Sure. On one condition.”

“What’s that?”

“Let Mary run it, even if she stumbles. Give her the chance. She was there from the very first moment and participated in every test.”

“That’s up to Doctor Alston. She’s his student.”

“And you’re not his Attending or anything like that, of course.”

“No, but what kind of Doctor would he turn into if I didn’t let him make his own decisions?”

I laughed, “Manage your team!”

“What?”

“What I tell the people who work for me. I delegate authority.”

“Then you understand.”

“I do. But make it happen, Doc. Sometimes the boss gets to be the boss.”

“Your wife must have bent your ear something fierce.”

“She did. And after seeing how things went for her from her third year through her Fellowship I’ll tell you the same thing I’ve told Al Barton. The entire training regimen for doctors is seriously fucked up. Excuse the language, but I don’t know another word that conveys just how disgusted I am with the whole thing.”

He nodded, “There are serious problems which need to be addressed. I’m sure you know how difficult change can be.”

“I do. But that’s no reason not to try to fix it Doc. I’m doing my part by insisting that you let Mary run the conference.”

“Point taken. Let’s go.”

We left his office and went to a conference room where Doctor Alston, Mary, and six other doctors I’d seen over the course of the two days were assembled, including the psychologist and psychiatrist.

“Doctor Alston,” Doctor Ross said. “I’d like to have your student lead this session.”

Doctor Alston raised an eyebrow, then nodded.

“Mary, you’ve sat in on several of these. Go ahead.”

She looked like she was going to crawl under the desk but she swallowed hard, cleared her throat, then started.

“The patient is a thirty-one-year old male in good general health. He presented with a history of vasovagal syncope for which there is no known physiological cause.”

She went through all of the tests that had been done and reported the results, then polled each doctor in the room for their opinions, making notes.

“Very good, Mary,” Doctor Alston said. “You and I will go over this tomorrow during our morning meeting. What’s the next step?”

“We need the blood chemistry to see if we can determine what is, well, odd, I guess, with Mr. Adams’ carbohydrate chemistry.”

“Is there a reason you didn’t say wrong?” Doctor Ross asked.

“He’s in perfect health, and it’s not clear there IS anything actually wrong with him, other than a strange reaction to adrenaline which seems to be exacerbated by consumption of complex carbohydrates, namely potatoes and rice. Evidence suggests it’s easily controlled by diet, and it’s not life-threatening, nor even health-threatening so long as he doesn’t have a syncopal event while driving or something like that, and there is no indication anywhere that such a risk exists.”

“Mary, what rotation are you doing now?” Doctor Schultz, the cardiologist asked.

“Endocrinology. That’s why I’m with Doctor Alston on this case.”

“List us first on your Match form, please, for endocrinology. You just passed your interview with me. And I’m the head of the committee.”

“Thank you, Doctor Schultz.”

“Thank Steve,” Doctor Ross said. “He insisted I have you run this conference.”

“Thanks! But why?”

“Because,” I replied with a wry smile, “my wife would KILL me for not helping out a promising medical student. We married during her third year. And I’d say, from my experience, you’re going to make a damn good doctor.”

“Thanks!”

“We’re done,” Doctor Ross said. “Doctor Alston, Mary, please stay for a moment.”

I shook hands with the other doctors and they left.

“I’ll let you go now, Steve. We’ll call you with the results, whatever they are.”

“Thanks, Doctor Ross. Mary, I look forward to hearing the results from you.”

“Get out of here and let me run my department!” Doctor Ross laughed.

“My work here is finished!” I grinned.

I shook hands with both doctors and Mary, then headed out to the lobby to call a cab to take me to the airport.

October 18, 1994, Chicago, Illinois

“Only you, Tiger,” Jessica said, shaking her head as she, Kara, and I cuddled after making love.

“What? I remembered what it was like for you during your clinical rotations your last year.”

“But a guaranteed Match at Mayo?”

“I didn’t do anything, Jess. She did it all. All I did was ensure she had the chance to show what she could do. She’s good. Very good. In fact, she reminds me of a girl from Plano, Texas in many ways!”

“Do you know how hard I had to fight to even do the most basic stuff?”

“Yes. Why do you think I insisted on them letting her do what she did? She’s smart and capable. That short white coat needs to be replaced with a longer one as soon as possible. I also got my digs in about the training system.”

“Of COURSE you did! That young woman owes you, big time.”

“And she can pay me back by being a good doctor. Heck, maybe she’ll be the one to figure it out.”

“You never know.”

October 20, 1994, Chicago, Illinois

“Do you want to see my speech?” I asked Cindi on Thursday morning.

“Is it any different from the previous ones?”

“Not really. I pretty much say the same thing to the User Group each year, just modifying it a bit for whatever is going on.”

“Are you going to say something about Rob?”

“Yes. It just doesn’t seem right not to. Are you in the office next week?”

“Yes. Why?”

“I want to go over all the plans for reorganization as well as discuss the succession planning. We need to wrap all of that up soon so Elyse can finish next year’s budget.”

“And Colorado?”

“I’ll sign off on the final plan next week. I delegated all of that to Barbara and Elyse provided her with a budget.”

“That’s a pretty big thing to delegate.”

“Yeah, you know, it’s not like I delegated the entire sales and support organization to her and never interfered with it a single time or anything.”

“Fuck you!” Cindi said, laughing.

“Speaking of that, how’s your fireman working out?”

“Very nicely, thank you!”

“And?”

“William likes him. Hell, Stuart is a better dad to William part-time than Chris was full-time. And honestly, Chris was a boring fuck. Stuart is NOT!”

“TMI, Ms. Spanos!”

“Bullshit!” Cindi laughed. “After all these years there is no such thing as TMI between us!”

“True. OK. I have work to do. I’ll see you tomorrow at the hotel.”

“In my dreams,” she laughed.

“You know what I meant!”

I left her office and went back to mine. The consulting candidate would be arriving soon for me to talk to, and then he’d talk with Charlie and the rest of her team. I’d already signed off on one hire for Dave and was waiting for him to present the second candidate. I’d barely started reading my email when Lucas buzzed me to let me know that Wes Cranston had arrived and Charlie was going to bring him up. I did my usual interview and finding nothing objectionable, turned him over to Charlie.

That evening, Jessica, Kara, and I had dinner with Ben Jackson, Ben van Hoek, and Ned Jenkins.

October 22, 1994, Chicago, Illinois

The User Group meeting had gone off without a hitch, and as I usually did, I skipped the Saturday sightseeing, opting to go to breakfast with the guys, go to the dojo and then head home for lunch. The twins, Maureen and Ryanne, arrived just before noon as planned. After we’d finished eating, I invited them into my study to talk.

“How is school going?” I asked when we sat down in the wingback chairs.

“It’s tougher than High School,” Maureen said. “But we expected that.”

“Are you sharing a room in the dorms?”

“Yes,” Ryanne said. “We’ve been in the same room since we were born! We do EVERYTHING together!”

“We even have a secret language.”

“Secret language?” I asked.

“It’s called cryptophasia,” Maureen said. “We used it a lot when we were little, but not so much anymore. Our parents were really confused because we spoke English to them but our secret language to each other. It’s common amongst identical twins.”

“I had no idea,” I said.

“There was a documentary made in 1980 called Poto and Cabengo about twins who had their own language and needed speech therapy to learn English. My parents showed it to us when we turned fourteen.”

“I learned something new today,” I said. “Is it a full language?”

“No,” Ryanne said. “Think about how a normal three-year-old would talk. I couldn’t have this conversation with you, even if you knew the words. And I think we’ve forgotten a lot of the words at this point because we don’t really use it except to be silly.”

The girls ‘spoke’ to each other using some completely unintelligible ‘words’ that contained sounds that didn’t fit English, Swedish, Spanish, Japanese, or any other language I was familiar with. I must have had a very perplexed look on my face because the girls both laughed.

“That was it!” Maureen said.

I shook my head, “That was VERY strange!”

“Do you mind if I ask why you went to the Mayo Clinic?” Ryanne asked.

“Not at all. Nobody knows what’s wrong with me, really. I have these odd fainting spells in certain types of stressful circumstances. The working theory is a congenital problem with my hypothalamus that is messing with my endocrine system, making me susceptible to syncope - fainting - in response to adrenaline. There isn’t anything that can be done because it’s not a tumor or anything like that. What’s weird is that consuming carbohydrates seems to make it worse. I was at Mayo to see if they could figure it out because there’s no apparent physiological link.”

“How bad is it?”

“It’s not life-threatening, and if I limit my carbohydrates, which I was mostly doing before for another reason, it stays completely under control.”

“Why limit your carbohydrates?”

“I’m mildly bipolar. Limiting sugar in any form as well as ensuring I get enough exercise and sleep keeps the mood swings at bay. And THAT might all be related to my messed up carbohydrate chemistry. I’m not a doctor, but that’s my suspicion, and it’s the suspicion of the medical student who did the workup.”

“Medical student?” Maureen asked.

I nodded, “I have a sneaking suspicion I’m going to be her life’s work.”

“Really?”

“She’s going to be at Mayo as a Resident starting next June. She’ll be Doctor Whittaker at that point.”

“So you have your own interesting quirk!” Ryanne said.

“I have more than one!” I chuckled. “And if your sister wants to be President, I’d say she has bigger problems than I do!”

“Hey!” Maureen protested, but she was laughing. “You don’t think a woman can be President?”

“All of my senior executives are women, along with the Chairman of the Board of my company. What does that tell you? I’m married to a doctor and a PhD candidate in Chemistry. The mother to two of my sons is my CFO. Getting the picture? I mentor a young woman who is the CEO of a multi-billion-dollar corporation. Should I go on?”

“No!” she laughed. “You made your point! You have no trouble with women in powerful positions.”

“Exactly. I just think anyone who wants to be President needs their head examined. You heard what I said last Sunday, right?”

“Yes. You’re very cynical,” Maureen said.

“I’d say that’s borne out by history. But I don’t think you came here to discuss politics!”

“No, not really. We’d like your help with something.”

“And what exactly did my trouble-making friends suggest?” I asked with a grin.

“Becka? You probably don’t want to know! But Jodie and Claire both said you’re mentoring them and helping them. And that you’ve done that for other kids. Would you help us?”

I laughed, because there was no other response.

“Sure,” I said when I stopped laughing. “I can do that.”

“I guess you DO know what Becka suggested!” Ryanne said.

“Let’s just say that Becka likes to tease me, and she’s pretty good at it. Just let me know when you want to get together. I’m busy, but I can come down to Hyde Park for lunch, or you guys can come here and we can chat.”

“Cool!” Ryanne exclaimed. “Thanks!”

“You could probably get good advice from Elyse as well. She’s my CFO, as I mentioned. And Michelle is my office manager.”

“They’d talk to us?”

“Absolutely,” I said. “Just watch out for Elyse. She’s more of a troublemaker than Becka!”

“Are you sure?” Maureen asked with an impish smile.

“Positive! I’ve lived with her for thirteen years!”

“I guess we’ll head back to campus. The next Rap Session isn’t until November 6th, right?”

“Right.”

“Bummer,” Ryanne said. “I wish they were every week!”

“We started running out of material despite being every two weeks. But anytime you want to talk, just call. I can pretty much always make an hour or two available.”

It would take some of my valuable time, but the kind of mentoring they were asking for was something I felt was very important. And an hour here or there wouldn’t be too difficult, especially if it could be done at lunchtime.

“Great!” they said together, standing up.

I stood up and walked them to the front door, then went to find my wives who were in the ‘Indian’ room.

“We figured you’d disappear into the sauna!” Jessica teased.

“As much as Becka is a troublemaker, it seems Claire and Jodie told them about my mentoring and THAT is what they wanted.”

“No way! Those two girls want the full treatment!”

“Then they are being VERY circumspect and playing a long game!” I countered. “Other than that reference to Becka, we mostly talked about them, politics, and then mentoring.”

“Speaking of that, after you left last Sunday, Kylie came to speak to me and basically asked for the same thing. You’ll probably see her around the house occasionally.”

“Same with the twins,” I said.

“So, the Rap Sessions have moved from a way to meet girls to finding kids who want to be mentored?” Kara asked.

“So it would seem, and in the scheme of things, that’s probably about the best result I could imagine.”

October 24, 1994, Chicago, Illinois

“Steve, I have a Mary Whittaker from the Mayo Clinic on the line,” Lucas said on Monday afternoon.

“Put her through, please.”

A few seconds later she was on the line.

“Good afternoon, future Doctor Whittaker!”

She laughed, “Hi, Mr. Adams.”

“If you don’t start calling me ‘Steve’, I’m going to be very put off!”

“Uh, OK, Steve. I have some results, but they’re inconclusive.”

“Color me NOT surprised by that. Let me guess, the adrenaline response tracks almost perfectly with changes in my blood chemistry that appear to be related to carbohydrate metabolism.”

“Are you and the other doctors messing with me?”

“No. Why?”

“Because you sound like a doctor or researcher.”

“My degree is in computer science and that’s what I do for a living. But I’m as intrigued as you are by this problem. I have to live with it, after all! And I’ve spent a lot of time talking about it with Doctor Barton here in Chicago and Doctor Ross at Mayo.”

“I wish I had more to tell you, but at this point, just continue with your diet and exercise program. Would you be willing to come back for another series of tests?”

“When do you complete your clinical rotation in endocrinology?”

“Unfortunately in about a week.”

“Are you going to do what Doctor Schultz suggested?”

“Of course! It’s exactly what I want.”

“Good. Then when you put on the long white coat, call me, and YOU can manage my case.”

“Me? I’ll just be a PGY1!”

“And younger than me, so I’ll have a doctor I trust managing my case for the rest of my life.”

“Why are you doing all of this for me?”

“Because you’re that good, Mary.”

“How did you know?”

“The way you took the history and did the exam, and how you paid close attention AND followed every single step of the testing. I saw you more than I saw Doctor Ross, the Attending, or Doctor Alston, the Resident.”