Chapter 18

Once we were outside Finestein’s room, Doctor Barrett just said, “Follow me.” She led me into her office, where she shut the door, pointed for me to have a seat before sitting down behind the desk. The charts from the patients I’d seen were already sitting on her desk. She began reviewing them, one by one.

After ten minutes of silence on her part, she asked, “Why did you cover for the mistake Doctor Devine made?”

“He followed standard protocol for treatment of someone with obvious and overt symptoms of alcohol poisoning. If there was a mistake, it was in the protocols, not in what he did,” I calmly replied.

She inhaled sharply, then slowly let it out. “I see. I also note that you’ve used security to directly assist patients with their private matters, as well as placing the hospital on the hook financially for deductibles and copays. In addition, you wrote orders outside the scope of general emergency medicine, involving several other routine medical services that are the responsibility of the patient to deal with, not us.”

I nodded. “That presumes the patient is even aware of those services in the first place. Someone who has spent his entire life in the Eastern Bloc after escaping from a Nazi concentration camp is likely unaware of what medical services are available in the United States. We are, so we care for the whole patient, not just the condition that brought him in here if possible. As for finances ... well, this hospital is doing a lot of things right. I was very pleased that even with those people that simply walked in – of which I treated two of those – that they were immediately brought back to be seen for treatment, and then only afterwards, their financial information was taken for billing purposes. I’ve had some time to look over the equipment available here, and I’m impressed that it’s the best I’ve seen. I’m going to have Tony Alameda and Rodney Young – they’re the administrators of the Reno County Medical Center, which I also own – come out and make up a shopping list based upon what you have for their facility. Our job is to first: ‘do no harm.’ Sure, we can save the life of the patient – but if we take his life’s savings to pay for it, then what’s the point?

“I admit I’m in a unique position here, because I’m your intern. But as you mentioned last night, I am the King, ruler, and owner of everything that is Stanford. While you are quite correct in that I’m here to learn how to deal with and treat patients in emergency situations, I’m also here to see if there’s something in my Kingdom that needs to be changed, to help everyone. Sending a guard to make sure the patient’s home is secured and that his wife knows what’s going on is simple, and helps ease the patient’s mind, when he’s facing major orthopedic surgery. You’re already using my Gurkhas to assist in keeping people who’ve committed crimes under control, and I approve of that, wholeheartedly. This is my Kingdom, and you – all of you – are my responsibility.”

She had leaned forward in her chair when I started replying, then as I continued speaking, simply sat further and further back. When I was done, she shook her head.

“One last question that’s really not a question, more of an observation. I wondered why you didn’t administer D50 via IV with Mister Finestein. Then I noticed his arms. Getting an injection in versus trying to get an IV started, and then having it blow was a judgment call on your part. It was a good one, though. You know, you pissed me off a little when you mentioned protocols. I was about ready to jump on you for that. Then the rest of your little speech reminded me of something. There are untrained interns, and there are interns without training. You’re the second kind. We don’t see that very often in this department. After reviewing your work from last night, I’m beginning to understand why Ed Kelly gave you such a positive endorsement. You didn’t make a single mistake, and you even saved the life of Mister Finestein, when our protocols would have killed him. David told me you were that good, and I didn’t believe him.”

I shook my head, and replied, “I’ll take it, but ... what you mentioned earlier, about being an intern without training? Until you mentioned it, I’d completely forgotten about D50. If there’d already been an IV hooked up, I think I would’ve remembered it. I got lucky with that.”

“Oh, my! An intern that admits he made a mistake, even when he actually didn’t? I don’t know if this hospital can handle that. His veins wouldn’t have supported a regular IV, not of that volume.” She picked up the phone. “Who’s the attending today? Good. Where is he? Good. I’m sending up our intern to discuss yesterday’s admissions with him. Thanks.”

She hung up the phone. “You’re off shift at noon, and will return here at eight tonight for another ten, four, and ten. Your job now is to go to the second floor, east wing nurse’s station, and brief the attending physician on the patients from here as he’s doing his rounds this morning.”

“Yes, Ma’am. A question, if I may?” She nodded, so I said, “Do I stay in scrubs, or do I change clothes first?”

“Stop by the locker and grab your lab jacket. Otherwise, scrubs until you’re done.”

I nodded, got up, and turned to leave. My hand had just touched the doorknob when she said, “Oh, and Doctor Lewis? Good job last night.”

“Thank you, Ma’am.”

I made it up to the second floor by ten after. “Hi, I’m Doctor Lewis, from the ER? I’m looking for the attending physician.”

From behind me, a man said, “Ah, not bad. An intern that is actually here five minutes early, for once. I’m Terry Anderson, the attending today.”

I turned, to see a man about my height, with a big grin and his hand held out. “Doctor Anderson, my pleasure,” I said, shaking his hand.

“Terry. You have the same two letters after your name that I have after mine, so just because I’ve been doing this for fifteen years, and you’ve been doing it for, what, a year or so, doesn’t mean we can’t be on speaking terms.”

I snorted. “Um, actually, I got my MD on November 8^th, and yesterday was the first day of my internship this week.”

“It was? You’re a fresh fish? Even better. Come with me, then, Doctor Lewis, and let us begin.”

A nurse came with us as well, pushing a cart stacked with more than a dozen charts.

“If you’re here to see me again after this morning, you’ll find I like to start with the ER patients that were admitted first, to see what we’ve got going on. Let’s see who’s first in the patient lineup, shall we?”

The nurse handed him a chart. “Ah, here we go, first. Room two fourteen, Mildred Underwood. What can you tell me about her?”

“Female, age seventy one, brought in at nine fourteen yesterday morning. Heart attack. Stabilized in ER, cardiac notified, admitted for monitoring by cardiology. Scheduled for full round of testing today, including MRI and dye tests for possible arterial blockage.”

He blinked, then looked at the chart again. “Why didn’t you reference a notepad?”

“I have a photographic memory,” I replied.

He drug out the word “Ohhkaaay” such that it took several seconds, then knocked on the door. “Good morning. You’re Mildred, right?”

We saw every patient that had been admitted and was in a regular room, including Norm, who was sleeping. His wife was there, and was grateful for the care we’d taken with him, as well as the assistance we’d given her. That got me another look. Then we went to check on the two patients that had required major surgery.

Liu Xiulan was in ICU and unconscious. Doctor Chapman was sitting at the nurse’s monitoring station, a cup of coffee in his hands. He looked up as we walked in.

“Hey, Terry. We’ve got both the patients you’re looking for in here. Lewis,” he said, acknowledging me, “that was a long fucking night of surgery. You were exactly right on all three of those patients. The old guy that fell off the ladder was straightforward and easy. About the time I got done with him, they asked me to assist with the Chinese girl. Her neck needed some stabilization, so we put three pins in there, then did her leg while she was still on the table. She’s in serious, but stable condition, and we’ll keep her out for a couple of days so she can heal some. The guy that ate his steering wheel ... the thoracic team saw I was still here and consulted with me, because we ended up taking out two of his ribs completely, while they took out part of his lung. He’s the same, serious, but stable.”

“I wondered about that. It was obvious he had a perforated lung, but I hoped the Carlens would help more than that,” I said with a frown.

“Shit, that Carlens saved his life. The EMTs had put in a regular tube, and if that’d been left in, one of those destroyed ribs would’ve punctured his periocardial sac.”

Doctor Anderson raised his eyebrows in surprise, even though he had the charts showing what’d been done. “Larry, according to my charts, Lewis here suggested the Carlens, not Devine.”

“I didn’t know about that, but from what I saw with the other two, it doesn’t surprise me too much. Devine will make a decent ER physician in a small hospital where they don’t see the volume and seriousness of what we see here on a daily basis. Lewis, I haven’t seen you before, but you’re cool under pressure. That old guy, Norm? He was cracking jokes with me the whole time, instead of being tense, because you’d put him at ease. How long you been doing the ER?”

“Um, last night was my first shift, and Mister Baxter was my first patient there.”

“Really?” he asked with some surprise. “Where were you doing your residency before?”

“I just got my MD last month from here, and I’m only doing a week now.”

Anderson said, “You know, I called you a fresh fish upstairs, but that’s a little ridiculous. New doctors don’t start in the ER, and they sure as hell don’t make zero mistakes their first night. They also don’t have every bit of information on every patient seen in the last twenty-four hours memorized. Something doesn’t add up.”

One of the nurse’s watching the remote vitals monitor chuckled just then. “That’s because the two of you don’t realize who Doctor Lewis is,” she said with a laugh in her voice.

“Oh?” Anderson asked. “And who is Doctor Lewis?”

“I just transferred from obstetrics to ICU last month, so I was on duty when three of his children were born here. He’s the quarterback for the Cardinal football team and owns Stanford.”

Anderson closed his eyes for several seconds, then opened them. “I bet if I go look at the board downstairs, your name is on the ER for the entire week and it was signed by David Korn.”

I nodded, then said, “Yeah. I wasn’t sure where I was going when I got here, but Sue Welsh showed me the board. David hadn’t told me where I was going, but I figure after working with Ed Kelly, this was a good spot for me. I’m in the MSTP program anyway, so once I’m done with my residency after Spring quarter, I probably won’t be seeing patients unless it is an emergency, anyway.”

“You worked with Ed Kelly? And didn’t wash out the first week of clinicals? And you’re doing your residency – all however the hell many years of it – in one quarter? What ... the ... fuck?” He shook his head, then walked over to the desk and picked up a phone. “Would you please page Doctor Korn and have him call me at this number? Thank you.”

Anderson had barely finished hanging the phone up when it rang. The nurse’s hand shot out as it was her desk. “ICU nurse’s station. One moment, he’s right here.” She held it up for Anderson.

“Anderson. Yes, I am. What the hell kind of ... Yes, I know what that means, of course. That doesn’t mean you wouldn’t ... Excuse me? David, what the hell is going on, then? Oh, you are? Yeah, I’ll send him down. Oh, really? I do still have ... Okay, fine. You’re still a world-class prick. See you in five.” He delicately hung the phone up, then said, “Doctor Lewis, our next stop on our tour this morning is the office of the hospital administrator. Do you know where that is?”

“No, Sir. Other than when I’ve been here for the birth of my babies, and to treat the first four people my antiviral cured of AIDS, I’ve never been in the hospital at all.”

“Mind if I tag along? I’m on downtime until after midnight anyway,” Chapman asked, standing up.

“You’re going to, regardless,” Anderson said with the faintest hint of a smile.

The three of us went down a flight of stairs, then I followed them through a series of corridors and into a suite of offices. There was a secretary typing a letter, who looked up as we walked in. “Oh, hello, Doctors. Can I help you?”

“David Korn said to meet him here,” Anderson said.

“Oh, yes. Doctor Korn is in with the Administrator now. Let me buzz him.” She pushed a button on her desk. “Sir? There are three Doctors here to meet with...”

The speaker interrupted and responded back, “Send them in, please.”

Anderson led the way into a very nice office, one that was larger and better appointed than Elroy’s judge’s chambers. A desk larger than the one in the Oval Office was in front of a huge window, with two full leather chairs in front of it, one of which was occupied by David Korn. There was dark wood paneling along two of the walls, with large oil paintings hanging on the walls above the chair rail. The fourth wall had built in shelves with books, an assortment of framed documents, and a rather well stocked liquor shelf. There was a smaller table with three comfortable looking chairs in front of it by that shelf.

“Doctor Anderson, please come in, and have a seat. Oh, Doctor Chapman. Please, pull up a chair, I didn’t realize you were involved in this. And you must be Doctor Lewis. I was just talking to Doctor Korn about your exploits in creative hospital billing, and we were just about to start a discussion of exactly what an intern can and can’t do in my hospital.”

I looked over at David and asked, “Really?”

He shrugged, then said, “You may as well listen, if you can keep your temper in check.”

The man behind the desk uttered in disbelief, “If he can keep his temper in check? I’ll remind you, Doctor Korn, that I’ve already had to deal with creative billing that was ordered by this student of yours regarding four other patients here. Fortunately, we were able to write the majority of those charges off, by applying them to your research budget. Now, he’s turned around and done that again, on his first night as a resident! And he got security involved in his schemes! If he’s going to be doing that on a regular basis in my hospital, then I’m not going to have any choice but to not allow him to do any work here at all!”

I sighed, then rubbed my eyes. “David, I know you were playing a few games with my schedule and such. Please tell me this is one of those.”

He shook his head and sighed. “Sorry, it’s not. I’m the Dean of the School of Medicine, and while the hospital and all the clinics are affiliates of the School of Medicine, they’re not subordinate to it.”

“Damned right we’re not,” the man said. “Now then, young man, I think it’s time I made some things perfectly clear to you!”

I sighed, too. “Just shut the fuck up. David, is this all Stanford?”

The man behind the desk stood up in a rage, slamming his hand on his desk. “Just who the hell do you think you are?”

That comment brought a smile to David’s face. “Yes, Cal, this is all Stanford, and thus all part of your Kingdom. Just a side note, though. Blood is so difficult to get out of carpet.”

I smiled, then. “Thank you for that advice. That’s a nice view out the window.” I jumped up and over the desk, then grabbed the asshole by his shirt and pants. Spinning, I threw him out of the office, through the window. His expensive and very comfortable looking executive chair almost followed him, but then I sat it back down, so I’d have a seat.

“It’s a damn shame we’re on the first floor,” I said.

“Thank you for keeping your temper in check,” David said.

Anderson had risen from his seat when I jumped past him. “That’s keeping his temper in check? Jesus Christ, is he okay?”

“I’m guessing Cal feels a little better. Oh, you meant Tomlinson? Cal didn’t cut his head off, which is what I was halfway expecting him to do,” David calmly said. “I guess you don’t have your big ass knife with you.”

“Oh, I carry my khukuri any time I’m not on the football field. Getting it to stay in place in the scrubs required a bit of creative use of a belt. I try to limit myself to only killing one person per quarter, if I can, and I already killed someone last month.” I looked out the window, where two people were helping the administrator to his feet. A couple of guards were running towards him as well.

“You’re FIRED!” I yelled. “Security, escort this pile of bovine excrement out of my Kingdom immediately, with only what he has on him. He may not re-enter, which means you may as well search him in case he has keys to a car on him. It is also forfeit.”

David snorted. “Oh, that’s really going to piss him off. He just bought a new BMW.”

Two guards and the secretary came bursting in the door. “Sir?” she asked, then screamed when she saw the window.

I sat down in the chair. “You, what’s your name?”

“Dawn Ellis. What happened to Mister Tomlinson?”

“He’s no longer employed here. Go out and call his deputy, tell whoever that is they have two minutes to get here, or they’re fired. In the meantime, do I have to dial ‘9’ to get an outside line?”

“Um ... um...” she looked at David in distress.

“Dawn, you’ll want to do what His Majesty says. And yes, Cal, these are just like our phones on campus.”

I looked at the two guards, who I recognized from our first batch of new hires the same day I dealt with Coach Kerr. “Stick around, you may be needed for some more trash removal,” I said.

“Yes, Sir,” one of them said, and saluted me.

I nodded back to him, then dialed ‘9’, followed by the number for the Reno County Medical Center. After two rings, it was answered.

“Reno County Medical Center, how may I direct your call, please?”

“Good morning, or I guess it’s good afternoon there already. This is Cal Lewis, out at Stanford. I need to speak to either Tony Alameda or Rodney Smith if they’re in, please.”

I’ll give her credit, she didn’t stutter. “One moment, Mister Lewis. Mister Smith is off today, but I know Mister Alameda is present. Let me see if he’s in his office, and if he’s not there, I’ll page him.”

“Thank you.”

Less than thirty seconds later, the phone went live. “This is Tony Alameda, how can I help you?”

“Hey, Tony, it’s Cal Lewis. I’m putting you on speakerphone here. I have a question for you. Would either you or Rodney like a promotion?”

“Why does the sound of that strike fear in my heart?” he said with a laugh. “I thought you wanted two administrators here so we wouldn’t turn into a fiefdom kind of thing, like what had been going on.”

“I do. I’m sure you both have competent subordinates, though. Who would do best with a promotion?”

“Considering I’m single and still live in a rental house, while Rodney has a wife and bought a house here, I hate to say it’s me, just because of that. It’d be easier for me to move somewhere, though.”

“Do you both have good assistants?”

“Actually, yes. We both have two of them, and keep a close eye on what’s going on here.”

“Are any of them worth promoting, and could they do your jobs?”

He was quiet for a second, then replied, “Yeah, we’ve both got one that’s ready for a step up. I don’t know if you know either of them or not. Mine is Faith Thomas, Rodney’s is Jerry Kirk.”

“Is Faith Olivia Thomas’s daughter?”

“Uh, yes, actually, she is. I didn’t know you knew Olivia.”

“I know the Knight brothers and helped fund them,” I said.

“That’s cool. You know they’ve got some robots they’re testing out here at the hospital? They look a little like the little androids from Star Wars. They run around and clean the floors on a continuous basis,” he said.

“Very cool. Are Faith and Jerry single?” I asked.

“Actually, Faith just broke up with her boyfriend last month.”

“Good. Call Rodney, tell him to promote Jerry into your job, and get two more assistants working out there. You and Faith pack a couple of bags, enough to stay here through New Year’s, and go to the airport. Tell SJ or whoever is in charge to load you on a jet for California. You’re both going to have new jobs here.”

“Um, okay?” he said in a questioning tone. “Doing what?”

“Oh, sorry. Co-administrators of a hospital here. I just fired the old one. I’ll make sure they get some temporary repairs to the window I threw him out just before I called you. Bring a broom or two, Tony. Big ones.”

He sighed. “Same shit as here?”

“No, actually the doctors here have nearly unlimited budgets, and are quite competent. It’s the administrators that thought this was their hospital, and some upstart student that just got his MD last month and was doing his first night of residency in the ER had no business doing what he did.”

“I heard you got that. Congratulations, Doctor Lewis. And yeah, I can understand why you’d throw him out a window if he said that to you. Hang on. You said, ‘a’ hospital. You’re not talking about the Stanford Hospital, are you?”

“Big teaching hospital? Best level one trauma center in the country, with some of the best doctors in the world? Yeah, that’s it.”

I heard him take in a deep breath, then let it out. “Thank you for the trust you’re putting in me, and in us. We’ll be there this evening.”

“Thanks, Tony. Talk to you later.” I hung the phone up. “Well, good. We’ll now have two new administrators here this evening. Doctor Anderson, I already own the Reno County Medical Center, which includes a one hundred ninety bed hospital that serves five counties, plus has six outpatient clinics and centers in surrounding communities. This isn’t the first time I’ve had to deal with administrators that thought it was their hospital, and not the patient’s hospital.”

I looked at my watch. “David, unless I’m mistaken, it’s been close to six minutes.”

“Well, at least I didn’t have to teach you how to tell time,” he said with a grin.

I looked around on the desk, then pushed a button. “Miss Ellis? I believe I gave you some instructions before you left this office.”

“Yes, Sir. I called Miss Thorndyke and told her to report to this office. She told me she’d come see Mister Tomlinson when she was done with what she was doing.”

I frowned. “Did you tell her she had two minutes to get here or she was fired?”

“Yes, Sir. She laughed and said for me to tell whoever told me to tell her that to try harder next time, she was in the middle of something important.”

I just looked at the security, still standing inside the room.

One of them said, “On it, Sir, and if I may ask, have you seen ‘The Blues Brothers?’”

I nodded, then smiled. “Ah, yes. To paraphrase the dispatcher, use of unnecessary violence in escorting Miss Thorndyke to this office has been authorized.”

“Thank you, Sir!”

As they left the room, I looked at David and asked, “Did you set this up on purpose?”

“On purpose? No. Did I expect it? Well, something not so spectacular, but along the lines of a change in the administration, yes.”

I shook my head. “You could’ve just told me they were assholes, and I’d have fired them. By the way, you’re paying for the replacement window.”

David laughed and replied, “It’s worth it.”

Terry Anderson said, “I’ll match it if you pitch Thorndyke out the window, too. She’s been a bitch ever since...” Miss Ellis opened the door, with the security officers literally dragging a screaming woman face down into the office by her legs.

“Ah, you must be Miss Thorndyke. Go ahead and drop her on the floor there.”

The officers dumped her legs on the floor. Since she’d been wearing a dress, that had managed to ride all the way up to her waist while they were dragging her. She was yelling, “I will have your jobs for this outrage!” just before they let go. She pulled her knees up under her, and managed to get to her feet, pulling her dress down. Her hair was totally disheveled, and the front of her dress was wet with several stains on it.

“Sorry it took so long, Sir. There were a couple of cups of coffee that got spilled on the floor when she resisted, and we didn’t want to create a slip hazard, so we mopped them up.”

“With ME, you cretins! What in GOD’S NAME were you thinking?” she screamed.

“They were following orders. MY orders,” I calmly said.

She spun around. “Who the fuck are you and what are you doing at Larry’s desk?” Then she noticed the other three doctors. “Doctor Korn? What is going on here? Do I need to remind you just who I am?”

“I don’t know who you are, but it’s rather obvious you have no idea who I am,” I said.

“I am Amanda Thorndyke, of Beacon Hill. My family owns half of the commercial properties in San Francisco, and are major contributors to this hospital!” she said, her voice dripping with venom. “As I asked, who the fuck are you?”

I glanced at Terry, who was now barely concealing a grin. David was just outright smiling, his stomach movement showing he was trying to avoid breaking into laughter.

I sighed. “Who the fuck am I? Why, I’m just a resident intern here, that just earned his MD last month.” Then I stood up, and walked around the desk. “Oh, and I just enrolled here at Stanford last December,” I said as I came closer to her. “I’ve earned five doctorates, including my MD, since then, and quite recently, I bought Stanford and everything associated with it.”

By this time I was right in front of Amanda Thorndyke. I was a good seven inches taller than her and glared down at her. “I think we can do without whatever paltry donation and thus tax deduction your family gives us. You didn’t listen to orders, so you can consider your employment here terminated. My stepsons love it when I hold them by the hands and swing them around like I’m playing airplane with them. Did your father ever do that with you?”

“What?”

I reached down and grabbed her wrists, then began spinning in circles. David and Terry quickly ducked down, because even though I didn’t fully extend my arms, Amanda’s feet were still cutting a circle nearly fourteen feet in diameter. After a good three circles, I let loose at just the right moment, so she sailed out the broken window as well.

I looked at Terry. “I’ll hold you to that. David, I’m tired, and I have to be back here at ten for another shift. Call Margie and have her come here to examine the books, because you don’t normally get offices this fancy and elegant unless you actually own the business. You’re in charge until Tony Alameda and Faith Thomas get here this evening. Unless there’s something else, I’d like to get some rest.”

One of the security guards had gotten on the radio, so officers outside had already come up to deal with Thorndyke. The other said, “Sir, I can escort you to the lounge so you can change, since I know you’re not that familiar with the facility.”

David just laughed a little and said, “I think you can go ahead and take off a half hour early today, Cal. Don’t expect this every shift, though!”

I followed the guard through the maze of corridors to the lounge where my clothes were. I changed, then went outside, where Chuck was waiting for me.

“Come on. I know why you don’t do individual sports. The record with a shot put is about seventy-two feet. I think you tossed her a good forty!”

“Yeah, well, not much water for her to land in nearby. Beth’s pretty good at that, too.” I was quiet the rest of the way home.

‘Knock, knock!’ I heard Margie’s mental voice.

‘Yes, dear?’ I answered.

‘I just got a phone call from David Korn. You obviously had a reason to throw both administrators out the window at the hospital. Do you suspect something?’

‘Margie, go check out their books, please. The head administrator had an office that makes Elroy’s judge’s chambers look cheap, and the other one was a bitch that said her family makes huge donations.’

‘Oh, good. Yeah, there’s going to be something not quite on the up and up, then. Thanks, I was just wondering.’

‘You might call your sister and tell her I told Tony Alameda and his assistant, Faith Thomas – she’s Olivia’s daughter – to fly out here. They’ll be here this evening to take over.’

‘Got it. Go get some rest, love.’ I felt her kiss on my cheek as Chuck pulled up in front.

“Good night, Chuck, and I’m due back in at ten tonight.”

“Got it, Cal.”

I went in, played with the children for half an hour, then took a shower and went to bed. I really wasn’t sure why I was so tired, but I was. Beth woke me up at quarter after nine.