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Chapter 4

GeeHad had just left the doctor’s lounge, where he had showered and changed into red surgical scrubs. It was 6:00 a.m., and his monthly administrative meeting was about to get underway. The members of his team slowly shuffled into the conference room, each sipping on coffee in a vain attempt to vacate last night’s alcohol-induced blues. The group included his corporate chief operating officer, Ms. Martha Mulch, the chief operating officers representing representing each of the twelve hospitals controlled by Lambed HCA, the corporate chief financial Officer, Mr. Johnny Cinch, the hospital’s medical director, Dr. Cornelius Lyon, and Abdul Salah, Mr. Bin-Sad’s personal assistant. GeeHad stood with his back toward them, staring out the window. The rain had begun to fall. His bloodshot, bleary-eyed executives did not focus on this strange man in scrubs until he turned to face them.

GeeHad Bin-Sad was a portly man in his late fifties. He was completely bald but sported a grey scraggly beard. His eyes were a cold jet black and only seemed to glisten when he received reports of revenue increases. No one had ever seen him smile. This morning GeeHad appeared to be in an unusually foul mood. Without warning, his fist came crashing down onto the conference table, startling all those present. The meeting had been called to order.

“Martha,” GeeHad growled as Martha Mulch snapped to attention and listened intently.

“Yes, sir?”

“This hospital is filthy, and the grounds look deplorable. Furthermore, I am tired of walking through a hundred yards of bird shit just to get onto my own property. I don’t know why in the hell thousands of birds have collectively decided to roost and poop on Carencrow Regional Hospital, but enough is enough! Fuck the environmentalists! I want this species of pests driven past the point of extinction no later than next week. Then, I fully expect the parking lot and the sidewalks to be power washed. How in the hell can we run a successful business surrounded by such filth?”

“You’re absolutely right, GeeHad. We’ve tried scarecrows and high-pitched noise to run the buzzards off, but now it’s time to break out the poison. Consider the PETA-protected pests history,” Martha replied with determination.

As Lambed HCA’s chief operating officer, Martha Mulch had clawed her way into a top management post of this large hospital chain by stepping on, over, and through others. Desired results were achieved at any cost and no sacrifice was too great. However, the years of trench warfare were evident. Her round face was a road map dominated by craters and deep furrows. Accentuating her rather plump body was the hairdo from hell. It appeared as if some ill-spirited hairdresser had placed a bowl over her head and then cut her hair short at a precise angle so that it would curl underneath. With the small, oval bald patch on top, the hairdo was an exact replica of the head of a giant penis. In polite company and well out of earshot, she was lovingly referred to as “Mushroom Head,” but the nickname “Dickhead” was far more appropriate for such a mean-spirited individual who ruled Lambed HCA with an iron fist.

GeeHad sneered at Johnny Cinch, Lambed’s CFO. This healthy, athletic, thirty-five-year-old accounting protégé had cut his teeth at Arthur Andersen, an unfortunate career choice, made even more disastrous by his handling of the Enron audit. By virtue of the two years he subsequently spent in prison for his misdeeds, Johnny had been blacklisted by all the large and semi-reputable accounting firms. As if this was not enough misfortune, his personal esteem had been crushed by a nasty divorce and the resulting bankruptcy. GeeHad knew that this was the right man for the job precisely because Johnny’s reputation was tainted. Most importantly, he had learned that Johnny was an expert at playing the corporate shell game and backdating executive stock options. Revenue and expenses were mere numbers on a piece of paper, and debt could easily be shifted from one company to the next. GeeHad felt sure he needed the talents of such a man to line his pockets.

“Johnny, where are this quarter’s operating results and next quarter’s revenue projections?” GeeHad demanded, finally deciding to get down to business after his tirade.

“Ah…” Johnny mumbled nervously, shuffling the profit-and-loss statement to GeeHad and each of the other executives. “For the quarter, Lambed HCA showed a profit, but relative to the same time period last year, our revenue was down ten percent, and our expenses had increased by well over eight percent. Unfortunately, it now appears that next quarter’s projections will also be disappointing,” Johnny concluded, as his voice started to wane. He knew GeeHad would not be pleased.

Immediately GeeHad turned beet red and began wildly beating on the conference table.

“Damn it! These results are absolutely unacceptable! We are a publicly traded company and every quarter our stockholders expect us to exceed our projections. Revenue must go up, and expenses down! Now, let’s start on the revenue side. Johnny, what exactly was the problem?”

“Well, sir, we are being squeezed across the board. The percentage of self-pay patients continues to increase at an alarming rate, and they seldom pay us a dime for valuable services rendered. Additionally, Medicaid recently… Unfortunately, I can’t foresee a viable solution to these problems.”

“Damn it, Johnny, I’ll give you a solution to this problem. I want those sorry, self-pay bastards and the worthless group of unemployed Medicaid deadbeats thrown out of our emergency rooms! Is that understood?”

“Yes, sir,” GeeHad’s corporate minions mumbled collectively.

“GeeHad, by federal law we’re not allowed to deny anyone access to medical treatment, regardless of their ability to pay,” Dr. Cornelius Lyon interrupted.

“Bullshit! Dr. Lyon, get creative! You will either be part of the solution, or part of the problem. You implement an emergency room policy denying those sons of bitches access to our quality medical care, or I will find someone who will! These thieves overrun our ERs and consume our valuable resources. Hell, we need to be pampering the paying customer. I could give a damn if the bastards end up dying in the street! However, as a humanitarian, I do have a soft side. So, if need be, we will purchase vans to deposit their dead carcasses in the slums down on Lower Third. Do I make myself perfectly clear?”

The executives around the table began to chuckle, as they all were accustomed to GeeHad’s tyrannical outbursts, leaving little doubt as to his position on any issue.

“Yes, sir, loud and clear! I will find a solution,” Dr. Lyon answered affirmatively.

Dr. Lyon had been very adept at meeting GeeHad’s demanding expectations over the years. He had no other choice but to do so, though, because, as a convicted felon, no self-respecting hospital would give him privileges to continue practicing as an obstetrician. Convicted of Medicare fraud, Dr. Lyon had spent over a year in federal prison, but was miraculously pardoned by the governor. Now, at the age of seventy, he felt untouchable. Without question he could implement policies which, if scrutinized by federal prosecutors, would result in his underlings taking the fall. Such was the price of success. The more he thought about it, the more he relished the challenge. In his mind, there was something very exciting about circumventing the law.

“Johnny, what’s our problem on the expense side of the ledger?”

“Well, sir, the cost of doing business is increasing across the board. Our labor expenditures continue to escalate at an alarming rate. Also, the drug manufacturers, citing the cost of product development and the threatened loss of patent protection, find it necessary to increase the price of their products by fifteen percent every year. Additionally, our expenditures for supplies and products keep rising, as well as the costs for telephone services, water, electricity, and sewage,” Johnny replied, his voice lowering as he bowed his head.

“That’s outrageous! It’s clearly time to squeeze the greedy drug manufacturers and our worthless suppliers,” GeeHad insisted, pounding the table yet again. Seconds later, he was calm and rational. Dead silence suddenly filled the room. Everyone gathered around the conference table felt that this was the eye of the storm.

“Now Johnny, please share honestly with me your overview of where Lambed HCA stands,” GeeHad asked in a cold and calculating voice.

Johnny Cinch squirmed in his chair. He could feel the beads of sweat ooze from his pores as dozens of self-serving eyes ripped into his soul, demanding answers.

“Well, the percentage of self-paying patients continues to increase, whereas the percentage of paying customers is decreasing. The net result is the loss of millions of dollars a year due to indigents not paying their bills. For example, in the emergency room we collect only thirty-seven cents on every dollar billed. Given these facts, along with the prohibitive costs of complying with existing federal mandates, it’s a miracle that any hospital is turning a profit,” Johnny concluded in an ill-fated attempt to rationalize his dismal corporate report.

GeeHad took a few moments to review the quarterly profit-and-loss statements from each of the twelve hospitals he controlled. All appeared to be in line, but the numbers were extremely discouraging. His train of thought was interrupted by a thunderous explosion from a lighting bolt, which felt like it touched down only blocks from the hospital. The lights flickered but remained on. Once again, the boardroom was deadly silent.

GeeHad stood and walked toward the window. It was pitch black outside, so he could not see the street below begin to flood, but he could make out the tops of tall trees being whipped back and forth. The rain was now coming down in sheets, pounding against the glass, and the force of the wind was so strong that it caused the windows in the conference room to vibrate.

Suddenly, there was a brilliant flash of light, followed by another thunderous explosion, and then the lights went out. Sixty seconds later, the hospital’s generator came online, establishing emergency lighting. In the subdued lighting, the conference room took on a sinister glow.

Somehow, GeeHad felt energized by the violence of the storm. He turned toward his executives and, with a deep, confident voice, issued the marching orders.

“We are in a war, and in this war you either win or you lose. The bottom line is that we need to increase revenue and slash expenses. Effective immediately, I want fifteen percent tacked on to each and every bill. With regard to the bad debt generated by our self-pay and Medicaid trash, I want our collection department to aggressively hound these deadbeats. I expect vigilante groups on retainer to find these bastards and beat them unmercifully for stiffing Lambed HCA. We will squeeze every last dime out of them, while at the same time discouraging repeat business. Concurrently, we will establish a policy to keep the indigent out of our emergency rooms. Now, if the government has the balls to cut Medicare reimbursement, then I expect us to pad the bills. On the expense side, the most dramatic and immediate savings will come from layoffs. Strive to cut ten percent of your labor force over the next thirty days. With Christmas so near, I would like you all to take pride in churning out those pink slips, eliminating middle managers, aids, techs, and even cleaning personnel. Also, make life so unbearable for the senior nurses that they quit. By hiring new nursing school graduates, we can save ten dollars an hour, while maintaining our unsurpassed standard of care. Additionally, the nurses sit around half the time doing nothing. Make them empty the garbage and mop the floors!”

GeeHad paused and scanned the table. Looking for weaknesses, he made eye contact with each and every person.

“Is anyone uncomfortable with my mildly aggressive policy?” GeeHad asked. No one spoke up.

“Excellent! Well then, we are all in agreement.”

“Yes,” the executives of Lambed HCA mumbled collectively.

“Pardon me? I can’t hear you!” GeeHad shouted.

“Yes, yes, YES!” everyone in the room chanted, with ever-increasing fear-driven determination.

GeeHad was clearly pleased by their collective response, which seemed to be magnified by the fiery flashes of light and thunderous roar from outside

“Excellent. This meeting is now adjourned,” GeeHad concluded.

As he stood up, GeeHad motioned to Johnny Cinch. Johnny walked over, and the two men found a quiet corner in the room as the battle-weary executives staggered out. GeeHad’s personal aid, loyal confidante, and lover, Abdul, stood close by awaiting his orders.

“I certainly had fun cooking the books. Have you had a chance to review the real numbers? Our hospitals did remarkably well, exceeding all our expectations,” Johnny shared enthusiastically.

“Yes, but I wanted everyone around the table motivated and fearful that heads may roll,” GeeHad replied. “By the way, I noticed that Lambed HCA’s debt is starting to creep up again. I believe it’s time to consider offloading a portion of this debt onto one of our close affiliates. The figure I had in mind is twenty-five million.”

“Absolutely, consider it done. Knowing that you’re a fan of The Little Rascals, and that we have already chosen ‘Alfalfa,’ ‘Darla,’ and ‘Buckwheat’ as clandestine corporate entities, would you have a suggestion for the new corporate shell?” Johnny asked.

“In fact I do. Name the new entity ‘Swanky Spanky,’” GeeHad chuckled.

“Give me the ‘high sign,’” GeeHad insisted as both men cupped their hands underneath their chins and began to wiggle their fingers in a wave-like pattern.

GeeHad and Johnny erupted in laughter at their own antics. Then GeeHad abruptly stopped laughing and motioned for Abdul to come closer. Johnny realized immediately that their conversation had concluded. He turned and promptly left the conference room.

Abdul and GeeHad were now alone. GeeHad placed his arm over Abdul’s shoulder. They turned to face the window, taking a minute to relish all the fury nature had unleashed.

“Our meeting went very well, Abdul. Did you notice how all the Christian infidels continuously nod their heads in agreement?”

“Allah is great, and they are very stupid,” Abdul chuckled.

“Yes, Allah is great. Fear and terror are the weapons of Allah. We grow very powerful, my friend. The nonbelievers will soon be in Hell. Have you heard from Abu Bakr?” GeeHad inquired.

“Your shipment from Wonsan arrives tomorrow, GeeHad,” Abdul confirmed.

“Excellent!” GeeHad replied enthusiastically.