Читать книгу Hunting for Hippocrates - Warren J. Stucki - Страница 11

Fortunately, there were no more procedures scheduled for the morning (damn that Sally for scheduling two back-to-back), but that did not mean they weren’t busy. With managing patient flow, doing laboratory tests like urinalyses and urine cultures, drawing blood, removing sutures, changing bandages and cleaning the exam rooms, Diane had been hustling. But that was a typical day in the office of Dr. Moses A. Mathis.

Sometimes she wondered if it was all worth it. Why was she still here, working for Moe? Certainly, it was not for the money, even though Moe was more than fair with wages and benefits. Was it for some noble ideal, like she was doing something worthwhile with her life and at the same time helping people? Somehow, her ideals had vanished a long time ago, disappearing into the hoard of bad tempered, unappreciative, demanding and complaining patients. She hated to admit it, but Diane knew perfectly well why she was still at Urology Associates. She was in love with Moses A. Mathis.

Moe was so different from the man she had married. In twenty years of marriage, Diane could not recall one single abstract or intelligent conversation she had ever engaged in with Dan, unless you considered discussing religion, abstract. And that wasn’t really discussing, but rather it was listening to Dan pontificate. In fact, lately their conversations seemed to be just a series of monosyllabic grunts. A high-toned soprano noise was taken as a “yes” and the deeper bass ones, a “no.”

Dan was a handy man. He could fix anything from hair dryers to automobiles. At first this impressed Diane, and this was one of the major reasons she had fallen in love with him. But as the years, the junk, and the bills piled up, the knack of repairing discarded leftovers started to lose some of its luster. For years, Diane had convinced herself that she still loved him, mainly because he was the father of her children and they shared common religious values. And then, of course, he smiled a lot. But lately, even his smile, which was once so attractive, was becoming irritating and made him seem like an aging clown.

Diane was depressed. She was in her early forties with her kids pretty much raised, and her good looks fading as fast as a hot oven with the gas turned off. More than once she had asked herself if this was all there was? Was life just an endless series of meaningless cycles? Going to work, coming home and cooking dinner, doing housework, paying bills while watching mind-crippling TV with Dan, then going to bed fatigued, only to have her rest interrupted by him constantly pawing at her in the dark bedroom and rolling his seedy, hairy, Simian body on top of her. Then to have this same sequence repeated day after unfulfilling day, it was almost more than she could take.

To make her life complete, Dan was also of the old Mormon school, a dedicated chauvinist. Even with the twenty-first century here, he continued to believe that there was men’s work and women’s work, and never seemed to realize, or perhaps didn’t care, that the division of labor was far from equal. Dan accepted the Bible literally, including the Old Testament’s patriarchal order and he constantly reminded Diane that God had given man the Priesthood and made him master of the house. More than once Dan had taken out his Bible and read from Paul’s epistle to the Ephesians: “Wives, submit to your husbands, as to the Lord. For the husband is the head of the wife, as also Christ is head of the church.”

In Dan’s mind, and without question in his own home, he was sovereign. His crude words constituted a binding decree from which there was no appeal. A couple of years ago, when Moe had come to the house to talk to her about working one Saturday morning a month at Urology Associates, which she definitely did not want to do, she was horrified, but not surprised, when Dan had declared, “She’s my wife, and she’ll do what I say.”

Early on in their marriage Dan and Diane got into financial trouble. At best, Dan’s work was spotty. Occasionally, they could almost live on what he made, but that was before children were born. After the kids, they had to borrow money, more and more frequently, usually from her family. It was during this period of time Diane realized she would have to return to work. There simply was not enough money. Years ago, she had worked as an operating room scrub nurse and perhaps she could go back to that. But there was the problem with taking call. As a scrub nurse, there would be her nights on call, away from her kids and Dan. And Dan just could not put up with a wife who was not home every evening to make his dinner.

With a fair amount of trepidation, she applied at the office of a young, new doctor in town, Dr. Moses A. Mathis, specializing in adult and pediatric urology. She had very little knowledge of what a urologist did, but within a week she was hired.

At first, there were just the two of them in the office, as the practice was new and small. Diane was the receptionist, nurse, bookkeeper and accounts manager, and Moe was still a young idealistic, enthusiastic physician. He was kind and empathetic with the patients, and actually took time to explain medical and surgical options to the patients, as well as potential side-effects. In those early days, he would literally tell the patients that he was not in this business to get rich, but to take care of patients. And what was surprising, Diane had the feeling that he meant it. What a novel idea. One day she overheard him telling a patient who had no money or health insurance that the most important thing was removing his kidney stone and relieving his pain, the issue of payment was unimportant. God, how Diane missed those days.

In retrospect, it was during those early years that she started to fall in love with him. Diane had thought Moe was the most handsome, sensitive, intelligent man she had ever met, and consequently, love germinated in the fertile soil of working closely with Moe, who needed her, and a growing disgust with Dan, who dominated her.

Also, Moe was a good teacher, and Diane learned the discipline of urology on the job. Under Moe’s tutelage, she had mastered most office urological diseases, including treatment. Eventually, when Moe was in surgery or out of town, Diane basically functioned independently as a physician assistant. She diagnosed and treated most simple urological problems almost as well as Moe. The patients began to trust her, and she built her own sub-practice within Urology Associates, managing most of the urinary tract infections, the urethral dilations and the chemotherapy patients on her own. Inevitably they began to share confidences. During slack times, they would talk to each other about life’s disappointments, about their expectations and their dreams and eventually about the frustrations of their personal life. Diane would tell Moe of her feelings of futility with Dan, and he would reciprocate by describing the heartache of his first marriage and how frustrating the dating scene was now. In short, they became very close friends and confidants, but Diane yearned for more.

Then came that humiliating day when Diane could not contain her feelings any longer, and with tears in her eyes, had told Moe she loved him. His reaction was totally unexpected and slammed her like a body blow. Instead of telling her he had the same feelings, Moe firmly reminded her she was a married woman and if their relationship were to progress any further, it would be disastrous.

At first she thought she could handle it. After all, she told herself, Moe was right and he was just being sensible. Adulterous, office relationships were almost always destructive. But in spite of the logic, after that day things were never the same. The bacterium of resentment grew, colonized then started spreading. Slowly at first, then steadily building, bubbling and fermenting like unsealed, under-cooked, home canned corn. Insidiously, resentment changed to rancor and rancor turned to botulism and once again, Moe became Dr. Mathis.

“Diane!” Sally hollered down the hall. “You coming to lunch?”

Diane flinched, startled by Sally’s voice. “No, I still haven’t cleaned the procedure room from the morning biopsies.” For Sally’s benefit she emphasized the “sies.” “And we’ve got a cysto to start the afternoon. Anyway, I’m on a diet.”

“Okay,” Sally shouted back, still oblivious to her scheduling faux pas. “You want me to pick up something for you?”

“No.”

Diane glanced at her watch. It was after one o’clock. They had patients starting at two and the first patient was a cysto for follow-up of a bladder cancer. She’d better quit day dreaming and get the damn procedure room cleaned and the cysto set up.

Ten minutes later, as she was washing the counter, she noticed the prostate biopsy specimen containers. Thinking that she should get them ready to send to pathology, Diane picked up the vials, then involuntarily winced. “Damn it!” She had forgotten to label the specimen containers. That’s what happens when your mind is not on your work. Oh well, too late to worry about it now. Anyway, she was almost a hundred percent positive that Mr. Swensen’s was the one on the right.

Just briefly, it occurred to Diane that she could cause Moe immeasurable problems by labeling the vials incorrectly. The ramifications were almost staggering. Mentally, she tried to follow a couple of possible scenarios to their conclusions. This thought made her smile. It would certainly put that condescending son-of-a-bitch with a fetish for blondes in his place. Should she?

“Diane!”

This time Diane’s feet did leave the floor. Hurriedly, she stuffed the specimen vials in the pocket of her nurses’ uniform, Swensen’s in the right pocket, Robinson’s in the left. Calming herself with a deep breath, she tried to put on her usual dour face, although she was afraid she still looked guilty as hell as she turned to face Moe.

“My, aren’t we jumpy today. Are you coming to lunch with Sally and me?” Moe asked, as he eyed her closely.

“No, I already told Sally,” Diane hissed. She hoped the irritation in her voice would mask her red face.

“Look Diane, about the whole Price Is Right thing, I’m sorry. I won’t do that any more.”

“I should hope not.” Diane’s eyes blazed with fury.

“Uh—uh, I’m sorry about everything else too,” Moe stammered.

“Me too.”

Diane glared at Moe, not saying anything more. After an awkward moment of silence, Moe whispered, “you want me to bring you anything back?”

“No! For the hundredth time, no.”

Diane watched Moe retreat down the hall, then retrieved the vials from her pockets. She absentmindedly toyed with the vials for a minute, then carefully labeled the specimen containers, Howard H. Swensen and Robert E. Robinson. Opening the counter drawer, she grabbed her log book and meticulously entered the serial numbers stamped on each vial by the manufacturer as the plastic cooled. For Howard H. Swensen, she entered #001198-G and for Robert E. Robinson she wrote #001199-G. Finally, she placed the vials in the pathology “out-box” and returned her log book in the drawer.

Russell Wright reclined the seat as far as it would go, but his Southwest Airline’s chair never angled far enough to accommodate his lanky frame. The meetings in New Orleans had been superb. He was anxious to get back to St. George and try the new procedure for female incontinence that he had learned. The early data for the fascial sling cystourethropexy was excellent with much better statistical results than for the Stamey or the Peyera. As usual, Moe would be pessimistic. He would probably mouth one of his tired cliches, “medicine is not a fashion show that you change each fall when new styles came out;” or “don’t be the first to try something new or the last;” or even worse, “if it ain’t broke, don’t fix it.” Rusty was growing tired of Moe’s rigid, uncompromising attitude and his folksy, country cliches. If it wasn’t for him, Moe would still be a nineteenth-century country doc, complete with painted wagon, patent drugs and a traveling medicine show. And to carry the analogy further, he probably would still be treating gonorrhea with potassium permanganate urethral irrigations and deep tissue infections with turpentine and a poultice.

Grudgingly, however, Rusty had to admit that Moe was a good surgeon. He could read the technical description of a surgical procedure, such as the fascial sling in one day, then walk into the operating room the next day and perform the surgery. Not just do the operation, but do it well. He, Rusty, was the one who always read the medical journals and went to the AUA meetings. Moe, who almost never went to meetings, would never even hear about new techniques if not for him. But without Moe there for backup, Rusty lacked the confidence and the guts to try new procedures. It frustrated him that he had to rely on Moe for anything, especially surgical assistance. Sometimes, actually quite a bit lately, he wondered why he had ever joined Moe’s practice. They were such complete opposites.

Moe had recruited Rusty as he was finishing his fifth and final year of residency at the University of Utah. Now, Rusty wondered why he hadn’t taken the job he’d been offered in Ogden at that same time. In reality, he knew why. St. George had an Arizona climate, whereas, Ogden had a Wyoming climate. But still, he couldn’t help but think that he had made a mistake. Undoubtedly, his life and his professional practice would have been more satisfying, more complete, in Ogden. At least there, he would not have had Moe as a senior partner. Rusty hadn’t made many mistakes in his thirty-two years of life, but perhaps joining Moe’s practice was the biggest, the one with the most lasting consequences.

Rusty had grown up in a typical middle-class Utah family. His father, a religion professor at Brigham Young University, was never home much, but he was a good provider. His mother, a full time housewife, raised him and his five siblings in typical conservative Mormon fashion, insisting on strict discipline, while at the same time, using the teachings of the church as a template for life. During the week, the family was rarely all together, but on Sunday they were scrubbed, cleaned and collected in the living room, then herded into the station wagon and driven to church. Although it was rare, even among Mormon kids, Rusty enjoyed church and rapidly advanced through the various offices of the Aaronic Priesthood, deacon, teacher, and finally priest. He was rewarded for his diligence by being called to the office of president in both the deacons and priests quorums.

In high school, Rusty excelled in academics and basketball. Accomplishments of his senior year included graduation with high honors, and he was voted to the all-state basketball team by the Deseret News. After high school, he enrolled in BYU for one year, then secured a two-year hiatus from college for a Mormon mission to Bolivia. While on his mission, Rusty, as expected, was very successful in convincing dozens of Bolivians to abandon their Catholic faith and be baptized into the Mormon Church. It did trouble him a little that half his baptisms were young Bolivian maidens who were obviously as much in love with him and the image of the rich-Yankee-gringo as they were with the doctrines of the church. But in a way, the end did justify the means. After all he was doing God’s work.

As a spin-off to his labor in the mission field, Rusty learned to love the church, and vowed to always remain active and true to his testimony. After returning from his mission, Rusty returned to BYU and resumed his studies. Majoring in zoology with a minor in chemistry, he eventually graduated summa cum lauda. It was during his last year at BYU that he applied and was easily accepted into medical school at University of Utah.

Just one month prior to graduation from BYU, Rusty married Faye, a woman he had dated intermittently since high school. Faye was a rather plain, domineering woman, who constantly tried to cover her homely features by lacquering on layers of make-up. Furthermore, it seemed she constantly wore loose, flowing clothing in a valiant effort to hide her steadily growing figure. But she did share Rusty’s religious and moral values, and though the sex was not great, the companionship was good. Through the years, they conceived and were still raising four children, two boys and two girls, all of whom Rusty was justifiably proud.

Following medical school, Rusty elected to stay at the U of U for his residency training in urology. His performance was above reproach. He was elected Chief Resident after just three years in the program, a position usually reserved for fifth-year residents. After completing the prescribed five years and passing his specialty boards, he had joined Dr. Moses Mathis in private practice. Rusty had considered staying in academic medicine, but in the end, he felt he was not particularly well-suited for the political games associated with academia, and without question, university physicians did not command the same salary as those in private practice.

Rusty excelled in private practice as well. Moe made him a full partner after only eight months. Of course, this early partnership was, in part, due to Faye’s constant nagging for more money, and eventually Moe capitulated. It seemed a little surprising now, but initially, he and Moe had not only been partners, but social friends as well. Their social and professional relationship had started to sour when Moe and Annie got a divorce. Moe had eventually started dating, as well as doing some drinking and was never really active in the church again. Not the kind of lifestyle Rusty and Faye wanted to be associated with, either socially or professionally.

However, it would be hard to leave St. George. Rusty had a busy practice, almost as busy as Moe’s. The kids were in school and they had made new friends. Uprooting them from St. George would be somewhat akin to trying to extract an 8mm stone from a ureter that was 2mm in diameter ureter. It could be done, but not easily. And Faye didn’t want to leave either. She had developed her own circle of friends. She was also a member of a couple of elite ladies’ social clubs and president of the Relief Society.

Rusty had considered breaking clean from Moe and establishing his own practice, and that was still an option, but he wasn’t entirely sure he could make it on his own, especially if he was in direct competition with Moe. No, in the final analysis, he really didn’t want to leave, though he knew they were again looking for a urologist in Ogden. His patience with Moe was definitely growing thin, but was this a good time to make a move? There had to be another way, a way he could have it all.

And to complicate his life further, there was Judy, an operating room nurse. God, was she pretty with lively brown eyes, a crooked mischievous smile and a flippant devil-may-care personality. They had been benignly flirting for several months, but lately, there had been more inadvertent touching, more long conversations and recently, a fairly harmless luncheon date.

Rusty knew Moe had been intermittently dating Judy for several months now, but that was part of the intrigue. And though he would never admit it, that was the reason, at least in part, why he was showing more interest in Judy lately. Anyway, Judy was better suited for him; Moe was just too old for her. It was irritating to see Moe trying to act down to her level, awkward, like a pimply, pubescence teenager. It would be a freezing day in hell before Moe could best him in the art of romance.

Regardless of that unspoken challenge, Judy was very sexy and fun to fantasize about, not at all like Faye. In fact, she had been on his mind so much lately she had almost become an addiction, an obsession. Just the thought of her nude, supple, young body next to him made him get hard. Kind of like that gorgeous, serpentine dancer at that strip joint on Bourbon Street that he had skipped the meetings to see.

“Do you want something to drink, honey?”

Rusty jerked, startled out of his reverie. He had almost forgotten Faye was seated next to him. He glanced up to see both his wife and the flight attendant peering at him.

“What?”

“Do you want something to drink?”

“Oh—uh, yes, I’ll have a Sprite,” he answered a bit sheepishly.

“You were a thousand miles away. You still worried about your practice?” Faye asked sweetly.

“Yeah, I just can’t decide what to do.” Rusty turned away. He was still feeling guilty about his carnal thoughts and afraid they might show in his eyes.

“About Moe?”

“Yes,” Rusty answered. “I’m not sure how much longer I can work with that man.”

“I know, honey, he has the morals of a rodent. You should really think about starting your own practice.”

“I might just do that, Faye. I might just do that.” Rusty took a long sip of Sprite and patted Faye’s hand, then to change the subject, he deliberately looked at his wristwatch. “We’ll be landing in a few minutes.”

About ten o’clock that evening, after the two hour drive from Las Vegas’ McCarran airport to St. George, Rusty dropped Faye at the house, then stopped by the office to check his schedule and see if there were any urgent messages. As usual, Moe’s office appointments were full for three weeks in advance, while Rusty’s future patient bookings were only full for less than a week even though he had been gone for a week. This fact always annoyed the hell out of him.

Rusty just could not understand why Moe was consistently more popular. It certainly wasn’t that he was a better doctor. Then to add to fuel to that argument, Moe was divorced, didn’t go to church and had started drinking. In this town, all of those were serious social offenses and this type behavior was totally unacceptable for a partner of his. Yet, people still continued to go to Moe. Even some of the good Mormons.

On the other hand, Rusty was a happily married man, went to church every Sunday and had never been in a bar in his life, at least as far as anyone in St. George knew. But in spite of this, Moe always saw more patients, did more surgery and subsequently made more money. To Rusty, this was unbelievable and unacceptable. What were patients thinking? However, he knew that regardless of the fact that his personal life was a mess, Moe rarely made mistakes in his professional life, and that was the hitch. If Moe screwed up more as a doctor, then most of these patients would be coming to him.

After checking his messages, Rusty started rummaging through the pathology outbox. Not surprisingly, it looked as if Moe had been busy. Idly, he picked up the two prostate biopsy specimen vials, one marked Howard H. Swensen, the other Robert E. Robinson. He could feel the corrugated gripping surface of the plastic caps, he popped the lid off one of the vials and the pungent odor of formalin stung his nostrils. Just for a fleeting second, he considered how much trouble Moe would be in if the vials were switched. It would serve that aging playboy son-of-a-bitch right. Wouldn’t that be the ticket? If he did switch them, how would anyone ever know? Should he?

“You back?”

Rusty jumped! Fighting for composure, he slowly turned around, rotating the uncapped specimen vial behind his back.

“Didn’t hear you come in.”

“That was obvious, I thought you were going to hit your head on the ceiling,” Moe said jokingly, but did not smile.

“What are you doing here at this hour?” Rusty asked hurriedly. It would be better if he took the offensive, started asking the questions.

“I was driving by and saw a light on. Thought I’d better check it out. You know, Ali Butras had his office broken into last month.”

“I heard. Kids looking for drugs. Any problems with any of my patients while I was gone?”

“No, not really. Oh—Laura Slembosky passed her stone, so I canceled her lithotripsy for tomorrow.”

“Guess I should have done her before I left,” Rusty joked. “After New Orleans, I need the money,”

Moe did not laugh. “How were the meetings?”

“Great! When we get a minute, I want to talk to you about a new procedure for stress incontinence, the vaginal sling. The initial patient trials show up to a ninety percent success at five years,” Rusty gushed.

“Yeah, I’ve heard of it. Reminds me of what Mark Twain said about statistics. You going to be here much longer?”

“Nah, just going through some of my messages.”

“Smell like formalin in here to you?” Moe asked as he sniffed the air.

“Uh—uh, probably the cleaning solution housekeeping is using.”

“Yeah, probably. You’ll lock-up?”

“Of course.”

With an uneasy blend of relief and hostility, Rusty watched the old bastard leave. With his thumb, he recapped the specimen vial, then idly toyed with the vials. After a minute, he placed the specimen vials in the pathology outbox, turned out the lights and left.

The courier, clothed in a white lab coat, stopped at the office of Urology Associates at precisely 5:00 p.m. the next afternoon. There she collected blood and tissue specimens, a service provided by the lab of Dixie Pioneer Hospital to their private physicians. From Urology Associates, the last stop on her route, she collected three biopsy specimens, two from Dr. Mathis dated the previous day and one from Dr. Wright labeled with today’s date.

Her carrying tray was packed to over-flowing with specimens, mostly blood tubes and biopsy vials. She had missed two collections, yesterday evening and this morning. Her baby, Geoff, had been sick with otitis media and the day care would not take him until he was better. But this afternoon, her mother had agreed to watch the child so she could make her evening pick-ups. Anyway, a few hours really didn’t really matter. All the biopsy specimens were pickled in formalin and the blood tubes contained preservatives. Nothing was damaged.

After leaving Urology Associates, the courier delivered the specimens to the hospital lab, placing the histology specimens in the histology receiving box and the blood products in the hematology box.

Histology technician Tammy Everett retrieved the specimens five minutes later and wrote down in her log book the time, date and the vial serial numbers, which had been pre-stamped into the specimen containers by the manufacturer. For the first container, she entered into the log, Howard H. Swensen-#001198-G, then, Robert E. Robinson-#001199-G and the third, Joseph P. Kuck-#001201-G. After the paperwork, she then began the time-consuming task of preparing the tissue for pathological examination. The entire procedure was pretty much automated. Tammy just had to get things started. First, she placed each specimen in a cassette, then submerged the cassettes into a formalin solution. Through the day the cassettes would systematically rotate from the formalin, through a solution of 80 percent alcohol, then a solution of 90 percent alcohol, followed by a solution of 100 percent alcohol and lastly, through a solution of xylene. By morning, the tissue would be properly dried, then imbedded in molten paraffin wax. The paraffin wax would then be cooled, the tissue oriented and sliced with a microtome, and eventually fixed on a glass slide. As a final step, the tissue would be stained with hematoxylin and eosin (H&E), then placed on the pathologists’ desk to be read. After analyzing the slides through a microscope, the pathologist would dictate a report. The slides and any excess tissue would then be catalogued and stored for future reference.

Two days later, Dr. Catherine Connelly picked up the three sets of newly processed tissue slides. When she saw Dr. Mathis’ name, she was immediately flooded with anger and clenched her teeth. It was involuntary—a gut reaction. Through the years, Catherine had grown used to this response. Every time she saw any pathological specimen with his name on it, she felt the old fury. Moe Mathis was a son-of-a-bitch!

Catherine had always been an over-achiever, though it hadn’t been easy in a profession dominated by men. In spite of this, she had done well in a society where women were considered chattel and second-class citizens, and were usually relegated to raising children or simple clerical jobs. It infuriated Catherine that women’s work usually consisted of waiting on men, whether in the workplace or at home. All her life, she’d had to battle this archaic attitude, especially prevalent in Utah, and had surreptitiously developed a seething dislike for men. Particularly men in positions of power. Men in power were to society like untreated gangrene to a leg. If left unchecked and untreated, it would ultimately kill the patient.

In her thirty-nine years of life, Catherine could only remember one man she’d not had to struggle with for respect, Joe Connelly, and she had married him. Sweet sensitive Joe, wouldn’t raise a foot to kill a spider. She had met Joe at the University of Washington in Seattle where they were both students. As luck would have it, they were seated together in biochemistry her senior year. Joe was majoring in pharmacy, while she was pre-med. They often studied together, eventually started dating and were married in the summer just after they both graduated from college.

From the onset, it was apparent to both of them that Catherine was more intelligent, more ambitious and had a better chance to succeed. Without giving it another thought, Joe acquiesced, dropped out of pharmacy school and got a job, while she continued on in medical school. After medical school, she took a residency in pathology at the University of Utah. During this time, Joe continued to support her.

Catherine and Joe had one child, a girl, who with true medical precision, was calendar-timed to arrive about a month after she had finished her fourth year of residency. Their timing, though not perfect, was adequate. The baby was delivered about three weeks after graduation.

Following her residency, Catherine accepted a position at Dixie Pioneer Hospital in the pathology department working with that pseudo-intellectual, that rumpled slob, Dr. Ray Mosdell. With her making a good salary, Joe no longer had to work so he managed the domestic part of married life, taking care of the house and raising their daughter.

Immediately after arriving at Dixie Pioneer Hospital, Catherine had trouble with Dr. Mathis. Moe was Chief of Staff at the time and was in the process of preparing the annual staff committee assignments. Initially he had assigned her as chairwoman of the safety committee, a fairly insignificant committee when compared to the more powerful surgery, medical or credentials committees. However, she had derived a certain satisfaction at being appointed to chair a committee in her first year on the staff.

Then inexplicably, Moe called her and told her he was switching her assignment. Instead of chairwomen of the safety committee he was putting her on the pharmacy committee, and not as chairman. And Dr. Ray Mosdell would continue as chairman of the safety committee. Catherine was furious and she and Moe had words. Moe had tried to convince her the reason for the re-shuffle was that the safety committee was in the middle of several safety audits and the committee members had unanimously asked for Dr. Mosdell to continue as chairman until these projects were completed. Catherine didn’t buy this, not for a minute. She accused Moe of being a chauvinistic bastard and hinted that staff government was being conducted by the good ole boy system, with Moe being the worst example. But Chief of Staff Mathis did not capitulate to her tirade, and through the ensuing years she and Moe had been cordial, but were never friends. Fortunately, time had corrected that mistake. She was now chairwoman of the more influential peer review committee.

Five years ago, Joe had started passing blood in his urine. Catherine was in a quandary on which urologist to use. Without a doubt, Moe had the better reputation as a surgeon. Eventually, she put her pride in her purse and asked Moe if he would evaluate Joe for the bleeding. Of course, he was happy to do it and started Joe’s work-up with an intravenous pyelogram then cystoscopy. The cystoscopy was negative, but the IVP showed a large mass in the upper pole of the right kidney. The CAT scan confirmed it was a solid mass, probably a hypernephroma. Fortunately, the metastatic work-up was negative with no evidence of tumor in the lungs, liver, bones or brain. Moe had then advised surgery and subsequently took Joe to surgery the next week, performing a right radical nephrectomy on him. After surgery, Catherine distinctly remembered that Moe had assured her that Joe would do well, that it looked like they had gotten all the cancer, and that Joe was probably cured.

That was a laugh. For two years Joe did do well, then he started having severe left-sided headaches, sometimes associated with nausea, projectile vomiting and fleeting parathesias. A CAT scan of the brain showed a large mass in the left frontal lobe, probably a reoccurrence of the hypernephroma, which had metastasized to the brain. From this point on, things moved fast, and within two months Joe was dead.

Deep down, Catherine felt Moe was responsible for her husband’s death; obviously he didn’t get all the tumor at the time of surgery, even though he said he did. If he had, Joe wouldn’t be dead. Apparently, Moe had been careless, possibly to get back at her, and had left some tumor behind. She had never remarried and had never completely recovered emotionally or psychologically from Joe’s death. The lawyers had said there was no malpractice. Though Catherine thought otherwise, she never sued. Through the years, the bitterness lingered, punctuated occasionally by these feelings of rage. Damn that Moe Mathis!

Still angry, Catherine slammed the first slide in the microscope, and focused the eyepiece. There were rather uniform glands, though some were in chords. The epithelial cells showed deeply pigmented nuclei, but still fairly abundant cytoplasm. There was also obvious peri-neural invasion. She dictated it as a poorly differentiated adenocarcinoma of the Prostate, Gleason grade IV. Then she picked up the second and third sets of slides and examined them in order under the microscope. They were totally negative.

Briefly, a wicked smile of indulgence crossed her face. With a spiteful glow of satisfaction, she considered how much trouble Moe would be in if she were to switch the slides. That would be sweet revenge for Joe and the chauvinistic son-of-a-bitch deserved it. But should she? Catherine drifted off into that sweet stupor brought on by the opiate called vengeance.

“Hey, Catherine, could you give me a verbal report?”

As Catherine jumped, her hand jerked and collided with the stack of specimen slides. The harsh sound of glass slides clattering on the desktop filled the room. Sheepishly, she swiveled in her chair, turning to face the door. Immediately, her embarrassment was replaced by anger.

“Don’t you ever knock?” she hissed.

“I’m sorry Catherine. I thought you heard me coming,” Moe said, as he continued through the door.

“What do you want?” she demanded, starting to re-stack the slides.

“Since I was in the hospital anyway, I thought I would check on a biopsy. Howard Swensen. He’s the father of a friend of mine.”

“You have friends?” Catherine said icily.

“Come on, Catherine, be charitable.” Moe said, managing one of his disarming smiles.

Catherine toyed with the stack of slides. “Haven’t seen it yet.”

“But it’s been four days.”

“I don’t care if it’s been four months, I haven’t read it yet,” Catherine growled through clenched teeth. “When I do, you’ll be one of the first to know. My secretary will fax you a report as usual.”

“Catherine, I wish there was something I could do.”

“Do? What are you talking about?”

“Something I could do to repair our friendship.”

“We never had one,” Catherine snapped, hunching over her microscope again. “Anyway, you’ve done quite enough already.”

When she heard the sound of Moe’s retreating footsteps, Catherine turned around and watched him leave. When he was out of sight, she fingered the slides for a moment and let her mind wander, thinking about the possibilities. Men didn’t control everything. There was a way to get back at him. She smiled, then she carefully sorted the slides in three stacks, one for Howard H. Swensen, one for Robert E. Robinson and one for Joseph P. Kuck.

Later that day, Catherine dictated the reports, giving the tape to her secretary for transcription. By the end of the next day, the same white-coat courier delivered the completed reports to Urology Associates.