Implant

  "How long am I supposed to wait? " he said with a hint of an edge in his voice.

  "I'm waiting, too, Peter. I'm going half crazy waiting."

  He sighed. "Fine. Keep me hanging. Let me know when you find out what you're going to do. As soon as you find out."

  "I will. And I'm sorry."

  "That makes two of us. Bye, Gin. Call me soon."

  She sat in the doctors lounge for a long time with the phone in her lap, wondering how she could be right if everyone else thought she was wrong. Her beeper chirped before she came up with an answer.

  They wanted her on Two South.

  11

  THE WEEK OF SEPTEMBER 14 - GINA

  OVER A WEEK NOW SINCE THE INTERVIEW AND STILL no word from Senator Marsden's office. Chances of a call from Joe Blair seemed slim to none but Gin kept hoping the senator himself might intervene. Because throughout her meeting with Blair she'd got the impression that he was deigning to interview her only because his boss wanted it.

  The waiting was affecting her concentration. She had to resist the urge to call her answering machine every hour. The Guidelines committee started hearings in another week. Time was getting short.

  True to her promise, though, she wasn't forgetting about looking into Lisa Lathram. The question was how. She had a feeling Oliver had said all he was going to say, and she couldn't very well ask Duncan.

  Wouldn't the sudden death of the daughter of a prominent local warrant some newspaper coverage?

  Yes, it would. She called the D. C. Public Library and they connected her with their periodicals section. They were most cooperative but could come up with only one reference to Lisa Lathram.

  In the August 17 issue of the Washington Post, her obituary. Gin stopped in the main branch on G Street and found it on microfilm.

  No help there. Except for mention of the survivors, it might as well have been a high school yearbook entry.

  Gin would have liked to surf through the microfilm but she was due at Lynnbrook to do her house-doctor thing, so she left that for another day.

  She wasn't giving up on this. When Gin had left for medical school, Duncan was a top Virginia vascular surgeon with a wife and two children, when she returned from residency he was a divorced Maryland plastic surgeon with one child.

  Something had happened in that interval to turn his life upside down.

  Lisa's death? Maybe. Or maybe that was just a part of it. There had to be more. And Gin made up her mind to find out what it was.

  While on Three North at Lynnbrook she passed Mrs. Thompson's room and decided to stick her head in the door to see how she was doing. She saw the old woman shuffling between the chair and the bed. She tottered forward and would have fallen if she hadn't caught hold of the metal footboard.

  Gin stepped into the room as Harriet eased herself onto the bed.

  "You should call for a nurse before you try anything like that," Gin said as she helped her under the covers.

  "I'm practicing. I've got to go home. I don't want to get Dr. Conway in trouble."

  Curious, Gin sat on the end of the bed. "What makes you think he's in trouble?"

  "I overheard two of the nurses talking. They said the TRO and the hospital were on his back because of me."

  "That's PRO, Physician Review Organization. And don't you worry about Dr. Conway. He can take care of himself. You just worry about getting stronger."

  "Don't worry. I'll be strong enough to go home real soon. You can count on that. Real soon."

  "Good for you," Gin said. "And remember, Call the nurse when you need to get up. You fall and break a hip you'll never get out of here."

  "That will never happen. I'll not be a burden on anyone. I'll be out of here sooner than you think."

  "That's the spirit." Gin liked the old woman's determination. Maybe things would work out for Dr. Conway after all.

  A September storm was drenching the city when Gin dragged herself into her apartment around half past eight. As she passed the bedroom she noticed the message light on her answering machine blinking.

  Probably Gerry again. She'd been playing telephone tag with him since Taco Bell. Their schedules weren't meshing.

  When he was free, she was moonlighting. But they'd managed to connect last Friday when Gerry delivered on his promise to take her out to "a real restaurant for a real dinner." That turned out to be a delightful evening. A little French place on Massachusetts. Good wine, good food, and good conversation. They talked and talked, lingering over coffee until the maitre d' informed them that the place was closing.

  She learned that Gerry Canney was not only a dedicated father, he was a dedicated FBI agent as well.

  She yawned. Tired. This was no way to live. The rest of the city was up and about and starting the day while hers was just finishing.

  Luckily she didn't have to assist Duncan today.

  She sat in the bay window, watched the rain splatter and run down the panes, then sifted through her mail. Mostly "Occupant" fliers and the throwaway medical journals that had tracked her down and followed her from Tulane. The pile yielded two letters, both from medical headhunters looking for board-certified or board-eligible internists or family practitioners to fill primary-care slots. She averaged half a dozen offers a week.

  "Tired of being on call? Need a change of scenery?" As a matter of fact, yes. "Move to sunny Nevada." She read on. A new Las Vegas megahotel was opening an on-premises clinic for its ten thousand employees. No thanks.

  The other letter played coy with the precise location, but guaranteed $120,000 plus benefits to start as the fifth member of a family practice group "located just ninety minutes from beach, mountains, and D. C. " Gin thought about $120,000 to start . . . wouldn't that be nice. The profession had been running low on primary-care docs for years, probably because they occupied the bottom rung in prestige and income. But The growth of managed care had created a sudden demand for the lowly generalist. Over twenty-three hundred dollars a week, probably for fewer hours than she was working now. Tempting.

  But not yet.

  She dropped the letters into her lap and gazed down at the street watching the fallen yellow leaves swirl as they floated down the gutter toward 18th Street. Was she kidding herself? Was this whole idea of hooking up with the Guidelines committee a fool's errand? Was Peter right? Wasn't she wasting her training by doing presurgical medical clearance on Duncan's patients when she could be in a real practice treating her own patients?

  Maybe. But this wouldn't last forever.

  She spoke silently to the city beyond her window.

  I know it looks like I'm just treading water, folks, but trust me, I really do have a direction. It's just that lately the current always seems to be running against me. But don't worry. The tide will change.

  At least she hoped it would.

  I've got the blues, she thought. And why not? It's a damp, chilly, crummy morning, I've been up all night, my energy has bottomed out, and I'm overtired.

  Not the best time to make big decisions.

  She tossed the headhunters letters and occupant mail into the wastebasket, and put the journals aside to skim later. Then she hit the button on her answering machine. It would be good to hear Gerry's voice.

  But instead of Gerry it was an unfamiliar woman's voice. "Ms. Panzella. This is Senator Marsden's office. Mr. Blair asked me to call and inform you that Senator Marsden wishes to personally interview you tomorrow afternoon at four P. M. If you cannot make it at that time, the senator will not be able to reschedule. Please call to confirm that you will be there." She left a number and an extension.

  Gin realized with a start that the message had been left sometime yesterday. "Tomorrow" was today.

  She replayed it. She'd only met Joe Blair once, but she could smell him all over that message. He was incapable of calling her "Doctor." The arbitrary time and no rescheduling. She could almost hear his voice, Do or die, Panzella.

  She sensed some sort of a power struggle. What was it
? The senator choosing new staff and his chief of staff resisting an intrusion into his bailiwick? That could make for a tense atmosphere. Did she want to get caught in the middle of that? Come in on the wrong side of Joe Blair and have to buck him from the get go?

  She'd love it.

  Smiling tightly, Gin reached for the phone and jabbed in the number.

  After confirming her meeting, she strode back to the window and looked out on Kalorama Road.

  See, fellows? What'd I tell you? The tide's turning.

  12

  DUNCAN

  "I’M AMAZED," SAID SENATOR VINCENT. EVEN IN THE close confines of a doctor's examining room he spoke as if he was delivering a speech.

  "I'd been told how incredibly rapid your surgery healed, but didn't appreciate exactly how rapid until I'd seen it with my own eyes. Truly amazing."

  Duncan refrained from reacting to the man's condescension and continued inspecting the hairline incisions under the chin through an illuminated magnifier. Yes, the beta-3 was doing its work. Only a week post-op and, except for some fading ecchymosis, virtually all traces of the procedure were gone.

  Too bad I couldn't have done the Hogg reconstruction. Then you'd really be amazed.

  Sometime since the surgery, Vincent had had his hair per med. It stuck out from his head in frizzy tendrils, making him look like one of those Chi Pets they hawked on TV.

  Duncan backed up, examined Vincent's throat from the left, then the right. "Damn, I do good work!"

  Vincent laughed nervously. "So I guess it will be safe to go on TV next week."

  "Oh? " Duncan said with all the ingenuousness he could muster. "Face the Nation?"

  "No. More important. The hearings. On the Guidelines bill."

  "Next week? I didn't realize you'd be getting started so soon."

  "Oh, yes. We're pressing on without Lane and Allard. The first hearing is Wednesday."

  Got your sights set on any particular targets? Duncan wondered. Who's life are you going to ruin this time around?

  "You know," Duncan said slowly, "I've never been to one of these hearings. Do you think you could get me in to the opening session?" Senator Vincent scratched his head. "I don't know. It's a pretty hot ticket. And the hearing room's not that big . . . "

  "Well, I have other patients on the committee who'll take care of it. No problem."

  "You do?" the senator said, his tone warbling between pique at Duncan's implication that there was someone on the committee with more juice than he and voracious curiosity as to who else was getting fixed up for the hearings. "Who?"

  Duncan wagged a finger. "Now, now. You should know that's privileged information."

  "Yes, of course. But if you truly want a seat, Dr. Lathram, you've got one. I'll have my legislative director call you tomorrow. No problem."

  "Thank you, Senator. I knew I could count on you. It promises to be quite a show. And I bet yours will be a household name from the very first day." I guarantee it.

  * * *

  Later, Duncan stopped by Oliver's lab. He had to get down to D. C. General for The surgery on little Kanesha Green, but first he wanted to check his brother's progress on the latest refinement of the implant.

  He found Oliver seated with a number of empty implants in a tray on the counter before him. He handed one to Duncan who rolled it back and forth in his palm. Light as a feather.

  Duncan said, "How long can we count on the new model to sit in the subcutaneous fat without dissolving?"

  Oliver shrugged. "How can I say? Six months, two years, forever. We haven't tested them. We'll have to do animal studies. I mean, really, Duncan, we haven't even finished the clinical trials on the regular implants, and here you've got me working on a whole new type."

  "Got to stay ahead, Oliver. If we don't keep innovating, the intellectual slovens and me-too artists will plunder our work."

  "But why this new model? I thought the whole idea was to have it dissolve shortly after surgery."

  "Because I foresee a time when I may want an implant that dissolves when I tell it to. In trauma cases, for instance, with wide, deep wounds, premature release of beta-3 could prove counterproductive." He had to choose his words carefully. Oliver was bright but he hadn't the faintest idea what lay behind Duncan's insistence on an implant that would dissolve on command, and no inkling of what Duncan had already done with it.

  Duncan flipped the empty implant into the air and caught it.

  "But you do think it's possible one of these things could nest in the fat for a couple of years?"

  "I guess so. But I couldn't imagine why anyone would want it to sit there that long. The time when its dissolution would be of any benefit would have long since passed." Not exactly, Duncan thought. Not if it was filled with the right substance and hidden in the tissues of the right person.

  "Just wondering," Duncan said.

  Oliver's eyes lit. "But you mentioned trauma repair. Are you thinking of returning to real surgery?"

  Duncan laughed. "You mean vascular surgery? God, no. Why would I want to go back to being on call twenty-four hours a day and getting rousted out of bed at all hours of the night? For what? What good would that do me?"

  "You're a great surgeon, Duncan. You'd be putting your talents to their best use. It wouldn't just be good for others, it would be good for you as well."

  Moved by his brother's concern, and afraid Oliver might see something in his eyes that he shouldn't, Duncan looked away. Oliver was a good soul, the most decent of men. Complaisant, assiduous Oliver, his irenic presence, his lambent insight were a balm on Ouncan's soul.

  And he so admires me.

  At times like these Duncan hated himself for putting Oliver's discovery to uses that would horrify him. And Duncan himself was horrified by the knowledge that if his machinations were ever brought to light, Oliver's fulgent, indefectible character would be tainted.

  But that doesn't stop me, does it.

  Again he wondered what he'd do if Oliver found out. Or Gin. How far would he go to protect himself?

  He tried not to think about it.

  "Why would it be good for me, Oliver? You know what happened when I was in vascular surgery. The same thing might happen again. Why should I make myself vulnerable again? Look at me now. I'm working fewer hours, I have no calls to speak of, whoever heard of an emergency tummy tuck in the middle of the night? I'm earning far more now with half the effort."

  "You never cared about money."

  "The public did."

  "And you were saving lives then."

  "But while I was saving or improving all those lives, I was publicly stoned for unalloyed greed. Remember that time, Oliver? Remember?"

  Oliver nodded. "I remember."

  "Now I rake in seven figures simply for resuscitating the vanity of the local gentry, and no one says a word. No one even lifts an eyebrow. Truly we live in a remarkable society, Oliver. A remarkable society." What a world, Duncan thought, straining to hide the lava of rage erupting in his chest, flowing through his gut. What a goddamn world.

  Oliver was staring at him. "You shouldn't have let them drive you out, Duncan."

  "Now, now, Oliver. We've been over this countless times. I chose to leave vascular surgery. And it's the best thing I ever did."

  "But you could have gone into another surgical field where your work actually meant something."

  "But you had this new membrane you'd discovered, and then the Brits came up with beta-3. The writing was on the wall, cosmetic surgery was it." Actually, he had decided never again to deal with insurance companies, or governments, or any mixture of the two. Cosmetic surgery was perfect.

  Only a rare insurance policy covered it anyway, and he could limit his patients to those who wanted it and exclude those who needed it.

  "If that's the case," Oliver said, "then I wish I'd never developed this membrane."

  Duncan gripped his brother's shoulder. "Don't ever say that, Oliver. These implants are going to transform a host of lives.
People all over the world, mothers of children who'd otherwise be scarred for life will bless your name. And as for me, I've made peace with the past. Trust me, Oliver. I'm at peace."

  "I hope so," Oliver said, searching Duncan's face. "I find it hard to believe, but I hope it's true."

  Duncan glanced at his watch. "Oops. Time to run. Got to get over to the club."

  Oliver's expression was dismayed. "You can't play golf today. It's pouring.''

  "Poker, Oliver, " he said, nudging his brother's ribs. "When it rains we play poker. Want to join in?"

  "No, " he sighed, turning back to his implants. "I've got work to do."

  For a moment Duncan was tempted to tell his brother where he was really going. It would make Oliver's day, make his year. But dear Oliver was a blabbermouth. He'd be explaining to anyone who'd listen that his brother really wasn't the coldhearted, cash-up-front bastard he pretended to be. He was a saint in hiding.

  No, Oliver would have to go on being disappointed in the older brother he had once admired. And Duncan prayed he never found out about how he was using the new implants.

  "See you tomorrow, then." Duncan hurried across the wet parking lot, jumped in the Mercedes, and started the engine. But instead of putting it in gear, he sat staring at the hub of his steering wheel.

  I've made peace with the past. Trust me, Oliver. I'm at peace.

  How easily the lies come now. Peace? What was peace? He hadn't known a moment of it since the day he'd found Lisa Lying in the foyer in a pool of blood.

  If only . . .

  Bright light in Duncan's eyes brought him back to the present. The sun had broken through the clouds. He shook off the memory and threw the Mercedes into gear. I was all right, he thought. And I'd have stayed all right if not for the president's resurrection of the damn Guidelines bill. It all came back, all the pain, the rage, because of him.

  But he'll get his. His turn is coming.

  13

  ON THE HILL