“No!” Perino hollered, pinwheeling his arms, kicking his legs, and trying to get up, as Sam scooted from underneath him.
“Donald, please relax.” Eric straddled Perino and held him down with a hand on each shoulder. Blood bubbled from Perino’s head wound, dripping sideways onto the floor. “Be still. Calm down. You’re going to feel the sedative starting to work.”
Perino shook his head, his eyelids fluttering, already starting to lose consciousness. A commotion came from the hallway, and in the next moment, three security guards burst into the room, led by their captain, Jed Barneston. Grant, a security guard, rushed to Eric’s side, the other helped Sam to his feet, and a third went to restrain Perino.
“Chief!” Jed called out in alarm. “You okay?”
“Fine, thanks.” Eric got off of Perino. “He’s out now. Let’s get him into bed.”
“Doc, we have to clear the threat zone.” Jed shooed Eric and Sam out of the room, per procedure. Security guards hurried back in to help secure Perino, who would be treated for his head wound later, after it was safe.
“Thanks, buddy.” Eric exhaled, smiling at Sam. “I couldn’t have done it without you.”
“Nah, you couldn’t have done it without haloperidol,” Sam shot back.
And behind him, grinning at Eric with evident relief, stood Kristine.
Chapter Fifteen
An hour later, Eric was trying to catch up on his paperwork when there was a knock on his office door. He looked up from his desk to see Amaka, with a slight frown. “Something up?” he asked.
“Chief, can you come with me a minute? I need to show you something, right away.”
“Sure, is there a problem?” Eric rose, crossed to the door, and they left together. He felt concerned because she wasn’t the type to exaggerate. “What is it?”
“It’s personal. I need to discuss it with you in private.” Amaka took his elbow and whisked them down the hallway, toward the conference rooms. They reached the conference room, where she opened the door and went inside, with Eric following her.
“Congratulations, Chief!” everybody shouted.
“Whoa, what?” Eric gasped, astonished. His staff filled the conference room, and everyone was grinning—Sam, Jack, David, the medical students including Kristine, nurses, nurse’s aides, psych techs, social workers, occupational and art therapists, even the dietitian. Cupcakes, muffins, a sheet cake, cups, paper plates, and cans of soda covered the conference table, and in front of it like a banquet manager, stood their stout hospital administrator, Jason Kittredge, who was beaming at Eric.
“Congratulations, Chief!” Jason clapped him on the arm. “We’re number two!”
“We’re number two!” “We’re number two!” “We’re number two!” Everyone chanted, clapping their hands, and Eric realized he’d been so busy with Hannah and Max over the weekend that he hadn’t even realized it was that time of the year.
“We’re number two?” Eric asked, astounded. “We’re getting ranked number two?”
“Yes, we are!” Jason practically shouted with happiness. “Our psychiatry service, your psychiatry service, just got ranked number two in the nation by U.S. Medical Report! It’s still confidential. I got word through back channels.”
“You’re kidding.” Eric could never have hoped as much. The highest ranking they’d ever had was eleven, and he’d been trying to break the top ten.
“Congratulations!” Jason applauded, and everybody joined in, clapping.
“Wait, quiet, everybody.” Eric waved for the clapping to stop. “What about Mass General? They’ve been number two forever.”
“We knocked them out of second place. Like that old car commercial, we try harder!”
“Are you serious? They own second place.” Eric shook his head in disbelief.
“Not anymore! We scored a 29.6, almost a perfect 30. It put us ahead of every psychiatric service in the country but one, McLean. We came from behind! We’re the dark horse, the underdog!” Jason’s grayish eyes lit up behind his wire-rimmed glasses. “Thanks to you, your leadership, and your long-range planning. The changes that you’ve made over the past few years have come to fruition.”
“No, it was all of us.” Eric collected his thoughts, motioning around the room. “Congratulations, everybody. I’m so proud for all of you, and I appreciate everything you did to make this happen. We pulled together and it looks like—”
“We’re number two!” Kristine shouted, stepping front and center, and Eric got the distinct impression that she was trying to get his attention, as everybody joined in, chanting again, “We’re number two!” “We’re number two!”
“Chief!” Jack pushed Eric playfully. “Come on, Jason’s right. Take the credit. I’ve seen the changes you instituted—the formation of treatment-teams, the full multidisciplinary approach, especially liaising with the geriatric unit—they’re all working.”
Jason pumped his head, retaking the floor. “The other hospitals, they’ve been watching us, hoping we’ll fall on our faces, but we proved them wrong. We proved them all wrong.”
Eric couldn’t help but smile. “Jason, that’s a negative worldview. You might need a shrink.”
Everybody laughed, including Jason, but he wasn’t about to shut up. He turned to the medical students, with Kristine in front. “There are sixteen hospital specialties that are data-dependent for their rankings, but four specialties are ranked according to reputation only, psychiatry among them. That means that our ranking came from a reputational survey of physicians, who were asked to name the hospitals they consider the best in the specialty for difficult cases.”
“Woohoo!” Kristine cheered, louder than the others. Eric thought she was more dolled-up than usual this morning, with brighter lipstick and her long, dark hair blown-dry, which he knew was a big deal, from Caitlin.
Jason added, “That means it’s even harder to get because in certain respects, it’s somewhat subjective.”
Eric snorted. “Somewhat subjective? It’s completely subjective.”
Jack waved him off. “Chief, if somebody throws you a rose, don’t bitch about the thorns.”
Eric laughed, and so did everybody else.
“Not only that,” Jason interjected, “we made the Honor Roll. We never made the Honor Roll before.”
“Honor Roll?” Eric felt like the parent of a gifted overachiever. “How did that happen? Did we get the extra credit questions right?”
Everybody laughed except Jason. “Joke all you want to, but it’s only for hospitals that rank high enough in at least six specialties. The Board is over the moon. They extend their special congratulations to you, Chief.”
“Jason, enough. So what happens next? You promote it out the wazoo?” Eric knew that medicine had become about marketing.
“The sky’s the limit.” Jason’s enthusiasm bubbled over. “We have to wait to press-release it, but we can start priming the pump. There will be TV commercials, billboards, banners, radio ads, and targeted online ads on Facebook and Twitter, too.”
Eric smiled. “Don’t forget about the swag. We need pens that say We Try Harder, plus T-shirts.”
David burst into laughter. “How about bottles of hand sanitizer? And beach towels?”
“Yes!” Jack clapped his hands. “Travel mugs!”
“Beer coolers!” yelled one of the nurses.
Kristine caught Eric’s eye, saying, “Condoms!”
Everybody laughed harder as Eric looked away from Kristine, breaking eye contact. He didn’t want to encourage her.
Jason waved off the laughter. “Okay, I know you’re having fun, but this is a wonderful achievement, and it’s because of Eric and your hard work. It will redound to the hospital’s benefit for years to come.”
Eric nodded, then he realized he had come in this morning thinking that he might quit his hospital job over the custody issue, but he didn’t know if he could do that now. He’d never felt more a part of the team than he did at this very mom
ent, when he realized he would have to leave it behind. But he couldn’t say any of these things, so he pasted a smile on his face, and said:
“Jason, please thank the Board, on our behalf.”
Chapter Sixteen
Eric shut his office door behind him, walked to his desk, and sank into his chair. He’d been crazy busy—a running joke on the psych unit—because the number-two ranking had thrown the hospital into a tizzy. He’d fielded phone calls and congratulations from administration all day, then he had treatment rounds. Donald Perino had stabilized, though his forehead had taken three stitches.
Eric checked his desk clock, a clinician’s habit, which read 5:15; it made him think of Max, who was undoubtedly looking at the clock somewhere across town, then tapping his head. Eric worried about how he could help him, then about Renée Bevilacqua. Eric thought of what Arthur had said, that OCD patients rarely become aggressive, so he put it out of his mind, or tried to, as he swiveled to face his computer, palmed the mouse, and logged onto his email. He wanted to check it before he left to have drinks with the staff, most of whom had already gone to celebrate their number-two ranking.
He watched his email pile onto the screen, skimmed the senders and subject lines, and determined that none of it required an immediate answer. His gaze strayed to the late-day sun that struggled to make its way through the window, which had a view of approaching thunderstorms and the Medevac helicopters that rushed emergency cases to the rooftop landing pad. His was the best office on the floor, but even so, was a medium-sized box, barely big enough for an institutional desk of indeterminate wood across from two brown pleather chairs and a matching couch, on the side. The rug was a tweedy gray-green and the walls were painted a soothing green pastel, a color he thought of as Managed-Care Mint. His diplomas, board certifications, and professional awards blanketed them, although Eric wasn’t the show-off type. Caitlin had made him frame everything, showing off for him by proxy.
You have to toot your own horn, she would always say.
Eric looked out the window, trying not to think about Caitlin. He would normally have called her to tell her about being number two, but he’d stopped himself. His eyes fell on the bookshelves overflowing with medical and psychiatric textbooks, the professional journals and papers, the myriad volumes and memoirs on psychiatry, its history, and its neuroscience; Eric lived a life of the mind and it showed. His thoughts stopped at the familiar purple DSM, the volume that categorized the mental and emotional disorders that plagued human beings, and he wondered if being heartbroken was one of them. Or all of them.
Eric hadn’t reached a final decision about whether to go for primary custody of Hannah, and though he knew he was overthinking it, he couldn’t stop. He had to acknowledge that gaining the number-two ranking and even going through what they did with Perino had given him pause. He loved his job, and he had a purpose here at HGH. He owed Susan a call with his answer today, and it had been on the back of his mind all day. Suddenly he heard a knock, and he looked over to see Sam at his door.
“Hey, Chief. You’re coming out with the gang, aren’t you? We’re celebrating.”
“I suppose I should.” Eric rarely went out with the gang, trying to keep his professional distance, but he was going to make an exception.
“Of course you should come.” Sam frowned, surprised. “You’re the guest of honor. Plus you’re my excuse. I said I had to go to a party for the boss, so how would it look if the boss didn’t go?”
“What did you get out of?” Eric logged out of his email. He would call Susan later tonight.
“T-ball. Seth plays on Mondays, but I can go late.”
“How old is he these days?” Eric was thinking of Hannah, his allegedly abnormal kid who didn’t like sports. He rose, checking his pants for his cell phone and keys.
“Five. It’s young for T-ball but he loves it. I loved Little League, too. So did my brother. It’s a Ward thing.” Sam opened the door. “Come on, everybody’s there but us.”
“Okay, I owe you a drink, too. You saved my ass with Perino.” Eric went to the door, with Sam following.
“No worries. I’ll feel it in my back tomorrow.”
“Ha! I feel it in my back right now.” Eric locked his office door behind him.
“It had to be the new nurse that set him off. He didn’t recognize her.”
“Agree.” They fell into step walking down the hallway, and the unit was quiet because the patients were in the dining room for dinner. Eric waved good-bye to the nurses as they passed the station. “I’m worrying about him. He’s on risperidone for the psychosis and fluoxetine for the depression, correct?”
“Yes.”
“But he’s not responding to treatment, and if anything, he’s getting worse. I’m worried that his agitation is a side effect from risperidone.” Eric unlocked the interior door of the unit, letting them both into the airlock, then unlocked the outer door and locked it behind them.
“You think it’s akathisia?”
“Yes,” Eric answered, mulling it over. Akathisia was a common side effect from risperidone, involving agitation and extreme anxiety, which caused the patient to act out, even violently.
“I don’t think so. We’re not seeing any of the motoric movements, like marching in place, getting up and getting down, or tapping.”
“He says he’s anxious.”
“Right, and he is, because of his delusions that the CIA’s after him. He’s still hearing voices, too. I really believe that the agitation is a result of the underlying condition, his psychosis, and not a side effect.”
Eric could hear the conviction in Sam’s tone. “So you want to keep him on the risperidone and fluoxetine?”
“Yes, I want to stay the course. I don’t want to undertreat him. He’s really sick.”
Eric could hear the same concern he felt for Max. “Okay. He is your patient and you know him better.”
“I worry about side effects, too. But we can’t be so conservative that we don’t do right by him.”
“Agree.” They walked ahead to the elevator bank, falling into a companionable silence as they stepped inside the arriving cab, not talking shop because of patient confidentiality. The other employees chattered away, the elevator reached the ground floor, and they left the building and hustled across the street to the strip mall that held the gym, liquor store, Wawa convenience store, and their local watering hole, Thatcher’s, one of the last independents in a world of Chili’s and TGIFs.
Eric took the lead through the glass door, and his eyes adjusted to the darkness. The place was long and rectangular with an old-school wooden bar, but he didn’t see his staff at the bar area, which was crowded with employees from the Glencroft Corporate Center, scruffy middle managers and IT types in logo polo shirts chatting up women with freshened makeup and laminated ID lanyards.
“What a scene,” Eric said to Sam under his breath.
“Suburban singles, eh?”
“Lord deliver me. Stay married, Sam.” They made their way to a restaurant area in the back, and Eric spotted his staff, all of them in their red W lanyards, laughing around a table crammed with chicken wings, fried mozzarella sticks, sliders, and sweating pitchers of beer. Eric realized that his affection for them was tribal. After all, he was their Chief. They all began to look over at him, heads turning, each bursting into broad grins, clapping. He’d warned them not to say anything in public about their number-two status, but he got a better idea.
“Hey, kids!” Eric called out, holding up his right hand and extending the middle three fingers. “What’s this?”
“What, Chief?” one called back. “I don’t know!” another said. A third yelled out, “Are you giving us the finger?”
“It’s a W!” Eric said, laughing. “For Wright because we are Wright!”
“We are Wright, We are Wright, We are Wright!” The staff started cheering, then they dissolved into laughter, speeches, and self-congratulation.
In time, Eric settled ne
xt to Sam, Jack, and David, avoided eye contact with Kristine, drank warm beer, shared mediocre buffalo wings, and entertained his staff with bad jokes, laughing harder than he had in a long time. He noticed Jack flirting with Kristine, their heads bent together, but he looked away. He let himself forget about Caitlin, his lawyer, Max, and even his beloved daughter, and he bought everybody all the food they could eat but only two rounds of drinks. And in the end, he bid them good-bye with a lump in his throat that couldn’t be explained by a few watery beers.
He left the bar and breathed in the warm night air, acrid with cigarette smoke from a group on the sidewalk. It was growing dark, and he crossed the street, slid out his iPhone, and checked the time—8:48—so he had time before he called Hannah to say good night, at nine. He read his email as he walked to the hospital parking lot, a multilevel concrete affair. He reached the first level of the garage and the parking spaces reserved for department chiefs, where he put his phone on lock, slipped it back into his pocket, and dug in his other pocket for his keys.
“Hey, Eric,” someone said, and he looked up, surprised to find Kristine standing beside his car. She looked lovely, even better though her makeup had worn off. She’d had a blazer on at work and at Thatcher’s, but she’d taken it off and had on a black dress that outlined a gorgeous body, with black high heels, which reminded him he wasn’t dead below the waist.
“Oh, hi, Kristine. Didn’t I just leave you at Thatcher’s? How did you get here?”
“I slipped out when you weren’t looking. I wanted to see you. I’ve been trying to see you alone, all month.” Kristine pouted. “I only have one week left on my rotation, but no matter what I do, I can’t get you to notice me.”
“Oh, I notice you.” Eric caught himself. “I mean, I notice you.”
“Then why didn’t you answer my text?” Kristine took a step toward him, meeting his eye directly, her lips parting slightly, curving upward in a sly smile.