Trim and tall, Kim was cursed—as far as Sister Eileen was concerned—with more than the average Oriental inscrutability. He had come to Detroit and St. Vincent’s from Chicago, where he had interned at an even poorer hospital than St. Vincent’s. Chicago had been his first step after leaving his native South Korea.
Chicago had recommended him as having impeccable credentials and as specializing in general surgery. At St. Vincent’s he was expected to soft-pedal his specialty in favor of doing a bit of everything. Interns and residents all were expected to do a bit of everything.
There was no doubt in anyone’s mind that Dr. Lee Kim had definite plans and a timetable in which to accomplish his objectives.
One of those objectives most definitely was to not linger overly long at St. Vincent’s. Kim planned to move up and out of Detroit. In which direction, initially, was not of prime importance.
Kim crossed his legs. He exuded confidence. His performance deserved an award; in reality, he was not all that confident. Inside, he was a nervous wreck. He was well aware of his problem. His enemy was time. He had too little of it.
By his timetable, he should have been long gone from St. Vincent’s. Every time he walked its ancient halls, he was reminded that this institution had gobbled up any number of doctors in its time. It could too easily happen to him.
Look what had happened to Fred Scott, Kim’s superior in Emergency. Kim both admired and despised Scott. Scott was the most amazing technician Kim had ever experienced in emergency situations. At the same time, Scott had let his remarkable skills take root at St. Vincent’s. Kim’s greatest fear was that the same thing would happen to him. That years from now, he would be mired in Detroit’s core city in a health-care facility that should have closed its doors decades ago. He would still be patching stab wounds and removing slugs from people who’d been fighting over the final swallow of cheap wine. Still be exposed to their vomit and feces.
So, he tended to hurry things along. He really couldn’t help himself. It was late. Late in his ball game.
He hurried things along. Sure he didn’t spend a lot of time with the immediate families of terminal patients. It was, after all, up to them to inform themselves of their options. Surely they’d seen enough movies and television to know what life-support systems were all about. If they wanted their kin to be maintained in a vegetative state, what concern was it of his?
Same with the whores who were forever getting pregnant. Too dumb to stay on the Pill. Just as likely to pull out their IUDs as their tampons. Counseling was a waste of time. Far easier to scrape out their prematurely tired uteruses, and the fetuses in there as well. The dumber ones you could always badger into agreeing to a hysterectomy. And while that could be time-consuming, it was good practice.
Time was better spent being in the right places, being seen by the right people, talking to the movers and shakers of the local medicine scene, brown-nosing them. The big thing is to get St. Vincent’s behind you. Get into the real world of the Caddies, country clubs, influential patients. And get there yesterday. Time was an enemy.
The other enemy, perhaps even more threatening than time, was sitting across from him. Sister Eileen Monahan. He knew she had her suspicions. He was also pretty sure that she had no proof. Without proof, she would never bring him up on charges. Which didn’t mean she didn’t want to get him. Only that, for now, she couldn’t.
But he also knew that the very instant she could, she would get rid of him. And then where would he be? Dismissed from St. Vincent’s! Who would consider him after such degradation?
That was why he was in such inner turmoil. He had no way of telling what she knew. He would soon find out. Meanwhile, it was crucial that he present a calm and tranquil exterior.
They sat across from each other for several moments in silence, each measuring the other.
Eileen opened a file folder and began paging through it. Kim shifted in his chair. It was increasingly difficult to retain an unruffled exterior.
“Dr. Kim,” she said at length, “is all going well for you here at St. Vincent’s?”
“As well as can be expected.” He was pleased to use the bromide response traditionally given in hospitals to almost any question.
Eileen smiled tightly. “And how ‘well’ may we expect that to be?”
“I have no complaints.” Pause. “Have you?”
Pause. “Doctor, when you came here from Chicago last year, we had a long talk.”
“I remember it well.”
“Good. Then you’ll recall that I spoke at considerable length about the spirit here at St. Vincent’s.”
He did remember it well. At the time, he had thought her a bit over-age to be a cheerleader. “May I again remind you,” Eileen continued, “that this is only a small health-care facility, in precarious financial balance at best. So much so that, in order to survive, we must work together in a spirit of trust unequaled in most similar institutions. We lack the numerical strength to carve out a niche for ourselves and bury ourselves in some specialty. But, most of all, among the capabilities we lack—and I wish we could afford—is we have no ‘watchdog’ committee to police our operation. So, to a greater extent than most health-care facilities, we must function on an honor system. We must police ourselves.”
“I remember all of that very well, Sister.”
“As you complete your first year of residency, Doctor, I thought it would be good to evaluate your position here.”
“Have there been complaints? Has not my work been satisfactory?”
“Satisfactory? Technically, yes. Every evaluation of your work has been more than satisfactory. In emergency situations and particularly in the OR, you are reported to be calm under fire and a gifted surgeon.”
“Then all is well.”
“Not quite. And this is not merely hearsay. It’s your attitude toward people. Toward patients and their families.”
“Attitude?”
“I know that’s difficult to define. For one thing, among our patients, an unusually high percentage of those on life-support systems are yours.”
“Without the systems, they’d be dead now.”
“With the systems, they are already dead now, for all practical purposes.”
“If it is the cost of maintenance—”
“Of course it isn’t the cost. No more than it would be in any other hospital. If someone’s life can be prolonged for any positive purpose, then of course we must do everything we can. But many of your patients are vegetating. Many have reached a terminal state even as you order procedures to begin.”
“If the wishes of the family—”
“I know all about the wishes of the family. And I’ve heard about your routine in getting their consent to put the patients on the machines.”
“Is there anything medically improper in all this?”
“Not technically. But one tends to wonder why so high a percentage of the families you talk to decide that we must, in your phrase, ‘do everything.’ One wonders if you are doing this just to save yourself the time it would take to sit down with the families and explain the options available to them.”
“Sister, do you not think your conclusion is a bit farfetched and rather unsubstantiated?”
“All by itself, perhaps. But then we have your rather cavalier attitude towards D & Cs.”
“What do you mean by that?” He knew she was coming close to pay dirt.
“The word I get—”
“From whom, may I ask?”
“We won’t get into that just now. These are not formal charges.”
He breathed a bit more easily.
“I’ve heard that you frequently don’t even order a pregnancy test when it is called for, before going right into a D & C,” she continued, “and there are times that you’ve removed a fetus.”
“That is not unique.”
“It isn’t unique unless it happens again and again. Then it’s another name for abortion.”
“Do you not think that is a bit strong, Sister?”
“No, I don’t. And you well know our policy on abortion at St. Vincent’s.”
“I see.
“Is there anything else on your mind, Sister, before I reply to all this?”
