The Select

Sometimes they'd study together, holding hands when they weren't scribbling notes or turning pages, but her presence was too distracting for Tim to get much done.

He hungered for her presence. And that baffled him. He'd always been so self- sufficient. Now, when Quinn wasn't around, he felt incomplete. Tim wasn't sure he liked that.

But looking at her face now, at the disturbed and troubled expressions playing across it, he wondered if he'd been wise to include her in the bull session tonight. Her expression drifted toward horrified as Harrison elaborated on his ideas on the formation of a central government authority to oversee the equitable redistribution of medical resources. Tim couldn't understand her reaction. Harrison's plan made perfect sense to him.

'I don't believe you people,' Quinn said when Harrison took a breath. 'You're all talking about 'redistributing' medical care like you're discussing natural resources.'

'A country's medical care is a natural resource,' Judy Trachtenberg said. 'Once of its most valuable resources.'

'But it's not a natural resource,' Quinn said. 'It wasn't sitting underground waiting to be dug up. It's human made. You're not talking about moving lumps of coal or steel around, you're talking about people—doctors, nurses, technicians. I don't know about you folks, but I don't become a national resource just because I've earned a medical degree. I'm not something to be shipped around at the whim of some appointee in Washington. I don't remember signing off my human rights when I became a student at The Ingraham.'

The room was silent. The eight other occupants sipped Pepsi or munched pretzels as they stared at her.

'Easy Quinn,' Tim said.

'No. I won't take it easy.' She was getting hot now. He could see the color rising in her cheeks.

She said, 'Since when are all of you in favor of bureaucrats making medical decisions? What are we going to medical school for? To become glorified technicians? To spend our professional lives taking orders from a bunch of political appointees? 'Here, Brown. Fix this one here but forget that one over there.' They'll shunt you here and shift you there and call you a 'provider' and a 'resource,' but what about the patients?'

The room was utterly silent. Tim saw eight uncomprehending faces staring at Quinn as if she were speaking a foreign language.

'Well,' Harrison said slowly, 'it's because of the patients—for the patients—that tiering is necessary. They can't all receive top-level care, so some will have to be satisfied with second-level care, and some with third-level care. And someone has to decide who deserves what level of care. No one's happy with that, but it's a reality that has to be faced. Hiding your head in the sand won't make it go away.'

The crack annoyed Tim but Quinn simply laughed it off.

'Who's got his head in the sand? You're talking about social engineering. What next? Eugenics? Or maybe a new Master Race?'

Judy groaned. 'We're not Nazis.'

'You know, I wish you'd all wake up and smell the coffee. I mean, don't you think there'll be a temptation for some of us to 'tier' patients according to political, religious, and racial prejudices?'

Harrison cleared his throat. 'I can't see that being a problem for an ethical physican.'

'I aggree,' Quinn said. 'But we're not all ethical—we're human. And we should be treating illness wherever we find it, not just in a select population. That's a God game I don't want to play.'

'But it's going to be the only game in town,' Harrison said. 'That's why it's so important that graduates of The Ingraham go into primary care. That's where the front lines are. That's where we'll be exposed to both the useful and the useless members of society. That's where we can make a real difference. And maybe we can work it so that some of those useless folks can contribute something to society.' He turned to Tim. 'You've been unusually quiet tonight, Brown. Any comments?'

Tim shook his head. 'No, uh...just listening.'

Tim avoided Quinn's eyes but knew she was giving him a strange look.

He deserved it. He felt strange. He'd had the oddest feeling while sitting here listening to the conversation. Schizoid. Dissociated. A deep part of him completely agreeing with Quinn and yet another part tugging him the other way. The only times he noticed this dichotomy in his attitudes was on those rare occasions when he discussed medical politics with Quinn, or when she stopped by the bull session. He'd attributed his attitude shift to the fact that he was now more conversant with the issues associated with the coming healthcare crisis than he had been in September. None of the bull session regulars seemed to differ much on the issue of tiering health care delivery, simply on the mechanics of how to implement it. Quinn was becoming the gadfly, the Devil's Advocate they maybe needed to goad them into examining their premises.

Except no one was examining premises. Tim seemed to be the only one of the group even remotely receptive to Quinn.

But what had rocked Tim back on his heels was Harrison's last statement.

That's why it's important that graduates of The Ingraham go into primary care. That's where the front lines are. That's where we'll be exposed to both the useful and the useless members of society. That's where we can make a real difference. And maybe we can work it so that some of those useless folks can contribute something to society

It had been a typical Harrison statement. That wasn't the problem. The problem was in Tim's head: The same statement -not the same sentiment, the same statement, word-for-word—had gone through Tim's mind in response to Quinn's question.

Almost as if he'd been coached.

Suddenly he wanted out of the session.

Not to walk out. To run.

MONITORING

'Guess who's on his way down,' Elliot said.

Louis Verran looked up from the daily status printout and groaned. 'Don't tell me...'

'Yep.'

'Shit,' Verran said. He wasn't in the mood for Alston tonight. But then, when was he ever in the mood for Doc Tightass? 'All right, pull that last bull session tape. Maybe it'll get him off our backs.'

Alston had developed this thing for the Cleary girl. He'd been on her case and had been dropping by the control room regularly since Thanksgiving, looking for anything and everything Verran could get on her.

'Good evening, gentlemen,' he said, breezing through the door like he owned the place. 'Any new elucidating snippets of tape for me, Louis?'

'As a matter of fact, yes,' Verran said. 'We found some good stuff for you this time.' He turned to Elliot. 'Got that tape cued up there? Let her roll.'

Alston took a seat and cocked his ear toward the speaker, listening intently. Verran listened, too, not so much to the words—he'd already heard them—as to the quality of the recording. Not bad. Pretty damn good, in fact. The kids must have been circled around the mike. Let Alston try griping this time about not being able to understand what they were saying.

Verran didn't record everything. Couldn't, and wouldn't want to if he could. Most of what went on in the dorm was studying and sleeping, the sound of pages turning followed by deep, rhythmic breathing. And when the kids were talking, it was usually about the most trivial, boring junk imaginable. So he sampled here and there. He'd rotate from pick-up to pick-up, eavesdropping from within the rooms or along the telephone lines, listening for anyone who might be talking about The Ingraham, or about any particular staff or faculty member. Happy talk was bypassed for the most part, but gripe sessions were always recorded. And any talk of a potentially compromising nature—sexual encounters, schemes to cheat on tests—was recorded and cataloged and filed away in Louis Verran's personal J. Edgar Hoover file...just in case.

The roving bull session tended to be as boring as all the other talk, except when a couple of them disagreed and got real pissed, but that only happened between newcomers early in their first year. After they'd all been here awhile, not only did the disagreements rarely get vehement, they rarely happened.