Authors: Gini Hartzmark
“What bad things have happened to Laffer?” I inquired. “He was named in a big malpractice suit five or six years ago. Your friend Joan Bornstein handled his defense. It was one of her first big, high-profile trials.“
“What happened?”
“You know that Laffer and McDermott are partners, don’t you?”
“No, I didn’t realize that.”
“It’s not exactly like they’re joined at the hip. They’re both in a practice group with six or seven other surgeons who share office space, cover for each other on vacation, and take turns being on call. All of them take trauma call at Prescott Memorial, as well. Anyway, around that time, McDermott was going through an ugly divorce, and in consequence he was leaning on his partners pretty hard.“
“Meaning?”
“Meaning he was doing a fair amount of drinking and even more feeling sorry for himself. It turns out that wife number two just so happens to be Dale Adelhelm’s sister.“
“Dale Adelhelm the divorce lawyer? They call him the Jackal.”
“Yeah, because he has a knack for picking the carcass clean. Between the two of them they hung McDermott out to dry. The way my investigator explained it to me, Dr. McDermott is going to be the only man in the history of the free world to end up paying alimony after he’s dead.”
“So she took him to the cleaners. What does that have to do with Laffer?”
“One night while all of this was going on, McDermott showed up on Laffer’s doorstep sloppy drunk and crying about all the bad things that his ex-wife was doing to him.“
“And?”
“It was a night that McDermott was on call.”
“And he was drunk?” Claudia wouldn’t have so much as a teaspoon of cough syrup the nights she was on call.
“Shit-faced. So Laffer does his best to be a sympathetic friend, and before you know it, McDermott’s fast asleep on the couch. Laffer covers him up with a blanket and is about to go to bed himself when he hears McDermott’s beeper going off. Now what he should have done is just ignore it and gone upstairs to bed. But I told you he’s a good guy, so instead he calls the page operator and tells her that he’s covering for McDermott.”
“So what happened?”
“The operator tells him there’s a patient being air-evacked to the hospital, a thirteen-year-old boy who’d been hit by a semi. Laffer grabs his car keys and arrives at the hospital at the same time as the boy. The kid’s a mess. He’s covered with blood from head to toe and has several abdominal lacerations, any one of which are deep enough to cause massive internal bleeding. He also has compound fractures of both of his legs—and that’s just what the paramedic tells him in the first two minutes.“
“Did the boy die?”
“Laffer had to operate to remove the spleen and repair internal damage, but he was able to save the other organs. An orthopedic surgeon was called in to set the patient’s legs, and after six hours of surgery, an exhausted Dr. Laffer walked out into the waiting room to tell the boy’s terrified parents that while his injuries had been severe, it looked like there was a good chance that their son would survive.”
“But something bad happened,” I said, not sure I wanted to know what it was.
“The boy died the next day from a massive brain hemorrhage. Apparently when he was hit, his skull had been literally torn lose from the neck, causing him to slowly bleed into his brain.”
“How awful.”
“From the trial transcripts it looks like the experts disagreed about whether Laffer should have known. There was one expert who testified for the defense that even if Laffer had diagnosed the head trauma there would have been no way to correct the problem and save the boy.”
“I imagine the plaintiff’s lawyer had a field day.“
“Absolutely,” replied Elliott, switching quickly to the badgering tone of voice favored by lawyers during cross-examination. “‘You mean, doctor, that you didn’t notice that the poor child’s skull had been separated from his spine?’ ”
“No jury in the world could sit there and listen to a detailed account of what had happened and not want to see someone pay.”
“And that somebody was Carl Laffer.”
“But what you’re saying is that if he hadn’t gone out of his way to protect Gavin McDermott, who’d behaved completely irresponsibly by getting drunk when he was on call, it would have been McDermott sitting there in that courtroom getting his lunch handed to him. No wonder Laffer was so quick to come to Claudia’s defense during the morbidity and mortality conference.”
“Yeah,” agreed Elliott. “He knows what it feels like to have your professional reputation publicly torn to shreds by a bunch of lawyers.”
“True,” I mused. “But what I was actually about to say is that he knows what it’s like to end up being screwed on behalf of Gavin McDermott.”
CHAPTER 20
After dinner I asked Elliott back to my apartment. Even though I did my best to make the invitation sound offhand, I knew I wasn’t fooling anybody. It had taken three years for me to make up my mind. There was nothing casual about it.
If Elliott was nervous, he didn’t show it. Instead, he spent the ride back to my place telling me about the fraud case that had occupied him for so many weeks in Springfield.
“It would actually make a pretty good soap opera,” he began, “at least the civil portion of the case. From the transcripts, the criminal trial actually seemed pretty cut and dried.”
“It was insurance fraud, wasn’t it?”
“Medical insurance. Two obstetricians with an incorporated practice were convicted of defrauding the government of millions by billing Medicaid for tests and procedures that were never performed.”
“But didn’t your client say all along that he didn’t know?”
“He did. But under the criminal statute it doesn’t matter. He was a principal of the corporation and that made him responsible in any criminal proceeding.”
“But not in a civil action?”
“Dr. Butler, our client, was seeking to recover for loss of income and damage to his reputation caused by his partner’s criminal behavior under tort law.”
“Do you honestly believe he didn’t know what was going on in his own practice?”
“If there’s one thing that this case has taught me, it’s that doctors can be incredibly naive when it comes to business,” replied Elliott. “Their whole training teaches them that medicine is far loftier and nobler than the crass pursuit of the dollar.”
“Maybe that’s why they hate managed care so much,” I ventured. “Companies like HCC rub their noses in the dollars and cents of medicine.”
“Oh, I don’t know,” he countered. “It’s not like most physicians have exactly taken an oath of poverty. My client didn’t have any problems taking the money—or spending it as long as it was coming in. He says it never occurred to him to question how, with insurers constantly lowering the ceiling on what they’re willing to pay for certain procedures and their patient population remaining pretty steady, their practice was making more instead of less money.”
“And it really was all his partner’s doing? „
“Apparently the partner was having an affair with the woman who was in charge of the practice’s billing. After the trial she confessed that it was like being given a license to print money. The other doctor actually argued during the civil case that he hadn’t considered what they were doing as wrong. He went on and on about how the government was unfairly forcing doctors to work harder and harder for less and less money. He was just leveling the playing field.”
“I get it,” I remarked, pulling off Lake Shore Drive onto Fifty-third Street. “It’s a variation on the Robin Hood defense. Only instead of robbing from the rich to give to the poor, you rob from the government to keep the rich rich. I take it the jury didn’t buy it.”
“Are you kidding? We had a panel of blue-collar workers and retirees from downstate Illinois. They didn’t have a lot of patience for doctors complaining about how hard they work and how poorly they’re rewarded.”
“And yet, you know, I’ve watched what Claudia’s had to go through for her training, and I’m not sure I’d be willing to go through it if I didn’t know that at the end of the road I’d be making a shitload of money. She and I were talking about it the other night—not the money, but just what she’s had to give up. She’s spent whole years of her life in the hospital, turned her back on anything resembling a normal life, all in order to become a surgeon. I’m not saying it justifies fraud, but I do worry that with the way things are going in medicine, we’re going to end up with too few doctors and too many investment bankers.”
“Now that,” said Elliott, leaning over to give me a quick kiss on the cheek, “is a truly scary thought.”
When I pulled up to the curb in front of the apartment, Leo was there waiting to pick up the car. He seemed ridiculously pleased that I’d brought a man home. When I introduced Elliott, he beamed and pumped Elliott’s hand like the father of the bride.
The movies have ruined so many moments that take place in real life, raising our expectations to impossible levels. But as Leo pulled away from the curb and Elliott slowly enveloped me in his arms, I swear I almost heard the swollen strains of a soundtrack in my head.
I took him by the hand and led him up the stairs to the outer door of the building. There were three doors to go through to get to the apartment, and three locks on each door, so that I had more keys than a janitor. As I fumbled to find the right ones, Elliott kissed the back of my neck, which made finding the keys difficult. We lingered in the vestibule, picking up where we’d left off on the street. By now the old ladies in the apartment building across the street were probably hanging out their windows with binoculars, but I honestly didn’t care. For once I wanted to surrender to the moment.
Eventually we made our way up the vestibule steps through the inside door—more kisses, more keys—to the first-floor landing. During the day, natural light filtered down from the third-floor skylight. At night, glass sconces that had once been illuminated by gas glowed dimly against the dark paneling.
But tonight what the soft light revealed brought me up short. The front door of the apartment was open. Not just unlocked, but ajar. Even Elliott, whose mind was now firmly on other things, immediately grasped the significance of this. Hyde Park is an urban neighborhood and Chicago is not Disneyland.
We looked at each other for a minute, not wanting this to be happening.
“Do you think your roommate might have just forgotten to close it?” asked Elliott, but I shook my head.
I felt sick to my stomach, my fear no doubt magnified by disappointment. All my instincts told me that we’d been broken into. Leo had even told me that there was a burglar at work on the street, and I had stupidly downplayed his warnings. While I dreaded the shambles and vandalism that most likely awaited me inside, I found myself wishing selfishly that I’d suggested that we go back to Elliott’s place and left Claudia to come home and pick through the wreckage. I pulled out my cell phone.
“I’m going to call the police,” I said.
“Let me just go in and check it out,” said Elliott, slipping the Browning from the holster beneath his jacket and flicking off the safety with a practiced hand. “This might be just like the box that was sent to your mother— a message to scare you, nothing more.”
“I’m still not so sure that going in there is such a good idea,” I protested. “I think it’s better to let the cops check it out.”
“Come on, one quick look,” urged Elliott. “It’s probably nothing.” Under the circumstances I couldn’t blame
him
for being less than enthusiastic about waiting for the police to show up.
“I’m going with you,” I said. “If it turns out that Claudia
did
forget to close the door behind her, then I sure as hell don’t want her to drop dead of a heart attack when she sees you creeping around the apartment with a gun.”
“Then stay behind me,” said Elliott, pushing open the door and stepping inside to listen, keeping the gun in front of him and slowly covering the room.
“Claudia?” I called out. “Are you home?”
The only answer was the silence of the apartment.
We stood for a moment in the entrance hall, listening. The light on the answering machine blinked silently from on top of the table in the dark, indicating that we had messages. The living room and dining room lay to our right.
I fumbled for the switch that turned on the lights in the living room and dining room. Both were exactly as I’d left them that morning. I took a deep breath and followed Elliott as he made his way down the long hallway that formed the backbone of the apartment. He stopped at the arched entryway that opened into the kitchen. I had forgotten to turn off the light that morning, but other than my profligacy with electricity, there was nothing else worthy of notice.
Elliott proceeded to work his way toward the back of the apartment. At each doorway he paused while I groped for the light. Then he stepped inside like a character in a TV cop show to check it out. With every room I felt more and more ridiculous. There was absolutely nothing out of the ordinary in the apartment. My dirty coffee cup still sat beside the kitchen sink, and the towel I’d used to dry myself after my shower lay on the floor of the bathroom exactly where I’d dropped it. A copy of
Clinical Anesthesiology
lay open on Claudia’s bed.