An illegal immigrant had come to the emergency room from one of the glitzier suburbs, brought by a woman still in her high-end tennis outfit. To save a few bucks, she had picked him up after practice from among the milling day laborers outside the big-box home improvement store. He was standing on her ladder, scooping leaves out her gutter, when he leaned too far and fell. His feet had apparently hit the boxwoods, flipping him backward. His head hit the patio flagstones, knocking him unconscious. The woman had driven the man to Chelsea General. Henry Ford was closer, but she apparently thought all indigent cases went to Chelsea General. Also, she thought St. Joseph’s was too close to home. That’s where she went. Day laborers went to Chelsea General.
A scan in the OR revealed a large blood collection on one side of the man’s head. Hooten couldn’t believe it. Here he was talking to a man about a gift that could transform Chelsea General and, with some luck, make a major breakthrough in some of the most heartbreaking neurological diseases—and he was called out to serve as the surgical equivalent of a glorified can opener. Hooten excused himself and spent ten minutes without success trying to find another neurosurgeon to do the operation.
“Eaton, I’d really like to continue our conversation. Can I talk you into relaxing up here for about twenty minutes. I’ve got a quick case.”
“Sure thing, Harding. If I can convince your secretary to find me a cup of coffee. Can’t go an hour without a caffeine fix. Terrible.”
Hooten stepped into the large bathroom connected to his office and changed into his scrubs. He walked fast to the OR, still irked that he had to leave Eaton Lake hanging in his office while he had to handle this mindless case.
When he arrived at the OR, the anesthesiologists had already inserted a breathing tube and were patiently giving anesthesia. Hooten took a quick look at the scan, grabbed a razor, and began shaving the left side of John Doe’s head, or, as the circulating nurse called him, Juan Doe. No time for a shaveless operation this time, he thought. Satisfied, Hooten told the nurse to prep the head. He stepped out of the OR to wash his hands.
A pair of vascular surgeons were walking by.
“Hooten, what a surprise.”
“Didn’t think you could find the OR without a guide.”
“I can’t believe you’re not wearing a tie with those scrubs.”
“I didn’t realize it was comedy hour at Chelsea General,” Hooten said as calmly as possible. He didn’t want to let on that their gibes got under his skin this time, although he knew full well that the OR was its own universe. The normal protocol and pecking orders were set aside. It was the great equalizer. Status didn’t matter. What counted were hard work and good technical skills.
Hooten worked quickly, cutting the skin and removing the bone. As soon as the bone came off, Hooten knew something was terribly wrong. The brain looked perfectly fine. No blood. No swelling. Nothing. Hooten began to panic. He ran over to the light box.
“These scans. They’re up backward!”
“Most doctors check the scan themselves,” the circulating nurse said.
Hooten was breathing rapidly, almost hyperventilating. He felt as though he might go vasovagal any second and keel over. This could not be happening. The chief of surgery had just committed a cardinal sin.
The
cardinal sin. He had operated on the wrong side of the head.
Hooten rushed back to the patient and started putting the bone back. He was shaking. He needed to flip the man as quickly as possible and remove the blood, but he had lost precious time, time that would cost the man dearly.
T
he Karmann Ghia had seemed like a good idea when Villanueva handed over a cashier’s check for fifty-five hundred dollars. He figured the vintage roadster would be a chick magnet for Nick.
The kid needs to get laid
, Villanueva thought. Standing behind the car, getting ready to give it another push, the big man was having second thoughts.
“When I say go, you pop the clutch and give it some gas.”
“Okay, Dad,” Nick said.
Villanueva had come up with the idea for the car in a flash and found an advertisement in the
Detroit Free Press
classifieds:
1971 Karmann Ghia. Mint Condition. Low Miles
. A friend growing up, Eric Ramirez, had a Karmann Ghia, a red one, and he got more ass than a toilet seat. Villanueva borrowed it once, but he just looked like Magilla Gorilla squeezed into the low-slung roadster.
Villanueva was smitten with the little car the moment he laid eyes on it. It was a shade of green no company would dare paint a car anymore. The man selling the car called it “Willow Green” as he ran a loving hand along the roofline. Looked more like the color of the kitchen linoleum in the apartment he grew up in. Also, the car had wood paneling on the inside.
Even after Villanueva said he’d buy the car, the seller needed to spend another twenty minutes talking about how the upholstery was original and how much work it took to get the original paint color restored with rubbing compound, polishing compound, and wax. The man lived in a small ranch house west of Detroit. Villanueva didn’t even know where the town was until he Mapquested it. Then he called a cab to take him there, so he could drive the car home.
T
he seller was in his late fifties. He wore jeans and a flannel shirt and had a twitch in his left eye behind a thick set of glasses. He looked as though he had shaved for Villanueva’s visit but missed a spot just below his jawline, leaving a small line of gray whiskers alongside the raw skin. Also, the man couldn’t take his hands off the car. He stroked it like a beloved pet. Villanueva almost asked the guy why he was selling the car if he loved it so much, but he figured that would be inviting at least a thirty-minute sob story, and the last thing in the world he wanted was to see this man cry. He wanted to buy the car and be gone. Villanueva couldn’t wait to see the look in Nick’s eyes when he handed his son the keys. When Villanueva gave him the cashier’s check for the asking price, the man took the check almost reluctantly.
Nick’s reaction had been everything Villanueva had hoped for. The soon-to-be-sixteen-year-old lit up at the sight of the car even before learning that it was his. Of course, he only had a learner’s permit and would have to wait several months before he could drive it legally without an adult along. Now, though, less than an hour after George gave Nick his first lesson on driving a stick, the engine was no longing turning over. George knew if he could just get the car moving, he could have Nick release the clutch, and the car would start. “We’re going to give you a lesson on how to pop the clutch,” George told his son cheerfully.
T
he Big Cat didn’t give a second thought to who should be pushing and who should be sitting in the driver’s seat. The first couple of times, Villanueva had leaned his enormous bulk onto the low trunk of the Karmann Ghia to get it moving, Nick had popped the clutch but forgotten to give the car any gas. It had chugged once or twice and died.
Now Villanueva churned his legs again, picking up speed. He enjoyed the sensation of the little car giving way to his force. He felt as though he were twenty years old again and pushing a blocking sled at Michigan, his fellow linemen at his side, the offensive line coach riding the sled and exhorting them to work harder. Villanueva’s enormous legs moved faster and faster over the asphalt, and Nick popped the clutch and hit the gas. The roadster coughed and jerked forward.
Even as he saw the car sputter away in a cloud of exhaust, Villanueva started to feel pressure in his left arm and his chest. The crushing pain of the heart attack came on so suddenly his brain was tricked into thinking Nick must have put the car in reverse and hit him. It was worse than any forearm shiver. Worse than lying at the bottom of a goal-line pileup. As Nick drove off, oblivious to the catastrophe unfolding behind him, the big man stumbled and fell, facedown, his right fist balled up. Villanueva did not hear his son return, or his frantic exhortations for him to wake up, or the hysterical call to 911, or the arrival of the paramedics, who tried to jump-start him the way he and his son had attempted to jump-start the car. He did not hear the wail of the ambulance as his massive, prone form sped toward Chelsea General, nor did he hear the wail of his son in the emergency room when he was pronounced.
H
ooten skipped the bird-watching and headed straight for the hospital at 5
AM
. He didn’t want to make a big deal about vacating his office, nor did he want some sort of funereal procession of colleagues coming by to wish him well, none of them daring to mention the horrible mistake that had precipitated his sudden departure. The silence would hang over the room like a suffocating gas.
Hooten wished someone would have the nerve to bring it up, to rebuke him, accuse of him of hypocrisy for all the times he’d made junior surgeons squirm for less egregious lapses. Hooten wished he could stand in front of his colleagues and own up to his mistake at M&M instead of slinking out under the cover of darkness.
The hospital’s lawyer said he did not want Hooten to linger, a lame duck and a legal liability. Hooten threatened to stay, to ride it out, but he knew he needed to step down. Somehow, the case had made it into the
Free Press
and was picked up by the Associated Press, illustrating the desperation of the undocumented, dying for five dollars an hour. The story ran in papers across the country, a black eye for the hospital that Hooten had worked so hard to better.
As a final act to show he retained a shred of control, Hooten threatened an age-discrimination lawsuit until the hospital granted his one wish. Smith and the board reluctantly agreed, and for that Hooten was grateful. The hospital would be a better place as a result.
“Maybe it’s for the best,” Martha had said when Hooten had confessed what he’d done. He’d been sitting on the side of the bed, staring at the carpet, crying like a schoolboy. She’d put her arm around his shoulder. He shrugged it off.
“Tell it to that worker on life support,” Hooten said. The patient had survived the operation, but he did not wake up. A ventilator breathed for him while the Mexican consulate tried to learn the man’s identity. The time Hooten wasted opening the wrong side of the head cost both men the rest of their lives. Hooten did not think he deserved affection. He felt a deep rage at how his reputation could be lost in an instant. He was the surgeon who operated on the wrong side of the patient’s brain. Everything else he did was now a footnote. Oh, and he worked for more than twenty years to improve the quality of care at Chelsea General.
Hooten would walk out of the hospital and not look back. Martha had been urging Hooten to retire for the last year or two. Martha had lost two of her close friends in quick succession, one with a heart attack and the other to ovarian cancer. She was keenly aware that their time together in the golden years was not guaranteed.
Hooten would get his chance to say good-bye to his friends and co-workers. They’d hold a retirement dinner for him. He was sure of that. They’d probably choose a restaurant rather than one of the hospital’s function rooms, at the lawyer’s suggestion. And they’d probably hang his portrait in the hospital’s main entrance as was customary.
Hooten used the electronic key to unlock the car, and the accompanying beep startled a mourning dove. The bird flew in a straight line from the underbrush into the low branch of a pine, its wings whistling as it flew.
As he drove to the hospital, Hooten thought how this would be his last trip there. The route seemed new. Along one stretch, he saw a law office he’d never noticed before. It was in an old Victorian house. The sign out front said
O’BRIEN AND SHEA
. Had that been there all along? He must have been thinking about the hospital. Hooten tried to use this observation to cheer himself up. Surely, as one door closed, another opened.
At the hospital, someone had set a stack of flat boxes outside his office. Hooten got to work. He boxed the framed pictures, the diplomas, the honorary degrees, the medals, and the knickknacks. He had an ornate set of chopsticks he’d received when he spoke at Osaka University. There was a Buddha he’d picked up in China, and a beer stein he’d bought in Germany after a conference at the Max Planck Institute. He stared at his Mark Roth
Untitled 1964
painting for a long time. Despite its mystique, he had always known what it meant for him. A gray rectangle inside a black space. All of his life, he had lived in the smaller, brighter inner box, protected from the blackness that surrounded most people. He worked hard to get there, always knowing that in a split second he could find himself outside, looking in. It had happened. The blackness was now surrounded by gray. He also looked at the picture of the scarlet ibis. Maybe it was time to finally take Martha to South America and find the rare bird for himself. “Bad things happen to good people,” he muttered to himself. Hopefully, the people at Chelsea General would learn from his terrible mistake, and it would never happen again. Hooten was always still the teacher, even as he was summarily dismissed from his post as chief.
It was surprising how easy it was to pack a lifetime’s memorabilia. He had all his things boxed before seven. J. J. Jerome leaned into the office as though he had just happened by.
“Morning, Dr. Hooten. You need some help carrying boxes?”
“Yes, thank you, Mr. Jerome.”
Jerome wheeled in a hand truck and stacked the boxes. One remained.
“I can come back and get that one, Dr. Hooten.”
“I can manage.”
Hooten bent down, lifted the box, and headed for the door. Jerome started following but stopped.
“You forgot a picture, Dr. Hooten.”
Hooten wheeled around. There on the shelf overlooking the desk was a picture of Hooten next to Dr. Sydney Saxena. They were both smiling, standing in identical poses, hands clasped in front. The hospital had taken the picture three or four years earlier after Hooten presented Saxena with the Julian T. Hoff Outstanding Young Professor Award.