“Which is why he has earned the nickname ‘Wild Bill,’” Noah said.
“Precisely,” Ava said. “He is a walking time bomb.”
Noah found himself nodding in agreement. What Ava was putting into words was exactly his take on Dr. Mason and the reason he was terrified about the upcoming M&M Conference. There was no doubt in Noah’s mind he was going to be in the unstable man’s crosshairs.
“Unfortunately, I am one of those people who have insulted him,” Ava said.
“Literally?” Noah asked with astonishment.
“No, not literally,” Ava said. “He has tried to come on to me multiple times. He has even called me twice here in my home in the evening, asking to come over with the excuse that he was in the neighborhood and wanted to talk about a patient. I have never been interested in a social relationship with anyone at the hospital, much less someone like Dr. Mason. There was no way I was going to allow him into my life, especially with him being married on top of everything else. I’ve tried to be diplomatic, but it’s hard, because he is so cocky and insistent and incapable of taking no for an answer. I am sure he has taken my continued refusal as an ongoing insult, especially now that he is backed into a corner with this Bruce Vincent case and needs a fall guy or girl.”
“I’m sorry,” Noah said.
“No need for you to be sorry,” Ava said. “The biggest worry for me is that Dr. Mason and Dr. Kumar are really buddy-buddy. I don’t want to lose my job, which might happen if Dr. Mason manages to blame the Vincent death on me. Losing my job would be a personal disaster. From my first year in medical school, it has been my dream to be on the BMH staff.”
“I’m sorry, because it is sexual harassment,” Noah said.
“I agree. Thank you for recognizing it.”
“What I find ironic about your story,” Noah said, “is that the main reason Dr. Mason dislikes me also has a romantic element.”
Ava’s mouth dropped open, and she stared back at Noah in shocked surprise.
“Wait a second!” Noah said, holding up his hands as if to ward off an attack. He laughed. “Don’t get me wrong. There’s no potential romance between Dr. Mason and me.”
“Okay,” Ava said, regaining her composure. “I don’t mean to jump to conclusions, but I suppose you are aware there have been some rumors about you and your social preferences. You are considered a very eligible bachelor, but it is noticed you don’t flirt with any of the available OR women.”
“I’m aware of the rumors, and it doesn’t bother me,” Noah said. “I’m not gay, not that anything would be wrong if I were.”
“Fair enough,” Ava said. “You said Dr. Mason doesn’t like you: explain. I mean, it is common knowledge that you are considered one of the best residents at BMH.”
“Do you remember Margery, or Meg, Green? She was a surgical resident almost three years ago.”
“I remember her,” Ava said. “What about her? As I recall, she left rather suddenly.”
“She certainly did,” Noah said. “She was dismissed from the program. What no one knew was that she and Dr. Mason were having some sort of an affair. The full details were never revealed, but it had to be the case.”
“She was dismissed because she was having an affair with an attending? That doesn’t seem right.”
“No, the affair aspect came out after the fact. She was dismissed because she was abusing opioids, and I was the person who outed her. I was the messenger, so to speak, and Dr. Mason has never forgiven me. Ergo, I’m terrified I’m going to be the messenger again at the upcoming M&M. I want to avoid antagonizing Dr. Mason as much as I possibly can. But it is going to take some planning and diplomacy because I think you are right: The two people mostly responsible for Bruce Vincent’s death are Dr. Mason and the patient.”
“Okay, I understand where you are coming from,” Ava said. “What it boils down to is that ‘Wild Bill’ is not fond of either of us.”
“I’d use a stronger word for his opinion of me,” Noah said. “And what makes that so worrisome is that he is an associate surgical residency program director. As vindictive as he is, I would not be surprised if he tried to get me fired.”
“I don’t think you have to worry about that,” Ava said. “You are much too respected by everyone else.”
“I know that is the case generally,” Noah said. “But it doesn’t make me feel any better. Unfortunately, I’ve had a rather exaggerated fear of authority figures for as long as I can remember, particularly once I decided I wanted to be a surgeon way back in middle school.”
“And you see Dr. Mason as an authority figure?”
“Certainly,” Noah said. “He’s definitely an authority figure.”
“If you don’t mind my asking, did you have issues with your own father?”
“My father passed away when I was in high school,” Noah said.
“Now, there is a coincidence,” Ava said with a slight, disbelieving shake of her head. “So did mine.”
“I’m sorry,” Noah said.
“I’m sorry, too,” Ava said.
“Well, let’s get to the topic at hand and talk about specifics,” Noah said. “Just so you know, I have gone through Bruce Vincent’s EMR, and I have spoken with all the key people except Dr. Mason. The wimp that I am, I am leaving that ordeal for last.”
“That’s smart,” Ava said. “Having a conversation with him might turn out to be as difficult as the M&M itself.”
“That’s exactly how I see it,” Noah said. “I’ve got to be prepared for both. What I need from you is anything at all you might feel is important that I might not have gotten from other sources.”
Ava thought for a moment, pursing her lips. “You noticed there was no resident history and physical in the EMR.”
“Of course,” Noah said. “Martha Stanley explained to me that the resident was backed up when Mr. Vincent showed up forty minutes late.”
“And you noticed that in the history and physical that had come from Dr. Mason’s office, there was no mention of reflux disease or obstructive symptoms from the hernia.”
“Well, that is not entirely true,” Noah said. “Both were mentioned.”
“They weren’t,” Ava said with sudden emotion bordering on anger.
“They were, but they were added after the fact,” Noah said. “I could tell because they are in a different font than the rest of the H&P. I think they were added later to cover up that the H&P was one of those copy-and-paste jobs off the Internet.”
“Good grief!” Ava exclaimed. “This case keeps getting progressively worse. Do you think Dr. Mason did it?”
“I can’t imagine,” Noah said. “He certainly would know better. I think it had to have been his fellow, Aibek Kolganov. I can’t talk to him because he has already gone back to Kazakhstan. But if the issue comes up, which will not come from me, I will blame him.”
“That might be helpful,” Ava said.
“It would be a way of diverting blame from Mason, even though he is ultimately responsible for his fellow’s actions.”
“Maybe you should bring it up at the beginning of the discussion,” Ava said. “Since the hospital attorneys would want to stop any talk about it because of the malpractice implications, Dr. Hernandez might insist on moving on to the next case.”
“The discussion will surely not be restricted to that one issue,” Noah said. “There are too many others that are glaringly important. Case in point: the patient’s unknown history of reflux disease. Did you actually question the patient whether he had reflux disease?”