“Right. So tell me!”
“I’d have to say he got the maddest when he was talking about the lack of a resident history and physical because the resident was backed up. Dr. Mason is one of those old-school surgeons who is convinced we residents today have it easy while he and his contemporaries worked themselves to the bone.”
Ava nodded. “I know the type. But it is interesting that he would zero in on that issue. I think that is important to remember. What else did he get mad at, specifically?”
“When I questioned him if he had personally examined the patient.”
Ava laughed. “Knowing what we do about his temperament, are you surprised such a question made him angry?”
“I suppose not,” Noah admitted, smiling in the face of Ava’s laughter. In retrospect, he lambasted himself for not being more circumspect. He should have worded the question to Dr. Mason differently so it wouldn’t have been interpreted as being critical. When dealing with a narcissist it is crucial to avoid any suggestion of blaming. “I was trying to be diplomatic but failing.”
“I’d say!” Ava responded. “Tell me this: Did he bring up again any nonsense of you being responsible for the death since you put the patient on bypass?”
“No, he didn’t.”
“At least that’s reassuring,” Ava said. “I’m starting to get an idea of how you should present this case.”
“Really?” Noah questioned. He sat up straighter. She was impressing him again, and he was eager to hear what she had in mind.
“Keeping him from getting mad is going to be key,” Ava said. “That’s number one. Number two, you have to steer the discussion away from the concurrent-surgery issue. That’s mainly for your sake. And number three, you have to avoid the issue of Anesthesia, meaning me, supposedly making the wrong decision about spinal versus general anesthesia.”
“That’s easier said than done,” Noah complained. “The facts are facts. I can’t change them.”
“What you will have to do is keep away from the troublesome facts. For instance, there is no reason to mention that the patient had been under anesthesia for an hour or more. As bad as that was, it didn’t contribute to the death. Instead, emphasize the two points Dr. Mason is most emotional about — namely, the lack of a resident H&P and that the patient ate a breakfast that Admitting didn’t uncover. If you are clever and mildly verbose, those two issues could be an hour discussion in and of themselves. Tell me! How many cases are scheduled for the conference?”
“Five so far,” Noah said. “There could be more.”
“Perfect,” Ava said. “Listen! Save Vincent’s case until last. Since the M&M has to be adjourned in an hour and a half without fail since surgery is scheduled and everybody has to get to the OR, you can run out of time. What do you think?”
Noah toyed with his food while he pondered Ava’s suggestion. The more he thought about it, the better he liked it, because it could work. The scheduling of the presentations was totally up to him. He had initially thought of doing the Vincent case first since there was so much interest in it, but there was no reason he couldn’t do it last, and if no one knew it was going to be last, no one, like Dr. Hernandez, could complain and try to change it. There was a good chance that whatever the discussion was, it could be prematurely terminated.
“I think you have some good points,” Noah said.
“I do, too,” Ava agreed. She picked up her wineglass and motioned with it toward Noah. They clinked glasses. “We have a few more days to plan, but I think we’re making headway. To your success!”
After getting the serious stuff out of the way, Ava and Noah switched to more lighthearted banter as they finished their dinner and cleaned up the plates and flatware. Ava dominated the conversation, since she was full of stories about her recent travels and athletic episodes, such as her latest bungee-jumping excursion. Noah had been amazed to hear that she had flown all the way to New Zealand to do it, although she also used the trip to scuba-dive in shark cages off the southern coast of Australia. Noah was fascinated but also intimidated, as it made his life seem all that more insular and hospital-bound. The last trip he had taken had been more than two years ago, and only to New York City. He’d gone with Leslie to see a play, and only for a single Saturday night. At the time he had been reluctant to go, since he had several patients he’d operated on in the hospital. Although he had arranged for people to cover for him, it didn’t seem right, since he couldn’t help but put himself in his patients’ shoes.
“How about we head up to the study and relax?” Ava offered when the kitchen was back to spic-and-span. “We can have a cordial if you’d like.”
“Thank you, but I think I’ll pass on the cordial. Sorry. Two glasses of wine are enough for me.”
“Hey, don’t be sorry. I’m impressed with your self-restraint. Your dedication is awe-inspiring. I’d want you to be my doctor any day.”
“Thank you,” Noah said.
While trailing Ava as they headed up the second flight of stairs from the kitchen level, Noah worked up his courage to ask: “Hey, do you take your trips solo or with friends?” He made it sound as if the idea just occurred to him, whereas he’d been wondering about it since he’d heard about all her travels the previous evening. He didn’t know what answer he wanted to hear.
“It depends,” Ava said. “My fun trips like to New Zealand and the previous one to India I went alone. With my business travel, I’m usually accompanied.”
“Seems to me it would be more fun the other way around,” Noah said.
“You have a point,” Ava said. “Are you interested in going with me when I go back to New Zealand for a repeat bungee-jump?” She laughed in her unique and charming fashion.
“I wish,” Noah said. “If you don’t mind my asking, are your business trips because of your nutrition background?”
Ava stopped several steps short of the landing outside the study and turned around to face Noah, who was forced to stop as well. She was smiling, but her tone was accusatory. “Have you been spying on me?”
“In a fashion,” Noah confessed. “I looked at your LinkedIn page. I was impressed that you majored in nutrition. I think it is a neglected area of expertise when it comes to doctors.”
“I agree,” Ava said. Her voice had returned to normal. “That’s why I chose it as an undergraduate major. But to answer your question, my business trips do involve my background in nutrition, at least indirectly.”
Ava didn’t elaborate, but rather turned back around and continued up the stairs. Noah followed her into the study. He was dying to ask her more about her business, which he assumed had to be remarkably successful, but he felt reluctant. He didn’t want to push it. While she went over to get a bottle of Grand Marnier and a glass from a bookshelf, he took the same velvet club chair he’d occupied the night before. He watched her, fascinated by the way she moved, which was accentuated by her flared dress. He was hypnotized by her entire persona.
“Are you sure you don’t want just a nip?” Ava said, holding up the liquor bottle in Noah’s direction. She took the other club chair.
“Thank you, no,” Noah said. “I also visited your Gail Shafter Facebook page and the fan page. I was truly amazed at the number of your followers.”
“I have to admit I have a lot of fun with it. I’ve even gotten some offers to advertise products.”
“Have you done that?” Noah asked.
“No, I haven’t,” Ava said. “I do it for pleasure, not for business.”
“I got a chuckle when I saw that Gail Shafter endorsed you on your LinkedIn page.”