When the hospital elevator arrived on Stanhope 3, Noah got out. As he hurried along the administration corridor, he checked his watch. He still had a full five minutes before the scheduled 4:00 meeting.
It turned out that Dr. Kumar was about twenty minutes late, but he was gracious about it. He came directly over to where Noah was waiting in a common waiting area and apologized. He explained he’d been called in on a problematic cardiac surgery case and had come down as soon as he was free. Noah assured him there was no problem, explaining he’d enjoyed the brief respite from a typically busy day. Dr. Kumar then led Noah into his office, the decor of which had an Indian motif. There was a collection of framed Mughal miniatures on the walls.
“Please have a seat,” Dr. Kumar said in his charmingly melodic Indian accent. He was dressed in a long white coat over scrubs that emphasized his darkly burnished skin tone. He went around and sat behind his desk, putting his elbows on the surface and clasping his hands below his chin.
“I assumed when you requested this meeting that the subject would be Dr. Ava London,” Dr. Kumar said. “That’s why I thought it best to meet down here rather than upstairs. Let me say at the outset, there is no need for you to worry about her tenure here at BMH, despite Dr. Mason’s recent comments. He is a passionate man, but I have spoken with him about Dr. London since his outburst at the M&M, and I believe he feels differently now. Does that put your mind at ease? And, by the way, I believe you handled both M&M conferences superbly, from the Anesthesia Department’s point of view.”
“Thank you,” Noah said. “I tried my best to present the facts.”
“You did a superbly diplomatic job.”
“I thank you again,” Noah said. “I did want to talk with you about Dr. London, but for a different reason.”
“Oh?” Dr. Kumar questioned. He visibly stiffened. His clasped hands lowered to the desk surface.
“There were a few aspects of Dr. London’s performance that I did not mention in my presentations but which I feel is my ethical duty to bring to your attention.”
“I’m listening,” Dr. Kumar said, with his voice changed. It had hardened a degree, but Noah pressed on.
Noah started with the Gibson case, followed by the Harrison and then finally the Vincent, describing in as much detail as possible his mild, and purely subjective, misgivings about Ava’s performance. When he was finished, a heavy silence reigned. Dr. Kumar stared back at him with his penetratingly dark, unblinking eyes, making Noah uncomfortable. The man had not shown any reaction during Noah’s monologue.
Noah felt an irresistible urge to add: “With the Gibson case I was directly involved, meaning I saw the situation. With the other two cases, what I’m relating is hearsay from a circulating nurse or Dr. London.”
When Dr. Kumar still didn’t respond, Noah said: “My motivation for coming to you is for you to hear my concerns and either substantiate them or dismiss them as you see fit. I haven’t said anything to anyone else and don’t plan to do so.”
“I find this all very troubling indeed,” Dr. Kumar snapped. “These are all very vague and, as you say, subjective observations. Our department and I have looked into these three cases with close attention to detail and found nothing wrong. If anything, Dr. London handled them very appropriately, if not superbly. Consequently, I can’t help but take your comments as a value judgment of my leadership skills and my competence as an administrator, since I was personally responsible for hiring Dr. London.”
Noah was flabbergasted. Instead of being thankful of his efforts, Dr. Kumar was taking his visit as a personal affront.
“There is only one question about Dr. London’s résumé,” Dr. Kumar said angrily, “and that is that she trained at a new, relatively unknown institution. But because of that, I and the faculty hiring committee went over her application with great care. And something else you might not know: Dr. London scored remarkably well on her anesthesia boards, both written and oral. I spoke to several of the examiners directly. She’s also passed muster with the Massachusetts Board of Medicine.”
“I certainly knew she had passed her anesthesia boards,” Noah said. “And I had heard she had done exceptionally. I am not surprised. She knows the science remarkably well.”
“We wouldn’t have hired her otherwise,” Dr. Kumar said with obvious annoyance. “And let me say this: If you continue to defame Dr. London by talking with others about these unsubstantiated and, frankly, vague impressions, you could be putting yourself and the hospital in a difficult legal situation. Am I making myself clear?”
“Perfectly clear,” Noah said. He stood up. It was painfully obvious that coming to Dr. Kumar had been a big mistake.
“Dr. Mason told me that it was his impression that you and Dr. London were having an affair,” Dr. Kumar added. “Is that now on the rocks, and are you coming to me out of spurned lover’s spite? Honestly, that’s what it sounds like.”
Noah stared at the Anesthesia chief with total disbelief. It was such an outrageous idea that Noah suddenly questioned if Dr. Kumar himself was a spurned lover of Ava’s. And what about Dr. Mason? Could his anger be from spite based on more than just having his advances rebuffed? From the little Noah had told Leslie about Ava, she had classified Ava as a manipulative person with a possible personality disorder. Could Leslie be right? Yet the moment the shocking idea of Ava’s possible promiscuousness occurred to him, Noah immediately dismissed it out of hand, sensing his paranoia was running away with itself. Dr. Kumar was not behaving like a spurned lover in the slightest. He wasn’t putting Ava down but rather the absolute opposite. He was truly convinced of Ava’s competence, as well as his own leadership abilities for having hired her. And it was his leadership that Noah was challenging by voicing his misgivings.
“My only motivation is my ethical duty,” Noah said. The last thing he wanted to do was get into any kind of discussion about his relationship with Ava. “Thank you for your time.”
Noah started to leave, but Dr. Kumar stopped him. “One last piece of advice: In the future, if you have any concerns about people in my department, I advise you to go through channels. You should speak with your chief, Dr. Hernandez, and not to me. Am I making myself clear?”
“You are,” Noah said. “Thank you for seeing me.” He turned and left. As he headed back to the elevators, he mocked himself for previously thinking that he was making progress in the diplomatic arena. It seemed that handling staff egos at the BMH was certainly not his forte. In retrospect, there was no doubt in his mind that it had been a remarkably poor decision to seek out the Anesthesia chief. Worriedly, he wondered if Dr. Kumar would mention their tête-à-tête to Dr. Hernandez. Unfortunately, he thought the chances were better than good.
27
MONDAY, AUGUST 7, 2:38 P.M.
Mondays were always difficult for Noah, even though he’d spent the entire weekend at the hospital, searching for things to do to avoid obsessing over Ava’s continued silence. Although he was completely caught up on all his responsibilities, the Monday surgical schedule was particularly heavy as every attending wanted OR time and pressured Noah to provide it. Everyone felt it was far better to get their cases done earlier in the week, the better so that by the end of the week patients could be sent home, which was more pleasant for patients and surgeons alike. To add to his burden, Noah had three of his own cases. Luckily, those had gone well, so he now had time to finish one of the projects he’d started over the weekend.
Changing out of his scrubs, Noah headed to the surgical residency program office. The administration area was in full swing, especially around the hospital president’s massive corner office. As Noah passed the anesthesia office he cringed, thinking of the unpleasant meeting he’d had with Dr. Kumar Friday afternoon. So far there had been no fallout, but Noah was quite certain it would happen, maybe even later that day.