"What Randolph didn't neutralize was Dr. Brown's powerful analogy about a pediatric patient and meningitis. He's right, because that is the way you have to respond to a postmenopausal female when you even think she might be having a heart attack. Women don't have the same symptoms as men in a surprising number of cases. Maybe I screwed up, because a heart attack did pass through my mind."
"Second-guessing oneself is a rampant tendency in physicians in every case of adverse outcome," Jack reminded Craig. "It's especially so when there's alleged malpractice. The reality is you bent over backward with this woman, who was actually taking advantage of you. I know it's not politically correct to say that, but it is true. With all her false alarms, calling you out in the middle of the night, there's no wonder your index of suspicion of real illness would have been down in the lower basement."
"Thank you," Craig said with his shoulders sagging. "It means a lot to me to hear you say that."
"The trouble is, Randolph must make the jury understand that. That's it in a nutshell. And keep in mind Randolph hasn't presented his case. You have your own experts who are willing to testify to exactly what I outlined."
Craig took a deep breath and let it out noisily. He nodded a few times. "You're right. I can't give up, but tomorrow I'll have to testify."
"I would think you would be looking forward to it," Jack said. "You are the one more than anyone else who knows exactly what happened and when."
"I understand that perfectly well," Craig said. "The problem is I despise Tony Fasano so much, I have trouble keeping my cool. You've read the deposition. He got to me. Randolph advised me not to appear arrogant; I appeared arrogant. Randolph advised me not to get into an argument; I got into an argument. Randolph advised me not to get angry; I got angry. Randolph advised me only to answer each question; I flew off on a tangent, trying to justify honest mistakes. I was terrible, and I'm afraid it might happen all over again. I'm not good at this."
"Consider your deposition a learning experience," Jack said. "And remember: The deposition lasted two days. The judge will not allow that. He's the one who wants this trial brought to an end by Friday."
"I suppose it boils down to the fact that I don't trust myself," Craig said. "The one good aspect of this whole damn affair is that it has forced me to look at myself in the proverbial mirror. The reason Tony Fasano got me to appear arrogant is because I am arrogant. I know it's not politically correct to say so, but I am the best doctor I know. I've had confirmation in so many different ways. I've always been one of the best students, if not the best, throughout my training, and I've become addicted to acclaim. I want to hear it, which is why the reverse, like what I'm hearing throughout this malpractice ordeal, is so goddamn distressing and humiliating."
Craig fell silent after his outburst. Both Alexis and Jack were dumbfounded and momentarily speechless. The waiter came over and bused away the dirty dishes. Alexis and Jack glanced briefly at each other and went back to staring wide-eyed at Craig.
"Somebody say something!" Craig demanded.
Alexis spread her hands palms up and shook her head. "I don't quite know what to say. I don't know whether to respond emotionally or professionally."
"Try professionally. I think I need the reality check. I'm in free fall here. And you know why? I'll tell you why. When I went to college and worked my balls off, I thought it sucked but that once I got into medical school, I'd be home free. Well, medical school sucked, too, so I looked forward to residency. You're probably getting the picture. Well, residency was no picnic, yet around the corner was opening my practice. That's when reality really set in, thanks to insurance companies and managed care and all the bullshit that has to be endured."
Jack looked at Alexis. He could tell she was struggling with what to say to these sudden revelations, but he was hoping she'd come up with something, since he was incapable. He was shocked by Craig's monologue. Psychology was not his forte by any stretch of the imagination. There'd been a time when it was all he could do to hold himself together.
"Your insight is dramatic," Alexis began.
"Don't give me any patronizing bullshit," Craig snapped.
"Believe me, I'm not," Alexis said. "I'm impressed. Truly! What you are trying to communicate is that your romantic nature has been constantly suffering disillusionment as reality has failed to meet your idealized expectations. Every time you get to a goal, it was not what you thought it would be. That's tragic."
Craig rolled his eyes. "That sounds like bullshit to me."
"It's not," Alexis insisted. "Think about it."
Craig pressed his lips together and knitted his brows for a long moment. "Okay," he said finally. "It does make sense. Yet it seems like a damn convoluted way of saying, 'Things just haven't quite worked out'. But then again, I've never been up on psychologyspeak."
"You have been struggling with some conflicts," Alexis continued. "It's not been easy for you."
"Oh, really," Craig said with a touch of superciliousness.
"Now, don't get defensive," Alexis urged. "You specifically asked for my professional response."
"You're right! Sorry! Let me hear the conflicts."
"The easiest one is your conflict between clinical medicine and research medicine. That has caused you some anxiety in the past because of your need to apply yourself one hundred percent in any pursuit, but in this case, you've been able to strike a balance. A more problematic conflict is between devoting yourself to your practice or devoting yourself to your family. This has caused a lot of anxiety."
Craig stared back at Alexis but remained silent.
"For obvious reasons, I cannot be objective," Alexis continued. "What I'd like to do is encourage you to explore these insights of yours with a professional individual."
"I don't like to ask for help," Craig said.
"I know, but even that attitude says something that might be valuable for you to explore." Alexis turned to Jack. "Do you want to add anything?"
Jack raised his hands. "Nope. This is an arena I'm not good at." Actually, what he was thinking was that he'd been struggling with his own conflicts – namely, whether to start a new family with Laurie, as he was scheduled to do come Friday. For many years he'd said no, he didn't deserve to be happy, and that another family would demean his first. But then as the years had gone by, it had changed to a fear of putting Laurie at risk. Jack had struggled with the admittedly irrational fear that his loving someone put them in jeopardy.
The conversation took a lighter turn, and Jack seized the moment to excuse himself to use his phone. Walking out onto the bricked esplanade, he dialed the OCME. He had meant to leave a message with Calvin's secretary. His hope was that Calvin would be out of the office at lunch. Unfortunately, that wasn't the case. It was the secretary who was out to lunch. Calvin answered the phone.
"When the hell are you getting yourself back here?" Calvin demanded when he heard Jack's voice.
"It's looking bad," Jack said. He then had to hold the phone away from his ear while Calvin cursed and carried on about Jack's irresponsibility. After Jack heard, "What the hell are you doing, anyway?" he put the phone back to his ear and explained the proposed autopsy. He told Calvin about being introduced to the Boston chief medical examiner, Dr. Kevin Carson.
"Really! How is that old southern boy?" Calvin questioned.
"Seemed fine to me. He was in the middle of a case when I met him, so we chatted only briefly."
"Did he ask for me?"