"I've lost my appetite," she said, "but I'll keep you company."
Tim remembered the weird black stick pin he'd found and held it out to her.
"By the way, is this yours?"
She gave it barely a glance. "Nope. Never seen it before. What is it?"
"Beats me. I found it on your floor, over there by the window. Stuck me in the foot."
She looked at it again, more closely this time, but no sign of recognition lit in her eyes. She shrugged.
"Maybe one of the maids dropped it."
Tim shrugged into his sport coat and stuck the pin into the lapel, then he struck a pose.
"May I present the very latest in men's accessories. Think it'll catch on?"
Quinn squinted at his lapel. "I can hardly see it."
Tim glanced down. The tiny black hockey puck was almost lost in the herringbone pattern.
"Oh, well. Another of my fashion milestones down the drain."
Tim followed her out the door.
*
About time, Verran thought as he watched Brown and Cleary leave and head for the caf. I was beginning to think they'd never leave.
He waited in the bushes until they disappeared into the caf, then he slipped into the dorm and hurried up to Broads' Country.
No one about. Quickly he unlocked 252 and closed the door behind him. He turned on the metal detector and went immediately to the space between the window and the second bed, where he'd hit the floor when Cleary had surprised him last night. Slowly, carefully, he waved the business end of the detector over the thick carpet, keeping a close eye on the needle in the illuminated gauge in the handle.
It didn't budge.
He ran his fingers through the deep pile. This was the most obvious area. It had to be here.
When his fingers found nothing, he turned and crept across the room, carefully sweeping the detector over the carpet all the way to the door.
The only flickers from the needle turned out to be a penny and a dime.
Great. Just great. The detector was working fine, but no bug.
Where the hell was it, then?
NOVEMBER
Claropril (ACE-I) the new ultra-potent ACE-inhibitor from Kleederman Pharmaceuticals, has captured a 20-percent share of the anti-hypertensive market a mere six months after approval.
Modern Medicine
THE WORLD'S LONGEST CONTINUOUS
FLOATING MEDICAL BULL SESSION
(II)
Tonight the session had wound up in, of all places, Harrison's room.
"He's not as bad as we all thought," Tim said as he led Quinn down the hall of the north wing's first floor. His sharp blue eyes were bright. He wasn't wearing his dark glasses as much as he used to. She preferred him this way. "Of course, he's hardly Mr. Warmth, either. Far from it, in fact. But at least he's articulate."
Quinn glanced at her watch. She was behind on her histology notes and had been in the middle of bringing them up to date when Tim had popped in and dragged her away to the bull session.
"Come on, Quinn," he'd said. "You need a break. Take five and add your two cents to the session. It could use some new blood."
"But my notes—"
"You want to crack like that guy Prosser who disappeared without a trace a couple of years ago? There's more to medicine than histology, you know."
"But if I don't pass the rest won't matter."
"You'll pass."
She'd come along because she realized Tim was right. She would pass. Just passing had never been good enough for her and still wasn't, but she did need a break. Between classes, labs, studying, and working with Dr. Emerson, she was beginning to feel a bit frazzled. She'd thought about quitting the lab job, but the work was getting more interesting now and she found the extra money came in handy for the sundries The Ingraham didn't provide.
Eight people were in Harrison's room. Quinn and Tim made it ten. They greeted Quinn with hellos but they had a cheer for Tim when he came through the door. He clearly had become a mainstay of these sessions. She marveled at his ability to make friends with almost anybody. And envied it.
"Tim, you're just in time." It was Judy Trachtenberg. Didn't she ever study? "Harrison here is going radical on us. He thinks chiropractors ought to be included in the tiering of care."
"Tiering?" Quinn said.
They quieted and looked at her.
"Tiers of eligibility," Tim told her. "You know. Alston mentions it every so often."
"Oh, right," Quinn said. Somewhere along the line Dr. Alston had turned tier into a verb: to tier. Last week he'd asked the class to assume a limited amount of medical resources, then directed them to create two sets of tiers: the first set listing levels of care in descending order of sophistication, the second set dividing the population into groups in descending order of their value to society. Quinn had found it a chilling exercise, but she'd considered it no more than that: an exercise in ethics. The bull session semed to be taking it seriously.
"What do you think?" Harrison said. Quinn wondered if anybody knew his first name. "Yes or no on the back crackers?"
"Definitely yes," Tim said. "Acupuncturists too. We've got to find a tier for every therapy if this is going to work."
Quinn waited for the zinger, the gag line that would turn around what he'd just said. But it never came.
"All right," Judy said. "Where to we lump them?"
"With the physical therapists," Tim said. "Take away all their mumbo-jumbo and look at what they do: physical therapy."
Quinn watched and listened in shock. "I thought you were against any kind of rationing," she said.
"I was," Tim said.
"Well, what happened?" Quinn realized that although she and Tim did a lot of talking, the future structure of healthcare delivery was not a topic of conversation. She had no idea he'd come around 180 degrees.
"That was before I realized the full scope of the problem. The day is coming when there won't be enough care to go around. And that means some people are going to have to make do with lower levels of care. Tiering is the only way to decide who gets what, Quinn. The only way."
She heard murmurs of agreement and saw heads nodding in agreement all around the room.
"What are you saying? Someone gets past a certain age and we throw them to the wolves?"
"Nothing so blunt as that," Harrison said. "Age should not be the sole criterion. Overall value to society should be considered. Of course, the older you are, the fewer years you have left—ipso facto, your chances of contributing much are reduced. Plenty of people of all ages contribute nothing. The homeless, the drunks, the addicts are the most obvious, but there are others, less obvious. People we never see, shut-ins who sit at home and do nothing. Should some couch potato on welfare get a coronary bypass while a hard-working mechanic who's the father of three has to go on working with chest pain? I don't think so."
"I don't think so either. But who's going to decide who gets stuck in which tier? Who's going to arbitrate human value?"
"You can bet we'll have something to say in it," Tim said. "Especially those of us who go into primary care. We'll be deciding who gets referred and who doesn't."
"But this tiering idea, this dividing people up and stacking them in order of how useful they are is so...cold." She turned to Tim. "What about compassion? Remember how we talked about finding a CPT code number for compassion?"
"Yeah," Tim said softly, his eyes suddenly distraught. "I remember. Trouble is, I don't know how I forgot."
Quinn didn't know what it was, but something in Tim's eyes unsettled her.
THIRTEEN