Strong Medicine (25 page)

about a penicillin allergy, which did not seem significant. The other was

the absence of any reference to heart disease, which did.

Still not overly concerned, but curious, Andrew decided to make discreet

inquiries about Wyrazik's death at the hospital later in the day.

That afternoon he went to the records office at St. Bede's. Wyrazik's

chart aiid other documents had been sent there from the medical floor

after the patient's death.

Andrew read the last entry on the medical chart first--the cause of

death, as recoyded by Dr. Townsend-then worked backward through the file.

Almost at once the order, in Townsend's handwriting, for six hundred

thousand units of penicillin leaped out at him, striking Andrew like a

thunderbolt. Equally shattering was the nurse's notation that the

penicillin had been administered and, as time sequences showed, it was

shortly before Wyrazik died.

Andrew read the rest of' the file-including the intern's note about

penicillin allergy and the earlier order for erythromycin-in a daze. When

he returned the file to a records clerk his hand was shaking, his heayi

pounding.

Questions hurled themselves. "at to do? Where to go next?

Andrew went to the morgue to view Wyrazik's body.

In death the eyes were closed, the dead man's features composed. Except

for a slight bluish, cyanotic tinge to the skin which could have been

from other causes, there were no telltale signs of the anaphylactic shock

which, Andrew now believed, had killed this young man needlessly,

He asked the morgue attendant who accompanied him, "Has an autopsy been

ordcred?"

"No, sir." Then the man added, "There's a sister who's supposed to be

coming from Kansas. There's to be cremation after she gets here."

Andrew's thoughts were in turmoil. Remembering his earlier experience

with the hospital administrator, he was stilt' uncertain about what to

do next. Clearly, something must be done, but what? Should he sound a

warning about the need for an autopsy? One thing Andrew was sure of: an

autopsy would show,there had been no heart failure. But even without an

autopsy the entries on the patient's chart were damning evidence.

By now it was early evening, most senior people in the hospital had gone

home, and there was little choice but to wait until next day.

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Throughout that night, while Celia slept beside him, unaware of her

husband's problem, he lay awake as courses of action chased themselves

around his mind. Ought he to go before colleagues in the hospital with

what he knew, or would impartial proceedings be more assurt,-d if he went

to authorities outside? Should he confront Noah Townsend first and hear

Noah's explanation? But then Andrew realized the futility of this, as

Noah's personality had clearly changed, even more than appeared on the

surface-the result of his drug addiction over years.

The Noah Andrew had once known and respected, and at moments loved, was

upright and honorable, holding the strongest views about ethics and

medicine, so that he would never have condoned in himself or others the

awful professional negligence, followed by subterfuge, which he had just

practiced. The old Noah Townsend would have stood up, confessed and taken

the consequences, no matter how harsh. No, a personal confrontation would

accomplish nothing.

Over it all, Andrew had a sense of great sadness and of loss.

In the end he decided wearily that he would keep what he knew within the

family of the hospital. If other, outside action needed to be taken, then

others in the hospital must decide. Next morning in his office he took

time to write a detailed summation of what he knew. Then, shortly before

noon, he went to St. Bede's and confronted the administrator.

If he closed his eyes, Andrew thought, he might well imagine he was at a

PTA meeting at the children's school, or perhaps in the boardroom of a

nuts-and-bolts industrial company making everyday, routine decisions.

The words flowed past him.

"May I have a resolution on that?" -

"Mr. Chairman, I propose

"Is there a seconder?"

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second that." been proposed and seconded . . . Those in favor of the res-

olution . . . "

A chorus of "aye.

"Against?"

Silence.

". . . declare the resolution carried By unanimous decision the hospital

privileges of Dr. Noah Townsend are suspended . . . "

Could this truly be the way it happened? This prosaic, formal, minor-key

accompaniment to deepest tragedy. Were these petty, pecksnifflan phrases

the best that could be found to signal the sudden, grievous ending of a

lifetime's work, a once dedicated man's career?

Andrew was not ashamed to find that tears were coursing down his face.

Aware that others seated around the hospital boardroom table were watching,

he made no attempt to hide them.

"Dr. Jordan," the chairman of the medical board executive committee said

considerately, "please believe me that the rest of us share your great

sadness. Noah was, and is, our friend and colleague too. We respect you for

doing what you have, which we are well aware was difficult. What we have

done was equally difficult, but equally necessary."

Andrew nodded, unable to speak.

The chairman was Dr. Ezra Gould. He was a neurologist and the chief of

medicine, having succeeded Noah Townsend in that office three years

earlier. Gould was small and soft-spoken, but quietly strong and greatly

respected at St. Bede's. The others on the committee were heads of

services--surgery, obstetrics and gynecology, pathology, pediatrics,

radiology, several more. Andrew knew most of them fairly well. They were

decent, sensitive, caring people, but doing what they had to, even though,

in Andrew's view, their action had been delayed too long.

"Mr. Chairman," Leonard Sweeting said, "I should inform the committee that

in anticipation of its decision I prepared a notice which will go

immediately to the entire hospital-nursing stations, admitting office,

pharmacy, and so on. In it I took the liberty of describing Dr. Townsend's

suspension as being 'because of health reasons.' I believe that's more

discreet than anything specific. Is that agreeable?"

Gould glanced inquiringly at the others. There were murmurs of assent.

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"It's agreeable," Gould said.

"I would also urge," the administrator continued, "that the details of

what has passed here be discussed outside this room as little as

possible."

Leonard Sweeting had guided the committee on procedure from the moment

the meeting's purpose had been made known-to ' the shock and

consternation of the senior doctors summoned here so hurriedly. Sweeting

had also, before the meeting began, had a hurried telephone consultation

with the hospital chairman, a veteran local lawyer, Fergus McNair, whose

practice was in Morristown. The conversation had been in Andrew's

presence and, while hearing only one side of it, Andrew did catch the

chairman's emphatic final words which rattled in the phone receiver,

"Protect the hospital."

"I'll do my best," the administrator had said.

After that Sweeting had gone into the boardroom, which adjoined his

office, closing the door behind him and leaving Andrew alone. In a few

minutes the door reopened and Andrew was summoned in.

All faces around the boardroom table were deadly serious.

"Dr. Jordan," the chairman, Dr. Gould, had said, "we have been informed

of the nature of your charges. Please tell us what you know."

Andrew had repeated what he had told the administrator earlier, at times

referring to his notes. Following his statement there were a few

questions and some discussion, but not much. Leonard Sweeting then

produced the hotspital's file on the deceased Kurt Wyrazik, which was

passed around and the patient's chart, with its damning entries, examined

amid doleful head shaking.

Andrew had the clear impression that although members of the committee

had not expected today's disclosures to unfold as they had, the subject

itself was no surprise to them.

The formal resolution had come next, stripping Noah Townsend of his

long-held status at St. Bede's.

Now the chief of pediatrics, a gaunt, slow-speaking New Englander, said,

"Something we haven't discussed is what's to happen concerning the young

man who died."

"Knowing what we do," the administrator answered, "it's essential that

an autopsy be performed. Just before this meeting I spoke by telephone

with the deceased's father in Kansas-a sister is on the way here--and the

father has given the necessary permission.

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So the autopsy will be done today." Sweeting glanced at the head of

pathology, who signified assent.

"All right," the pediatrics chief persisted, "but what do we tell his

family?"

"Quite frankly," Sweeting said, "because of the legal issues involved,

that is a delicate, potentially volatile subject. I suggest you leave a

decision on it to Dr. Gould, to me, and to Mr. McNair who will be here

shortly and who will also advise us legally." He added, "Perhaps, later

on, we will report back to this committee."

Dr. Gould asked the others, "Is that all right?" There were nods of

agreement and also, it seemed, a sense of relief.

Perhaps. Andrew thought: it was the operative word. Perhaps . . . we will

report back to this committee. And perhaps we wont.

What the hospital, in the persons of Leonard Sweeting and his boss Fergus

McNair, would undoubtedly like was for everything to be hushed up, and

for young Kurt Wyrazik, the innocent victim, to be cremated and

forgotten. In a way, Andrew supposed, you couldn't blame Sweeting or

McNair. They had their responsibilities. And if all this came to a

malpractice case in court, a jury award or financial settlement could be

horrendous. Whether insurance would cover it, Andrew had no idea and

didn't care. The only thing he was sure of was that he would not be part

of a cover-up himself.

There had been a buzz of conversation and the chairman rapped a gavel for

attention.

"Now," Dr. Gould said, "we come to the hardest part." He glanced around

the room. "I will have to go to Noah Townsend and tell him what has been

decided here. I understand he is still in the hospital. Is there anyone

who chooses to come with me?"

Andrew said, "I'll come with you." It was, he thought, the very least

that he could do. He owed that much to Noah.

"Thank you, Andrew." Gould nodded his appreciation.

In the calm of later, quiet reflection, and despite the pathetic,

strident scene that followed, Andrew had an instinct that Noah Townsend

had been waiting for them and was relieved to see them come.

As Dr. Ezra Gould and Andrew stepped out of an elevator on the medical

floor, to their right were a busy corridor, patients' rooms and a nursing

station. At the end of the corridor Townsend was standing, doing nothing,

appearing to be looking into space.