At that moment Bonnie Vanderway appeared. She was a stocky woman with a broad face, and although younger than Jack had envisioned from her voice and her commanding manner of speaking, she exuded an air of assurance. Dressed in a long white coat over blue scrubs, she wore her moderate-length brunette hair neatly pulled back with a tortoiseshell barrette. After they had introduced themselves, Bonnie invited Jack back to her office. Despite the invitation, Jack felt she was mildly standoffish, which he didn’t know what to make of, although he worried it had something to do with her recently expressed legal reservations.
“Can I offer you some coffee?” Bonnie questioned, once they were seated.
“I’m fine,” Jack assured her.
“I managed to get ahold of Dr. Barton and he’ll be stopping by momentarily,” Bonnie said. “I also let the executive director know you had arrived. Her name is Katherine English, and she’ll be stopping by as well.”
“Excellent,” Jack said, although he would have preferred some time with Bonnie alone. In his experience bigwigs tended to be less forthcoming in marginal situations, giving credence to the adage: Too many cooks in the kitchen can spoil the stew. “Sounds like we’re going to have a regular party.”
“Excuse me?” Bonnie said. She’d heard Jack’s comment but didn’t know how to interpret it.
“I brought you a photo of the patient, so we can possibly confirm the identity,” Jack said, ignoring Bonnie’s rhetorical question. As he unfolded the photo and smoothed it out on Bonnie’s desktop, he silently scolded himself for already allowing a bit of his renowned sarcasm to emerge. He had to do better. For Laurie’s sake, he was intent on behaving himself.
“Oh, wow,” Bonnie said, looking at the photo. “That’s not very flattering.”
“Not likely to get her any modeling jobs,” Jack said. “Autopsy photos make everyone look remarkably terrible. It’s deliberate. They’re taken so that every possible blemish and abnormality stands out in stark relief.”
“Again, I wouldn’t be able to be sure this is the same person we operated on here,” Bonnie said. “Let me quickly show it to Tatiana. Do you mind if I leave you here for a moment? I think it would be helpful to be sure we are talking about the same person.”
“I’ll stay right here and mind my manners,” Jack assured her.
While Bonnie was gone, Jack looked around the office. There was a whiteboard with a calendar, which Jack guessed showed all the upcoming cases for the month. It appeared that they did about two transplants a week, most likely dependent on the availability of organs. Another whiteboard appeared to be scheduling for the entire clinical team except physicians. It was a complicated schedule involving three shifts a day, seven days a week. As clinical director, Bonnie was a busy lady.
“Tatiana is willing to confirm this is the patient that she handled,” Bonnie said, coming back into her office. “She would have come in person, but she’s with a patient and his family.” Bonnie tried to hand the photo back to Jack, but he waved it off, saying MGH could keep it for their files.
With a knock on the open office door to announce herself, a tall, aristocratic woman entered. Like Bonnie, she was wearing a long white coat, but underneath was a business suit instead of scrubs. Without any attempt at subterfuge, she gave Jack a once-over. Jack had stood when she arrived, and he stared back at her. Her straightforwardness reminded him of his grammar school principal back in South Bend, Indiana. It wasn’t a wholly comfortable remembrance. Jack had been what the principal had described as a willful child, and she’d let him know on multiple occasions.
Bonnie formally introduced Jack to Katherine English, the executive director of the Heart Transplant Program.
“Bonnie filled me in on your earlier phone conversation,” Kathrine said, dispensing with any small talk.
“There’s been an update,” Bonnie told her. “Dr. Stapleton brought in an autopsy photo, and Tatiana has confirmed it is a patient we operated on.”
“I see,” Katherine said. “That is obviously disappointing news for us.We like to think that our patients all have long and healthy lives, thanks to our efforts.”
“At this early stage, it’s my impression that this woman’s death was not immediately associated with her surgery,” Jack said. “Actually, there was every indication your team did a great job. Grossly and microscopically, the heart appeared absolutely perfect, without a trace of inflammation.”
“How did the patient die?” Katherine asked.
“Manner or cause?” Jack asked.
“Both, I guess,” Katherine said.
“The manner was natural,” Jack said. “The cause we don’t know yet. The mechanism, I believe, was an overwhelming respiratory problem called cytokine storm, possibly of an infectious origin, which is why we are desperate for an ID. If it proves to be infectious, which we are attempting to do, we need to know her social contacts to either quarantine or monitor them.”
“That makes total sense,” Katherine said.
Another knock on the open office door heralded the arrival of another tall, aristocratic individual, making Jack wonder if AmeriCare was cloning these people. Jack struggled to rein in his instinctual cynicism. This new visitor was a particularly handsome male, about Jack’s height, six-two, and about Jack’s age. And like Jack, he appeared to be in excellent physical shape. Similar to Bonnie, he was dressed in a long white coat over scrubs. Unlike Bonnie, he had a stethoscope casually slung across his shoulders. A bit of ECG tape protruded from one of his pockets. A surgical mask dangled down over his chest.
“Hello, Dr. Barton,” Bonnie said with obvious respect. She then formally introduced Jack to Dr. Chris Barton, cardiac surgeon.
“I understand you’ve brought me some bad news,” Chris said to Jack. His tone was pleasant and his demeanor mild.
“I suppose you could say that,” Jack said, struggling to behave himself. He was privy to what he called the “narcissistic cardiac surgeon personality,” which saw everything from a personal vantage point.
“It has been confirmed it is one of your patients,” Bonnie said.
“That’s terrible,” Chris said. “It’s a tragedy, as the case went so smoothly, including the immediate post-op portion. I hate to see it mess up my stats.”
