___8.___

Alan

It began late Friday morning.

The only incident of note before that was the call from Fred Larkin.

Connie buzzed back with the word that Dr. Larkin was calling.

"Dr. Larkin himself, or his secretary?"

Alan already knew the answer. Fred Larkin was the local glamor-boy orthopedist who took in something like $750,000 a year, owned three homes, a forty-two-foot cabin cruiser, and traveled the 35-mile-an-hour roads from his home to the hospital in a 200-mile-an-hour, $90,000 Maserati with license plates that read FRED MD. Alan never referred patients to him, but one of his regulars had somehow landed under Larkin's care in January. He had been expecting this call.

"His" secretary, of course."

"Of course." Fred Larkin was not the type to deign to dial a phone number himself. "Put her on hold and hurry back here for a second."

As Connie bustled her short, plump frame into his office, Alan hit the button on his phone and said, "Hello?" When a female voice on the other end said, "Just a minute, Dr. Buhner," and put him on hold, Alan handed the phone to Connie. She smiled and held it to her ear. After a short pause, she said, "Hold on, Dr. Larkin," and hit the hold button. Giggling, she handed the phone to Alan and hurried out of the office.

Alan waited for a slow count of five and then opened the line.

"Fred! How are you?"

"Fine, Alan," he said in his officious voice. "Listen, I don't want to take up much of your time, but I thought you should know what one of your patients is saying about you."

"Really? Who?" Alan knew who, what, and why, but decided to play dumb.

"Mrs. Marshall."

"Elizabeth? I didn't even know she was mad at me!"

"I don't know about that. But as you know, I arthroscoped her right knee in January and she's refusing to pay the last two-thirds of her bill."

"Probably because she doesn't have the money."

"Well, be that as it may, she says"—he gave a forced laugh here—"that you told her not to pay it. Can you believe that?"

"Sure. In a sense, it's true."

There was a long silence on the other end of the line, then:

"You admit it?"

"Uh-huh," Alan said, and waited for the explosion.

"You son of a bitch! I half figured you put her up to it. Where the hell do you get off telling one of my patients not to pay my bill?" He was shouting into the phone.

"To say you charge too much is an understatement, Fred. You gouge. You never gave that old lady a clue that your fee for a look into her joint plus a little trimming of her cartilage would cost her two grand. You did it in twenty minutes in the outpatient surgery department—which meant your overhead was zero, Fred—and you charged her two thousand bucks! Then—and this is the kicker—then she had to come to me for an explanation of exactly what it was you did for her. You charge at a rate of six thousand bucks an hour and I have to do the explaining! Which I couldn't do because as usual you never bothered to send me a copy of the procedure summary."

"I explained everything to her."

"Not so she could understand it, and you probably had four more procedures lined up. Answering a few questions would take too much time. And when she told your office that Medicare and her other insurance only covered six hundred of the bill, she was informed that that was her problem. And you know what she said to me?"

Alan had now arrived at the point that infuriated him the most. He could feel himself coming to a boil. He tried to control it, but knew he could slip into a shouting rage at any minute.

"She said, 'You doctors!' She lumped me with you! And that pissed me off. Ill will from guys like you who treat patients like slabs of meat spills over onto me, and I don't take kindly to that at all."

"Don't give me any of your holier-than-thou crap, Bulmer. Nothing gives you the right to tell a patient not to pay!"

"I didn't tell her that, exactly." Alan's temper was stretched to the breaking point, but he managed to keep his voice low. "I told her to send your bill back to you in the shape of a rectal suppository. Because you're an asshole, Fred."

After a second or two of shocked silence, Larkin said, "I can buy and sell you, Bulmer."

"A rich asshole is still an asshole."

"I'm taking this to the hospital board and to the medical society. You haven't heard the last of this!"

"Yes, I have," Alan said, and hung up.

He was annoyed with himself for sinking to name-calling, but could not deny that he had enjoyed it.

He glanced at his watch. Nine-thirty already. He would be playing catch-up the rest of the morning.

Alan's mood lightened immediately when he saw Sonja Andersen waiting for him in the examining room. He smiled at the pretty little ten-year-old he had been following for the past three years and mentally flipped through her medical history. Sonja had been a normal child until age four when she contracted chicken pox from her older sister. It was not the usual uncomplicated case, however. A varicella meningitis developed, leaving her with a seizure disorder and total hearing loss in her right ear. She was a brave little soul and had been doing well lately. No seizures for the past year, and no visible ill effects from the Dilantin she took twice a day to control them.

She held up a Walkman tape player with lightweight headphones.

"Look what I got, Dr. Bulmer!" Her face was bright and open, her smile unstudied sincerity. She seemed genuinely glad to see him.

Alan was just as happy to see her. He loved pediatrics more than any other facet of his practice. He found something in caring for a child, whether sick or well, that gave him a special satisfaction. Perhaps this communicated itself to the children and their parents, explaining why an unusually large segment of his practice, nearly 40 percent, was devoted to pediatrics.

"Who gave you that?"

"My uncle. For my birthday."

"That's right—you're ten now, aren't you? What kind of music do you like?"

"Rock."

He watched as she put on the headphones and began bouncing to whatever she was hearing. He lifted the left earpiece away from her head and said,

"What's playing?"

"The new song by Polio."

He forced a smile, acutely aware of the generation gap. He'd heard Polio's music—a mindless blend of punk and heavy metal. They made Ozzie Ozbourne sound refined and were one of the reasons he kept the stack of oldies tapes in his car. "What say we turn it off for the moment and let me give you the once-over."

He checked her heart, lungs, blood pressure, checked her gums for the telltale signs of long-term Dilantin therapy. All negative. Good. He turned on the otoscope, fitted it with a speculum, and moved to her ears.

The left looked fine—the canal was clear, the drum normal in color and configuration with no sign of fluid in the middle ear. He came around to the other side. As usual, her right ear looked as normal as the left. Her deafness there was not caused by a structural defect; the auditory nerve simply didn't carry the messages from the middle ear to the brain. He realized with a pang that she would never hear her tapes in stereo—

And that was when it happened.

First the sensation in his left hand where he gripped the auricle of her ear, a tingling, needling pleasure, surging from there through his whole body, making him tremble and break out in a sweat. Sonja whimpered and clutched at her ear with both hands as she lurched away, toppling off the examining table and into her mother's arms.

"What?" was all the startled woman could say as she hugged her child against her.

"My ear! He hurt my ear!"

Weak and more than a little frightened, Alan sagged against the examining table.