Read an Excerpt
By William Heffernan
Akashic BooksISBN: 1-888451-47-5
Chapter OneNew York City A Monday in May 1975
The woman's hands fluttered in her lap like the wings of a frightened bird. She glanced at the clock, then lowered her eyes and stared at the hands dancing along the fabric of her dress, almost as if seeing them for the first time, perhaps even wondering if they might belong to someone else. She clenched her fists, ending their flight.
Her eyes again went to the clock on the wall, and she sighed. There were five other people in the waiting room, and she wondered what illnesses had brought them here. They were all reading magazines and seemed content to wait. Perhaps they didn't want to know, she thought. She understood that. Understood it too well.
She had left her Brooklyn apartment at five-thirty so she could have some time with Roberto at the hospital. She had been forced to leave him sooner than she wanted, just to be on time for this appointment. Then she had sat here, waiting for forty-five minutes now, realizing after the first half hour that she would also be late for work. She told herself that her boss would yell. He always yelled. But he wouldn't fire her. Not this time. He would dock her pay instead. Just as he always did. He looked for chances to do that. She began to calculate what it would mean to her already stretched budget. But it wasn't important. She would find a way to stretch it again, just as she always did. Only her son mattered. Now only her little Roberto was important.
Jennifer Wells knocked lightly, then opened the door and stepped into a well-appointed office in the faculty-practice section of the hospital. There was a smile on her young, pretty face, fixed there as it always seemed to be whenever she came near her employer.
Dr. James Bradford was seated behind his desk perusing a real-estate prospectus for a Florida shopping mall. He pulled his eyes away from the figures and peered over the half-glasses perched on the end of his nose. The corners of his mouth turned up slightly at the sight of the young nurse. Jennifer had worked for him nearly six months now, but unlike most of her predecessors, she had failed to become part of the wallpaper. He understood why, as he studied her perfectly fitted uniform. Today she was wearing her one-piece whites. He felt mildly disappointed. Although he appreciated the perfect shape of her legs, he much preferred the uniform slacks ensemble. The woman had one of the most magnificent asses he had ever seen. Bradford raised his eyes to her face. Pretty and pert, he thought, with bright blue eyes that seemed to jump out from beneath tousled blond hair that, in his imagination, always made her look as though she had just climbed out of bed. He chided himself for the thought. As the hospital's chief of service for cardiac surgery, and the top-ranking member of its university-affiliated faculty, he was expected to be beyond such libidinous predilections. But this woman, he told himself, made all such restraint impossible.
Bradford allowed a small smile to form. "Yes, Jennifer?"
Jennifer's own smile widened. "Mrs. Avalon's still waiting," she said. "You had her scheduled for eight."
Bradford glanced at his watch. Eight forty-five. "Give me ten minutes, then show her in." He looked at the corner of his desk. "And bring me a fresh box of tissues," he added.
He saw Jennifer's smile vanish. She's seen the boy's file, he thought. And she's acknowledging your compassion.
"Oh, I almost forgot," she said. "Maggie asked me to tell you Dr. Gruenwalt called to confirm your golf date on Wednesday."
Bradford snorted. "Yeah, I guess I'll have to let him win. He's referred five cases this month."
Jennifer let out a small, happy laugh. "Oh, and Maggie said your wife called. She wants you to get tickets to that new Broadway show, The Wiz. She said you should call her back right away."
"Then you better give me fifteen minutes," Bradford said, the irritation in his voice palpable. Jennifer smiled again. In complicity? he wondered - a signal that she understood his dissatisfaction? She was twenty-five, twenty years his junior. Not much at all - perfect really, he told himself. His wife intruded on the notion. She, too, had once filled his mind with similar thoughts. Now she simply drained his bank account to overfill her very expensive clothing.
Jennifer spun around and started out the door, and Bradford again wished she had worn her slacks. He wondered if he should say something. Perhaps he should. They had known each other for six months now, and it would be interesting to see what her response would be.
Maria Avalon sat in the visitor's chair, staring anxiously at the doctor, waiting for him to raise his eyes from the chart on his desk. He seemed so self-assured, so successful, so different from the doctor at the clinic who had referred her here. This man wasn't as pleasant, she decided - he was much more distant - but he looked more like a doctor. His hair was gray at the temples, and he wore those half-glasses, just like the doctors she had seen on television. He even dressed like those doctors. His blue shirt was starched and crisp and clean, and she could tell the striped silk necktie he wore was expensive. Even his long white hospital coat was starched and had his name embroidered on the breast pocket. Maria only wished he would look up and speak to her, but she was too frightened to say anything.
Bradford let out a weary sigh, then closed the chart he had been reading. He glanced up and was genuinely surprised by the beauty of the woman seated across from him. He had been concentrating on the medical file when she had entered his office, and he hadn't really looked at her. Now he took in her very-light-coffee complexion, the large almond-shaped brown eyes and full lips, which together made her seem both alluring and vulnerable. He removed his glasses and smiled. Her dark brown, nearly black hair, hung to just above her shoulders, and it gave off hints of red in the harsh fluorescent light. She was quite appealing, he thought, as he discreetly took in her demurely crossed legs. A bit older than his nurse, Jennifer. Late twenties, he guessed. But every bit as lovely.
Then he changed his mind. No, not that lovely. Not on second glance. It was the woman's hands that had forced him to reappraise - rough and work-worn and bearing the marks of small, partially healed cuts. And then there was her clothing - a simple flower-patterned dress that was really quite cheap, probably homemade, and her plain, plucked-from-a-bin tennis shoes. Definitely discount-store variety.
"I'm afraid the news isn't very good," he began. He watched her hands close into fists, the knuckles turn white. There was a tightening at the corners of her mouth, and he suddenly feared she would begin to cry. "Let me try to make this as simple to understand as possible." And as quick, he added to himself. "At your physician's request, I examined your son and confirmed the initial diagnosis. What ..." Bradford hesitated and glanced at the chart again to check the name. "What Roberto has is a congenital defect of the heart. Basically, he was born with a small hole - only a pinprick, probably - in the chamber of the heart that pumps blood back into the body. It's grown over time, which is why he's shown a gradually increasing weakness and loss of energy." He drew a deep breath, preparing the worst news. "The child is dying, Mrs. Avalon. It's only a question of time. And surgery is the only way to reverse that process."
He watched the woman's lips begin to tremble and glanced at the corner of his desk to make sure the fresh box of tissues was in place. He hated crying in his office. It was disruptive, and he was never certain how to deal with it. He struggled to look as reassuring as possible, then hurried on. "Now, this is far from hopeless. It's 1975, and open-heart surgery is quite advanced and quite effective. The heart is no longer the mystery it once was. We've even been doing transplant surgery for the past eight years, and that's far more complicated than the procedure your son would need."
"But he's only five," Maria whispered. Her jaw trembled, and her eyes were suddenly awash with tears. She seemed to struggle with it, then fight back the emotion.
Bradford twisted in his chair, discomfited by the threat of further tears. "Children handle this surgery far better than older patients. I've performed dozens of these procedures, some on patients even younger than your son. They all survived, and every one is doing quite well." He paused as if weighing his next words. "But it is important not to wait any longer than necessary. Your son's condition is deteriorating, so it would be best to move ahead quickly."
Maria bit her lip, uncertain about how she should respond.
Bradford glanced at the chart again, his eyes narrowing with disapproval. "I don't see anything here about insurance," he said. "And I must point out that this is a rather expensive procedure, both from the standpoint of the surgical team and the hospital. Even before surgery, a great many tests are required, and" - he glanced at the chart again - "Roberto would have to remain hospitalized throughout that period. Then there's the postsurgical care - fairly long in itself - and some rather expensive medication." He shrugged, watched her chew on her lower lip. "Do you have any insurance?" he asked.
Maria shook her head. She hesitated, as if struggling for the correct words. "But I have a job, and I can get another one, too. I can pay you. I can give you money every week until everything is paid. The hospital, too."
Bradford stared at his desk and blew out a long stream of air. Then he looked at the woman and smiled. "Mrs. Avalon, let me try to explain. This is a private teaching hospital. That means it's supported by the university and the medical school with which it's affiliated. Unfortunately, neither the university nor the hospital is designed to take on patients who present this kind of financial risk. And neither looks very favorably on surgeons who impose that type of risk on them." He raised his hands and let them fall back to the desk in a gesture of helplessness. "There are public institutions, of course, places like Bellevue and Harlem Hospital. Their function is to treat uninsured or charity patients." He let his hands rise and fall again. "Regrettably, public hospitals do not have the facilities for this type of advanced cardiac surgery. They can treat your son to some degree - provide medication, monitor his condition, and so forth. But I won't mislead you. Surgery will be needed eventually. There is no other hope. And for that a teaching hospital is really the only choice. It's why the doctor at your clinic sent you here. But ..." He paused, extending his hands out to his sides. "A teaching hospital cannot function as a public hospital. We do some charity work, of course. But we simply cannot afford to assume the costs of these types of very expensive procedures." He sighed. "So ... simply put, the money would have to be guaranteed in some way before we could even schedule the surgery."
Maria stuttered momentarily. "H ... H ... How much money?" There was a look of fear in her eyes, and her fists were held even more tightly in her lap.
"We're talking eighty or ninety thousand dollars," Bradford said. "Probably closer to ninety." He watched the woman's face fall, seemingly crushed beneath the weight of his words. "And I'm afraid at least eighty percent of that would have to be guaranteed in some way before we could begin." He paused a beat, then went on to ask what he knew was a useless question. "Do you have any relatives or friends who could help?"
Maria Avalon shook her head. "No. But I will find the money," she said. "I promise you I will find it."
Bradford smiled. It was the kind of smile one gives a small child who has said he can fly. He nodded. "When you do, please contact me immediately, and I'll get things rolling. In the meantime I'll authorize your son's release from the hospital. You can take him home tonight. Just try to keep him as inactive as possible."
When Jennifer entered Bradford's office a half hour later, he handed her Roberto Avalon's chart. "The mother has zip for insurance," he said. "I doubt we'll be hearing from her again, but file this as an ongoing case anyway."
"Should we be expecting the results of any tests?" Jennifer asked.
"No, no tests. I didn't order any." He noted the surprise on her face. "I've given her a free consultation. I can't give her free tests, too." Bradford gave a regretful shrug. "In fact, the child is being sent home today. The hospital's already absorbed the cost of a bed for three days. And that's about as far as they're willing to go. So just file it and we'll see what happens. Who knows, maybe the mother will come up with the money." He sat back, allowed the look of regret to fade. Jennifer tucked the chart under her arm and turned to leave. Bradford's voice stopped her.
"Before you go, there's just one other thing." He smiled as she turned back to face him. "I wanted to talk to you about your uniform," he said.
"My ... my uniform?"
"Oh, it's nothing to worry about," Bradford said. "Just something I thought we might agree on."
Tuesday, 3 a.m.
Frankie Fabio, affectionately known to friends as Don Cheech, waddled up the wide marble steps of Brooklyn's 78th Precinct. He was short, perhaps five-seven - and plump, about a hundred and eighty pounds - but he walked with a swaggering arrogance that few short, fat men ever achieved. To do this he held his head tilted slightly back, which allowed him to look along his nose at whomever he encountered. The pose was augmented by a permanent smirk that complemented the arrogance reflected in his eyes. It told all he met that he knew they were full of shit.
Frankie swaggered toward the high desk that dominated the dingy, dimly lit waiting area. He was dressed in a tan sports jacket over sharply creased brown trousers, with a wildly patterned sport shirt open at the neck. A gold cross was visible against his hairy chest. As he moved forward, he took in the name tag of the sergeant who occupied the desk, trying to recall if he knew this gray-haired, balding old hairbag. Frankie had spent twelve years of his newspaper career as police bureau chief for the New York Globe. Now, as an assistant city editor, he liked to intimidate young reporters by claiming that during that time he had spoken to every cop above the rank of sergeant. But this hump - this Kowalski - didn't ring any bells at all. He pursed his lips with displeasure. Tonight of all nights you gotta run into the one fucking Polack you missed, he told himself.
Fabio removed his press card from his wallet and held it up. "Frank Fabio, assistant city editor for the Globe," he said. "I understand you got one of my troops upstairs."
The sergeant looked up, glanced casually at the press card, then looked down again. "That's right," he said.
Excerpted from Cityside by William Heffernan Excerpted by permission.
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