Read an Excerpt
Dr. Ivan Munro liked saving lives, liked making a difference in those lives. It was people he didn't care for.
People with their endless complaining. People with endless details about their humdrum lives that he had absolutely no interest in. If he possessed so much as a thimbleful of mild curiosity regarding his patients, he would have gone into a medical discipline that required contact with those patients on a fairly regular basis.
But such contact would have necessitated feigning interest on his part and he had never been one to lie or even seen the need to lie. Ever. For any reason whatsoever. The truth, any truth, was what it was and needed to be faced. No sugarcoating, no beating around the proverbial bush. Just shooting straight from the hip.
He'd chosen neurosurgery as much as it had chosen him and he'd selected it for three reasons. The first was to heal, to pit himself against the power that delivered such a low blow to the individual on his operating table. The second was that it was the only way he could possibly make it up to Scott, even though Scott was no longer around to see the results.
The last reason was distance. Neurosurgery afforded him distance. Once he tackled a condition, he could distance himself from the recovering patient and thus move on, leaving the chore of hand-holding to the patient's friends, relatives and/or referring physician, all people who were far better suited to the tedious chore than he. They were the ones who either wanted or felt compelled to establish and maintain a rapport with the patient.
He'd been told, more than once, that he had the bedside manner of an anaconda. He took it as a compliment. Ivan could not,would not, allow emotions to get in the way of his making a judgment call.
Unfortunately, emotions or some sort of cursory display of them, was what most patients thought they both needed and were entitled to. His chief of staff, Harold Bennett, a man he grudgingly admired and respected, told him that was the way patients knew that they were in capable hands. They measured capability by the physician's capacity to act as if he or she cared.
Ivan cared, all right, cared that he successfully eliminated the tumor, or reconnected the nerve endings, cared that he did no harm and only accomplished what he'd set out to accomplish: to make the patient better than he or she had been when they'd first laid down on his operating table.
But as for verbally talking the patient through the steps of the surgery before it transpired to set to rest any fears that patient might have, well, that just was not why he got up each morning to come to Blair Memorial Hospital.
Being "patient with patients" wasn't something he was any good at and he saw no reason to pretend that he was. He wasn't in medicine to forge friendships, only to save lives.
"They call you Ivan the Terrible, you know," Harold told him over the lunch he'd insisted that his chief neurosurgeon share with him in his office.
There was an ulterior motive for the invitation. It was that most painful time of year again. January. Time for the annual review where budgets were wrestled with and unpleasant decisions had to be made. It was a time to lightly sprinkle praise and to make a sincere call for improvement. This meant even from a man who clearly did have the ability to walk on water, but did not, to any and all who took note, possess so much as a single drop of humility.
"I know," Ivan replied, his attention appearing to focus on his sandwich. "It's my name. Good sandwich," he commented in the next breath, infusing as much interest and feeling in the last sentence as he had in the first two he'd uttered.
After almost a dozen years, Harold was skilled at tiptoeing into conversations with his chief neurosurgeon. "Funny, I don't remember seeing 'the Terrible' on your application form."
"I didn't want to brag," Ivan replied in the semi-raspy voice that was his trademark. As far as anyone knew, it had been awarded him courtesy of a near-crushed larynx he's sustained from an incident in his late teens. An incident that he never talked about. Rumor had it he'd offended someone and they'd tried to hang him. The rumor tickled Ivan and he never bothered correcting it.
Harold tried again. "Ivan, I know that you're good at your job"
Dark eyebrows rose on a relatively unlined forty-six-year-old forehead as Ivan looked up at the man across the desk. He stopped eating.
"'Good' is a very mediocre word, reserved for things like pudding or foodstuffs chosen for breakfast and touted in mindless television commercials. It also can be used to praise a child for mastering accomplishments society requires, like potty training. 'Good boy, good job," Ivan added for emphasis and as examples. "It also blandly shows up in greetings. 'Good morning. Good afternoon." Or in partings. Such as good night or goodbye. Equally as bland and in no way descriptive of what I do when someone comes to your illustrious hospital holding a severed hand and expecting to be reunited with it so that it's of some use to them."
The chief of staff closed his eyes for a moment, searching for strength. He and Ivan had known one another for twelve years now. He had been the one to hire him and he was as close to a friend as he imagined Ivan Munro had. But there were times when the man's personality was a little hard to take. Specifically the hours between dawn and midnight.
To get to his point, Harold acquiesced. "All right, you're magnificent at your job"
"Better," Ivan allowed charitably, nodding his head and once again focusing on his pastrami on rye.
It was getting late. He had a meeting scheduled at one, Harold thought. At this rate, he was never going to get to his point. "Look, I didn't call you here to praise you"
There was a hint of a smile as Ivan looked at him. "Goodsee how I worked in your word?because you're doing not that excellent a job of it."
Abandoning finesse, Harold blurted, "Ivan, you need to learn humility."
Ivan cocked his head, as if he were deliberating over the request. He obviously found it wanting. "Why, Harold? Will it make me a better neurosurgeon?"
Harold blew out a breath. "It'll make you easier to get along with."
Ivan laughed shortly. He paused to take a sip of the iced coffeehe required and consumed all forms of caffeine whenever possiblebefore commenting on what he felt was the absurdity of the last statement.
"I'm not here to get along with people, I'm here to put together people's pieces, remember? You want someone easy to get along with, hire some clown in big, floppy shoes and a red rubber nose. I don't do floppy shoes or red rubber noses, Harold."
Harold looked at him over the half glasses that were perched on the tip of his nose. He wasn't about to be dissuaded or diverted from the path he was determined to take. "We have classes now."
Wide, rangy shoulders that could have belonged to a onetime football guard rose and fell carelessly at Harold's words. "You've always had classes, Harold. This is a teaching hospital." Holding his sandwich with both hands now, the pastrami overflowing at the nether end, he fixed Harold with a penetrating look. "The question is, do you have hot mustard?"
Harold sighed. Reaching for a packet of the requested condiment that was on his side of the tray, he pushed it across the desk toward his irritating neurosurgeon. "Classes that teach interns bedside manner," he doggedly continued.
To his surprise, Ivan nodded his approval. "Excellent." Harold squelched the urge to pinch himself. His association with Ivan had taught him never to jump to an obvious conclusion even if it was shimmying before him. "You mean that?"
"Of course," Ivan attested with feeling. "The more of those little buggers who come out knowing how to coo and make it 'all better' for Sally or Bobby or whoever, the less likely we'll be having this annoying conversation again."
Harold sighed. "How is it your parents never drowned you?" "I was too fast for them," Ivan deadpanned, then nodded toward the chief of staff's plate. "You going to eat that pickle?"
"Why?" Harold asked. "You're not sour enough?"
"Touché." Not standing on ceremony and aware that the older man didn't really care for pickles, Ivan commandeered it and dropped it on his own paper plate. A tiny yellow-green pool of pickle juice formed. Ivan played along with the chief's quip.
"Let's just say I don't need any input in that category."
"No, by God, you don't." It was more of a lament than an evaluation. "All right, I can't force you to take that class."
"Glad you see that."
Harold wasn't finished. "But I can assign you a resident." Ivan's expression was deceptively bland, but his eyes locked on the other man. "Not if you know what's 'good' for yousee, there's that word againor for the resident."
And then Harold said the unthinkable to him as he shook his head. "This is not negotiable, Ivan. You refuse and you're gone."