by David McLeod
The Patient is a Doctor
Jon held his wrist in front of the scanner. The machine beeped, his photo flashed on a screen, and the door to the physical therapy center opened. Tyler's eyes widened. "You're in greens . . . and the screen..." he pointed to his monitor which displayed a new photo. "You're staff?"
"Yep," Jon said. "Discharged yesterday morning and hired yesterday afternoon. Seems they're short of surgeons, and the Chief of Surgery liked the way I dealt with a couple of his people..."
Jon stopped speaking, realizing he was about to gossip in front of Tyler. "Anyway, he liked my work on my own case."
Your combat surgery record, more like it, Tyler thought. But I'm not supposed to know about that, I think.
Jon sat in his office–well, it was a space with a desk and a phone and his name on the door–when a familiar voice interrupted him.
"Dr. McLauren," Dr. Strand, the Chief of Surgery, said. "I have a request from one of our junior interns to rotate into surgery."
"Junior interns?" Jon asked.
"It's in the handbook," Strand said, and then flushed. "Sorry, I forgot we hadn't gotten one for you, yet. Advanced placement high school students, and kids at the Community College who show interest and aptitude in medicine. They work here part time during school, full time in the summer. It's supposed to be a learning experience, but most of them are used as cheap labor." Strand's animosity toward the Medical Center's civilian administration was a poorly hidden secret.
Moving one of the kids into surgery–where he or she could really learn something–would not only help the student, it would piss off Harkness, Jon thought. Edgar Harkness was the administrator who had hired Jon, at Strand's insistence but with great reluctance. "Is this one any good?"
"Will you do it if he is?" Strand asked. "I would appreciate it very much."
"Of course, if he's any good," Jon said. "Or has the potential of being good."
"In that case," Strand gestured to someone who had been standing in the hallway. "In that case, Dr. McLauren, please meet Tyler Sampson, your junior intern."
"Tyler, why didn't you ask me, first?" Jon asked when they were alone.
"I was afraid you'd say no," Tyler mumbled. "Are you going to fire me?"
Jon sighed. "No, Tyler. I promised Dr. Strand I'd take an intern if he were any good or if he had the potential to be any good. Dr. Strand said you were both." Jon paused.
"Tyler, do you remember when we promised to tell the truth to each other?" Jon asked.
The boy nodded his head, afraid to say anything.
"That's a condition of this job. Complete honesty. And that includes not using subterfuge."
"I understand. Um, I want to have sex with you," Tyler blurted.
"Tyler! I want honesty, but–"
"But that's why I applied. That's a subterfuge, and you said no subterfuge."
"Okay, Tyler," Jon sighed. "You are right. But that opens up two more cans of worms. First, do you really want to be a doctor, or did you apply for this job only for sex? Second, if sex between doctor and patient is not proper, why do you think that sex between supervisor and subordinate, or student and teacher, would be okay?"
"Oh," Tyler said, his face falling. "I didn't think about that."
Jon found Tyler to be all that Dr. Strand had promised, and more. The boy had a quick mind that created connections and made links between what he'd studied and what he saw in the operating theater. Jon's unvoiced concern that their mutual sexual attraction would prove problematic did not materialize. Jon found that he could hold the boy's hand, guiding it while Tyler probed a surgical incision, without distracting either of them.
"Tyler," Jon said, "on the first day of your internship, you said that you wanted to have sex with me."
Tyler blushed. "Yeah, I remember."
"Do you still want to?" Jon asked.
"Huh?" Tyler blurted. "But you said…student and teacher... boss and subordinate..."
"That ended 30 minutes ago, Tyler, when I turned in your final evaluation," Jon said. Seeing the look of anguish on the boy's face, he added, "You knew the internship lasted only until Christmas break, didn't you?"
Tyler stood, silent. Jon could no longer read the emotions that flashed across his face. Finally, the boy spoke. "Yeah, I guess I did. So, it's back to the gym and the mop bucket, I guess."
"No, Tyler, it's not. If you like, in January you'll begin an internship in the pathology department. Dr. Morgan has agreed to it, and you seemed to be very interested–"
Jon stopped talking abruptly. Without warning, Tyler had closed the distance between them and was hugging Jon tightly. "Thank you, Jon," he said. "Thank you."
Jon wrapped his own arms around the boy. "You're welcome, Tyler." Jon paused, but Tyler wasn't inclined to turn loose. "Um," Jon continued, "about my earlier question?"
"Yes. Yes I do," Tyler said.
"Dr. McLauren?" Dr. Strand's voice came through Jon's half-opened door. "May I come in?"
"Of course," Jon replied. "Although I can't offer much hospitality." Jon's office was still a cubbyhole that held little more than a desk and a single chair jammed between the desk and the wall.
"This won't take long," Dr. Strand said. "And I'm too angry to sit."
Jon merely raised his eyebrows.
"Harkness has been fired. And arrested," Strand began. "The board has named me Administrator. I want you to be my deputy."
"Arrested?" Jon replied. "Perhaps I'd better hear more before I consider your offer."
"That facility he built for ambulatory patients and families?" Strand began. "It sounded like a good idea. Rather than expensive hospital rooms for people who didn't need them–like you, for example, the first month or so you were here, and then during rehab–Harkness talked the Board into building something like an extended-stay motel."
Jon nodded. The building had been under construction when he arrived, and had been completed only a week or so ago.
"Two things. First, what he built had far greater capacity than historic data or projections called for. Second, he managed to embezzle about $10 million in the process."
Jon raised his eyebrows again.
"And, the money probably can't be recovered. It seems Harkness has a gambling problem," Strand concluded.
It took only an instant for Jon to reply. "Dr. Strand, I do not believe I can or should be your deputy," he said. "I do not have the interest in the job or the personal skills. I owe you a great deal, and will help in other ways, if I may. Perhaps you have an executive officer position I could fill."
"What's the difference–oh, it's your military experience talking–but I still don't understand."
Jon thought for a moment. "A deputy is a line officer. He has command responsibilities and authority. An executive officer is not a commander. He's an administrative assistant. In the Army, doctors aren't commanders or in the line of command. I am good at planning, organizing, paperwork, and administration–I had to do a lot of that at one time. But I've not had command training or experience."
Dr. Strand extended his hand. "You've got the job, Jon. It'll be an additional duty, you know. I can't spare you from surgery."
Jon looked around his new quarters. The center had offered rooms to staff members in what people were already calling the Harkness Hotel. The two-room suite Jon had rented was slightly smaller than the apartment he'd occupied in town, but was connected to the center by an underground tunnel–something to be appreciated in the harsh winters.
Some weeks later, Jon sat on the bed beside Tyler and massaged the boy's back. "You're tense," Jon said. "Something the matter?"
Tyler gasped when Jon pressed hard into a knotted muscle, and then caught his breath. "A little bit," he said. "My Aunt Cathy–mother's sister–and her family have moved in with us. Uncle Evan lost his job, and they were foreclosed. It's only supposed to be until he gets another job, but with the auto plant shut down, I don't know when that will be.
"Anyway, I have to share my room with my cousin. He's only twelve, but he's noisy. And he snores. He has three sisters, all younger than me, and they're chattering all the time. I've got no place to study, and I'm afraid I'm going to flunk chemistry."
Jon continued rubbing the boy's back for a couple of minutes before responding. "What options have you considered?" he asked.
"I thought about getting one of the single rooms here," Tyler said. "But I can't afford it. I thought about getting another job, but there aren't any. I thought about dropping calculus so I could spend more time on chemistry, but it's too late to get tuition refunded, and I don't want to waste that money."
"Looks like you've covered all the bases," Jon said. "Except that you didn't ask me for help..."
Now it was Tyler's time to be silent. Finally, the boy spoke. "I thought about it. I even dreamed about moving in with you... but I know I can't. I thought about asking you for money, but... Jon... I like you... I like you a lot, and I didn't want you to think I was having sex with you for money."
Jon stopped rubbing Tyler's back. "Tyler, roll over and look at me," he instructed.
"Tyler, I still remember the first day I saw you, at the fitness center. I remember what I thought. The exact words, even. I thought, Too bad he's so young; I could have a crush on him if he were a little older.
"Tyler, I was very happy when I found out that you were a little older–of age. I like you a lot, too. If I thought either of us were trying to create some advantage by having sex, I'd have stopped it, instantly.
"You're right, of course," Jon continued. "You couldn't move in with me. Dr. Strand is very open-minded, but he has to answer to the board–and the community." Tyler had been aghast when Jon had said they'd have to tell Dr. Strand about their relationship.
"He must know," Jon had said. "He has given us both too much for us to blindside him should someone find out."
Tyler still objected. "He'll wig-out if he finds out you're gay!"
Jon smiled. "He already knows. I told him before I took the job."
"Did he wig-out?" Tyler had asked.
"No," Jon had replied. "He only asked if I knew of any ethical or legal issues that might arise, and I assured him that there weren't. I also told him that if any surfaced, I'd tell him right away. Hmm. You might be considered an ethical issue."
"I am not an ethical issue!" Tyler had exclaimed, and then smiled when he realized Jon was pulling his leg.
"If you move into one of the single rooms, you'll also need money for food. They don't have any cooking facilities. What about a suite like this one?" Jon asked.
Tyler replied instantly. "Too expensive. I did a budget including food. A single room and eating in the cafeteria would be cheaper than a suite and fixing my own food. And I'd have more time to study. But I still can't afford it."
"Will you let me help?" Jon asked. "No strings attached. You can walk out of our relationship at any time, and I would still help."
Tyler looked at Jon. "I can't think of anything that would make me want to walk out... yes. Thank you. But, how?"
"Tyler, I'm far from wealthy, but for several years, I drew combat and specialty pay, and had no place to spend it. I can certainly afford to pay for a room…well, to give you money so that you can pay for a room, here."
Jon held his wrist to the scanner. The machine beeped, his photo flashed on a screen, and the door to the Sports Medicine Center opened. "Hey, Tyler," he said to the boy at the desk. "What are you doing here?" Tyler had started a third internship, this one in the laboratory, and this one arranged by Tyler, himself. Two of the senior lab techs had graduate degrees in chemistry, an area where Tyler still needed considerable help.
"Carl–the orderly–he's paying me to cover his shift. It's copacetic; the supervisor knows. I'll get off in time to catch the swing shift at the lab."
"Sounds good," Jon said. "What are you studying?"
Tyler blushed, and handed Jon not a textbook, but a garish Japanese graphic novel. The cover featured two androgynous, prepubescent children watching in awe a taller, slightly older figure with flowing hair and caricatured muscles threw an obviously demonic creature through an opening in the sky. The heroic figure had beams of light radiating from his eyes and elsewhere on his body. Jon raised an eyebrow and handed the book back to Tyler.
Tyler blushed again. "It's a Being of Light," he mumbled. "He rescues people who are in trouble and who can't help themselves. Then he encourages them to take martial arts and go to school so that they can defend themselves in the future. It's silly…I probably shouldn't..."
"Do you enjoy it? Do you think you spend too much time reading it? Are you neglecting your studies or social life?" Jon asked.
"Huh?" Tyler sputtered. "Yes, no, and no." He grinned, "As you well know."
"Well, then," Jon said. "Would you do something for me? I'm going to be away for about two weeks. I have some personal business to deal with. Would you collect my mail?"
"Sure," Tyler said. "But where are you going?"
"Tampa," Jon replied. And then to MacDill Air Force Base, and then to the Middle East, but I can't tell you that.
"You lucky dog!" Tyler said. A blizzard had swept in two days before, and snow had piled nearly to the base of the first floor windows.
Tyler was waiting when Jon returned. "Jon! You're back!" the boy said when Jon stepped through the door into his apartment. "Dr. Strand told me your flight number. I got you some bread and milk, and turned up the heat–"
"What happened?" the boy added, seeing the bandage on Jon's left arm.
"Um, later, Tyler," Jon replied. "I'm glad to be home. And I'm glad you're here to meet me." He hugged the boy awkwardly with his right arm.
Jon dropped his duffle bag to the floor. "Tyler, would you go with me to one of the nurse's stations and re-bandage this arm?" he asked.
"Sure, but don't you want one of the doctors to look at it?" Tyler said.
"It's already been doctored enough," Jon said. "Come on." He cuffed the boy lightly on the butt with his right hand.
"It's a bullet wound!" Tyler gasped. He'd unwound the bandage in the privacy of an empty patient room.
"Um hmm," Jon said. "How does it look?"
"Sutures are still solid, and it's clean. No signs of infection. Are you on antibiotics? And who shot you, damn it!" Tyler replied.
"Yes, I'm on antibiotics," Jon replied, "and I can't tell you, Tyler."
"I know who shot you," Tyler said. He'd come into Jon's apartment at 3:00 AM. While Jon splashed water on his face, Tyler made coffee. Now they sat in the kitchenette–a corner of the outer room–talking.
"Not by name," the boy added, "but I know it was one of the people who kidnapped the US Ambassador who was rescued by a mysterious ninja force–meaning an Army Ranger team–three days after you left for Tampa which is near the Air Force base from which Ranger Teams are dispatched."
"Hmm," Jon said. "Good coffee. Are you sure of that?"
"Yes," Tyler said. "A DC paper had a picture of the Ambassador. I found the original on the internet and enlarged it. You're the only trauma surgeon who still ties bandage ends instead of using clips or tape."
"It's faster than tape," Jon said. "And, it's less likely to come loose than clips. This is really good coffee."
"Don't fuck with me," Tyler said. He blushed, and then added, "And you know what I mean!"
Jon put down his coffee cup and reached across the table with his right hand. "I'm sorry Tyler. I don't mean to be obtuse. You figured out something that a team of Army opsec–operations security–experts were supposed to cover up. It's a bit of a secret, especially my involvement, especially since I'm a civilian. Please don't tell anyone?"
Tyler nodded agreement.
"Could you really see the bandage ties in the photo?" Jon asked. "That's a detail I should not have overlooked."
Tyler had stood up. Now he walked around the table to stand behind Jon. He wrapped his arms over Jon's shoulders and hugged him. "No, but I figured that would get you to admit that I was right. If you can fuck with me, I can fuck with you," Tyler said, smiling.
"In that case," Jon said. "I guess you'd better come to bed. It's too late to go back to sleep, too early for breakfast, and the floor is too hard."
Tyler groped for his cell phone. It was a recent birthday gift from Jon. It's either Jon or mother, Tyler thought. They're the only ones who have the number. The screen of the phone was the only light in the room save the illuminated numerals on Tyler's clock: 2:13 AM.
"Tyler," it was Jon's voice. "Get dressed–greens. Meet me at the portal in three minutes."
Tyler was instantly awake. Glad I showered before I went to bed. My bed, I mean, he thought. He slid green cotton scrubs up his legs and then pulled the shirt over his head while sliding his feet into surgical scuffs. On the way out the door, he grabbed the fanny pack that held his wallet, and stuffed the phone in it. He walked swiftly to the stairs. He heard soft footsteps on the stairs below him; he was only a few seconds behind Jon.
They walked briskly down the hallway. "Don't run," Jon had told him once. "You'll save only a few seconds, at most, and the risk of injury isn't worth it, especially in scuffs. Besides, if a patient sees you running, they'll think something is really wrong, and may panic." He chuckled at that.
"Call from County General," Jon said. "There's been a major accident on the interstate. A tractor-trailer and a charter bus carrying a swimming team from some high school. Helicopter will take us."
The rest of the sentence was lost in the noise of helicopter blades beating the air on the helipad.
Jon handed Tyler a set of headphones and gestured to show him the push-to-talk button. "Listen, for a moment; we'll talk later," Jon said when Tyler had the 'phones on.
Jon flipped switches and pushed buttons on an overhead panel. The County General operator answered and then patched Jon through to the Emergency Room.
"You heard?" Jon asked Tyler when he'd released the circuit.
"Yeah," Tyler replied. "It's going to be grim."
"Tyler," Jon said. "You're going to have to fly solo. I'm going to put you on the sub-critical triage line. I'll be close, but you're going to have to work on your own. Okay?"
Tyler nodded, and then realized that Jon couldn't see him in the dim light. He pressed the talk button. "You didn't ask if I thought I could do it," he said.
"I know you can do it," Jon said. "I just want to know if you will."
The staff at the county hospital were not only overwhelmed, they were paralyzed. Jon spent ten seconds assessing the situation, and took charge. "Tyler–scrub. I'll have your first patient when you get out."
Picking up the receptionist's telephone, he pressed a series of buttons. His voice came over the speakers. "Listen up, people. Triage in the parking lot. Crit-stat, only, in the ER..."
Tyler looked up from the boy on the gurney. Where is Jon? This one needs surgery, stat!
Jon listened to Tyler's diagnosis. "You're right. But the surgery staff is already busy. Come on."
Together, they wheeled the gurney into an operating room. What? Stirrups? It's the OB operating theater, Tyler thought. Hope no one needs a C-section today!
Twelve hours later, the job was done. Seven major operations had saved the lives of seven boys. Only one had died, and he was probably dead before he'd reached the hospital. The last of the non-critical patients had been splinted and bandaged.
Jon and Tyler were the only ones in the cafeteria. Saturday evening was never busy. This Saturday was New Year's Eve. Patient population was low, and even fewer members of the staff than usual were on duty. Furthermore, it was nearly 10:00 PM–somewhere between dinner, and the midnight meal for the night shift. Jon and Tyler had been talking quietly for several hours. Rather, Tyler was talking, and Jon was listening. Floodgates had opened. Tyler poured out his frustration.
"My dad's lost his third job since the plant closed," the boy said. "Mom's salary isn't enough to pay the bills and the mortgage. It's not even enough to pay the bills."
Many townspeople were out of work since the auto plant had shut down. Without the salaries from the autoworkers, the rest of the area's economy had been slowing down. Restaurants, department stores, supermarkets, and auto dealers had been the first to go. Now, even the fast food places and the convenience stores were feeling the pinch. The only people who prospered were the title loan and pawnshops. Even the bottom-feeders in the payday loan businesses had left town. There simply weren't enough people with paydays.
The medical center and the junior college were islands of prosperity in the midst of the darkness and despair. The medical center's endowments kept it in the black. And, it didn't have an emergency room. It didn't face the financial drain that the unemployed and uninsured made on public hospitals that had to offer emergency treatment to anyone who came to them. That burden was borne by the county hospital. Jon was not the only doctor from the med center who offered pro bono services. Tyler accompanied Jon whenever possible, continuing his training.
The junior college, where Tyler's mother worked in administration, received federal and state funds. Any state resident who graduated from high school was eligible for admission and a scholarship, so the state paid many of the bills. Jobs at the school, like those at the hospital, were eagerly sought by the townspeople, but those two institutions didn't have enough jobs to replace those lost when the auto plant and its suppliers shut down.
"They're going to have to move," Tyler said. Jon saw that the boy was fighting off tears. "The bank's foreclosed on the house. Dad's stealing the car from the finance company... they came to repossess it, but he hid it in a neighbor's garage... they're no better off than my folks are–"
"What's that?" the boy asked. The lights in the cafeteria were flickering. From overhead, came a rhythmic clicking that coincided with the flickers. Through the large windows, lightning played from cloud to ground.
"MRI," Jon said. "It's right over the cafeteria. Usually they have the Muzak playing and you don't hear it. I don't know why it's making the lights flicker, though. Maybe–"
From the windows, a blinding flash of lightning interrupted whatever else he was going to say. An intense smell of ozone was followed by the sharp scent of cinnamon. Before their eyes could recover from the flash of the lightning, they were in blackness.