The emergency room nurse took one look at the bruised and bloody face before her and immediately bypassed the waiting list. "Bring her over to table one," she said. "I'll get a doctor for her right away."
Caldwell and Rachel walked the girl to the nearest examining table and helped her up onto it.
A doctor arrived seconds later. "How did this happen?" he asked, as he began examining the girl's injuries.
"She got beat up by someone," said Caldwell. "Probably a boyfriend. Or maybe her father or some other relative. We don't know very much yet. She hasn't said a thing since we found her."
"I'm not surprised," said the doctor, "given the extent of her injuries. She may have a mild concussion, which would explain her silence. Has she cried or shown any emotion at all since you found her?"
"No, she hasn't," Caldwell said.
"Fear," Rachel said. "She was shaking with fear when I got to her. And she was covering her face with her arms."
"Can you talk to me, Miss?" the doctor asked the girl. "Can you tell me your name?" The girl looked in his direction but did not seem to see him.
The doctor spent a few minutes evaluating the trauma to the girl's face and head, mentally cataloging the nature and severity of each distinct injury. Finally he stepped back and let out a depressed sigh. "Okay," he said, "here's her situation. She's got numerous abrasions, lacerations and contusions. Some of them are recent, but several of them are not. The fresh injuries obviously occurred right before you found her, but I would say that she's been assaulted at least two additional times in the past two weeks. The bruise on her left cheek is two or three days old. She has partially healed lacerations on her scalp that go back farther than that—probably a week or more. She may have more injuries on the rest of her body as well, but I can tell you from what I've already seen that this is one very abused girl."
Rachel stared wide-eyed, her hand covering her mouth, first at the doctor and then at the girl, as the doctor recited his inventory of harm. Caldwell shook his head in disgust.
"You mean to tell me that somebody has been beating her like this repeatedly?" Rachel exclaimed. "And nobody did anything about it?"
"Apparently not," replied the doctor. "As far as I can tell, her older wounds have not been treated. She's going to need stitches over that right eye, and probably on her lip, too. We'll have to do a CAT scan to determine if she has any cerebral swelling or cranial damage. Hopefully she doesn't have any broken bones anywhere else. Help me get her shirt off and we'll see if she's injured below the neck."
Caldwell and Rachel took hold of the girl's arms from opposite sides of the table and lifted them up while the doctor started to unbutton her shirt. Suddenly the girl came to life. Her arms flailed from side to side, shaking loose from their grasp. An elbow struck Caldwell square in the chest and he grunted with the force of the impact. The doctor managed to grab hold of the girl's wrists and pin them together in his hands. The girl then started kicking her feet wildly at him.
The doctor talked to the girl as reassuringly as he could manage, trying simultaneously to calm her and to avoid her kicking legs, but the girl was impervious to his words and only struggled harder to free her hands from his clutch. Caldwell and Rachel both stepped back from the table to avoid the girl's thrashing limbs. Unable to break free of the doctor's grip, the girl threw her head back and let out a piercing scream—a cry which drew its anguish more from fear than from pain.
A nurse came running into the examining area and took over the task of trying to calm the girl. "Let go of her hands," she told the doctor. "You're only upsetting her."
The doctor obliged the nurse's command and released the girl's wrists as he stepped back several feet from the table. Immediately the girl's struggling stopped and her arms went up to cover her face again, just as they had done when Rachel first came upon her. She then took a deep, desperate breath and broke down into an uncontrollable fit of sobs. The nurse gently took the terrified girl into her arms and guided the girl's head down onto her shoulder. For several minutes the girl's tears ran from her swollen eyes and flowed across the half-coagulated blood which remained unwashed from her face. The mixture bled freely onto the nurse's starched white shirt, leaving a pink stain.
"That's actually a fairly positive sign," the doctor said, trying to restore a sense of calm to the room. "I was worried that she was unresponsive due to trauma to the brain, but she would not be able to fight like that if she had a serious brain injury. Now I think her behavior is due to trauma that is more emotional than physical."
"She sure is stronger than she looks," Caldwell said, rubbing his chest.
"You're saying that she's been emotionally abused too?" Rachel asked in disbelief.
"That's my suspicion," replied the doctor. "We'll treat her cuts and bruises and do a CAT scan anyway, just to be sure. But after she's been patched up, I think she's going to need some counseling. I'll have her admitted overnight and set up an appointment with the psychologist for tomorrow."
"I'd like to have a detective question her to find out who assaulted her," Caldwell said.
"That'll be fine, Scott," said the doctor, "but not today. I think this girl has been through enough stress for one day. Have the detective call the psychologist tomorrow, after he's had a chance to see this girl. Maybe she'll be able to talk then."
* * *
Rachel remained at the hospital for a long time after the girl had been placed in a wheelchair and taken down the hallway toward the area where the CAT scanning equipment was located. Told by the doctors that she would not be allowed to accompany the girl through the rest of her treatment, Rachel went to the waiting area and sat down to think. She felt conflicted. She knew that she was under no obligation to care for the girl any further, yet she could not persuade herself to simply walk out of the medical center and put the entire incident behind her, leaving the girl in the hands of the hospital staff and its bureaucracy. Rachel had felt, from the very moment that she first came upon the battered child and held her protectively in her arms, that it was her duty to look after her and shelter her from any further injury. Some might call it a maternal instinct, although Rachel herself certainly would not characterize her feelings so. Perhaps it was more a basic human compassion, or the natural sense of sisterhood that women feel for one another in times of distress. Regardless of the psychological explanation, Rachel's concern for the girl was irresistibly strong, and the feeling became more powerful with each passing minute.
As she sat alone in the waiting area of the busy hospital, she observed closely the rote comings and goings of the doctors and nurses. They moved with such harried urgency, Rachel thought. Each member of the staff walked hurriedly from place to place, perpetually behind schedule, continuously performing multiple tasks at once. Here was a nurse talking to one patient on the telephone about an upcoming appointment while simultaneously filling out paperwork on a second patient. Next to her, another nurse retrieved various pharmaceuticals from a cabinet while instructing an intern regarding the care of a third patient. And there went a doctor, moving from one room to the next, dispensing treatment orders in the form of pills and injections and intravenous fluids with the rapidity of a mother bird feeding her young, interrupting his rounds only long enough to assign additional duties to the already overworked nurses. It all seemed so hectic to Rachel. The longer she sat there and observed the medical staff at work, the more impersonal their work seemed to be, and the less acceptable it became to just walk away and leave that tormented girl in the sole care of this distracted system.
Rachel walked over to the admittance nurse and offered her assistance in filling out whatever paperwork was needed for the girl's treatment. Although she knew virtually nothing about the girl whom she had known for less than an hour, the gesture was not pointless. She took the admittance form from the nurse and wrote down her own name as the person to be contacted in the event that an adult's consent was required for any treatment, and she gave her address and phone number. In the space labeled "Relationship" she wrote "Friend/Guardian".
Upon returning the form to the nurse, Rachel inquired as to the visiting hours for the following day and made a mental note to return to the hospital the next morning to see the girl. At that moment she was uncertain as to her intentions for a longer-term relationship with this girl. Did she want to be friends with her? Was that feasible? There was, she guessed, about ten years' difference in their ages, and that fact alone implied that they might have little in common. In her peaceful moments the girl was probably a typical junior high schooler—infatuated with boys and clothes and little else. Probably still impressed by any guy who drove a car or played on a varsity sports team, Rachel thought. She had difficulty picturing the two of them spending time together as friends. She could not hope to be an adequate substitute for friends of the girl's own age, yet she felt instinctively that the girl lacked companionship. Lonely, isolated people had a certain way about them that she rarely failed to recognize; it was a gift that she had always seemed to have. Even through the drama of the day's events, through the ordeal which the girl had suffered and the silence and the fear and the pain which were its obvious results, Rachel believed she had perceived the true essence of the girl's need. She did not want to be the girl's mother, nor did she wish to be her only friend, but she felt the desire to play some role of support for her. A mentor, a guardian, an adoptive older sister—perhaps these were the types of relationships that she could provide in the girl's life. If not forever, at least until she knew that the girl would be all right. At least until she could see the girl smile back at her without those ugly bruises on her face, and without those frightened arms held up in habitual defense. Her instincts told her that the girl was in desperate need of some such person in her life. She felt that she owed the girl at least this much.
* * *
Rachel walked through the lobby at the front of the building and out the front entrance. A brilliant wave of sunlight washed over her as she passed from beneath the building's short portico and onto the walkway that led through a courtyard and toward the street. She pulled a pair of sunglasses from the pocket of her shirt and put them on. Out on the sidewalk she saw two groups of people milling about on opposite sides of the property. Some of them paced back and forth in lines along designated portions of the sidewalk on their respective ends of the block. Some carried above their heads crude homemade signs attached to wooden sticks. Others wore their signs across their chests, held there by lengths of string that ran behind their necks. Still others wore their signs in sandwich-board fashion over their torsos, both front and back, the two faces connected and supported by straps laid across their shoulders. Those who were not walking at the moment sat uncomfortably on plastic chairs, their feet swollen and tired, their signs laid wearily on the ground beside them. A few of them were engaged in conversation with one another while the others simply sat alone, staring off absentmindedly into the distance at some unknown image, the nature of which could not be discerned by the looks on their faces.
The marchers were all quite familiar to Rachel and she walked directly toward the group occupying the southern end of the block. Each member of the group recognized her immediately as she approached, and she exchanged greetings with several of them. She spotted one particular female member who was about her own age and made her way over to her.
"Hi, Jennifer," Rachel said.
"Rachel!" the young woman exclaimed. "Where have you been? Allison and I waited for you as long as we could back at your apartment, but you never showed. What gives?"
"I'm sorry about that," Rachel apologized. "I should have called you guys and told you what was going on, but things got kind of crazy and I guess I lost track of time."
Rachel told the woman about the earlier events of the day. All of the others in the group, either genuinely interested in Rachel's story or simply in need of an excuse to stop pacing for a few minutes, gathered around to hear the tale.
"Is she going to be all right?" Jennifer asked when Rachel had finished.
"I think so," said Rachel, "but I'm really concerned about her situation. She seems so vulnerable, so defenseless. I have a hard time accepting the fact that somebody would do something like that to her, and nobody seems to have raised a finger to help her. I just feel so sorry for her."
A male voice spoke up out of the gathered group. "Well, I'm glad you didn't let that cop just take her away by himself," the voice said. "That guy's a fuckin' bastard."
Everyone in the group turned to look at a wiry young man, about twenty years of age, who stood off to one side of the gathering. He was slightly under six feet tall, with long, stringy blonde hair which covered his ears and obscured most of one eye. He wore a once-white tee-shirt which was shrunken and yellowed with age and which curved around his upper body, molding to the contours of his chest and shoulders and spine which all arched noticeably around a concave space centered at his breastbone. His hunched posture gave him the look of an old western gunfighter perpetually ready to draw his pistol on an enemy. A half-smoked cigarette hung loosely from one side of his mouth as he spoke, and his eyes were squinted into narrow slits. He took a hard drag on his cigarette, then reached up with his right hand and plucked the object from his lips, holding it between his fingers as he pointed emphatically at the rest of the group.
"I've had my eye on that guy for a long time," the young man declared truculently, white smoke venting from his lips. "He's not going to get away with any of his shit as long as I'm around."
The rest of the group did not reply to the young man's statement, but silently cast their glances away from him. The man, seemingly satisfied that his proclamations had been heard and understood, returned the cigarette to his mouth with authority and lifted his sign back above his head. He began walking away along the imaginary line which most of the group had been tracing a short time earlier. For several minutes he remained the sole picketer on that end of the block.
Rachel whispered sarcastically to Jennifer, "I see that Billy is his usual pleasant self today."
Jennifer rolled her eyes. "At least he hasn't started yelling at the Lifers yet," she whispered back. "I think that as long as we keep him moving up and down the line we can keep him under control. He's like a cheetah in a cage, though. He has to keep pacing or else he goes nuts."
Rachel nodded her agreement.
"He worries me sometimes," Jennifer continued. "He doesn't seem to understand that we are not the aggressors here. It's those guys who are supposed to be the belligerent ones," she said, tilting her head toward the group of people occupying the northern end of the block.
"Yeah," Rachel said, "I agree with you for the most part. We can't let our emotions get the better of us, that's true. But sometimes I think it's good to have a little spark on our side. Otherwise it looks like they are the only ones who feel passionately for their cause and we come off looking timid."
Jennifer sighed in half-hearted agreement. "I suppose," she said reluctantly.
"You also have to admit that it's more interesting out here on the line when Billy's around," said Rachel with a smile. "Besides, I don't really think he's got much bite in him. I think he's just a lot of bark."
"Yeah, maybe you're right," replied Jennifer. "I guess he just embarrasses me sometimes with the things he says. Oh, that reminds me, did I tell you about the dream I had the other night?"
Rachel shook her head and leaned in closer to Jennifer to indicate that she was anxious for her to tell.
"Well," said Jennifer, "I had spent half the day out here on the line with you-know-who, and he was behaving in his usual way the whole time. I was so tired when I got home that I went straight to bed and fell asleep almost immediately. And I dreamed that I was sitting in a movie theater right in front of this really loud guy who kept yelling these rude comments all the way through the movie. I mean, the guy was acting like the most obnoxious person you ever met. It was terrible!"
Jennifer hunched her shoulders forward, lowered her voice to a more masculine level and rattled off some of the more humorous remarks that she had dreamed. Rachel put a hand to her mouth and tried to stifle a laugh.
"Then I smelled this repulsive cigarette smoke," Jennifer continued. "It was so bad I could barely breathe! It smelled like somebody was smoking fermented hamster droppings rolled up in old fish-wrapping paper. It was just the most god-awful smell you could imagine. I tried to get up out of my seat and leave, but my legs wouldn't work. I was trapped there. I thought I was going to die!"
Rachel struggled harder to control her laughter. Her face turned a deep red and her eyes began to well up with tears. She shot a quick glance over in Billy's direction, but the young man was walking away with his back to the group, completely oblivious to the mirth being bandied about at his expense.
"So finally I turned around in my seat to see who it was behind me," Jennifer went on, "and guess whose face I saw?"
"Please, please, don't tell me!" Rachel sputtered through her fingers. "I can hardly breathe as it is!" She coughed a few times and struggled to inhale in short, rapid breaths between her convulsions.
Jennifer waited several seconds to let Rachel's laughter play itself out a bit. Then she pulled a handful of her hair down over one of her eyes with her fingers and squinted at Rachel with a menacing look.
"This movie sucks," she mockingly growled, pointing her finger in Rachel's face. "I'm gonna get my money back from that theater manager. That guy's a jerk."
Rachel bent over with laughter until her face almost touched her knees. She held both of her hands as tightly as she could over her mouth, but it was of no use. She could no longer suppress her laughter, which came bursting out of her with a force that was only multiplied by her efforts to contain it. Her shrieks were instantly contagious, and several others who were gathered around laughed heartily along with her.
"What's so funny?" Billy's voice said abruptly. There was no emotion in the inquiry. It was completely devoid of anger or humiliation. His voice was not upset in the slightest way when it spoke, for it did not speak from within that circle of people who actually knew what was so funny. The voice spoke from somewhere else, a place outside that group of intimates who were able to find humor in a shared joke among themselves. It was not so much the dream from which they drew so much merriment, but more the connotations thereof, and that was the disparity which separated the individual from the group.
Rachel straightened up immediately when she heard Billy's voice, and her fit of laughter died in an instant. She saw Billy standing immediately behind Jennifer, looking in to the center of the group from over her shoulder. The two women shared a brief look at each other, a look in which they both promised to go along with whatever lie the other was quick enough to invent under the circumstances.
"Oh," Rachel said, trying to regain her composure, "Jennifer was just telling us a funny story about her aunt."
"Yes," Jennifer added hastily. "You really have to know my aunt to appreciate it. She is just such a strange person. She's always doing crazy things."
A feeling of dread hung in the air for a moment as everyone waited for Billy's response. A tension grabbed at them as they considered what his reaction might be. Would he see through their little lie? Had he overheard any of their conversation before he spoke? Did he already know they were lying? Or would he be fooled by their ruse and innocently ask them to share the whole story with him? And what story would they invent if he did? They consciously braced themselves for any of these possibilities.
"Hmmm," Billy said slowly. "I don't know her. I think we should get back on the line."
The other members of the group gladly abandoned their conversation. They picked up their signs of protest and accompanied Billy back into formation along the picket line. A palpable sense of relief came over them as they welcomed their narrow escape from such a potentially embarrassing situation, but they were subdued at the same time by a shared sense of shame. They resumed their march in silence with their heads slightly bowed and their eyes cast down toward the ground, because they dared not to look at each other. Billy walked proudly and defiantly at the front of the line and set the pace at which the others followed. And none of them laughed for the rest of the afternoon.
* * *
Sally Wheelan sat in the middle of the row of chairs on one side of the large conference table. She was the first to arrive in the board room, a few minutes before the meeting was scheduled to start. This would be her first meeting since joining the medical staff the previous week, and she purposefully positioned herself at the center of the table so that she would not be far removed from any of the other attendees. Although she was the newest member of the staff, she wanted to demonstrate that she was ready to participate fully in the business of the medical center immediately.
All of the doctors who worked at the medical center were free to attend the monthly board meetings if they felt so inclined, although few took advantage of the opportunity unless some specific topic of personal interest was on the agenda. Representatives from the corporation which owned the facility attended regularly, so it was a perfect forum for a physician to raise an issue, if it was thought sufficiently important, to upper management.
The other attendees arrived sporadically and took their seats around the table. Wheelan received greetings from the other members of the staff, all of whom she had already met, welcoming her to her first meeting. The non-staff attendees were a bit more aloof, but Wheelan made it a point to introduce herself to each of them. The director arrived and, after taking his seat at the head of the table, informally called the meeting to order.
The meeting proceeded according to the usual agenda. There was a standard set of business items that needed to be handled at the beginning of every meeting. Schedules had to be coordinated among the physicians to avoid the possibility that too many of them would simultaneously plan to be away at seminars or conferences or vacations. When such absences did occur, alternate physicians needed to be identified to take up the care of patients while the attending physician was away. Wheelan, being the newest physician on the staff and thus having the fewest current patients, quickly found herself covering for several other doctors in the coming weeks. She accepted the additional responsibilities without objection, since her workload was still rather light. She welcomed the opportunity to work more closely with the other doctors and to involve herself more fully in the day to day operations of the hospital.
The meeting then moved on to a discussion of finances. An accountant from the corporation distributed reports showing the income and expenses of the hospital and the clinic for the prior month and for the fiscal year to date. The data were not good, he opined. The hospital was over budget in several categories of expenditure, and revenues were below target. The clinic had better ramp up its business even more than it already had, he said, and quickly, to compensate for the shortfalls elsewhere. Until that occurred, the staff would have to cut back several percentage points on discretionary spending and delay large capital purchases until the following year. The staff groused openly about these new financial restraints, claiming that their budgets were already too stingy.
Wheelan remained silent during these discussions. It seemed to her that the corporate management was being neither overly frugal nor profligate when it came to budgetary matters. The medical center did not maintain the full array of equipment and supplies that was currently available, that was true, but it was an impressive arsenal nevertheless. The equipment they had was all fairly new and was certainly sufficient to handle the needs of a large majority of the patients who were treated there. Any advanced diagnostic procedures which a doctor felt were required could easily be performed at other specialized facilities in the area without placing an undue burden on the patient. Wheelan felt that it was more important for the hospital, especially at a financially tenuous time, to prove that it could operate in a fiscally stable manner than it was for the doctors to have every implement of modern medicine at their immediate disposal. The most important thing, she thought, was for the facility to be here. The town needed the hospital and the clinic, and foregoing one or two pieces of expensive equipment would not restrict them from fulfilling that need. But she kept her thoughts to herself, not wanting to make enemies among her fellow staff. She could live with whatever the corporation decided to do, so long as they kept the place open. After much debate the accountant's opinion prevailed, and the staff seemed to accept the budget cuts with resignation.
The director then broached the subject that Wheelan was most interested in discussing. Copies of the mayor's letter were passed around the table, and the director read the letter verbatim to the group. Wheelan did not need to read along with the director. She had read the mayor's letter many times in the preceding few days and could now recite it from memory. She watched the other members of the staff closely, trying to judge their level of interest in the issue from their body language. A few of the attendees followed along with the director as he read, but most of the group seemed inattentive. Several of them continued to study the financial reports or concentrated on other papers that they had brought with them.
The director finished reading the letter and asked a corporate attorney to give his opinion of its contents and its ramifications for the center. The attorney acknowledged that the letter was highly unusual. He had sent copies to several other attorneys he knew who were well versed in medical law and asked them for their opinions. None were able to offer a definitive opinion or to identify a firm body of case law which would govern such a regulation. The consensus was that the mayor's edict was an idea so novel that, to their knowledge, it had never been tested before a court of law. The lawyer concluded, therefore, that the corporation had only two options. It must either comply with the order immediately or challenge it in court immediately. To ignore the order or to delay in acting upon it would only cause the corporation harm and leave it susceptible to punitive action by the town council, as the mayor stated in his letter.
What were the chances that the center could have the mayor's order overturned by a court if it chose to pursue that option? the lawyer was asked.
The attorney could offer no guarantees. It would likely be a contentious, protracted fight. There would be many issues, both legal and medical, that would have to be considered by the court, not the least of which would be the fact that the city itself granted the business licenses under which the hospital and the clinic operated.
Could they count on any assistance from the state in overruling the order? the director asked. What priority did the town's regulatory interest have versus the competing interest of the state? Would the court uphold a regulation of a town council which superceded the regulations of the state?
Again, the lawyer replied, this was unclear. They could approach the state for assistance, but ultimately it would be a matter for the court to decide. The mayor and the council may have already consulted with the state before they acted. And even if the state was not in agreement with the mayor, there was a large difference between disagreeing with the actions of an individual jurisdiction and actively working to overturn those actions. The lawyer said that he would place a call to the state attorney general's office to gauge his level of interest in the matter, but in the meantime they should assume that they were in this fight alone. The corporation could take the city to court, but it would most likely be at their own effort and expense. And, again, no guarantees could be made as to what the ultimate outcome would be.
And what would the medical center be required to do during the period of time when all of these issues were being worked out in court? the director wanted to know. Would they have to comply with the regulation during this time, or would the regulation be delayed from taking effect until the court made a final decision?
They would have to comply with the order unless and until the court decided otherwise, the attorney said. Local laws were valid and enforceable until specifically ruled invalid or stayed. They could certainly request a stay from the judge, but such motions were rarely granted in the local district. Alternatively, short of deciding wholly in favor of one side or the other, the court might order some sort of intermediate procedures to be followed. Perhaps the collection of tissues would be ordered as stipulated in the regulation, but the requirement that they be turned over immediately to the medical examiner's office could be held in abeyance until a final ruling was issued. In the interim, the clinic might be ordered to either preserve the tissues at its own facilities or turn them over to some third party designated by the court for storage. That was the best hope he could offer at the moment.
And how long would a case such as this take to work its way through the courts?
Years, the attorney said. At least two years, maybe longer, depending on the number of appeals.
The director hesitated for a moment and looked briefly at the accountant as he contemplated his next question. He didn't really want to hear the answer, but he knew that the question had to be asked. How much would all of this legal action cost? he asked the lawyer, his tone of voice resigned to the unaffordability of the situation.
A lot, replied the lawyer. A conservative estimate would be half a million dollars. A more likely figure would be anywhere from a million to a million and a half dollars after all of the proceedings were concluded.
The director took a deep breath and looked around the room apologetically. He saw a variety of expressions looking back at him. Some of the staff looked entirely disinterested in the subject. Others seemed concerned, but their faces reflected a sense of resignation at the inevitability of the decision to be made. Wheelan wore the most steadfast expression of any in the group.
The director felt obliged to ask for feedback. How did they feel about the procedures called for in the mayor's letter?
Wheelan remained silent for a few moments, preferring to let a more senior member of the staff make the first objection, to which she would then lend her support. She looked around the room, but to her great disappointment none of her colleagues spoke up. After a long silence she took it upon herself to voice the first objection.
"It's unacceptable," she said firmly.
All eyes in the room turned toward her. She felt the need to make her case strongly in order to shake the others out of their complacence.
"We can not allow the mayor or the town council or anyone else to dictate to us how we are to conduct our medical procedures here," Wheelan continued. "I don't care how much it costs; this is an issue beyond money. The mayor has no legitimate right to collect tissues from our patients. I don't know precisely what his intentions are for these tissues, but I'm fairly certain that it has nothing at all to do with 'protecting the health and welfare of the citizens of Bazelton', as he claims in his letter. He's pulling some sort of political gimmick, probably to win votes in his governor's race, and he's using this clinic to do it. I think it's absolutely appalling, and I don't think we should stand for it."
The director and several others nodded in silent acknowledgement of Wheelan's position, but their reactions were subdued. No one voiced immediate support for her position.
"Does anyone else care to comment on the issue?" the director asked, trying to coax some further discussion from the group.
"It's a tough situation," offered one doctor.
"Yes," agreed another. "I'm not very happy with the idea either, but it's hard to fight city hall, especially in this town."
The others nodded and grunted in agreement.
Wheelan sat transfixed in her chair, amazed at the sudden timidity of the group. Five minutes earlier they were up in arms over a slight delay in the procurement of some completely superfluous medical equipment, she thought to herself, and now they were willing to let the mayor roll over their authority as doctors.
"You must be kidding me," said Wheelan, trying to control her impatience with the group. "This is a medical issue. We are the physicians here, not the mayor. You don't see any of us firing off letters to the town council telling them that we are going to confiscate their leftover campaign materials, do you? Why are we so willing to allow the mayor to interfere in the business of this clinic?"
Several of the attendees exchanged looks among themselves as Wheelan spoke. They seemed to be deciding which of them would take up the task of replying to her argument.
"Sally," said one of them, a radiologist named Roger, in a tone which Wheelan heard as condescending, "you haven't been here very long yet, so it's understandable that you want to fight this. But the rest of us have seen this sort of thing happen before, and we have a better idea of what we would be up against."
The man leaned his elbows on the table and talked to Wheelan like a father trying to explain to his young daughter the impracticalities of caring for the pony which she has put at the top of her Christmas list.
"You see, Sally, in this town the Mayor pretty much gets what he wants and there's not much that anybody else can do about it. He's got the council under his thumb, and between his office and the council, there is really no way to fight him except through the courts. And we've all just heard the kind of headaches that that would entail. If he were clearly breaking the law it would be a different story, but this is what you might call a test case. And believe me, our Mayor never loses a test case. We would just be pouring our money down a rat hole."
"I agree with Roger," said a woman from the end of the table. "The Mayor always gets his way. My brother has been running his own business in this town for twenty years and he tells people all the time, 'Don't cross the Mayor.' 'Get the Mayor on your side,' he says. There's no other way to run a business around here. Some people try to fight him, but they don't ever last very long. They wind up either giving in to him or shutting down and moving on to something else."
Wheelan began to feel an anger welling up inside her. Memories of the many arguments she had had with hospital management in years past came back to her all at once. The same resentments, the same feelings of betrayal that she had felt back then were surfacing once again.
"I don't care how much power the mayor thinks he has around here," Wheelan said defiantly. "He can't just order us to give him whatever he wants. Suppose he ordered us to operate while standing on our heads. Would we just throw up our hands and do it?"
The others sat back in their chairs and did not respond. They seemed content to let their newest colleague vent her objections without rebuttal. Wheelan saw that her arguments were not having a persuasive effect. She decided to pursue a more reasoned line of argument.
"Look," she said, a bit more calmly, "we all know that the mayor is not really interested in getting his hands on all of the various types of tissues that we may take from our patients here. That's just a smoke screen. He is purposely requesting all tissues in order to avoid specifying precisely what he wants. What he is really after is one particular type of tissue. He wants to collect aborted fetuses. Does anybody here doubt that that is his real objective?"
Wheelan looked around the table. No one replied, but she could see that they were all in agreement with her on this point.
"Okay," she continued, "so we know what he's after. And we are all familiar with the mayor's position on abortion. And we are all aware that the man is running for governor. Given all of that, it doesn't take a lot of thought to see that the guy is up to something shady. I don't know exactly what he's planning to do with these fetuses once he has them, but my instincts tell me that it will be something underhanded. And whatever it is, it will very likely reflect badly on this clinic. He's going to try to tar and feather us on this issue in order to advance his career. I don't know about the rest of you, but I personally do not relish the prospect of having my professional reputation used as a stepping stone by an ambitious politician."
"I don't think anybody disagrees with your assessment of the Mayor's motives, Sally," the director said. "It's just that we have to ask ourselves two fundamental questions before we march off to court to fight him. Number one, how much will the fight cost us? And number two, what are our chances of success? I know that in a perfect world these things wouldn't be a consideration, but unfortunately for us they are. I'm being told that the costs will be high and our chances of winning are low. I hate the whole idea too, but we have to be realistic about the situation."
Wheelan took a deep breath and let it out slowly. She had to admit that the director had a valid point. There was a cost-benefit tradeoff that had to be considered, and, judging the situation from a purely financial standpoint, the tradeoff weighed steeply toward simply abiding by the mayor's decree. Yet Wheelan could not allow the fiscal argument to override the principles which she felt trumped any financial consideration.
"Jacob," she said, addressing the director by his first name in order to make her plea more personal, "you see that he's targeting my practice, don't you? You see that I have more at stake here than anybody else. It won't make much difference to anyone here if the mayor collects and then disregards an appendix or a tumor of some sort, right? But he isn't going to do that with the tissues from my patients, is he?"
She paused and looked around the table once again.
"No, he isn't," Wheelan said, answering her own question. "He's going to collect these fetuses and he's going to use them against me. And an assault on my practice is an assault on all of us. It's an assault on the principle that doctors, and only doctors, decide how to treat patients. You may not feel vulnerable to the mayor's actions at this point in the same way that I do. I guess that's understandable. Maybe that's part of the reason why the rest of you are not willing to fight him on this issue. But if we don't stand up to him now, then I don't see how we can stop him from exerting more and more authority over this facility in the future. Eventually he will have his hands in everybody's practice. In a few years he might as well be sitting in your chair, Jacob."
The director drummed his fingers on the table as he turned Wheelan's argument over in his mind. He was half doctor and half administrator, and at that moment his two halves were wrestling mightily with each other. Each side knew exactly how the decision should be made, and they were both right.
"Let me think about it," he said at last. "I'll make some phone calls tomorrow—see if I can locate somebody with a way around this thing. If anybody here comes up with any ideas in the meantime, please let me know. I'm open to suggestions."