“Top of the morning, ladies,” I declared upon entering my practice.
I was a single practicing Internal Medicine physician working out of a medical building
that stood next to a huge family practice that filled a two story building in the office complex next door. Mary Higgins handled all my scheduling and billing, while Melanie Jones was my nurse.
“You have an 8:15 and your day is filled except for one slot at 1:30, but I'll bet that gets
taken this morning,” Mary stated. “It looks like the lab might be busier than usual. How was your
weekend?”
Mary was in front of the computer holding her customary mocha cream. She had a cast
on her left forearm, a victim of a nasty spill on a friend's boat down at the Jersey shore.
“The weekend was mighty fine, thank you,” I said a tad smugly though I didn't mean to.
“Oh, you're in a good mood, what's up with you?” Mary asked.
I didn't think I was in a particularly good mood and struggled to give her a satisfactory
answer. But maybe I'd been trying to be more cheerful lately and it had thrown people off. Susan
liked it, though I was not sure anybody else did.
“Do we have the lab figures back for Leon Blue?”
Leon came into the after-hours clinic over the weekend, complaining about having a head
cold for seven months. He wasn't running a fever and wasn't in any pain, just congested as all get
out.
“Yes, I'll call him in a bit. Nothing popped up on the blood screen,” Melanie chimed in
from down the hallway.
“Okay….tell him I'm prescribing Sifanext for allergies.”
Pulling out my prescription pad, I started writing it all out, trying to ignore Mary who
stood up from the computer and let out a moan while she stretched.
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It was clear Mary had something big to let me in on.
“So, get this,” she starts. “I'm driving home on Friday night and I'm on my street. Six
houses down from us, I see all the contents of the home out there on the lawn…all of the beds,
entertainment centers…everything!”
Mary grabbed from me the prescription to fax over to Mr. Blue's pharmacy.
“Big garage sale?” I asked.
She let out a loud chuckle and came up to me with crossed arms, which was her way of
saying, „I want your full attention now.'
“Does this have anything to do with your brother's situation?” I asked innocently.
Mary's brother was arrested last weekend over charges of serving alcohol to minors, after
her brother and sister-in-law hosted a keg party for their high school senior daughter, Lindsay and
her friends. One of these friends left the party before passing out on his own front lawn until the
next morning when his parents called the police.
“What?” Mary yelled out. “No, stupid, I'm not talking about that! Okay…this lady and
her kids were renting the house from a couple that had moved back to Arizona…It turns out that
she's a stripper…which I have a hard time believing because she never looked that thin the few
times I saw her…”
“Where are you going with this?” I demanded.
Mary took a sip of her mocha cream. “Okay…the next door neighbor called the cops on
Friday morning to complain about a toxic smell coming from this lady's home…well, the cops
show up and find a meth lab in her basement.”
I didn't dare point out the mocha cream mustache on Mary's lip.
“Can you make meth in a basement?”
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Mary pushed me with her good arm.
“Where have you been? Crystal Meth was the leading drug for teens last year and it's
growing like mad.”
I shrugged my shoulders.
“Well, why did this couple rent the house to a bunch of meth dealers?”
Mary threw up her arms and walked back to her station with the prescription that we
needed to fax.
“I was just kidding, you know!” I shouted back to her and headed into my office.
My nurse, Melanie, came into my office two minutes later.
“Hey hon….there's a Dr. David Clark waiting for you in the lobby, Should I send him in?
You have about 10 minutes before the first patient.”
This was odd, because I had known Dave since Princeton and he had never come into the
clinic. Dave was a cardiologist - a highly successful one at that – who had been a key part of five
or six major heart-related drug studies in recent years and had consulting gig with Distal
Pharmaceuticals on the side. It helped that many of these companies' drug studies were located
around the New York metro area.
We tried to have lunch every month and we were pretty good at keeping that schedule.
Dave loved Italian food, so I tried to accommodate him on that end.
We were roommates in college for one year along with four other guys. Dave was
legendary for his upside down tap suck technique in which he would be held upside down by the
side of the beer keg and drink from the keg's tap. Dave grew up in Boston and still had a slight
accent when I met him. An easy target himself, Dave stopped trying to make fun of the Jersey
accent years ago. He was the first member of his family to go to college, though Dave rarely
discussed his extended family with me. He had one boy, age 15, and was married to Toni.
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I walked out to the lobby and spotted Dave reading last week's Sports Illustrated. He
looked up at me with a mighty smile.
“Interesting article on the Patriots…you should check it out,” he remarked.
Dave knew that I was a huge New York Jets fan and couldn't stand the Patriots.
“Funny man! Good to see you, Dave…what brings you down here? I don't think you've
ever set foot in this clinic.”
Dave laughed and grabbed my arm. “Is your office back here?”
Was the great David Clark off today? That would make sense given that Dave only
operated a few days a week and always in the very early morning. I couldn't recall if Monday
was an off day or not.
We walked down the hallway to my office, passing Mary who gave me a funny look.
“Have a seat,” I said.
I closed the door to my office. “Okay, what's up?”
Dave kept standing and put his hands in his pockets. He stood 6'2 and always wore a suit
during non operating business hours, which I found odd given that I never wore suits if I didn't
have to. I only owned two good suits that still fit me. I bought a tuxedo eight years ago, but had
worn it just once to a black tie wedding and I had thought since that I would have been much
better off renting a decent one - no one would ever have noticed.
For five years, Susan wore a knock-off diamond wedding ring after losing the original
ring during our vacation in the Bahamas. When I surprised her one Christmas with the real deal
again, we viewed this as more symbolic.
“I'm sure you're aware of the drug Zyptorin – it's the coronary drug that aims to be 40-
50% more effective in artery plaque reduction,” Dave started. “It stays in your system longer and
spends more time in the arteries.”
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“Okay….” I inserted, knowing he could easily be speaking for a few more minutes if I
didn't cut him off at the pass.
“Well, we are about halfway done with the study and I'm one of the heads of the study
committee,” Dave continued. He clapped his hands together. “Ralph Lacher, one of our
committee members has had to drop out due to family issues and I'd like you to join the steering
committee.”
This, I wasn't expecting - the great David Clark was asking me to be on one of his high
profile drug study committees. Susan was going to have a cow when she heard this, given that she
had informed me on several occasions over the years how Dave was a pompous ass who could
spend an entire dinner party talking about himself and his affairs. I couldn't say I entirely
disagreed with my wife but the guy and I had some strange bond, like he needed me as a constant
in his life. I never called him to arrange our monthly lunch because I knew he always called me to
set it up first. If Dave got my voice mail, he had been known to call again before I had a chance to even hear the voice mail. I had a far busier day than Dr. David Clark, yet I made one fifth of what
he pulled in each year and this only bothered me every other week.
“Really?” I tried to act as calm as possible, taking a sip of my bottled water. I probably
drank 7-8 of those suckers every day.
Dave laughed. “Yes, really! It will be very helpful to have an Internal guy at the table,
and you won't have to do much of the work.”
Sitting back down in my chair, I looked at the clock on the wall, realizing that I had less
than two minutes.
“Why's that?”
“Well, the steering committee acts like a buffer between the study researchers and the
drug company. We simply review the data…we have statisticians for the big leg work.”
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Buffer was an odd, yet decent choice for describing how a drug study steering committee
worked. Things could get kind of nasty when a drug company got a study result that they didn't
like, since neither scientist nor pharmaceutical CEO was fond of hearing that the drug they
created had some nasty side effect or, worse, was conclusively ineffective.
“When does the study end?” I inquired.
“Not entirely sure at this point. My guess is that the committee will be able to release
conclusive results nine months from now.”
Dave was a scratch golfer and played in pro-am tournaments across the country, a level
of productivity in sharp contrast to his college days when he always said that he could be on the
golf team if he put a little dedication into the sport. Enter the easy life as a cardiologist and the golf game blossomed.
“I'll call you later this evening with more details,” Dave told me. “I believe there is a
meeting Thursday at 5:30, but I need to double check.”
“That's fine,” I said.
“Oh, I almost forgot,” Peter declared. “I'm having lunch with Peter Hansen tomorrow to
talk about investing some of my money with him. I hear PLH has been performing reasonably
well.”
“You are not a high flying celebrity but, whatever,” I replied. “Say hello for me.”
My son Tom was best friends with Peter's son, Charlie. Peter ran an investment firm in
town, though I could honestly say that I hadn't been tracking his firm's performance over the
recent years. I had a Merrill Lynch broker in town that I had been using for over twelve years.
“I will do, sir!” Dave said and then let himself out of my office.
I sat back in my chair, thrilled that he finally asked me. I never wanted to beg to be on
one of his cool drug committees but this was an opportunity to break out of the funk I had found
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myself in with my career. Was this a mid-life crisis, even though I had earned the same amount of
money for ten years now? I couldn't see any more patients, meaning that I had hit the proverbial
glass ceiling. Meeting with pharmaceutical big wigs or hobnobbing with the upper ranks of the
medical community was out of my league. That opportunity that Dave gave me could open doors
in my stagnant career. It was not about the money – it wasn't clear to me if committee members
got paid for their service – yet I wanted to be looked at as somebody more than some Internal
Medicine doctor in a small clinic.
I didn't want to get my hopes up too much and I was sure Susan would ask me just to be
happy with whom I was. This caused me to cringe every time she said this. Why did everybody
need to understand who they were and be happy with that? The ego is a complicated beast within
us and it needs feeding. I shouldn't have needed somebody like David Clark to ride to my rescue
but I kind of did need him. I wanted Susan to brag more about me to her friends, she needed that
and I needed that.
Mary poked her head in my office and, with her hair already getting out of place, she was
clearly getting frustrated.
“Mr. Kane is waiting in room 2. He's got a huge lump on his neck. He's really worried
about it.”
“I'll be right in, Mary.”
She looked at me oddly, cocking her head to the right.
“Hey, are you alright? You look a bit flushed.”
“Mary, I'm okay…don't waste time talking to me…we have a busy day ahead of us!”
Standing up and stretching out my arms, time to be a doctor. I walked out into the
hallway and almost ran into Melanie.
“Hey, how was your weekend?” she asked cheerfully.
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“Not too shabby. The Bartlett's had a barbeque on Saturday night. I thought Susan and I
might see you and Tim there.”
Melanie, Susan and Lisa Bartlett were in our neighborhood book group. Melanie and her
husband Tim lived up the street from us. Tim was an accountant for a hedge fund in the city,
while Melanie had been with my group for twelve years now.
“Oh, we got together with the parents of Lucy's boyfriend. We met them at the Summit
Hotel. Nice folks…”
“Rick…right?” I jumped in. “That's the boyfriend's name?”
Lucy was the 22 year-old daughter of Melanie and Tim who had just graduated from
Penn State. She wanted to be an actress.
“Nice boy! You have a great memory, Mr. Nick Johnson. Yes, Rick is a fine young
man…and he's an investment banker!”
“Sounds like a match made in heaven.”
I didn't quite see what Rick being an investment banker had to do with it, because most
of the investment bankers that I knew had been laid off in the past year. This seemed like a
potentially lucrative but not so stable career path, while the path for an Internal Medicine doctor
was the flip side of investment banking. Sure, the pay was better than most professions, yet I
could never make over $1 million in a single year like a banker on Wall Street could. The most
patients my practice could see in a single day was sixteen, so my income was capped at the rate
my practice charged for those sixteen patients. Granted, some patients underwent lab and X-Ray
treatment which added to their bill, but for most intents and purposes, my income had a clear
ceiling.
However, my career was very stable and I didn't have to worry about getting laid off. Bill
Arbor lived next door to me and was a banker in the city, up until six months ago. He was a
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Senior Vice President in the Corporate Finance department until they gave him the axe one day
out of the blue. Bill had just returned from a trip to a client who agreed to issue their next bond
deal through Bill's firm. Even though his firm earned ten years of his salary on the bond deal he
brought before being axed, they gave him only one month severance.
“Didn't you tell me that Rick and Lucy have been dating for over a year?” I asked
Melanie.
“Uh huh, he graduated a year before Lucy from Penn State and was living in Soho with a
group of guys that work on Wall Street.”
“What a life these young kids lead.”
“Oh, did the Bartletts serve their rack of lamb? That dish is out of this world!” Melanie
exclaimed.
Melanie and Lisa Bartlett shared recipes often and joked about launching a cooking show
together or starting a catering service of some sort. Big dreamers, the both of them.
“No, this was kind of an ocean theme…lobster, shrimp…Lisa does make wonderful
stuffed crabs... Okay, I'd better get in to see Mr. Kane.”
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Monday, September 1st,
2:30pm