Pushing Glass-Thin Walls

Thin Walls

Jasmine enveloped James as he held Deanna close to his chest. The relentless ring of the telephone, the blare of the overhead speaker, all were silenced beneath the whispers of their breaths.

"James," Deanna looked up at James. "I think you need to speak to someone. If you don't want to talk to Nomura, at least talk to another attending."

James caressed her hair as he responded. "I will speak to Nomura but you're right, we need as many allies as we can get."

"What about Haas?"

James nodded. "It's funny, isn't it? Never would have even considered her a few months ago but our relationship is pretty good now. But I've never spoken to her about anything other than our cases. Don't know how she would respond."

"It can't hurt. She may know the right people. She may even have experience with this. I've spoken to her about career choices. She's not the warmest person but her advice is sound. I think you'll get the answers you need."

Deanna's points were compelling. Events were moving quickly and he didn't know how much damage had been done. "I'll try to see her this afternoon." James embraced Deanna. "She'll help us."

Haas was the attending on hematopathology that week. The bone marrow biopsies had more than doubled over the last two years as bone marrow transplants became increasingly common at Memorial. During these weeks, it was rare to find her office without the hematology attendings or fellows clammering for the biopsy results on their patients. The door was ajar; James peered into her office.

"Dr. Haas?" Haas was seated at her desk, her back to the door. She glanced at a small pocket mirror on her desk. Her eyes caught James' reflection.

"What is it, James?" Her voice was neutral, yielding no insight to her mood.

"Excuse me, Dr. Haas. Do you have a few minutes? I need to speak to you about something."

"Is it about a case? I didn't know you were on hemepath."

"No maam. It's..."James hesitated and entered her office, drawing the door to a close. "...a personal issue."

Haas turned to face him and motioned to the chair. "Sit down. What's this about?"

James drew a heavy sigh. "Dr. Haas, it's about ULS and-"

"The lawsuit?"

"In a way-"

"James, I don't think you should be speaking about the lawsuit. I'm sure your attorney discussed this with you."

"Yes, he did. It's...it's not directly about the lawsuit. It's about Carlisle and the contract between Memorial and ULS."

"What about it?"

"Carlisle has been meeting with Dr. Hartman, the medical director at Riverside Hospital in Ladue. I have reason to believe that he intends to end the contract between ULS and Memorial and hire Hartman's group instead."

Haas' eyes opened wide. "And what makes you so sure about this?"

"Someone...Carlos...is dating one of the donor center nurses at their hospital. He saw him there last night meeting with Hartman. Turns out, they've had several meetings over the past weeks."

"And?"

"And...I'm concerned that with the lawsuit and all, Carlisle will use this as an opportunity to replace Dr. Nomura."

Haas looked at James for a few seconds and then sat back in her chair. "I see. And who else knows about this?"

"Just Deanna. I wanted to share this with you. I thought you might know what I should do with this information. Do you think I should take it to Dr. Morelli?"

Haas smiled. "Alex Morelli wouldn't know what to do with useful information if it was tattooed on his brain."

"Yes maam."

"You've done the right thing. The ULS contract is very important to Memorial. If we didn't have it, there would be even more downsizing. It brings in quite a bit of revenue." Haas stood up. "James, let me think about what you've told me. I need to figure out the best approach. Let me get back with you. Just don't tell anyone else about this."

James smiled. "I won't. Thanks for your time, Dr. Haas."

As James closed the door on her office the waving arms of Dan caught his eye. James leaned toward his office door. "James, come in and close the door," he whispered. James obliged as Dan turned up the volume on his CD player. "Miles Davis...Live at the Plugged Nickel. Good stuff."

"Dan, I'm sorry. I don't have time to listen to Miles Davis."

"Shhh...just listen to his tone."

James folded his arms. "Dan, I have to go. I need to meet with several people."

"Like Hartman?"

"How do you know about that?"

Dan held up his fingers and approximated a space of about a quarter of an inch with his thumb and index fingers. "There's not too much wall between our two offices. I hear everything."

"What do you know?"

Dan threw his head back and uttered a laugh. "A lot more than you and Carlos know."

"Dan, I'm confused."

"Of course you are. Haas has been playing everyone for a fool!"

"What?"

"James, this goes back way before you even started. You asked me once whether I thought Haas was a racist. I still don't know but I can tell you this for sure, she hates Nomura."

"But why?"

"She's one insecure bitch. Nomura's the attending the residents love. He's the one the surgeons go to when they have a diagnostic problem. He's the one bringing in revenue to the group with his skin biopsies."

"But, she's a great diagnostic pathologist. Even Nomura relies upon her opinion."

Dan shook his head. "No one cares. All she sees are the accolades headed toward Nomura." Dan whirled around in his chair. "Haas is leaving Memorial. She's accepted a position in Hartman's group in Ladue."

"Oh my God!"

"When the lawsuit began, she was contacted by Hartman. He and Carlisle have completed their negotiations. As soon as the lawsuit is over, Nomura and Memorial are out. Hartman and Haas are in." Dan stood up and placed both of his hands on James' shoulders. "Get the hell out of here, James. This program is falling apart. Memorial's going to lose the ULS contract. Morelli's impotent, he doesn't know how to stop the hemorrhaging."

"What am I supposed to do? I still have three years of training left."

"Just apply to another program and transfer. Morelli asked me to stay on as an attending. If I didn't know what was happening, I might have taken the position. Now? No way. I've accepted a position in Wisconsin. I'm going home."

James was immobilized. The truths he had surrounded himself with were all lies. Wretched lies.

"So what are you going to do?" Dan's words were never clearer.

"I'll let you know." James rushed out of the office before Dan could answer.

The path to his car was ten minutes with a brisk walk and catching all of the elevators. James covered the distance in half the time, leaping several flights of stairs in the fire exit. His car roared out of the doctor's lot, barely missing a patient in a wheelchair. Within minutes, he was running through the front doors of ULS and outside Nomura's office.

"Dr. Nomura." James could barely speak between his gasps.

"James. What's wrong?"

"Dr. Nomura...I need to tell you what's been going on."

Nomura listened as James recounted the events, the conversations he had with Carlos, Haas, and Dan. For a seeming eternity, Nomura sat and stared at his desk, his eyes transfixed to a glass slide perched on the microscope stage.

"Damn them." It was almost a whisper. James thought he imagined it.

"Damn them!"

"Dr. Nomura, I-"

"I have given everything to this lab. Never complained. Never! And for what?" Nomura pounded his fist on the desk. "For what?" he repeated, his voice growing louder. "Why do I do this? Why? Why?" Nomura placed his head on his desk. He was broken. His fragile dreams shattered. His words, spoken so powerfully to James just the other day, now rang hollow.

"Dr. Nomura, we need to do something. We need to confront Carlisle!" His words were urgent, pleading.

Nomura didn't look up but shook his head. "No James. I will accept this and you should to. You cannot change the inevitable."

James looked at the crumpled figure, hidden by his white coat. James clenched his fists. His eyes swept the office and recorded each painful detail, the stacks of slides, the detached requisition sheets, the broken slide. The insults, the snide remarks, the laughter at his expense; the memories flooded his senses and converged at this point, in this room. Is this what he worked for? Would he become a pathologist who refused to stand up for his own honor? Would he so easily allow others to degrade and abolish his accomplishments? The answer boiled to the surface.

"It's not going to be that easy." James leaped to his feet and bolted out the door.

"James..wait!" Nomura's cry could barely be heard. James pushed through the transcriptionists that surrounded Carlisle's office. Carlisle was alone, on the phone, when James invaded. His face was flushed, his eyes brimming with tears. Carlisle surveyed the heaving anger that stood before him and muttered on the phone, "I'll call you back."

"James, something I can do for you?"

James' words were delivered in rapid succession. "I know all about your plans to dump Dr. Nomura and ULS. I know all about the deal you've struck with Hartman. I know about Haas leaving Memorial. I know-"

"You know nothing. You're out of line!"

"You don't know how much Dr. Nomura has done for you and ULS. You told me you needed him. You told me you needed us, the Memorial pathologists. But all you care about is someone to push your glass. You don't care who it is!"

"Get the hell out of my lab!" The words spewed forth. James stood and faced Carlisle.

"You have no honor. You have no idea. I'm not afraid of you!"

Carlisle grinned. "You should be."

The pool of transcriptionists were gathered outside the door and feigned interest in an old coffee pot as they jockeyed for listening positioning. James burst through the door, slamming into one of them, and knocking her into her desk. "Watch it!" he barked. A chorus of ,"Ooo!" followed James as he exited.

Deanna was there to meet him when he returned to his office at Memorial. She was pacing the hall awaiting his return. It was 6:30PM. They were the only residents left in the department.

"Dan told me about what's been happening."

"Deanna, I confronted Carlisle."

"You did what?"

"I told him I knew about everything. I told him that Nomura was far more important to ULS than he could ever imagine."

"What did he say?"

"He threw me out of his office."

"Oh James!"

Deanna pained look alarmed him. "Deanna-"

"James, you could be fired for this. He's probably talking to Morelli right now."

James sat back and smiled. "Is that what you're concerned about? I know that. It doesn't matter anymore."

Deanna shook her head.

"It doesn't matter anymore, Deanna. This..," James lifted a glass slide from his microscope, "is all that matters."

Deanna forced a smile. "James...it's not that easy to get another position, especially if you're fired."

"Deanna, if I have leave America and return to the Philippines to become a pathologist, I'll do it. This is who I am. Nothing is going to stop that. Ever since I came here, I've been dogged with the label, foreign medical grad...FMG. What does that mean? Does it mean I can never push glass as well as an American graduate? If people are going to hate me because I'm a foreigner, let them. But they will never hate me for being a bad pathologist. That will never happen. I'll never let that happen."

Deanna nodded. "I know you won't. Maybe this will blow over. Morelli hates to rock the boat unless he has everyone on board with his decisions. With Nomura behind you, there's no way he will do anything."

"I don't know and I don't care. I'll speak my mind, stand up for what I believe in. I won't hide behind the fear that I can lose my position. There is no honor here Deanna. Thin walls and hollow words." James thought of Nomura's crumpled figure. "Only hollow words."

By Wednesday of the following week, James learned from Dan that Carlisle had contacted Morelli. As Deanna predicted, Morelli attempted to smooth over the entire incident hoping that he could keep the ULS contract alive. He was still unaware of the negotiations that Carlisle and Hartman had concluded.

The trial had been scheduled for Monday morning in Ladue County Courthouse. When the plaintiff's attorneys lowered their demand to $110,000 in damages, the ULS attorneys capitulated on Friday afternoon at 4PM and agreed to pay $85,000 toward the settlement while Moynihan, representing Puritan Insurance, agreed to contribute $25,000 on Nomura's behalf. Moynihan informed Nomura of the final settlement. James was sitting in the office when the phone call came.

Nomura looked up and through James. "James, I need some time to myself."

James nodded and left the office. The bolt clicked as he closed the door. Nomura dimmed the lights, slumped into his chair, and stared at the diplomas and awards on the wall. His eyes closed as he wrapped his arms around his chest. His soul had been on trial. There was a settlement. But no settlement would ever dispel his demons of deceit. James heard the sound of glass breaking as Nomura threw a book at his wall.

James shook his head. Deanna hugged James as he arrived in his office. "I think it's time for that dinner I promised you." They clasped their hands and exited the hospital.