Corrective Action

By Gordon R. Kelly

Seeking to leave his prominent Boston family and privileged background behind, Doctor Wade Bowers comes to practice in a small New England town. With his Ivy League education and the finest surgical training, he is welcomed by nearly everyone. But not by internist Miles Warner, a native son of humble origins and a product of the state university. Warner views Bowers as an elitist intruder who has no place in his hometown. They instantly dislike one another. Over the years, antagonism escalates to obsession and hatred, with fatal results.

• Language: English
• Publisher: iUniverse
• Release date: Feb 26, 2013
• ISBN: 9781475977929

Gordon R. Kelly

Gordon R. Kelly is a graduate of Princeton University and Yale University School of Medicine, and received post-graduate training at The Buffalo General Hospital and the Institute of Ophthalmology of the Columbia-Presbyterian Medical Center in New York. He and his wife Barbara Caird Kelly have three adult children, and live in Rutland, Vermont, where he practiced for thirty-five years.

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Copyright © 2013 by Gordon R. Kelly.

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This is a work of fiction. None of its characters is now alive. None has ever lived. Any resemblance to anyone, living or dead, is unintended.

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ISBN: 978-1-4759-7791-2 (sc)

ISBN: 978-1-4759-7792-9 (ebk)

iUniverse rev. date: 02/21/2013

CONTENTS

Dedication

Acknowledgements

One

Two

Three

Four

Five

Six

Seven

Eight

Nine

Ten

Eleven

Twelve

Thirteen

Fourteen

Fifteen

Sixteen

Seventeen

Eighteen

Nineteen

DEDICATION

To Bonnie, the catch of a lifetime.

In memory of John Raymond Paul,

Princeton University ’61, author, friend.

ACKNOWLEDGEMENTS

This work could not have been written without the support and cooperation of many friends and family. My wife Barbara C. Kelly spent decades listening to me rant about other people’s writing, and believed me when I said I could do better. My children, Jennifer Kelly Geddes, Elizabeth Kelly Rossetti, and Brendan Robert Kelly, have provided unfailing encouragement. Colleagues Andrew P. Zak MD and Frederick H. Bagley MD provided a view into the workings of medical practice boards, and Henry R. Dimuzio, Jr. MD informed me about Emergency Department matters. My good friend and fishing buddy Arthur E. Crowley, Jr. coached me on legal questions. Robert J. Andrews MD FACS, gifted surgeon and poker player, kept me from straying too far from surgical accuracy. Authors Jo Andrews, whose friendship I have enjoyed for many years, and Luise van Keuren were astonishingly generous with their time, experience, wisdom and insight. Teacher and actor Burnham Holmes kindly contributed advice. Any failings which remain, despite their efforts to the contrary, are mine.

Gordon R. Kelly MD

ONE

It was just after seven when I entered the hospital’s main corridor, but already a stream of housekeepers and volunteers and nurses going off shift flowed toward the coffee shop. Cranston Howe was bucking the traffic, and we saw each other at the same time. He waved and hurried toward me, a concerned frown on his handsome features. Putting a hand on my shoulder he steered me toward my office.

Wade Bowers is in the ED. Evidently he collapsed while fueling his truck down on Prospect Street early this morning. Cerebral event.

He conscious?

No. It doesn’t sound good, Red.

I slowly set down my chipped Radiologists Do It In The Shadows coffee mug and the current issue of a journal on my desk. I drew a deep breath and held it a second. OK. Thanks, man. I’ll go over now.

He left, and I made my way to the Emergency Department. A few of the day staff were clustered at the desk. As I opened my mouth to ask, I spotted Bowers on the board and wheeled around to Room 3. I tapped on the door and opened it a few inches. The Head Nurse Ms. Gajdusek looked up from adjusting the IVAC machine that regulated the IV in Wade’s arm. He lay on his back, his skin pale and damp, his breathing slow and labored, and as I watched, it stopped for a few seconds and started again. On the wall a heart monitor graphed a green tracing of his cardiac activity. A urinary drainage tube led to a plastic bag hung under the bed.

Oh. Hi, Dr. Munro.

What can you tell me, Pauline?

She smoothed the sheet over his chest. He’s unresponsive. She gestured toward the monitor. Blood pressure is 150/95. Heart rate 56. Pupils are five millimeters and sluggishly reactive. Dr. Alton’s on for neurology, and he ordered a stat CAT scan, but, she hesitated, and turned back to the still form on the bed, but he may not even . . . She straightened and was still for a couple of seconds. Sorry. It’s just that . . . She turned back to me, blinking hard. He’s always been kind of a hero to me.

I could not take my eyes from the still form of my mentor and friend. This is the end, I thought, of all the years of your companionship and guidance, of all you have taught me by lesson and example, of all your influence in my life. I could not have known as I fought back my own tears that it was not to be so. Yeah, I said, He’s been that to a lot of us.

TWO

Wade did not even survive the day, but, in the way of small towns and smaller medical communities, by the time of his passing that evening word had spread far and wide.

I hated every second of the funeral. Wade would have, too. Wade was no Catholic. His son, raised in the faith in accordance with his mother’s wishes, had dictated the arrangements. The priest droned on as if the sentences had worn out from overuse, and no longer held any meaning for him. Funeral, generic. There was no effort to portray the man as an individual, to say who he was and what he meant to everyone assembled there. He should have stuck to calling him Doctor Bowers. When he referred to him as Owens, I tuned him out.

Owens Wade Bowers, Junior, MD hated his first name all his life. His famous father, once Chief Surgeon at the Massachusetts General Hospital and past president of the Massachusetts Medical Society, respected philanthropist and pillar of Cambridge society, hung it on him. I guess The Old Man, as Wade used to call him, possessed of an ego the size of New England, needed his name to live on after his own time. Wade did two things about that. One, he never used his first name. A lot of people didn’t even know what it was. His checks were printed O. W. Bowers, Jr. MD, but he signed his hospital records WBowers. And, two, he named his son Mitchell Arnold Bowers, which made Wade’s mother, descended of the South Carolina Arnolds, very happy, and pissed off The Old Man something fierce.

I squirmed in the pew and glanced around me at the dozens of other doctors massed in the left front of the packed church. Across the aisle Mitchell sat alone, pale but composed. The priest was about to serve communion, and my Catholic colleagues squeezed past, leaving me with the Jewish guys, to file forward. The rosy light from the high stained glass windows glowed on the flag-draped coffin as they trooped up to receive the Host. This was the part I had always disliked about Catholic funerals. It made it seem that this was just another mass, except you have to walk around the dead guy to get the wafer and the wine. I regularly took communion in my own church, and appreciated the power and beauty of its symbolism, but to participate in it at a funeral somehow took away from the reason we were there. For me, it became empty ritual.

Footsteps clicked and shuffled up the white marble of the main aisle. Hundreds of Wade’s former patients had turned out to honor him. Old women in black, old men looking ill at ease in their ties and best clothes. One old guy, in overalls and a tweed jacket, so bent that his face paralleled the floor, tottered with a cane and the support of a younger woman. These people knew what this occasion was about. But for Wade’s skill, some of them might not be here at all. The line stretched backward all the way to the vestibule. The main doors were open, framing an achingly beautiful late-September afternoon. God, how I wanted to be out of there. I should pay attention, I told myself, but all I could think about was another matchless fall afternoon.

It was 1976, I had recently come to town to join the radiology group at the hospital, and Wade had invited me to go hunting with him. We followed his old German shorthair Molly across the fields of yellowed grasses undulating in the breeze, the sun high and bright in a startlingly blue sky, ostensibly looking for upland game but content just to be out on such a day. I didn’t even own a shotgun then, and Wade had lent me one of his, a handsome 20-gauge Browning over-and-under. I found my attention drifting from the ground to the hills, their green already splashed with the red of maples and sumac, reveling in the impossible purity of the air, with its hint of distant dairy farm and the faint acrid tang of autumn.

The music jarred me back to the present, a female voice with a pronounced wobble and a sketchy sense of pitch. At first I had trouble locating where it was coming from, but then I spotted her across the sanctuary beyond the nine-man Navy honor guard seated across the aisle, solemn and dignified in their black uniforms. It was an elderly nun crooning some annoying trivial song into a microphone. After seemingly endless repetitions, it was over. The priest waved a censer around Wade’s coffin, filling the hushed space with its powdery stink, the sailors in their white barracks covers took up their positions with satisfying precision, and we followed them and the body slowly out.

A few doctors slipped away to office hours and rounds. The rest milled around under the ancient oak that shaded the churchyard, talking softly among themselves, and waiting for the honor guard to load the casket into the hearse. Allan Levy spotted me and came over. He stretched and craned his neck, taking a long breath and shaking his head slowly.

Hey, Red, he said. What a day. If you gotta be dead, it’s a good day for it. But it’s a better day to be alive.

Yeah, I muttered. I watched the crowd spilling down the steps, collecting in bunches, in no hurry to leave.

Sorry, man. No offense. I know how close you and Wade were.

Uh huh. Across the street the parochial grade school was letting out and the clamor of young voices filled the air, the kids in their neat uniforms oblivious to the scene over here.

We going to play Thursday? It’s at your house, right?

I suppose so, I said. Sure, Al.

THREE

The Game, as we called it, had been going on monthly for nearly thirty years, mostly with the same players. It was Cooper, Doyle, Howe, Levy, Munro, Parinello and Wigginton, in the alphabetical order we used to keep track of whose turn it was to host the next session. We gravitated to Thursdays to avoid family and travel time on weekends, and with the idea that if we stayed up late, at least Friday was the end of the work week. Though in recent years we didn’t play very late any more. And with Trey Parinello retired and travelling a lot, we relied more on subs. Some of those didn’t get asked more than once, so the subs that did became regulars in their own way.

Grace was unwrapping cold cuts and arranging them on a platter when I got home. Bags of chips and cans of nuts were arrayed in serving bowls on the counter. This was the standard mid-game break food. Sometimes I would cook when the guys came to my house, but this week my heart wasn’t in it.

How’s the knee, hon? I asked.

She turned to me with the smile that never failed to melt me. Better. That Celebrex is pretty good stuff. Last week I could hardly get across the room. She grabbed a stalk of celery and bit into it as she came over to me. She put her arms around my waist and I rested my chin on the top of her head. Keith, are you OK? she asked. Grace never used my nickname.

I guess. Count yourself lucky you were away and didn’t have to sit through that funeral.

I should have been there. She moved back to the refrigerator and began getting out jars of pickles and olives, mayonnaise and mustard. I moved her knitting basket and sat on a stool to watch her.

You’d agreed long ago to go down and help Eileen. If you had come rushing home, you’d have been letting her down. On another topic, I don’t know why you persist in beating yourself up playing tennis twice a week.

Because I need the exercise. Because I need to lose some weight. Again. Because if I give it up, I’ll just sit around reading and knitting, and needing to lose more weight. Besides, I’m the youngest one in the group. I can’t wimp out in front of those old ladies. Here, open these.

I twisted the lid off a jar of cherry peppers.

This the usual suspects tonight?

Yeah. Trey is going to Kansas City to see his youngest tomorrow, but he’s coming tonight. I don’t see anything that looks like dinner.

She held up the plate of carrot sticks and celery. These are my dinner.

Thank God. I thought you were going to try to feed those to the animals.

I know better, Mr. Smartass. Your poker players wouldn’t touch them. You are having pasta salad, and there’s a baguette in the oven.

Thank you. I’m going up to change, I said over my shoulder. And it’s Doctor Smartass.

I was slicing onions and tomatoes when the doorbell rang. Fat drops of a chill rain were pelting the windows, and the wind tried to snatch the storm door as Conrad Cooper slipped in.

Hey, Supe, I said. Dump your coat on the bench.

Hope it’s OK I’m a little early. He smoothed his bushy gray hair and followed me into the kitchen.

Sure. You hungry?

Nah. I been eating on and off all afternoon, waiting for this middle-aged primipara to deliver. Her blood pressure is up, and I’m thinking my whole evening is going down the drain. Then, when I’ve cancelled my office hours and sent my staff home, she decides to get going. By the time I’m done with the delivery, written my orders and taken a shower, I figured I’d just come over. He had the refrigerator open. Sure could use one of these, though, he said, wiggling a bottle of Harpoon India Pale Ale. I handed him an opener, and he drained most of it in two long pulls.

Not going to be the same without Wade, he said. End of an era.

Yeah. But he’d way rather be dead than hemiplegic or mute or half blind. Or all three.

I guess. He lowered his bulk into the small flowered armchair near the cold fireplace. He was an active guy.

Wade lived to be outdoors. Always did. Fly fishing, hunting, snowshoeing. More since his wife died, and practically all the time since he retired. Did you know Alice? I sat opposite Cooper.

Sure. Met her several times. Nice woman.

Sweet lady. And he worshipped her. But she wasn’t ever the same after their daughter Julie disappeared. Nineteen years old. Never heard from her again. They near went crazy trying to find her.

Did I hear she had a drug problem?

May have, I don’t know. Wade looked like he’d been drawn through a knothole for a long while after. Then about three years later, Alice gets the ovarian Ca. Damn near crushed him. He about lived at the hospital in her last weeks. And for months after she died. Spent endless amounts of time with his patients. Headlights washed over the windows, and I got up to look out. Looks like Levy, and he’s brought Mac Doyle. One more and we can play some cards.

I went to the door while Cooper went for another beer.

Shit, I’m blind, gasped Levy ducking in. It’s pouring out there. He shucked his windbreaker and