An Insider's Guide

Chapter Nine

Dr. Thomas Wolcott Franklin III had the second-best office in the St. Francis Hospital complex.
When it came to quality administrative real estate, the pecking order was determined by your revenues, and as chief of dermatology, T.W. was behind only one other department head.
Of course, the fact that his department was such a good earner was because he'd "sold out," as some of the academic stalwarts maintained. Under his leadership, dermatology not only handled lesions and cancers and burns in addition to chronic skin conditions such as psoriasis, eczema, and acne, but there was a whole subpision that did only cosmetic procedures.
Face-lifts. Brow-lifts. Breast enhancements. Lipo. Botox. Restylane. A hundred other improvements. The health care model was private-practice service delivered in an academic setting, and wealthy clients loved the concept. The bulk of them came up from the Big Apple--at first making the trip for the anonymity of getting first-class treatment out of the tight-knit plastics community in Manhattan, but then, perversely, for the status. Getting "work" done in Caldwell was the chic thing to do, and, courtesy of the trend, only the chief of surgery, Manny Manello, had a better office view.
Well, Manello's private bathroom also had marble in the shower, not just on the counters and walls, but really, who was counting.
T.W. liked his view. Liked his office. Loved his work.
Which was a good thing, as his days started at seven and ended at--he checked his watch--nearly seven.
Tonight, though, he should have already been gone by now. T.W. had a standing racquetball game every Monday night at seven p.m. at the Caldwell Country Club . . . so he was a little confused as to why he'd agreed to see a patient now. Somehow he'd said yes and had his secretary find a replacement for him on the courts, but he couldn't for the life of him remember the whys or whos of it all.
He took his printed schedule out of the breast pocket of his white coat and shook his head. Right next to seven o'clock was the name B. Nalla and the words laser cosmetics. Man, he had no recollection how the appointment had been made or who it was or who'd given the referral . . . but nothing got onto that grid of hours without his permission.
So it must be someone important. Or the patient of someone important.
Clearly he was working too hard.
T.W. logged on to the electronic medical records system and ran a search, again, for B. Nalla. Closest match was Belinda Nalda. Typo? Could be. But his assistant had left at six, and it seemed rude to interrupt her while she was having dinner with her family with just a what-the-hell-is-this?
He stood up, checked his tie and buttoned his white coat, then picked up some work to review while he waited downstairs for B. Nalla or Nalda to show.
As he headed out of the department's top-floor stretch of offices and treatment areas, he thought about the difference between up here and down in the private clinic. Night and day. Here the decor was done in hospital non-chic: low-napped dark carpet, cream walls, lots of plain cream doors. The prints that were hung had spare stainless-steel frames, and the plants were few and far between.
Downstairs? Top-tier spa land with concierge services delivered in the kind of luxury the very rich expected: the treatment rooms had HD flat-screen TVs, DVDs, couches, chairs, tiny Sub-Zero refrigerators with rare fruit juices, food that could be ordered from restaurants, and wireless Internet for laptops. The clinic even had a reciprocal agreement with Caldwell's Stillwell Hotel, the five- star grande dame of lodging in all of upstate New York, so that patients could rest overnight after receiving care.
Over-the-top? Yes. And was there a surcharge? Absolutely. But the reality was, reimbursements from the federal government were down, insurers were denying medically necessary procedures left and right, and T.W. needed funds to fulfill his mission.
Catering to the rich was the way to do it.
Thing was, T.W. had two rules for his doctors and nurses. One, offer the best damn care on the planet with a compassionate hand. And two, never turn a patient away. Ever. Especially the burn victims.
No matter how expensive or how long the course of treatment for a burn was, he never said no. Especially to the children.
If he was seen as a sellout to commercial demand? Fine. No problem. He didn't make a big deal about what he did on the free- care side of things, and if his colleagues in other cities wanted to portray him as a money-grubber, he'd take the hit.
When he got to the elevators, he reached out with his left hand, the one that was scarred, the one that was missing a pinkie and had mottled skin, and pressed the button for down.
He was going to do whatever he had to to make sure folks got the help they needed. Someone had done it for him, and it had made all the difference in his life.
Down on the first floor he hung a right and walked along a stretch of corridor until he came to the mahogany-paneled entrance of the cosmetics clinic. In discreet lettering that was frosted into the glass were his name and the names of seven of his colleagues. There was no mention of what kind of medicine was practiced inside.
Patients had told him they loved the exclusive, members-only-club vibe.
Using a pass card, he let himself in. The reception room was dim, and not because the lighting had been turned off after main business hours were through: Bright lights were not becoming on people of a certain age, either pre- or postoperatively, and besides, the calming, soothing atmosphere was part of the spa environment they were trying to create. The floor was tiled in soft sandstone, the walls were a comforting deep red, and a fountain made from cream and white and tan rocks twinkled in the center of the area. "Marcia?" he called out, pronouncing the name MAR-see-uh, in the European fashion.
"'Allo, Dr. Franklin," came a smooth voice from the back where the office was.
When Marcia came around the corner, T.W. put his left hand in his pocket. As usual, she looked right out of Vogue with her coiffed black hair and her tailored black suit.
"Your patient is not here yet," she said with a serene smile. "But I have the second lasering bay set up for you."
Marcia was a perfectly touched up forty-year-old who was married to one of the plastics guys and was, as far as T.W. knew, the only woman on the planet except for Ava Gardner who could wear bloodred lipstick and still look classy. Her wardrobe was by Chanel, and she'd been hired and was paid well to be a walking testimonial to the outstanding work performed by the staff.
And the fact that she had an aristocratic French accent was a bonus. Particularly with the nouveau riche types.
"Thanks," T.W. said. "Hopefully the patient will be here soon and you can go."
"So you do not need an assistant, no?"
This was the other great thing about Marcia: She was not just decorative; she was useful, a fully trained nurse who was always happy to assist.
"I appreciate the offer, but just send the patient back and I'll take care of everything."
"Even the registering?"
He smiled. "I'm sure you want to get home to Phillippe."
"Ah, oui. It is our anniversary."
He winked at her. "Heard something about that."
Her cheeks reddened a little, which was one of the charming things about her. She might be classy but she was real, too. "My husband, he says I am to meet him at the front door. He says he has a surprise for his wife."
"I know what it is. You're going to love it." But what woman wouldn't like a pair of flashers from Harry Winston?
Marcia brought her hand up to her mouth, hiding her smile and her sudden flusters. "He is too good to me."
T.W. felt a momentary pang, wondering when the last time was that he'd bought something frivolous and fancy for his wife. It had been . . . well, he'd gotten her a Volvo last year.
Wow.
"You deserve it," he said roughly, thinking for some reason about the number of nights his wife ate alone. "So please go home and celebrate."
"I will, Doctor. Merci mille fois." Marcia bowed and went over to the receiving desk--which was really nothing more than an antique table with a phone hidden in the side drawer and a laptop you accessed by flipping open a mahogany panel. "I shall just sign out of the system and wait to welcome your patient."
"Have a great night."
As T.W. turned away and left her to her glow, he took his ruined hand back out of his pocket. He always hid it from her, part of the leftover from having been a teenager with the damn thing. It was so ridiculous. He was happily married and not even attracted to Marcia, so it shouldn't have mattered at all. Scars, though, left wounds on the inside of you, and as with skin that didn't heal right, you still felt the rough spots from time to time.
The three lasers in the clinic's facility were used to treat spider veins in legs, port-wine-stain birthmarks, and red dermal imperfections, as well as provide resurfacing treatments for the face, and the removal of the guiding tattoo marks of cancer patients who'd received radiation.
B. Nalla might need any one of those things done--but if he were a betting man, he would go with cosmetic resurfacing. Just seemed to fit . . . after hours, in the downstairs clinic, with a mysterious name. No doubt another one of the very wealthy, with a paralytic need for confidentiality.
Still, you had to respect your cash cows.
Going into the second laser suite, which he preferred for no good reason, he took a seat behind the mahogany desk and logged on to the computer, reviewing the patients who were coming in the morning and then focusing on the dermatology fellows' reports he'd brought with him.
As the minutes ticked by, he started to get annoyed at these rich people and their demands and their self-important view of their place in the world. Sure . . . some of them were fine, and all of them helped support his efforts, but man, sometimes he wanted to choke the entitlement right out of them--
A six-foot-tall woman appeared in the doorway of the exam room, and he froze solid. What she was wearing was simple, just a crisp white button-down shirt tucked into a pair of ultraslim blue jeans, but she had Christian Louboutin's red-soled stillies on her feet and Prada hanging off her shoulder.
She was exactly his kind of private clientele, and not just because she was wearing about three grand's worth of accessories. She was . . . indescribably beautiful, with deep brown hair and sapphire eyes and a face that was the sort of thing other women asked to be surgically altered to resemble.
T.W. slowly stood up, shoving his left hand deep into his pocket. "Belinda? Belinda Nalda?"
Unlike a lot of women of her class, which was clearly stratospheric, she didn't waltz in like she owned the place. She took just one step past the doorway.
"Actually, it's Bella." Her voice made his eyes want to roll back into his head. Deep, husky . . . but kind.
"I, ah . . ." T.W. cleared his throat. "I'm Dr. Franklin."
He extended his good hand and she took it. As they shook he knew he was staring, and not in a professional way, but he couldn't help himself. He'd seen a lot of beautiful women in his day, but nothing like her. It was almost as if she were from another planet.
"Please . . . please come and have a seat." He indicated the silk-covered club chair next to the desk. "We'll get your history and--"
"I'm not the one being treated. My hell--husband is." She took a deep breath and looked over her shoulder. "Darling?"
T.W. scrambled back and hit the wall so hard the framed watercolor next to him bounced. His first thought as he looked at what walked in was that maybe he should get closer to the phone so he could call security.
The man had a scarred face and serial-killer black eyes, and as he came in, he filled the entire room: He was big enough and broad enough to classify as a heavyweight boxer, or maybe two of them put together, but Christ, that was the least of your problems as he stared at you. He was dead inside. Absolutely without affect. Which made him capable of anything.
And T.W. could have sworn the temperature of the room actually went down as the man came to stand next to his wife.
The woman spoke calmly and quietly. "We're here to see if his tattoos can be removed."
T.W. swallowed and told himself to get a grip. Okay, maybe this thug was just your garden-variety punk-rock star. T.W.'s own taste in music ran more toward jazz, so there was no reason he'd recognize this guy in the leathers and the black turtleneck and the gauge in his ear, but it could explain things. Including why the wife was model gorgeous. Most singers had beautiful women, didn't they?
Yeah . . . the only problem with that theory was the black stare. That was no manufactured, commercially viable, hard-ass front. There was real violence in there. True depravity.
"Doctor?" the woman said. "Is there going to be a problem?"
He swallowed again, wishing he hadn't told Marcia to go. Then again, women and children and all that. Probably safer for her not to be here.
"Doctor?"
He just kept looking at the guy--who made no move other than breathing.
Hell, if the big bastard wanted to, he could have busted up the place twelve times over by now. Instead? He was just standing there.
And standing there.
And . . . standing there.
Eventually, T.W. cleared his throat and decided that if there was going to be trouble, it would have happened already. "No, there's no problem. I'm going to sit down. Now."
He planted it in the desk's chair and bent to the side, pulling open a refrigerated drawer that had a variety of sparkling waters in it. "May I offer you anything to drink?"
When they both said no, he cracked open a Perrier with lemon and downed half of it like it was Scotch.
"Right. I'll need to take a medical history."
The wife took a seat and the husband loomed over her, eyes locked on T.W. Odd, though. They were holding hands and T.W. got the impression that the wife was the husband's tether in some way.
Calling on his training, he took out his Waterman pen and asked the usual questions. The wife did the answering: No known allergies. No surgical procedures. No health problems.
"Ah . . . where are the tattoos?" Please, God, let them not be below the waist.
"On his wrists and his neck." She looked up at her husband, her eyes luminous. "Show him, darling."
The man reached to one side and pulled up his sleeve. T.W. frowned, medical curiosity taking over. The black band was incredibly dense, and though he wasn't an expert on tattooing by a long shot, he could safely say he'd never seen such deep coloration before.
"That is very dark," he said, leaning in. Something told him not to touch the man unless he had to, and he followed the instinct, keeping his hands to himself. "That is very, very dark."
They were almost like shackles, he thought.
T.W. eased back into the chair. "I'm not sure whether you're a good candidate for laser removal. The ink appears to be so dense that at a minimum it's going to require multiple sessions to make even a dent in the pigmentation."
"Will you try, though?" the wife asked. "Please?"
T.W.'s eyebrows popped. Please was not a word in the vocabulary of most of the patients down here. And her tone was equally foreign to the locale, its quiet desperation more what you would find in families of patients treated upstairs--those with medical issues that affected their lives, not just their crow's-feet and laugh lines.
"I can try," he said, well aware that if she used that tone on him again, she could get him to eat his own legs just to please her.
He looked at the husband. "Would you remove your shirt and get up on the table?"
The wife squeezed the big hand in hers. "It's okay."
The husband's hollow-cheeked, hard-jawed face turned to her, and he seemed to draw tangible strength from her eyes. After a moment he went over to the table, got his huge body up on the thing, and removed his turtleneck.
T.W. left his chair and walked around--
He froze. The man's back was covered with scars. Scars . . . that looked like they had been left by whips.
In his entire medical career he had seen nothing even resembling this--and knew it must have been left by some kind of torture.
"My tats, Doc," the husband said in a nasty tone. "You're supposed to be eyeballing my tats, thank you very much."
As T.W. blinked, the husband shook his head. "This isn't going to work--"
The wife rushed forward. "No, it will. It--"
"Let's find someone else."
T.W. came around to face the man, blocking the way to the door. And then he deliberately took his left hand out of his pocket. That black stare dipped down and fixated on the mottled skin and the ruined pinkie.
The patient looked up in surprise; then his eyes narrowed like he was wondering how far up the burn went.
"All the way to my shoulder and down my back," T.W. said. "House fire when I was ten. Got trapped in my room. I was conscious while I was burned . . . the entire time. Spent eight weeks in the hospital afterward. Have had seventeen surgeries."
There was a beat of silence, as if the husband were running through the implications in his head: If you were conscious, you'd have smelled the flesh cook and felt every lick of pain. And the hospital time . . . the surgeries . . .
Abruptly the man's whole body eased up, the tension flowing out of him as if a valve had been released.
T.W. had seen it happen time and time again with his burn patients. If your doctor knew what it was like to be where you were, not because they had been taught about it at medical school but because they had lived it, you felt safer with them: The two of you were members of the same exclusive hard-core club.
"So can you do anything for these things, Doc?" the man asked, laying his forearms out on his thighs.
"Is it okay to touch you?"
The man's scarred lip lifted slightly, as if he'd just given T.W. another point in the good category. "Yup."
T.W. deliberately used both his hands on the patient's wrists so the guy could have plenty of time to look at the scars of his doctor and relax even more.
When he was through, he stepped back. "Well, I'm not sure how this is going to go, but let's give it a shot--" T.W. looked up and stopped. The man's irises . . . were yellow now. Not black anymore.
"Don't you worry 'bout my eyes, Doc."
From out of nowhere, the idea that everything was fine with what he'd seen flooded into his brain. Right. No. Big. Deal. "Where was I . . . Oh, yes. Well, let's give the laser a shot." He turned to the wife. "Perhaps you'd like to pull up a chair and hold his hand? I think he'll feel more comfortable that way. I'm going to start on one wrist and we'll see how it goes."
"Do I have to lie down?" the patient said darkly. " 'Cause I don't think . . . yeah, I might not be cool with that."
"Not at all. You can stay sitting up, even when we do the neck, and for that part I'll get you a mirror so you can watch me. At all times I'll tell you exactly what I'm doing, what you're likely to feel, and we can always stop. You just say the word and it's over. This is your body. You are in control. Okay?"
There was a moment of silence as both of them stared at him. And then the wife said in a broken tone, "You, Dr. Franklin, are a total peach."
The patient had an incredible pain tolerance, T.W. thought an hour later as he tapped the floor toggle and the laser snapped out yet another thin red beam onto the inked skin of that thick wrist. An incredible pain tolerance. Each zap was like getting hit with a rubber band, which was not a big deal if it was done only once or twice. But after a couple of minutes of those strikes, most patients needed to rest. This guy? Never flinched, not even once. So T.W. just kept going and going. . . .
Of course, with his nipples pierced as they were and his gauge and all his scars, he'd obviously been intimately familiar with agony, both by choice and without it.
Unfortunately his tattoos were utterly resistant to the laser.
T.W. let out his breath on a curse and shook his right hand, which was getting tired.
"It's okay, Doc," the patient said softly. "You gave it your best shot."
"I just don't understand." He whipped off his eye protection and glanced over at the machine. For a moment he wondered whether the thing was working properly. But he'd seen the laser. "There's no change in coloration at all."
"Doc, for real, it's cool." The patient took off his goggles and smiled a little. "I appreciate your taking this as seriously as you have."
"Goddamn it." T.W. sat back on his stool and glared at the ink.
From out of nowhere words jumped out of his mouth, even though they were arguably unprofessional. "You didn't volunteer for those, did you."
The wife fidgeted as if she were worried about the answer. But the husband just shook his head. "No, Doc. I didn't."
"Goddamn it." He crossed his arms and refiled through his encyclopedic knowledge of the human skin. "I just don't understand why . . . and I'm trying to think of other options. I don't think a chemical removal would be any more efficacious. I mean, you took everything that laser could give you."
The husband ran his curiously elegant fingers over his wrist. "Could we cut them out?"
The wife shook her head. "I don't think that's a good idea."
"She's right," T.W. murmured. He leaned forward and prodded at the dermis. "You have excellent elasticity, but then again, as you're in your mid-twenties, that's expected. I mean, it would have to be done in strips and the skin stitched closed. You'd get scarring. And I wouldn't recommend it around the neck. Too many risks with the arteries."
"What if scarring wasn't a problem?"
He wasn't going to touch that question. Scarring was obviously an issue, given the man's back. "I couldn't recommend it."
There was a long silence while he continued to think things over and they gave him space. When he got to the end of all the options, he just stared at the two of them. The gorgeous wife was seated next to the scary-looking husband, one hand on his free arm, the other on his mutilated back, stroking.
It was obvious that his scars didn't affect his worth in her eyes. He was whole and beautiful to her in spite of the condition of his skin.
T.W. thought of his own wife. Who was just like that.
"Out of ideas, Doc?" the husband asked. "I am so sorry." He shifted his eyes around, hating how helpless he felt. As a doctor he was trained to do something. As a human with a heart, he needed to do something. "I am so very sorry."
The husband smiled that little smile of his again. "You treat a lot of people with burns, don't you."
"It's my specialty. Kids, mostly. You know, because of . . ."
"Yeah, I know. Betcha you're good to them."
"How could I not be?"
The patient leaned forward and put his huge hand on T.W.'s shoulder. "We're going to take off now, Doc. But my shellan's going to leave the payment on the desk over there."
T.W. glanced at the wife, who was bent over a checkbook, then shook his head. "Why don't we just call it even. This really didn't help you."
"Nah, we took your time. We'll pay."
T.W. cursed under his breath a couple of times. Then just spat out, "Damn it."
"Doc? Look at me now?"
T.W. glanced up at the guy. Man, that yellow stare was positively hypnotic. "Wow. You have incredible eyes."
The patient smiled more widely, flashing teeth that were . . . not normal. "Thank you, Doc. Now listen up. You're probably going to have dreams about this, and I want you to remember I left here tight, 'kay?"
T.W. frowned. "Why would I dream--"
"Just remember, I'm okay with what happened. Knowing you, that's what's going to bother you most."
"I still don't understand why I would h--"
T.W. blinked and looked around the examination room. He was sitting on the little rolling stool he used when he treated patients, and there was a chair pulled over next to the patient table, and he had his eye protection in his hand . . . except there was no one in the room but him.
Odd. He could have sworn he was just talking to the most amazing--
As a headache came on he rubbed his temples and became suddenly exhausted . . . exhausted and curiously depressed, as if he'd failed at something that had been important to him.
And worried. Worried about a m--
The headache got worse, and with a groan he stood up and went over to the desk. There was an envelope on it, a plain creamy envelope with flowing cursive script that read, In gratitude to T.W. Franklin, M.D., to be applied at his direction in favor of his department's good works.
He turned it over, ripped open the flap, and took out a check.
His jaw hit the floor.
One hundred thousand dollars. Made out to the Department of Dermatology, St. Francis Hospital.
The name of the person listed was Fritz Perlmutter, and there was no address at the upper left, just a discreet notation: Caldwell National Bank, Private Client Group.
One hundred thousand dollars.
An image of a scarred husband and a gorgeous wife flickered in his mind, then was buried by his headache.
T.W. took the check and slipped it inside his shirt pocket, then shut down the laser machine and the computer and made his way to the back clinic exit, turning lights off as he went.
On his way home he found himself thinking of his wife, of the way she'd been when she'd first seen him after the fire all those decades ago. She'd been eleven and had come to visit him with her parents. He'd been absolutely mortified when she'd walked through the door because he'd already had a crush on her at that point, and there he'd been, stuck in a hospital bed, one side of him covered with bandages.
She'd smiled at him and taken his good hand and told him no matter what his arm looked like, she still wanted to be his friend.
She'd meant it. And then, proved it over and over again.
Even liked him as more than a friend. Sometimes, T.W. thought, the fact that the one you cared about didn't care how you looked was the best healing there was.
As he drove along, he passed by a jewelry store that was locked up tight for the night, and then a florist and then an antique shop that he knew his wife liked to browse in.
She'd given him three children. Nearly twenty years of marriage. And space to work this career of his.
He'd given her a lot of lonely nights. Dinners with just the kids. Vacations that were limited to a day or two tacked onto dermatology conferences.
And a Volvo.
It took T.W. twenty minutes to get to a Hannaford that was open all night, and he jogged into the supermarket even though there was no closing time to worry about.
The flower section was to the left, just as he walked in through the automatic doors. As he saw the roses and the chrysanthemums and the lilies, he thought about backing up his Lexus and filling the trunk with bouquets. And the backseat.
In the end though, he chose one single flower, and he held it carefully between his thumb and forefinger all the way home.
He parked in the garage, but didn't go in through the kitchen. Instead he went to the front door and rang the bell.
His wife's familiar, lovely face peeked out of the long, thin windows that framed their colonial's entryway. She looked confused as she opened the door.
"Did you forget your--"
T.W. held the flower out in his burned hand.
It was a lowly little daisy. Exactly the kind she'd brought to him once a week in the hospital. For two months straight.
"I don't say thank-you enough," T.W. murmured. "Or I love you. Or that I still think you're as beautiful as the day I married you."
His wife's hand trembled as she took the flower. "T.W. . . . are you okay?"
"God . . . the fact that you have to ask that just because I bring you a flower . . ." He shook his head and hugged her into his arms, holding her tight. "I'm sorry."
Their teenage daughter walked by them and rolled her eyes before heading up the stairs. "Get a room."
T.W. pulled back and tucked his wife's salt-and-pepper hair back behind her ears. "I think we should take her advice, what do you say? And by the way, we're going somewhere for our anniversary--and not to a conference."
His wife smiled and then outright beamed. "What has gotten into you?"
"I saw this patient and his wife tonight. . . ." He winced and rubbed his temple. "I mean . . . what was I saying?"
"How about dinner?" his wife said, fitting herself into his side. "And then we'll see about that room?"
T.W. leaned into his wife as he shut the door. As they went down the hall to the kitchen together, he kissed her. "That sounds perfect. Just perfect."