The Imposter (22 page)

Alex
was uneasy.  She'd been put off when the meeting had been delayed.  She, too,
had decided that was another manifestation of Favre's uncooperative, passive
aggressive behavior.  Favre remained useless.  Unfortunately, she knew that
Favre's management style was similar to that of many nursing leaders.  Favre
neither supported nor appreciated the efforts of the great nursing staff at CCMC
and rarely advocated for them in tough situations.  Her style was more one of
nepotism and fear.  Hence, her nickname was Bigfoot in polite company, but she
had more ribald nicknames that were used in the back of the cafeteria.  With
the initials B.F., it didn't take much imagination.

It
was well-known that Betty had pet nurses.  One of the male nurses in critical
care served as her on-call gardener, weeding her garden and mowing her lawn. 
Another nurse baked cookies for her every week and catered her dinner parties
at no charge.  Of course, they were rewarded -- with favors, promotions, and
extra time off.  It was so unfair and so unethical.  Alex just shook her head. 
This favoritism had to end.

Alex's
thoughts turned from Favre to Whitset.  She was convinced he was playing a
large part in the current events at Crescent City Medical Center.  She wondered
if Jack had been able to find out anything on either Whitset or Anthony
Gavette.  She'd asked Monique after the executive meeting.  Alex was so deep in
thought that she jumped when her private phone rang.

"Alex
here," she spoke into the phone.

"Alex,
it's Sandy Pilschner.  We've got Donna Meade over here in emergency."
Sandy paused, waiting for a response from Alex.  When none came, she continued,
"Did you know there was another incident over the Pavilion?"

Finally,
Alex squeaked out a no.

Sandy
continued, "Apparently one of the patients whacked out and tried to
strangle Dr.  Desmonde ….  Alex, are you there?"

"Oh,
no, no.  What happened?" Alex's voice was a whisper.

"I
don't know much, Alex.  The techs had to hurry back.  They said the place was
wild and they couldn't stay."

"Is
Monique all right? Is she all right," Alex repeated to herself in her
anxiety.

"What?"
Sandy seemed confused for a moment.  "Oh, Alex, I'm sorry.  I wasn't
clear.  Yeah, I guess she's okay.  Dr. Desmonde is not here.  Donna Meade is. 
She's the one who is hurt.  The tech said Dr.  Desmonde seemed okay."

"How's
Donna doing?" asked Alex.

"Well,
I guess she's doing as well as any woman can  -- who's just had most of her
lady parts ripped at.  She's in a lot of pain … and in shock, too."

"My
God! I can't imagine." Alex cringed at the thought.  That's horrible, just
hideous.  Who did it?"

"Yeah,
it is.  Awful.  No question.   I don't know who did it.  You know, Alex,"
Sandy paused briefly, "I would never work in the Pavilion.  It's
dangerous, and it's a hell hole.  I think Angie hated it."

 "I
expect she did, I sure do.  It is
a hell pit
.  I understand perfectly,
Sandy.  Perfectly." Alex silently agreed with her.  She would never work
there, either.

"Gotta
go, Alex." Sandy's voice was brisk.  "We have got  red blankets on
the way in.   Just thought I'd keep you up-to-date."

"Thanks,
Sandy.  I appreciate it," Alex said as she hung up the phone.  She was in
a state of bewilderment.  She rubbed the chill bumps that had formed on her
arms, as she thought about what happened to Donna and Monique.  Something had
to give up there or the whole place would spontaneously combust.  I've got to
call Monique, she thought to herself, and make sure she's okay.

 Monique
answered Alex's call on the first ring.  She hoped her disappointment wasn't
reflected in her voice.  She had hoped it was Jack returning her call.  Monique
assured Alex she was not injured and promised she could see for herself
shortly.  Then, Monique decided to take the plunge.

"Alex,
do me a favor?  Go over to Don's office and make sure Whitset's there.  If he
is, call me right back.  I want to take a quick look in his office and I sure as
hell don't want him to catch me."

Alex
felt a quickening in her gut.  "Monique, are you sure?  Suppose someone
sees you?"

"I'll
be very careful, don't worry.  Just call me back as soon as you get over
there."  Monique's voice sounded strong and steady.

"Okay,
I'm with you.  Give me about five minutes.  Just be careful – promise me."
Alex's voice was pleading and Monique detected a tinge of fear.

"Promise. 
You got it.  Just call," Monique said as she hung up the phone.

Alex
called Monique back a few minutes later and reported that the coast was clear. 
Latetia had confirmed that Whitset was in Don's private office and Alex had
even interrupted them to be absolutely sure.  She tolerated the ridicule in
Don's voice with a small degree of triumph.  At least Monique wouldn't be
apprehended by Whitset as she quickly searched his office.

Dr.
Desmonde walked quickly down the hall towards Lester Whitset's office, nodding
briefly to staff, patients, and family members.  She waved aside the questions
of several staff, assuring them that she was okay and would return to the unit
later.  She failed to notice the curious glances that several patients in the
day room gave her.  It was completely out of character for Dr. Desmonde to
rush.  She was the coolest, calmest, most collected cucumber that most of the
patients had ever seen.  Rose was relatively indifferent to the physician's
movements, but was concerned.  She'd been worried about Dr. Desmonde for the
past few days and had heard through the patient grapevine that Anthony had just
attacked her.                     Rose, in her confused and flustered state,
really liked Dr. Monique.  She decided the physician may need some help, so she
decided to follow her.

As
Monique entered the hall between Pavilion I and Pavilion II, she looked around
furtively.  The last thing she needed was someone reporting to Whitset that
she'd been hovering and snooping around his office.  Her heart froze when she
thought of the possible repercussions, but she shook off the fear.  Monique looked
around again, just to be safe.  The coast was clear.  She didn't see the
waiflike profile of  Rose peering at her from around the corner.

Dr. 
Desmonde tentatively turned the knob on Whitset's door.  It was locked.  Just
my luck, she thought to herself.  She thought for a second and then pulled the
master key to the psychiatric unit from her pocket.  She inserted the key into
the lock, her heart pounding in her chest.  She'd never broken into anything
before.  Please Lord, please Lord, let it open, she prayed to herself.  She was
in luck.  The lock clicked with a slight turn of her wrist and she pushed the
door open.  She entered Whitset's office, closing the door softly behind her.

The
first thing that struck the psychiatrist when she opened the door was the
darkness of the office.  The heavy curtains had been drawn over the double
windows opposite the door.  As her eyes adjusted to the darkness, she noted
that the office was immaculate.  Nothing was out of place.  Whitset's highly
polished walnut desk was completely clear of any notes, files, or
correspondence.  The leather desk set and inkstand were easily visible.  The
round, leather container held four different colored ballpoint pens.  Several
pencils with sharp points were also in the container.  A bookcase held several
psychiatric reference books and several recent journals were on an end table,
next to a pair of leather side chairs.  All in all, the office looked like a
magazine advertisement for office furniture.  It was as if no one really worked
in the place.  It didn't even have a scent.  It smelled like nothing.  Monique
sniffed again.  Well, maybe it did smell like something.  She could smell
something metallic.  It had a salty, metallic scent, kind of like old blood.

After
looking around a second time, Monique decided the most impressive thing about
the office was that it was unimpressive -- except for its neatness, which was
pretty typical of an obsessive personality.  She continued to look around
carefully, convinced that if she searched closely enough, she'd find
something.  She walked around to the side of Whitset's desk and switched on his
brass desk lamp.  A warm glow from the light bathed the office in a comfortably
colored hue.  The polished wood of the desk gleamed brightly in the lamplight. 
Monique's eyes searched the desk and nearby bookcases for any possible clues.  

Once
again her senses were heightened to the metallic smell.  What was that smell? 
As she tried to open the desk drawers, her eyes noted something glistening in
the lamplight.  It was hanging out of the bottom left desk drawer.  Monique
reached to pick it up and found it was a slender gold chain that was caught in
the drawer.  She tried to pull it out, but couldn't because it was stuck between
the drawer and the desk frame.  Monique reached down to examine the chain more
closely.  She saw that the chain was broken and missing several links.  The
clasp was in place.  The chain looked like one a woman would wear.  It was much
too fragile to be male jewelry.

Monique
tried for several moments to detangle the chain from the desk drawer.  
Convinced that she couldn't remove the chain, Monique looked around the office
again.  Her eyes fell on Whitset's diplomas, which were hanging neatly on the
wall over his bookcase.  He had an undergraduate degree from some university in
Europe.  His graduate degree was a masters in business administration from the
University of Pennsylvania.  Monique looked closely at the date on the MBA. 
The degree was conferred in 1966.  Immediately, her heart started beating
hard.  It seemed impossible.  Whitset certainly didn't appear old enough to
have received a Masters degree in 1966! She didn't think he was over 45.  If he
had received a Masters degree in 1966, he must be a lot older than she thought
he was – how then could he look so youthful?  Monique intuitively knew that it
wasn't Whitset's degree.  She quickly looked back at his undergraduate degree. 
It was awarded in 1963.  Damn, that was impossible!

As
she stood contemplating this information, there was a soft knock on the office
door.  Her heart sank.  She immediately killed the light and ducked behind the
desk, holding her breath for what seemed like an eternity.  Her pulse beat
rapidly.  Wow, the smell was overwhelming.  What was that smell?  At that
point, Monique noted a green bottle, the shape that red wine came in, on the
bottom book case near the back.  She picked it up a sniffed. 
Oh My God,
the smell of old wine and metal about knocked her out.   She had to take
several deep breaths to recover
.   Whew,
she thought to herself.
   If
I drank that stuff, I'd be loco, crazy too.  

After
several minutes of silence, Monique rose from her hiding place and slipped
surreptitiously out of the office.  When she reached her own office, she pulled
out her personnel file on Whitset.  Her eyes scanned his resume.  His date of
birth was recorded as January 27, 1951.  Monique smiled a half smile.  She knew
Whitset was smart, but she doubted he was smart enough to have been awarded a
Masters degree when he was only 15 years old! Her watch beeped.  It was almost
3:15.  She rushed over to the main campus to the executive meeting, her face
highly colored because of her discovery.

Alex
was getting antsy at the meeting.  She found herself fidgeting in her chair. 
Where was Monique?  Where was Commander
Françoise
? 
She'd expected that he would attend the meeting to report on the progress of
the investigation.  Don was obviously getting cross about being held up by his
'employees'.  Favre was droning on and on about how safe the psych units were
and how other hospitals didn't have the sophisticated monitoring systems that
CCMC had installed several years ago.  Favre maintained the staffing numbers in
the Pavilion were better than the staffing numbers of several hospitals
considered competitors to Crescent City Medical.

Alex
wanted to hug Robert Bonnet, present at the meeting because he was acting chief
of surgery, when he interrupted Betty Favre's drone.  Robert directly addressed
the nurse executive in a reasonable tone, "Ms. Favre, how can you suggest
that the Pavilion is safe?  Only last night an elderly patient was murdered and
no one heard her screams because the only staff member was on the far hall, a
long distance from where the incident occurred."

Betty
raised her eyebrows and gave the handsome surgeon a dirty look.  "Dr. 
Bonnet, last night was an extreme and unusual situation.  There'd been an
emergency over on the prison unit.  All other staff had been sent over there to
handle it.  This is an isolated incident!" Favre gave Robert a tight
little smile.

Elizabeth
spoke up, "It may be an isolated incident, but it still has a heavy
impact.  There should be enough staff to cover the unit, even when there's a
problem.  When the media gets a hold of this, as I believe they already have –
based on the stack of messages on my desk – were going to be in for some nasty,
negative publicity."  Elizabeth Tippett used her advantage well and looked
straight at Don Montgomery.

Montgomery
didn't respond, but Whitset did.  "I believe we are blowing the
repercussions of this incident out of proportion in relationship to the actual
threat.  Accidents happen in hospitals.  They happen every single day …."

Elizabeth
interrupted the psychiatric administrator, "Really, Mr. Whitset, accidents
and incidents do occur in hospitals regularly, but it's a bit extreme to have a
patient murdered by another patient on the psychiatric unit.  I believe you're
the one underestimating the potential disaster here."

Alex
wanted to give Liz a standing ovation.   She was proud of Elizabeth for the way
she was standing up to Whitset.  She had emerged from a shrinking violet just a
few months ago to a strong member of the executive team.  She was a master at
dealing with the press and sorting out difficult, press related issues. 
Elizabeth had a well-connected press network, which complimented her ability to
perform her job well.

Whitset
stared at Liz and gave her a chilling look.  Even Alex could feel the coldness
his manner exuded.  He said in an icy voice, his black glittering eyes raking
the media director's face and upper torso, "My dear, I do believe you're
wrong."

Elizabeth
maintained her composure and said simply, "No, Mr. Whitset, I'm
right." She turned to Betty Favre and said, "Besides, it's clear to
me that our sophisticated equipment you mentioned, Ms. Favre, was useless last
night -- particularly since there were no staff members available to monitor
it!" She glared at the nurse executive, her eyes displaying her
displeasure.   Betty just stared at the table.  There was nothing she could
say.

Alex
and Robert both eyed each other after they saw the look of intense hatred
Lester Whitset gave Elizabeth Tippett.  Elizabeth seemed not to notice.  Alex
was glad.  It was bad enough that she and Robert were worried.

Montgomery
checked his watch and eyed the group.  "Where in the hell is Dr.
Desmonde?  And, where is that useless police Commander?  I was sure he would be
here to entertain us with his consistent incompetence."  Don looked around
at the group to see which of the members appreciate his humor.  Betty Favre and
Lester Whitset both smiled broadly.

Alex,
per usual, was disgusted with Don.  She said "Don, I believe Dr. Desmonde
is on her way.  There was another incident up on the unit and ...."

Whitset
about fell out of his chair, 'What incident, what happened?"

Alex
looked around the room and said, "I don't know the details.   Monique will
tell us when she arrives."

Don
was livid, his faced flushed bright red.   "Shut up, Alex.  I know what
happened and  I don't care about that."  Don paused as the door to the
conference room opened, "Well, well, well, look who finally made it,"
Don sneered as Monique entered the conference room.

Robert
was angry as well, but his voice was calm.  "Don, please watch what you
say and keep this meeting professional.  Dr. Desmonde and Ms. Destephano don't
deserve your sarcasm and disrespect."

Alex
flashed Robert a smile.  She could hardly believe the CEO had told her to shut
up.

Don
ignored Robert and said, "Dr.  Desmonde, I don't recall you telling me I
was going to need double staff to take care of these wackos.  Did you tell me
that, Dr. Desmonde?"  Don's voice was demanding and so sarcastic that Alex
could feel Robert get ready to say something else to him.  She placed her hand
on Robert's arm and whispered to him to let Monique handle Montgomery.

"No,
I didn't tell you that precisely, Don.  What I did tell you was that there was
a distinct possibility our work load would increase significantly and that we
may need more staff  later.  That, I believe, is when you, as our esteemed
leader, hired Mr.  Whitset's company to manage the psychiatry service!"
Monique's voice was disdainful and patronizing.

Whitset
had been watching the exchange with a great deal of interest.  He interjected,
"Yes, Mr.  Montgomery did hire us around the time he signed the state
contract.  He was obviously worried about the costs of caring for such a
diverse population of psychiatric patients.  My company assured him that we had
helped many other hospitals do the same type of thing we have done here at
Crescent City -- successfully managing a changing population of psychiatric
patients without increasing costs.  We're successful here.  It's a good
model."  Whitset smiled broadly, his thin lips curling over his small
rodent like teeth.

Monique
could hardly abide Whitset's tiresome ponderosity.  What a pile of bull shit
she thought to herself.  When she couldn't stand it any longer, she addressed
the pompous Whitset.

"Mr.
Whitset, your model may be a good financial model for the hospital, but it is a
poor clinical model.  I'm sure the only reason it's saved the hospital money is
because you cut staffing positions."

If
looks could kill, Whitset would have eradicated Monique.  But, he remained
silent.

Elizabeth
Tippet pushed her long, dark hair back and looked at Whitset as though he were
a moron.  "I'm a bit confused by your comments.  I wouldn't call these
recent events successful, Mr.  Whitset.  I'd call them tragic.  I agree with
Dr. Desmonde.  I vote we increase the staff to the levels she's suggested. 
It's pretty clear to me that we’re understaffed over there.  I, for one, don't
want any more of these patient or staff incidents to occur."

"I
second Elizabeth's suggestion.  I trust Dr. Desmonde's judgment implicitly in
these matters."  Dr. Bonnet smiled warmly at Monique and continued
talking.  "She is a nationally known expert in her field and she knows the
internal needs of her department."

Don
Montgomery gave Robert Bonnet a deprecating look.  He'd always hated and
distrusted the surgeon.  In some respects, Alex believed Don was jealous of
Robert.  "Thanks, Bonnet.  What a surprise! You physicians never disagree
with each other."  His voice was laced with sarcasm and disdain as he
sneered at Robert.

Montgomery
turned to Whitset.  "What do you want to do, Whitset?  It's really your
call, you know.  You're in charge of the Pavilion.  If you think we need the
staff, we'll work it out."

Alex
intervened.  "Don, I object to giving him this authority.  He is hired
contract help.  This system is an administrative disaster.   I would certainly
like him on our team, but I wouldn't give him the authority to make the
decision.   In fact, I don't think he has that authority based on hospital
by-laws and policy."

Whitset's
eyes shot daggers at Alex, his black eyes penetrated her face.  Alex could feel
the coldness he exuded.  She could feel the chill as it washed over her.

Don
shrugged his shoulders and looked at Whitset.  "Don't know, Whitset.  What
do you think?"

Whitset
managed a complete turn about.   He looked at the group, nodding at Donald
Montgomery.  His smile was pleasant and his voice congenial.  "Thanks,
Don.  Thank you all for your input.  I'm not in favor of hiring additional
staff.  We don't need them.  According to my numbers, CCMC is well staffed. 
The staff we have are competent and are use to caring for the type of patients
we admit.  Secondly, our productivity would drop if we hired 10 new positions. 
It would take us over six months to hire and train them.  Hiring these people
makes no business sense at all -- particularly because we don't need them.  I
figure these positions would cost us better than $1 million the first year. 
I'm against it."

Betty
Favre nodded her head in agreement with Lester Whitset.  "I quite agree
with Mr.  Whitset.  If we have money for positions, Don, I'd much rather put
the FTEs in critical care or on the medicine units.  Psych is doing okay. 
Besides, it's hard to fill psych nursing positions.  We have to pay them more
because of the perceived notion that working with these patients can be more
dangerous.  I'm against increasing the staff over there."  Betty rolled
her eyes at the 'perceived notion' that caring for psych patients could be
dangerous.

Monique
interrupted, "Perceived notions, really Betty, you are intolerable.  Two
nurses have been attacked in the Pavilion!"

Alex
gave Betty Favre a disgusted look and shook her head.   One thing about Betty
was that she never disappointed.  For some reason, she always expected that the
nursing leader would emerge as supportive of nursing and their needs.  Favre
never did. 
I ought to be use to her by now,
Alex thought. 
At least
I know what to expect,
she mused. 
I guess it's better than people
shooting from the hip.  Expect nothing, get less.  That's going to be the way I
approach her.

Alex
spoke, "I recommend, from a legal standpoint, that we fill the slots.  We
have a file full of complaints from patients, staff, and visitors about how unsafe
the Pavilion is.  We're required by law to provide for the reasonable safety of
those who visit our premises.  If we don't, we could be liable for all types of
actions .…"

"Now,
now, now, Alex.  Perhaps you're being a little overzealous?  Aren't you flaunting
your lawyer credentials?" Lester Whitset looked at her, a mollifying smile
on his face.  His voice was so low she could hardly hear him.

"Absolutely
not, Mr. Whitset.  I'm only being reasonable and prudent, doing my job as the
hospital attorney.  Dr. Desmonde has offered a convincing argument,
substantiated by statistics, that we are severely understaffed here in
psychiatry.  Her numbers aren't even adjusted for the severity of our patient
index or patient population.  Our overall patient acuity is higher than that of
any other hospital in New Orleans.  Therefore, …."

Alex
was interrupted by Whitset as he jumped up from his seat and leaned across,
practically lying on the conference table across from her, his face white again
with fury.  He looked like a little boy who was pouting.  "We will not
hire any additional staff!  It's my decision, and it’s final!  It's no longer
open for discussion."  Whitset stared around the room.

Alex
was incredulous.  How dare that creepy SOB undermine her.   She looked at Don
and said, "Don, really, we must have some type of closure here.”

Montgomery
looked at the hospital lawyer and shrugged his shoulders.  "It's Whitset's
decision, Alex.  He has the last say.  It's in his contract."

Alex
was incredulous.  "No, no, Don.  You're wrong. 
It's our contract
. 
Whitset is contracting with us.  We are in charge here.  We are driving the
bus."

Robert
looked scornfully at Whitset.  "What's in this for you, Whitset?  A bigger
bonus based on dollars saved at the end of the year?"

Whitset
said nothing and continued to look around the room. 

Alex's
sense of smell was assaulted by a strange odor.  She couldn't quite place it,
but it was very familiar.  She looked around to see if anyone else noticed it. 
Whatever the smell was, it had a metallic scent.

Elizabeth
said clearly, "I must go on record here as being positively opposed to
this decision."

Robert
and Alex nodded their heads in agreement with Liz.

Monique
Desmonde, still standing at the wall-mounted board with her statistics clearly
in sight, looked at the group and said quietly, but assuredly, "I disagree
completely with Mr.  Whitset.  The Pavilion is a powder keg.  Anything could
happen up there at any time.  In fact, it already has."