An excerpt from The Evening Hero.
This was apparently not to be a Yungman-only meeting. It was in their conference room, same one where had their monthly morbidity and mortality conferences, and it was packed with doctors. In fact, there was just one chair open, and Yungmans best friend Ken the internist had his arm resting on the back of it.
“Dr. Kwak!” he said, pointing. In any another man, this seat-saving might seem like jerk behavior, but not Ken. Everyone knew he had his own unerring sense of balance and decency that everyone, even Mitzner the surgeon who was a genuine jerk, respected. Which was probably why Ken had been drafted into the position (“a pain in the keister!”) of being their Medical Officer, the liaison between the doctors and management. Tinklenberg the CEO had chosen Ken because “it’s hard to find a person everyone in the hospital likes,” but soon regretted it—”You’re supposed to be a liaison for the doctors, not an activist.”
Yungman gratefully slid into the chair.
“I don’t know when we’ve all been back here like this,” mused Dr. Rasmussen. They’d just had their weekly M&M; he must be referring to when they would meet to uses this room for job interviews. The hospital had not had a new hire, Yungman was realizing, since Clausen the anesthesiologist, who had been in thirties then but was now no spring chicken. Tinklenberg in his two-year tenure certainly hadn’t hired anyone, he only fired. No wonder they had all grown so old on the vine.
The door opened. Mitzner the surgeon strode in. A tall man with a stoop from both age and decades leaning over an OR table, he’d once looked like Charles Lindberg, but now his bowling ball pate was covered by a Minnesota Twins surgical cap. He was trailed, as always, by Clausen the anesthesiologist, who, at fortysomething also had a stoop because he unconsciously copied everything his idol Mitzner did. Seeing no chairs left, Clausen immediately pivoted and left the room.
Mitzner stood behind Yungman, crossed his hairy forearms. Yungman turned partway around. “Hello, Dr. Mitzner,” he said. It was a civic duty, he felt, to be pleasant to everyone in the workplace, no matter how he was feeling.
“Ahoy, to ol’ Dr. Quack,” he replied. Ugh. Mitzner had not deployed “Dr. Quack” in ages, Yungman had even dared hope that odious nickname had gone on to the graveyard of unfunny jokes. He recalled with some shame that when he first started at Horse’s Breath General, he didn’t even know Mitzner was making fun of him. Yungman had been still getting used to the heavily Scandinavian-Canadian inflection of Horse’s Breather’s speech (“Jeet?” Rose would say, for “Did you eat?”) and had just chalked “Quack” up to regional dialect. Indeed, some Horse’s Breathers cleaved Kwak into two syllables Ka-walk. But Yungman vividly remembered Mitzner hello’ing him shaking his hand, “So nice to meet you, Dr. Quack is it?” He had stageily winked at some passing nurses that way during the war, GIs had, trying to get the attention of a Korean woman.
Later, Young-ae, whose English was more sophisticated than his, explained “quack” was like being called a tol-pari surgeon, a pseudo-doctor. What an insult!
Mitzner looked down at him, winked, again.
Yungman kept his face pleasant. He was highly allergic to conflict. But: “Speaking of ‘old,'” he said, extra-pleasantly. “Isn’t your birthday coming up, Dr. Mitzner?” Mitzner was going to be 80, the oldest grape on the vine. Yungman was also nobody’s chump. He turned back in his seat.
Tinklenberg strode in. The previous president, Dr. Sam Reynolds, had worn a lab coat like the rest of them. Tinklenberg wore a navy blue suit. In one hand he held a travel mug from St. Thomas Business School. The other held a sheaf of papers that had extremely fine print on them, that he now looked at without glasses. It must be nice to have young eyes.
“Gentlemen,” he said. “I have some good news and bad news –”
“Good news first,” demanded Mitzner. Chest hair poked out of the top of his scrubs. Yungman almost never left the surgical area in scrubs or took equipment out of the suites. Mitzner acted as if he were operating 24 hours a day, but he did general surgery–how many hernias could there be? His magnifying eyeglasses hung around his neck with a neoprene band that said BEECHCRAFT. He fiddled with the glasses and to Yungman’s disgust and astonishment, put the tip of the left earpiece into his mouth. Yungman made a note if he ever needed surgery to go to UMD hospital.
“The bad news is—” Tinklenberg was the one person in the hospital unbossed by Mitzner. “—I regret to inform you, the hospital is closing.”
A dozen mouths fell open.
“For a hiatus?” asked Ken. “Are we being furloughed?”
“I mentioned six months ago the hospital was having financial problems, mounting debt.”
Dr. Rasmussen raised his hand, as if they were in class. “You said the balance sheet would be saved if we OKed that last round of cuts, like sacking longtime employees like Kate Javorina the social worker–and making the rest of the staff forego raises. You also didn’t let me replenish my lifesaving clot busting drugs.”
“Yes, but the debt is so overwhelming, it’s not enough.”
“Not enough for what?” said Rasmussen. Mining was dangerous work, so the mining company had established a fund for the hospital, precisely so they wouldn’t have to worry about balance sheet issues from day to day–the company had promised there would always be a hospital here.
“For corporate HQ.”
“‘Corporate?’” said Mitzner. “We’re an independent nonprofit.”
“Oh, Gentlemen, not for a long while. That’s the whole reason I and Synergistic Action Network-US Healthcare was brought in, to fix decades of no one minding the store. Horse’s Breath General has been in Synergistic Action Network-US Health Systems for an entire year before I even set foot in this place—you must have seen the new logo.'”
There had been a series of new logos and mottos in the front hall.
Synergistic Action Network-US Healthcare: A Passion for Care
What did that even mean?
“OK, then hit us the good news. Maybe we could finally consider converting to employee ownership, like I’ve been saying we should all these years.” Mitzner’s grandfather came to town with a brace of Kentucky mules and started the mercantile. He was supposedly there when the mining company made the promise to the town, to electrify the streetlights downtown and also, “The hospital will always be open no matter what. Miners and their family need their care, this is the way to make physician life up here attractive to this generation and the next.” Indeed, the doctors here were paid what was more comparable to Duluth or the Twin Cities compared to the other rural towns in Minnesota (even still, Yungman noted, no one wanted to be the OB here before him).
“The good news is: anyone over 55 will get their full defined benefits pension.”
“Of course we will,” said Ken. “That’s our money.”
“Well” said Tinklenberg. “You are the lucky ones. The hospital will officially close on Friday.”
“But what’s going to happen to our patients?”
The door opened. Clausen—dragging in a chair for Mitzner. It screeched on the floor. “What’d I miss?”
“You aren’t getting your pension,” said Mitzner.
“Is that a joke? I’m only 42.”
Tinklenberg tapped the edge of the papers on the table, straightened them. “This is all coming from corporate–I’m just the messenger. I wouldn’t mind a word of appreciation for saving your pensions—in the M&A transaction, Synergistic Action Network-US has inherited all assets of this hospital.”
“How can they just close a hospital?” asked Yungman.
A glum silence followed. They had to do something, but what?
One by one, they all got up. No matter what happened, they had patients to attend to.
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