close to his groin during a “dispute” over money with a friend. Hart, the Mr. Fix-it, who’d fallen off his roof at ten in the evening. And Traynor, an ungrateful son-of-a-bitch dotcommer who’d wrecked himself on his motorcycle for the second time in two years. When they brought him in four nights ago, Cogan didn’t recognize him because he was so racked up. It took twelve hours of surgery and three surgeons to put him back together. But when he woke up a couple of days later in the ICU, Cogan realized he’d worked on him before.
“Hey, didn’t I put you back together a couple of years ago?” he’d asked.
“Déjà vu, Doc,” replied the kid, who was twenty-six and liked to boast to the nurses that he was worth ten million. “Déjà fucking vu.”
The second accident only seemed to have made him more ungrateful, and Cogan should have known not to joke with him, but this morning, after he finished his examination, he let one slip out: “You know, if you’re going to continue to hurt yourself like this you might think about getting paid for it. Evel Knievel made a nice living breaking his bones.”
“Is that supposed to be funny?”
“It’s a polite way of saying maybe you should give the bike a rest for a while. Like indefinitely. You don’t seem to have much luck with it.”
“They pay you to give personal advice?”
“No, that’s a freebie.”
“Well, just do your fucking job and I’ll do mine.”
“And what would your job be?”
“To get the fuck out of here.”
“Let me know when that position opens up, I’d like to interview for it. Does it come with stock options?”
“I wouldn’t touch it if it didn’t.”
The list of people went on. These were his trauma patients. He would see them during their hospital stays, then once or twice afterward to make sure his work was holding up. But beyond that, they would see their regular doctors or be passed on to specialists.
He went to see his elective surgery patients next. Although he was trained as a trauma surgeon and performed that function four nights a week at Parkview, he was boarded as a thoracic surgeon, which meant he was a specialist in chest surgery. In some hospitals, the main reason trauma surgeons took elective cases was to make extra money because they were paid by the number of operations they did. But Cogan, who was on salary, took them for reasons that didn’t offer an immediate pay-off: to stay sharp in his area of expertise, establish a reputation outside trauma, and to appear productive to hospital administrators. He wasn’t planning on leaving Parkview tomorrow, but he knew he would someday, and he wanted to be able to pick his next destination.
Sometimes he wondered whether the extra work was worth it, for there were days when he felt burnt out and longed to leave the profession altogether. When he was really fried, he prescribed himself a vacation, and his attitude and outlook would improve. But in the last eighteen months he’d noticed that the medicine seemed to be having less and less of an impact. Even after he upped the dosage to a whole month away from the hospital, the all-too-familiar funk returned within a few days.
He tried not to let the little things get to him, like cocky dotcom douchebags who were making more than him. Or Mrs. Ellen Richter’s hemorrhoids. But inevitably they did.
Mrs. Richter, age sixty-five, was the first of three lung-cancer patients he saw that morning. Cogan had removed a malignant tumor along with a third of her right lung two days earlier. Her prognosis was good. She might live five years. But this morning a complication had developed completely separate from the cancer. Mrs. Richter had hemorrhoids—she now had pain above and below—and she wanted to know what Cogan could do about it. She wanted him to operate on her again. Demanded it, in fact.
“Isn’t there some laser surgery you could do?”
These were the moments that Cogan found most frustrating. A patient in Mrs. Richter’s position should have been happy. She’d gotten through a life-threatening operation. He’d taken out her lung cancer. He might not have cured her, but she was far better off now. And she should have been happy he’d done what he could for her. But here she was, demanding he fix her hemorrhoids at seven in the morning.
“I understand you’re uncomfortable, Mrs. Richter,” he said. “But right now, you don’t need a surgeon. Right now, we