“Yes,” she said. “Emily told us in a meeting a week or two ago.” She sat at her desk, while Peggy organized her desk. “You were at that meeting, Brian.” The conversation stalled, but Brian sat still. “What do you want, Brian?” Ann said.
“I just wanted to talk to Dr Valdez, but alone.”
“I have a few minutes of work here, Brian. Why don’t you make an appointment with the lady and talk to her at her convenience?”
“Why are you always so insulting, Ann? She’s my peer, and I guess this is her office.”
“I don’t see it that way. You are the junior faculty. She is the senior. You should show some respect and consideration. It’s her first day, and something tells me you are not the welcoming committee.”
Brian said, “Dr Valdez — and Ann, you should call her Dr Valdez, too — when would be a good time?”
“Any time is fine,” Peggy said. “I will be here for a while figuring out my computer and organizing. I don’t have any responsibilities until rounds at four this afternoon.”
“Is it all right if I just wait?”
“Certainly.”
Brian stayed seated. “This seems like a demeaning place for you. Don’t you think it’s awful?”
“No,” Peggy said. “It has just what I need and it’s temporary. Emily said I would be needed less than a year.” She looked at Ann, “The ‘fellows’ closet,’ is that a term everybody knows? So, I could say, ‘Meet me in the fellows’ closet,’ and everybody would know what I’m talking about?”
“Yes,” Ann said, nodding.
“Where are you from, Ann?”
“Detroit.”
“Where did you go to college?”
“Wayne State.”
“Where did you go to medical school?”
“Case Western.”
“Where did you do your residency?”
“Here.”
“Did I make you feel like you were being interrogated?”
“No. But now back at you. Where did you go to college?”
“University of Colorado, Boulder.”
“Where did you go to medical school?”
“Washington University in St Louis.”
“Where did you do your residency?”
“Columbia-Presbyterian in New York.”
“Where did you do your fellowship?”
“I didn’t do one. When I trained, this specialty was called ‘Perinatology’ and it was rudimentary. We didn’t have a pregnancy test, we didn’t have ultrasound, and we were just beginning to use fetal monitors.”
“Gad. I can’t imagine.”
“I can’t either,” Peggy said. “The change in the specialty during my career transformed it. Nowadays, we never have surprise twins, we can diagnose tubal pregnancy before it ruptures, and we have almost no stillbirths. We know when a child with a heart defect is coming and can get ready.”
“You didn’t have that before?”
“Shoot no. Neonatal ICUs weren’t what they are now, either. We could only save premature babies after thirty-two weeks. Now we can save twenty-four weekers, a drastic change for the extremely premature.”
“That’s amazing. Well, I have to get going. I’ll talk to you later.”
“Bye.”
Brian remained seated. “I don’t know why you’re here.”
“I was assigned this desk, and it’s a place I can read, update myself on patients, and—”
“No, not in this room. Why are you here at this medical center?”
“I’m not sure what you want to know. I was invited by Emily to provide extra help. My assignments include taking call and being generally instructive.”
“But you are not qualified to do that,” Brian said. “What qualifies you to be on our faculty?”
“Well, I have a lot of experience, have prided myself in learning all I could, and I enjoy fetuses.”
Brian turned his back to Peggy and paced like an attorney questioning a witness, negotiating the tight quarters like Packman on the chase. “Are you board certified in obstetrics and gynecology?”
“Of course. For forty years.”
“Are you board certified in maternal-fetal medicine?”
“No, anesthesiology.”
“Then you are not qualified to be here.”
Peggy said, “I didn’t make that decision. Everybody knows that I’m not boarded in maternal-fetal medicine, and I’ve never told anyone I was. Are you board certified in maternal-fetal medicine?”
“No, I’m—”
“Are you board certified in obstetrics and gynecology?”
“No, but I—”
“So, then, what’s the real question?”
“You are not qualified to be on our faculty,” Brian said. “Someone of your age and experience should be board certified. It’s unconscionable that you are parading around with fellows, residents, and students claiming to be someone you aren’t.”
“First, I don’t parade around claiming to be a maternal-fetal medicine specialist. Second, I plan to carry out my assignment until the people who hired me tell me differently.”
“That’s ridiculous.”
“Perhaps we should have this conversation with Emily. I would be glad to set that up.”
“Emily Beacham? You call that a division chief? She’s part of the problem,” Brian said. “She’s the one who invited you. I don’t know why she thought you would be a good addition to our ranks when it’s clear that you’re not.”
“In what way, besides certification, do you think I’m lacking?”
“When you talk about sending patients over the border for medicines, when you suggest antiquated drugs like theophylline, and when you think you can instruct fellows. How can someone who has never done a fellowship instruct people in a fellowship?”
“Perhaps we should have a meeting with Dr Beacham. Maybe we can iron things out. I would be glad to arrange that.”
“I was thinking Dean Rhodes.”
“No. Departments and divisions are not democracies. It is not your responsibility to police or rectify irregularities in the faculty structure of the University. There are people assigned to do just that.”
“But this is so urgent and so blatant, that it needs to be corrected,” Brian said.
“Well, I’m not willing to skip levels of command in this situation. The correct way to work toward a solution is to start with the division chief, progress to the department chairman, then to the dean of faculty, and finally to the dean. Am I correct that you have discussed this with no one besides me?”
“Yes.”
“Then no one has refused to address this problem for you,” Peggy said.
“For me? For me? This isn’t about me! It’s about you! And you could solve the whole problem in a heartbeat by getting out of here!”
“Gosh, I’m sorry for causing this disturbance,” Peggy said. “Emily Beacham, the chairman, the dean, and several other faculty members were all involved in my invitation.”
Brian amped up his argument, “That doesn’t clear the qualification problem. You are not qualified to come here and assume any kind of patient care. This is despicable.”
At that moment, Peggy became physically afraid of Brian. She stood, backed up a step, and pushed her chair under her desk.
“Forget it! Forget it! I’ll take this to a higher level. But you have been warned. There will be consequences!”
With that, Brian spun on his heals, left the room, and slammed the door rattling the frosted glass window.
For Peggy, this was a confusing interaction. Brian was not in an administrative position of any kind or at any level. There were people entrusted by the University to select and groom faculty. The position Peggy occupied was a temporary one, just to bridge from a faculty shortage until new players were recruited and on scene. She didn’t need the job. Being terminated on short notice would be no insult or inconvenience, since she could scamper back to Crystal Springs, resume her role as great aunt, spouse, and citizen. There had to be more to the story than lacking board certification in high-risk obstetrics.