“She’s respected without peer for her broad-based understanding of—”
“I’m happy to wait,” Michael said, putting it to bed.
In pushing Dr. Sanchez, the dean was genuinely suggesting a terrific clinician. But she had a low-level ulterior motive: the dean knew such a consultation might well irk Dr. Martin. Dr. Sanchez was by the book, the sort of scholar who privately blanched at some of Lyle’s more “creative” methods, and he, the dean guessed, was just as unimpressed by her. It would be nice to see something get under Dr. Martin’s skin.
On the other hand, as the dean stood there, she managed a feeling of genuine pride as the students asked Lyle their questions. This group, like all the graduate students at the UCSF medical school, were not just among the best and the brightest but were arguably the best, a pick of the litter that matched Harvard, Stanford, and the rest. One student, seated at the table, pulled from his backpack a white mask. He described it to Lyle as a new version of an N-95 respirator, which, generically, was one of a handful of field air-purifying respirators. But the student said his version, which he’d made in his spare time, did a better job at resisting degradation from industrial oils. Would Dr. Martin take a look?
“Not exactly my expertise—product design. But I’m happy to glance,” Dr. Martin said, turning the mask over in his hands. “Check with me next week. If I’m still alive, it worked.” Laughs. “Okay, anything else? I can see that if I keep Dean Thomas waiting any longer, I may be killed anyway.”
He looked around the room. It seemed the meeting was over when his eye fell on a student whose arm was half raised, as if she couldn’t decide whether to ask a question.
“What’s on your mind,” he encouraged.
“What about doctor-patient privilege?” Her voice sounded familiar.
“Sorry, I’m not sure I know what you’re asking,” Lyle said.
“You shared the story of the minister—in Saudi Arabia. What about privacy?”
Now Lyle placed the voice’s familiarity; it was the woman seated in the back of his lecture who had correctly shouted out “CT scan with contrast” in answer to a question Lyle had asked the audience: What procedure did the minister need?
Lyle studied the face belonging to the voice. Dark blue eyes and short hair, glasses with edgy frames.
“The minister is dead,” Lyle said.
“Does that matter?” Her tone seemed equally curious as pointed.
Lyle took it in. “It can. Societal concerns factor in. When weighing what to describe publicly about any medical issue, I ask myself: Does the disclosure serve a larger health-related purpose? Anything else, gang? As you can see the dean awaits.”
“That’s what the AMA says.” It was the woman’s voice again.
“Pardon?”
One of the other students said, “Sheesh.”
But the young lady, seeming to have found the full of her voice, continued undaunted. “The American Medical Association says doctors can disclose patient information following death if there is a societal benefit.”
“Right. Okay, so we’re on the same page…”
“Isn’t there another wrinkle?”
“I’m not following, Ms. …”
“Obviously your work is so much about the societal good, the big picture, and it requires you in some cases to divulge personal information. Y’know, to make a larger point. To, say, prevent an outbreak. I’m just wondering if that is truly necessary or if it can be done without…” She paused.
“Go on.”
She cleared her throat. “Bringing notoriety to yourself.”
“Oh, come on,” another student said.
“No, hold on. You know what?” Lyle smiled. He could feel a touch on his arm. Emily, his intern. Instinctively, she was trying to hold him back from saying something untoward. But he had no such thing in mind. “That’s a damn good question, you’re asking, Ms.-I-didn’t-catch-your-name, and a fair one. My answer is that the patient comes first and, then, would-be patients and, in the case of the story I told you, then the doctors who would serve them. I felt it was valuable to impart the story as a way to inform the doctors of the future. I sincerely hope I’ve made the right call in this case but I am never beyond reproach.” He had been looking around the group but, near the end of his explanation, let his eyes meet the woman’s glasses-obscured gaze. She blinked, losing her nerve.
“I… I think you did,” she stammered. “Thank you.”
“Keep asking good questions,” Lyle said. “You all could learn something from her.”
The students quickly departed. Dean Thomas, watching them walk out, could only shake her head at how Lyle had managed to turn yet another situation in his favor. Now the students would imbue Lyle with the characteristic of humility, of all things. In her view, he was humble like frozen yogurt was nonfattening—it’s what everyone let themselves believe but she knew better.
“Okay, Dean Thomas, you can see that I’m warmed up for your skewering,” Lyle said, turning to her. “Emily, thank you for everything today. Let’s chat over the next few days.” In this way, he dismissed his intern.
The dean made sure everyone had left the room.
“Lyle, this is—”
“Michael Swateli.” The man extended a beefy mitt. Lyle took it and shook. “Impressive lecture. Your reputation as a clinician proceeds you, but I had no idea about your capacities as a presenter.”
Lyle studied the man’s eyes, the faintly lighter skin where his sunglasses had been, a residue of brown dirt beneath his thumbnail. “You were just there. How many days ago, or was it mere hours?”
“I beg your pardon?”
“Wherever you want me to go. You were in the midst of it. You had to borrow someone’s suit. A family member or someone formerly in your unit?”
Michael laughed. “Wrong about that one, Dr. Sherlock Holmes. It is mine or, rather, it was. I wore it for my own college graduation and I have since had much more food. But you are correct that I was there not very long ago. It is bad. Very bad. I only had time to race home to get this old suit and get on an airplane.”
“Tanzania?”
“You’ve been, I think.”
“Years ago with the CDC. Has high rates of albinism, twelve times greater, I think, than does virtually any other population.”
“Yes, yes. My green eyes. It is in here somewhere, as you can see,” Michael said. He looked down and Lyle understood why: time was wasting.
“Look, Mr. Swateli, I want to hear what’s going on. I also want to let you know that it’s a very busy time. Class and grant reports due and, chiefly, my wife and I have just gotten settled and—”
“Please, Dr. Martin,” Michael cut him off. He reached for the inside breast pocket of his too-tight suit and pulled out several pieces of paper. “Just look.” He unfolded the papers on the table. The pictures printed on them were grainy but clear enough. Bodies ravaged by disease. One showed a woman who looked like life had literally oozed out of her.
The dean cringed.
Lyle looked down and gritted his teeth. “I’m not sure that I can—”
“Dr. Martin,” the dean cut him off. “How can you look at this and not say yes. What’s going on with you?”
Lyle studied her. He tried to hold back his thoughts but he couldn’t. “Don’t pretend you give a damn, Jane. You’re only here because, what, there’s foreign grant money on the line, or who knows what.”
“You have no right.”
“Oh, Jane, you’d give your mother TB if it would lead to matching funds. Just own up to your motives for once.” He said it with a shrug, making it more funny than mean. And Michael chuckled.
Across the room, through the far doorway, the slight woman who had asked the question about doctor-patient privilege—the same one who had talked during the lecture—watched rapt. Then, just as Lyle looked her direction, she spun out of view.