He stepped back and pushed her away as he released her. "I'm leaving," he said. "Get out of my way."
She was rubbing her arms, then holding them out. "Look what you've done," she said. "You've hurt me."
"You'll live," he said.
She stepped in front of him, all but daring him to go another round.
But leached out of the hurt and rage, he had no more stomach for fighting her. "Why don't you go home, Ann? Back to the kids. You don't belong here."
But she stared obstinately up at him. "I need to see him. Where is he now?"
He knew what she meant. She wanted to view Markham's body. But fuck that, he thought. "Best guess right this minute," he said. "Somewhere close to the center of hell."
Then he pushed past her and made it out of the room.
Little League was playing havoc with the Hardys' schedule. Vincent practiced on Mondays and Wednesdays, and Hardy was coaching. So he and Frannie had had to change their sacred date night to Tuesdays for the duration of the season. Tonight, at a little after 7:00, Hardy pushed open the door of the Little Shamrock where they were supposed to rendezvous, but she hadn't yet arrived.
Her brother, Moses McGuire, though, was behind the rail, talking to a young couple who were decked out in a lot of black leather. In one of his manic phases, McGuire's voice boomed enough to drown out Sting on the jukebox, who wasn't exactly whispering himself.
Hardy pulled up a stool by the front window, half turned so he could watch the cypresses bend in the stiff wind at the edge of Golden Gate Park across the street. Moses glanced at him and began to pull his Guinness-an automatic call for Hardy nine times out of ten. The foam in the stout would take several minutes to fall out, and this way Moses could keep talking until it had. No point in breaking up a good story.
Which continued. "…so the guy'd had a stomachache for like nine months, they'd already taken out first his appendix-wrong-then his gall bladder-whoops, wrong again. Nothing helps. And they don't find anything and finally send him on his way, telling him he's stressed out. Well, no shit. So he starts doing acupuncture, seeing a chiropractor, taking herbs, getting massages-nothing helps. And meanwhile"-here McGuire turned to Hardy, pointed at his pint, almost ready-"meanwhile, the guy's trying to go on with his life, he's supposed to be getting married in a few months."
The couple asked almost in unison, "So what happened?"
"So two weeks ago, he wakes up doubled over. Can't even get out of bed. They cut him open again, but this time close him back up and say they're sorry. He's got a month. They must have missed it."
"A month to live?" the girl asked. "Is that what they meant?"
"Yeah, but it wasn't a month, either," Moses concluded. "Turns out, it was five days."
The guy was staring through his drink, shaking his head. "Five days?"
McGuire nodded in disgust. "I served him a drink in here three weeks ago and went to his funeral on Monday." He grabbed Hardy's pint and walked it down the bar.
Hardy drank off a mouthful. "That was a fun story. Who were you talking about?"
"Shane Mackey. You didn't know?"
From his own days as a bartender, Hardy had known Mackey when he'd played on the Shamrock's softball team for a couple of years. He couldn't have been much beyond forty years old. Hardy remembered buying him and his fiance´e a drink at the New Year's party here, four months ago. He carefully put his glass on the bar and swirled it. "Was that a true story?"
"The good parts, anyway. The wedding was going to be next month. Susan and I had already bought them some dishes."
7
At 9:30, Malachi Ross was in his office, in his leather Eames chair, a cup of coffee grown cold on the glass table in front of him. Across from him, in his wheelchair, a yellow notepad on his lap and a tape recorder next to Ross's coffee, sat Jeff Elliot. Through the vertical blinds, Ross was looking past the reporter, out over downtown from the seventeenth floor. But he noticed neither the lights of North Beach dancing below him nor the stars clear in the wind-swept sky above. He hadn't eaten since breakfast, yet felt no hunger.
They'd been at it for almost a half hour, and Ross had brought the discussion around to himself, his background. How he'd joined the Parnassus board as a doctor whose original job was to provide medical legitimacy for the company's profit-driven business decisions. This was back in the first days of aggressive managed care, and Ross told Elliot that he had come on as the standard-bearer for designating a primary care physician, or PCP, for each patient as the gatekeeper of the medical fortress, a concept which by now had pretty much become the standard for HMOs everywhere in the country.
"But not a popular idea," Elliot observed.
Ross came forward in his chair and met the reporter's eyes. "Give me a better road and I'm on it tomorrow," he said. "But basically it works."
"Although patients don't like it?"
A resigned shrug. "Let's face it, Mr. Elliot, people are hard to please. I think most patients appreciate the efficiency, and that translates to satisfaction." He wanted to add that in his opinion, people were overly concerned with all the touchy-feely junk. The body was a machine, and mechanics existed who knew how to fix it when it broke. The so-called human element was vastly overrated. But he couldn't say that to Elliot. "It's really better for the vast majority of patients."
"And why is that?" the reporter asked. "Doesn't it just remove them from any kind of decision loop?"
"Okay, that's a reasonable question, I suppose. But I've got one for you, although you won't like the sound of it. Why should they be in it?" Again, he held up his hand, stopping Elliot's response. "It's hard enough to keep this ship afloat with professionals who know the business. If patients had the final say, they'd sink it financially. Now I'm not saying we shouldn't keep patients informed and involved, but-"
"But people would demand all kinds of expensive tests they don't really need."
Ross smiled with apparent sincerity. "There you are. Healing takes time, Mr. Elliot, and you'd be surprised at how many health problems go away by themselves."
He stood up and went over to the small refrigerator at the corner of the room and got out a couple of bottled waters. He gave one to the reporter and sat back down.
"Look," he said, leaning forward and speaking, ostensibly, from the heart. "I know this must all sound pretty callous, but nobody's opposed to losing the money on tests if they're necessary. Hell, that's what insurance is all about, after all. But if fifty guys show up month after month, and each one gets his test when only five really need it, then instead of Parnassus losing twenty-five grand, which is covered by premiums, we lose a quarter mil. To cover that, we'd have to increase premiums and copays by a factor of ten, which nobody can afford. So the whole system falls apart, and no one gets any health care."
Elliot drank some water. "But let's say out of the fifty guys who want their tests, ten in fact need them. Not five. What happens to them?"
"They get identified, Mr. Elliot. Maybe a little late, which is regrettable. Nobody denies that. They're tough choices, I admit. I personally wish nobody had to go through any pain ever, honest to God. That's why I became a doctor to begin with. But it's my job now to keep this ship afloat, and if we tested every patient for everything they wanted as opposed to everything they truly needed, we'd sink like a stone, and that's the cold, hard truth. Then nobody would get any tests because nobody could afford them. You think that would be better?"
"Let me ask you one," Elliot replied. "I've heard a rumor you haven't paid some of your doctors. Would you care to comment on that?"
Ross kept on his poker face, but Elliot's awareness of this fact startled and worried him. He also thought he knew the source of it-the always difficult Eric Kensing, who'd admitted Baby Emily and then, he suspected, been Elliot's source on the breaking story. But he only said, "I don't know where you would have heard that. It's not accurate."