As the days had stretched into weeks, Tim had found himself falling into the rhythm of The Ingraham's class and lab schedule. The basic first-year courses were mostly rote. Anatomy, pathology, and histology were purely memory. Biochemistry and physiology were more analytical, but still mostly regurgitated facts. And regurgitating facts was Tim's specialty. Poor Quinn needed hours of crunch study to master what he could absorb in minutes.
So he'd found himself getting bored. Sure there was the roving bull session in the dorm, but he could take only so much of speculating and arguing about the future of medicine. Novels and his tape collection could hold his interest only so long. With everybody's head but his own buried in a book most of the time, he'd begun to feel like the only seeing, speaking person in a land populated by the deaf and blind.
The only answer was to get off campus. The nearby county seat of Frederick was little better than staying on campus. He needed a city. Baltimore and Washington were the two obvious choices.
He was passing the pond when he heard a familiar voice.
"Where have you been?"
He turned and saw Quinn hurrying up the walk behind him. He stopped to wait for her, nodding to others he knew as they swirled past him. She looked great but he didn't want her to get too close. He figured he had a terminal case of morning mouth.
"Miss me?" he said.
"I was looking for you last night. Kevin told me you took off after dinner. God, you look awful. Where on earth have you been?"
"Baltimore."
He knew a little about the city. Some guys he'd hung with in high school had gone to Loyola and he'd made a few trips down there during his four years at Dartmouth. But last night he'd headed for downtown, far from Loyola's suburban neighborhood. He'd hit Baltimore Street: The Block. Baltimore's down-sized equivalent of New York's West 42nd Street or Boston's Combat Zone.
He hadn't gone there for the porn shops, the peep shows, the strippers, or the whores. He'd gone for the games. He'd learned on his past visits that there were a couple or three backroom card games in progress on any given night, games with stakes high enough to make things interesting.
Trouble was, they hardly ever played blackjack. Poker, poker, poker was all these guys cared about. Tim knew he was a decent poker player, but nothing close to what he was in blackjack. Still, he was desperate for some action, and Atlantic City was too far.
"Did you get mugged or something?" Quinn said, looking him up and down.
He smiled and thought: In a way, yes.
He'd stayed up all night playing five-card stud. The other players had been stand-offish at first—because of his youth, Tim assumed—but after they'd seen he could play, they'd warmed to him. Even started buying him drinks after a while. Jack Daniel's. Many Jack Daniel's.
Good ol' Tim. C'mon back anytime.
They loved him. Why not? He'd dropped a couple of hundred.
Poker. Not his game.
"No. Just not enough sleep."
"Well, come on. You're late, and Dr. Alston will cut you up into little pieces."
"You go on ahead. I'm going to sit in the back. Way in the back."
He watched her cute butt hurry off and followed at a slower pace.
Dr. Alston's Medical Ethics: the semester's only non-regurgitant course. It was scheduled for only one hour a week but that hour fell at 7:00 a.m. on Wednesday mornings. Some days it was hell getting there, and today was pure murder, but Tim had never missed it; not simply because attendance was required and strictly monitored, but because the class actually was stimulating.
I could use some stimulating now, he thought as he slipped into the last row and took a seat in a shadowed corner.
Dr. Alston seemed to take delight in being provocative and controversial. His manner was brusque, witty, acerbic, and coolly intellectual, as if he were contending for the title of the William F. Buckley of the medical world.
Tim vividly remembered the first lecture a couple of weeks ago...
"Most medical schools don't offer this course," Dr. Alston had said on that first morning. He'd looked wolfishly lean in his dark business suit and one of his trademark string ties. The overhead lights gleamed off his pale scalp. His movements were quick, sharp, as if his morning coffee had been too strong. "I guess they expect you to become ethical physicians by osmosis—or pinocytosis, perhaps. And a few schools may offer something called Medical Ethics, but I assure you it's nothing like my course. Their courses are dull."
Amid polite laughter he'd stepped off the dais and pointed at one of the students.
"Mr. Kahl. Consider, if you wilclass="underline" You have a donor kidney and three potential recipients with perfect matches. Who gets the kidney?"
Kahl swallowed hard. "I...I don't have enough information to say."
"Correct. So let's say we've got a nine-year-old girl, a 35 year-old ironworker with a family, a 47 year-old homeless woman, and a 62 year-old CEO of a large corporation—who, by the way, is willing to pay six figures for the transplant." He pointed toward the rear of the room. "Who would you give the kidney to, Mr. Coyle?"
"The little girl."
"She has no money, you know."
"Money shouldn't matter. I wouldn't care if the CEO was willing to pay seven figures for the kidney."
"We wouldn't be indulging in a bit of reverse discrimination against a rich, older man over an indigent child, would we, Mr. Coye?" He turned to another student. "How about you, Mr. Greely? Think carefully and unemotionally before you answer."
Tim was impressed. This was Dr. Alston's first lecture to the class and already he seemed to know every student by name.
"I believe I'd also give it to the little girl," Greely said.
"Really? Why?"
"Because she's got the most years ahead of her."
"Years to do what? You don't know what she'll do with her life. Maybe she'll perfect cold fusion, maybe she'll die at eighteen with a needle in her arm. Meanwhile you tell the homeless woman, the ironworker, and the CEO to go scratch?"
He turned toward the second row. "Who would you choose, Miss Cleary?"
Tim leaned forward when he realized Quinn was on the spot. He saw her cheeks begin to redden. She wasn't ready for this. No one was.
"The ironworker," she said in that clear voice of hers.
"And why is that?"
"Because he's got a family to support. Other people are depending on him. And he's got a lot of productive years ahead of him."
"What about the CEO? He's very productive."
She paused, then: "Yes, but maybe he'll get twenty years out of the kidney. The ironworker might get twice that."
"Perhaps, perhaps not. But the CEO's present position places him in charge of the livelihoods of thousands of workers. Without his management expertise, his corporation could go under."
Quinn obviously hadn't thought of that, but she didn't seem ready to back down. Tim decided to buy her some time.
"Are doctors supposed to be playing God like this?" he called out.
Dr. Alston looked up and pointed at him. He didn't seem annoyed that Tim had spoken without being recognized.
"An excellent question, Mr. Brown. But 'playing God' is a loaded phrase, don't you think? It implies an endless bounty being dolled out to some and withheld from others. That is not the case here. We are dealing with meager resources. There are barely enough donor organs available at any one time to fulfill the needs of one tenth of the registered recipients. No, Mr. Brown, we are hardly playing God. It rather seems more like we are sweeping up after Him."