Against Doctor's Orders Read online

  “Flannery O’Connor, we’ll not have that language at my table,” Ida said without raising her voice.

  “Sorry, Mama,” Flannery muttered.

  Everyone quieted.

  “What do you mean,” Harper said, “sold the hospital. Sold the hospital to who?”

  “Can they do that?” Flannery interrupted.

  “Wait,” Carson said, shifting Davey in her lap as she pushed her coffee cup beyond his grasping hands. “Why haven’t the staff been informed? A lot of jobs are at stake, not to mention our patients’ welfare.”

  “It’s complicated,” Edward said, “but like most community hospitals that were started by a few individuals, the hospital transitioned to a for-profit institution sometime during the middle of the last century. The bank and a few major shareholders and the board of trustees control the business side of things. Apparently, the hospital’s profits have been declining and the sale is the only way to pay our creditors.”

  “Well, decreased profits is to be expected,” Harper said. “With the fall in reimbursement from insurance companies and the cost of new equipment, that’s true everywhere. Our beds are always pretty full—” She glanced at Carson, who’d opted for business over medicine and now headed patient admissions. “I think?”

  Carson nodded. “We run at eighty percent capacity most of the time and sometimes close to one hundred.”

  “So why wasn’t the staff informed?” Flann reached for a biscuit and glanced at her mother. “How long to bacon?”

  “Until I put it on the table.”

  Flann grinned. “Soon?”

  Ida’s eyes softened as she rose, stroked Flann’s hair, and went to the refrigerator.

  Carson started to get up. “I’ll get that, Mama.”

  “You sit.” Harper rose. “You’ve got the baby. I’ll get it.” She took a carton of eggs from her mother. “I’ll do this. I can hear from here.”

  “Keep the heat low so the eggs don’t get rubbery.”

  “Yes, ma’am.”

  As Harper cracked eggs into the skillet and listened to the questions and her father’s quiet answers, a hard knot settled in her stomach. The hospital was as much the center of her life as her family. Her friends and her colleagues there were her community. She knew the halls and stairwells as well as she knew the paths and streams that ran through the land she’d grown up on. The hushed murmur of voices in the dimly lit corridors at night and the steady beep of monitors from open doorways were as familiar as birdcall in the morning and the lowing of cows outside her bedroom window at night. The hospital was an extension of her world, and she’d never wanted to be anywhere else. Her father and his father before him and his before that had been the chiefs of staff, and she had known from the time she was twelve that one day she would be too. The hospital was her destiny, and she’d never considered any other path.

  She flipped the eggs and tuned out discussions of profit and shares and stockholders and other things she didn’t care about. She cared about her patients, cared about the community she served, and the rest was of no matter to her. She wasn’t interested in profit. She’d never been interested in money or paid much attention to it at all. She lived in what had once been the caretaker’s house on four acres of land a quarter mile down the road from the big house. She had four rooms that were plenty of space until she met the right woman to start a family with, a garden where she grew her own vegetables in the summer, apple and pear trees, a dog who slept as often at her mother’s as he did on her back porch, three cats who’d claimed the woodshed, and chickens who roosted in a coop beside it and gave her more eggs than she could eat. Her life was going just according to plan.

  She slid the eggs and bacon onto a big white platter and put it in the middle of the table. Margie took down dishes and silverware and stacked them at the other end. Everyone automatically helped themselves.

  “What does this really mean?” Harper sat back down with a fresh cup of coffee. She didn’t take any food. She’d lost her appetite.

  Edward shook his head. “No one really knows for sure. Maybe nothing. We’ve still got sick people to take care of, and that’s what we need to focus on.”

  Flann drummed her fork on the table to a beat only she could hear. “What did you say the name of the corporation was that bought the hospital?”

  “SunView Health Systems,” her father said. “They’re located out west somewhere.”

  “Strangers.” Flann glanced at Harper. Fourteen months apart, they were as close as twins. They’d gone to the same medical school, had done their residencies at the same hospital, and on rare occasions had competed for the attention of the same girls.

  Harper could read the warning in Flann’s eyes. Change was coming, and it couldn’t be good.

  *

  Presley lugged her suitcase and briefcase through the front door and found herself in a central foyer facing a wide staircase against one wall. Two large rooms opened on each side, and she took a quick glance into each. On the left was a sitting room with a sofa and several oversized chairs arranged in front of a stone fireplace. An oil painting of a red barn and fields of swaying green stuff hung above the broad granite mantelpiece. She shook her head. Didn’t they get enough of that view just driving down the road?

  A faded Oriental rug in greens and browns covered the wood floor. The other room also had a fireplace against the far wall and walnut-stained, floor-to-ceiling wood shelves holding a haphazard assortment of hardback books, and a pair of comfortable-looking reading chairs with round, dark wood casual tables beside each one. The rooms appeared lived-in and surprisingly welcoming. She’d expected a rental house to be furnished, but this place looked as if the owner might return at any moment.

  “Whose house is this?” Presley asked Lila, who waited for her at the foot of the stairs.

  “It’s been in the White family for a hundred years or so,” Lila said. “Old Mrs. White finally gave in and went to live with her son downstate. They haven’t had any buyers, so they finally decided to rent it.”

  “Can’t imagine there are many buyers for places out here.”

  Lila laughed. “You’d be surprised how many city people like to try their hand at country living.”

  “You’re right about that.”

  Presley followed Lila upstairs where she found three bedrooms, one with a large bathroom attached, and a second bathroom down the hall. She’d never lived with anyone—she liked to work at odd hours and didn’t care to worry about someone else’s schedule, but Carrie could stay here for the short time they’d be on-site. They got along well and they wouldn’t actually be spending that much time in the house. Carrie had been her personal assistant now for almost three years, since Carrie had graduated from college and finished an internship at SunView. She was organized and efficient, respected personal space, and appreciated that Presley wasn’t a chatterer. Exactly the kind of person Presley could tolerate having around.

  She took the master bedroom with bath, dumped her bag by a broad, tall four-poster bed, and walked to the open window. Lace curtains billowed in the breeze. The room overlooked a sloping lawn to the drive and, beyond that, a broad green pasture bordered by a wooden rail fence. The air was surprisingly clean and bright. She could almost smell the green in it. The thought struck her as ridiculously whimsical, and she turned away to study the room with its tall armoire in lieu of a closet in one corner and a matching dark wood dresser topped with a huge wood-framed mirror. Another Oriental-patterned rug covered the floor, and a small chair upholstered in a floral brocade design sat by the window with a standing brass reading lamp nearby. Homey. And absolutely nothing like her condo in Phoenix, where she favored glass and steel and modern art, highly polished tile floors, and a gleaming gourmet kitchen she rarely used. Not that she really noticed her surroundings when she got home late at night and put in a few hours’ work before bed.

  “Talk about a fish out of water,” she muttered with a shake of her head. Frowning, she scanned
the wall, checked what appeared to be a thermostat, and walked out into the hallway. Leaning over the wooden banister, she called, “Lila?”

  Lila appeared below and looked up. “Need something?”

  “Where are the controls for the air-conditioning?”

  Lila stared at her for a few seconds. “Well, there aren’t any.”

  “Come again?”

  “Most places up here don’t have it. You won’t need it except maybe in August, when it can get a little stuffy. Then just open the windows, and if you want a bit more air, you can put a fan in one of them. I’ll see to it when the time comes.”

  “A fan. In August.”

  “Maybe.”

  “Wonderful.” Presley added another item to her list of things she intended to torture Preston for. “Which direction is town? I thought I’d walk around and get acquainted.”

  “You won’t be walking to town. It’s about eight miles.”

  “Eight miles. Lovely.” She couldn’t wait for Carrie to arrive to see to the rest of the arrangements Preston had neglected. “All right then, I’m going to need a car. Today. Where’s the nearest rental place?”

  “I imagine that would be in Albany. And that’s a good—”

  “Yes, I know, forty-five minutes away.” She considered her options. “Where would I go to buy one?”

  “Well”—Lila seemed to be searching for words—“a new one or used one?”

  “One that runs.”

  Lila smiled. “I know just the place. When you’re ready, I’ll drive you over.”

  “Let’s go.”

  Lila’s cousin’s husband Clyde operated a small used-car dealership out of a garage next to his house twenty minutes away. Lila called, and a big man in baggy jeans and a faded T-shirt met them in the driveway in front of a single-story white cement building surrounded by a dozen cars and trucks.

  “Good morning, ladies. You’re looking for a car, I hear.”

  Presley surveyed the vehicles, all of which looked relatively new and surprisingly clean and in good condition. “I need something reliable with air-conditioning and GPS.”

  The man glanced at Lila, who gave him a nod. “Are you going to be hauling anything?”

  “What would I want to haul?”

  He lifted a shoulder. “Hay, sod, feed, furniture—that kind of thing?”

  Presley smiled thinly. “No. No hauling.”

  “And I guess you won’t be pulling a trailer, either.”

  “Not in this lifetime.”

  “Well then, I think I’ve got what you want.” He showed her a relatively new Subaru hatchback with all the basic requirements and assured her it was in excellent condition. “And if you have any problems with it, just bring it back and I’ll take care of it.”

  “Fine. Will you take a check?”

  “I sure will. And I’ll get the registration taken care of for you this morning as soon as motor vehicles opens up. You’ll need insurance.”

  “I’ll have my assistant call you with that information. Can you have someone deliver it to me when it’s ready? My cell number is on the check. You can call me, and I’ll tell you where.”

  “I can do that.”

  “Excellent.” She wrote a check, handed it to him, and turned to Lila. “Might I impose upon you a little while longer? I’ll need a ride to town while Clyde gets this ready for me.”

  “Of course. I was going to go grocery shopping and stock up the kitchen anyhow.”

  “Wonderful.”

  Lila dropped her off a little before nine.

  “Thanks, Lila.” Presley grabbed her briefcase. “You’ve been a tremendous help.”

  “If you need a ride back before Clyde gets the car ready, you call me. It’s no bother.”

  “That’s all right. I can always call a cab.” She paused, reading Lila’s expression. “Or not.”

  She laughed before Lila could. The absurdity of the entire situation was starting to feel normal. She waved as Lila drove away, and surveyed Argyle Community Hospital for the first time. The ivy-covered red brick building with its white colonnaded front entrance and two symmetrical wings extending out in a lazy U stood on a hillside above the village. The road up wended through what Lila had told her were apple orchards. A rolling grassy lawn studded with shrubs and flower beds bordered the circular drive in front. With its tall gracious windows and elegant portico, the place might have been a grand hotel or a private summer home. It bore no resemblance to the modern, sprawling hospitals Presley was used to. A pretty place. She started up the broad stone sidewalk, thinking of all the uses for a building like this when it wasn’t a hospital any longer.

  Chapter Three

  The hospital foyer soared two stories to a vaulted ceiling painted in swirling patterns of dusky rose, periwinkle, and pale cream. A line of brass chandeliers with candelabra bulbs lit the upper recesses, and floor-to-ceiling windows on either side of the massive entrance let sunlight in to dance across the highly polished marble floors. Presley’s low heels tapped rhythmically as she crossed to a gleaming mahogany desk in the center of the expanse, behind which sat a tiny white-haired woman wearing a bright red jacket and a blazing smile. Presley glanced around and didn’t see anyone resembling a security officer, and she doubted that this diminutive octogenarian could stop a flea. Hopefully the other entrances were staffed more conventionally.

  “Good morning,” the woman said in a surprisingly full, strong voice. “Are you here about a patient? Visiting hours aren’t until one unless you’re here to see someone in the ICU.” She pulled over a clipboard. “I can check a room number for you.”

  “No, I’m not here to see a patient,” Presley said, scanning the desk in vain for a computer monitor. A clipboard? Why should she be surprised? “A business matter.”

  “Oh, then you’ll want administration.” A thin bony hand pointed toward another set of polished wooden doors at the far end of the foyer. “Right through there to your left, second hallway on the right, and then follow the signs. Oh”—she held out a laminated card with a V on it—“just clip this to your jacket there.”

  Smothering a smile, Presley took the little laminated card and clipped it to her jacket. A visitor’s badge. What next? Perhaps the plane had been caught in a time warp and she’d been transported back in time rather than simply across the country. “Thank you.”

  “Not at all, dear. You have a nice day.”

  Have a nice day. When was the last time someone had said that to her and sounded as if they really meant it? She spent her days in meetings with others just as busy and absorbed in their own projects as she was, or spearheading acquisitions that more often than not were unpopular with most of the people involved. Unused to the simple interchange, she searched for the appropriate response. “You do the same, Ms.…”

  “It’s Mrs.…Mrs. Dora Brundidge. You can call me Dora. Everyone does.”

  “All right, Dora. You enjoy your day.”

  “Why, thank you. I will.”

  Presley made her way from the reception area toward the main hospital entrance, slowly taking in the portraits dominating both side walls. On the left, four men, stern and serious looking in stiff, high-collared white shirts, vests, and coats, faced two men across the foyer in more modern garb. All the paintings were done in oils, the style formal, the elaborate frames gilt with engraved plaques beneath illuminated by individual brass lamps. Moving from one to the next, she perused the names. Alexander Rivers. Roger Rivers. Charles…William. Rivers all. Curious, she crossed to the right and studied the others. Andrew. Edward.

  She pulled up a mental image of the report Carrie had given her on Argyle Community Hospital. Her memory was eidetic, or nearly so for practical reasons, and she sifted through the names of the board of trustees and then came to the entry she was seeking. Medical Chief of Staff: Dr. Edward William Rivers. She returned to the reception desk. Dora gave her another smile.

  “Did you forget something, dear?”

  “No, just c
urious. It looks as if the Rivers family is an institution around here.”

  “Oh, well I would say so,” Dora said. “The first Dr. Rivers—that would have been Alexander Rivers—founded the hospital way back when the community was established, and there’s always been a Dr. Rivers at the Rivers.”

  “The Rivers?”

  “That’s what the hospital was called until after the war. Then, you know, the hospital name was changed, but it will always be the Rivers to a lot of us. We were mostly all born here, and our children too.” Dora laughed. “We’ve got some new blood over the years, of course—people moving in to try their hand at farming or raising goats and alpacas and such—but the majority of the families have been here a long time.”

  “Yes, of course.” Presley tucked away that little bit of information. Community resistance in any kind of takeover was a possibility, although in this instance, she doubted any kind of organized or effective opposition could be mounted in time to slow the transition. She planned to be in and out as soon as possible, but it never hurt to be forewarned. “Well, thank you again.”

  As soon as she passed beyond the foyer into the main building, the ambience changed. The hallways were still wide and grand with paneled wainscoting and tasteful muted colors and paintings of pastoral scenes hung at intervals, but the familiar signs of hospital activity were everywhere. Small discreet signs directed patients toward radiology, the outpatient labs, admissions, and the ER. Others pointed visitors to the elevators for the intensive care unit, the surgical waiting room, and the patient floors. Hospital personnel in scrubs, lab coats, and smocks hurried through the halls, some pushing gowned patients in wheelchairs. A young blonde in a white shirt with a logo above her breast that said Food Service pushed a rattling cart with pots of coffee and trays of bagels. She slowed and smiled at Presley, her gaze unmistakably appreciative.

  “Looking for the conference room?” the blonde asked. Her ID read Deana.

  “Is that where the coffee is going?”

  Deana laughed. She was pretty in a completely unstudied way—clear eyed, no makeup, youthful and fresh. “Yes. Grand rounds, right?”