CHAPTER ONE
“RETRACTOR!” SNAPPED Dr. Rex Maxwell.
His surgical nurse quickly placed it in his palm.
“We need to find this bleeder. Suction.” With a gentle movement, Rex lifted the liver as his assistant, standing across the OR table from him at Metropolitan Hospital in Memphis, Tennessee, obeyed his command.
Rex watched intently for any sign of red liquid. This patient had come through the emergency department the night before and one of his colleagues had patched the man up but the patient wasn’t recovering as he should. His midsection had swelled. There was internal bleeding. Rex was known as the “go-to man” who handled hard-to-find problems like this. He didn’t disappoint. Confident in his skills as a surgeon, his success rate had proved him more than competent. Except in one case.
His heart jumped as he spotted the problem. “Found it. Sutures.”
“That figures. You find them when no one else can,” the anesthesiologist said, admiration in his tone.
Rex looked over his mask at the man. “Thanks.”
Over the next few minutes Rex repaired the leak. He was almost finished when the phone on the wall rang. A nurse answered. Seconds later she hung up. “Rex, you’re wanted in Administration as soon as you’re done here.”
He muttered a word that his mother would scold him for using. Polite people didn’t use words like that. But, then, to her, life was about always making the right impression.
An hour later he trudged down the wide tiled hallway toward the hospital administration offices. With a patient in surgery prep who had been pushed back hours because of the bleeder, Rex should be back in surgery, not on his way to a meeting he wasn’t interested in being a part of. Hadn’t he spent enough time in the last twelve months with Dr. Nelson, the hospital administrator? Being arbitrarily summoned to Nelson’s office should have stopped when the unpleasant malpractice suit had been settled.
Rex had endlessly replayed the details of that night and that surgery in his mind and had told lawyers the tale of what had occurred more than once.
He’d been called in late on a Saturday night after having been to a club on a date. Since he had been on call he hadn’t been drinking and when he’d arrived at the hospital the patient had already been prepped for surgery. It hadn’t been until after he was in the OR that he’d learned his patient was Mr. Royster, the man who had been both his father’s best friend and chairman of the board of the country club when his father had filed for bankruptcy. Royster was also the father of Rex’s ex-girlfriend, who had dumped him because she’d been ashamed of being seen on Rex’s arm after his family’s financial downfall had become public knowledge.
The situation with Mr. Royster’s perforated stomach had by now deteriorated to the point that he’d had little chance of surviving even with surgery. The repair hadn’t been difficult but the chance of serious infection had been high. Less than twenty-four hours post-op Mr. Royster had steadily been going downhill. In another forty-eight, he was gone.
Devastated and grief-stricken to the point that they couldn’t accept what had happened,
Royster’s family had lashed out by filing a malpractice suit against Rex, accusing him of not taking the necessary medical steps to save Royster’s life in retaliation for how he and his family had been ostracized all those years ago. Powered by the family’s money and influence, the case had gone further than it should have. The most damage had been done by the Roysters’ manipulation of the media, which had dragged the hospital into the nastiness.
The relationship between Rex and Dr. Nelson had been contentious at best while the hospital had been faced with the possibility of paying millions in damages. Rex’s career, as well as his and the hospital’s reputation, would still take years to repair. Thankfully, though, both he and the hospital had come through the experience bruised and battered, and both were still in business. So what could Dr. Nelson possibly want now?
Opening the glass door of the administrative suite, Rex went straight to the assistant’s desk. “Marsha, please let Dr. Nelson know I’m here.”
She nodded toward a closed door. “Go on in. He’s waiting on you.”
Relief washed through him. At least he didn’t have to waste time waiting. He checked his watch as he entered Nelson’s office. He was determined to get to his patient sooner rather than later. As Nelson looked up from his chair behind the desk, Rex closed the door.
Dr. Nelson waved him toward a chair. “I’m glad you could make it on such short notice.”
Rex dropped into the seat, elbows resting on his knees, and looked squarely at Dr. Nelson. “I have a patient waiting.”
“I won’t keep you long. After the unpleasantness of the last year, the hospital’s reputation has taken a hit. The community is left with the impression the hospital doesn’t provide quality service.”
Without thinking, Rex uttered that foul oath again. Dr. Nelson’s eyes narrowed. In turn, Rex straightened in his chair. “Everything about my service is high quality. Was and will be in the future. I’ll put my skills up against any surgeon’s.”
“The question is, does the public believe that?” Nelson countered. “This is a serious situation. I’m sure you’ve noticed the downward turn in your workload.”
“Yes, but I’m still very busy.” Rex was confident people would soon forget about the long-drawn-out court case. Especially since it was no longer nightly news. Time was the secret. After all, he’d lived through scandal before and survived.
Dr. Nelson’s face sobered. He leaned forward, placing his arms on his desk and clasping his hands. Maybe there was more to this meeting than Rex had originally thought. He gave Mr. Nelson his full attention.
“Because of the situation, the board of directors has decided to bring in a public relations firm to help minimize the fallout. With the hospital accreditation committee planning a visit at the end of the month, we need to bolster public opinion as much as possible. Since you were involved in the lawsuit they want your cooperation in the matter. The idea is that if the public perception of you improves then so will the hospital’s and vice versa.”
Rex held back a frustrated groan. Nelson must be joking. There wasn’t time in his day for PR stuff. Instead of voicing his real opinion, he said, “Do you really think that’s necessary?”
“It’s not what I think but what the board has decided. However, I agree with them. I expect your full cooperation.”
Rex started to open his mouth.
Dr. Nelson raised his hand. “The board knows you’re a talented, dedicated doctor. They want to keep you but the hospital’s reputation must improve. If you plan to continue working here, I highly recommend you go along with this.”
Rex was invested in Metropolitan Hospital. With his surgical skills he could work anywhere, but that wouldn’t be enough to get him the promotions he craved and if he were to leave it was highly likely that any hospital he applied to would take a dim view of him, given the malpractice lawsuit, even though he had been legally cleared.
He’d been able to start work at Metropolitan as his own person without the worry of the negative connotations of his family name. He’d been exceptionally successful, despite being what some would call a free spirit. There had been no issues until this recent incident and he didn’t anticipate any more problems in his future. His intention was to achieve the position of departmental head in this hospital.
Now he was being pressured into unnecessary PR nonsense with no say in the matter.
Just like when he had been a teen and his family had become the subject of too much outside attention.
After his family’s fall from their high-society status, he’d vowed he would never be forced into putting on a façade to impress people. However, it seemed that that was what it was going to take if he wanted to achieve his goals in medicine. Even though experience had taught him that putting a pretty face on an ugly reality could backfire badly.
His mother and father had lived that way. The best clothes, nice cars, private school for their children, big house and membership to an exclusive country club. The problem was that they couldn’t afford it. Everything had been outward appearance and no substance. When Rex had been seventeen it had all come crashing down. His parents had been exposed and the family had gone bankrupt.
Reality was a too-small apartment on the other side of town, a ten-year-old car, cheap clothes and no more country club.
Most of Rex’s friends had turned their backs on him because they’d no longer had anything in common. What had really hurt, though, had been the girl he’d been in love with ending their relationship. When he’d been snubbed by country club snobs, she’d declared they had no future. He wasn’t enough for her. So much for love.
Rex had promised himself then that he’d never judge someone by where they lived or what they drove, neither would he ever put on pretensions of wealth and social status to impress again. He was who he was. People could like him or not. That was one of the reasons he wore a T-shirt, jeans and boots to work. He might be a well-paid physician, but his open, honest lifestyle had nothing to do with his salary, his brain or his skills in the OR. He would not tolerate pretense in his life.
Forcing his attention back to the dilemma Dr. Nelson had just created for him, he decided that during this new PR push he’d just lie low and concentrate on his patients. Refuse to get any more involved than he absolutely had to. He had nothing to prove to anyone and nothing to hide.
The moment Rex sighed, satisfied with his decision, Nelson punched a button and told his assistant to send in Ms. Romano.
* * *
Tiffani Romano waited apprehensively in the outer office of the administrator. She’d already seen Dr. Nelson but he’d asked her to wait while he spoke to Dr. Maxwell in private, then he would introduce them.
When her boss at Whitlock Public Relations had asked her into his office and explained that Metropolitan Hospital wanted to hire the firm to improve their image she had been excited that he was putting her in charge of the job. Tiffani saw this as a once-in-a-lifetime opportunity to advance in the company. Success in the campaign would give her the two things she desperately wanted—a promotion that would move her to the corporate office in another city and the chance to no longer encounter Lou, her ex-boyfriend, daily.
The only glitch was that she had no respect for the medical community. She knew from personal experience that doctors were only interested in themselves and cared little about the patients whose lives they ruined instead of healed.
When she’d been a child her father had been crippled in a motorcycle accident and he had lost one leg completely and part of another, condemning him to a wheelchair. The situation had made him a very bitter man. To this day, he insisted the doctors had done nothing to save his lower limbs. With his lack of mobility had gone his desire for life—his only joy to be found at the bottom of a bottle or in the comfort of prescription drugs. These tragedies had been underscored by his sullenness, all making it impossible for him to hold down a job.
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Her mother had supported her father’s vendetta. Suffering through her father’s recovery and attitude about his life, the lawsuit he’d pursued against the physicians and hospital, and having little money, she had been almost as unpleasant as her husband. She’d soon divorced Tiffani’s father and the once happy household had changed to one of permanent misery. Nothing had been the same after that fateful day.
Her father still complained about how he had been mistreated. Today he was wasting away at an assisted living home, spending more of his time in bed than out. It made Tiffani miserable to visit him and see him like that, but he was her father and she loved him.
Would Dr. Maxwell, with whom she’d have to work closely, be any different than the doctors who had destroyed her father? From what she had read and seen on the news about the malpractice case, she’d believed Maxwell guilty. Nevertheless, he’d been cleared of all charges. She wasn’t surprised. Like all physicians, she was sure he’d played God with someone’s life with no thought to what would happen to the patient afterward, or the effects on the family. Her father lived in pain daily because of hasty decisions and half-efforts his doctors had made. Though her father had survived, unlike Maxwell’s victim, his life and the lives of his family had been destroyed.
Regardless of Dr. Maxwell’s devil-may-care attitude, his surgical success rate was above average. That could be used to her advantage if she could keep him in check long enough to achieve the “you-can-trust-me” crusade she envisioned. Her intense month-long strategy was to boldly make him the face people associated with the hospital. It was an ambitious plan and she had no time for indecisiveness or uncertainty.
She would keep her opinions on the medical field to herself and convince him that it was in his best interest, and the hospital’s, to cooperate with her plans. The board expected positive results and she intended to deliver. Doing so was too important to both her career goals and her sanity.