TREATMENT of CHOICE

MARY KING

This book is a work of fiction. The events and situations in this story are purely fictional. Any resemblance to actual persons living or dead is coincidental.

No part of this book may be reproduced, stored in a retrieval

system, or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without the written

permission from the author.

T R E A T M E N T O F C H O I C E

Chapter 1

Lauren McFadden scribbled a reminder to read over the final draft of her living will after dinner that evening. Tomorrow, she would meet with her attorney and file the document. She’d chosen not to spend endless months on life support, sustained by a ventilator and a feeding tube. Patients who opted for that kind of long-term care risked monumental health problems and often created a financial burden for those left behind. She’d signed a DNR order. Equally important, she’d left specific instructions for donating her organs. Unlike last time, she planned to be ready.

She stared down the length of the conference table, trying to think over the din of fourteen male voices locked in debate. Polished mahogany reflected eerie ghost-like images—faces blurred and devoid of features. Haunted by thoughts of dying strangers, she quickly withdrew to the notes in front of her.

At her back, sleet driven by forty-five miles per hour wind gusts spattered against a wall of floor-to-ceiling panes of glass. New tawny-beige drapes shut out the storm, blocking all but a faint glimmer of sharp lightning. The factory smell of the fabric clashed with dinner aromas. Tonight's cafeteria entrées included Italian-style baked chicken breasts, and broiled tilapia.

Thirty minutes into the meeting and she'd composed two department memos. She'd approved six overnight passes and had sent six computer-generated patient prescriptions to the pharmacy.

While she was thinking of it, she made a note to pick up the dry-cleaning on the way home.

Thunder broke directly above the building. The tremendous crack twisted her gut and set her heart pounding. The men paid no attention. The rumbling resonated, muted by the building’s concrete construction.

No voices came. No faces appeared. Not this time.

Drawing up a living will is the sensible thing to do. Not many people get a second chance.

The discussion at the table escalated to an argument…something about cutting back the staff by two therapy assistants and one speech therapist.

Lauren shut the lid on her tablet. She snatched a financial summary handed out at the beginning of the meeting and her yellow notepad. She grabbed her pen last and shoved it all into her briefcase.

Getting to her feet required a simple strategy: Plant both feet close to the chair. Push up on the armrests. Simple, provided she got her balance before the chair rolled out from under her. Now walk. The impaired gait went unnoticed when she wore rubber-soled oxfords or gym shoes. Two-inch black pumps on a tile floor were quite another matter—and a noisy one at that.

She could have cared less if the limp—or the shoes—attracted attention. In fact, she’d have stormed out of the room had she been able.

“Dr. McFadden, is there a problem? We’re in the middle of the meeting.”

“A problem, Mr. Allen?”

The other men seated at the table bothered to look because Dr. McFadden—the only female invited to sit on the advisory board—had turned her head and mocked the administrator’s thorny tone.

The discussion came to a halt.

“Yes, is there a problem?”

“Mr. Allen, as the head of this rehabilitation center, you should know that staff cuts mean less therapy time for patients and more work for the rest of us. Some of my therapists are already pushed to the limit. Budget cuts usually lead to program cuts and fewer services. From there, we lose credibility in the community and risk losing our competitive edge with the top rehab facilities in the country. I can take it one step further if you’d like: Slash my staff and budget, and you destroy any chance of gaining future private funding for research and new equipment.”

“Cutbacks also mean we improve our chances of staying afloat until the economy improves, Doctor.”

Lauren gripped the door lever, pulled the door open a few inches. “I don’t have the time—or the stomach—to listen to you or anyone else on this board try to downsize us out of business, especially when patient admissions have remained constant and we continue to operate at near-full capacity. I came here today with a proposal to expand services.”

“That’s all well and good from your perspective, Dr. McFadden, but where did you get the idea that we can afford to branch out?”

“The corporate office, that’s where. Colonial Health Northeast intended for Saint Michael’s to thrive when the doors first opened nine years ago. That goal hasn’t changed and neither should our standards of care. You’re proposing that I cut at least two therapists from my staff—maybe more. In case you’ve forgotten, Jack, my department is the nucleus of this entire medical center. So to answer your question…yes, I believe there is a problem.” And to the other board members, she turned and added, “Good day, gentlemen. I have work waiting for me.”

“Dr. McFadden, you can’t leave now.”

“And just why not?”

“Administrative policy, Doctor. Now that you’re officially back to work, we can’t approve any decisions without your signature.”

Jack Allen didn’t like dealing with women when it came to business matters, especially an unpredictable spitfire like Lauren McFadden. Hardly a day went by that he didn’t question how he’d survived with the two of them working under the same roof.

When he came onboard as administrator three years ago, he quickly discovered that Dr. McFadden was more than a gifted orthopedic surgeon. She was considered brilliant among her peers. Besides her stunning appearance, she had a sterling reputation. The woman was nationally recognized, a celebrity both inside and beyond the boundaries of the medical world. But under those bouncing waves of chestnut brown hair—behind those large spellbinding brown eyes and that perfectly proportioned body—there lurked the proverbial she-devil with claws. Lauren McFadden never agreed with him about anything.

Now Dr. McFadden was back after being on medical leave for three months. Their disagreements raged worse than ever.

“I already told you, Jack. I’m not cutting anyone from my staff. I’m not cutting any services either, and that's final. We can barely meet patient demand as it is!”

“But you heard the financial report at the beginning of the meeting.”

Lauren opened her mouth to reply, but a young man whose fair complexion and white-blonde hair she didn't recognize cleared his throat and held up an index finger. He stood, took a breath and clasped the lapels of his coat.

“Dr. McFadden, my name is Ellis Worthington. I’m a licensed CPA. I was recently appointed by Mr. Allen as his new administrative assistant. I haven’t had the pleasure of meeting you formally until today, but I’ve heard some wonderful things about your work here. You’re an accomplished musician too, I’m told. I can relate to your temperamental behavior, believe me; I understand that it’s all part of being an artist. You are undoubtedly talented in addition to being quite a formidable woman. But let’s face it, some of our most brilliant and influential people just don’t understand a thing about money. As unpleasant as the task may be, it is my job to inform you that most of the financial drain at Saint Michael’s is coming from your department.”

“Excuse me?”

“Oh dear.” Jack saw the smoldering look in her eyes and wilted. “Doctor, I’m sure Mr. Worthington didn’t mean…”

“The numbers speak for themselves,” Ellis boldly interrupted. “I justified my conclusions in my report.”

“I glanced through your so-called report,” Lauren replied. “You seem to know very little about what goes on at this rehab center—a non-profit facility, I might add. Your opinions regarding what services and equipment we need—and what we don’t need—are inconsequential. You say we should stop accepting low-income patients and those who don’t have insurance. That’s ludicrous—or should I just say ‘asinine’ and be done with it?”

“I’m sorry you feel that way, Doctor. But I’ll not recant. We can’t afford to treat people for free.”

“We’re not treating them for free, Mr. Worthington,” she mocked sarcastically. “Now I realize you’re paid to translate everything that goes on behind these walls into dollars and cents, so you should understand perfectly when I tell you that we have private contributors and multiple foundations giving us money. Certain funds are specifically earmarked for patients who cannot otherwise afford treatment. Those funds, plus the donations of equipment and other non-specified monetary contributions, all should have been included in your report—but were not. Such blatant and significant errors prove that you really have no clue as to what you’re doing. What’s more troubling is I did the math on what you did include in your report, and many of your calculations contain critical errors.”

“Those are rather strong accusations, Dr. McFadden,” Jack warned.

“Check the calculations yourself if you don’t believe me. Oh, and another thing…the report doesn’t mention the renovations made to the center while I was away. The materials and labor must’ve cost a small fortune. Or were those amounts just magically absorbed by each department to keep the costs hidden?”

“I don’t want to get into what you might be implying, Doctor.”

“No, Jack, I’m sure you don’t.”

“We can go over the figures and correct any discrepancies later. I admit there may be a few minor errors, but the bottom line still stands. We have to reduce the number of employees and services if we intend to stay afloat over the next six months. Private funding isn’t something we can count on indefinitely. Now, Doctor, are you going to help us decide on what cuts to make or not?”

“No. I’m not. And when someone asks me why we're going under, I’ll just explain that we had to buy pricey artwork and custom window treatments. I’ll point out the lovely crystal chandelier over our brand new conference table. I’ll say we can afford new floor tile, new paint for the entire medical facility and a new administrative assistant for you, Jack. And then I’ll add, ‘Unfortunately, we canNOT afford to provide the necessary programs for our patients!’”

“You don’t have to raise your voice, Dr. McFadden.”

“I’ll raise my voice if I damn well please.” But she toned it back when she heard people in the hall outside the door. “I’ll conclude with a public announcement that we had to cut back my staff, and as a result we don’t have enough therapists to properly treat everyone.”

Jack sat back in his chair and tossed his pen on the table.

Lauren turned to the door once again and pulled it open. She looked back to the men one more time. “Irresponsible management is not the way I do things. Come up with a plan that’ll move us forward, gentlemen. Until then…don’t expect me to sign anything.”

Chapter 2

Inside her office, Lauren locked the door and put down her briefcase. She wanted nothing more than to be left alone and to get the image of Ellis Worthington out of her head.

The room was quiet. Too quiet. Dead silence unnerved her. So did too much noise. Anything in-between rated as mildly irritating.

She turned on the recessed ceiling lights, dimmed them a bit and then started for the closet to get a pair of flat shoes. At the same time, she glanced across the room to see if she’d left a lab coat on the back of her chair. The yellow envelope at the front of the desk caught her eye. Made her stop abruptly and change course.

“My dolphins!”

She plucked the letter wedged between the two graceful mammals and tossed it aside. It teetered on the outside edge of the incoming mail tray, threatening to fall into the wastebasket below.

She picked up the figurine, ran a single fingertip along dorsal fins and inspected horizontal flukes. A curled wave held the arced dolphins suspended in mid-leap. Satisfied no harm had come to the treasured piece, she returned it to its place beside her nameplate.

Lauren snatched the in-house envelope and turned it over to see who’d intruded on her space. Bryan was the only other person to have access to her office and he certainly wouldn’t have used one of her favorite keepsakes as a letter holder.

She immediately recognized the signature.

Just as quickly, the memories—the weeks of guilt and the shame—came rushing back.

She’d shared little with Sean Cody these last three months—had flatly insisted the parish priest of Saint Catherine’s Church stick to counseling patients and stay out of her personal affairs. Sean had taken her at her word, had left her alone…until now.

She stepped over to the windows behind her desk. Beyond the glass, a heavy fog had begun to roll in. Still, she could see clearly the events of the past few months. Events she only wanted to forget…

Forcing her thoughts back on track, she turned her attention to the work ahead.

On her desk, a black appointment book lay open, the outside margins filled with shorthand memos. In the weekend block, she’d started a grocery list. A stack of telephone messages awaited her attention. At least a dozen patient files begged to be updated. It would all have to wait; she hadn’t the strength to deal with any of it now.

She reclined in the executive chair to ease the strain on her leg and unwound the twine from the envelope’s red button closure.

“Lauren?”