Wednesday, March 14, 2012

House Of Cards

Very few people knew that Jed had studied architecture before medical school. They also didn't realize that his trip to Europe after residency was less leisure and more scouting structural gems in various locales.

No, Jed was known as a brilliant general surgeon. And he was OK with that. But sometimes his curiosity and prior education got the best of him.

One morning, while rushing to get to the office after rounding on post op patients, Jed huddled in the corner on 4S to tie his shoe. He balanced his weight on one knee, while he reached out for the laces dangling from the other extremity. To his great surprise, before his grasp was successful, he clumsily fell forward and landed on outstretched hands. As he moved to the corner and braced against the wall, he completed the task absentmindedly. His brain was lost in thought.

He knew he had superb balance. He rarely fell in even the most treacherous situations. By the time he finished, he was convinced that the floor was not level. He rose and ducked into a supply closet where he looked for a round object. He quickly settled on a tiger top blood tube and made his way back to the hallway.

After looking to make sure both directions were clear, he placed the tube on the ground and pushed it due west. It meandered down the large hallway for a few moments and then slowly veered south. Jed followed it into the corner and was surprised to find that at the intersection of the very south and west walls of the building, a collection of round objects had formed.

There were tubes, marbles, and a series of coins. Someone had even apparently lost a tennis ball. Jed was now convinced that there was a material defect in the building. He stared up at the ceiling and then back at the floor. Within moments, his pager buzzed and he glanced down at his watch. The mystery would have to wait till the end of clinic.


Over the next few days, Jed conveniently found reasons to be on each of the hospital's eight floors. He was not surprised to find that every time, a pile of odds and ends had collected in the building's southwest corner. He envisioned an imperfection in the bracing or support. Something had to be done.

Jed decided to call the engineering department and discuss his concerns with the hospital staff. After a number of transfers and accidental hang ups, he eventually was able to reach the head of the department. As he accompanied the gentleman to the southwest corner of the building on the second floor, he explained what he had found.

The structural engineer seemed unfazed. He cleared the debris from the corner with his right leg as he looked at the wall.

It's just settling son, nothing to worry about.

Jed could see that he wasn't going to get anywhere with the man, so he thanked him and returned to the work of being a surgeon. But as the hours passed, he again felt a nagging sense of impending doom.

Jed's last option was to call the head of surgery and plead the case to his boss. Unfortunately, the conversation ended with a promise to bring it up again with the engineering department. Jed doubted very much that that would really happen.


Days turned into weeks, yet Jed couldn't stop the unnerving, demanding thoughts that ran through his mind. The building was insecure and needed to be corrected. The lives of countless patients and staff depended on it.

One night after waking up in a cold sweat, Jed decided he had enough. He threw on a pair of scrubs and drove to the hospital. At three in the morning, the halls were quiet, and he had no problem slipping undetected into the maintenance elevator.

He pushed the button marked SB for sub basement and waited till the doors opened. As he exited, he was cautious to avoid being seen. It only took a few moments to find the southwest edge of the building.

Upon turning the corner, he was surprised to find a door that lead to a dirt covered room with a low ceiling. As he closed the door behind him, Jed realized that for all intents and purposes he was outside the building. Looking up, he calculated that he must be standing directly under the front steps to the main entrance of the hospital. He could hear the occasional distant thumping of shoes overhead.

The room was roughly twenty feet by twenty feet, and it was barren except for hole jutting into the ground at the southern most edge. Jed stepped over to inspect and found a thin steel ladder plunging downward. He grabbed tightly and shook the metal structure before he climbed into the hole and started the descent into the earth.

Although he could barley see, he felt his way forward with his hands and feet. After what seemed like hundreds of steps, he finally came to the end of the ladder and his legs rested on flat ground. He grasped for the penlight clipped into the breast pocket of his scrubs.

By the faint illumination, he could see what lay at the bottom of the rabbit hole. The very southwest edge of the building was being propped up by something. He bent to look closer and blinked his eyes multiple times unconvinced of their accuracy. The mortar was balanced on top of two playing cards that were bridged together by a third. Jed squinted to see that the top card was facing up. The foundation came to a point and impaled the chest of a laughing joker as if amused by his own impotence.

Jed's head started to spin. A rush of memories and seemingly unrelated thoughts popped into his mind. Had not his medical school listed in a similar direction? Hadn't his clinic also felt slightly off balance?

As Jed began the long ascent back up the ladder, he felt queasy. It was not just the hospital but the whole kit and caboodle.

The whole healthcare system was built on a house of cards.

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