The Imposter (Alexandra Destephano Book 2) Read online

  Elizabeth spoke up, "It may be an isolated incident, but it still has a heavy impact. There should be enough staff to cover the unit, even when there's a problem. When the media gets a hold of this, as I believe they already have – based on the stack of messages on my desk – we’re going to be in for some nasty, negative publicity." Elizabeth Tippett used her advantage well and looked straight at Don Montgomery.

  Montgomery didn't respond, but Whitset did. "I believe we are blowing the repercussions of this incident out of proportion in relationship to the actual threat. Accidents happen in hospitals. They happen every single day …."

  Elizabeth interrupted the psychiatric administrator, "Really, Mr. Whitset, accidents and incidents do occur in hospitals regularly, but it's a bit extreme to have a patient murdered by another patient on the psychiatric unit. I believe you're the one underestimating the potential disaster here."

  Alex wanted to give Liz a standing ovation. She was proud of Elizabeth for the way she was standing up to Whitset. She had emerged from a shrinking violet just a few months ago to a strong member of the executive team. She was a master at dealing with the press and sorting out difficult, press related issues. Elizabeth had a well-connected press network, which complimented her ability to perform her job well.

  Whitset stared at Liz and gave her a chilling look.

  Even Alex could feel the coldness his manner exuded.

  He said in an icy voice, his black glittering eyes raking the media director's face and upper torso, "My dear, I do believe you're wrong."

  Elizabeth maintained her composure and said simply, "No, Mr. Whitset, I'm right." She turned to Betty Favre and said, "Besides, it's clear to me that our sophisticated equipment you mentioned, Ms. Favre, was useless last night -- particularly since there were no staff members available to monitor it!" She glared at the nurse executive, her eyes displaying her displeasure.

  Betty just stared at the table. There was nothing she could say.

  Alex and Robert both eyed each other after they saw the look of intense hatred Lester Whitset gave Elizabeth Tippett. Elizabeth seemed not to notice. Alex was glad. It was bad enough that she and Robert were worried.

  Montgomery checked his watch and eyed the group. "Where in the hell is Dr. Desmonde? And, where is that useless police Commander? I was sure he would be here to entertain us with his consistent incompetence." Don looked around at the group to see which of the members appreciated his humor. Betty Favre and Lester Whitset both smiled broadly.

  Alex, per usual, was disgusted with Don. She said "Don, I believe Dr. Desmonde is on her way. There was another incident up on the unit and ...."

  Whitset about fell out of his chair, “What incident, what happened?"

  Alex looked around the room and said, "I don't know the details. Monique will tell us when she arrives."

  Don was livid, his faced flushed bright red. "Shut up, Alex. I know what happened and I don't care about that." Don paused as the door to the conference room opened, "Well, well, well, look who finally made it," Don sneered as Monique entered the conference room.

  Robert was angry as well, but his voice was calm. "Don, please watch what you say and keep this meeting professional. Dr. Desmonde and Ms. Destephano don't deserve your sarcasm and disrespect."

  Alex flashed Robert a smile. She could hardly believe the CEO had told her to shut up.

  Don ignored Robert and said, "Dr. Desmonde, I don't recall you telling me I was going to need double staff to take care of these wackos. Did you tell me that, Dr. Desmonde?" Don's voice was demanding and so sarcastic that Alex could feel Robert get ready to say something else to him. She placed her hand on Robert's arm and whispered to him to let Monique handle Montgomery.

  "No, I didn't tell you that precisely, Don. What I did tell you was that there was a distinct possibility our work load would increase significantly and that we may need more staff later. That, I believe, is when you, as our esteemed leader, hired Mr. Whitset's company to manage the psychiatry service!" Monique's voice was disdainful and patronizing.

  Whitset had been watching the exchange with a great deal of interest. He interjected, "Yes, Mr. Montgomery did hire us around the time he signed the state contract. He was obviously worried about the costs of caring for such a diverse population of psychiatric patients. My company assured him that we had helped many other hospitals do the same type of thing we have done here at Crescent City -- successfully managing a changing population of psychiatric patients without increasing costs. We're successful here. It's a good model." Whitset smiled broadly, his thin lips curling over his small rodent like teeth.

  Monique could hardly abide Whitset's tiresome ponderosity. What a pile of bullshit she thought to herself. When she couldn't stand it any longer, she addressed the pompous Whitset.

  "Mr. Whitset, your model may be a good financial model for the hospital, but it is a poor clinical model. I'm sure the only reason it's saved the hospital money is because you cut staffing positions."

  If looks could kill, Whitset would have eradicated Monique. But, he remained silent.

  Elizabeth Tippet pushed her long, dark hair back and looked at Whitset as though he were a moron. "I'm a bit confused by your comments. I wouldn't call these recent events successful, Mr. Whitset. I'd call them tragic. I agree with Dr. Desmonde. I vote we increase the staff to the levels she's suggested. It's pretty clear to me that we’re understaffed over there. I, for one, don't want any more of these patient or staff incidents to occur."

  "I second Elizabeth's suggestion. I trust Dr. Desmonde's judgment implicitly in these matters." Dr. Bonnet smiled warmly at Monique and continued talking. "She is a nationally known expert in her field and she knows the internal needs of her department."

  Don Montgomery gave Robert Bonnet a deprecating look.

  He'd always hated and distrusted the surgeon. In some respects, Alex believed Don was jealous of Robert.

  "Thanks, Bonnet. What a surprise! You physicians never disagree with each other." His voice was laced with sarcasm and disdain as he sneered at Robert.

  Montgomery turned to Whitset. "What do you want to do, Whitset? It's really your call, you know. You're in charge of the Pavilion. If you think we need the staff, we'll work it out."

  Alex intervened. "Don, I object to giving him this authority. He is hired contract help. This system is an administrative disaster. I would certainly like him on our team, but I wouldn't give him the authority to make the decision. In fact, I don't think he has that authority based on hospital by-laws and policy."

  Whitset's eyes shot daggers at Alex, his black eyes penetrated her face.

  Alex could feel the coldness he exuded. She could feel the chill as it washed over her.

  Don shrugged his shoulders and looked at Whitset. "Don't know, Whitset. What do you think?"

  Whitset managed a complete turn about. He looked at the group, nodding at Donald Montgomery. His smile was pleasant and his voice congenial. "Thanks, Don. Thank you all for your input. I'm not in favor of hiring additional staff. We don't need them. According to my numbers, CCMC is well staffed. The staff we have are competent and are used to caring for the type of patients we admit. Secondly, our productivity would drop if we hired 10 new positions. It would take us over six months to hire and train them. Hiring these people makes no business sense at all -- particularly because we don't need them. I figure these positions would cost us better than $1 million the first year. I'm against it."

  Betty Favre nodded her head in agreement with Lester Whitset. "I quite agree with Mr. Whitset. If we have money for positions, Don, I'd much rather put the FTEs in critical care or on the medicine units. Psych is doing okay. Besides, it's hard to fill psych nursing positions. We have to pay them more because of the perceived notion that working with these patients can be more dangerous. I'm against increasing the staff over there." Betty rolled her eyes at the 'perceived notion' that caring for psych patients could be dangerous.

  Monique interrupted, "Perceived n
otions, really Betty, you are intolerable. Two nurses have been attacked in the Pavilion!"

  Alex gave Betty Favre a disgusted look and shook her head. One thing about Betty was that she never disappointed. For some reason, she always expected that the nursing leader would emerge as supportive of nursing and their needs. Favre never did. I ought to be used to her by now, Alex thought. At least I know what to expect, she mused. I guess it's better than people shooting from the hip. Expect nothing, get less. That's going to be the way I approach her.

  Alex spoke, "I recommend, from a legal standpoint, that we fill the slots. We have a file full of complaints from patients, staff, and visitors about how unsafe the Pavilion is. We're required by law to provide for the reasonable safety of those who visit our premises. If we don't, we could be liable for all types of actions .…"

  "Now, now, now, Alex. Perhaps you're being a little overzealous? Aren't you flaunting your lawyer credentials?" Lester Whitset looked at her, a mollifying smile on his face. His voice was so low she could hardly hear him.

  "Absolutely not, Mr. Whitset. I'm only being reasonable and prudent, doing my job as the hospital attorney. Dr. Desmonde has offered a convincing argument, substantiated by statistics, that we are severely understaffed here in psychiatry. Her numbers aren't even adjusted for the severity of our patient index or patient population. Our overall patient acuity is higher than that of any other hospital in New Orleans. Therefore …."

  Alex was interrupted by Whitset as he jumped up from his seat and leaned across, practically lying on the conference table across from her, his face white again with fury. He looked like a little boy who was pouting. "We will not hire any additional staff! It's my decision, and it’s final! It's no longer open for discussion." Whitset stared around the room.

  Alex was incredulous. How dare that creepy SOB undermine her. She looked at Don and said, "Don, really, we must have some type of closure here.”

  Montgomery looked at the hospital lawyer and shrugged his shoulders. "It's Whitset's decision, Alex. He has the last say. It's in his contract."

  Alex was incredulous. "No, no, Don. You're wrong. It's our contract. Whitset is contracting with us. We are in charge here. We are driving the bus."

  Robert looked scornfully at Whitset. "What's in this for you, Whitset? A bigger bonus based on dollars saved at the end of the year?"

  Whitset said nothing and continued to look around the room.

  Alex's sense of smell was assaulted by a strange odor. She couldn't quite place it, but it was very familiar. She looked around to see if anyone else noticed it. Whatever the smell was, it had a metallic taint.

  Elizabeth said clearly, "I must go on record here as being positively opposed to this decision."

  Robert and Alex nodded their heads in agreement with Liz.

  Monique Desmonde, still standing at the wall-mounted board with her statistics clearly in sight, looked at the group and said quietly, but assuredly, "I disagree completely with Mr. Whitset. The Pavilion is a powder keg. Anything could happen up there at any time. In fact, it already has."

  The silence was deafening and no one spoke.

  Montgomery looked at Whitset for help and support, but Whitset didn't seem to be paying attention.

  Monique continued as she locked eyes with Don Montgomery and said to him, "Don, don't take this as a threat. Take this as a fact. If those new positions are not approved by noon tomorrow, I will personally call a press conference. I'll tell them, as the former chief of psychiatry at Crescent City Medical Center, just how unsafe patient care is here. I'll tell the press in great detail about the attack and rape of Angela Richelieu, mentioning her commitment to her work, her unpaid overtime, and the unavailability of a security guard to walk her to her car. I'll also talk about the death of Mrs. Smithson in great, gory detail. I'll describe her injuries -- the way in which the knitting needle protruded from her mouth and the fact that her face had virtually been eradicated by her murderer. I'll also mention her patient call light -- about how it was covered with her blood and how it was disconnected from the wall. I'll tell the press how Mrs. Smithson, as an elderly, loving grandmother and great-grandmother, frantically called and called for help while she was being brutally raped and murdered because there were no available staff to come help her. I'll tell them where the staff was, both of them. I'll tell the Times Picayune and the Associated Press how both of our staff members were on the prison unit trying to prevent the inmates from raping the new admission."

  Monique stopped for a few moments and looked at the group, as if surveying the effects of her words. Then she continued, pulling down the neck of her blouse. "Finally, I'll show them my neck, my bruises. By tomorrow, this redness will clearly delineate the hands that tried to strangle me an hour or so ago on the nursing unit. Then, I'll describe the patient attack on the nurse manager. Good story, don't you think?" Monique's pale face was red with fury, anger, and wrath as she continued, "It should keep the tabloids busy for several weeks. Trust me, if you think our Mardi Gras press was bad this year, wait until this hits TV, radio, Facebook and burns up Twitter and the local news all over the country. It will go viral in a matter of several hours. I may even uplink a YouTube video of my injuries!"

  Montgomery looked as though he were going to cry, "Monique, no! You wouldn't do that! You couldn't!" He was pleading with her.

  "Don, I can and I will. Count on it. I want an answer by noon tomorrow. I want the positions at mid-to-upper salary scales and I want to hire them myself." Monique gave Lester Whitset a sideways glance as she left the room. His look chilled her to the bone, but she didn't care. She was on a roll. "I don't need Mr. Whitset's assistance with any of the human resource issues. As a matter of fact, I would prefer Mr. Whitset not interact with the patients at all," Monique concluded, as she shut the door behind her.

  Alex glared at Whitset. She was shocked, but pleased at Monique's ultimatum, although she was afraid for her. The look on Whitset's face was one of unmitigated hatred and rage. Alex was scared for her friend and her heart raced at the potential danger Monique could be in.

  As Whitset watched Dr. Desmonde leave the conference room, he saw her turn into one of them. When she had given him that glance, he had seen it. She was one of them. An imposter. Whitset felt his heart speed up. A hot flush came over him. He was sweating. Could he be wrong? There were so many lately. No. He'd seen right. Right in front of him, Monique Desmonde's face turned into plastic -- just as he thought it had earlier in the day. Then, he hadn't been sure, but, now, he was positive. Whitset found himself becoming nervous and agitated. He felt like he was being suffocated. He had to get out of the room. He looked around at the others. They looked okay. Their faces had real skin. Suddenly, he got up from his chair and left the room. The noise and screaming in his head was all he could stand. There was no way he could stay for idle conversation.

  Don watched him leave and said sarcastically, "Great, he's a lot of help. What a piss poor manager." He turned to Alex.

  "Do you think Monique will go to the press? Will you help me?" His voice was pleading, even begging.

  Alex hated Don's pleading, whiny voice. She was silent for a few moments. "I don't know, Don. Dr. Desmonde is a woman of principle. She feels strongly about things in the Pavilion. She's felt strongly for a long time. In addition to the security issues, she is convinced that the treatment milieu is inappropriate for optimal clinical outcomes. She maintains that mixing ages and placing depressed patients on the same unit with acute psychotics is inappropriate and substandard." She paused for a few seconds. "Yes, Don. She may indeed go to the press. Robert, what do you think?"

  Robert Bonnet looked at Alex and Don. He nodded affirmatively. "No question about it -- I'm sure she'll go. I've known Monique most of my life. What Alex says is absolutely right. Besides, she has nothing to lose, and a great deal to gain …."

  Don interrupted, reverting to his little boy destructive act. "Nothing to lose! Hell, I'll fire her ass! I'll jerk her privileges
! I'll black list her from every hospital in town!" His eyes gleamed in anticipation of destroying Monique.

  Robert laughed at him. "Montgomery, Monique Desmonde is one of the leading psychiatrists in the United States, with an impressive international reputation to boot! Besides, she said she would quit. She's known globally for her work with adolescents and more recently she's built quite a reputation for herself as a forensic psychiatrist. For God's sake, Montgomery, she is a consultant to the CDC and NIH on mental health issues. She can get a job anywhere. She could write her ticket to Hopkins or Harvard tonight and be there next week."

  "I'll be damned if she'll get one in New Orleans. I'll see to that," Don ranted and threatened.

  Robert snorted at the CEO. "You are powerless on this one, Don. Monique's currently an attending professor in psychiatry at Tulane, has staff privileges there, and an open invitation to head the service at Oschner. The only reason she has stayed here is because you got the state contract and she was interested in building her forensic practice. You'd better give her what she wants."

  Don looked dismal. "I can't. I really can't. It's Whitset's decision -- it's in the contract."

  "That's BS, Don. You are in charge of CCMC. Where's the contract? I've never seen it!" Alex was furious. "You shouldn't be entering into agreements with other groups without my advice. That is what you pay me for!" Alex looked at him disdainfully. Don was such an idiot and an appalling leader.

  "I'll have Latetia copy it. See if you can work around it." Don looked scared. "Alex, please talk to Dr. Desmonde. Make her change her mind. She'll destroy us!"

  "I'll talk with her, Don. But you best talk with Whitset. He's the problem."

  "I will. Let's get out of here. You all think about this and let me know what we should do." Don dismissed the rest of the executive team with a wave of his hand. He disappeared into his private office and shut the door tightly.