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  “Absolutely,” Sam said. He picked up her resume again, running through it. “It’s a nice solid mix of Business Intelligence, Information Technology, and computer graphics. It’s exactly what we’re looking for.”

  Michelle tried to suppress the smile that threatened to burst across her face. “I’m glad to hear that.”

  Sam Greenburg regarded her from across his large glass desktop. “Tell me something about your stint at Kaiser. You indicate you produced financial reports with Crystal. Did those include cubed reports?”

  “Yes.”

  Sam nodded, flipping through the resume. He was wearing a dark gray suit and his salt and pepper hair and goatee gave him more the appearance of a college professor than a corporate consultant. “And the sample you include here,” he said, pausing from looking at the resume to pluck a copy of a sample report Michelle had in her portfolio which she’d delivered to Sam two weeks ago during her first interview. The sample report consisted of fifty pages of text, bar graphs and flow charts. All professionally laid out and designed. “It’s very impressive. Something like this usually requires the work of two, sometimes three people. Not to mention a technical writer.”

  “I do some technical writing, too,” Michelle said, stifling the urge to elaborate further. The excitement she was feeling as it became clear to her she was going to get the job eclipsed her common sense, but she quickly put an end to that.

  “Again, I’m very impressed.” Sam put the report down on his desk and leaned forward, smiling. “There’s just a few minor details that need to be worked out and then I think we can go forward. How does that sound?”

  “Great,” Michelle said.

  “You indicated last time we spoke that you would be available to start immediately. Does that still stand?”

  “Absolutely,” Michelle said. “I’m mostly doing 1099 contract work now and am on an assignment that ends this Friday. I don’t have anything lined up beyond that, so I can start anytime after that.”

  Sam looked at his desk calendar. “Would Monday, April 3 be a problem?”

  “Not at all.”

  Sam looked satisfied. He stood up and Michelle rose from her seat. They shook hands over his cluttered desk. “I’ll be in touch with you by Thursday. Friday at the latest.”

  “Okay,” Michelle said, so into the role of interviewee that it came natural to her. “Thank you again for the opportunity to speak with you. As I said earlier, I’m very impressed by Corporate Financial Services and I’m very eager to be a part of your team.”

  “The feeling is mutual, Ms. Dowling,” Sam said, smiling. He motioned her to the door of his office and walked her out. As they walked down the hall past other offices and toward the bullpen of gray-walled cubicles, Sam said, “Corporate Financial Services is a great company to work for. I think you’ll find our corporate culture, benefits package, and career opportunities beneficial to your overall life plan. People who come on board Corporate Financial tend to make it their life work and stay for a long time. We have a very high level of employee satisfaction here, Ms. Dowling. The highest in Pennsylvania, in fact.” They reached the third floor lobby where the elevators were. Michelle pressed the down arrow button and Sam remained with her as she waited. “We have a good group of people here.”

  “Yes, you do,” Michelle said, thinking about the technical team she’d met with during her first interview. The technical group was made up of men and women her age and older, and the team leader had been a jokester. She’d felt relaxed and at ease with them immediately.

  “And the commute won’t be too long for you, either,” Sam said.

  “No, it won’t. I can get here through back roads.”

  The elevator dinged and Sam smiled as the doors opened and Michelle shook his hand a final time. “Thank you again for the interview Mr. Greenberg.”

  “I’ll be in touch,” Sam said as she stepped into the elevator.

  As she rode the elevator to the lobby, Michelle let out a sigh of relief. She felt tingly; giddy.

  I’ve got it, she thought.

  She’d hoped she would get the job the minute she finished the first interview. In a way it was a dream job because it would allow her to focus on her strengths—computer graphic design and technical writing. The financial reporting via Crystal Reports would be a minor hindrance, but only to the extent that she didn’t get a particular joy out of that type of work. She could do it, was very good at it in fact. But she held no overwhelming interest or passion for it. The other two portions of the job she could do in her sleep.

  The official title for the job was Business Intelligence Design Architect. Whatever the hell that meant. The official job description, without all the corporate mega-speak, was that they wanted somebody who would be able to design and create financial reports using Crystal Reports (this, in itself, required knowledge of relational databases, most likely Oracle or SQL); compose technical documentation to go with the financial reports and gear it toward a wide variety of people; and create, design, and publish eye-catching manuals and web publications. Basically she’d be the back end support for the main Business Intelligence designers and sales people. The company itself was a financial and business consultant firm who assisted their clients—most of them large corporations like Wal-Mart, Microsoft, Prudential and other powerhouse firms—in maintaining their bottom line and running a cleaner, tighter ship. There would be some travel required, but she was used to that. They were looking for somebody with experience and skills in all of the main things the job required, as well as a Bachelor’s Degree in Business, Accounting, Finance, Computer Science, or five years of related experience. She lacked a degree, but had more experience and knowledge than most college graduates. Plus, she’d spent the better part of a decade at jobs that required Bachelor’s or Master’s degrees as a minimum requirement and had excelled in all of them.

  And she knew from that first interview that Sam Greenberg was not only impressed by her credentials, he was impressed with her. Of course, she had pulled out all the stops in her performance; she’d asked the right questions, had put forth how interested she was in the position and the company, emphasized that she lived for her work, that it defined her, and she could tell he was sold. Reeling him in had been easy.

  The elevator deposited her on the ground floor of the building and she exited, making her way to the security booth in the lobby. She stopped and found her name in the guestbook and signed out. The African-American guard behind the booth looked bored. Michelle set the pen down and smiled at him. “Have a nice day,” she said.

  The guard nodded, still bored, and Michelle headed outside.

  Downtown Lancaster was busy as always. As she made her way to the parking garage where she’d left her car, she tried to tell herself to not get her hopes up too much. Things could still back-fire. Sam, or somebody else above him, could change their mind about the position. There could be somebody else competing for the job that Sam might choose over her. There were a number of possibilities at play that might derail things.

  But she truly hoped the job was hers.

  For one, the firm itself was one she’d heard of and knew had been around for the better part of sixty years. A division of a firm with a similar sounding name, Corporate Financial Consultancy Group, the company had field offices in nearly every major city in the country and had satellite offices on every continent except Antarctica. There was a generous compensation package, along with matching 401k, a separate pension, and a health plan. During the interview Sam had mentioned casually that if she were in town in the winter during a snow storm, she could work from home remotely. That was a very attractive perk—most companies would rather have you come in and risk life and limb in an auto accident during a snow storm rather than let you work from home. And then there was the pay—

  It was at least twice her present salary.

  Michelle entered the garage on Prince Street and walked up the slight incline to her car, a 1999 Acura. She felt excited a
bout this job. More excited about any job she’d ever interviewed for before. It still wasn’t her dream job—she’d probably never find her dream job since her tastes and skills were so narrow—but it seemed to be the next best thing.

  Michelle Dowling drove home that afternoon feeling good for the first time about the future.

  DONALD BECK, MD donned a rubber glove over his right hand as he asked his latest patient, a twenty-four year old male named Michael Brennan, who had come in complaining that he felt his right testicle had multiplied in size, to shuck his drawers.

  The patient fumbled with his jeans nervously. Donald waited, rubber gloved hand held out and ready. The patient looked nervous, as if he were afraid of being labeled a fag because he was going to consent to having another man feel his balls. Donald could tell that thought was going through the young man’s mind as he slowly unbuttoned his jeans and pushed them down his skinny legs. He’d had similar patients matching this young man’s background come right out and express this fear, irrational that it was. Donald had pegged this patient the minute he walked into the examination room; uneducated with maybe a high school diploma, worked a blue-collar job (not that this was bad; he knew several men who worked as either mechanics or janitors who were smarter than people with college degrees), with a vocabulary that suggested he was a frequent watcher of The Man Show and Monday Night Football and that his idea of fine dining was going to Hooters. When Donald began his examination by asking the patient what the trouble was, the young man had been quick to emphasize that it was his girlfriend who told him his right nut had suddenly gotten bigger. “She kept telling me it was bigger,” the young man said. “She kept telling me it wasn’t normal and I should see a doctor.”

  “Did you check it yourself?” Donald had asked casually.

  “Um...ah...no,” Michael had responded, shuffling slightly. He looked embarrassed. “I mean...Suzie did the checking for me, you know what I mean?”

  Donald knew what the young man meant. The patient didn’t want Donald to think he was queer for touching himself. What was the world coming to?

  As they talked Donald felt the patient’s neck, checking his lymph nodes. He asked the patient to take off his shirt and then felt along his collarbone and under his armpits. Lymph nodes felt normal. He asked the patient to lie down and examined his abdomen; there was no tenderness, no abnormalities. Finally, he asked the patient to stand up and pull down his pants and underwear and that’s when the young man began displaying his nervousness.

  Donald knelt down and, ignoring the young man’s obvious unease, examined both testicles. He took the patient’s scrotum in his hands gently and felt each testicle. The left was normal but the right was obviously larger. It was normal for one testicle to be slightly larger than the other, but this was abnormal. There was some definite hardness in the teste. “Does this hurt at all?” he asked the patient.

  “No,” Michael said, grimacing slightly.

  Donald gingerly examined the teste, rolling it around between thumb and forefinger, prodding as gently as possible. There was a hardness about the size of a small marble, and as his prodding fingers traveled along the organ he encountered the slightly spongier section of the teste. The patient hissed slightly. “Sorry,” Donald said. He released the man’s scrotum and stood up, pulling the rubber glove off. The young man had a slightly pale expression as he quickly pulled his pants up. “You didn’t notice this yourself?”

  “No,” the young man said quickly. He buttoned his pants.

  “When did your girlfriend notice it?”

  A shrug. “A few weeks ago.”

  “Any pain when you urinate?”

  “No.”

  “Have you been able to have normal sexual relations?”

  “Oh yeah. I have no problem there.”

  “Any painful ejaculations?”

  A shake of the head.

  “And you’re certain you haven’t felt this yourself?” Donald asked, watching his patient’s reaction. “Not even while dressing?”

  “N...no,” the young man said. He sounded nervous. To Donald’s trained eye, the young man had noticed the sudden explosive growth of his right testicle and ignored it. Thank God his girlfriend pestered him into making this appointment. The young man would have likely continued ignoring the problem until it was worse. “Have you noticed any pain or discomfort anywhere else? Tingling at the base of your spine, perhaps? A numbness in any of your limbs?”

  The patient shook his head. “No. Nothing like that.”

  “Have trouble breathing?”

  “No.”

  Donald pulled a lab order out and began scribbling instructions on it. “I’d like to have a series of tests run. Blood work and a chest X-ray.” He paused as he finished completing the order and then tore the paper off and handed it to the patient, meeting his gaze. “And I’d like this done today.”

  “Today?” The young man’s face fell. “I’ve got—”

  Ignoring him, Donald continued. “It could very well be nothing, but I’d like to rule out testicular cancer. Blood work and a chest X-ray will help me with that diagnosis.”

  “Cancer?” Now he had the young man’s attention. All the blood seemed to run out of his face. “You think I got cancer?”

  “If it’s testicular cancer and your girlfriend is correct in saying she noticed the change in your testicle a few weeks ago, we caught it early,” Donald quickly said. “Even at a later stage, testicular cancer is highly curable.”

  “But...it’s still cancer,” Michael said, his voice tinged with worry. “What will—”

  Donald held up a hand to stop the patient. “Don’t worry about this yet. Get those tests done today and I’ll have the results back by tomorrow. If it is testicular cancer, I can put the order in to have you ready for surgery in three days at the latest.”

  “Surgery?” The patient now looked terrified.

  “It’s okay,” Donald said. He helped the young man off the examination table, putting his arm around his shoulders. “It might not even be testicular cancer. It might be something else. You’re sure you haven’t had any injury to that region recently?”

  “No! But—”

  “There could be a number of other factors,” Donald said. “It could be a cyst. That can be treated with medication. It can be a number of other things but we won’t know precisely until you get those tests done.”

  “Testicular cancer?” The patient was clearly having a hard time dealing with this.

  “Is highly curable.” Donald gave the young man a smile, hoping to put him at ease. “Trust me, Michael. If it is testicular cancer, it’s highly curable. In fact, out of every form of cancer out there, Testicular cancer is the most curable.”

  “If it’s...if that’s what it is, how did I get it?” Michael asked. He appeared to be handling this better but his eyes still had a look that radiated pure fright.

  “We still don’t know what causes testicular cancer, but it usually occurs due to a buildup of various proteins that are produced by the testes themselves. Of course other factors can be weighed in as well: smoking, excessive drinking, an exposure to radioactive material, a family history of cancer. Another cause is the overproduction of testosterone, which help produce sperm cells. Stimulate that production through fertility drugs and that can be a factor as well.”

  Michael was listening now. Donald liked it when he had the undivided attention of his patients, especially those that were usually not prone to listening to their doctor’s advice. “So what do we do?”

  “Get those tests done today. I’ll have the results tomorrow and I’ll call you and we’ll take it from there.”

  “And if it is testicular cancer?”

  “Then I’ll put in a request for you to undergo surgery at Lancaster General as soon as possible. Who’s your insurance carrier?”

  “Red Rose Medical,” Michael said, his tone of voice suggesting his displeasure at his insurance company. “They’re not...well, they’re not very
good, but it’s the only insurance I can get through my job. My deductible with them is pretty high.”

  “I’ll take care of it,” Donald said, clapping Michael’s shoulder, trying not to let his own displeasure show through. Red Rose Medical was one of the worst insurance carriers he’d ever dealt with. Most claims sent their way were questioned, and a third of them were denied before they went through a Byzantine process before finally being paid grudgingly six months later. Donald had one patient who suffered from chronic asthma that had become so bad she was forced to breathe through a ventilator. Red Rose denied his claim for surgery to remove nodes from the lungs causing the asthma, claiming such surgery was not medically necessary. Donald had gone to bat for the patient, a thirty-eight year old single mother of three who lived in Marietta, and recruited a colleague of his, Dr. Edward Staley, a Pulmonologist, who refuted Red Rose’s absurd claim that the surgical procedure wasn’t medically necessary. Red Rose’s definition of medically necessary usually meant,’If the patient is on life-support and is going to die, then any medical procedure necessary to save the patient’s life is necessary. Anything else, forget it.’

  Donald remembered that incident well. He and Dr. Staley had shown up at the lofty offices of Red Rose’s corporate office in King of Prussia ready to do battle. Present at the meeting had been the panel that listened to appeals, all of them corporate types with no background in medicine save for a quick trip through some Health Care Administration courses in college, and one physician, a substitute for Henry Wagner, MD, who was their only physician on the appeals board and usually sided with the corporate types despite the medical evidence; Donald was sure Wagner was paid handsomely for ignoring the Hippocratic oath. Wagner’s substitute turned out to be a last minute replacement and – surprise, surprise! —had once worked in Pulmonology as an Intern and now practiced Internal Medicine.

  After Donald and Edward presented their case, along with their recommendations for immediate surgery for Mary Hess, they waited for the verdict. Several of the executives were conferring with each other in whispered tones and Donald had tried to pick up bits of the conversation. The executive sitting next to the substitute MD, Dr. Cantrell, was talking quietly with him and shaking his head. It was clear from the look on the executive’s faces that they didn’t like what Dr. Cantrell was telling them. Finally, the executive in charge turned to Donald and Edward. “What are the underlying causes of the patient’s asthma?”