Chapter 7
SEVEN
LORENZO
He should have had Winnie Smith come to the conference with him.
For the past several weeks, Winnie had quietly and efficiently done what he’d asked, and a bit more.
Both his homes were running efficiently; she had vetted and hired housecleaning, landscaping, and dry-cleaning services.
All of his bills were now paid automatically online.
She had presented him with three options for new homeowner’s insurance, scheduled payments for his property taxes and attended a meeting on his behalf with the ridiculous condominium association board for his place in Boston, effectively advocating for renovating the rooftop garden, as he’d instructed.
She now ran his personal calendar, finding windows for him to run, attend the gym, call his mother.
She even bought a slew of birthday cards for him to send to his family members.
She drafted responses to the emails from grateful patients and family members, sent him lists of speaking and social engagements, and responded politely on his behalf.
Winnie Smith, Personal Assistant to Lorenzo Santini, M.D.
, Ph.D., Chief of Special Surgeries, Massachusetts General Brigham Hospital, Moseley Professor of Surgery, Harvard University Medical School.
He had to admit, he liked seeing her title. It made him feel…not safe, exactly, but protected. He had a gatekeeper, and she freed him from time-consuming, sometimes irritating tasks.
It wasn’t awful to have her around, working in his office in Boston or at the house in Chatham.
When he came home, she would give him a quick update on anything he needed to know, then disappear to her room.
Sometimes, he thought, it might be nice if she had suggested they sit together on the deck, but he wasn’t sure how to say this, and just left it alone.
One day, he saw her down on the beach at his place in Chatham, throwing a stick to a big, blond dog, and he thought about joining her.
He liked dogs. It looked like they were having fun.
Just as he’d started down the deck stairs, though, the dog had run down the beach, and Winnie turned to come back in.
Whatever. She was a very good assistant so far, and he wished very much she’d been working for him when this particular trip to Chicago had been arranged.
Alas, she had not been, and every single travel irritation had occurred—the car service had been late, making him rush through the airport, only to find his flight had been canceled.
The next flight to Chicago was at midnight, and he’d had to fold himself into a seat in row 35.
Then his luggage, which he’d been forced to gate-check, was somehow lost. He filled out a claim at the counter, jaw clenched, then finally left O’Hare.
When he checked into the hotel, he found himself in an ordinary room—not the suite he’d ordered and always chose. He went back to the desk, told them of the mistake, and was shown that, no, indeed, he had mistakenly booked the River Room, not the River Suite. Full house, so no, he couldn’t upgrade.
Without his luggage, he had to go shopping on Magnificent Mile (what a pompous name) and bought a new suit at Paul Stewart’s, the sleeves of which were an inch too short.
Nothing to be done about it, since he didn’t have the time to get it tailored.
He bought a shirt, a tie, and even socks and underwear.
Then, when he’d gone back to the hotel, showered, dressed in the new clothes and was just about to go down to the conference, the desk attendant told him his suitcase had arrived.
Now, he stood in the area outside the conference rooms, his fellow doctors milling about and talking.
Not his favorite thing, conferences. Too much glad-handing, too much small talk.
He nodded to a colleague, scanned the room for someone who wouldn’t be painful to talk to.
He wasn’t an introvert—he didn’t think so, anyway.
He just had other things he’d rather be doing. Surgery, for example.
There was Damian Hughes. Inwardly, he groaned.
Damian Hughes (pronounced Dahmmy-ahnn, something the man enjoyed correcting and repeating ad nauseam) was several years younger than Lorenzo.
He had a solid CV—Notre Dame undergrad, Stanford Medical School, a fellowship in endocrine surgery at UCLA.
But he was the type of doctor Lorenzo liked least—spending a lot of time announcing that he was the next savant in the world of difficult surgeries.
He was not. Not yet, anyway. Rumor had it he had a TikTok channel and did something called reels on other social media platforms, which Lorenzo found juvenile and undignified.
He himself did not have social media accounts, prescient enough decades ago to realize there would be no benefit to him to spew personal information out into the world.
It seemed Damian had a personal assistant with him.
While many surgeons may have had such a staffer, it wasn’t common to travel with him.
A lover, perhaps? No, the man definitely gave off the impression of employee.
He obsequiously brought Damian a bottle of water, head slightly bowed, handed him an iPad, and whispered something in his ear, all actions meant to telegraph Damian’s status.
Damian wore a pale lavender suit and somehow made it look…
good. The man always dressed as if he were Ryan Gosling on the cutting edge of fashion with some kind of flair.
Lorenzo may have never seen a Ryan Gosling movie, but he did appreciate the art of tailoring, spent a small fortune on his own wardrobe and subscribed to GQ.
In another life, he and Damian might’ve been friends.
Except Damian was always telling people how innovative and brilliant he was, though he had yet to do anything truly different or groundbreaking.
It was the look at me, look at me! attitude Lorenzo despised, both ass-kissing and superior, laughing and glad-handing and ingratiating himself to the right people.
Lorenzo was one of the right people. However, when he was training, when he was a rising star, he’d did nothing to ingratiate himself to his superiors.
Instead, he’d kept his head down, concentrated on his work, and let things flow from there.
He’d listened to the chief residents, spent more time on the floor and in the OR than any other surgical resident, and, yes, was simply gifted, the same way Pavarotti had been born with a voice from God.
Of course, the singer had to train, but a thousand other men could train as long and hard as Pavarotti and never sound like him.
And then there was his suture. Lorenzo had gone a step beyond, fulfilling the dream of many a physician by creating something that had never before existed in the medical world.
Just after his residency, he designed a bio-responsive polymer suture that could detect inflammation or infection and release microdoses of antibiotics before these issues could be detected by bloodwork or radiology.
He’d been thirty-three at the time (the same age as Jesus when he died, his grandmother had pointed out).
The Intraweave suture had made him a star…
and a very wealthy man. That, his gift in the OR and his excruciating standards made him legendary. He wasn’t bragging. It was just true.
And, if he was being honest, it made him a little isolated among his peers.
Small talk was a waste of his time, let alone golf or sailing.
He didn’t have children and didn’t foresee any in his future (though he enjoyed holding Sofia’s two children, as long as they were sleeping).
He didn’t think it would be fair to father a child he might only see a few hours a week, and he wasn’t willing to cut back his schedule to change that.
So, no kids. His siblings would have plenty, he was sure.
Ah. Damian had just clocked him. Too late.
It was time for his talk. He went into the largest conference room to ensure everything was working.
His lecture was on advanced trauma operative management.
As usual, when he talked, it was standing-room only.
The hotel staffer assured him everything was connected; the moderator gushed a moment and shook his hand, then introduced him.
There was the usual applause, and he went to the podium.
“Good afternoon,” he said and began, his PowerPoint organized and clear. It had taken him days to put together.
The other surgeons typed away or recorded his talk, scribbled notes, nodding, murmuring. After the forty-five minutes had passed, he took questions until the hour ran out. “Thank you for your attention,” he said, stepping down from the stage.
Immediately, Damian, his assistant trailing slightly behind him, approached.
“Lorenzo, great presentation. I’d love to discuss it more and get your take on a tricky septal myectomy I have next week. Can I buy you dinner? Chicago Chop House. I’ve heard it’s the best. I have a reservation for two at eight o’clock, right, Carl?”
“That’s right, Dr. Hughes,” the assistant said. “The car service will pick you up at 7:45.”
Lorenzo didn’t answer. First of all, Lorenzo?
He barely knew Damian Hughes and preferred that the younger man call him Dr. Santini until Lorenzo told him otherwise (which would be never).
Second, Damian had presumed Lorenzo would accept the invitation to the iconic restaurant.
And third, the showiness of having his assistant murmur affirmations, as if the details were too much for Damian to keep track of.
Yes, yes, Lorenzo had just hired Winnie, but he wasn’t three years out of residency.
He was Dr. Satan, known and feared and, most of all, respected, not because he had an assistant but because he was a great surgeon.
“I already have plans with a group of senior surgeons, Dr. Hughes,” he said.
“But thank you.” He kept his voice chilly, and saw the message land on Damian’s face.
You haven’t earned it yet. And Lorenzo did have plans (not that he was looking forward to them and, in fact, was considering canceling).
While he loved talking about surgery and medical issues, his fellow surgeons gushed about vacations and grandchildren and retirement.
But these were a necessary part of his job, both for him and the hospitals where he worked. He’d interact during conference hours. He’d suffer through a dinner. But whenever possible, he ordered room service or found a restaurant far from the hotel where he could read without interruption.
His rejection of Damian Hughes did not go unmet.
Later that afternoon, Lorenzo sat in on a panel discussion about the readiness of chief residents.
When asked by the moderator if senior doctors were too hard on residents, Lorenzo answered first. “Not hard enough, frankly,” he said.
“If they can’t handle the pressure of being criticized, they certainly won’t be able to handle a crisis in the OR.
The kid-glove approach is detrimental to their success, and, more importantly, to patient outcomes. ”
Damian’s hand shot up in the air. The moderator walked down the aisle and handed him the microphone.
He stood, hand in one pocket of his lavender suit.
“Dr. Santini, I disagree. Mentoring and empathy have been shown time and time again to be a more effective training method. Insults and embarrassment should be a thing of the past.” There was a murmur of agreement from some of the audience.
“I do not condone insults and embarrassment,” Lorenzo said. “You misunderstand. If a resident makes a mistake, I am clear in correcting that mistake and suggesting further education so said mistake is not made again.”
“But you do insult and embarrass your residents,” Damian said. “Your nickname is Dr. Satan.”
A ripple of laughter rolled through the room.
“My residents go on to become some of the best surgeons in the world,” Lorenzo said, his words icy. “Because I trained them. Next question, please?”
Of course Lorenzo was hard on his residents.
When a patient began hemorrhaging, when their heart rate dropped, when a lung collapsed or they went into shock, when the tumor was bigger than projected and clean margins meant working half a millimeter from the aorta, a surgeon had to ignore everything else and focus.
Treating a surgical trainee like a fragile snowflake did not serve them. That was mentoring.
Also, the Dr. Satan reference was juvenile. Granted, Lorenzo was somewhat proud of it, but it should stay in the applicable hospitals—not something to be made into a joke by a younger surgeon in front of their colleagues.
Irritating. When the day finally ended and all the talks were done and groups of people stood in the lobby waiting for their rides, Lorenzo walked briskly through the crowd, nodding here and there, saying “thank you” when told his talk was informative, greeting a few people by name.
He texted the organizer of the dinner and said unfortunately he would have to cancel.
Getting back to his room felt like getting a reprieve from the governor at ten minutes to midnight. Even if his room was not a suite.