18. Chair Four
Chair Four
She came at two o'clock on the Tuesday, alone, in cream, eleven minutes early, and she brought flowers.
Not for me. For Kayla, at the front desk — a small bunch of ranunculus, handed over with a warm word about how nice the courtyard looked — which is exactly the kind of thing that makes a person impossible to dislike and is also, as I now know, the single most reliable tell of the entire species.
"New patient exam," she said to me, in the doorway, holding up her hands, rueful. "I'm forty-nine days overdue and I have been lecturing dentists about recall intervals for eleven years. Please don't tell anyone."
"Come on back."
Chair four is the last operatory on the left, the one with the window onto the courtyard and the good light, and I put her in it because it is also the one with the clearest line to the door and because Floss's bed has been in the corner of it for five years.
I did an actual exam. I want that understood, because it turned out to matter later in a courtroom: I took a full set of photographs, I charted her existing restorations, I did an oral cancer screening and a perio probe, and every single thing I did that afternoon was clinically indicated and correctly documented, and Serena Locke's chart is the most thorough new-patient record I have ever produced in my life.
She had good teeth. Two old crowns, upper left, competent work from the nineties. Mild recession. She ground at night.
"You're a grinder," I said.
"I'm told."
"Recently, too. These facets are fresh." I set the mirror down. "Are you sleeping?"
And Serena Locke, in the chair, with the light on her face and her hands folded on her stomach, said: "No. Not since September."
We were twelve minutes in.
"I've thought about your offer," I said, conversationally, rolling the stool back. "I'm sorry I went quiet. It's been a strange autumn."
"You don't owe me an answer."
"I think I owe you a conversation." I pulled my gloves off and dropped them in the bin, which is a thing that changes a room; the exam was over, and now two people were talking.
"Serena, can I be honest with you? I've seen about ninety patients on Saturdays since October.
Most of them yours. And I've found things. "
She did not move. She was very still in a way that a person in a dental chair is not usually still.
"What sort of things?"
"Work that was billed and never placed," I said. "Crowns that aren't in mouths. Onlays that aren't in mouths. Grafts on gums that have never been touched." I let it sit. "It's not one or two. I stopped counting in the twenties."
"Dear God," said Serena Locke.
And she said it beautifully. I want to be fair to her; she was extraordinary.
Her eyes went wet and her hand came up to her mouth and she said it the way you'd say it if you had just learned it, and if I had not spent six weeks in a locked drawer and nine minutes on the website of the Yuma Sun, I would have believed her completely.
"Who?" she said. "Which doctor? Was it—"
"That's the thing," I said. "It's under Preston's number. All of it."
"Preston." She closed her eyes. "Oh, Preston."
And there it was. That was the move, in front of me, in my own chair: a dead man, three feet from a thing that could not be explained, being gently offered up.
I sat on my stool in my own operatory and watched Serena Locke decide to give the profession's fraud to the man who had printed four hundred ledgers by hand at night and written NO in the margins, and something happened in my chest that I have never entirely gotten back.
"So here's my difficulty," I said. "I've got ninety charts and a stack of releases and I don't know what to do with them.
If I send that to the board it's four years.
If I send it to the insurers it's a mess.
And I've got a bank note with eleven years on it and a practice that's lost a third of its book.
" I let my voice do the thing it wanted to do anyway, which was shake slightly.
"And you offered to buy me in October, and I've read the NDA about forty times. "
Serena Locke opened her eyes.
"I can take the NDA out," she said.
"You can?"
"Lila." She sat up in the chair, unhurried, and swung her legs around so that she was facing me, and she was warm, and she was tired, and she was very, very good.
"I'm going to say something to you that I'd rather say in a room with no one in it, and this is the only such room I've had in two months.
That building is going to be a disaster.
It's going to be a disaster for everyone who touched it.
And the only two people in this county who have not yet been swallowed by it are sitting in this room, and one of them has ninety charts and the other one has the money to make the next four years survivable. "
"What are you proposing?"
"I'm proposing I buy the practice at the October number, plus twenty percent, and I'm proposing the charts come with it," she said.
"Not to bury. To *manage*. Lila, look at me — those patients are owed remediation and every one of them is going to need work done and somebody is going to have to pay for it, and it is not going to be an insurance company.
It's going to be me. And I would ten thousand times rather be the woman who quietly made four hundred people whole than the woman who got shredded on the six o'clock news for something Preston Hale did with a provider number I couldn't see. "
There it was. All of it. Handed over in a warm voice by a woman with fresh wear facets on her molars.
"You couldn't see it?" I said.
"I couldn't see it."
"Serena, you're the management company. Billing is the management company. That's the entire—" I stopped myself, deliberately, the way a frightened woman with a loan would. "Sorry. I don't understand the structure."
"Nobody does, that's the tragedy." She reached out, and put her hand on my forearm — and every muscle in my body locked, and about nine feet away Floss's head came up off the bed — and she said, gently: "The billing runs on a platform.
A third-party platform, with a vendor, under a coordinator who reports to a regional office.
It is not me. Lila, I have spent four weeks trying to get into those submissions myself and I don't have credentials either. "
"Then who does?"
"The compliance coordinator," said Serena Locke.
"Does she have a name?"
And Serena Locke smiled at me, sadly, warmly, with her hand still on my arm, and said:
"Dana Kirsch. And I'd very much like to know how you got hold of that photograph, Lila, because it was taken at a ribbon-cutting in Yuma in 2021 and there are eleven people in it and only four of them are still alive."
The room went absolutely silent.
Floss got up.
She did not bark. She did not growl. She came across the operatory at a walk, put herself between the stool and the chair, leaned her entire seventy pounds against Serena Locke's shins — the full-body lean, the one for people who are about to cry, the one she has given to two hundred frightened children in this room — and stood there, immovable, with her head against the woman's knees.
Serena Locke could not stand up.
"That's a lovely dog," she said.
"She likes you," I said. "She has terrible judgment. Serena — how did you know about the photograph?"
"Deb Krzyzewski has a very active Facebook and a daughter who works for me," said Serena Locke.
"That's all it is. That's all any of this ever is.
" She looked down at the dog against her legs and then up at me, and the warmth was still there, perfectly intact, which was somehow the worst thing I have ever seen on a human face.
"Dana is going to be a problem for both of us.
She's the one who ran the submissions in Arizona and she's the one who ran them here, and she is not — Lila, listen to me — she is not somebody you send a letter to. Wendell Park sent a letter."
"To the board."
"He was going to." Her hand was still on my arm. "On a Monday."
And there it was, in a dental operatory, in daylight, on a Tuesday afternoon in November, recorded on a system I had signed a consent for, with a small printed notice at the door that she had walked straight past: a woman telling me, kindly, with her hand on my arm and my dog on her feet, that the last two dentists who had planned to file on a Monday had not made it to Monday, and that it had not been her fault, and that she would very much like to help me not be the third.
"Floss," I said. "Out."
The door opened.
What I remember is the order of it, which was: Floss did not move — she has never once obeyed that word, because I have never once said it — and Marisol Vega was in the doorway with the printed appointment book held in both hands like a shield, and behind her, filling the entire hallway of my practice, there was a hundred pounds of Bernese mountain dog who was absolutely not supposed to be in the building.
Then Ray Dominguez. Then Diane Kessler. Then, from the courtyard window, going past at a run, Nate.
"Serena Locke," said Ray, "Santa Barbara Police Department."
"I'd like to stand up," said Serena Locke.
"You'll have to ask the dog," I said.