VD Man
By Larry BlumeniUniverse, Inc.
Copyright © 2010 Larry Blumen
All right reserved.ISBN: 978-1-4502-1941-9 Chapter One
1
In 1965, the only harbinger of spring in Miami, Florida, is a headline that blooms one morning in the Herald: MIAMI SYPHILIS HIGHEST IN NATION.
The Chamber of Commerce calls the mayor. The mayor calls the health commissioner. And the health commissioner calls Dr. Leo Belden, chief venereologist of the Fourteenth Street Clinic. Belden, sitting at his desk with an unlit cigarette in his mouth and a lighter in his hand, listens in silence for five minutes and then says, "Right," twice, and hangs up the phone.
He lights his cigarette and blows smoke in the air. Through the partly open door of his office, he sees Kelly, leaning against the wall just outside. Kelly has a hot one. The day is about to begin.
2
Outside Belden's office, the waiting room is full, not surprising for a Monday. A few walk-ins, but mostly regulars, litter the benches-insurgents in a perpetual war against modern medicine. Kelly shifts his weight from one foot to the other, waiting for the old man to come out.
Still in his office, Belden is a study in unhurriedness. He puts on his white coat and checks his Waterman for ink. He takes a long, last drag on his cigarette and stubs it out in the ashtray on his desk.
When he finally emerges, Kelly steps into his path and says, "I got a primary for you, Doc."
"Have you been peeking again?"
"I swear I haven't-the guy described it to me. It's classic!"
Belden says, "Okay, put his chart in the basket, and I'll look at him this morning."
Kelly doesn't let go. "He's infectious, Doc!"
"He isn't going anywhere."
"Doc, you don't know how much trouble it was, getting him in here."
The old man relents. "Okay, I'll look at him now."
Kelly gets the guy, and Belden takes him into the exam room. A minute later he comes out and sends the kid back to his seat. Kelly waits for the diagnosis. Scribbling in the chart, Belden says, "Early latent."
Kelly's jaw drops. "Early latent? What about the lesion?"
"It's a zipper cut."
"Zipper cut? Doc, I drew the blood myself-he's got 128 dils!"
"Happens all the time-early latent. I'm giving him 2.4 Bicillin."
"Did you do a darkfield?"
"I don't do darkfields on zipper cuts."
Kelly, muttering to nobody in particular, retrieves his patient and takes him to an interviewing room. The rest of the morning is busy but uneventful-three more early latents, no primaries, no secondaries. By lunchtime, the waiting room is empty except for a few stragglers hanging out and hustling dates for the weekend.
3
Kelly is a victim of his environment. His mother, in a fit of national pride, named him after James Joyce, the famous author, but withheld this fact from other members of the family, who know him only as "J. J." Everybody else calls him Kelly-if they know what's good for them. He grew up skinny and Irish in South Philadelphia, practicing survival of the fist. With maturity, however, he learned to make his way more subtly-figuring out the game and finding ways to rig it.
After the morning session, Kelly goes directly to an office in the back of the clinic, where he is stopped by a closed door with a taped-up sign.
We're doing arithmetic DO NOT DISTURB
Kelly goes straight through the door. Inside is a good-sized room with a banner on the far wall that says, "All Through in '72." In the center of the room, two desks, each piled high with paper forms, have been pushed together, back to back. At one of the desks, the federal manager of the Miami VD Program, Howard Stepman, is looking down on a sheet of chicken-scratch tabulations. At the other desk, his deputy, Parson Ramey, is looking at Kelly, his fingers frozen in midcount.
Stepman looks up and asks, "Is the building on fire?"
"Worse!" says Kelly, under full steam. "Belden's gone cuckoo!"
Stepman, in the same tone of voice, says, "Would you like me to include that observation in this monthly report I'm working on?"
Before Kelly can respond, Ramey says, "What's Belden doing?"
Kelly says, "I brought in a beautiful primary lesion this morning, and Belden called it early latent!"
Ramey says, "How do you know it's a primary?"
Kelly says, "I peeked. It's beautiful. And his titer is through the roof!"
Ramey says, "Did Belden do a darkfield?"
"He said it was a zipper cut!"
Ramey starts to say something else, but the words are slow in coming.
Stepman cuts him off: "Wait a minute-where is this morning's paper?"
Ramey goes to a drawer in his desk and retrieves the paper. He says, "I was going to show it to you later."
Stepman grabs the paper and finds the front page.
He says, "I thought so!"
Kelly says, "What?"
Stepman is reading down the page. His face is getting red. He says, "That Kowalski woman is writing articles again! Just in time for the beach crowd to arrive! She does this every year!"
Kelly says, "I don't get it."
Ramey opens his mouth to explain, but nothing comes out.
Stepman keeps reading, but then stops abruptly and says, "Where did she get these numbers? These numbers haven't been released yet!"
Kelly says, "What numbers?"
Ramey looks on, his mouth still open.
Stepman stands up to his full height in shoes and places his hands flat on the desk. "There's a leak in this office!"
Kelly says, "Don't look at me!"
Stepman moves toward the door. He says, "I'll get to the bottom of this later. But first I'm going to have a little chat with Belden."
Kelly says, "What do you want me to do?"
Stepman says, "Start adding up those weeklies."
Kelly looks at Ramey. Ramey resumes his count on the third finger of his right hand.
4
Belden is sitting in his office with his after-lunch cigarette. He gave up lunch years ago, but not the cigarette. Across his desk, he looks at Stepman, who is requesting an audience with him.
Belden says, "I was expecting you."
In their dealings with each other, they observe a fine line. Stepman goes just far enough to show the old man that he knows what's going on but he stops short of alleging medical malpractice. Belden, for his part, refrains from telling the younger man to take a flying leap.
Stepman leans forward in his chair and says, "How you feeling, Doc? Your ulcer been acting up again?"
Belden says, "I don't have an ulcer."
Stepman says, "Well, you know what I mean-maybe a little irregularity that keeps you from feeling tip-top?"
"Why do you ask?"
"Kelly was telling me this morning that you looked a little tired."
"I'm feeling fine."
"Yes, well. Excellent. I'm glad to hear that."
"So, what can I do for you?"
"Did you see the paper this morning?"
"No."
"You didn't?"
"Somebody read it to me over the phone."
"Well, then, you know about the woman reporter, making us look bad again."
"I'm told that the information came from your office."
"Yes. Well, that's what I wanted to talk to you about. I've learned that there has been a lapse of security in the office, and I want to assure you that I'm going to get to the bottom of it."
"Good. If there's anything I can do to help, just let me know."
"Great. Thanks. You know how the public is-they think a high rate of infectious syphilis is bad. They don't understand that the high rate is good because it means that we're finding the cases early and stopping the further spread of this dreaded public health menace."
"Right."
"And they don't understand how important it is that we have a top-notch clinician, such as yourself, to diagnose every case accurately so my boys will be able to stay on top of the situation."
"I understand."
"Great. 'Cause, if my boys don't make their monthly quotas, then I will fire them and their families won't eat."
"I'm sure they'll do fine."
"We do our best, sir."
"Anything else?"
"I can't think of anything right now."
When Stepman gets back to his office, Kelly is gone. Ramey asks, "How did it go with Belden?"
Stepman says, "The son of a bitch is killing us!"
5
The next day, at Stepman's behest, Parson Ramey gets the word out to all the reps that a mandatory meeting will be held, first thing in the afternoon, in the main office shared by Stepman and Ramey. No excuses.
After lunch, the reps start straggling in. With no place to sit, they gravitate toward the walls, except Kelly, who sits down on the corner of Step's desk with the confident air of a man who knows this meeting is not about him. The rest exchange greetings and tidbits of information. Ramey sits at his desk, twirling his pencil.
At the appointed time, Stepman comes out of the men's room across the hall and makes his entrance. He walks slowly around the room, sizing up the group.
Louis Maphis and the county guy, Anderson, both black, are standing together. Louis has on his usual short-sleeved white shirt and thin, black tie. His natural smile suggests confidence. Anderson, also known as Ashtray, rests his cigarette-holding hand on his great girth, which eponymously catches the ashes.
Standing by himself is Goldstine, wearing thick, black-rimmed glasses, through which he covertly observes the others. Originally from Switzerland, Goldstine spent several years at the University of Mississippi before getting a job with the government. But he still looks like a European. European coat. European tie. European pants.
Over from Goldstine, in the corner behind Ramey, stands a young man who is wearing the finest suit of clothing Stepman has ever seen. Stepman looks him up and down. He says, "Who the hell are you?"
Ramey sits up in his chair and clears his throat. "Step," he says, trying to sound serious but friendly, "This is Allen Kravass, the new rep I told you about. He was in Atlanta last week, getting briefed."
Stepman says, "Very good. When did you get back from Atlanta, Allen?"
"Last Thursday, sir."
"What were you doing last Friday?"
Ramey clears his throat again. "Step," he says, "I told Allen it would be all right with you if he took Friday through Monday off to get settled in."
"Excellent. Very good, Allen."
Stepman then becomes thoughtful and walks around to his desk. He shoos Kelly away from his spot on the corner and then occupies the space himself. The group takes on a defensive posture.
From long experience, Stepman knows that it's good to start off with an icebreaker, so he says, "Where's Jake?"
Everybody laughs.
"Anybody seen Jake?"
Everybody laughs again.
Stepman then becomes solemn for a moment. The gathering resumes its defensive air.
"Men," he says, finally, "we have a problem."
He holds up the newspaper with the headline out so everyone can see. "Some of you," he says, "might look at this headline and say, `This is the problem.' But this headline is not the problem. The problem is elsewhere. The problem has to do with loyalty. Somebody in this room doesn't have any. That's the problem."
The group looks puzzled.
Stepman continues: "I mean that the sixth paragraph in the front page story in this paper contains morbidity counts that only appear in the confidential weekly internal report that I received from Atlanta two weeks ago-a report that I distributed, in the strictest confidence, to each of you, except Mr. Kravass."
Kravass raises his hand up about halfway and says, "Sir, could I see a copy of that report?"
Ramey fishes around in a desk drawer and pulls out the report. Kravass looks it over and says, "They gave me this report in Atlanta. I have it-or, at least, I did have it."
Stepman jumps off his desk perch and walks over to Kravass so he can hear more clearly.
"You don't have it anymore?"
"No, sir."
"Did you tear it into little bitty pieces and throw it away?"
"No, sir. I gave it to a woman who was sitting next to me on the plane."
"Why did you do that?"
"She asked if she could have it. She said she was interested in public health."
Ramey interjects, "It's not his fault, Step. He didn't know."
Stepman looks down at the floor for a couple of seconds. Kravass says, "I'm sorry, sir."
Stepman says, "That's okay-you didn't know. It's Atlanta's fault-they should have explained what `Do Not Distribute' means."
Stepman then turns to the group and says, "Okay. You mugs are off the hook. But the next time I see any of you, I want your shoes to be as shiny as Kravass's. Good shoes, Kravass."
When everyone has left, Stepman says to Ramey, "Get rid of Kravass."
6
A little after five, Parson Ramey sticks his head into Doc Belden's office and says, "You ready?"
Ramey doesn't remember when his arrangement with Belden started. Sometime last year, he said to the old man, "You know, I drive right past your house on my way to work every day." The next thing he knows, he is picking the good doctor up each morning and dropping him off each night, five times a week.
That's okay with Ramey. He feels that Doc likes a little company, and so does he. They can ride for miles without speaking.
Parson Ramey, in the judgment of his birth, was officially named Parsons, which is his mother's family name. As he grew up, though, the handle sounded plural to his buddies, so they shortened it to Parson, and the name stuck because, in an odd way, it fit him. A tall, gangly Tennessee mountain boy, he had a hesitation in his speech while he grew up. To get the words out, he had to tilt his head up and down, several times in a row, before speaking. Over the years, the hesitation went away, but the head movement stayed with him.
When, as a young man, he emerged from Bull's Gap with a government job, everybody in the county knew about it. With a big send-off and high spirits, he moved to Knoxville, where his assignment was to rid the surrounding counties of syphilis. He came to know those counties and the people in them as well as he knew his home town. Everybody liked him. His shy, earnest manner compelled them to take him into their confidence. Syphilis decreased in the area. He married, had kids, and settled down.
It didn't last. After many years, word came from Atlanta that he was to be transferred, for the benefit of his career, to Miami. At first he thought that someone in Atlanta had it in for him. It was true that he didn't like to play poker and smoke cigars with the honchos when they came to town, and he didn't golf. But that's not enough to transfer a man. He thought the matter through and finally decided that nobody in Atlanta cared much about him either way. He was transferred because, up to that point, he had never been transferred. His number came up.
So, with no option except to quit, he loaded up the family and moved to North Miami, near Hialeah. In the beginning, he liked living close to a racetrack. He liked watching the horses run and placing the occasional bet. But that's the only good thing about Miami. His wife says that she has no friends, it's too hot, and the kids hate it. And Ramey's particular talent, which routed syphilis in the environs of Knoxville, does not translate to the streets of Miami. He's miserable.
Ramey says, "This was not a good day."
Belden looks around and says, "Why not?"
"Step's in his tree again."
"Newspaper headline?"
"That got him started. He thinks you're trimming the P & S out of your diagnoses."
"I am."
"There has to be a better way."
"Like what?"
"Look, I don't care if Miami has more cases than Orlando or fewer. Atlanta doesn't care either. That's Step's thing."
"So?"
"I just want the guys to make their quotas. Sometimes Louis might have more than he needs, and Goldstine might be short. If they both bring in a primary, and it could go either way, maybe I could give you a nod as to which one to stiff. That way everybody would be on quota."
"We would be playing God with people's careers."
Ramey gives Belden a look and says, "That's Atlanta's job."
A few minutes go by. Then Belden says, "How's the new guy doing?"
"How did you know about him? He just got here."
"Well, yesterday, after the commissioner read the news to me, he mentioned the new guy."
Ramey says, "I've been here a year and a half and the commissioner doesn't know me from a wart on a hog. How did he find out about the new guy?"
"I don't know."
"Well, what did he say?"
"It was a little odd. He told me to take an interest in him."
"Well, you'd better do it fast, because Step wants me to fire him."
"Already?"
"I can't fire a man on his first day. Hell-the guy has to go to Interviewing School next week. That's already in the works."
Ramey muses to himself for a moment and then says, "I can stall for a week. When he gets back, Step will probably have forgotten all about it."
"You think so?"
"It's my plan."
The sun is low on Ramey's side. The streets go by.
(Continues...)
Excerpted from VD Manby Larry Blumen Copyright © 2010 by Larry Blumen. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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