Originally from New Jersey, I now live with my wonderful wife, (and a brilliant labradoodle) in Clayton, North Carolina, where I write, maintain an extensive bonsai collection, and exercise. We have three terrific sons and six lovable grandchildren.
This is my debut novel, having retired from the world of oral & maxillofacial surgery, where I worked in ‘The Trenches’ of Humanity-vs-disease. My prior writing experience has been in my profession’s journal: International Journal of Oral Surgery, Oral Medicine, and Oral Pathology, and for a hobbyist’s newsletter: Triangle Bonsai Society. I’m a member of North Carolina Writers’ Network, Neuse River Writers, and International Thriller Writers.
Writing Double Blind made me reflect on my involvement with cancer: No, thank God none of my family had it, except for my maternal grandfather (supposedly I’m his ‘spitting-image’) who died in the 1940’s from leukemia.
Dental school training taught me how to screen for oral cancer. This extended into my oral & maxillofacial surgery residency where I participated in tumor board conferences, took biopsies, did initial readings of slides for pathologists, and participated in oral management, repair, and reconstruction during and after cancer treatment. In my private practice, I often made the presumptive cancer diagnosis and was the one giving the good, or not-so-good, news after the biopsy results. I lost many a night’s sleep imagining how the anxious patient would deal with the terrible news. Strangely they took it far better than I dreaded. Maybe that was because it was presented along with an immediate appointment with the best oncology team on the East coast. The patient could then take prompt steps in their treatment.
Early in my practice I was athletic and healthy, with a wife, a young son, and twins on the way. When I began experiencing significant fatigue, my internist drew routine blood work. A few days later, he called insisting that I immediately see his oncologist friend in the local ER for a stat bone marrow biopsy. Results were indeterminant and I got a bone scan. I can definitely relate to that uncertainty stage of cancer fears. It turned out that my bone marrow had been damaged by tainted tryptophan nutritional supplements. No cancer, and I luckily recovered.
At forty, I elected to run in the New York City Marathon, collecting donations on behalf of the Leukemia Society, and in the name of my grandfather; I almost died in that race, but that’s a totally different story. My wife and I have been long-term donors to St. Jude’s Hospital.
I’ve worn many, but thankfully not every hat involved with cancer; it’s allowed me a close enough vantage point to share empathy, and wholeheartedly support the organizations, researchers, caretakers, and those coping with cancer through both my words and deeds.
Michael J. Markoff, Author
An excerpt from my first manuscript, a speculative medical suspense:
DOUBLE BLIND
as an informant? Was it me who bragged about owning doctors and violating the standards of clinical trials? No. All I did was bring the issue to Dr. Brady, a man who has actual integrity. Here’s a better question: Do you have any idea what your games are doing to the reputation of CCH?”
The men stared each other down. From Altieri’s stunned expression, it had been a long time since anyone dared talk back to him. He narrowed his eyes and took a step away from his intended prey, then looked back at Michael. “Doctor, are you familiar with the Hippocratic Oath? Not the dusty, worn, classic oath, but the shiny, modern one?” This sounded like a courtroom cross-examination.
“Yeah?” Michael was on guard for an Altieri angle.
“You know the part which says, ‘I will apply, for the benefit of the sick, all measures that are required?’”
Silent hostility was a reply unto itself. Michael sensed where this was going.
“…The doctors are therefore obligated to apply all measures required to help me, the sick. I won’t be given some placebo, those clinical standards be damned.”
Staring at him, Michael could well imagine Altieri shoving his way onto a lifeboat ahead of women and children while the Titanic sank. It was all about him.
“Well, Mr. Altieri, I guess you’re going to have to play by the same rules as everyone else, for a change.”
Altieri paused to catch his breath, his posture flagging. “Dr. Morse, Michael, if I was your father, how far would you go to--”
“Don’t you go there,” Michael spat. A flash of sweat dampened his forehead. If it was his dad, he would’ve held him close and melted away the cancer in a heartbeat. He would never let him go. “You are not my father.” He shook, barely restraining anger.
“I’m dying, Goddammit,” said Altieri, withering. “What do you expect me to do?”
Michael sensed this was the closest to vulnerable Robert Altieri could ever admit to. He was circling the drain fast and knew it. It was the unconditional surrender of truth held hostage for too long: No amount of wealth, prestige, or cleverness would save him.
Michael’s skin prickled recalling the Do-Not-Resuscitate orders he ignored in the desperate attempt to save Abe, and the heartache of losing his sister, Sarah. Unfortunately, he could relate to Altieri’s fear and helplessness.
The system wasn’t designed to save any one person. It was set up to generate the best outcomes for the greatest number of patient services. It was data-driven, and people were merely one part of the data. That’s how it was taught. But that was of little consolation if you, or someone you loved, was one of those statistics; the “n-of-1.”
He bowed his head under the sheer weight of that truth. This above all else, ‘Do no harm’ came to him, as did, ‘No act of kindness goes unpunished’. Mercy, or justice? Choose.
Steeling himself, Michael reached through Altieri’s imposing visage and spoke directly to the frightened man within. “You’ve donated millions to CCH. Maybe you should actually try trusting the system you’ve been supporting all those years. That’s all I can give you.”
Chapter 39
Michael shook off the cobwebs when his phone rang, despite almost nine hours of uninterrupted sleep. He was on backup call for the ER, and the number belonged to the page operators.
“Morse,” he croaked, through a dry throat.
The page operator apologized. “Dr. Morse, I know you’re not on primary call, but this lady was persistent in speaking to you immediately.”
“Number?” he asked flatly.
“I’ll connect you,” said the operator, sounding eager to dispense with the call.
The line clicked twice. “Dr. Morse?” said the familiar voice.
“Yes?”
“This is Tina, Mr. Altieri’s personal assistant. He would like to see you.” She sounded nervous.
It was like a bucket of ice water tossed in his face. “When?” Michael asked through an unconscious sneer.
“Immediately. ‘Stat,’ as you say.” She waited for his response. “Hello?”
“I’ll be there,” he grumbled. Hanging up, he regretted his tone. Tina was assigned the chore by Altieri. He couldn’t ignore the arrogant jerk, but wasn’t about to rush up there at his beck and call.
Twenty minutes later, Michael stood within the VIP suite, hands in his lab coat pockets, hair still damp from a hasty shower. Neither beverage nor seat was offered.
Across the room Tina held open the door, allowing Altieri to enter. She rested his forearm atop hers for support on one side, while he used a cane in his other hand to shamble into the room.
Altieri glared at Michael. “Dismissed,” he said to Tina. She hesitated, her concern for his steadiness apparent. He peered down to her and softened. “Go.”
Michael eyed Altieri’s approach, the slow thud of his cane on the floor in syncopation with the man’s labored breathing. The dark red cancer marks jerked and shuddered after each step until he stood ten feet away.
“Apparently, you told the details of our last conversation to Dr. Brady, who brought it to the attention of Dr. Farhadi, who took the matter up with me. Do I have that about right?”
“Yeah,” Michael said. “I guess so.”
“Did you tell anyone else?”
“No, I haven’t,” Michael said a bit too quickly, not wanting to get Eddie or Ray caught up in this.
Altieri studied him for an uncomfortable moment. “From my years in practice, I’ve developed a nose for lies. I’m disappointed by your lack of candor.”
“I’m telling the truth, sir.”
Taking a step closer, Altieri stood taller, squinting from the effort. Even in his condition, he was an imposing figure. “I’m sure you are. Do you have any idea what you’ve done to me?” he thundered like an ominous storm cloud
Michael clenched fists in his pockets. “What I’ve done to you? Did I call you up here to taunt you and press you into serving