SERIALIZATION OF THE DOCTOR AND MR. DYLAN… CHAPTER SIX

the anesthesia consultant

Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group
Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.
email rjnov@yahoo.com
phone 650-465-5997

6) MR. DYLAN’S BLUES

Johnny and I ate breakfast together at 6:30 a.m. It was a complex meal—we split a six-pack of powdered sugar donuts from the Seven-Eleven and washed them down with two glasses of orange juice. The talc-like sugar dusted Johnny’s upper lip and the collar of his San Francisco Giants T-shirt. The kitchen was quiet as a library. The only sounds were our glasses clacking against the tabletop. It was Johnny’s first day of school and my first day to report to the local hospital. We were each journeying into the unknown, and the tension connected us.

I broke the silence. “Nervous?” I said.

“Nope.”

I didn’t believe it. Johnny’s eyebrows cast dark shadows, shielding his sunken eyes in blackness. I waited a minute for a sequel to his monosyllabic teenage offering, but no conversation followed.

“Want me to walk over there with you?” I said. “Make sure the paperwork is all OK for your transfer?”

Johnny scoffed. “Are you kidding? I’m 17 years old, Dad, not 7. I’ll figure it out.” He pushed away from the table and left the kitchen. I watched him pace back and forth across the living room floor like a skydiver awaiting his turn to jump out of the plane. Then he grabbed the front door knob and said, “I hope this school doesn’t suck, for both of our sakes.” The door slammed shut, and I looked out the front window to see Johnny hopping through last night’s frozen footprint holes in the snow. Steam rose from his wet hair. He wore a fleece turtleneck over a pair of cotton sweat pants, and no gloves, hat, or boots. I watched him bound two stairs at a time up the entryway of Hibbing High School.

I needed to be at Hibbing General Hospital before 7:30. I’d filled out all the necessary paperwork online. I’d already secured my medical staff privileges and my appointment to the anesthesia service. I wanted to arrive early to check out the facilities and meet the people I’d be working with in the coming months.

I dressed myself in a pair of Sorel boots, a North Face jacket, and one of Dom’s Minnesota Vikings knit caps. A puff of wind from the north scorched my face as I headed out into the winter morning. The stark chill woke me up faster than two espressos. The hospital was a three-block hike from Dom’s house, so it made sense to leave the battered BMW on the curb and walk to Hibbing General.

The hospital was an aging three-story building made of yellowed stone. The front doors were tall brown slabs flanked by two white Doric columns. I smiled at the polished surface of the brown wooden doors. I’d worked summers as a maintenance helper at the General during my college years. One day my foreman gave me a can of red paint and told me to paint these very doors. The next day the hospital administrator chewed our heads off for painting the hospital front doors the color of blood. He dispatched me to the front of the building with a paintbrush and a gallon of brown paint. The doors were still brown this very day.

I found the surgical locker room, a small space one-tenth the size of the men’s locker room at Stanford. I selected a set of scrubs off the shelf and changed out of my street clothes. At Stanford the scrubs were bright royal blue. In Hibbing the scrubs were faded green and looked like they’d been in use since the day I was born in this very building.

I was edgy, even though I was overqualified to work at this little community hospital. At Stanford every nurse, doctor, and janitor knew my name. Here I’d have to earn the respect of dozens of people who’d never heard of me. Medical careers don’t travel as well as business careers. A businessman in California could be promoted to a CEO job in Minneapolis, but doctors who moved from one state to another started at the bottom of the ladder, behind physicians who had reputations and referral patterns already established in the new community.

I entered the hallway of the operating room complex. Hibbing General had only six operating rooms, compared to the 40 rooms at Stanford. The schedule for the day was posted on a white board across from the central desk. My old med school classmate, Michael Perpich, the Chief of Staff at Hibbing General, was the surgeon working in operating room #1. Dr. Perpich was repairing an inguinal hernia on a 43-year-old man—a routine case. I could pop in and say hello without distracting Perp from his task.

I put on a surgical hat and mask and pushed open the door into O.R. #1. The operating room was small, a compact 30 feet by 30 feet. The linoleum floor showed brown stains from old iodine spills. The faded turquoise tile on the walls had witnessed thousands of hernia surgeries. Michael Perpich was bent over the patient’s abdomen. He saw me walk through the door, and said, “Nico Antone. The Tone. Get your ass over here.” A surgical mask covered his face, but I knew my friend was grinning.

“They said you needed some help to fix this hernia,” I said.

“You’re a God damned gas-passer. You couldn’t fix this hernia if I held the book open for you.”

“I’m here to see if your hands shake as much as they used to, Perp.”

“I came here straight from the card room at the Corner Bar at dawn. Never felt better.”

“You’re so full of shit.”

“Did you guys get situated over at Dom’s?”

“We did. Johnny wasn’t thrilled about waking up at 6 a.m., but he ran up the high school steps two at a time this morning.”

“So he’s a gunner. Just like his dad.”

“I got by.”

“You opened a textbook once a week in med school, and you still finished number one in our class. I can’t believe you came back. When you left for California you said never wanted to see a snowflake again.’”

“Things change, Perp. My kid needs an upper-Midwest high school diploma.”

“California kid comes to the wilderness to go to the head of the class, eh? I’ll tell you one thing: the Hibbing teachers will shape him up. I had sergeants in the Army who were more mellow than the Hibbing faculty.”

The scrub tech, a blonde woman wearing too many layers of blue eye shadow, said, “My son is a sophomore. He studies four hours every night.”

“Nico, meet Heidi, my right-hand woman,” Perpich said. “She’s my assistant, my psychotherapist, and the encyclopedia of all gossip great and small in the village of Hibbing.”

“Nice to meet you,” I said.

“Heidi, this is Dr. Nicolai Antone, a welcome addition to the anesthesia staff. Dr. Antone and I went to med school together. He was an anesthesiologist in California, but now he’s one of us, the slightly-better-than-average staff of Hibbing General. So you left Alexandra behind?”

“I did.”

“Good move. Not much up here for princesses.”

“You’re married, Dr. Antone?” Heidi said.

“I am. My wife is back in California.”

She fluttered mascara-laden eyelashes at me and said, “Welcome to Hibbing General. I look forward to working with you.”

Perpich looked up toward the head of the operating room table and said, “Bobby, did he get his antibiotic?”

A wisp of a man—narrow and bony—stood at the head of the operating room table in the anesthesia cockpit of machines, monitors, intravenous drips, and drug cabinets. The man said, “She did. One gram of Kefzol at 7:45.”

“Nico, I want you to meet Bobby Dylan, our Director of Nurse Anesthesia,” Perpich said.

My head snapped back. I wondered if I trusted my ears. Bobby Dylan? The same name as the legendary musician? Here in Hibbing?

The nurse anesthetist ignored Perpich’s cordial introduction and said nothing to me. I was miffed. Who did this guy think he was? He was only a nurse anesthetist. Why the ingratiating attitude toward me, a board-certified anesthesiologist physician?

It was a small hospital, and despite my negative first impression I felt compelled to meet my fellow anesthesia colleague. I walked around the operating room table and entered the anesthesia station. A blue paper hat and mask covered Dylan’s face. His sole facial features were the recessed caves that housed his glossy fish eyes, and the speckled black and gray eyebrows that floated above them.

I extended my hand and said, “Greetings. I guess we’ll be working together.”

Dylan turned his back on me. The beep, beep, beep of the patient’s pulse rate hung between us. He reached over and turned the knob on the anesthesia machine that titrated the oxygen flow. He coughed twice—loud, harsh, barking sounds, and said, “We opted out here, Mac.”

“What?” I said. I wasn’t sure what I had just heard.

“We opted out,” Dylan repeated. He still wasn’t looking at me. He picked up his clipboard and made some notations on the patient’s chart with a pen.

I was getting more and more pissed off. My first impressions were confirmed. This guy was a dick. I didn’t care if this was Dylan’s anesthetic, his operating room, and his hospital. I was unaccustomed to this degree of condescension within two feet of an anesthesia machine. He turned up the intravenous propofol infusion and continued to ignore me, even though I was close enough to smell the staleness of his body odor.

I checked the settings on the anesthesia machine and monitors, looking for some sign that Dylan was as incompetent as an anesthetist as he was as a conversationalist. He was using routine concentrations of standard anesthetic drugs. The ECG, blood pressure, and oxygen saturation numbers all showed normal values. Dylan wasn’t a doctor, but at the moment he was delivering a routine anesthetic in a safe fashion.

I thought to myself, Fuck you, you dirtball. If this Bobby Dylan character wanted to be left alone, I was going to leave him alone. I said, “Hey Perp, I’ll catch you when your case is done, OK?”

“Will do. I’ll meet you in the lounge. Give me 30 minutes.”

“See you there.” My feathers were ruffled. It was great to see Michael Perpich again, but if my initial contact with this nurse anesthetist was any indication, my welcome in the Hibbing medical community was going to be as chilly as a January dawn. I made my way to the operating room lounge, a stark room with four walls of undecorated peach-colored wallboard. The sole furnishings were two long tables and a dozen chairs. All the chairs were empty. Sections of the Duluth News Tribune and the Hibbing Daily Tribune were strewn over the tabletops. The aroma of fresh brewed coffee filled the air. I poured myself a cup and selected a glazed doughnut from a platter.

I felt like a midcareer misfit, stuck in somebody else’s workplace. I missed Stanford. On a professional level, this move to Minnesota looked to be a near-death experience for me.

Michael Perpich’s clogs hammered the floor when he walked in. He pinched the back of my neck, snatched two doughnuts for himself, and plopped down in a chair across from me. “It’s great to see you, Tone,” he said. “I still can’t believe it.”

I hadn’t sat eye to eye with Perp for years. With his surgical cloaking removed, he looked ten years older than me. The top of his head had more dandruff than hair, and the creases around his nose and mouth were deep and long. His smile was genuine, and I chose to disregard the ancient appearance of the only acquaintance I had within a thousand miles.

“Glad you’re here,” I said. “I’m counting on you to be my lifeline at this place.” I waved my hand at the desolate room. “Does anybody else work here?”

“Of course. We have a full staff, like any other community hospital, but we’re light on anesthesiologists. Your timing is perfect. Our last two anesthesiologists retired and moved to the Sun Belt in November. We have six nurse anesthetists, but for tough cases we need an M.D. anesthesiologist in town. Now we’ve got you.”

“So the rest of the anesthesia staff is all nurses?”

“Yep. Six nurse anesthetists. They’re a solid group. I haven’t had too many problems with them.”

I was unconvinced. Nurse anesthetists were registered nurses with a year or more of intensive care unit experience, followed by two or three years of training in a nurse anesthesia program. They learned how to anesthetize patients, but they weren’t medical doctors. In some hospitals, anesthesiologists worked with nurse anesthetists in anesthesia care teams, a team model in which one M.D. anesthesiologist might supervise four nurse anesthetists working in four separate operating rooms. Because this hospital had no anesthesia doctors, the nurse anesthetists were working unsupervised.

“What’s the deal with the Bobby Dylan guy?” I asked. “He stopped one step short of open hostility. Is he a prick, or what?”

“Sometimes he is.”

“He didn’t give me the time of day.”

“It’s a turf thing. This is his hospital. You’re an outsider. The guy doesn’t want you here.”

“He’s a nurse. How does he get off giving me a hard time?”

“Minnesota is an opt-out state, Nico. The Minnesota governor opted out of the requirement for a medical doctor to supervise nurse anesthetists. Bobby Dylan can give anesthesia here, just the same as you can, even though he’s not a doctor.”

We opted out here, Mac. The words Dylan had uttered to me. Opted out.

“So it’s legal here for a nurse anesthetist to give an anesthetic without being supervised by a physician?”

“That’s right.”

“That’s substandard care, if you ask me, and it still doesn’t make this Bobby Dylan guy a doctor. If you had enough physician anesthesiologists in town, would you still let jokers like him give anesthetics alone, or would you replace him with a doctor?”

Perpich threw up his hands. “That’s never going to happen, so who cares? Dylan has been here a long time. He hasn’t had any deaths, he’s kept his nose clean, and he’s not going anywhere.”

“Why is he named Bobby Dylan? That can’t be for real.”

Perpich shrugged again. “I don’t know what his real name is, and I don’t care. He showed up in Hibbing 8 or 10 years ago, and his license and paperwork all identified him as Bobby Dylan. I asked him if that was his real name or if he’d changed his name.”

“And he said?”

“He said his name was Bobby Dylan. Period. He dodged any questions about his past. He was a nurse anesthetist in the Afghanistan War. He’s got a wife and a daughter. He plays guitar and sings at a bar downtown. Plays all the original Dylan songs. People tell me he’s pretty talented. Maybe he was a huge Bob Dylan fan and he just wanted to move to Dylan’s hometown, take Dylan’s name, and get a job here. If so, he’s done all three.”

I shook my head. “That’s pretty weird stuff.”

“It gets more weird. He bought the old Zimmerman house.”

“You’re kidding.”

“Nope.”

“He’s a psycho,” I said.

Perpich’s eyes twinkled. “Up here, there are a lot of characters. Get used to it. He’ll grow on you, once you accept the fact that he’s your peer.”

“My peer? I’ll never accept that.”

As if summoned by their conversation, Bobby Dylan came in through the doorway, poured himself a cup of coffee, and sat in the opposite corner of the room. He peeled off his surgical hat to reveal a fuzzball of curled black and gray hair. He took out a pen and started filling out a crossword puzzle from the morning paper. His mouth stretched into a long yawn. It was just another day for him. My presence was of no consequence.

“I’m going to make rounds on my patients upstairs on the surgical wards,” Perpich said. “Will you be home tonight?”

“Where else would I be?”

“I’ll drop by. I’ve got some housewarming presents for you.”

“I hope it’s a digital video recorder. Dom doesn’t have one.”

“No DVR. Just make sure you’re hungry.”

“Sounds good. See you later.”

Right after Perpich left, I heard a rumbling voice behind me say, “Doctor Antone?”

I turned. It was Mr. Dylan. His facial expression was a cross between a smirk and an all-knowing smile.

“Yes?” I said, puzzled at the encounter.

“I dissed you back there in the operating room. Sorry about that. I was concentrating on my patient, and no one told me you were coming to town. I expect this place is big enough for both of us. No hard feelings?”

I was suspicious. The curl of Dylan’s upper lip seemed to say, I don’t like you one bit, but I’ll pretend that I do just to fuck with you. Before I could answer, he sat on the tabletop in front of me and asked, “Why does a California guy like you move to the Iron Range?”

“I grew up here. I missed the ice fishing and deer hunting.”

“Bullshit.”

“My son transferred into the 11th grade. We want him to graduate from Hibbing High.”

“Let me guess. You think he’ll be the smartest kid in town.”

“I have no idea. We just got here.”

Dylan twirled a wisp of his moustache between his fingers and thumb. “I’ll bet $1000 you and your kid are gone by next January. This ain’t no place for boys from Californ-eye-aye. No place at all.”

“We’ll adjust.”

“You OK working here, where nurse anesthetists are your equals?”

I bit the inside of my cheek. “I’m not sure nurses and doctors are equal. I expect I’ll get used to the fact that nurses can give their own anesthetics here.”

“Of course you will. Just remember, you’ve got no power over me here. No power at all.” Dylan winked and said, “Now, if you’ll pardon me, I’ve got to go make me some money.”

He walked away, and his words echoed in my ears: No power over me at all. My first impression was reconfirmed. This Bobby Dylan was trouble.

It was break time, and the lounge was filling up. An attractive woman sat down at the adjacent table. She had the palest of green eyes that precisely matched the color of her scrub shirt. She had flawless skin and adorable dimples, and the knack of smiling nonstop as she chatted.

I smiled to myself, and forgot about the onerous Mr. Dylan. The sight of a beautiful woman trumped all of life’s ills.

It really did.

*
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*
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Published in September 2017:  The second edition of THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a medical-legal mystery which blends the science and practice of anesthesiology with unforgettable characters, a page-turning plot, and the legacy of Nobel Prize winner Bob Dylan.

KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

Click on the image below to reach the Amazon link to The Doctor and Mr. Dylan:

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Learn more about Rick Novak’s fiction writing at ricknovak.com by clicking on the picture below:  

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SERIALIZATION OF THE DOCTOR AND MR. DYLAN… CHAPTER FIVE

the anesthesia consultant

Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group
Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.
email rjnov@yahoo.com
phone 650-465-5997

5) BOB DYLAN DRIVE

In Northern Minnesota, a “Ranger” is an inhabitant of the mining towns along the Mesabi, Vermillion, and Cuyuna Iron Ranges. Unlike a mountain range, a Minnesota iron range has no elevated topography, no grand vistas and no snow-capped peaks. An iron range is a geological phenomenon, named for the deposits of rich iron-laden minerals just beneath the earth’s surface. Rangers take great pride in their iron mines. They’ll tell you the American ships, tanks, and planes which won World Wars I and II were constructed from steel that originated in these Minnesota mines. No tunnels are required to mine Minnesota ore—a mere scraping of the top layer of trees and topsoil is all that’s needed to expose the largest deposits of iron-containing rock in the United States.

Johnny and I passed the open pit of the Pillsbury Mine, five miles outside of Hibbing. Deep in the concavity of mines like this one, electric shovels the size of small office buildings excavated the iron-containing taconite rock, while the largest dump trucks on Earth carried 240-ton loads of rock to the mining factories on the edges of pit.

Johnny pointed to a solitary billboard standing in the woods on the left side of the highway, and said, “Whoa, check that out.” The billboard depicted a giant fetus in utero. The caption read, Hello world. My heart was beating 18 days after conception.

“Hmm. Disturbing,” Johnny said. “What’s the point of that?”

“Some folks up here don’t believe in abortion. They believe life begins in the womb. I guess they pay for billboards to try to sway people to their way of thinking.”

Two more curves up the road, the town of Hibbing spread out before us. A row of boxy stucco homes stood shoulder to shoulder, their canted roofs covered with fresh snow. A silver water tower bearing the stenciled name HIBBING crested a hilltop behind them. Our journey was at an end.

Bob Dylan once wrote, “Hibbing’s a good ol’ town… I ran away from it when I was 10, 12, 13, 15, 15 ½, 17 an’ 18. I been caught an’ brought back all but once.” I followed a similar path. I blew out of this town years ago, and clawed my way to a better life in California. I vowed never to return. That was before I had a son, a son who needed Hibbing.

I turned onto Howard Street, the main thoroughfare, and drove along the downtown strip of commercial buildings. Neon lights flashed the names of two banks, three restaurants, three taverns, and a liquor store. Six inches of new-fallen snow covered the surface of the two-laned street. Our tires made a scrunching sound as we drove. Mounds of ice and snow lined the perimeter of the road like levees isolating the street from the storefronts.

The vista was familiar, and it saddened me. Hibbing was unchanged from the Januarys of my youth. A woman dressed in a bulky goose-down parka crossed Howard Street in front of us, her scarf trailing in the wind behind her. I slowed to let her pass. She tested the snow-covered surface with exacting steps. Johnny followed the parka-clad woman’s progress in wordless wonder.

I drove the 12-block length of Howard Street and made a left turn onto 1st Avenue, the second of Hibbing’s two main business routes. Similar to Howard Street, 1st Avenue was home to three gas stations, four more bars, and two liquor stores.

“What do you think?” I said.

“There’s not much here,” Johnny said. “It looks like a ghost town. Black and white. Dark buildings and white snow. Lots of bars and liquor stores.”

“Alcohol is a tonic against the tedium. It’s a long winter up here.”

“Iron miners drink a lot?”

“As long as there have been mining towns, there have been mining towns with taverns. But Hibbing is different. There are a lot of educated people here. Remember, this is the biggest urban area between Duluth and Winnipeg.”

Johnny laughed. “That’s not saying much, Daddy-O.”

I turned off 1st Avenue and drove through six blocks of humble residential neighborhoods until I reached 7th Avenue, a narrow tunnel between rows of stark leafless trees. Stocky two-story homes lined up behind the trees like chess pieces behind pawns. Windows were miniscule. Walls were thick. The buildings were efficient barricades for holding in heat against brutal conditions. Hibbing houses weren’t built for style; they were built to protect people from bitter cold.

After five or six blocks, the 7th Avenue street signs changed, and read Bob Dylan Drive. I parked the car when we reached the corner of 24th Street and Bob Dylan Drive. The corner house was a two-story grey cube lacking a single gable. Foot-long icicles hung from the roofline. No sign or placard designated the structure as a famous building.

“Why are we stopped here?” Johnny said.

“This was Bob Dylan’s house.”

“This was where he was born?”

“No. He was born in Duluth, 75 miles south of here. His parents moved to this house when Dylan was a boy. His real name was Robert Zimmerman, and this was his home back in 1959 when he graduated from Hibbing High School.”

“So it’s not a museum or anything.” Johnny craned his neck to take in the particulars of the scene.

“No. It’s someone’s residence. I don’t know who lives here now, but it’s just a regular house.”

As I spoke, a man came out of the front door. He tightened the hood of his parka against the wind and aimed a shovel at the snow on the walkway. After his second shovelful, he stopped and looked up at us in our bashed-in BMW. A $120,000 German sports car with a smashed-in front end and California license plates couldn’t be commonplace in Hibbing in January. On the other hand, I suspect an out-of-town vehicle perusing the old Zimmerman home was not unusual. Muslims made pilgrimages to Mecca. Dylan fans made pilgrimages to Hibbing.

The shoveler wore his hood pulled down over his eyebrows and a brown scarf wrapped snug over his mouth. Only his eyes were exposed to the frigid air. He continued to stare at Johnny and me.

Behind my windshield, I felt like a goldfish inside an aquarium. To ease the awkwardness of the moment, I waved at the man. The resident of 2425 Bob Dylan Drive only exhaled steam into the frigid Minnesota air. He did not wave back.

“Friendly guy,” Johnny said.

“Cut him some slack. I’ll bet every day some dude from New York, Pennsylvania, Illinois, England or Italy knocks on this guy’s door and asks him if they can take a tour of the house. It must get old.”

“Let’s get out of here,” Johnny said.

I put the car in gear and drove thirty seconds down the road to the intersection of Bob Dylan Drive and 21st Street. To our right, an imposing three-story red brick fortress sprawled over four square blocks. It was easily the largest building in town.

Johnny craned his neck up at the structure, and said, “What’s this?”

“This is your new school.”

“It looks like a castle. How can they have such a monster school in such a little town?”

“A hundred years ago the town of Hibbing was located two miles north of here. When the mining companies discovered the richest supply of iron ore in the United States in the soil below the existing town, they cut a deal. The mining companies agreed to move the entire village and build Hibbing this wonderful high school in the new location as a reward for being relocated. C’mon, let’s go take a look.”

We walked up the front steps of the high school. I touched the brass railing with my bare hand, just like I had when I was 17 years old. At that moment, I was proud of my roots and proud of my alma mater. The front door was unlocked, and we stepped inside. The entryway was adorned with a tiled mosaic floor, a majestic marble staircase, and original oil paintings and murals on the walls depicting the history of the Iron Range.

“It looks like a museum,” Johnny said.

“See that plaque? This building is on the National Register of Historic Places. Wait until you see the auditorium.”

We walked to the end of the main hallway and passed through a set of double doors into the auditorium, an Art Deco wonder adorned by cut-glass chandeliers built in Czechoslovakia, and modeled after the ornate Capitol Theater in New York City. With a capacity of 1,800, the auditorium could seat every student in the school at once.

“This is where I received my high school diploma. And this is where Bob Dylan first performed and sang in public. They say he banged on the piano like a Little Richard clone.”

Johnny said nothing. He was biting the nails of his right hand, and he looked nervous.

“You OK?” I said.

“I don’t know. Now that I see this place, I’m getting worried. What if it doesn’t work out for me here? I mean, wherever I go, I’m still Johnny Antone. What if I’m in the middle of the pack here, just like I was in Palo Alto? What if we moved here for nothing?”

“You’ve got what it takes, Johnny. You’ll do great here. Let’s go. I’ve got something else to show you.” I led him out the front entrance of the school, and pointed across the street to a white colonial mansion on the corner of Bob Dylan Drive and 21st Street. It was twice the size of any house we’d seen in town. The front lawn was an expansive half-acre of drifted snow.

“That’s Uncle Dom’s house,” I said.

“Nice.”

“It’s one of the most impressive homes in town. When I was a schoolboy, doctors were the wealthiest people, and Dr. Dominic Scipioni was the top surgeon in Hibbing.”

We crossed the street together. Dom’s front walk was covered by a foot of crusted snow, unbroken by a single footprint. Johnny tip-toed up the path, his Nike Air Jordans sinking in and filling with snow on every step. “Dom isn’t doing a great job of keeping the snow off his walk,” he said.

“He doesn’t live here anymore, that’s why we got the place. Dom has homes in Arizona and Montana. He keeps this family house for the nostalgia of the old homestead.”

“What’s the deal with this Uncle Dom, anyway?” Johnny said. “Is he your uncle, or is he my uncle?”

“He’s nobody’s uncle. Dom’s not related to any of us, but he’s always treated me like family. Dr. Dom was my role model and mentor ever since I was a teenager.”

I bent over and peeled back the corner of the welcome mat. A shiny steel key lay underneath. “This is a sweet deal for us. We get one of the best houses in town, two blocks from the hospital and across the street from the high school, no questions asked. It’ll be our Minnesota man-cave.”

Johnny followed me into the house. The interior was meat-locker cold. We could see the water vapor of our breath. A lifelong ectomorph, I loathed hypothermia. I turned the thermostat up to 72 degrees and switched on the lights in the living room. “I recommend you proceed at once to the den in the basement. Dom has three big screen televisions, side by side by side. You can watch the NBA, the NHL, and the PGA Tour at the same time, by the mere effort of swiveling your neck a few degrees. And you want to know the best thing about Dom’s house?”

“What’s that?”

“There’s no one here to yell at you.”

“I’m with you there, Dad.” Johnny descended the stairs into the basement.

I toured the living room. Dom’s house lacked the towering ceilings of our glassed-in California home. The space felt claustrophobic with its tiny square windows, dark paneled walls, and smoke-stained brown-bricked fireplace. I knew every knot-hole in this room from my previous lifetime here, when Dom’s family was my family. Once upon a time, this room represented the height of luxury to me.

I walked over to the framed black-and-white photograph I knew would be standing on the fireplace mantle. The photo portrayed a young man and a young woman dressed in formal attire. The dark-haired girl wore a square-necked white dress, and held a broad bouquet of flowers. Her lips were closed, and she had a solemn, far-away look in her eyes. The man wore a tuxedo and a goofy smile that was incongruous with the woman’s apparent gloom.

A flood of grief overcame me. I’d traveled all day, and this picture was the tortured endpoint to my journey. It was Dom’s house, and Dom could decorate the place as he pleased. Some people preferred to put their memories on their fireplace mantles. Some memories were better left hidden.

The boy in the picture was Nico Antone. And the girl? She was from another lifetime. I’d shoveled dirt over this unsmiling girl years ago. She was dead, and I needed her to stay dead.

*
*
*
*

Published in September 2017:  The second edition of THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a medical-legal mystery which blends the science and practice of anesthesiology with unforgettable characters, a page-turning plot, and the legacy of Nobel Prize winner Bob Dylan.

KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

Click on the image below to reach the Amazon link to The Doctor and Mr. Dylan:

41wlRoWITkL

Learn more about Rick Novak’s fiction writing at ricknovak.com by clicking on the picture below:  

DSC04882_edited

 

 

SERIALIZATION OF THE DOCTOR AND MR. DYLAN… CHAPTER FOUR

the anesthesia consultant

Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group
Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.
email rjnov@yahoo.com
phone 650-465-5997

4) HIGHWAY 61 VISITED

I drove the black bullet of my BMW up Minnesota Highway 61, one hour north of Duluth and two hours short of the Canadian border. Johnny and I flew in from San Francisco to the Twin Cities that morning, and picked up the car from an interstate driving service in Minneapolis.

Our send-off in California was bitter. Alexandra dropped us off at the curb at San Francisco International Airport. She gave Johnny a big hug and said, “I love you, John-John. Call me every night.”

“Love you too, Mom,” he said. I watched their exchange with intrigue. Although he was eager to move thousands of miles away from her, Johnny still loved his mother. What can you say? She was the best mom he’d ever had.

As for me, I wasn’t going to profess any love this morning. Alexandra faced me, her eyes vacant and cold. “Are you going to be OK without us?” I said.

“I’ll be better than OK without you,” she said, her voice dripping with its customary arrogance. “If I’m lucky, you’ll never come back.” She grabbed the door handle of her Aston Martin, jutted her chin toward the sky and said, “Go.”

That’s the way it ended. I watched her drive off, and I was jolted by an unexpected surge of glee. I felt an unfamiliar sense of freedom, like a captive hawk unhooded and released from its tether. I had no idea when I would see her again, and I wasn’t in a hurry to find out.

Ten hours later, Johnny and I were driving north on a spectacular Minnesota winter day, with the blue expanse of Lake Superior sprawling ocean-like on our right and the setting sun disappearing behind the infinite expanse of pines on our left. I detoured up Highway 61 for the novelty of the famous road, so my son could witness the world’s largest freshwater lake. The scenery was world class, but for me the highlight was spending time with Johnny uninterrupted by the distractions of a television, an Xbox, or cell phone calls. Exiled from California, Johnny had no friends except me, and I liked it that way.

He slumped in the passenger seat and stared out the side window. Despite the winter temperatures, he’d rolled down his window and the icy breeze from Highway 61 fluttered through his hair. I was in control of the music. For this occasion, it had to be Bob Dylan. I cued up “Highway 61 Revisited,” and blasted the title song though the speakers. I belted out the lyrics in a nasal twang: “Well Abe says, ‘Where do you want this killin’ done,’ God says, ‘Out on Highway 61.’” My “61” came out as a screeching “sexty-waawn,” mimicking Dylan to the best of my ability.

“Bob Dylan wrote that song about this highway?” Johnny said.

“He did.”

“It’s a pretty creepy lyric. And you’re screaming it out like it’s an anthem. He’s singing about killing a son?”

“It’s from the Old Testament. God told Abraham to sacrifice his only son.”

“So? Did he kill his son?”

“No. He was prepared to do it, to obey God, but at the last minute God sent an angel to stop him. Instead of killing his son, Abraham sacrificed a ram.”

Johnny shook his head. “What kind of song is that? Sorry, Dad. I can’t get into the Dylan thing. It’s so hard to listen to the guy’s voice. That screeching is pretty awful.”

“Bob Dylan is one of the most imitated vocalists of the last hundred years. He gave every singer with a less-than-perfect voice a blueprint of how to sneer and twist off syllables.”

“He’s all mumbles to me.”

“Try to get past the sound of his voice, and listen to the words. Dylan was the first songwriter to turn poetry into popular music.”

“Who cares about poetry?”

“What is rap and hip-hop music but poetry? What do Jay Z or Kanye West do but chant some simple rhymes over a drum beat?”

Johnny looked unconvinced.

“Bob Dylan changed music forever. Before Dylan, the top singers were crooners like Frank Sinatra and Elvis Presley, guys with silky voices who performed songs written by unknown people. Then along came Dylan, coughing out “Blowin’ in the Wind” with a voice like sandpaper on wood. He jammed his songs into your ears with that raspy nasal twang, and crossed you up with changes in inflection no one ever heard before.”

“Why would anyone ever listen to that?”

“Great songs. ‘The Times They Are A-Changin’,’ ‘Mr. Tambourine Man,’ ‘Like a Rolling Stone.’ Songs that influenced every writer that followed after him.”

“It doesn’t make sense to me. How can a guy who changed the world come out of all this?” Johnny said, waving his hands at the endless forests. “From up here in the sticks?”

“God only knows where genius is born, but education had something to do with it. Hibbing High School. The same classrooms and hallways you’ll be in tomorrow.”

I spun the steering wheel to the left as we departed Highway 61 and veered west toward the heart of the Superior National Forest. Lake County Highway 15 was a curving two-lane highway that slalomed over gentle hills and carved through wilderness untouched by 21st-Century development. It connected the two metropolises of Silver Bay and Hoyt Lakes, each with a population of about 2,000. The road was smooth and the setting was desolate. We hadn’t seen another car in ten minutes. I compressed the accelerator pedal and watched the speedometer climb. “Hang on, son. We’re going for triple digits.”

When our speed hit 100 miles per hour, I looked over at Johnny. There was no trace of fear—he was loving it.

A sudden blaze of brown fur streaked across the road as the deer jumped out of the forest 100 yards in front of our car. “Shit!” I yelled, and stomped on the brakes so hard I thought my foot would break through the floorboard. Our car fishtailed counterclockwise. The rear wheels made a skid into the dirty snow on the side of the road, and our front fender slammed into the deer’s flank. I heard the crunch of crumbling steel, and saw the deer’s white tail slide up the windshield and over the top of the car. The airbags deployed, and twin balloons of white fabric blotted out the sun. The rear of the car wracked into something solid and stopped with a resounding thump.

I reached down and turned off the ignition. My hands were shaking. We’d hit the deer broadside at 100 mph. Highway 15 was now graced with one dead deer, one smashed-up BMW, and two happy-to-be-alive Antones. I took census of my four limbs and my vital functions. I didn’t seem to be injured. I feared for Johnny. I elbowed my air bag aside, and looked over at the passenger seat. There was movement behind Johnny’s air bag. I pushed the fabric aside, and saw my son crouched forward with his head between his knees.

“Are you all right?” I said.

Johnny was hyperventilating—a violent wind entered and exited his gaping mouth. Blood dripped from the right side of his chin. “Are you nuts, Dad?” he screamed. “You almost killed me. That was the scariest thing I’ve ever seen.”

I was reeling. What kind of father was I? I’d almost offed us both. “I’m sorry,” I said. “I didn’t think…”

You didn’t think? Do you ever think? Oh, what the hell am I doing up here?” Johnny buried his face in his hands and wailed, “Everybody I know is in California. My mother is thousands of miles away. I’m up here in the woods with you, stuck in a ditch in outer Mongolia. We’re going to freeze to death and die right here. I should never have left home.”

I didn’t know what to say. I started to reach out toward my son to comfort him, but Johnny grew more agitated, turned away, and wrestled with the airbag until he found the door latch. He pushed the door ajar, and burst out into the sub-freezing air outside.

I opened my own door and twisted my way out of the car. The right front quarter of the vehicle was buckled like an accordion. The deer lay mangled on the roadside at the rear of the car, its glassy eyes staring skyward into the void. Blood seeped from its ears, nose, and mouth. Its thorax was buckled, concave and deformed.

What a waste.

Behind me, Johnny said. “Dead deer. Totaled car. Stranded in the middle of nowhere. Great job, Dad.”

“It all happened so fast…”

“No. You were driving like a maniac, and now we’re stuck. We’re so stuck. There’s no people in these woods but lumberjacks. Lumberjacks who would be hunting this deer if you hadn’t killed it.” Johnny shook his head. He stuck out his jaw, square and resolute. “I’m done. I changed my mind. I want to go home.”

I’d heard enough. “No. We’re going to Hibbing,” I barked. “It’s what you and I decided to do. Together, that’s what you and I decided.”

“I’m un-deciding.”

“It’s too late for that. I’m pulling rank on you. We’re in Minnesota, and we’re staying in Minnesota.” I walked back to the driver’s door, unsheathed a small Swiss Army knife from my key chain, stabbed the point of the blade into the airbag, and slashed a 10-inch gouge in the material. I squeezed the remainder of the air out, compressed the bag into a dense lump the size of a basketball, and stuffed it back into its housing inside the steering wheel. I repeated the same treatment on the passenger airbag, and pushed the deflated fabric back into the dashboard.

“Get in,” I commanded.

“You don’t understand, Dad. What’s the point of getting into this wreck of a car, marooned ass-end first in a snow bank?”

I ignored his sky-is-falling attitude, and pushed the ignition button. The engine sprang to life. I floored the accelerator pedal, and listened to the roar of the motor echo off the virgin pines around us.

“Get in,” I repeated.

Johnny looked both ways on the deserted highway, and his shoulders slumped. He climbed into the passenger seat, with a look of hopeless resignation etched on his face. We were miles from the nearest town, and the deformed car was our only hope to limp out of the wilderness. I shifted the transmission into Drive and wondered if the right front tire would move within the mangled fender. With a lurch, the BMW rolled forward out of the snow bank. Lucky us. I whistled through my teeth and turned the automobile back onto Highway 15 for the last leg of our trip toward Hibbing.

I vowed that the next time I saw God, I’d run a little slower. Abraham sacrificed a ram instead of killing his son.

I settled for a deer.

*
*
*
*

Published in September 2017:  The second edition of THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a medical-legal mystery which blends the science and practice of anesthesiology with unforgettable characters, a page-turning plot, and the legacy of Nobel Prize winner Bob Dylan.

KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

Click on the image below to reach the Amazon link to The Doctor and Mr. Dylan:

41wlRoWITkL

Learn more about Rick Novak’s fiction writing at ricknovak.com by clicking on the picture below:  

DSC04882_edited

 

 

DR. NOVAK’S DEBUT NOVEL: THE DOCTOR AND MR. DYLAN

the anesthesia consultant

Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group
Richard Novak, MD is a Stanford physician board-certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.
email rjnov@yahoo.com
phone 650-465-5997
Published in 2017:  The second edition of THE DOCTOR AND MR. DYLAN, a legal mystery which blends anesthesiology and the legacy of Nobel laureate Bob Dylan.

Click on the image below to reach the Amazon link to The Doctor and Mr. Dylan:

41wlRoWITkL

Why does an anesthesiologist write a novel?

Anesthesiology is fascinating. We anesthetize patients for operations of every kind, from cardiac, brain, and abdominal surgeries to trauma and organ transplant surgeries. We anesthetize people of all ages from newborns to one-hundred-year-olds, relieve the pain of childbirth and chronic malignancies, and attend to all types of individuals from millionaires to the homeless. No one knows the breadth of human suffering and recovery better than a physician, and no physician sees a wider range of patients than an anesthesiologist.

The story of The Doctor and Mr. Dylan deals with an anesthesia complication, a crumbling marriage, a son’s quest for elite college admission, and a courtroom drama, all set in Bob Dylan’s hometown of Hibbing, Minnesota.

Stanford professor Dr. Nico Antone leaves the wife he hates and the Stanford job he loves to return to Hibbing, Minnesota where he spent his childhood. He believes his son’s best chance to get accepted into a prestigious college is to graduate at the top of his class in this remote Midwestern town. His son becomes a small town hero and academic star, while Dr. Antone befriends Bobby Dylan, a deranged anesthetist who renamed and reinvented himself as a younger version of the iconic rock legend who grew up in Hibbing. An operating room death rocks their world, and Dr. Antone’s family and his relationship to Mr. Dylan are forever changed.

 Equal parts legal thriller and medical thriller, The Doctor and Mr. Dylan examines the dark side of relationships between a doctor and his wife, a father and his son, and a man and his best friend. Set in a rural Northern Minnesota world reminiscent of the Coen brothers’ FargoThe Doctor and Mr. Dylan details scenes of family crises, operating room mishaps, and courtroom confrontation, and concludes in a final twist that will leave readers questioning what is of value in the world we live in.

The opening pages to THE DOCTOR AND MR. DYLAN follow:

CHAPTER 1) GOING, GOING, GONE

            first-degree murder n. an unlawful killing which is deliberate and premeditated (planned, after lying in wait, by poison or as part of a scheme)

My name is Dr. Nico Antone. I’m an anesthesiologist, and my job is to keep people alive. Nothing could inspire me to harm a patient. Alexandra Antone was my wife. Alexandra and I hadn’t lived together for nearly a year. I dreaded every encounter with the woman. I wished she would board a boat, sail off into the sunset, and never return. She needed an urgent appendectomy on a snowy winter morning in a small Minnesota town. Anesthetist options were limited.

Life is a series of choices. I chose to be my wife’s doctor. It was an opportunity to silence her, and I took it.

Before her surgery, Alexandra reclined awake on the operating room table. Her eyes were closed, and she was unaware I’d entered the room. She was dressed in a faded paisley surgical gown, and she looked like a spook—her hair flying out from a bouffant cap, her eye makeup smeared, and the creases on her forehead looking deeper than I’d ever seen them. I stood above her and felt an absurd distance from the whole situation.

Alexandra opened her eyes and moaned, “Oh, God. Can you people just get this surgery over with? I feel like crap. When is Nico going to get here?”

“I’m three feet away from you,” I said.

Alexandra’s face lit up at the sound of my voice. She craned her neck to look at me and said, “You’re here. For a change I’m glad to see you.”

I ground my teeth. My wife’s condescending tone never ceased to irritate me. I turned away from her and said, “Give me a few minutes to review your medical records.” She’d arrived at the Emergency Room with abdominal pain at 1 a.m., and an ultrasound confirmed that her appendix was inflamed. Other than an elevated white blood cell count, all her laboratory results were normal. She already had an intravenous line in place, and she’d received a dose of morphine in the Emergency Room.

“Are you in pain?” I said.

Her eyes were dull, narcotized—pinpoint pupils under drooping lids. “I like the morphine,” she said. “Give me more.”

Another command. For two decades she’d worked hard to control every aspect of my life. I ignored her request and said, “I need to go over a few things with you first. In a few minutes, I’ll give you the anesthetic through your IV. You won’t have any pain or awareness, and I’ll be here with you the whole time you’re asleep.”

“Perfect,” she oozed.

“When you wake up afterward, you’ll feel drowsy and reasonably comfortable. As the general anesthetic fades and you awaken more, you may feel pain at the surgical site. You can request more morphine, and the nurse in the recovery room will give it to you.”

“Yes. More morphine would be nice.”

“During the surgery you’ll have a breathing tube in your throat. I’ll take it out before you wake up, and you’ll likely have a sore throat after the surgery. About one patient out of ten is nauseated after anesthesia. These are the common risks. The chance of anything more serious going wrong with your heart, lungs or brain isn’t zero, but it’s very, very close to zero. Do you have any questions?”

“No,” she sighed. “I’m sure you are very good at doing this. You’ve always been good at making me fall asleep.”

I rolled my eyes at her feeble joke. I stood at the anesthesia workstation and reviewed my checklist. The anesthesia machine, monitors, airway equipment, and necessary drugs were set up and ready to go. I filled a 20 cc syringe with the sedative propofol and a second syringe with 40 mg of the paralyzing drug rocuronium.

“I’m going to let you breathe some oxygen now,” I said as I lowered the anesthesia mask over Alexandra’s face.

She said, “Remember, no matter how much you might hate me, Nico, I’m still the mother of your child.”

Enough talk. I wanted her gone. I took a deep breath, exhaled slowly, and injected the anesthetic into her intravenous line. The milky whiteness of the propofol disappeared into the vein of her arm, and Alexandra Antone went to sleep for the last time.

CHAPTER 2) A PHARMACIST’S SON IN SOUTH DAKOTA

Eight months earlier

My cell phone pinged with a text message from my son Johnny. The text read:

911 call me

I was administering an anesthetic to a 41-year-old woman in an operating room at Stanford University, while a neurosurgeon worked to remove a meningioma tumor from her brain. I stood near my patient’s feet in an anesthesia cockpit surrounded by two ventilator hoses, three intravenous lines, and four computer monitor screens. Ten syringes loaded with ten different drugs lay on the table before me. My job was to control my patient’s breathing, blood pressure, and level of unconsciousness, but at that moment I could only stare at my cell phone as my heart rate climbed.

                                                                       911 call me

911? My son was in trouble, and I was stuck in surgery, unable to leave. I wanted to contact Johnny as soon as possible, but my patient was asleep, paralyzed, and helpless. Her life was my responsibility. I scanned the operating room monitors and confirmed that her vital signs were perfect. I had to make a decision: should I call him now, or attend to my anesthetic and call after the surgery was over? My patient was stable, and my son was in danger. I pulled out my cell phone and dialed his number. He picked up after the first ring….

*
*
*
*

Published in September 2017:  The second edition of THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a medical-legal mystery which blends the science and practice of anesthesiology with unforgettable characters, a page-turning plot, and the legacy of Nobel Prize winner Bob Dylan.

KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

 

The most popular posts for laypeople on The Anesthesia Consultant include:

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The most popular posts for anesthesia professionals on The Anesthesia Consultant  include:

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What Personal Characteristics are Necessary to Become a Successful Anesthesiologist?

 

 

Learn more about Rick Novak’s fiction writing at ricknovak.com by clicking on the picture below:  

DSC04882_edited