Little Elephant Week
Part One
By Scott J. Welles
scottjwelles@yahoo.com

DISCLAIMER, for those who enjoy reading disclaimers: All "ER" characters and institutions are the property of Warner Bros., ConstantC Productions and Amblin Television, and ain't nobody making a profit on this piece. (I trust that covers the bases.)



(On Monday, Ryan Bradley held an interview near the emergency room...)

WEAVER: When people work together to build a bridge, or a skyscraper, they are devoting themselves to the service of something which is larger than any of them, but which will benefit all of them. The structure that results is greatly to everyone's credit. But none of their individual talents, as invaluable as they are, will do any good unless they all have a blueprint to follow, a pattern to give their efforts direction and form. Emergency medicine is no different. Without adequate leadership, even the most gifted, dedicated group can end up running in all directions like chickens with their heads cut off.

Kerry Weaver's voice is a surprising thing. From her picture, I expected it to be deeper, maybe a little sultrier. Or maybe that's just wishful thinking on my part. I bet she'd do a hell of a Margaret Hamilton impression. I also infer that she's speaking from experience about the absence of leadership. When asked if this is so, she hesitates visibly before replying.

WEAVER: There have been occasions that support my point. We had an incident last year in the emergency room, for example. A patient was rushed in, contaminated with benzene, which is extremely toxic, as you know. The entire ER had to be evacuated, and Hazardous Materials summoned to contain the situation. One of the attending physicians was on vacation at the time, and another... was incapacitated momentarily. As a result, there was - very briefly, I emphasize - the potential for a panic which might have led to loss of lives. However, the staff was able to minimize the disaster without further complication. I would cite this as an excellent example of organization triumphing over adverse conditions.

There's more to this story than she lets on. Her account has the feel of being carefully edited, perhaps to conceal some perceived failure on her part. A good interviewer picks up on these things, but he also knows when not to press for details.

This is my first time meeting Dr. Weaver, an attending physician in Chicago. We're sitting across the street from Cook Country General Hospital in a greasy spoon called Doc Magoo's. The image that springs to mind, that of scalpels and surgical probes being wielded by the nearsighted cartoon character Mr. Magoo, is indicative of the sort of dark humor that permeates the medical community.

Weaver herself does not seem, at first glance, to be a practitioner of humor, dark or otherwise. Her red hair is cut manageably short, her makeup and jewelry are understated, and her ensemble, camelhair coat over green turtleneck and woolen slacks, is conservative to a fault. Her entire image seems tailored to project nothing more than pleasant competency. The only item that catches the eye is the aluminum or titanium crutch on her right arm. Although she walks with a marked limp, it seems to be an insignificant detail to her. I imagine that it would be less noticeable in a hospital environment than elsewhere. The overall impression is that of someone ten years older than I know her to be.

I admit I had a preconceived mental picture of Kerry Weaver, garnered mostly from Professor Hillerman. He spoke of Dr. Weaver with obvious affection, and showed me a photograph from one of the albums in his den. Clearly taken during one of the student-faculty mixers he's known for, it showed an animated young woman in a tee shirt - reading TRUST ME; I'M A DOCTOR - surrounded by cheering classmates, her long hair flying wildly as she chugs from a bottle of tequila. It's difficult to picture that spitfire in the woman sitting across from me now. This woman looks more like a librarian. Dr. Weaver has graciously agreed to be interviewed for the Johns Hopkins alumni magazine, even though she transferred out before graduation. Although I've made it clear that this would be more of a casual chat than a formal interview, she retains an air of clinical detachment, and at times becomes slightly pedantic.

While reticent when discussing personal matters, she becomes highly opinionated on the state of medicine in general. I have to wonder what she'd be like if I was from the Journal of the AMA.

BRADLEY: What prompted you to become a doctor? Was there a particular inspiration or turning point in your life that made you feel this was the career for you?

WEAVER: There was no definitive event, per se. Medicine has always seemed the most worth-while of human endeavors to me, and my choice was very carefully considered, but my choice of careers wasn't triggered by anything catastrophic or melodramatic, if that's what you're asking. It's not often a clear chain of cause-and-effect.

BRADLEY: So what was the motivating factor?

WEAVER: For myself, it was simply a desire to ameliorate human suffering and improve the quality of life. I'm sorry if that sounds like a cliché, but the fact remains. I'd like to think that the majority of people in our field have the same motivation.

BRADLEY: Well, it's certainly a noble attitude...do you feel that it's true of doctors in general?

WEAVER: I gather you're being a little ironic. (smiles) No, your question is a valid one; people join the profession for a variety of reasons. As long the end result is in the service of the patients, I'm not inclined to question anyone's motivation. For some, medicine is perceived as a fast track to wealth or social status. For others, it's a form of overcompensation for personal loss...

BRADLEY: And how about for yourself?

WEAVER: I think we've covered that. Actually, I guess I should elaborate a little... when I was very young, I saw a great deal of illness and injury, in parts of the world with standards of health far below those of the United States. I'd just as soon not go into specifics, but I'll say that it impressed upon me the need for healing in all its forms. It rarely occurred to me to do anything other than pursue that need.

BRADLEY: Would you say it's possible to be entirely selfless in that pursuit?

WEAVER: Well, I'd say that's a question better suited to philosophers than physicians. I'm not making any claims to sainthood... (laughs briefly)

BRADLEY: Aha, so there is some personal ambition there?

WEAVER: You aren't going to let go of that, are you? (sips coffee) All right. I have been accused, mostly in jest, of being a domineering schemer out to rule the world. That sort of reputation is one of the accepted consequences of being organized and strong-willed, if you'll pardon the immodesty. Anyone who has been in the armed forces will have similar complaints about drill sergeants who, ultimately, win their respect. Those who actively try to effect change, increase efficiency, or improve the established order of things are often seen as tyrants or slave drivers, even when their efforts are ultimately to the good. (leansforward) Between you and me and your readers, Mr. Bradley, I've been subliminally encouraging this reputation.

BRADLEY: Why?

WEAVER: Mostly because it helps the morale of the staff to have an authority figure to gripe about...

BRADLEY: But also because...?

WEAVER: It's a lot of fun.

BRADLEY: (laughs) So, you're not actually interested in taking over the world?

WEAVER: (shakes head) I'd have no place to put it. My closets are full as is.

BRADLEY: (laughs harder)

WEAVER: (shrugs) I've worked with these people for a few years now, and I think that most of them consider it more of a running gag than anything else, by now.

BRADLEY: And the others...?

WEAVER: (pauses) Well, if I was really as power-hungry as I'm made out to be, there would certainly be easier ways for someone of my ability to achieve it than by enduring the daily pressures and horrors of emergency medical services.

BRADLEY: Let's talk about that. Why choose emergency medicine?

WEAVER: Haven't we been over this?

BRADLEY: No, I mean why this particular branch of the field.

WEAVER: Oh.

BRADLEY: For someone as organized and analytical as yourself, I would have thought that research, or perhaps surgery, might be more your forte. Emergency seems more suited to, uh...

WEAVER: Cowboy medicine?

BRADLEY: Something like that, yeah.

WEAVER: (nods) That's a common perception. The ER is a relatively chaotic arena, by nature. However, it's for precisely that reason that I feel a stronger chain of organization is needed. Obviously, there will always be an uncontrolled element, as we're the first to receive sick and injured patients, barring perhaps the paramedics. The trick is to get things under control as soon as possible. Emergency medicine struck me as the place I could do the most good. It's a simple question of supply-and-demand.

BRADLEY: I see...

WEAVER: I can understand your preconception. The image of the rough-and-ready maverick doctor is a popular one, because it's highly individualistic. It appeals to the ego. But if that egotism comes at the expense of our ability to care for our patients, it does far more harm than good.

BRADLEY: How do you mean?

WEAVER: Well, there is a tendency among devoted physicians - and I mean this at all levels, not just the ER - to neglect the big picture. That is, if a doctor has a patient in need, the obvious impulse is to do whatever's necessary to help them. In itself, this sounds perfectly laudable, but some doctors have been known to obsess, and to ignore all other considerations.

BRADLEY: Such as...budgetary factors?

WEAVER: Sometimes, but also issues both ethical and moral. A radical procedure, for example, may save one life, but expose the hospital to legal and financial hardship, thus endangering many others. There simply isn't room for loose cannons here. Believe me, we have all had occasion to wish we could say "to hell with the rules" and take direct action to achieve our goals. I'd be lying if I didn't feel the same way sometimes, but it's just not that simple. None of us exist in a vacuum, after all. We all have a responsibility to consider the long-term consequences of our actions, to the hospital, to our patients - future as well as present - and sometimes to ourselves. (sighs) I'm sorry, I don't mean to get on a soapbox here...

BRADLEY: A moment ago, you sounded like you had someone specific in mind that you were describing.

WEAVER: (coolly) I'm not here to name names for you, Mr. Bradley. I have no intention of turning your alumni magazine into a scandal sheet.

BRADLEY: No, no, that's certainly not what I meant. I just wondered if this was an issue you had to deal with on a frequent basis.

WEAVER: I see. Well, I will admit that there have been conflicts in the past, and probably will be again in the future. Not to imply that it's all anyone's fault. I'll admit that I've probably contributed to these conflicts. It takes a very strong personality to become a successful practitioner, after all. Any time two or more such egos are in a room together, there's always a clash of wills waiting to happen. (smiles tiredly) Mine don't wait very long, it seems.

BRADLEY: Getting away from medicine for a moment, do you have any particular hobbies?

WEAVER: (deadpan) I collect spores, molds, and funguses.

BRADLEY: Uh...really? I suppose that must - wait, that's a line from "Ghostbusters."

WEAVER: (nods) You see, Milady Dictator hath a sense of humor. Actually, I don't have a very active lifestyle outside of work. I read a lot, when I can...and I do a little writing.

BRADLEY: What sort of things do you write?

WEAVER: (pointedly) No comment.

BRADLEY: Just out of curiosity, what are your impressions regarding the coming millennium? Do you think that there will be any great changes, either in medicine or the world in general?

WEAVER: (pauses for thought) I'd have to say no. At least not in terms of any great, sweeping changes. Things are changing all the time, of course, but that's just the natural progress of time. I'm not inclined to believe that the world will turn upside down simply because the calendar changes. No, the only way that the world will improve is if everyone, individually, makes the choice to improve it, instead of wallowing in the way things are.

BRADLEY: Hmmm. With what you know of human nature, do you believe that people are likely to make that choice?

WEAVER: I did.

As we step out of Doc Magoo's, I'm almost sorry that the interview is over. Despite her tendency to answer with impersonal generalities and well-rehearsed platitudes, talking to Kerry Weaver is surprisingly enjoyable. Still, I admit I was hoping to see some trace of the free-spirited Tequila Queen in the photograph. I guess that time works changes on all of us.

As we shake hands, I give it a final try. "Professor Hillerman said to extend his best wishes, by the way," I tell her.

"Oh, yes, he referred you to me, didn't he?" she replies.

I nod, smiling. "He's my faculty advisor at Johns Hopkins."

"He was mine as well."

"I know," I say, momentarily thrilled to have made a personal connection, "He remembers you very fondly."

She smiles, without warmth. "That's because I was young, impressionable... and female," she says, then adds, "Ryan, you strike me as an intelligent young man who's honestly interested in learning. If that's so, I'd advise you to leave Hillerman and find an advisor who'll point you in the right direction."

I'm taken aback at this, and it must show, because she continues, "Arnold Hillerman is popular because he's charismatic and influential. He keeps track of his former students because the successful ones make him look good. But the truth is, he's not a good doctor, and he's certainly not a good teacher. It's your choice, but I'd dump him if I were you."

Feeling compelled to defend a man who has befriended me, I say, "Excuse me, Dr. Weaver, but you seem to have done reasonably well because of him."

She gives me her most level gaze. "No, Mr. Bradley, I've done very well, in spite of him. Or didn't he tell you that he was the reason I transferred out of Hopkins?" And with this, Dr. Kerry Weaver takes a firmer grip on her crutch and goes back to work.