Worst Case Scenario by Michael Bowen Page A

I’m translating it into plain English for you, you understand. The paper itself didn’t actually come out and admit that rationing was what it was talking about.”
    â€œI shouldn’t think so.”
    â€œAnyway, it was a pretty standard-issue Washington work product. The executive summary was one page long, the body of the paper was thirty-two pages, and then eighty pages of appendices were attached. An appendix is always the safest place to put the truth in a report like that, so that’s where I looked for it.”
    â€œAnd the truth turned out to be what?” Michaelson prompted.
    â€œThe truth turned out not to be there. I studied the appendix summarizing the sets of standards used to decide who gets organ transplants, because that’s the one area where we haven’t been able to kid ourselves about rationing. We’ve faced up to it because we haven’t had any choice: it’s triage, someone’s gonna live and someone’s gonna die, and we have to decide who.
    â€œThis appendix included a table, and the column for liver transplants had a footnote that said, ‘Data incomplete because of extra-criterial allocations.’”
    â€œMeaning what?”
    â€œThat’s what I intended to find out. Turns out it meant that some liver transplants went to people who got pushed to the top of the list without reference to the triage criteria. I asked for summaries of every case where that had happened. The name of Walt Artemus’ daughter came up, and my antennae started quivering big time. That’s what I meant when I said Pilkington wasn’t that far off. I thought maybe I was really onto something. I’ll admit it: I really did see myself testifying in front of a congressional committee and being interviewed on CNN and PBS.”
    â€œSo. What did you do?” Michaelson asked.
    â€œJust what Pilkington said I should’ve done,” Deborah said. “I wrote my own report with my own executive summary and a snappy little action memo attached to it.”
    â€œAnd nothing happened.”
    â€œRight. Tickled it after one month, tickled it after three months, six months, nine months. Nothing.”
    â€œSo you pushed.”
    â€œNot right away, to tell you the truth,” Deborah said. “I’d do a little follow-up memo every few months, just to sort of stake my claim to the issue. The kind of thing that goes from the in-basket to the out-basket with eight-point-two seconds’ reading time in between. But I didn’t start breaking furniture until early ’ninety-three. That’s what got me taken to the woodshed.”
    â€œWhat did you start doing then?”
    â€œWent outside channels. I even went outside the service. Started adding bitchy little cc’s to the memos. And then,” Deborah added, suddenly lowering her voice at the enormity of what she was about to confess, “I threatened to go to the Hill.”
    Michaelson did his best to look shocked. The executive branch mentality knows no heresy more outrageous than the notion that the elected representatives of the people should be allowed to participate in governing the country.
    â€œWhat provoked you to this, ah, extreme measure?” Michaelson asked carefully.
    â€œIt just started to get to me,” Deborah explained, her tone rising slightly in angry frustration. “I wasn’t always a suit. I didn’t learn about triage from thirty-page reports, I learned about it in an OR at Da Nang.”
    She leaned forward, eyes widening with intensity as her face came alive.
    â€œThe triage rules at Da Nang were crystal clear, especially during Tet. The marines we treated first weren’t the ones about to die or the ones in the most pain. They were the ones who could be patched up quickest and sent back to kill more Charlie.”
    â€œYes,” Michaelson said softly, “I do see.”
    â€œSo I’m sitting at my desk in 1993