Unsaid: A Novel by Neil Abramson Read Free Book Online

husky—occupy the spot on his desk usually reserved for family pictures, disproving the myth that all dog owners eventually begin to look like their dogs.
    When I find him, Joshua is palpating the abdomen of a large mutt with the help of Eve, one of our vet techs. The dog clearly is uncomfortable and will not remain still for Joshua’s probing fingers.But Joshua never loses his patience and tries to comfort the dog as best he can with soothing noises he has never uttered to another human being.
    “How much food did they say was in the bag that Misha got into?” Joshua asks.
    Eve looks at the file before answering. “It was almost full. So twenty pounds or so, I guess.”
    “I think it’s moving,” Joshua notes as he continues his exam. “No bloat, but let’s do an X-ray and keep him overnight to be sure.”
    The exam room door bangs open. Beth, our other full-time vet tech, carries in her arms a small whimpering mess of blood and dog fur. I know too well that wounds of this magnitude can only be caused by a car striking animal flesh and bone. The dog will soon go into shock, if it isn’t there already.
    “Sorry Dr. J,” Beth says in her usual unflappable calm despite the blood dripping onto her scrubs. “This one just came in. Police found him by Wingate Road. Compound leg fracture. No tags.”
    The receptionist buzzes Joshua on the office intercom. “Dr. J, your two thirty and your three o’clock are both waiting. And your three fifteen just walked in. What should I tell them?”
    Joshua rubs his head in frustration and then barks at Beth. “I’m already half an hour behind on my appointments. See if Helena can take the emergency. Tell her…” I almost blurt out that Beth should bring the dog to my office with a suture kit and a saline bag, but then I remember.
    Beth and Eve gape at Joshua. From the looks on their faces, he realizes his error. “I’m so sorry,” he says. In exhaustion, embarrassment, or both, Joshua covers his face with his hand. “Eve, can you please take Misha for his X-ray? Beth, just give me a second and then I’ll see the fracture.”
    Beth backs out of the office with the dog in her arms and Eve follows with Misha. Once they’re gone and Joshua believes he is alone, he grabs a handful of pencils from a jar on the desk and, one at a time, slowly begins to snap them in half.
    The only other animal hospital that services our area is about as far removed from our type of practice as you can get. Dr. Thorton’s Animal Medical Center occupies a large, modern glass-and-metal structure off Route 100, right smack in the most affluent area of the community. Thorton runs a twenty-four-hour operation with four full-time vets and a large support staff of technicians and helpers. He even has his own lab and lab techs on premises. This means Thorton has a great deal of overhead and he freely passes these costs on to consumers—whether they can afford it or not.
    Over the years that we worked together, I saw Joshua spend hour after hour on a particularly difficult case, researching each option, calling experts from the Animal Medical Hospital in Manhattan and humbly asking them for advice, all for the price of the same office visit—if even that. He would send blood or urine out to the lab for testing only when necessary and only at cost. At the end of all this work, Joshua would present his conclusions and recommendations to the nervous clients with the type of compassion and understanding that only comes from having been on the receiving end of unfortunate news.
    This approach is not part of the Thorton economic model. For the same type of case, Thorton instead runs a battery of expensive diagnostic tests irrespective of the animal’s symptoms. Since he owns his own lab, the markup on even the most mundane blood test is huge and goes directly into his pocket.
    At the end, after all the tests have been exhausted, Thorton reaches a conclusion predicated largely on the process of