Do No Harm

Chapter 45

When Pat ignored David, he thought it was merely residual ill will from their confrontation earlier in the week, but the entire staff was stiff with him as he made his way to the Central Work Area. He couldn't find the attending on call, so he tapped a nurse on the shoulder as she passed. "Can you tell me what's going on?"

"You haven't heard?" She had a cruel, stupid face and wore too much eye shadow.

"I guess not," David said.

A medicine intern looked up from his paperwork. "There's been another attack, Dr. Spier."

David felt the air leave his lungs all at once. "On who? Who is it?"

The CWA was full, but no one answered. They stared with dull, implacable eyes, or turned back to their charts. "Who is it?" he said again.

The medicine intern angled his head toward the door to Hallway Two and David walked out at a fast clip. Bronner slumped in a chair near the door to Exam Eight. Jenkins stood over him, sipping coffee from a Styrofoam cup.

Jenkins looked at David with more concern than anger, which sent David's anxiety through the roof. He strode toward the door and shoved it open.

Diane lay on the bed inside, her forehead and right cheek blistered in streaks and patches. A series of raised white bubbles ringed her right eye.

David stepped forward, dazed, his hand swiping the air several times before finding the back of a chair. He leaned. A tingling warmth spread across his face, and he blinked hard several times to strike preemptively against tears.

Diane looked away. "That bad, huh?"

He knew his voice would be unsteady, so he waited a moment to speak. "No," he said. Fighting to keep his emotions from overwhelming him, he crossed to her bed, dragging the chair along with him. She still didn't meet his eyes. He wanted desperately to touch her, to caress her face, but could not. Her hair, still wet from saline irrigation, had darkened the pillow. He took her hand, and she let him.

He sat at the side of her bed.

"You just missed plastics. Can't do anything acutely. Probably have some scarring, but no disfiguring contractions. Neosporin and Silvadene, blah blah blah. Wait and see. Should be fine." Head still turned, she laughed to herself, a nasty little laugh. "Wait and see."

"Ophthalmology?" David asked, still not trusting his voice to form longer sentences.

"Hourly Pred Forte, Cipro four times a day. Mild corneal epithelial erosion, faint anterior stromal haziness, no ischemic necrosis of perilimbal conjunctiva or sclera." She shook her head. "Words. Lots of words."

"Prognosis?"

"I should have little or no corneal scarring." She raised an index finger and twirled it lazily. "Whoopee."

David exhaled, relieved. "You're very lucky."

"Lucky. God, do we sound that stupid to people who come in here? I don't feel lucky, David."

He weathered her burst of anger quietly. She was entitled to it. After a moment, he asked, "Where did he…?"

"Emptied out medicine gelcaps, filled them with alkali crystals. Then, he broke into my place, unscrewed my showerhead, and stuck them behind there. Hot water melts the capsules. Presto. Liquid alkali."

"Who thinks of that?" David asked in disbelief.

"I hate to confess I find it somewhat ingenious. If he'd just packed the showerhead with straight crystals, it would've clogged up, or I would've noted the immediate change in water color. Of course, it was slightly diluted, which is why I can see you right now."

He picked at the skin of his cuticle, drawing blood. "That bastard. That sadistic bastard." He stood up and paced around the room. "This is my fault."

"This isn't your fault, David." Her face remained turned away. "Pardon my manners, but I don't really feel like being comforting right now." Her voice softened, though she still didn't turn to him. "It's a fucked situation. Let's use it for what it's worth. You told me he sensed you and I were close when I burst in on you in his room in the ER. He probably did this to piss you off or get back at you for something. I'd guess that I'm actually irrelevant."

David stared at the back of her head, admiring her, still waiting for the heat to leave his face.

"It's a more elaborate setup," Diane continued. "Not to mention a tedious, time-consuming one." Her voice colored with acrimony. "Our little boy's growing up."

David tried to think, but couldn't find his way through the jumble of his emotions. He walked over and stood beside her bed. "Look at me."

"No." Her shoulders began to shake.

"Diane. Look at me."

Her voice, tiny like a child's, was wrenched high. "I can't."

Crouching, he reached out and touched her unmarred chin, ever so gently, and turned her face to his. The blisters were slick and shiny with cream, and they leaked a pale yellow fluid.

She tried to turn her face away, but he didn't let her. Her lips were trembling so hard she could barely speak. "I look repulsive. I must look repulsive to you."

"We're beyond that, Diane." His voice was hard, reprimanding. She wavered on the verge of tears, her face fighting itself. "I've scraped out bedsores," he said. "I've packed infected abdominal wounds. I've cut into gallbladders that spilled green bile. I've seen enough of the human body for six lifetimes-seen enough to know not to take it literally." He leaned forward, his face inches from hers. She met his stare, her eyes green and smooth. "You are as beautiful as you have ever been," he said.

She reached up with trembling fingers, took his hand, and pressed it to her chest.

The gray sky had given way to showers. After ducking the press outside the hospital, David drove home carefully; the anomalous bursts of rain of the past few days had brought the oils to the surface of the roads. He watched the windshield wipers beating double time, trying to let them clear his mind. Puddles spotted the dark streets like pools of oil. The roads were deserted; the rain had even driven the dogged Tibet picketers from the sidewalk outside the Federal Building.

He had wanted to stay with Diane through the night, but found he couldn't. He held a reservoir of strength for such things-pain steeped in personal emotion-and for the past two years, his wife's memory had drawn steadily from it. Thoughts of Diane worked on him from the inside, guilt and fury searing him.

He thought of Clyde's dull, flat head, the odd, decaying odor of his body, like rotting wood, the fat fingers that rubbed and slid among themselves like rodents clustering for warmth. David imagined him holed up in a dark room, lurking and plotting and healing, wrapped in a blanket of unutterable sorrow. Clyde's wiring was off. He was broken.

David's medical ethics seemed distant right now, stolid and brittle like shelf things. He recalled Yale's aspersion-you don't know much about how things work on the street-and it stung like a virgin blow. David had been a child playing with a loaded gun. The most painful thing of all was that he'd suffered none of the consequences himself. Diane had.

The Mercedes's tires whipped through puddles, sending water hammering up on the undercarriage of his car. Through the bleary windshield, he saw flashing red lights ahead on San Vicente. An ambulance had pulled over near the lawned median, beside a car that had skidded off course and smashed into one of the gnarled coral trees.

Digging in the pocket of his white coat for his stethoscope, David pulled over behind the ambulance. A woman lay on her back in the grass, two EMTs kneeling over her with a backboard.

David sprang out, his shoes pooling with water as he splashed through a puddle to his trunk, where he kept his father's old-fashioned leather doctor's bag for emergencies. "Do you need any help?" he called out.

One of the EMTs delicately wrapped a C-spine collar around the woman's neck and secured it with a strap across her forehead. "We got it covered," he said.

"Did you check her airway?"

"We got it under control, buddy."

David pulled to a halt, his stethoscope dangling from his hand. "I'm an ER doctor."

On a three-count, the two EMTs raised the backboard and headed back to the open doors of the ambulance. A moment later, the vehicle was off, siren screaming.

Behind him, David heard the pinging open door alert from his car. The ambulance faded slowly from view. He stood in the rain, the crashed car steaming before him, water dripping from his hair and running over his lips.

He didn't feel much like going home.