(Originally published with the title, Do No Harm)
DR. GEORGE LATHAM pulled the inner core of the biopsy probe from the outer sleeve and handed it to the scrub nurse, his eyes fixed on the small amount of blood welling from the sleeve’s opening.
This didn’t happen often, but when it did it always stopped. And today, it had to, because as deep as he was in this child’s brain, if it didn’t, there was nothing he could do.
To Latham’s left, Dr. Christopher Timmons, present for the inaugural operation that signaled the final phase of everything they’d worked for, sensed something was wrong. He leaned over and whispered through his mask. “Does it always bleed like that?”
Latham gave him such a sharp look, Timmons took a step back. Now he knew for sure… the bleeding was unexpected.
Ten seconds later, as blood continued to issue from the sleeve, the beep of the pulse oximeter slowed, and its tone dropped. Both Latham and Frank Michaels, the anesthesiologist, looked at the heart monitor, where the beat was still steady.
“George, do we have a problem?” Michaels asked.
Before Latham could answer, the child’s pulse fell below the warning setting on the oximeter, and the beep became a continuous buzz.
“Talk to me, George,” Michaels pleaded. “Can you handle this?”
Latham turned to his scrub nurse. “Get me a 10-cc syringe, filled with saline.”
Latham’s voice was calm, and he seemed under control, but Timmons was finding it hard to breathe, and there was a metallic taste in his mouth.
The nurse brought the syringe, and Latham discharged a small amount of saline into the biopsy sleeve, hoping to wash out the blood clot he knew was forming in the child’s brain. Blood diluted with saline kept coming, but no clot.
As the child’s blood pressure continued to fall, Michaels thumbed the IV lines to full open and poured fluids in, trying to compensate. “Is it a big bleeder?” he asked. “Is that the problem?”
“You just concentrate on keeping this kid alive,” Latham said. “I’ll handle the surgery.”
Timmons glanced at the heart monitor. Although he was the laboratory arm of their enterprise and wasn’t accustomed to reading heart rhythms, even he could see that the tracing was becoming abnormal. Then, to his horror, the tracing suddenly flatlined, setting off the EKG alarm.
With the patient crashing, Michaels assumed control, shouting orders. “George… get on her chest…” Then, to the circulating nurse standing out of the sterile field, “Doris, call Doctor McCloud and get some more hands in here.”
In seconds, help flooded the room. Being untrained and useless, Timmons took up a position against the wall and out of everyone’s way, the stink of fear pouring from his skin.
For the next thirty minutes the team that had formed so quickly fought off the child’s impending death with the same ferocity they’d have shown defending their own lives. Finally, after failing to get a single heartbeat in all that time, Latham looked into the child’s eyes and announced what no one wanted to hear. “Pupils fixed and dilated.”
The action stopped in freeze-frame. In a flat monotone, Latham made it official. “Let’s call it.” He yanked his mask down and looked at his scrub nurse. “Lee-Ann, finish up here, will you?” Stripping off his gloves, he turned and headed for the door, throwing the gloves against the wall as he left.
Timmons followed Latham to the locker room. Once he was sure no one else was there, he stood beside Latham, who was already taking off his scrubs.
“George… the kid died,” Timmons said.
Latham looked at him with hard eyes. “I don’t need you to tell me that.”
“It’s an omen, George. We should stop now.”
Latham suddenly grabbed Timmons by the arms and shoved him against the lockers. “It is not an omen. This was just a chance occurrence. It won’t happen again.”
“But there’ll be an inquiry…”
Latham let Timmons go and returned to changing his clothes. “Which will find nothing.”
THREE YEARS LATER
IF ANYTHING, THE spot where George Latham had touched Lee-Ann on the shoulder had become even warmer and more tingly by the time she reached home. Moreover, it had been augmented by the most delicious prickly sensation between her thighs.
What a fool she’d been. He did care. Those hours she’d spent hating him for his indifference… the days. All without reason.
Her imagination frequently got her into trouble. But even knowing that, it was hard to avoid the trap. Often, she didn’t see it until it was too late. That’s the way it is with your imagination.
Trying to ignore the other feeling, the unpleasant gnawing anticipation higher up in the pit of her stomach, prompted by what she must do in less than two hours, Lee-Ann carried the tissue retractor she’d stolen into the bedroom. At the dresser, she opened the bottom drawer, which was filled with bagged and dated instruments from each of the operations in which she’d assisted since joining Latham’s team, minus, of course, any from those that had taken place during the times when she hated him.
She dated the new plastic bag with a marker from the top of the dresser then added the bag to the others and stood for a moment admiring her collection. It was like owning a part of him.
She wanted to linger and spread all the bags out on the bed in chronological order, reminisce about each case and picture him working, but there was no time.
It was now time to think.
She went to the bed, sat on the edge, and closed her eyes, trying to see the physical layout of the eight-story parking garage adjacent to the restaurant where she was to meet Greta Dunn. Dunn would almost certainly never find a place for her car on the street, and, if she did, the maximum time on those meters was only fifteen minutes. That meant she would surely choose the garage. So that was the scenario Lee-Ann thought about.
In short order, the same imagination that had gotten her into this spot showed her a way out. It wasn’t a perfect plan, but given the circumstances, it seemed to offer the best possibilities.
She would need paper for signs. But how many?
She thought there were only two elevators, but there could be three. Better to over-plan than be caught short. Did she even have any paper?
A frantic search turned up something better—three old jumbo Christmas cards, which, along with a roll of adhesive tape, she took to the bedroom. There, she ripped the front halves off the cards, and with the Magic Marker she’d used to date the bag containing the stolen retractor, jotted the same three words on the back of each card.
She put the cards and the tape in her handbag.
One more item, and she’d be ready to leave. But what item?
She went to the kitchen and pulled out the drawer containing the tableware. While considering the choices laid out before her, she remembered her late father’s old toolbox in the basement, which contained just the trick. But she’d have to change handbags. Go with the straw beach bag.
But it was fall, and straw was out of season. In the end, deciding that being in fashion was the least of her worries at this point, Lee-Ann packed everything in the straw bag.
Was that it? Did she have everything? Latham had put her in charge of supplies, and it was her job to make sure they always had plenty of everything on hand, which she was very good at. But this was different. And she found her mind clouded and disorganized.
Gloves… of course.
She added a pair of thin tan gloves to her bag, then leaned into the mirror and fussed with her hair.
Lee-Ann hated her appearance, those fat cheeks that resisted every diet she’d ever tried. She could get almost anorectic, and those cheeks would never change. When most women smiled, they looked more attractive. But not her. Oh, no, not Lee-Ann. She looked like a demented chipmunk.
It was genes. Some people get good ones and others, like her, get the pot scrapings. That was why she’d coated all the mirrors in the house with hair spray, leaving only a few small clean spots where she could do her hair or lipstick without being reminded of the total obnoxious picture.
And there were only two people responsible. There were times when she missed her parents, and times when she worried about how arsenic could be found in tissues many years after death. But mostly, she felt nothing toward them and barely remembered what they’d looked like.
LEE-ANN ARRIVED at the garage twenty-five minutes before her meeting with Greta Dunn, who was driving into New Orleans from Baton Rouge. She took her ticket from the automated dispenser and started looking for a parking place.
The restaurant where they’d agreed to meet was one floor below street level in a ten-story medical arts building so busy that only rarely could a space be found on the garage’s lower levels. Today was no exception, and Lee-Ann had to go up to level E before locating a spot.
She didn’t know what kind of car Dunn owned, but even if she did, she wouldn’t have been able to stand on level E and watch the street out front for it because the woman might find a slot on a lower floor. There’d be nothing she could do then.
Her heart tripping, Lee-Ann hurried to the elevators, which she noted were two in number, just as she had remembered. She took the right member of the pair down to ground level, got off, and positioned herself beside a white van where she could see the driver of every entering car as it passed, but she would not be visible unless the driver looked to the left.
Lee-Ann had listened through the door when Dunn had her preoperative discussion with Latham. And she’d seen the woman at her son’s bedside before leaving him in Latham’s care. In both instances, Dunn had been composed and in control of herself. Next to beauty, Lee-Ann admired toughness more than any other trait, and Greta Dunn seemed to have that in spades. That was why when Lee-Ann was wondering who could create the most trouble for Latham, she’d thought of Dunn.
It was raining hard now, and gusts of wind were blowing in through the open front of the garage, soaking the entry ramp. Behind Lee-Ann, a burgeoning waterfall seeped copiously from a supporting beam overhead, splattering the cement retaining wall behind her.
A car passed into view from the entry, and Lee-Ann was pleased that she had no trouble seeing the driver clearly, even though he’d put up his window after taking his ticket. To get a feel for how things would go when Dunn arrived, she moved down the van to where she was still concealed from anyone entering and watched the car that had just come in.
When it turned at the end of the garage and started back up the ramp behind her, Lee-Ann realized that her plan was in major trouble. If Dunn didn’t find a slot on the ramp behind her and had to go up several floors, it was going to be hell keeping up with her.
Lee-Ann studied the wet retaining wall behind her. She’d have to scale that wall. Then…
Hearing another car coming in, Lee-Ann turned to get a look at the driver, praying it wasn’t Dunn. It was too soon. Her plan needed shaping.
The sharp clang of a ticket issuing from the dispenser rang through the garage. A pause was followed by the simultaneous sounds of a power window closing and the car’s engine revving.
The sound came closer, and the front wheels rolled into view. The hood…
It was her.
The first car that had come in had gone up to a higher level, so Lee-Ann knew there was no slot on the ramp behind her. Springing into action, she threw her straw bag up to that ramp, stepped onto the van’s bumper, and grabbed the horizontal steel cable that bisected the opening above. Receiving a healthy spattering from the indoor waterfall, she pulled herself onto the cement wall and dropped to the floor between a pickup and a convertible as Greta Dunn’s car passed, heading toward the elevators.
Lee-Ann scraped her knee going over the wall but was barely aware of it as she snatched up her bag and hurried after Dunn’s car, her mind focusing on the fact that if Dunn found a parking spot on this floor, there’d be no way to get to the elevators before she did. And that would be disastrous.
But the floor was fully occupied, so when Dunn reached the elevators, she turned left and went up to the next level. Afraid she would lose her, Lee-Ann broke into a run.
By the time she reached a point where the sloping floor on the next level was low enough so she could climb over that retaining wall, Dunn’s car was turning onto level C. Lee-Ann gave chase, her throat already raw from all the air she’d taken in through her mouth.
Going over the next wall, the metal cable snagged her coat. Now Dunn’s car was once again between Lee-Ann and the elevators. But once more, the floor was full.
Doubting she could keep this up much longer, Lee-Ann chased Dunn’s car up to the next ramp, where, as before, every spot was taken. Soon they’d be on the floor where Lee-Ann had parked. She should have just waited up there.
She wasn’t sure she could climb another wall. But the thought that she was protecting her man propelled her forward.
Miraculously, a few steps later, looking through the gap where she could see up to the next ramp, Lee-Ann saw an empty slot at the far end of the garage. She waited just long enough to be sure Dunn wasn’t going to do something crazy like pass it up, then she turned and bolted for the elevators behind her.
There was so little time…
The elevators she was heading for were one level below the ramp where Dunn was parking. And Lee-Ann needed to be on the same level. Elevators or stairs—which would get her there the quickest?
Sometimes you could wait forever for an elevator… and she didn’t want Dunn to see her get off one. So she took the stairs, her footsteps and ragged breathing echoing in the closed space.
Twenty seconds later she burst into the lobby a floor above, just as an old man in a green John Deere cap stepped off one of the elevators.
Damn. Had Dunn seen that the elevators were working?
Lee-Ann looked through the glass enclosing the lobby and saw Dunn on her way, the slight incline causing the woman’s head to tilt slightly down, so her gaze was more on the floor than straight ahead. There was a chance…
The OUT OF ORDER signs she’d made from the jumbo Christmas cards were now useless. There was no time…
Lee-Ann dropped into one of the blue plastic chairs beside the elevators, put her bag in her lap, and let her chin fall to her coat, trying to slow her thudding heart and gain control of her breathing.
If only no one else gets off the elevator…
Ten seconds later, Greta Dunn stepped into the lobby, walked to the elevators, and pushed the down button.
“They’re out of order,” Lee-Ann said without looking up. “You’ll have to use the stairs.”
Lee-Ann watched Dunn’s feet to see what she’d do.
For a moment, Dunn didn’t move. Then she headed for the stairs.
As soon as Lee-Ann heard the stairwell door close, she jumped out of her chair and followed. When Lee-Ann entered the stairwell, Dunn was halfway down to the first landing. She didn’t look up.
From that point on, everything Lee-Ann did was instinctual. No weighing of alternatives or consequences, just raw response. The door behind her was still shutting as her hand found the ice pick in her bag. A heartbeat later, her feet thudding on the stairs, she closed in.
Hearing the urgency in Lee-Ann’s approach, Greta Dunn turned and looked up. Without hesitating, Lee-Ann brought the ice pick down in a looping overhand stroke, burying the pick to the handle in the top of Greta Dunn’s head.
Eyes wide with surprise, her mouth open, Dunn stared into Lee-Ann’s face.
Fearing that the pick might not have done enough damage, Lee-Ann rocked the handle from side to side, horribly scrambling Greta Dunn’s brain. She then raised her foot and kicked the woman down the stairs.
When the body came to rest at the door to the next level, Lee-Ann could tell from the odd angle of the head that Greta Dunn’s neck was broken.
Lee-Ann’s training told her to make sure, to check for a pulse. But she’d already pressed her luck too far. Afraid that at any moment someone might find them, she fled.
Later, driving home through the rain, Lee-Ann felt so close to Latham. Even though he didn’t know it, they now shared something very special. The only blemish on the moment was that she’d had to carry a straw bag out of season.