Shoot Not to Kill

by Daniel L Stephenson

  “Derek, can we do that? Can our digger come here?” Colin asked.

  “Sure. He’d love it. I’ll check on that, Ms. Yost. I need a contact to call to get someone back in your system. You will need to tell that contact not to divulge what we’re looking for. I may have to gag them, too. Getting pretty handy with that paperwork,” Derek said. “But I’ll have the digger here within a couple hours.”

  “This will start a clock on your work. Keep me in the loop, would you please?” Ms. Yost said as she started from the room.

  “We will, thanks,” Derek said as he turned toward the back door to the conference room.

  Michelle started to talk but noted a glare from Derek and remained quiet.

  Chapter 7

  Dr. Bishell Away From Patients

  Ms. Yost called her secretary. “Sandy, I need some overtime. We need a meeting in two hours. Yeah, Credentials Committee and counsel. Has Mr. Crawford resigned? Why am I not surprised. No, never mind, you don’t want to know and will soon enough. OK, call in whoever replaced him, then. Thanks. My office is fine. Oh, yes, thoracic surgery chiefs too. OK, thanks, I owe you one. Bye.”

  The first to arrive was a young lawyer from the firm the hospital had used for forty years. Mr. Crawford had been hospital counsel for the last fifteen years. A young Mr. Reynolds arrived thirty minutes later.

  “Mr. Reynolds, you are now counsel for the hospital from the same firm that Mr. Crawford works at. What reason did Mr. Crawford give you for leaving a position he enjoyed for many years?” Ms. Yost asked as the lawyer walked into her office.

  “I was given this job and told to carry the card. I was not afforded an explanation. Should I have been?” the young lawyer asked as he stood near the door.

  “Do please come in, and that is what we’re both about to find out. What is your experience with hospital corporate jurisprudence, may I ask?”

  “I’ve been specializing in malpractice defense for ten years. I am now out of the trenches and into the boardroom. Our firm hired several young lawyers to work malpractice and kicked me up to partner level, and here I am. I do not know a great deal about the internal workings of the hospital, but I do know the credentials process as having defended this and other hospitals on questions of their staff. What is the problem?”

  “I think we’ll cover that within the hour. I have two senior physicians coming as well as my secretary and several physicians on the credentials staff. This will be an impromptu meeting of the Credentials Committee to consider the furtherance of privileges for one of our physicians. I hear someone now,” Ms. Yost said as she went to the door.

  “Sandy, who’s here now?” she asked.

  “Dr. Cranfield and Dr. Wilkinson are here, though Dr. Wilkinson is getting coffee.” Sandy answered. “Rest of the committee is on the way.”

  “Dr. Cranfield can come in at his discretion. When Dr. Wilkinson returns, I would appreciate your coming in with him for meeting minutes.”

  “Yes, ma’am. He’s just coming in now.”

  “OK, Sandy, tell the rest of the credentials folks to wait. Gentlemen, please come in,” Ms. Yost requested.

  Ms. Yost walked to her desk and sat on the corner. She stood then and turned on several lights as the room was beginning to darken. She sat again as the two doctors entered warily.

  “Thank you for coming in at this hour. I have been approached by a member of the Los Angeles Police Department with the most outrageous discovery, which if it proves true may have repercussions on the very survival of this institution. I will just start from the top,” Ms. Yost began.

  “A pattern of attempted homicides has emerged from the LAPD Diamond Miner, a sophisticated search engine. This pattern developed a spike of insured, white males that have come through our hospital with thoracic gunshot wounds. As you to know,” Ms. Yost nodded to the thoracic surgeons, “we have recently been recognized for our survival statistics in thoracic gunshot wounds. This tool, the Diamond Miner, brought an undercover investigation into our hospital. This investigation was sanctioned by the board of directors, just before five out of nine of them resigned, as did our longtime friend and counsel, Jeff Crawford. This investigation has pointed to one physician, and events of the last several hours have created a crisis.”

  Dr. Cranfield looked at his longtime partner, turned to Ms. Yost, and said, “It’s that son of a bitch, Bishell, isn’t?”

  “Yes, it is. Events are important here, Robert. The LAPD attempted to follow a patient of Dr. Bishell’s from ER to the surgery suite, and then to the floor. They were then going to go to the crime scene and tie Dr. Bishell in there. Well, Bishell was being observed in surgery by an undercover agent who foolishly dropped her handcuffs. He’s on the lamb now, but so far without charges. Now they have had a break-in to agent’s locker in the female locker room within minutes of Dr. Bishell’s discovery of the investigation. We have a fellow that is under ongoing investigation and charges are pending for the crime of shooting as many as twenty-three people, males it seems, who have been treated here.”

  Dr. Wilkinson whistled a shrill note and shook his head, while Dr. Cranfield spoke. “Lynda, I must correct you, and it is difficult for me to tell you this, but we do not have a fellow of the Cardiothoracic Surgery Department under investigation. As of last week, we have a full member of the staff in good standing under investigation. We signed a very attractive contract with Dr. Bishell only last Thursday.”

  “How, tell me how, can this get any worse? I know it can. I know it could be much worse, but this will pull us down, gentleman. It will pull this institution down. Bob, Steve, I want Dr. Bishell’s credentials in abeyance within the hour. I want this block into the system if you have to call in the entire HIM department to get the electronic record blocked. I need action, I need an investigation, and I need it now. Dr. Bishell will have few options. They may be searching his home and car now. They have enough on him to pull him in if they can get a connection to the sites of these crimes. They will get an order for sample collection, and this will be news before the sun comes up again. So folks, what are your thoughts?” Lynda asked as she leaned back.

  William Reynolds spoke up, “Abeyance is accomplished by the chairman of the Credentials Committee, which by happenstance is you, Dr. Wilkinson. Your order is good for thirty days with a one-time extension of thirty days. This can be done legally without legal recourse on the defendant’s position if the abeyance is called for any cause for patient safety. Any of your licensed staff of providers that might be impaired by drugs, alcohol, psychiatric, or medical conditions are the common reasons. Licensure is the next most common reason. When you suspect that a provider is not currently licensed, you place that provider in abeyance until such time that the license can be verified. In this case, Dr. Bishell is not impaired, nor is he charged with a crime. He is not a felon, and he has not licensed himself under false pretenses.”

  “Are you telling me I can not pull the privileges of a suspected killer?” Ms. Yost asked as she stood and paced the floor.

  “No, I am telling you that you can suspend Dr. Bishell. I am trying to work through the process of determining the grounds for abeyance so that he cannot retaliate with litigation for loss of incorporation, which means loss of income, let alone slander. Please understand that none of these events is required. You may accomplish the action of abeyance simply for the purpose of patient safety stating that Dr. Bishell must clear these issues to resume patient care. The problem is he will have thirty days in which charges must be established or his credentials recoup. This means there must be cause to terminate the abeyance one way or the other. Dr. Bishell can sue for loss of incorporation if you can not establish a reasonable and sustaining reason for not recouping his privileges.”

  Dr. Cranfield interjected, “We can hold a meeting of the Credentials Committee and go over his credentials with a fine-toothed comb, and find some reason to fire him.”

  “Dr. Cranfield, given that you recently changed his status from
fellow to staff would suggest your efforts to find flaw in his credentials would only establish the fact that there is flaw in your processes internally. His coming on as staff, does it carry a provisional period?” Mr. Reynolds asked.

  Dr. Wilkinson ruefully laughed, “We waived that seeing as how he’s single-handedly been accounting for the majority of successful cases through the trauma committee.”

  “It just got worse,” Ms. Yost said.

  “Not at all,” Bill Reynolds said. “It will get worse as soon as the newspapers get this. That’s when your house had better be in order. Mr. Crawford said something to me when I first was pitched this job. It stuck in my mind like a penny in my shoe. He said, ‘I hope you’re up to it.’ Given the litigation and defense folder he handed to me, I thought it was a very unusual statement. Now, it seems an understatement.”

  Ms. Yost walked to the door and opened it. She leaned out and said, “Sandy, please call HIM VP in. Type up an abeyance with the statement for Dr. Bishell please, under abeyance for personal issues.”

  Ms. Yost closed the door and said to the audience, “If he’s a killer, that’s pretty personal.”

  “It would seem that he is not a killer. His intentions would not be homicide. He only intends to injury. Aggravated assault is the best I can do, at this point.” Reynolds said.

  “Make it so, I’ll have Sandy make it aggravated assault. Doctors, could you please case out your wing and floors to see if you can find Dr. Bishell. If you do, please call this number,” Ms. Yost said as she passed a copy of Derek’s card to the four of them. Finally, please respect the institution in this. I fear this will bring us all down, but it will be interesting. The full Credentials Committee will be meeting in one hour to discuss and sanctify these actions.”

  “May I ask something?” Dr. Wilkinson asked.

  “Sure,” Ms. Yost replied.

  “Did any of the thoracic patients die under Dr. Bishell’s care? If one did die, we may have murder charges if we can pin him to the site of injury.”

  Lynda Yost answered, “Let me check. I do recall there have been some fatal gunshot wounds, but I’ll have to look at the files.”

  “Mr. Reynolds, do we need a meeting of the full Credentials Committee on this matter?”

  “No, the chairman can place anyone on abeyance. Continuation past thirty days requires a quorum,” he answered. “They can meet and review at their next scheduled meeting.

  “Then we meet Monday at 10:00 in the morning if that is OK with your schedules,” Lynda suggested.

  “Noon’s only free for me,” both physicians interjected.

  “My bet is we’ll be missing a lot of lunches soon. OK, we’re done here.”

  They walked from the room, leaving Lynda Yost staring out the window into the light-sparkled hills. “Oh, Sandy, please dismiss those physicians that came in for the credentials meeting with my apologies. Tell them full explanations will be forthcoming.”

  “Yes, ma’am,” Sandy said as she closed the door.

  Dr. Wilkinson and Dr. Cranfield walked down the corridor to their office wing.

  “Bob, we’re in real trouble here. What do we do if we find him?” Steve asked.

  “First, I’m not prowling around the teaching floor at night. That’s not our job. Secondly, I think we draft a letter with the abeyance information and certify it to Dr. Bishell. Finally we have to bring in some others to keep him off the surgical floors. I’ll call the senior resident and see if I can get him involved. Security will be notified and posted on the floors. Until Bishell is cleared of all charges or suspicion we have no other choice. Do you recall our conversation earlier about our wonder boy? Odd we just talked about him. I recall our mutual amazement as to his progress. Now it looks as if we know more of the story. We’ll likely lose our jobs on this, Steve. You figured that out yet?” Dr. Cranfield asked.

  “I just don’t think so. This will be a sensation, all over the country, very likely, but we’re just clogs in the gear, Steve. Keep your head down, and don’t get caught talking to the press, and we’ll be fine.”

  “Christ, I was looking at another three years then sailing around the world. Seems like I’ll never get that now. Don’t know what to tell the wife. She’s heard a lot over the years and never been a problem with anything getting out, but this might just be too big to share.”

  They had taken the elevator down a floor for the passage to the adjacent building where their offices were located. As they entered the passage, another figure entered from the opposite door. It was Dr. Bishell.

  “Hello, Steve, Bob. What brings you two to the hospital so late?”

  Dr. Cranfield was the first to respond, “Hello, Dr. Bishell. I have not had the opportunity to congratulate you on your status as full staff.”

  “Thank you, Dr. Cranfield. I am delighted. Well, I guess it is back to work,” Dr. Bishell said as they parted.

  “Call should slow down for you now that you are on staff,” Steve said. “See you Monday.”

  As they turned to the passageway, Dr. Wilkinson said, “Quick thinking. I sure didn’t want to confront him here. What a mess. That’s for the cops. Let’s get out of here.”

  “So right. I’ll be happy to block his access, but that still leaves a big problem right now. He can be on the floor tonight and give orders through any junior resident or fellow. The abeyance can’t stop that. Bob, one of us has to stay tonight, and the other tomorrow. Also, if Bishell’s on call, he’ll have to be replaced on the duty. I’ll take call tonight unless you have any options or better ideas,” Dr. Cranfield observed.

  “Good points all. I guess you can call central paging and change the call list. I’ll pick it up at 8:00 AM and run with it through the next 24 hours. Best check the floor. You have to sign the abeyance order. Sandy is supposed to have that ready in an hour.”

  “Oh, yeah, I forgot. OK, see you in the morning. I’ll get my coat and kit, head up to the floor. If I see Bishell again, I’ll dream up something to send him home.”

  “Works for me. Think Lynda said something about the cops getting warrants out now, so things may get hot on your watch. Call me if you need to. Wholly buckets, as Lynda is fond of saying. I’ll call that cop and tell him we’ve seen Bishell.”

  As they parted, the figure of Dr. Bishell took a different exit from the corridor. Dr. Bishell started going through his pockets, discarding scraps and papers in different trash cans, finally shedding his white coat, which he dropped into a dirty linen container next to a remote staff door. He walked out of the door and stood in the entrance walkway, surveying the parking lot. It was a dark entry, and he was still dressed in scrubs, which was not unusual at all.

  Dr. Bishell thought of his father, the great surgeon of Traverse City, Michigan. Stan thought of all of the times he heard how wonderful his father was, how his father saved his friend’s life. How his unselfish father did pro bono charity work for the poor and how he contributed to every cause. Stan thought of the hours at home without a father. Of the trips they took all over the world, and he was supposed to feel so lucky to go to China when all he wanted was his father to build an airplane with him and tell him, “Good job.” Instead he had been told, “Keep your eye on Joey, your brother’s going to be something someday. You will, too, Stanley. You’re named after your grandfather, and he was a good man, but your brother, now, keep your eye on him.”

  Bishell felt for his wallet, checked that he had the key to his storage shed and walked into the night.

  Chapter 8

  Scene of the Crime

  “Geech, what did you find?” Colin asked as they returned to their temporary hospital office.

  “Dude got nailed in a bar called, ‘Cameo.’ It is about three miles from here. Transported by ambulance. Called the team that did the transfer, and they say there was nothing special about him. Same stuff. Running a search on the joint. I called Whistler and asked him if he could go in to run the Diamond Miner on it. Said he could do it from home, but I had t
o promise I wouldn’t tell anyone—not counting you two. He ran the data while I was talking to him. Got one other shooting there within the index time frame, none before that. He’s getting me names and said he’d email me those data. So we’ve got a second from the Cameo.”

  “OK, The Door wants us out there. It seems like it’s getting pretty late, though, but these joints stay open late. Call us if you come up with anything.”

  “Got it.”

  Colin and Michelle drove out to the Cameo. The bar seemed like a quiet place. They walked in and sat at the bar.

  “Coke for me, honey, what do you want?” Michelle said with a sparkle in her eye.

  “Same here. Who’s boss tonight?” he asked.

  “Me, why?” the bartender asked. He was a late-middle-aged guy with a way of watching them from the side of his eye without looking straight at them. He had a lean body and closely cut hair. His beard was well trimmed and a simple earring adorned the left earlobe. His T-shirt advertised a brand of whiskey from Tennessee.

  “My name is Colin Roach, I’m from LAPD, and I’d like to ask you some questions.”

  The bartender leaned on the inner rail and dropped a wet bar towel into a sink. “You guys don’t talk to each other? I’ve talked with two sets of yous today since that dude got nailed. What’s happening to your town? I gotta nice little place here, and now in the last year, two of my Joe’s are shot. I could lose my business if this keeps up.”

  “We’re looking at things from a different spin. What’s your name?” Colin said, taking out a pen and pad. “How long have you worked here?”

  “Lester Dennis. Been here for twelve years. Bought the place from my brother.”

  “So you know the place well. Can you tell me anything about the other shooting you had here?” Michelle asked.

  “Which one?” Dennis asked. “We’ve had several since I bought the place. Two in the last couple years.”