by Gary Birken
Even though it was not a response she was accustomed to hearing, Judy simply smiled. “If you’ll just fill out both sides of the form, Dr. Hawkins will be with you shortly.”
Clipboard in hand, and with the assistance of a brandy smuggler-styled cane, Gideon hobbled across the waiting room and took a seat on a dark green upholstered couch. It had taken him two hours to prepare for his appointment with Dr. Hawkins. He had set his alarm for five to allow himself ample time to dye his hair, apply foam latex to his cheek-bones, and affix a gray artificial mustache.
When he finished filling out the form, he reached into the inside pocket of his sports coat and removed a paperback book of advanced crossword puzzles. Over the past month he had completed most of them, leaving him only the last few to work on.
At that moment, Carrie Alexander, Dr. Hawkins’s physician’s assistant, stepped into the waiting room. “Mr. Artesian?” she asked, glancing around the room.
Gideon caught her attention by raising his cane. “I’m Stuart Artesian.”
She took a few paces toward him. “We’re ready for you.”
Carrie escorted him down a long corridor and then into a nicely appointed examination room where she helped him onto a table. While he was getting settled, she read his patient information sheet.
“You mentioned you were referred to our practice by Dr. Connolly.”
“That’s right.”
“Would that be Morgan Connolly?” she asked.
“Yes. She was the emergency room doctor who took care of my hand.”
“Are you sure?”
With a smile he said, “I may be getting old and senile, young lady, but I can still remember the names of the doctors who treat me. I liked Dr. Connolly very much. When she told me she was referring me to her father and that she chaired the hospital’s Patient Safety Committee, I was very comfortable.”
“I’m sorry. I didn’t mean to . . .”
“Don’t you accept ER patients?”
“Of course,” Carrie was careful to answer, still a little perplexed. She knew Dr. Connolly never referred patients from the emergency room to her father. She didn’t know why exactly, but she was pretty sure it had something to do with hospital politics. Instead of trying to explain a difficult situation to Mr. Artesian, she moved on. “How did you hurt your hand?”
“It was stupid, really. I was in my garage trying to pull down some heavy boxes from an eight-foot shelf. I did okay with the first one, but I lost my grip on the second and it pinned my hand against the wall as it fell.”
Carrie made notes as they spoke. “How long ago did this happen?”
He thought for a few moments. “I’d say about a month now.”
“And is the pain is getting worse?”
“Definitely, and the swelling has never completely gone away,” he answered, gently rubbing the back of his left hand.
“I noticed you walk with a cane.”
“Oh that—it had nothing to do with the accident. I’ve had arthritis in my right hip for more years than I can remember. My family doctor told me I’ll eventually need a hip replacement.”
Before Carrie could ask her next question, the door opened.
“Mr. Artesian. I’m Dr. Hawkins.”
They shook hands.
“Actually, it’s Dr. Artesian.”
“My apologies. Are you a physician?”
“No, but I was accepted to medical school. I decided to get my PhD in anthropology instead. I felt that teaching at a college level would be a more sensible life. I’m a full professor at the University of Miami.”
“Do you live in Coral Gables?”
“Ever since I moved to Miami.”
“What brings you all the way up here? There are a number of excellent orthopedic surgeons in South Miami,” Hawkins inquired.
“I only see doctors who are on staff at Dade Presbyterian.”
“Why’s that?”
“I’m a thorough man, Doctor, and I’ve done my homework when it comes to patient safety and hospital mistakes. To put it bluntly, your medical staff’s the best of a bad lot.”
“What brought you to that conclusion?”
Gideon paused just long enough to move his cane a little closer. “Have you read the Institute of Medicine’s report on medical errors?”
Being quite familiar with the landmark publication, Hawkins answered, “As a matter of fact, I have.”
Gideon rolled on, “Then you must know that this country’s hospitals are hopelessly unsafe. Do you realize that simply being admitted to a hospital is now the eighth leading cause of death in this country? It doesn’t even matter what’s wrong with you. In England, a patient has a one in three hundred chance of dying from a preventable medical error.”
Hawkins rolled up a chair and sat down directly in front of his verbose patient. He then took his hand, turned it palm down, and began his examination. Hawkins was old school and had lived through a lot of changes in medicine. Overly familiar, opinionated patients were no longer an oddity in his practice.
“Does that hurt?” he asked, checking each finger and its range of motion.
“A little.” Hawkins nodded and continued his examination. He hoped the brief silence meant his new patient had nothing further to say on the topic of patient safety. “I’ll tell you something else,” Gideon said, dashing Hawkins’s hopes. “It’s the patient’s responsibility to make sure that he or she is safe. I wouldn’t be admitted to any hospital unless I knew its Code Fifteen history.”
“Code Fifteen history?”
“You seem surprised.”
“It’s not a term I hear patients use very often.”
With a patronizing smirk, Gideon lowered his head and chuckled.
“Just because the medical profession wants to put a fancy name on its catastrophic errors doesn’t mean the general public won’t figure it out.” Gideon glanced over at Carrie and then cleared his throat. “Excuse me, Dr. Hawkins,” he began with a note of trepidation in his voice. “There’s another matter of a more personal nature that I’d like to talk to you about.”
Taking the less than subtle hint, she came to her feet and headed for the door. “I’ll go check and see if the X-ray’s ready. I’ll see you over there, Mr. Artesian.” Just before she closed the door she exchanged a bemused look with Dr. Hawkins regarding their self-important patient.
Gideon waited another minute before asking, “Do you love your daughter?”
“Excuse me?”
“The only reason I ask is because I loved my sons. I’ve been spending a lot of time these past months trying to figure out why your daughter decided to become a doctor. I mean, most people who make that choice have a conscience. They don’t make callous mistakes and then deny responsibility for them.”
Astonished more than angered by his patient’s inflammatory comments, Hawkins stopped his examination and chanced a look. The supercilious grin had run from Gideon’s face, leaving it pinched with rage.
His bewilderment soaring, Hawkins locked eyes with Gideon in a frigid silence.
CHAPTER 7
Before Hawkins could speak, Gideon’s open hand shot past him like a hot piston.
Hawkins had no time to react before he felt the back of his collar being grabbed. At the same moment, he saw Gideon’s opposite hand coming straight for his mouth. As if it were the next move in a precisely choreographed dance, Hawkins found himself being spun around with such extreme force, he felt as if he were made of papier-mâché.
With his back now slammed against Gideon’s chest, his first instinct was to scream. But Gideon had already cupped his mouth shut with the palm of his hand. He tried anyway but all he could manage was a frantic series of muffled groans. Hawkins felt Gideon’s forearm sliding down beneath his chin and onto his neck. Consumed with terror and now breathless, he was powerless to move under the death grip of Gideon’s raw strength. Hawkins felt the man’s arm tightening around his throat like a hungry constrictor. Still conscious, he could f
eel his windpipe being flattened.
Hawkins’s field of vision contracted into an infinite blackness. The asphyxiation turned the whites of his eyes bloody from tiny arterial ruptures. His brain, exhausted of its vital supply of oxygen, began to swell. His pupils then rotated up in their vacant orbits and his facial muscles became flaccid.
Gideon was tempted to finish what he had come to do by simply maintaining his stranglehold for another couple of minutes, but being a man of discipline, he decided to stick to his plan and resist the temptation to choke Hawkins to death. He released his grip, allowing the doctor’s body to crumble to the floor. He observed the unconscious man for a few seconds to assure himself he was still breathing before reaching for his cane. Training his eyes on Hawkins’s pallid face, he unscrewed the top and turned the hollow walking stick upside down. Using his index finger, he slid out a what appeared to be a simple apparatus consisting of a clear plastic tube attached to a large-bore medical needle. He uncapped the needle and set the device on the examination table.
Gideon stole a glance at his watch. He then reached into the inside pocket of his sports coat and removed a metal cylinder that was about the size of an ordinary flashlight. The device, which was sold under the name of Life Support, was a five-minute supply of emergency compressed air used by scuba divers. Gideon had considered a number of different ways to kill Allen Hawkins, but a massive collapse of his lung seemed the most fitting.
Completely focused on the task at hand, he attached the plastic tubing to the cylinder and then knelt down. Using his fingers to guide him, he located the space between Hawkins’s ribs at the level of his right breast. Gripping the needle between his thumb and index finger, he easily slid it through the space and into Hawkins’s chest cavity.
Confident in its position, he pushed the button on the Life Support system initiating an immediate blast of compressed air into Hawkins’s chest cavity. The first effects were apparent within seconds. The high pressure created by the compressed air collapsed his lung like an accordion. As the pressure built further, it squeezed his heart against his chest wall, severely restricting its ability to pump blood. Hawkins’s slow but effortless breathing instantly turned to a series of coarse grunts. His neck veins, engorged with oxygen-starved blood, appeared as if they would burst at any moment.
Gideon reached for his victim’s hand. While the Life Support continued to empty its air with a barely audible hiss, he felt for the old man’s pulse. It was threadlike, markedly irregular, and failing rapidly. Coming to his feet, he stared down at Hawkins. His face and lips were cobalt in color from the unremitting cyanosis. Gideon turned off the flow of air and pulled the needle out of Hawkins’s chest. He then detached the plastic tubing from the Life Support and put it back in the cane. Next, he replaced the canister in his pocket. He checked his watch again. Two minutes and fifty seconds had elapsed from the time he had snatched Hawkins into his death grip.
Pleased with the ease of his plan’s execution, Gideon reached into his pocket and pulled out a folded sheet of white paper. He looked around for a moment before setting it down on the countertop in plain view. Without so much as a backward glance, he picked up his cane and calmly strolled over to the door. Before reaching for the handle, he closed his eyes and used the next few seconds to force a horrid look of shock to his face. He drew a deep breath, flung the door open, and limped out into the hall. Looking around wildly, he spotted Carrie at the far end of the corridor.
“Dr. Hawkins collapsed,” he screamed, while gesturing wildly at her. “I don’t think he’s breathing.”
Carrie, with two other staff members right behind her, charged down the hall. They flew past him but stopped in the doorway for an instant before rushing in.
“Call nine-one-one,” Carrie yelled.
“He was fine,” Gideon insisted in a booming voice from the hallway, “and then, all of a sudden, he grabbed his left arm and fell to the ground.”
When the pandemonium reached its crescendo, he moved off to the side. By this time, Carrie and the others were huddled around Hawkins, who was twisting and jerking from a major convulsion. Using the chaos of the moment, he made his way back down the corridor and then out to the waiting room. An unintelligible buzz filled the room from the anxious patients all craning their necks trying to figure out what the commotion was about. Acting as if nothing were amiss, Gideon walked out of Allen Hawkins’s office and rode the elevator to the first floor.
Leaving the building through the main entrance, he climbed into his car and started for home.
Entering through the garage, he went directly to his bedroom and removed his disguise. When he was finished he went downstairs to the kitchen. Fancying himself a gourmet cook, he opened the refrigerator and took out a large bowl of eggs. Devoid of any remorse regarding the morning’s events, he meticulously began preparation of a crabmeat omelet. Watching it cook, he became filled with a powerful sense of righteousness regarding his achievement.
At the same moment he savored the first bite of the omelet, the paramedics were racing the stricken doctor across the street to Dade Presbyterian’s emergency room. He had no pulse or blood pressure and they were performing full CPR.
By the time Gideon had finished cleaning up the kitchen, Charles Barnes, the ER physician on duty, had already pronounced Dr. Allen Hawkins dead.
CHAPTER 8
From her terrace, seven stories above the Intracoastal Water-way, Morgan gazed down at the myriad of unhurried pleasure boats making their way up and down the man-made inland passageway.
Enjoying her first full day off in two weeks, she absently massaged her lower abdomen. When she looked down and realized what she was doing, it brought an immediate grin to her face. She imagined that most women facing the likelihood of a divorce wouldn’t embrace the news they were pregnant. But Morgan felt that irrespective of what the future held for her, she was overjoyed at the prospect of being a mother.
After taking the last few sips of her cranberry juice, she stepped back from the railing and checked her watch. Annoyed at herself for losing track of the time and running the risk of being late for her first yoga class, she hurried back into her living room and grabbed her purse from a smoke glass coffee table. She was halfway to the front door when her pager went off. She glanced down at the digital display. It was the emergency room—the last place she wanted to hear from. After an aggravated groan, she picked up her cordless phone and dialed the number.
A man answered on the third ring. “This is Dr. Barnes.”
Barnes was the vice chief of Emergency Medicine. He was an accommodating and even-tempered man who had always been supportive of Morgan’s agenda as the department chief.
“Hi, Charles, it’s Morgan. Somebody paged me.”
“I paged you. Are you in the hospital?” he asked in an unusually serious tone.
Fearing she was in peril of missing her yoga class, she said, “C’mon, Charles. This is my first day off in weeks. Whatever the catastrophe is, can’t it wait until tomorrow?”
“I’m not calling about a departmental problem, Morgan.”
With a measured amount of concern creeping into her voice, she asked, “You sound awful. What’s going on?”
“I’m afraid it’s your father.”
“My father?” she grumbled with relief. “Don’t tell me he yelled at one of the nurses again. I told him the next time he did that I wouldn’t be able to save his—”
“Morgan, your father was attacked in his office a little while ago. The paramedics brought him straight here.”
Her purse slipped from her hand. She fell into the couch. “Attacked?”
“At first I thought he had had a heart attack or stroke. But when I saw the marks on his throat . . .”
Morgan clamped down on the receiver, sending every muscle in her hand into spasm.
Desperately trying to maintain her composure, she asked, “Is . . . is he okay? Have the trauma surgeons seen him? It doesn’t matter who’s on call today,
he’d want Katz or Fairland called.”
After a difficult pause, Barnes said, “When he arrived, he was in full cardiac arrest. We . . . we tried to . . . I’m so sorry, Morgan. We tried everything. We just couldn’t get him back.”
With the finality of the words reverberating in her head, Morgan found herself helpless to move or speak. She heard what Charles had told her, but she couldn’t fully process it.
Finally she uttered, “I . . . I don’t—”
“May’s our charge nurse today. She said she’d come get you.”
A few more seconds passed. Feeling as if everything was happening in slow motion, Morgan whispered, “No, I’d prefer to drive myself.”
Her hand opened and the phone fell out. She glanced at her credenza where she had displayed a dozen or so framed photographs. Her favorite was the one of her father and her taken in Park City, Utah, on a skiing vacation.
Involuntarily, Morgan’s eyes closed. The thought that Charles Barnes’s phone call was some horrible mistake or awful nightmare from which she would soon awaken never entered her mind. As inconceivable as it was, she knew her father was gone. Having the presence of mind to slow her breathing, she waited a minute before reaching for her purse.
She hadn’t taken more than a few steps when she suddenly felt light-headed. Stopping for a few moments, she steadied herself against a high-backed chair. When she felt her legs under her again, she took a few cautious paces toward the entranceway and summoned the elevator.
She exited the building and got into her car. It wasn’t until she pulled away that the unthinkable reality of the situation finally got the better of her, leaving her frantically sobbing.
CHAPTER 9
It had been twelve hours since he had murdered Allen Hawkins.
Alone in his den, Gideon considered himself living proof that any rational man was capable of murder. He gazed over at the ornate grandfather clock that had taken him twelve months of painstaking work to restore. It was a hobby that most men would find tedious but one he embraced for just that reason.