by Alexi Venice
“Why are two dismissed?” he asked.
“They serve as backup in case someone gets sick or has an emergency during the trial, so 12 jurors remain for deliberations,” she said.
“How do they choose the two at the end of the trial?”
“By a random drawing.”
He rubbed his whiskery jaw. “So, the jurors come from this county and are selected by the lawyers?”
“Yes and no. The lawyers can make a few strikes to eliminate jurors, but they don’t get to pick and choose. Why? Do you have a concern?” She was used to physician’s being obsessive about details, but she sensed he had something more fundamental in mind.
“Trevor McKnight is from this community, so I assume the jurors will know him as a neighbor and a friend. Why would they send him to prison for beating a Saudi student who they didn’t know and didn’t have any connection with?” His question was more of an indictment than an inquiry.
“Because it’s against the law to beat someone regardless of where they are from or why they are here. The judge will instruct the jury that they’re sworn and duty-bound to apply the law to the facts of the case. Granted, every juror will bring some type of life-bias to the case. That’s expected. However, in my experience, people follow their civic duty and hew to the judge’s instructions.”
He blinked slowly while holding eye contact, a contemplative mannerism honed in adulthood. “Does the DA think she can win a hate crime case against a Saudi student with a local, all-American jury?”
“Interesting question. Well, this is a felony murder case—not a homicide case, and not merely a hate crime case.”
“What’s the difference?” he asked.
“Felony murder doesn’t require intent. It simply requires that a death occur during the commission of a felony. For example, if I accidentally shoot you while robbing you at gunpoint, then I’m guilty of felony murder.”
“Are you saying that if Trevor McKnight only intended to hit Abdul, but Abdul died, that McKnight is guilty of felony murder?” he asked.
“Yes, if McKnight’s punch was a substantial factor in causing Abdul’s death.”
“I didn’t realize that,” he said. “I thought this was a murder case.”
“A felony murder case,” she said. “In addition, if the DA establishes that McKnight intentionally targeted Abdul based on race, religion, color, nationality or ancestry, then the punishment is increased by a fixed number of years pursuant to statute. The judge would apply that during the sentencing phase.”
“I see,” he said. “So the hate crime can add to the punishment?”
“Yes,” she said.
“Please, go on.” He rolled his hand over in the air, apparently satisfied with her explanations.
“I spoke to the DA, Dominique Bisset, and she believes she can get a conviction against Trevor McKnight. That’s why she brought the case. Like her, I believe in our system of criminal justice. It isn’t perfect, but I think it’s fair, and I think 12 people from this county can be objective and unbiased in their ability to reach a verdict.”
“What about me?” He motioned to his face.
She squinted. “I’m sorry. I’m not following.”
“With my name and appearance, similar to Abdul’s, won’t the jury think I’m exaggerating his injuries and overattributing them to the punch thrown by the white boy?”
Wow. I didn’t see this coming. She took a deep breath and chose her words carefully. “My general impression, Dr. Khouri, is that people in this community will respect your medical testimony regardless of your nationality. In my experience, jurors like and respect doctors and nurses and listen attentively to their testimony. Apple Grove residents are law-abiding citizens who abhor the type of violence that was inflicted on Abdul. I don’t think the jury will dismiss your medical explanations only because you and Abdul are both from Saudi Arabia.”
“We aren’t,” he said. “I’m from Dubai in the United Arab Emirates, Saudi Arabia’s neighbor, but we’re both Arab and Muslim.”
She nodded. “I’m sorry. I shouldn’t have assumed. Again, I think the jurors will focus on your medical testimony, not your nationality or religion.”
He stroked his unshaven chin with fingers that were reddened from being scrubbed several times per day. “Do you think I should testify?”
Her tone was serious. “That subpoena requires you to testify. If you ignore it, you’ll be held in contempt of court, and a warrant will be issued for your arrest.”
“Oh really?”
“That’s why I’m here—to prepare you and coordinate the logistics for your testimony.”
“I don’t have a choice?”
“I’m afraid not, Dr. Khouri.”
“In that case, prepare away,” he said.
“Very well. What did Abdul look like when you first saw him?”
Dr. Khouri gazed out the window, accessing his memory. “He was unconscious, had a bloodied face, and was bleeding from the back of his head.”
“Where was the blood on his face?”
“His lip and nose. His nose was a little crooked from being broken. Do you have my ED note with you?”
“I don’t,” she said.
He looked around the room for a computer. “Mind if I pull up the medical record while we talk?”
“Please do.” She rose and followed him to the computer on a table in the corner.
He quickly entered his password, and within a minute, they were looking at Abdul Seif’s chart. “Yes. He had a broken nose, but it didn’t need to be reduced, so I didn’t consult ENT.”
“What do you mean by, ‘it didn’t need to be reduced?’”
“The break didn’t cause the nose to shift out of alignment, so it could heal on its own and stay relatively straight.”
“Okay. What other injuries did he have?”
“He had a fractured skull in the occiput region.” He pointed to the back of his own skull. “Let me pull up his CT Scan and show you.”
She watched while he navigated to the images. “See this hairline fracture at the base of his skull?” Dr. Khouri pointed to the thin, white line on the monitor.
“Yes.”
“That’s the thickest part of your skull, so for that to be fractured, there has to be a pretty strong force hitting it.”
“Like a punch to the face that causes the person to fall back onto a sidewalk?”
“That would do it. There’s also a small amount of blood evident on his brain where the fracture is located.” He traced his pointer finger around the irregularly-shaped pool inside the skull. “The neurosurgeon and I watched that area closely to see if it would continue bleeding.”
“Did it?”
“No. It was more of an ooze that stopped about the time he arrived in the ED.”
“What did you do to treat his injuries?”
“Since he was unconscious, we ran our trauma protocol to assess his airway, breathing and circulation.”
“How do you do that?” she asked.
“We looked in his mouth and the back of his throat to make sure the airway was open. We listened to his lungs to see if he was pushing air, and we took his pulse. We decided to intubate him right away because the treatment for a head injury includes sedatives that depress respiration.”
“So you wanted a machine to breathe for him?” she asked, having learned that from Dr. Epstein.
“Precisely. We intubated him to assure his respirations would be steady and strong. Then we sedated him for the CT scan.”
“And, after the CT scan?” she asked.
“We admitted him to the CCU to monitor his brain for bleeding or swelling.”
“Did you take care of him there as well?”
“No. I consulted the neurosurgeon, Dr. Danielle Rice, right away, and she assumed Abdul’s care.”
“You didn’t do anything further?” she asked.
“Technically speaking? No. My medical care ended. However, I kept up on the progress of Abd
ul while he was in the CCU.”
“By looking at his medical record?”
“That, and by visiting him and calling his parents.”
She thought about that for a second. “Do you visit all of your patients after they’re admitted?”
“No. Only some. I was concerned for Abdul.”
“Why?”
“Head trauma can be deceptive,” he said. “The patient sometimes looks like he’s doing better, but then the brain swells, and the patient goes downhill very quickly.”
“Does the swelling occur right away?”
“Sometimes it can take a day or two.”
“Is that what happened here?”
“Yes. I think the care team was initially reassured by Abdul’s reaction to sedatives and rest. They extubated him, and he was talking. Groggy but talking. After that, in the middle of the night, his brain swelled quickly, and despite emergency neurosurgery, he died.”
“How tragic,” she said.
“Indeed. He was too young.”
She allowed a respectful silence before continuing. “You spoke to the family?”
“Yes, Dr. Rice and I called them twice.”
“What did you say when you spoke to them?”
“Our first call was within a few hours of admission. We explained Abdul’s injuries and his care plan.”
“How did they receive the news?”
“They were understandably upset and asked very good questions.”
She made notations on her pad. “Anything else about that conversation?”
“After we spoke for a while, I sensed relief that I was one of the physicians because they immediately recognized my accent.”
“That had to be comforting to them.”
“I think it was, especially since the police had already spoken to them and explained the nature of the fight.”
“Did you talk to the police?”
“No, but they were in the ED at the time of treatment. The young man who hit Abdul, Trevor McKnight, was in the ED at the same time, receiving treatment from my colleague for a broken knuckle.”
“Tell me about that,” she said.
“I wasn’t involved directly, but from what I heard, McKnight had a boxer’s fracture on his right hand.”
“What’s that?”
“It’s a fracture behind the knuckle, here.” He pointed to the top of his own hand. “Where I come from, we call it a ‘brawler’s fracture,’ because professional boxers know how to hit without fracturing their knuckles.”
“Valid point,” she said. “How many knuckles did Trevor McKnight break?”
“One. The pinky knuckle of his right hand, which I assume is his dominant hand. It probably means that he swung wide instead of delivering a more direct blow like a professional boxer would.” He demonstrated with an air-punch straight in front of him.
“And the treatment?” she asked.
“A fiberglass splint. It takes about six weeks to heal.”
“Good to know.” She made a note. She pictured Trevor McKnight in court wearing an incriminating splint. There’s no way his lawyer will let him wear that in front of the jury. The trial was scheduled amazingly close to the date of the incident, which was rare. Monica guessed that Trevor’s lawyer had requested a quick trial date since Trevor was in jail without bond.
She felt Dr. Khouri’s intelligent eyes studying her. “It isn’t uncommon for us to treat both the victim and the assailant at the same time in the ED.”
“And for the police to be in the ED as well?” she asked.
“Exactly. I saw an officer go into McKnight’s room and talk to him for quite a while,” Dr. Khouri said.
“I’m sure Trevor had no idea of Abdul’s condition.”
Dr. Khouri nodded. “McKnight was pretty inebriated. He probably doesn’t remember what he told the police.”
“Perhaps not, but they record everything from their lapel microphone, you know.”
“I am aware,” he said.
“To the extent McKnight admitted anything, I’m sure that recording will be played at trial.”
“Will his lawyer allow that?” Dr. Khouri asked.
“His lawyer will probably try to keep it out, but the judge will most likely allow it. I don’t see a reason why it wouldn’t come into evidence.” After a beat, she asked, “You said you had two conversations with the Seif family. Tell me about the second one.”
He nodded and sighed, his tone turning somber. “Dr. Rice and I called them after Abdul died.”
“What did you say?”
“Dr. Rice explained her emergency surgery, and I answered their questions about prayers and preparing Abdul’s body for transport.”
She made a note. “Anything else?”
“We expressed our condolences.”
“They must have been devastated.”
“They were. One of the hardest calls I’ve ever had to make.”
“I’m sorry. Such a senseless loss.”
They allowed a respectful moment to pass.
“When is the trial?” he asked.
“Next week. They don’t need you there the entire week, only one day for testimony. As soon as I find out the time and day, I’ll let you know.”
“Will you be there with me?” he asked.
“Yes. Do you want to do a prep session before you go?”
“I’d like that. I’ve never testified before, so I have no idea what to expect.”
“I’ll schedule a meeting with you to go over your testimony after I talk to the DA.”
“Excellent.”
“I think we’re finished for today. It was a pleasure meeting you, Dr. Khouri.”
“Likewise.”
They shook hands, and he left.
Chapter Six
Monica used the break between meetings to stand and stretch. She returned to the window to view Apple River Oxbow, shimmering in the sunlight. Does Dr. Khouri really believe that a local jury would discount his testimony because he’s from the same part of the globe as Abdul Seif? God, I hope we’re better than that.
After a few minutes, there was a light tap on the open door. “Are you the attorney?”
Monica turned to see the receptionist. “Yes.”
“We just took a message from Dr. Dani Rice’s nurse. She said Dr. Rice got called to a trauma, so she won’t be able to meet with you today. You’ll have to reschedule.”
“Darn. Always a risk with a neurosurgeon. Taking care of patients is more important, though,” Monica said. “Thank you for letting me know. I still have another physician to meet with—Dr. King. He’s an intensivist. Can you page him for me?”
“I’d be happy to,” the receptionist said and left.
Within minutes, a white-haired physician of substantial girth, teetering on toothpick legs, filled the doorway. “Am I in the right place? Are you the lawyer?”
Monica extended her hand. “Yes. I’m Monica Spade. Thanks for coming.”
He moved to a chair and dropped into it with a whoosh of air, as if his knees could no longer bend during the sitting process. “I only have a few minutes.”
I’m pretty sure my office told you we needed 30 minutes, Monica thought. She pushed the subpoena across the table. “You’ve been subpoenaed to testify in the murder trial of Trevor McKnight. I believe you treated the victim, Abdul Seif, while he was in the CCU?”
“I rounded on him, yes, but his care was being directed by Dr. Rice, the neurosurgeon. Did she get subpoenaed too?”
“Yes,” Monica said. “The prosecution subpoenaed several physicians but will narrow down who they’re going to call based on our meeting today.”
“Do you work for the prosecution?”
“No. I’m with the Daniels, Smart & Whitworth law firm, hired by Al Bowman to represent the hospital and physicians. Here’s my card.” She removed one from her blazer pocket and slid it across the table.
He read her card then dropped it in his white coat pocket.
�
�Out of respect for your time, maybe we should talk about the care,” she said. “Can you speak to the cause of Abdul’s head injury and subsequent death?”
The doctor sighed, as if he had explained Abdul’s cause of death a thousand times, and the incremental effort was taking a toll on his patience or energy level, or both. “It’s not uncommon for us to see head injuries like this when someone falls on the ice, or in Mr. Seif’s case, on a sidewalk. He was acutely intoxicated. I believe his blood alcohol level was close to .20, which is way past the legal limit to drive of .08. As I recall, he weighed approximately 170 pounds, so he probably had more than 10 servings of alcohol on board.”
“Are you saying that he cracked his skull because he fell down from being drunk?”
“Probably.” Dr. King shrugged, portraying a this-happens-everyday attitude.
“Are you aware of Abdul’s broken nose?” she asked.
“I saw that in the ED note. I understand he was in a shoving match before he left the bar and fell down outside.”
“Who told you that?” she asked.
“I can’t remember. Maybe I saw it on the news.”
How does a nose get broken during a shoving match? “Can you tell me about your care and treatment of Abdul?”
“I was working day shifts, so I rounded on him both Sunday and Monday. He improved, so we extubated him. He was groggy, but he could talk. He even had a brief phone call with his parents but drifted off to sleep during the call. That isn’t unusual while sedated for a concussion injury. He also received a few visitors—some friends from school, I think.”
“Was this a concussion or a traumatic brain injury?” she asked.
“Well, same thing.” He waved her off.
“Really?” she asked. “Because his CT scan showed blood and swelling. Do those happen with a concussion?”
“Technically, no.”
She wondered why he was downplaying Abdul’s injury. “I understand that Abdul’s brain suddenly swelled on Monday night.”
“Yes. Monday night going into Tuesday morning, his neuro exams changed dramatically. Dr. Rice ordered a CT scan after being paged Monday night. It showed significant swelling that was different from the CT performed six hours earlier. She came in immediately and performed bilateral craniotomies to relieve the brain pressure, but the swelling was too much, too fast. He died.”