Conscious Bias

by Alexi Venice

  “Did a change occur?” Dominique asked.

  “Yes.”

  “When?”

  “Around nine o’clock. The nurse paged me with the information that Abdul’s pupils were fixed and dilated.”

  “What’s the significance of that?”

  “Brain swelling is the leading cause.”

  “What did you do?”

  “I ordered Mannitol by IV and a CT scan then drove immediately to the hospital.”

  “When did you arrive?”

  “Within 15 minutes, while Abdul was in the CT scanner. I observed the images with the technologist and immediately requested an OR for neurosurgery.”

  “What type of surgery did you perform?”

  “A procedure called ‘bilateral craniectomies.’ I cut small circles on each side of the skull and removed them here and here.” With her index finger, Dr. Rice traced a circle about the size of a quarter on each side of the skull exhibit.

  “Did that cure the brain swelling?”

  “Unfortunately not,” Dr. Rice said. “The brain swelled rapidly and irreversibly, cutting off blood flow and causing brain death.”

  “What did you do next?” Dominique asked.

  “We transferred Abdul back to the CCU and called his parents.”

  “What did they say?”

  “I informed them that Abdul was brain dead, and they consented to me withdrawing the ventilator from him to see if he could breathe on his own.”

  “Could he?”

  “No.”

  “What happened?”

  “He passed peacefully with the Imam at his side, saying prayers over him.”

  “Was there anything else you could’ve done for Abdul?”

  “No.”

  “Did you and your care team act fast and responsibly?” Dominique asked.

  “Yes. I feel that everyone on the team did their best,” Dr. Rice said.

  “To a reasonable degree of medical probability, Dr. Rice, what injury, if any, did Trevor McKnight’s punch cause to Abdul Seif?”

  Halliday objected at the same time that Dr. Rice said, “Severe brain trauma and death.”

  “Your Honor!” Halliday protested. “Object to foundation.”

  “Sustained,” Judge O’Brien said. “DA Bisset, I sustained the last objection when Dr. Khouri testified. You’ve been warned.”

  “Forgive me, Your Honor, I’ll rephrase,” Dominique said.

  “Dr. Rice, what caused Abdul’s death?”

  “Irreversible brain swelling.”

  “What caused the swelling?”

  “Head trauma.”

  “Would a punch to the face, breaking Abdul’s nose, and causing him to land on the sidewalk, cracking his skull, be enough force to cause head trauma?”

  “Yes,” Dr. Rice said.

  “Thank you. I have nothing further.” Dominique returned to her chair.

  The pall of death hung over the courtroom. The Seifs hunched down into the wooden row, the women openly, but silently, sobbing into tissues.

  The McKnights looked stricken, with the exception of a teenaged daughter, who was looking at her cell phone.

  Halliday eased out of his chair and came to the podium.

  “How many head traumas have you treated, Dr. Rice?”

  “I would guess around one thousand.” Monica had prepared Dr. Rice for this question.

  “Of those, how many had a full recovery?” Halliday asked.

  “I don’t keep track, but maybe fifty percent. It depends on what caused the trauma.”

  “Have you ever used Mannitol before?”

  “Yes.”

  “With success?”

  “Yes.”

  “Was it too late to administer after Abdul’s pupils were fixed and dilated?”

  “No.”

  “Well, it didn’t help at that point, did it?”

  “I don’t believe so.”

  “Neither did your surgery, did it?”

  “No.”

  “If you had administered Mannitol and performed the bilateral craniectomies sooner, would they have helped?”

  “We’ll never know, but I doubt it.”

  “Why?”

  “First, because neither treatment was indicated. Second, because Abdul’s brain swelled faster than I’ve ever seen a brain swell.”

  “Did you consult with any other neurosurgeons?”

  “Yes.”

  “Who?”

  “My partners.”

  “Are they more experienced than you?”

  “They’ve been in practice twice as long as I have.”

  “What did they say?”

  “They wouldn’t have done anything differently in real time.”

  “How many bilateral craniectomies have you performed?”

  “Dozens.”

  “What percentage were successful?” he asked.

  “About 50% in traumatic head injuries, which is the standard for my specialty, considering the initial insult and that it’s a last-ditch effort at treatment,” she said.

  “In your hands, 50%?” he reinforced.

  “Which is the same as in other neurosurgeons’ hands,” she said.

  He scratched his head in a theatrical manner. “So, if you know your surgery is only 50% effective, why not try the Mannitol before the pupils become fixed and dilated?”

  “Objection,” Dominique said. “Asked and answered.”

  “Overruled,” Judge O’Brien said. “I’ll allow the doctor to answer.”

  “Because Mannitol can cause harm when used prematurely, and has an even lower success rate,” she said. “Moreover, we were running a three-percent saline drip, which is safer than Mannitol and can be as beneficial in some patients.”

  “Okay, we’ve heard that Abdul improved to the point of being able to sit up and call his parents, isn’t that correct?” Halliday asked.

  “Yes.”

  “Then he took a sudden turn for the worse Monday night, right?”

  “Yes.”

  “What would cause such a reversal?”

  “The body’s response to swelling.”

  “Could he have fallen on his way to the bathroom in the hospital, re-injuring his head?”

  Dr. Rice frowned, taken aback. “There was no report of him falling in the hospital.”

  “Well, you weren’t with him the entire time, were you?”

  “No, but those who were didn’t report any falls.”

  “Was someone with him all the time, 24/7?” Halliday asked, emphasizing “all the time.”

  “Well, no, but no one reported a fall, Abdul himself never reported that he fell, and his room is constantly monitored by video.”

  “Does someone sit and watch the video constantly?”

  “No, but the nurses are regularly monitoring it at the nursing station.”

  “And, Abdul was groggy and sleepy, correct?”

  “At times,” Dr. Rice said.

  “Thank you. Nothing further, Your Honor.” Halliday returned to his chair, satisfied that he made his point.

  “Any redirect, Attorney Bisset?”

  “No.”

  “You may step down, Dr. Rice,” Judge O’Brien said.

  Monica rose and followed Dr. Rice out of the courtroom.

  As soon as they hit the hallway, Dr. Rice quickly turned to face Monica directly.

  “How did I do?” Dr. Rice asked.

  “Very well,” Monica said. “I thought your testimony was instructive and helpful.”

  “Was the defense attorney trying to punk me about my experience?”

  “Probably,” Monica said.

  Dr. Rice shook her head. “Jackass.” She studied Monica’s face.

  “Did Abdul fall in the hospital?” Monica asked.

  “Not that I know of,” Dr. Rice said. “And, that’s something the staff would tell me.”

  “Halliday is such an underhanded prick,’ Monica said.

  “No argument there,” Dr. Rice said. “
Well, I should get back to the hospital. Thanks for your help.”

  “My pleasure.” They shook hands, and Monica was again reminded of Dr. Rice’s vice-like grip.

  “I hate to be so direct, but I don’t have the luxury of time,” Dr. Rice said, shuffling her busy feet. “Do you have someone special in your life? Like a girlfriend?”

  If Dr. Rice had told Monica the world was flat, she wouldn’t have been more shocked. “Ah, sort of, and how did you know?”

  “My keen clinical eye,” Dr. Rice said, pointing to her temple.

  “Well, very astute of you.” Monica found herself blushing.

  Dr. Rice gave Monica a demur smile. “If your ‘sort of’ doesn’t work out, text me. I’d love to get together sometime.”

  “I’ll keep that in mind, Dr. Rice.”

  “Call me Dani.”

  “Thanks. I will.”

  “I have to run now,” Dani said. “Thanks again.” Dani tapped Monica on the arm and, in a coquettish gesture, ran the back of her knuckles down Monica’s forearm. Unfortunately, Dani ended with the tops of her fingernails, and her jagged cuticles lightly scraped Monica’s skin, which was a major turnoff.

  “My pleasure,” Monica said in her professional lawyer voice. She stood motionless as Dani speed-walked down the hallway toward the exit. Wow. A high-powered neurosurgeon just hit on me. Monica felt nothing. No bump in her pulse. No thundering in her chest. No sharp intake of breath at Dani’s touch. No swooning. Nothing.

  She consulted her iWatch. It was a quarter to noon. The timing couldn’t have been better for a possible lunch with Shelby and the CrossFit class at The Broken Spoke. She slipped quietly back into the courtroom in time to hear the judge dismissing the jury for a one-and-a-half-hour lunch. Yay me. Without acknowledging anyone around her, she scooped up her laptop case and rushed out the front door before getting caught behind the crowd.

  She hustled down the courthouse steps, in a race against time, and got in her truck. Barely two blocks away, her cell phone rang.

  A quick glance at the screen told her the prefix of the number was from her current law firm, and her first thought was that Jim Daniels was calling to update her on his efforts at starting their firm.

  She picked up. “This is Monica.”

  “This is Charles Smart.”

  Her stomach clenched. Why is he calling me?! “Hello Mr. Smart. What can I do for you?”

  “Are you in that trial?” he asked.

  “I’m on lunch break. The physicians just finished testifying.”

  “I saw you on TV last night.”

  “Oh really?” she asked.

  “I didn’t appreciate your interview. At Smart, Daniels, we like to keep a low profile. That means staying out of the media.” True to his personality, he emphasized his name and elided Whitworth’s.

  Except that you’re a total media hound, trying to get your name in the newspaper and on the news at every opportunity. She bit the inside of her cheek and remained silent.

  He continued. “It isn’t befitting of a young lady who wants to become a partner in this firm to take an adverse position to an esteemed member of our community and longstanding client of this firm.”

  “I simply explained what the physicians’ roles were in the trial, and that Jeffrey Halliday’s wild accusations in his opening statement didn’t accurately portray the medical care.”

  “Your simple explanation didn’t reflect well on the McKnight family,” Charles said.

  “I represent the hospital, which has been a client of the firm equally as long as David McKnight, and has given us a lot more business in the last few years. It’s my job to advocate for my client, and the physicians are employed by my client. I can’t help it if Halliday’s defense strategy is voodoo medicine.” She gripped the wheel harder.

  “You will not do so at the expense of a businessman and pillar of this community,” Charles growled. “That’s a direct order from me.”

  Does he think he can give me orders as if I were a soldier? “Some pillar. McKnight called Al Bowman and offered to donate a million dollars to the hospital if Al convinced the physicians to testify according to Halliday’s defense narrative.”

  “What?” Charles asked.

  “You heard me,” she said. “Where I come from, that’s called suborning perjury.”

  “I strongly doubt that happened, young lady. You’d better be careful about saying that to anyone else.”

  “Don’t you ‘young lady’ me,” she said. “Al and I are professionals who know what’s going on here, and we won’t stand for it. McKnight is lucky that Al didn’t report his attempted bribe to the DA.”

  “I don’t believe you,” he said, but his voice had lost some fight.

  “I’ll tell you what, Charles. Why don’t you talk to Jim Daniels about this. The hospital is his client, and he approved in advance everything I’m doing.”

  “Don’t you tell me to talk to someone else!” Charles thundered. “I’m talking to you. If you want to make partner in this firm, you’d better listen. No more interviews! No more assisting the prosecution! No more sitting with the Seifs!”

  Even though her head throbbed, she remained strong, stealing herself against his tirade. “Again, you need to take this up with Jim. I’m going to continue lawyering this case as I deem appropriate.”

  “You’re jeopardizing your position at this firm, young lady. It’s bad enough that you’ve been fraternizing with Nathan Taylor and his boyfriend. Now you’re interfering with my business relationships, and I won’t stand for it.”

  She had to hold her phone at arm’s length to compensate for his loud blast of hot air. “Are you telling me that my friendship with a gay male is jeopardizing my employment at your law firm?”

  “Of course not,” he said sarcastically. “I’m telling you that you’d better figure out how to stay out of the media when you represent interests adverse to my clients!”

  “You can take that up with Jim. I’m going to represent my clients as I see fit.”

  “Is that your final position?”

  She could hear the threat behind his words. “Yes.”

  He hung up on her.

  Well, fuck me. Jim better be on my side. She found Jim’s name in her contacts list and dialed him.

  “Hi Monica. How’s it going?” he asked.

  “Not so well. Charles Smart just called me and read me the riot act about giving an interview and representing the physicians. He told me my good lawyering is adverse to the McKnight family.”

  “You’ve got to be kidding me.”

  “I told him to talk to you. I assume you’ll have my back?”

  “Of course, but what difference does it make? We’re leaving.”

  “I was hoping you’d say that,” she said. She also told him about McKnight’s attempt to bribe Al Bowman.

  “You have to be kidding me,” he said. “What a dumbass. Does Dominique know about this?”

  “No. Al asked me not to tell her.”

  There was silence on the line.

  “Jim? Are you still there?”

  “Yeah. I was thinking about the ramifications of withholding this info from Dominique, and the equally distasteful consequences of telling her.” He sighed. “I don’t think you have an ethical obligation to tell her.”

  “That was my conclusion too,” she said. “And, you wouldn’t believe it. Someone left a note on my windshield this morning.”

  “What? A note?”

  “Yeah, it said, ‘The physicians better testify that Abdul fell down drunk and cracked his head.’”

  “That’s way out of bounds,” he said.

  “Well, it’s too late now. The physicians already testified honestly that Trevor’s punch caused Abdul’s head injury.”

  “I don’t like the sound of this threat. Let me arrange for some security detail for you.”

  “Oh, come on,” she said. “That sounds a little dramatic. The physicians already testified, so there’s no need f
or the McKnights to continue to threaten me. I’ll be fine.”

  “If you think so,” he said. “Just watch yourself.”

  “I always do,” she said. “Switching topics, how are you coming on the details of our new firm?”

  “Swimmingly. I signed a lease on some space, and I need you and Nathan to as well—”

  “I thought you owned our space?”

  “I co-own some commercial real estate, and there happened to be a vacancy in one of our buildings. The lease is a formality for the accountants. You’re going to love it.”

  “I’m sure I will. I can’t worry about all that stuff while I’m in the middle of this circus, though.”

  “No worries. Get out there and be the face of our new firm. Do more interviews. The publicity will be good for your practice and our firm.”

  “Gotcha. Never thought of that. Now I’m going to turn into a media hound like Charles.”

  “Except better looking. Go for it. I’ve got your back.”

  “Thanks.” She ended the call and worked her jaw, stretching out the tension and stress that she was carrying there. I guess I’m going head-to-head with Charles and the McKnights now. Well, they don’t know who they’re dealing with...I need to show the note to Dominique after lunch.

  Chapter Twenty-Seven

  Monica’s mind was a tangled mess when she drove into The Broken Spoke parking lot. She was a tad late but considered it fashionable for this social outing, redirecting her thoughts to her game plan for Shelby. Don’t look overeager. Don’t act overeager. Don’t sound overeager. Be cool.

  As Monica drove through the parking lot, she scanned the stalls for Shelby’s Jeep. She spied a few cars with “MoFit” stickers on their back windows, indicating others from the class were already there, but no Shelby yet.

  She found a spot, and as she was getting out of her car, Shelby pulled up alongside Monica in her muddy Jeep. Monica waited with the excitement of a second-grader for Shelby to join her on the sidewalk.

  Shelby hopped out of her Jeep, and to Monica’s delight, Shelby’s eyes roamed Monica from head to toe. God, I hope she likes what she sees.

  “Hey, you,” Shelby said in a deep voice.

  “Hey, CrossFit goddess.”

  “You can’t call me that,” Shelby said in a please-do-anyway whisper.

  Monica allowed herself a quick glance over Shelby’s body as they walked into the restaurant. She was disappointed that Shelby was wearing boots that rose to her knees, a loose-fitting, flouncy dress that hid her figure, and a cute jean jacket that covered everything the dress didn’t. Appropriately dressed for an art teacher, Shelby looked cute as hell, but under that tent was the sexiest body at CrossFit, and Monica had been looking forward to feasting her eyes on it for the duration of lunch. Dang.