First Do No Harm

by L Jan Eira

  They arrived at Jack’s office. Jack nodded at Beverly who was on the phone. She remained motionless with mouth agape and watched in disbelief as the three walked by and entered Jack’s office.

  “Please make yourselves comfortable. Will either of you take some coffee, soft drink, water?” Jack asked politely, as he took his chair behind his desk. This was a small table almost completely buried with papers, electrocardiographs, large X-ray envelopes, and stacks and stacks of medical records. In the midst of all that, like two tiny islands about to be swallowed by the immenseness of the vast sea of paperwork, there was a mug and a name-sign afloat. It read, Jack Norris, MD, Chief of Fellows, Department of Cardiology, Section of Electrophysiology.

  “Nothing for me,” answered the older detective, as he sat and looked over at his partner as if to solicit her reaction to the same question.

  “No, I’m fine, thanks,” replied Susan.

  They all sat down. Susan had the notebook on her lap and a pen ready to take notes.

  Herb began. “Dr. Norris,” he paused as if to choose his words just right. “We have a lot of witnesses as to who pulled the trigger and caused all these deaths. What we need to do now is try to understand why. We need to find out where the gun came from. We’d like to start by gathering some information about routines here at Newton Memorial and about this patient.”

  “Sure, I can help you with that,” volunteered Jack.

  “What time did you last see the deceased patient?” asked Herb.

  “I was with him at around five; I helped with the admission process before I went home.”

  “Did he have a gun on him?” continued Herb.

  “Not that I noticed, but I didn’t go through his personal things. The nurses do that when patients are admitted. They take a complete inventory of all the possessions. Did you review that document?”

  “Yes, we did look at the paperwork and no mention of any weapons. We didn’t talk to the nurse that admitted him, since she ended her shift at seven o’clock yesterday evening. We’ll talk to her later today.”

  “Do you own a gun, doctor?” asked Susan suddenly.

  “Oh, no, not me. Why? Do you think I gave him a gun?” Jack appeared uncomfortable with the question.

  “It’s just a question. We have asked it of everybody we talked to this morning,” she explained putting Jack a bit more at ease.

  “Do you know anybody that owns a gun? Can you think of anyone that works here that might have brought in a gun for any reason? Any reason at all?” asked Herb.

  “No, not really. I’m just not a gun person.”

  “Did you have any arguments or issues with the people killed today?” asked Herb.

  “No, John and Heather were my friends. I’ve seen the security guard around campus, but didn’t know him at all. And the patient, I met him for the first time yesterday evening,” answered Jack. Susan wrote on her notebook.

  “What about the medical issues? Could the patient have been faking his symptoms?” asked Herb.

  “I don’t think so. His EKG was abnormal and he had runs of tachycardia.” Jack studied the expression on the faces of the detectives and suddenly realized he needed to explain in layman’s terms. He continued: “His electrocardiogram showed abnormalities suggesting a heart attack and a heart rhythm disorder that cannot be faked.”

  “Is there any way at all that he could have fooled you?” asked Susan.

  Jack paused for a beat. “There maybe drugs that mimic the EKG changes we saw, but—” He paused again, pensively.

  “Like what? What kind of drugs?” persisted Herb, intrigued with the possibility.

  “I don’t know. Let me research that and get back to you.”

  “The other thing bothering us is why he became agitated and paranoid. The nurses say this is unusual for somebody to do this when they had no psych history. Is it?” asked Susan.

  “Yes, in my entire career dealing with cardiac patients, I never experienced anything close to this. Sure, people get scared and sad, some may cry, some become a bit agitated. But not enough to shoot people,” confessed Jack.

  “As far as the typical routine around here, did anything seem out of place or unusual this morning?” asked Susan.

  “No, but I just got here. I don’t know that I can say yet,” answered Jack.

  “Tell us what a typical day is like for the doctors,” asked Herb.

  “Well, let’s see,” began Jack, “everything starts with morning reports at eight in the morning. That goes for an hour. All the medical students, interns, residents and fellows—“

  “Interns, residents and fellows? Help us out with the jargon, doctor,” interrupted Susan politely and inquisitively.

  “Sorry.” Jack paused for a few seconds to gather his thoughts, then continued: “These are doctors in training at different levels. The first year of training after med school, they are called interns, then two years of being a resident in the Department of Internal Medicine. Those that don’t want to specialize are done; they become internists. For those of us that want to specialize, then we do a fellowship. In my case, I did a fellowship in cardiology for three years and I am now doing a fellowship in electrophysiology.” Before Susan had a chance to interrupt for clarification, Jack smiled and explained: “Electrophysiology is the field within cardiology that deals with heart rhythm disorders.”

  “We appreciate your explanations. Please continue,” interceded Susan.

  “So all the med students and doctors in training rotating through the department of cardiology come to a session every morning at eight to discuss the cases that were admitted the night before by the on call team. I oversee that meeting. Medical rounds start around nine to nine-thirty in the morning. The trainees are grouped and assigned a certain ward to round on. Each group has a few students, an intern, a resident and a fellow. So at the time the murders occurred—” Jack paused. “What time did the murders occur?”

  “Around six-fifteen,” answered Susan.

  “That early in the morning, there is nothing going on. The nurses don’t change shift until seven. There are people in the unit drawing blood, setting up portable X-rays machines, and getting EKGs on patients,” responded Jack.

  “Do you know if the patient had any visitors?” asked Herb.

  “Yes, his wife and daughter were with him yesterday. They were with him when I left him. They seemed concerned and close to the patient,” answered Jack.

  “Do you know if the patient had any visitors this morning?” inquired Herb.

  “I don’t know about this morning.”

  “Do you know if anyone unusual came to see him since his arrival in the hospital?” asked Susan.

  “I really don’t know.”

  “Do you have any theories or thoughts about why this man might have wanted to commit these murders?” questioned Herb.

  “Dr. John Connor was a research fellow. I know they use and sacrifice many animals down in the research lab. My first thought was some animal activist group, but that seems far-fetched,” answered Jack.

  “Okay, Dr. Norris. We appreciate your time and if you could let us know later about any possible drugs that could have been used to fake the patient’s medical condition, that might be helpful,” said Herb.

  The detectives got up, shook Jack’s hand and left the small office, having made plans to meet again at four o’clock that same afternoon.

  As he watched them depart, Jack remained standing by his desk, motionless and in silence, his eyes gathering moistness again.

  “The bastard murdered John. He killed my best friend. May that son-of-a-bitch killer rot in hell forever and a day.” Jack wept once again, tears flowing down both cheeks. Once the sobbing ceased, he would compose himself and call Claire. More than anything right now he needed to hear her voice. She would provide comfort, strength and much needed direction.

  *****

  9:05 AM

  “So, what do you think about young Dr. Jack Norris?” asked Herb, when
he and Susan were no longer within an earshot of Beverly, who sat at her desk talking on the phone taking notes. The detectives walked by slowly towards the elevator, gesturing goodbye as they briefly made eye contact with the busy secretary.

  “He seems sharp and trustworthy enough. I don’t think he had anything to do with the murders, do you?” she replied.

  “No, I don’t think he’s involved. He seems to be honest. I think he can be helpful to us. Let’s see what he comes up with,” continued Herb.

  “He was flying at the time of the murders. At least we know he didn’t give the perp the gun this morning,” she said.

  “Unless he gave it to him yesterday during the admission process. But I don’t think so,” said Herb wisely. Susan nodded.

  “I’ll research as much as I can about him and I’ll assign Jim Franklin to follow him for a while. I’ll find out if he owns a gun and if he had any reason to dislike those murdered,” said Susan.

  “These early cases always disrupt my morning routine. I need coffee and food. Have you had breakfast, Suzy?”

  *****

  3:42 PM

  Jack spent three hours in his office. He read textbooks and used the PC. He accessed all the medical websites he could think of for answers to the question: How does one fake the abnormalities on the electrocardiogram he witnessed the day before? A list of drugs that could have affected the EKG changes was predictably and repeatedly shown in every source he examined. Jack knew damn well that if one of these had been ingested, there would have been other signs.

  He worked through lunch.

  At two o’clock, he realized there were several in-patients on whom he had to round. He knew the medical students and residents had been sent home at the recommendation of the police as the murder scene was probed and inspected. But, there were patients to be seen. He would do that quickly without students to teach and residents and junior fellows to guide. The last thing he wanted to do was to be late for his meeting with detectives Fuller and Quentin.

  It was 3:58 p.m. exactly when the two cops arrived.

  “Come in, please and make yourselves comfortable,” remarked Jack to the cops gesturing for them to come in and pointing at the empty chairs in the small room.

  “Well, what did you come up with?” began Detective Quentin.

  “I came up with nothing. There is no known drug anyone can take to fake the objective cardiac signs displayed by this patient without having other overt signs of toxicity. The only explanation is that this man really did come in with an acute coronary syndrome.” Jack paused, suddenly realizing he was going to be interrupted by the detectives for using medical jargon. He forced a smile. “Sorry, but this guy really did come in with a serious bona fide heart problem. He did not fake it. I also checked on his cardiac markers; uh, blood tests we order routinely to check for heart damage and his were slightly positive. Therefore, he did have a heart attack. This was for real.”

  “Okay, that settles that issue,” stated Susan.

  “No, not yet. He might have been given an experimental drug. I want to continue to search but I need more time. I need to visit the medical school library and do a more extensive search of the literature,” interjected Jack.

  “Okay, for now it doesn’t appear that he got himself admitted just to kill someone. The next question is where he got the gun. Why the bizarre psychiatric behavior,” inquired Detective Fuller, who had remained silent.

  “Sometimes people with heart attacks have anxiety and panic attacks. But to the degree of murdering doctors and nurses,” replied Jack pausing briefly, clearly puzzled with the notion. “It’s strange. I’ll review the medical record closely and search for drugs that may cause these symptoms,” he continued.

  “I think these are all the questions we have for you, at this time. Please get back to us when you complete your research. We will have a meeting every morning at eight-thirty at the police station. You are welcome to come, anytime you have some information, doctor,” stated Herb.

  “You can call me Jack.”

  “Fair enough. I’m Herb and this is Susan. Our cell numbers are on the card, if you come up with something,” said the older gumshoe, giving Jack his business card. Susan mimicked the gesture giving Jack her card. Jack reciprocated.

  “Incidentally, Jack, we need you to keep the details of our conversations private,” said Susan as they exited the room.

  *****

  5:12 PM

  Jack was thrilled to be involved in the investigation, but at the same time, being involved provided a continuous reminder of his loss. It would keep the wound open. But he would do it. He would be strong and get the job done. He owed this to his best friend. He would find out what happened and why John was killed. Only then could the wound begin to really heal.

  Before leaving the hospital, Jack swung by Dr. Thomas Lindsborg’s office. If he were going to take time to help the police, first he would have to get permission from his boss.

  Arriving on the eighth floor, Jack first noticed that the beautifully decorated door to Lindsborg’s office was closed. An extravagant and overstated sign on the door read: “Dr. Thomas Lindsborg, Medical Director, Head of Department of Internal Medicine & Cardiology.”

  Gina, Lindsborg’s secretary, had already left. Her desk was positioned gracefully to the left of the director’s elegant dark mahogany door. Jack approached her desk and sat down. The desk was impeccably clean and organized. Not a thing out of place. He took out his pen from his breast pocket and started to write a note for her requesting a meeting with Dr. Lindsborg for the morning. As he began writing the words, he realized there was a conversation between two men in the director’s office. One was definitely Dr. Lindsborg. The other voice sounded vaguely familiar. Straining to make out the words, Jack realized the second man was Rupert. He was speaking.

  “Of course, this is stressful. For everyone. For you, too.”

  “How can we help the staff? Besides psychological assistance, of course? I already spoke to Joel Garrison. He will make all his psychiatry residents and psychologists available as necessary to help our staff.”

  “Give them some time off. I gave my research staff two weeks off. They will want to be with their families and friends and process this. Some may want to transfer to another facility. I told them I would support their decision. Of course, the research lab can stop for a while. In the hospital, with sick patients, the show must go on.”

  “You know the offer stands. Anytime. Just let me know. The place is very relaxing and soothing. I, myself, spend a lot of time there,” offered Rupert after a moment of silence.

  “I may take you up on that. Let me talk to my wife and see what she says. I will let you know. A weekend up at your cabin in the mountains may be exactly what we need.”

  There was a short pause as the door to the director’s office slowly opened. Jack didn’t notice at first but as the conversation continued, the louder tone of the voices made this obvious. He was still writing the note.

  “What about this weekend? The cabin’s all yours, if you want to go up there,” insisted Dr. Rupert.

  “Jack,” said the familiar voice of Dr. Lindsborg.

  “Good afternoon. I was just leaving a note for Gina to arrange a meeting with you tomorrow morning. I didn’t know you were still here.”

  “I am so sorry about John. And Heather. Come in, let’s talk.” Jack walked into the ostentatious office guided by Dr. Lindsborg. As he was entering the office, Dr. Lindsborg turned to Dr. Rupert behind him.

  “We’ll probably take you up on your offer to use your cabin. I’ll give you a call later this evening. I really appreciate it. Thanks.” The two men shook hands and said goodbye. By then, Jack was inside the office. Dr. Lindsborg closed the door, entered the spacious room and sat at his captain’s chair behind his desk gesturing for Jack to sit. Jack picked one of several elegant and comfortable chairs and sat down.

  “I told Gina to go home early. I saw no reason to have her stay here given t
oday’s events. What a mess, huh? Are you doing okay? I know you were close with John Connor,” asked Dr. Lindsborg in his concerned and customary fatherly manner.

  “Thanks for your concern. I’m doing okay. I’m angry about his senseless death, but I’m coping all right.”

  “Give yourself time to heal. I’d like you to see a psychologist and talk this through.”

  “I’ll see Claire tonight and—”

  “You should see a different psychologist, Jack. I’m serious about this. I know Claire will tell you the same thing. She can help you, too, but I want you to know that there are mental health personnel available to help you. Please avail yourself of their services. Don’t take this for granted. I’m having all the students, residents, and fellows do this.” Dr. Lindsborg’s face was serious and exuded concern.

  “Okay, I’ll do it. The police asked for my help with the case. They asked me to do some medical research for them. This may be the best therapy for me. If I’m helping with the investigation, I’ll feel better about the whole thing.”

  “The police asked me that earlier today. They interviewed me at length this morning. One of the things they felt was important to their investigation was to have someone from the hospital helping them. I thought of you and told them so. I do agree that could be therapeutic for you. Are you willing to do it? And more importantly, are you up for it?”

  “I think so.”

  “Okay, then do it. Keep me informed and let me know how I can help. Meanwhile, I’m giving most of the staff two weeks off. I will ask the attendings to do all the rounds. We will hold off on all elective procedures and surgeries until the smoke clears.”