First Do No Harm

by L Jan Eira

  “I appreciate that. Thank you.” Jack sat up paralleling the director’s movements.

  “One of the early theories is that the patient faked a heart attack to come into the hospital purposefully to kill someone, possibly John, Heather, or both. The patient’s EKG showed significant changes and he did rule in for a small heart attack. Can you think of a way to fake this? ” asked Jack with a pensive gesticulation.

  “Faking a heart attack? I don’t think so,” answered Dr. Lindsborg.

  “I’ll search the medical literature for drugs that may fake EKG signs of heart attacks. What about a research drug? Are you aware of any research drugs being investigated here at Newton that may fit the bill?” Jack finally got himself to ask the question.

  “No. Do you think our research department is out killing people?” said Dr. Lindsborg, walking slowly towards the door signifying that the meeting was over.

  “No, of course not. I think I’m tired and not thinking straight.” Jack returned the grin.

  “I understand. We all have had a tiresome day.”

  As he drove off the hospital campus, Jack attempted to reflect on all possibilities, especially those that involve thinking outside the box. He was emotionally spent and physically exhausted. Any fruitful speculation would have to wait until he had a good night’s sleep and some food. His thoughts went back to John Connor and Heather McCormick. Jack wept silently and drove on.

  *****

  6:17 PM

  Jack couldn’t wait to get home and hug Claire. He entered the house quietly and searched for her. She heard him come in and approached him. They embraced for a long moment. In silence, Jack felt some relief in Claire’s arms; he felt anchored.

  “I’m so sorry about John,” Claire started, her eyes tearful, her tone serious. Jack remained quiet, tears flowing down his cheeks.

  Claire took his hand and guided him into the living room. They sat comfortably on the large couch, silent, wordlessly commiserating their loss.

  “Tell me what you know,” asked Claire, breaking the stillness after a long moment.

  “It’s just crazy. I admitted a man yesterday with a heart attack. He was doing well and stable. His heart attack was relatively minor. He was polite and calm. This morning, for no apparent reason he became agitated and confused, pulled out a gun from God knows where, and shot John and Heather, one of the CCU nurses. Security came in and exchanged shots with the patient. They both died. Four people dead and why?”

  “Where did he get the gun?” asked Claire intrigued.

  “No one knows. Nobody saw the gun until he used it this morning.”

  “And why did he become agitated and paranoid? Did he have a history of psych disorders?”

  “No. No history of any disturbances. Everything appeared normal until he started shooting.”

  “How strange. How senseless.”

  “The cops want my help. I’m researching the possibility that the man used a drug that gave him paranoia. Maybe the same drug that may have mimicked a heart attack and arrhythmias.”

  “Is that possible?”

  “I spent all day today researching and came up empty handed. I’ll go to the medical school library and do a more extensive search there. There is a meeting tomorrow morning at the police station. I’m going to go and see if I can help out with anything else.”

  “Jack, I’m not supposed to tell you about my patients. But, I’m seeing a woman in therapy that lost her parents and brother about three months ago. The father was healthy, physically and psychologically. He was admitted at Newton Memorial overnight with chest pains. A heart catheterization showed his heart was normal. He was discharged in great condition. Twenty-four hours later, he suddenly became agitated and confused and shot his wife and son, then dropped dead of a heart attack. The daughter was not home at the time, but found them later. All of them dead. She has been in therapy ever since. She told me her father was a stable man. Never had any psychiatric problems. Very calm man. They believe the stress of being in the hospital caused his psychiatric disturbance, but it seemed odd to me. It sounds like your patient that murdered John and the others today.”

  “It does seem odd. Do you think there’s a connection?”

  “I don’t know. Maybe.”

  “What’s that patient’s name?”

  “I don’t know. The daughter is Peggy Snyder. I’ll find out what his name was and let you know tomorrow.”

  The possibility was intriguing. But what would that mean? If these events were connected, these men were assassination puppets? If so, who was the marionette master? And how was he pulling the strings?

  This type of voodoo was implausible. A more probable explanation for it all would likely be forthcoming. Jack was anxious to learn more about the homicides and what the cops had uncovered. He looked forward to the morning meeting at police headquarters.

  *****

  Twelve days ago

  September 19

  8:27 AM

  Jack arrived at the Evansville Police Department Headquarters. The old ornate building also served as Evansville’s municipal building, containing all city functions including courthouse and the mayor’s office. In front of the magnificent art-deco edifice, there were several marble steps. To the sides, there were tall beautifully sculptured columns, giving the structure a façade of stylish sophistication and elegance. Walking up the front stairs, Jack could not help feeling both insignificant and important. He kept his head high and pushed through the main door.

  Inside there was a large foyer, highlighting an elegant marble stairway leading upstairs. A graceful chandelier hung high overhead. To the left, another door was labeled: Evansville Police Headquarters. Jack pushed the door open and entered. There were several people, some sitting others standing in line waiting to see an older police officer with gray hair sitting behind a tall countertop. Multiple conversations among many people echoed loudly in Jack’s ears.

  Jack looked behind the counter, hoping to see a familiar face.

  “Good morning, Jack,” said a woman’s voice. It was detective Susan Quentin, who had spotted him entering the building from the office she shared with the other detectives. She shook his hand and led him to the conference room.

  When the door opened, Jack could see several people inside, some dressed in police blue uniforms and others well dressed in plain clothes. The room itself was much like the conference room where Jack and the others met every day for morning report. A podium and blackboard were positioned in front of the large room. There were several chairs, each with a small desktop just large enough for a note pad.

  “I think we’re all here now. Please have a seat,” said Detective Herbert Fuller taking control of the pandemonium in the room. All sat down including the newly arrived Jack and Susan. Quickly, silence reigned.

  “First, some introductions are in order,” continued Herb after a few seconds of complete stillness. “We have with us as part of this investigative team, Sergeant Mike Ganz from the FBI. He has been here before to help us with a few of our big cases. Most of you know him. He’s here to help us out with this one.” Mike stood up and waved hello to all, a grin on his face. As he sat back down, he winked at Susan. Jack noticed the gesture. Herb continued to speak.

  “Also Dr. Jack Norris from Newton Memorial has agreed to assist in the investigation. Suzy and I felt an inside source was necessary to expedite our data gathering as far as the hospital is concerned. Welcome, Dr. Norris and thank you for coming.” Herb pointed and gestured at Jack. Jack stood and looked all around the room. People gave him silent nods and grins. Jack sat down again as Herb continued.

  “I will summarize the case, as we know it. Arthur Butterworth was a sixty-three-year-old man admitted to the hospital with a heart attack. Dr. Norris tells us he was a legitimate cardiac patient. Dr. Norris, would you mind reviewing for us the information you have on his medical condition?”

  Shyly, Jack stood up slowly. As he spoke, he sounded professional and concerned.
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  “I believe this man came into the hospital with real problems. It’s hard to fathom that he came in or was planted purposefully to make a kill.”

  “Doctor, is there any question about that?” asked Mike inquisitively.

  “There were changes on the electrocardiogram when he first arrived at the hospital, highly suggestive of a heart attack. There are poisons and drugs that can be taken to mimic those changes, but the man subsequently had blood tests showing heart damage.”

  “Are there poisons or drugs that can fool doctors with the blood test results?” persisted Susan.

  “None of which I’m aware, but I’m doing a full literature search to confirm that. I’ll let you know what I come up with, but I’d be surprised if this is anything but a guy that came in with a heart attack.” Mike and all others looked at Jack intensely as he spoke. All nodded in acknowledgement.

  After a short moment, Herb continued.

  “We appreciate your help with that, doctor. The way I figure it, if Butterworth was acting alone, he either came in to kill somebody or decided to kill somebody after being in the hospital. If he really had a heart attack, the latter is more probable. Then the question is, why would he want to kill those people? I have interviewed the family and friends and I can’t get any prior connection to any of the people murdered. No one in the hospital at all. We’ll need to find out where he got the gun. It seems he didn’t arrive in the hospital with a gun.”

  “Who brought the patient to the hospital? Did he have any visitors after his arrival?” interrupted another detective Jack didn’t know.

  “He came in by ambulance,” interjected Susan. “Mrs. Butterworth and his daughter visited him in the hospital for an hour. They say he never had a gun. He was totally opposed to guns. The wife told me a story about the time his father took him hunting when he was a little boy. The father shot a rabbit. The sight of this bunny shot to death created a psychological issue with guns. All his life the man detested anything to do with weapons. The family assured me that the patient would never have anything to do with any killing or guns. Jim is checking into that, but I believe the family. I don’t think we’ll find any reason why this guy would want to kill anybody. So why did he? There is no question of that. He had a smoking gun in his hand.” Susan was confused. Even angry. What was missing here?

  “The witnesses at the scene say the man was oriented, calm and amicable the whole time,” continued Herb. “He was very appreciative of their help. He said, ‘yes please and thank you’. The man suddenly became very agitated and paranoid. What is it you doctors call it—?” Herb looked at Jack and paused inquisitively.

  “Freakin’ crazy?” deadpanned Jack. All laughed, much-needed relief from the wretchedness of the moment. Jack continued after a moment. “I think you mean acute dissociative delusional disorder.”

  “That’s it. Anyhow, the nursing staff couldn’t calm down Butterworth. He became even more agitated. He took out a gun from somewhere and pointed it at the staff. The staff backed off immediately and retreated to a safe place. All except the nurse taking care of him, who got trapped in the room at gunpoint. He didn’t permit her to leave. One of the doctors went into the room to talk the man down and get the nurse out of there. Butterworth shot the nurse then the doctor. The man shot twice more but hit no one. The bullets were recovered from the wall in the adjoining cubicle. Meanwhile, the hospital security had been called. A security guard was nearby. He had a gun and pulled it out. The guard and Butterworth exchanged shots, both being fatally wounded.” Herb paused a moment for all to digest the information. Exteriorly, Jack appeared composed. Inwardly, he was mortified and overwhelmed by the factual description of how the life of his best friend was coldly and abruptly terminated.

  “So, the number one question is where he got the gun,” continued the lead detective.

  “Did the gun come back registered?” asked Mike.

  “Nah, no registration. The serial number was destroyed and ballistic reports are pending,” said another detective.

  “Keep at it, Jimmy. Let me know when you have something. I think the gun is the key to solving this case,” said Herb.

  “I can search the FBI database and cast a wider net. I’ll talk to you after the meeting and coordinate with you, Jimmy,” said Mike assertively looking at the young Evansville detective, then Herb. Jimmy and Herb nodded silently.

  “Dr. Norris, will you let us know if you come up with any drugs that may be involved? We’ll send a full drug screen on the perp. It’ll take a while to come back. The routine drug test should be available today,” said Susan. Jack nodded.

  After this, several other people had a chance to speak. Some were part of the Crime Scene Unit and spoke about their findings. Much minutia was brought up about the microscopic materials found at the scene, the victims’ cars, the perp’s clothing and belongings, but the gist of it all was that nothing helpful was found. The detectives interviewed all the witnesses, family members, relatives of relatives, friends and their cousins. Nothing. Nothing important was uncovered. The murders continued to appear unprovoked and senseless.

  Several detectives had interrogated all the people that had been in the hospital. This included patients that had been in the CCU cubicle turned murder scene, before the killer patient. All these detectives and cops had a chance to talk about what they had learned. After endless dissertations by numerous people, the bottom line was the same—no helpful hints or clues. In the midst of the lengthy discussion, someone reported that Dr. Rupert had been seen in CCU about an hour before the murders. That bit sparked Jack’s interest.

  “Rupert up and about at five o’clock in the morning? No way,” thought the young doctor. Jack found that incredibly unusual but he didn’t say a word. He had never seen Rupert in the hospital before ten in the morning. One of the detectives added that Dr. Connor entered the unit a few minutes before the whole thing went sour.

  “Another humongous coincidence,” thought Jack, the biggest skeptic about coincidences in the world.

  John would not be in the hospital that early either, thought Jack to himself as others spoke. Jack’s mind wandered. He didn’t like Rupert, but him being at the hospital so early had to mean something. It had to mean Rupert was involved. What if his feelings towards the man were biasing his reflections? Was he being fair and impartial? At that moment, Jack vowed to let the evidence lead him where it may.

  “We’ll meet again every morning to gather our thoughts and get marching orders for the day. Any information you discover let me know right away. I will coordinate the data,” said Herb authoritatively disrupting Jack’s meditative state, jerking him back into reality. “Jack, see what you can find out and let me know if something useful comes up.”

  Jack nodded agreeingly. “I should have some information for you in two or three days. If a drug was involved, I’ll find it,” he added confidently.

  *****

  4:50 PM

  “Lucy, I’m home!” exclaimed Jack, trying to put on a happy face. This was the worst ever imitation of a Cuban accent. Claire was busy in the kitchen. Jack approached her and they kissed.

  “How was your day, Dick Tracy?” inquired Claire, completely aware of his tactics to convince her he was coping well.

  “You’ll be surprised to know, it was a bit intimidating. We had a meeting for several hours going over all the evidence.” Jack’s initial smile faded as he continued. “Claire, I’ve been thinking about this all day. I think Rupert has something to do with the murders.”

  “Rupert? Why do you think that?” This received Claire’s full attention.

  “I have worked at Newton Memorial for how many years now? Rupert has been there almost as long. Every morning I drive in to the doctor’s lot and drive by his parking stall. I always read his name on the placard posted on the wall. Do you know why? It’s always empty.” Jack put emphasis on the word always. “The day of the murders his car was in there when I got in at 7:30 for the first time ever. I hear he w
as in around five o’clock. Why? Is it a coincidence?’

  “Hmmm, I see what you’re saying, Jack. But what motive could Rupert possibly have? And how did he do it? He didn’t pull the trigger. How could he influence that man to kill John, Heather, and the guard?”

  “Those are the real questions. Let’s think outside the box. The man had to be put under some hypnotic state. Drugged, perhaps?”

  “What kind of drug could do this? Have they done a drug screen on the murderer?”

  “Yes, and preliminarily it was negative. You know, in real life the process is much slower than on TV. Law and Order detective’s Logan or Boren or CSI Grisham would have the whole case solved in one-hour and that includes commercials. They get lab results pronto. Here in the real world these things take time. Lots of time. They have sent blood, urine, hair and God knows what else to be tested for drugs. We’ll see what that full report adds to the case.”

  “What about hypnosis? Could Rupert, or anyone else for that matter, put somebody under hypnosis to such a degree that he would perform these heinous acts?”

  “I don’t know. Rupert had been in the unit an hour or so beforehand. He apparently was not present at the time. If it was hypnosis, wouldn’t he have to be present at the onset of the delusional state?”

  “I think you’re probably right. I don’t know much about hypnosis.” Claire paused for a moment. “Did you talk to the police about your suspicions of Rupert?”

  “Not yet. It would be premature. I hate the son of a bitch, but I want to be fair. I don’t want to be like those doctors that fall in love with their diagnosis too early then pursue data in support of their biased first impression and neglect the truth and facts. I’ll do my own investigation into Rupert and keep my mind open.”

  “Your own investigation? Listen to you, Detective Norris,” exclaimed Claire facetiously.