First Do No Harm

by L Jan Eira

  “Any recent changes?” asked Mike. All present had smiled at James’ comments, save for the FBI agent, who pressed on.

  “No, no recent changes. I’ve worked for that man for years and that’s just the way he is. Very smart, but very nervous.”

  “James, what about the experiments and research trials you are doing here at the research lab?” asked Susan, attempting to move the questioning along.

  “We are in the midst of many. I can provide a list of all of them, if you’d like.”

  “Yes, that would be great,” interjected Jack before the other interrogators had a chance to reply.

  “Give me a couple of hours and I will have a complete list detailing our efforts here at Newton Memorial,” said James agreeably. He yawned again, putting his right hand in front of his mouth.

  “We would greatly appreciate that. Of the research treatments and unknown drugs you are working with, any of them capable of causing paranoia and delusion?” persisted Jack, more to the point.

  “No, not that I know,” declared James, pensively and demonstrating little confidence in his answer.

  “Are you experimenting with any drugs that affect the central nervous system?” persevered Jack.

  “No, most of our research involves cardiovascular; some cancer, too, but not much. Dr. Rupert could give you a much more detailed analysis of the actual research being carried out,” responded James.

  “We will talk to him, as well,” said the FBI agent.

  “You mostly work with rats, huh?” asked Herb.

  “We almost always start out with the rodent model, then either progress to small mammals like pigs or chimps, or go directly to humans, depending on the situation. Dr. Rupert and his research group make those decisions. I just make sure they have what they need to work with.”

  “We noticed that nine to twelve months ago, you went through a lot of rats. More than ever before in the history of the research lab. What was that all about?” asked Herb.

  “Rat Poison,” James said and smiled. “LFJ659 is a new drug for congestive heart failure that we were testing on rats. Instead of improving the heart failure, the stuff was killing rats. Dr. Rupert called the drug Rat Poison. Usually it takes us a couple of weeks to figure out the right dose, but this one is so potent that it can only be administered in minute quantities. We spent a lot of time and money buying rats getting to the right dose. They kept dying from what was subsequently found to be too high a dose. We now have it right and are getting great results. Dr. Rupert is satisfied with the progress we’ve made with this drug.”

  “How does the drug work and how is it administered?” asked Jack, fascination in his voice.

  “The mode of action remains unknown and it is administered intravenously.”

  “Will you show us your records about the human phase response? Any human deaths?” inquired Jack.

  “No, the patients so far have been all rats. No deaths recently. We will start the human phase soon.” James knocked three times on the wooden table.

  “Are you working on any drug delivery systems?” asked the young doctor.

  “Yes, we are placing medications in tiny bubbles which can be administered intravenously or by inhalation. When the drug reaches the target organ or site, we can use ultrasound to disrupt the bubbles and deliver the material exactly where it’ll do the most good. This is done remotely through a specific pre-determined high-frequency ultrasound wave.”

  “So you can burst certain bubbles with one frequency and others with a different frequency?” Jack was impressed.

  “Sure, that way we can administer different medications simultaneously, but time the delivery of each agent by dialing in the desired frequency.” James yawned yet again, covering his mouth with his right hand.

  The two-sided conversation continued for several long moments, with the technical lingo increasing with each passing minute. At some point, the cops became totally lost with the medical jargon. Since Jack was on a roll, they remained silent. They would later ask for unriddling of all the scientific gobbledygook. While conversing enthusiastically, the two medical men walked to the area of the lab where the equipment in question was housed. The cops followed, still unsure of the details of the on-going dialogue. James showed the increasingly fascinated Jack the MultiTech RF Sonicator, Bubble Maker, and other units used in the different experiments. James demonstrated how they operated and explained their utility.

  James was helpful, accommodating and courteous. And sleepy. It was clear, he truly wanted to be a positive factor in the investigation into the carnage of last week that had so devastated the hospital. The town. The county. The country. Unfortunately, the conversation with James, though informative, did not appear to be rewarding in advancing the hunt for the monster or monsters responsible for the bloodshed.

  *****

  Five days ago

  September 26

  8:34 AM

  By the time Jack arrived at police headquarters, the meeting had already begun. Herb was speaking to the group, which consisted of the usual faces: detectives Susan Quentin, Jim Franklin and Mike Ganz. Today’s meeting also included a homely, stocky, well-dressed bald man with ill-fitting clothes and thick glasses. Jack would later find out this was Sebastian Ritter, the district attorney.

  When Jack entered the room, the group was discussing the mounting evidence against Dr. Ian Rupert. Ritter agreed Rupert was a person of extreme interest, but the evidence was circumstantial. They needed more to arrest him. Mike discussed his search efforts with the FBI database to see if the gun was tied to Rupert somehow. So far, the search had remained unfruitful.

  “Let’s bring him in for an interview,” opined Herb.

  “I don’t think we have enough to compel him to do that yet,” disagreed Mike.

  “What do you think, counselor?” asked Herb of the DA.

  “I will give him a call and invite him to come in. It doesn’t have to be threatening. We’re just asking for his help to solve the murders that occurred at his hospital. I know him personally from previous fundraising events for the research lab and hospital. It’ll be better if I do it instead of you.” This said, Sebastian excused himself and left the room to make the phone call.

  The conversation then shifted to Major Rooner and Muhammad Akrim. Jack talked about his discussion with Steve Peski at the airport. Mike had not been able to find out much.

  “Major Rooner is a military man who disappeared off the face of the earth seven years ago. This typically means he is deep undercover for the government. We’re still trying to get more information and even speak with him directly about all this, but don’t hold your breath. I have my FBI connections working on this and I’ll keep you informed of their progress,” said Mike.

  “What about Akrim?” asked Jack.

  “Akrim is a business man, but what his business is we cannot say, as yet. He was born in Pakistan but has lived in Libya for several years,” answered Mike.

  “Is he involved with terrorism?” inquired Herb.

  “We don’t know yet,” responded Mike.

  Having murmured these words, Mike appeared microscopically edgy, thought Jack. If not for Claire’s insistence that Jack learn to read body language so as to better understand what his patients were feeling, he too would have missed the nearly indiscernible signs. Mike clenched his jaw and his hands became fidgety. Mike tried to hide his restlessness by placing his hands under the table. Mike looked intently at Herb and Susan. As he did so, Jack fleetingly stared and concentrated on his forehead. A tiny bead of sweat had actually become visible, but barely. Mike was nervous. Something was bothering him. But what? And why? As Jack contemplated these questions deep in his head, he heard his name.

  “Jack, what is your view of all this?” asked Herb.

  “I think Rupert and his team, while investigating a new treatment, stumbled upon a way to kill people from a distance. I think the U.S. military is interested in it as well as some other foreign organization, either for
military use or maybe even terrorism.” As Jack spoke, he continued to notice the almost imperceptible physical and emotional changes in Mike.

  “Interesting opinion,” said Susan. Herb nodded with interest and agreement. Mike was still sitting on his chair quietly, endeavoring to remain inconspicuous, despite his internal agitation. Interestingly, besides Jack, no one else seemed to have noticed. For that, Jack had Claire to thank. Jack continued, “We need to find out more about the research projects Rupert has going on. It is conceivable that John Connor found out and threatened to go to the authorities. So the hospital murders might have been a ploy to get rid of him with the others being innocent bystanders.”

  Jack paused, an eye still on Mike. At this point, Jack did not want to tip his hat anymore. He was no longer sure he could trust the FBI man.

  “Great work, Jack. It is a great theory.” Mike had gotten off his chair and was now walking slowly toward the young doctor. He rested his hands on Jack’s shoulders, as he continued to speak to the group.

  “I will send the gadgets we obtained from the lab to the FBI headquarters for further analysis. I bet the lab geeks will come up with a plausible theory as to the methods of the killers.”

  “I think we can do that here. I would love a chance to analyze the equipment,” said Jack although he was quickly interrupted by Herb.

  “I agree that the FBI is in a better position to make a determination, Jack. I know you are interested in looking at the stuff, but in the interest of time, I think we should send everything to the FBI lab. Mike, will you arrange that?” Mike nodded.

  “Jack,” said Mike, “Have you discussed any of our meetings with anyone outside these walls?”

  “Claire, my wife,” answered Jack in a serious tone.

  “Anyone else?”

  “No, just Claire.”

  “It is very important for you not to reveal our conversations to anyone. Anyone at all. Even your wife. Can we agree on that?” asked the FBI agent. Jack nodded. Mike’s newfound sense of calmness was disconcerting, especially given his nearly indiscernible body language of a few moments earlier. Jack was now having second thoughts about his prior interpretative prowess. Maybe he had it all wrong. Or maybe he was right on.

  The conference door opened and in came Sebastian wearing an ear-to-ear smile.

  “I did it,” he announced proudly to the group. “Rupert is coming in with his lawyer tomorrow morning at eleven. I’ve cleared my schedule so I can be here.”

  *****

  10:03 AM

  After the meeting, all participants left the conference room. Jack sat in his car contemplating what to do about his new philosophy regarding Detective Mike Ganz.

  He decided to talk to Herb. He dialed his cell number.

  “Herb, it’s me, Jack.”

  “Did you forget something?”

  “No, I have to talk to you in private. Away from the rest of the team.”

  “What’s the matter?”

  “Can you come out to my car? It won’t take long. I’m out in the parking lot.”

  “Sure, I’ll be right there.” The phone line went dead. As promised, Herb soon appeared. The parking lot was full of cars, but nobody was in sight. Herb entered Jack’s car, when the doctor opened the door from the driver’s seat.

  “So, what’s bothering you, Jack?”

  “Mike.”

  “What about Mike?”

  “I don’t know. Herb, I get bad vibes from him.”

  “Really? What makes you say that?”

  “I don’t know, Herb. I just don’t know.”

  “What do you think we should do about it?”

  “Just watch him. Watch his body language. Watch his work. I don’t trust him.”

  “Well, I guess I owe you that much. I will watch him closely.”

  “Herb, this is just between us. Don’t say anything to Susan or anyone else. Let’s see what you observe in the next twenty-four hours.”

  “Okay. Deal.”

  Reassuringly, Herb made a fist and lightly hit Jack’s right arm as he exited the vehicle. As he disappeared from sight, Jack wasn’t sure if Herb took him seriously or not. If he was having trouble coming to grips with his own observations of Mike, how would Jack expect Herb to take this cryptic request?

  “Herb’s probably having a good laugh with Mike right now, telling him about my amateurish conclusions,” thought Jack with a smile. “Couldn’t blame him, if he did.”

  *****

  Four days ago

  September 27

  9:52 AM

  The room was quiet and dark. The man with the phone was standing, looking out the window. The light emanating from the outside and his reflection on the window would not betray his real identity. He was wearing a multicolored robe.

  “Rupert is pathetic and jumpy. I don’t trust him. Too itchy.” The man paused, the phone receiver to his ear.

  “That’s a shame.” A quiet moment ensued while the other party spoke.

  “No. There’s no way around it,” he responded confidently to the voice on the line.

  “No. I will take care of it. You find and bring to me all the paper trails. I want everything. He has contracts, letters, invoices. Everything.” Another pause.

  “I don’t care how you do it. Just do it.” Silence again.

  “I will not tolerate sloppy work. We have too much riding on this.” A long pause.

  He slammed the phone down on the receiver, his anger erupting to the surface. His body tensed. The blood vessels on his temples engorged, visibly throbbing.

  The man got a small suitcase from underneath the bed. On the bed, there was a suit jacket, neatly positioned to avoid wrinkling. He placed the suitcase on a nearby couch, dialed in the correct code on the combination lock causing it to fling open. He unzipped the valise. He pulled out a small contraption, about the size of a deck of cards. He quickly analyzed its small LED display to assure that the battery had sufficient power and that the unit would not fail the project at the appropriate time. After a quick inspection, he slid the unit into his right jacket pocket. Inside the suitcase, the man also found and removed a small tank and a small handheld nebulizer. He attached the tank to the nebulizer and turned the unit on. He pulled the trigger demonstrating that the nebulizer was operational. The man then pulled out a small leather box and removed from it an ampule, which he broke open. He carefully dripped its content into a chamber inside the nebulizer. Satisfied with the results, the man placed the contraption inside his left suit pocket.

  The stranger got on his knees. He grabbed the suitcase, ascertained that the padlock was properly and securely fastened and returned the baggage to its concealed nest under the bed. The man stood up, removed his multicolor robe and set it on the bed neatly.

  *****

  10:41 AM

  The doctors had just begun ward rounds. Jill Jeffries, a first year medical resident was discussing her patient.

  “Mrs. Richardson is a seventy-two year-old woman who presented with atrial fibrillation. She has a history of CHF from a cardiomyopathy, which proved to be resistant to appropriate optimized medical therapy. She received a defibrillator with CRT.”

  “I’m sorry, a what?” interrupted Peter Joseph, one of the medical students.

  “CRT is cardiac resynchronization therapy,” answered Jill, hoping Jack would take it from there and explain the procedure to all.

  Rounds were abruptly interrupted by a deafening uproar coming from the room behind them. The loud noises became screams, which became progressively louder and real. Two people ran out of the room. They were John Connor and Heather McCormick.

  “John. Heather. I thought you were …”

  These thoughts were broken up by thunderous gunshots. Red stains suddenly appeared on John’s white lab coat, his face abruptly turning ghostly pale, and Heather’s forehead, immediately disintegrating her stunning facial features. Both stopped running frantically and slowly fell forward, into Jack’s arms. Jack felt helpless and p
owerless. As the two lifeless bodies fell at his feet, Jack stared at his hands, which had become blood-soaked, dripping crimson red.

  “Is it the coronary sinus?” asked Jill, her voice miles away. Jill looked at Jack, noticing his pallor, air hunger and intense perspiration. Jack stood, looking frantically at his own hands, palms facing upward.

  “Are you okay, Dr. Norris?” asked Taylor also noticing Jack’s distress.

  “I’m alright. Sorry. I missed what you were asking.” Jack felt asinine and silly.

  “I don’t think you’re okay at all. You’re short of breath and broke out in a cold sweat.” Jill appeared worried.

  “I’ll be okay. What were you asking?” endured Jack, feeling a bit better about his dreadful nightmarish fantasy of a few moments ago.

  “I was asking about CRT. Jill was telling us how it is a procedure where three intracardiac leads are used to pace the right atrium, right ventricle and left ventricle to help synchronize the heart contractions in patients with cardiomyopathy resistant to medical therapy. The right-sided leads can be placed inside the right heart, but the lead that paces the left ventricle cannot be placed in there, so Jill was saying the leads is placed in the coronary sinus. I was hoping you could say more about it,” explained Peter going back to business, as usual.

  “Yes, the left ventricle is paced from the coronary sinus. Why don’t you plan to observe a CRT implantation? I’ll find out when we have a case and I’ll let you know.” Jack paused. “I’m not feeling especially well. Let me take a break. I need to go get some water. Stan, you go ahead with rounds and page me if you have any questions. I’ll catch up with you in a little bit.”

  Jack did not look well. His customary olive-colored complexion was absent, leaving behind a weary paleness and cold beads of sweat dripping down his forehead and temples. As he walked away from the group, Jack looked outside the window to his left. From that vantage point, he could see the edifice that housed the Emergency Medical Service rigs, next door to the emergency department main entrance. He spied the ambulance bay door open and witnessed Rescue One depart the premises with lights and siren on the way to some mysterious catastrophe.