First Do No Harm

by L Jan Eira

  Jack took Herb’s carotid pulse. His pulse was extremely rapid, but faint. Sirens in the distance grew increasingly louder by the second, alerting the group that an ambulance with paramedics would soon arrive.

  Herb briefly regained consciousness becoming agitated and hyper.

  “My guns, my gun, my guns,” repeated the confused, combative patient, slurring his words, which were barely comprehensible.

  “Herb, do you know what happened to you?” asked Jack hoping to assess Herb’s mental status.

  “Ma guns, ma guh…” persisted Herb with increasing difficulty in forming his words. His combativeness and agitation was waning rapidly as he faded.

  The ambulance siren was now loud, as the emergency vehicle arrived. Two young men dressed in a blue uniform jumped out of the ambulance carrying a large container full of drugs.

  “It looks like he had a seizure,” said Mike to the approaching paramedics.

  “Does he have a history of seizures?” asked Jack looking at Susan.

  “No, he’s been healthy all his life. He had a full physical three months ago and was told he was a picture of health,” answered Susan.

  The paramedics cut off Herb’s shirt and placed skin electrodes on his chest.

  “I’m a doctor. Jack Norris,” introduced the young doctor.

  “I recognize you, doc. I’m Ray, this is Bo,” said one of the paramedics.

  “Ma gun, mmm,” continued Herb now even more feebly.

  “Sinus tachycardia,” said Jack, as the monitor unit came alive, indicating Herb’s heart beat. It was racing. Racing at 220 beats per minute.

  “Get a blood pressure, please,” asked one of the paramedics of his partner who obliged.

  “Let’s administer verapamil and propranolol as soon as we establish an IV line,” commanded Jack.

  As this was being done, the monitor suddenly changed. The extremely rapid QRS sharp waves, indicating each heart beat, suddenly slowed to 100 then 40 then became a straight line. Simultaneously, Herb, took a deep last breath.

  “Start CPR. Let me help you get a line. Get ready to give one milligram of epinephrine and one milligram of atropine,” commanded Jack authoritatively.

  Susan started chest compressions. One of the police officers had obvious first aid training, grabbed an Ambu bag and placed the mask over Herb’s mouth and nose. At his request, another officer brought an oxygen green cylinder closer. This was attached to the Ambu via the appropriate clear tubing. He squeezed the bag every five seconds forcing air into Herb’s lungs. Susan continued chest compressions like a pro.

  In no time at all, and with the expertise of a magician, Jack had intravenous access. A bag of five percent dextrose in water was held by one of the medics. The tubing from the IV bag was hooked to the IV port, which was taped securely to the skin.

  “Epinephrine and atropine are in,” yelled one of the paramedics. CPR efforts continued for a minute. The monitor was reassessed but still showed a flat line.

  “One more round of epi and atropine,” ordered Jack.

  Instantaneously, the paramedic giving drugs complied.

  “No response,” said one of the paramedics despondently.

  “Continue CPR to the hospital. Let’s move fast and give another round of drugs,” commanded Jack with sorrow. Jack realized that the chance of a successful outcome was nil.

  The group positioned Herb on the stretcher, placed it in the ambulance and sped to Newton Memorial Hospital. A radio announcement to the emergency department’s personnel would facilitate the transfer on arrival. In the rig, Susan continued CPR, Jack, at her side, had taken on the task of breathing for Herb. More drugs were administered intravenously in the hopes of restarting the heartbeat. None did any good.

  As the ambulance sped away with lights and sirens blaring, Jack could not stop hearing Herb’s last words in his head: “My guns, my guns!”

  Strange. “Why would he want his gun,” thought Jack. “Did he want to commit suicide? Kill people around him? Was he poisoned like the others?”

  *****

  Two days ago

  September 29

  12:36 AM

  A nurse led Claire, Susan and Mike to the solace room. Anxious and concerned, none of them could sit still. Instead, they stood outside the door to the solace room, gazing at the door to the room where Herb was taken. Jack and the emergency department’s personnel continued resuscitative efforts on Herb.

  Ten minutes later, the door to Cardiac Room Three opened, allowing Jack to exit. For the brief moment the door was ajar, the commotion inside the room became visible. The dreaded reality they all feared was now on display as a white sheet, a telltale sign of the unsuccessful resuscitation covered Herb’s total body, including his head. Jack’s body language was revealing of the anguish and sorrow he was feeling inside.

  Jack joined the group. They entered the solace room and sat down. This time, they were there to mourn one of their own.

  “I can’t believe he’s gone. I must call his family. What will I tell them?” asked Susan rhetorically.

  “I know it’s tough. I’ll do it with you, Susan,” offered Claire, sympathetically.

  “Thank you so much. I have done this so many times with so many different people. But now, it’s one of our own.” Susan’s eyes were moist, tears flowing down her cheeks. Claire sat by her silently, holding a box of tissues.

  “I’ll be with you for as long as you need me,” said Claire.

  “I should tell his wife in person. I think that’s what he’d want,” alleged Susan.

  “I’ll go with her,” said Mike before Claire could speak.

  “Thanks, Mike. You two go on home. Mike and I will take care of this. You need some rest. We’ll talk in the morning,” offered Susan appreciatively, looking at Jack and Claire.

  The river of tears flowed even more briskly now. The two couples exited the emergency room and walked outside towards the parking lot. Susan and Mike entered a waiting police car and soon were on their way.

  Jack and Claire exited the ED main door and prepared to walk towards the car she had driven back from the airport.

  “Claire, give me a minute. I need to run downstairs. I’ll be right back,” said Jack as he ran off into the guts of the hospital. In a few minutes, Jack returned with a large shopping bag full of medication vials, syringes, needles, a tourniquet and alcohol swabs.

  “What’s all this stuff for?” asked Claire intrigued by the sack of drugs.

  “All these people that have died, either in the hospital or at home, have done so in a cardiovascularly hyper-stimulated manner. Herb tonight had a heart rate over 200 beats per minute. That is incredibly difficult to fathom unless there are stimulatory drugs in his system. So these vials of medicines in here are drugs that block the cells in the body from being stimulated.”

  “Are you saying Herb was poisoned? I thought he had a seizure,” asked Claire puzzled.

  “He did have a seizure, but why? With a seizure, the heartbeat may quicken a bit, but not that fast. He had to be poisoned with the same stuff as the others,” concluded Jack.

  “Rat Poison?” asked Claire.

  “Yes.”

  “But who?” Claire seemed perplexed and troubled.

  “Herb and I have been suspicious of Mike Ganz. He’s an FBI agent working on this case. He could have done it. He was there and—”

  “I think so, I think it’s Mike Ganz. He’s an FBI agent…” Jack suddenly stopped talking, a look of elation in his eyes, as if to say ‘Eureka!’

  “What’s wrong, Jack?” asked Claire.

  “Mike Ganz. Mike Ganz,” repeated Jack with a progressively excited tone. “Mike Ganz!”

  “What about him?”

  “Don’t you get it? Mike Ganz. My guns!” Jack sounded like he had lost it.

  “No, I don’t get.”

  “Herb was trying to tell me Mike Ganz. I thought he was saying my guns but he was telling me the name of his killer. Mike Ganz.”

&n
bsp; “Well, Mike is on the way to Herb’s house with Susan. What should we do about it?” asked Claire vexed by how the situation had unfolded.

  “I don’t think he’ll do anything to her. Not right now. He knows Susan doesn’t know anything. I think Herb found out and that’s why he killed him. Herb and I had been talking about Mike. We suspected him; Herb was going to approach Mike. I think he did tonight and paid the price. Claire, if something happens to me, I will use these drugs in the bag. I think they’ll help me.” Jack stopped for a moment to search his wallet in his back pocket. In it, he removed two business cards. He put one back into his pocket and handed the other to Claire.

  “This is Susan’s card. Her cell number is on there. Call her, if something happens to me.”

  “What’s going to happen to you, Jack? I’m scared,” said Claire.

  “I know you are, sweetheart. We’ll be all right.”

  As they approached their house, Jack and Claire noticed a police car in the driveway.

  “Good evening officer, we’re Jack and Claire Norris,” explained Jack after he parked his car next to the police car and opened up his window. It was a beautiful dark evening. The temperature was comfortable. The officer sat in the car with the windows open enjoying the cool delightful mist the autumn evening offered.

  “Welcome home. Rest assured I’m on the job. Nobody will bother you while I’m here. I know a lot has happened, but you can feel safe. Sleep well,” reassured the cop. He was young, but extremely well built; the kind of body structure that could only come from repeated trips to the gym.

  “Can we offer you anything? Some coffee?” offered Claire leaning down to see the cop from the passenger’s seat.

  “No, thanks, Mrs. Norris, I’m fine,” he said lifting up his large cup of McDonald’s coffee. He smiled reassuringly.

  Jack drove on with a polite nod and wave of his left hand. Once in the garage, the automatic door closed. Jack watched as the garage door locked firmly in place. As Claire prepared to go to bed, Jack went around the house, door-to-door and window-to-window, making sure they were all properly and securely locked. As the last window was tested, Jack looked outside into his driveway. The police officer was now standing outside the car leaning on the driver’s door smoking a cigarette and sipping his coffee.

  *****

  5:30 AM

  “Two thousand dollars to each of you,” offered the man in the dark room as he spoke into the cell phone. After a long pause, the mysterious man continued to speak. He sported a comfortable multicolor robe and was sitting on a divan, his feet up on an ottoman. He was wearing his bedroom slippers and sipped coffee as he spoke.

  “Okay, make it five thousand, total. Dead or alive, it doesn’t matter to me. But I don’t want any screw-ups. No mistakes.” The incomprehensible distant words emanating from the cell phone was the only sound that disturbed the calmness and silence of the night.

  “No, five includes all.” The other party interrupted his words, for a short moment.

  “Don’t forget, you owe me. That’s my final offer. If you’re not interested, I’ll go somewhere else,” continued the man pausing to hear a reply.

  “When can you get here? I need this done right away.” Another break while the other voiced his viewpoint.

  “Not soon enough. I need this job done now.” The mysterious man commanded respect and fear.

  “Okay, tomorrow night. Don’t be late or you’ll be sorry.”

  *****

  2:12 PM

  Jack and Claire felt safe with the police protection. The officer had proven respectful and sympathetic. In the morning, another policeman arrived to relieve the one that spent the night on sentinel duty. The newly arrived man seemed just as competent and professional as the other. The two cops were rewarded with coffee, bagels, muffins and orange juice for breakfast.

  Around mid morning, Jack left for an hour to purchase an alarm system. There was no time to have it done professionally, but Jack thought, “I’m an electrician of hearts. I’m not all together unintelligent. How difficult could it be to wire this house safe?”

  Jack tried to contact Susan. Several voice messages were left on her cell number. Finally, she called back but Jack was on a ladder wiring the upstairs windows. He didn’t hear the phone ring. Later, when he realized he missed a call, he heard the voice message left by Susan. She said she was sorry she had not answered her phone calls, but that she was busy comforting the Fuller’s. They had been close and Susan felt it was her duty, as a friend and colleague, to be with his family. She vowed to call later in the evening or the next morning. Jack understood the pain and anguish they were suffering. He felt it, too.

  When lunch was served, the police officer was invited inside to experience Claire’s wonderful culinary skills. The guard expressed his appreciation for Claire’s superb talents and stated that this was the best fried-chicken he had ever had. Throughout the meal, he gave his thanks for Claire and Jack’s hospitality many times.

  Jack spent the rest of the day installing the alarm system. The task proved arduous and grueling.

  “Why don’t we just get a dog?” he asked Claire.

  “Is it working yet?” she inquired.

  “What, the dog?”

  “No, the alarm system?”

  “It’s all installed, but I need to plug into the electrical. You know, a dog doesn’t need electrical. They work on kibble, which is easier to install. I need to research this some more. I don’t want to short out the whole Evansville board. I’ll finish this tomorrow.”

  “You call yourself an electrician? That’s a joke.” Claire smiled as they made eye contact, dirt and oil stains all over Jack’s face and clothes.

  “Heart electrician! Not house electrician,” he amended.

  “Doctors,” Claire shook her head, a faint smile on her face.

  “Do you know how many psychologists it takes to change a light bulb?” asked Jack.

  “No, how many?”

  “Just one, but the light bulb really has to want to change.”

  “Jack, do you know how many cardiac electrophysiologists it takes to change a light bulb?”

  “No, how many?”

  “Two. One to hold the bulb, the other to rotate the house.”

  *****

  3:52 AM

  During hospital rounds, Jack had begun to regain his confidence. Things were definitely resuming some degree of normalcy. The medical group had entered Room 622 as they discussed the intricacies of the patient’s medical problems. An elderly man lay in bed under the covers, on his back, his hands under his head. The young doctors continued the discussion about the patient’s medical ailments. Barely noticeable, the man slowly moved both his arms to under the linens. Engaged in the conversations, Jack and the other doctors hardly became aware of the patient’s activities. Subtly and covertly, the old man pulled his right arm out from under the bed sheets, exposing the small revolver. Suddenly, the patient sat up in bed, holding the firearm with both hands, the muzzle pointed at Jack. A loud gunshot was heard, the bullet traveling directly towards Jack’s forehead at 2,000 feet per second. The earsplitting sound caused Jack’s body to jerk awake from his nightmare. Jack sat up in bed, sweating profusely, heart pounding and breathing rapidly. He looked over at Claire, who slept peacefully, like an angel.

  Despite trying, Jack could not fall back asleep, his nightmare and the events of the last few weeks were playing wildly in his mind. He got up as slowly and as silently as he could, not to disturb Claire. He glanced out the window to see the police car parked on his driveway, a reassuring detail. A spotlight mounted high under the roofline illuminated portions of the front yard, driveway and police car. A quick shadow passing over the driver’s door disappeared as rapidly as it had appeared.

  “What was that?” thought Jack curiously. “Maybe it was a blowing tree branch shadow?” Whatever it was, it caught Jack’s eye. Jack strained to listen for unusual sounds. Nothing. No wind blowing, no dogs barking, no coyote
s howling, no ghosts jingling. Nothing at all, just weary utter silence.

  Jack walked out of the master bedroom and took the steps stealthily to avoid making any sound. He opened up the kitchen door into the backyard and paused to soak in the calmness of the night. He turned on the flashlight he picked up in the kitchen and headed for the police car. He was deliberately strident and conspicuous as he approached the vehicle parked on the driveway, lest he would find the police officer fast asleep at his post. That would be not only awkward for both men, but more importantly, it would irreparably diminish the incredible reassurance the police car represented for him and Claire. On the other hand, maybe the officer would be super efficient and shoot him dead as he approached unannounced.

  As he converged upon the automobile, he could see the officer sitting comfortably inside. He was still and quiet, his left arm hanging out the window, his head resting snugly on the headrest. Jack continued to approach, ensuring that he stepped on a small, dry, fallen tree limb to proclaim his arrival. The officer remained silent.

  Now ten feet from the police officer, Jack took a whiff of a smell he recognized only too well. Fresh blood. This was a scent he was accustomed to in the operating room and emergency department, but not on his driveway and not emanating from a professional dispatched to protect him and his wife. Surprised at the sensation and curious to learn more, Jack quickened his step towards the car.

  Jack gasped uncontrollably. The police officer bled profusely from his neck, ear to ear. Jack noticed that the blood, though freshly spilt, had stopped spurting indicating death had arrived for the police officer. Jack entertained the thought of checking for a pulse to be sure, but this impulse was immediately interrupted by thoughts of Claire. Jack ran into the house. Before he entered through the kitchen door, he first stopped in the garage to pick up a baseball bat. Then, he made a quick stop by his cell phone, charging in a cradle on a table nearby. He dialed 911 and put the phone down. The police would get the call and dispatch help to the signal beacon.