First Do No Harm

by L Jan Eira

  At the pilot’s request, the airplane was readied for quick departure by the ground crew. The aviators entered the FBO but soon returned to the aircraft with a man that had driven in by himself and had parked his car right outside the building. He was wearing an expensive suit and carrying a briefcase. His name was Mike Ganz. Steve noticed that one of the pilots had politely offered to carry his small suitcase, but he vehemently refused.

  “What’s he carrying in there, gold pieces?” thought Steve, amusingly.

  The three men boarded the plane and soon the door was retracted and locked from inside the aircraft.

  The vicinity of the jet was vacated in anticipation that the crew would soon be firing up the engines with a noteworthy increase in decibels. Before long, the jet engines came alive.

  “Gulfstream, four-two-tango-juliet, ready to taxi for immediate take-off,” announced the loud speakers mounted outside the building, echoing the conversation between the cockpit and ground control.

  “Gulfstream, four-two-tango-juliet, negative on taxi; we are awaiting clearance for your IFR file.” The two pilots looked at each other, perplexity painted on their faces. An airport of this size, would rarely delay taxiing to the runway. Clearance for a flight from here would inevitably take a few computer keystrokes and a few seconds.

  ”What’s wrong? Why aren’t we moving?” asked Mike, impatiently after a minute.

  “They’re asking us to hold here until we get clearance, sir. It shouldn’t be long,” said the pilot in command, sitting on the left seat in the cockpit.

  A few more tense moments passed. By then, Mike was irritated, rubbing his hands on his knees forcibly.

  “What’s going on? Let’s go. Now!” he commanded.

  “I’m sorry, sir. We cannot taxi without instruction from—” The pilot stopped talking as he felt the barrel of the revolver touch his right temple.

  “Let’s go, damn it. Now!” screamed Mike.

  The pilots glanced nervously at each other. They had no choice. The jet began moving forward as the throttle lever was advanced slowly.

  “Gulfstream, four-two-tango-juliet, you do not have permission to taxi,” warned the ground traffic controller noticing from his high perch that the aircraft was moving forward, in clear violation of FAA regulations.

  “Ground control, Gulfstream four-two-tango-juliet, I am being forced to taxi. We are taxiing to runway one-eight.” The pilot sounded petrified as he spoke into the microphone.

  The jet slowly made its way to Taxiway A, then B and finally Taxiway E. Another right turn and they would take the runway marked eighteen.

  “Gulfstream, four-two-tango-juliet, hold short of runway one-eight,” yelled the controller.

  The jet did not obey and soon, the airplane was lined up with the center dashed line.

  As the airplane approached the runway, Mike returned to his seat, although he could still spy the two pilots, the cockpit door ajar. He looked out his window, apprehensively. Seeing the airplane take the runway, he sat back and took in a deep slow breath. He fastened his seatbelt.

  It was at that time, that multiple emergency vehicles sped onto the runway. Susan’s unmarked car was leading the procession. In moments, the cars barricaded the plane on all sides. The officers got out of their cars, guns drawn.

  *****

  12:22 PM

  The hospital room was quiet, save for the rhythmic sounds of the respirator pushing air into the sedated patient. Multiple IV bags dripped medicines into his veins. At his side, a woman sat gloomily, holding the patient’s hand, staring at his face. The woman was Claire.

  A loud ring upset the stillness and monotony in the room. It was Claire’s cell phone, located in her purse at the foot of the bed. Startled, Claire sat upright and answered the phone.

  “We got him!” exclaimed Susan.

  Claire, noticing that the loud ring awakened the patient, passed the word on to him.

  “Jack, they got him. Susan arrested Mike Ganz. He’s in police custody,” she repeated felicitously. Claire closed the cell phone after telling Susan she would call her back later.

  Despite the deep sedation, Jack seemed to smile. Maybe even nod. He had an endotracheal tube in his mouth, which was attached to a respirator, metrically pushing oxygenated air into his airways and lungs, necessary due to high-dose of sedatives required.

  Jack’s brain was in a deep fog, due to the intense intravenous medications he was receiving. Once Claire’s message registered in Jack’s brain, adrenaline commenced to outpour into his circulatory system. Inside his body and mind, turmoil was afoot. Jack fought the heavy sedation, wanting to shout and scream. There was more to be declared. There was much more to be done.

  Stop these drugs. Let me speak. I have to speak. I have something I have to say right now, Jack wanted to yell. But he could not. His muscles were paralyzed and his mind was blanketed by the sedatives. Sitting right next to him, Claire could not perceive any change whatsoever. All was calm.

  Jill, Jack’s nurse, strolled into the ICU cubicle.

  “What’s going on?” she inquired looking around the room, then at Claire.

  “Oh, nothing. He seems to be doing okay.” Claire was a bit intrigued with the question. Jill had just checked on him about ten minutes before and all was stable. All was well.

  “We just picked up an increase in his heart rate and blood pressure on our monitors up front. His oxygen levels are still fine. I wonder what caused the sudden changes in his vital signs.” Jill continued to snoop around looking at all instruments and assessing all the information she could glean from them. The monitor indicated a heart rate of 92 beats per minute and the blood pressure monitor showed 168/92.

  “Is that bad?”

  “No, no. Nothing bad. Just a change is all. Hmmm.” Jill placed the stethoscope in her ears and listened to Jack’s heart and lungs. She felt his extremities, then his forehead. She took his temperature. She assessed the tiny tube in Jack’s groin artery, allowing for constant monitoring of his blood pressure. She flushed the line. She inspected all the intravenous lines for signs of irritation or infection. All seemed intact. All was registering properly.

  “What do you think?” inquired Claire not sure of what to think.

  “It’s all normal,” reassured the young nurse.

  “I just got great news on the phone. I shared the information with Jack. Do you think that caused his pulse and blood pressure to go up?”

  “Maybe. Yes,” answered Jill hesitantly. “Could it have been bad news?”

  “Great news. Why do you ask?”

  “Well, bad news would be more likely to cause this. Not so much good news. It’s more of a distress response. I’ll increase his sedation and paralyzing meds. We’ll watch him carefully for now.” Jill dialed in the higher drip rates for the intravenous agents and documented the changes in the electronic medical record. She walked around the bed again. The effects of the drugs would be instantaneously. The nurse observed for a few minutes as the higher dose entered Jack’s blood stream noticing the change in vital signs. Happy with the results, Jill walked out of the room.

  Jack felt himself start to drift away deeper yet into unawareness. Blissfully, a tear escaped from Jack’s right eye cascading down his cheek. Claire immediately wiped it off then squeezed his hand. They locked eyes for a short moment, until Jack slipped again into much needed deep sleep.

  After five minutes, the heart rate had begun to drop back to the fifties, Jack’s baseline. His blood pressure was back down to 102/56. Claire decided to call Susan back.

  “As I told Jack the good news about you arresting Mike, he first appeared happy then became a bit agitated. He is so drugged up that the only hint of his restlessness was that his heart rate and blood pressure temporarily increased a little bit. His nurse told me this usually means bad news rather than good news. Go figure. She sedated him more heavily and he’s back totally asleep and unaware. His vitals are back to baseline.” Claire waited for a reply from Susan fo
r a moment.

  “I wonder if Jack was trying to tell us something. Some bad news. I wonder if he knows something. If he was trying to speak. I’m on my way in. Will you talk to the doctors and see if it’s safe to stop the sedatives for a little while?” said Susan excitedly.

  “Sure, I’ll page Dr. Irvin and discuss this with him. I’ll see you here soon.”

  Claire asked Jill to page Jack’s doctor. Twenty minutes later, Susan arrived and hugged Claire. Four minutes later, Dr. Irvin arrived. Introductions were made and the three stepped outside to talk away from the patient. Jill took Claire’s place at Jack’s side and re-evaluated him once over again.

  “It would be potentially dangerous to stop these medications. Especially if that was done suddenly. When we do it, we have to wean them over about twelve hours.” Dr. Jeff Irvin was an older intensivist with many years of experience. Jack thought the world of him and had so told Claire many times. When he was assigned to his care, Claire felt very comfortable.

  “I understand, Dr. Irvin. I appreciate your time,” said Susan shaking the doctor’s hand. She hugged Claire again and departed the area without a word.

  The detective walked back to Jack’s office. The area was deserted, as it had been designated a crime scene, yellow police tape closing off access to this wing. She sat at Jack’s desk. She felt it necessary to recreate the situation when Jack was attacked.

  “Okay, I’m sitting here reading a whole bunch of files and documents. Some guy enters and sprays me in the face. I know it’s a poison that’s going to kill me. Now, what do I do?” Susan conversed with herself, no one else in the room. She stood up and held her breath.

  “I know this stuff enters my body as I take breaths. So, I hold my breath and run out of the room. Where do I go?” She stops for a second. She exited the small office and looked to the right and left.

  “To the left, there are only other offices. Dead end. I go right. I run fast. This guy may be chasing me.” She walked to the right, down the hall, past several offices and a conference room. She arrived at the elevator she had used to come up to the office. She pushed the Down button and the light became illuminated. She crossed her arms and waited.

  “I’m not going to wait. I’ve been poisoned. A bad guy may be chasing me.” She looked around and found the door to the stairway.

  “No, I take the steps. I’m used to taking the steps and they’re faster.” Susan recalled briefly the day she met Jack. They walked up these stairs to go to his office. She pushed through the door and stopped.

  “I go downstairs.” She climbed down the stairs. She continued until she arrived. Arrived at the message on the wall. Astonished, she used her cell phone as she reread the blood-written memo:

  J MILLER = RAT POISONER! CHECK CPAP STORES

  *****

  1:21 PM

  The multicolored robe was the last thing to pack. This done, all bags were packed and James Miller was ready to go. Leave forever. Never to return. On the positive side, he had a one-way ticket to Jamaica, where life was easier, beer smoother, and the ocean waves soft. With time, he would even learn to enjoy watching a game or two of cricket.

  He closed all his bank accounts. He would invest his money overseas. He would drive the rental car to Miami then fly to Jamaica. It was all planned out.

  James got into the car and placed the key in the ignition. He started up the car and drove on. He turned right at the second light, en route to Newton Memorial.

  At that exact moment, an unmarked car arrived at his house. Two detectives got out of the vehicle. Wordlessly, one of them walked to the front door of the home while the other strolled towards the back of the property. There, a separate smaller structure served as the garage, being occupied by James’ car. The detective walked around the vehicle making observations. He used a flashlight to illuminate the semi-dark environment. The garage and car were impeccably clean. He felt the hood of the car. It was cold, a sign that the engine had not been turned on for several hours. Meanwhile, the cop on the small front porch looked around for clues. Once at the main entrance, the officer pushed the doorbell.

  “Police department. Open up,” he said, knocking on the door. Nothing. Nobody.

  Moments later, the officer tried the doorknob. It was unlocked. He opened the door and prepared to enter the residence when he heard a distinct noise. A click. Quickly, the detective shut the door and ran away from the house.

  It was at that point the earsplitting explosion occurred, heard many blocks away. The officer was thrown several feet in the air landing on his side, temporarily stealing his breath. With all his might, he fought to drag his body as far from the burning structure and scattered flying fiery debris as he could. By then, his partner was at his side, helping him escape from the house ablaze.

  “Dispatch, Delta-seven-six, officer down. We have an explosion and fire at this location. Send the fire department and EMS,” shouted the cop anxiously.

  “That was quick,” thought James, hearing the blast, driving down the street. “That was way too quick.”

  An instant later, multiple sirens could be heard converging on the scene of the burning house. James pulled over to the side of the road as a red fire truck sped by, going in the opposite direction. Then another. Then an ambulance.

  “The only connection to me is Norris. Maybe he’s come back from the dead,” whispered James to his own face displayed on the rearview mirror, he still spied the emergency vehicles as they sped away.

  James drove to the Home Medical Equipment facility, near the hospital campus, where he would make a quick stop on the way to Florida. As he turned the corner, he noticed a police car parked in front of the store.

  James kept on driving past the establishment. When he turned south onto Interstate Route 41, he accelerated, pulled out his cell phone and dialed.

  “Marlene, I won’t be needing that CPAP equipment after all. I’m all better. Goodbye, darling.” James closed the phone, opened up his car window and tossed the mobile device.

  He turned on the Rolling Stones CD, picked the seventh song, sat back comfortably and prepared for the long trip to paradise, while Mick sang his heart out: You can’t always get what you want! But if you try sometimes, you might just find, you get what you need!

  *****

  Two days after

  October 3

  2:33 PM

  The Rat Poison was now out of Jack’s system. The weaning process from the sedatives, other intravenous medications and respirator had been initiated earlier in the day. As this process was carried out, Jack’s awareness of the world around him would slowly return. When his brainpower sufficiently came online punching through the fog, Jack anxiously signed to Claire and his nurse that he wanted to write something down. The endotracheal tube was still in his lungs bypassing his vocal cords and, as such, he was unable to speak. As soon as he was provided with a clipboard, paper and a pen, he wrote:

  “Get James Miller!” Jack wrote, and handed the clipboard to Claire forcefully and repeatedly pointed to the words.

  “I’ll call Susan right now,” she said. Claire fished out her cell from her purse and dialed. After a short phone conversation between the two women, Claire closed the mobile phone and placed it back in her purse.

  “Susan already knew it was Miller. She told me to thank you for your message on the wall. The police have been trying to find him but he’s nowhere to be found. He may have left the city, maybe even the country. She’s on the way here and will fill us in when she arrives,” said Claire. Somehow, this seemed to have had a soothing effect on Jack. He took a deep sigh.

  Jack tolerated the slow discontinuation of the sedatives and other medication drips and was taken off the respirator. It felt good to be alive, to breathe slowly, and not to feel his heart hammering away inside his ribcage.

  Susan walked in the room, greeted Claire and hugged Jack tightly.

  “Thank you, Jack. Thank you,” said Susan appreciatively. “We couldn’t have done it without yo
u.”

  “If medicine doesn’t work out for me, maybe I can come work with you?” asked Jack, his voice still a bit raspy from the recently removed endotracheal tube.

  “Don’t make me laugh, it still hurts,” said Claire, holding on to her left side.

  “Jack, how did you know James Miller was involved with the murders?” asked Susan.

  “He was the one that sprayed Rat Poison in my face,” answered Jack.

  “I got your message,” said Susan. “We’ve been looking for Miller ever since. We have every cop in the state looking for him. We’re checking airports, bus and train terminals all over the state, but so far, we’ve not found him. He booby-trapped his house to explode It went up in flames when the front door was opened. One of our detectives got minor burns, but he’ll be okay.”

  “If I was him, I would change my name, my appearance, and leave the U.S.,” offered Jack.

  “I agree. I’d be gone by now,” said Susan. There was a pause.

  “Did you check stores that carry CPAP equipment?” inquired Jack.

  “Yes. It took me a while to get that part of the message, but ain’t Google great?”

  “CPAP? What’s that?” asked Claire, wearing an expression of puzzlement.

  “Continuous positive airway pressure,” answered Jack.

  “Why were CPAP equipment stores places to look for Miller?” asked Susan.

  “Miller has obstructive sleep apnea,” said Jack.

  “He has what?” asked Claire.

  “Obstructive sleep apnea is a condition where people stop breathing when they enter deep sleep. That makes them feel very tired all the time since the quality of sleep is very poor.”