No Cure for Murder

by Lawrence Gold

  “Listen, Harrison, and you too nurse. You’re about to make a grave mistake. If you raise her sodium level too quickly, you could kill her.”

  “I know what I’m doing, Weizman. I’d appreciate it if you’d butt out.”

  Jacob looked up in dismay. “First of all, Doctor, Mrs. Brown is my patient and has been for many years.”

  “I’m sorry, Doctor, but she’s on my service, and I’m responsible for her care.”

  “How many emergency cases of low sodium have you treated, Dr. Baldwin?”

  “That’s none of your business.”

  “Tell me what you know about central pontine myelenolysis or CPM, Doctor Baldwin.”

  “Central pontine what?”

  “As I thought. After you give that salt solution and Mrs. Brown has seizures or winds up paralyzed in all her extremities, you’ll be pleased to know.” He pointed at the surgeon and the nurse, “that I’ll be the prize witness for the plaintiff when they sue you both. Keep this little fact in mind, this won’t merely be a malpractice case, this will be felony assault and if she dies, manslaughter.”

  Harrison paled.

  The nurse looked at Jacob with a new level of respect. “Tell me what I should do, Dr. Weizman.”

  Jacob smiled, and then looked at the IV bag of fluid and at Harrison. “First stop this IV. It’s only making her situation worse. I’m writing new IV orders and a series of blood tests for the next six hours. I’m making additional adjustments as I see how she’s correcting her sodium level.”

  Harrison turned away from the bed and shuffled toward the door.

  Jacob followed behind. “I thought I was arrogant in my youth, but compared to you, sir, I was humble.”

  “Fuck off, old man.”

  Jacob laughed. “Some time soon, you’ll recognize that I just saved your ass. Do me a favor, please.”

  “What?”

  “Don’t thank me.”

  Chapter Five

  At 4 a.m., the indirect lighting on the fifth floor medical unit was on its lowest setting in Brier Hospital’s silent hallways. Carol Fox, the ward clerk, sat at her desk organizing patient charts and adding the lab and other diagnostic reports.

  Carol looked up over the raised nursing station counter and saw Tommy Wells’s smiling face.

  “Don’t you ever get to go home, Tommy?”

  He winced at her use of Tommy, but smiled. “It’s Thomas, please.”

  “I’m sorry.”

  “That’s okay. The lab ran out of technicians again, so I volunteered to do a second shift. I really wish the laboratory administration would get its act together.”

  Thomas was five feet four inches and looked a bit like a fifteen-year-old Michael J. Fox, although he recently celebrated his twenty-fifth birthday. Always small for his age, Tommy took crap from the first day he entered intermediate school. He complained to his brothers, one a sophomore and the other a senior in high school. “I’m tired of being pushed around.”

  His oldest brother Stan wasn’t sympathetic. “Keep away from them.”

  “I can’t.”

  “Then, you better stand up. If you let them get away with it, they’ll never stop.”

  “They’re going to kill me, Stan.”

  “You want me to have a word with them?”

  Tommy’s first thought was damn yes, and then he changed his mind. “No. That will only make things worse.”

  The next day when Mitchell Davis, his main tormenter, knocked the books out of Tommy’s hands saying, “Watch where you’re going, shorty,” Tommy surprised him by landing a punch squarely on Mitchell’s nose, his face erupting with a spurt of blood.

  Mitchell held his nose. “You fucking punk. I’m going to kill you.”

  As Mitchell charged toward Tommy, the principal approached the group. “What’s going on here?”

  “Nothing, Sir. I just tripped and banged my nose.”

  The principal took one look at it. “Have the school nurse check it out.”

  Mitchell turned to leave then leaned over to Tommy and snarled, “I’ll see you after school.”

  After school, Tommy was beaten so badly, he was hospitalized and swore he’d never let this happen again.

  He took karate lessons and was more than ready when, at eighteen, he joined the Marines and trained as a medical corpsman. After his discharge from the Marines, he took a job at Brier, working in the lab drawing blood. He had fantasies of becoming a physician, but his grades were poor. Who wanted to spend most of his life studying? Tommy thought about nursing, made some inquiries, but in spite of the college counselor’s enthusiasm, he knew he didn’t have the discipline or the patience for five more years of education.

  As he worked each day with physicians and nurses, Tommy was less than impressed with their skill and intelligence.

  They’re no smarter than me, he thought.

  Finally, he concluded that his long-term goal was to be an Emergency Medical Technician. That would give him some degree of independence and he would no longer be at other people’s disposal.

  Tommy’s friendly attitude and helpfulness made him popular among most of the nursing staff. He often stopped at the local Krispy Kreme on his way to work bringing doughnuts for the staff. He dated several nurses, but had yet to sustain a relationship.

  Tommy leaned over the counter. “What have you got for me, Carol?”

  “Mrs. Hanson in room 512 needs a clotting time.”

  “No problemo. I’ll get right to it.”

  Tommy hesitated a moment, then smiled at Carol. “Why don’t you join me for breakfast after the shift? We can go to Spenger’s. They have great seafood omelets.”

  “I’d love to, Tom...I mean Thomas, but my boyfriend is picking me up this morning. Maybe some other time.”

  Right.

  It was a quiet night except for Sylvia Brockman, an eighty-one-year-old patient of Jacob Weizman. This was the third time she activated the nurse call button.

  “I can’t sleep,” she cried. “They’re keeping me awake, get me something to sleep.”

  Carol, the ward clerk pushed the talk button. “Who’s keeping you awake?”

  “The rats. They’re here. I can hear them chewing.”

  “Just a minute, Sylvia. I’ll get your nurse.”

  Carol turned to Marion Krupp, Sylvia’s nurse, who sat nearby writing chart notes. “You heard, Marion?”

  “Yes goddamn it. I’m sick of her complaints and of her physician too. Get Weizman for me, please.”

  “Dr. Weizman, this is Brier fifth floor. I have Marion Krupp for you about your patient Sylvia Brockman.”

  “What can I do for you?” said the sleepy voice.

  “It’s Sylvia again. She’s driving us crazy. You must prescribe something for her.”

  “I’m sorry, Marion. She’s only sundowning, getting confused at night. Anything I give her can only make things worse.”

  “Listen, Doctor, I have five other patients to care for. I can’t spend my time holding her hand.”

  “Get a sitter.”

  “I don’t know if one’s available at this time of day. Just give her a mild sedative, please.”

  “What’s mild for you or for many of your younger patients can be dangerous and possibly life-threatening for Sylvia. If you can’t get a sitter, call her family and have someone come in. Her hip’s much better and she should go home today or tomorrow at the latest.”

  Marion’s face reddened. “You’re not helping us, Doctor. This isn’t the first time either. I’m reporting this to nursing administration.”

  “Do whatever you think best, Marion. I’ve been treating the elderly for a little while, and I know what’s best for them.”

  “We’ll see.”

  “Yes, we will, nurse. Goodnight.”

  Marion Krupp, now in her mid fifties, was a grouch. Appearance matching personality, she looked like a linebacker in drag. A few senior nurses at Brier had worked with her years ago when she was a practical nurse
and equally cranky. After she completed her Associate in Arts degree, she obtained her RN license and continued to work at Brier.

  She was an equal opportunity malcontent. Few took Marion’s griping personally. She applied her animus to patients, staff, her husband but not to Abigail, her only child. Abby, age eight, was Marion’s oasis in the desert of her discontent and could do no wrong.

  When Marion’s complaining had escalated into vitriolic attack, she found herself before Judy Hoffman, the Director of Nursing.

  “You’re a good nurse, Marion, but you’re so angry.”

  “I know. I’ll do better.”

  “What’s going on?”

  “We go way back, Judy. Each year, being a nurse is more difficult and frustrating. I guess I haven’t mellowed over the years.”

  Judy laughed. “I’m not asking for mellowness, Marion, but a little civility would go a long way. When doctors, patients and others on the staff make note of your grim disposition, we have a problem.”

  “I’ll do better, I promise.”

  “We have resources available from counseling to anger management programs. Think about it before this escalates out of control.”

  “I will.”

  Several staffers had known Marion from early childhood. She grew up in Berkeley near the Oakland border. Even with a neglectful mother and an alcoholic father, Marion, to the casual observer, appeared to have a normal happy childhood.

  All that changed when her mother died unexpectedly shortly before Marion entered Berkeley High School. She retreated into a shell, refusing the help of friends, relatives, or counselors.

  Lola, now awake, turned to Jacob. “What was that?”

  “Just another nurse, too lazy or too overworked to sit with an old lady for a minute. Drug them; that’s the way out for too many of them these days.”

  “Put yourself in their place, Old Man. You know how inadequate staffing is at even a good hospital like Brier.”

  “I’m sorry, Sweetie. To sedate or tranquilize a confused old lady only increases the chances that she’ll never go home. I won’t do it.”

  “You’re going to get yourself in trouble with the nurses.”

  “It won’t be the first time.”

  Jacob’s brain had a built-in time clock. His eyes popped open regularly at 5:30 a.m., except if something had disturbed his sleep pattern overnight as it had last night. This morning, Lola shook him at 6:15. “Get moving, Old Man. Time’s a wastin.” One look at the clock and Jacob sprung out of bed and headed to the bathroom.

  After they finished breakfast, Lola pointed at the calendar. “Don’t forget Saturday. It’s Donald’s birthday.”

  “Not again.”

  “I can’t believe we have a son eligible for Medicare. Think how old that makes us.”

  Jacob smiled. “Can I sedate myself?”

  “I can’t believe that our three have produced ten.”

  “I’d substitute quality for quantity.”

  “You’re so full of shit, Jacob. You love your grandchildren.”

  “I love them when they’re asleep. What are you up to today?”

  “I’m working at the clinic.”

  The Berkeley Women’s Mental Health Clinic had the support of the city’s Department of Health. Lola, a practicing psychotherapist during their early days in Berkeley, was a founder and advisor. She worked closely with younger women, particularly teens, who recognized in Lola a kindred free spirit. She’d done it so long, each generation had its own lexicon that she thought she’d earned a degree in Adolonics, the teenage linguistic lexicon.

  Each time she brought one or more of her girls home, Jacob made notes of their peculiarities of speech like the substitution of ‘go’ for ‘said’, and the use of chillin’, crusin’, kickin’, ‘tights’, and ‘whatevers’.

  Lola smiled as Jacob engaged them in conversation, understanding their syntax and meaning, yet responding with the King’s English, albeit with an Austrian accent.

  Lola smiled at her husband. “I love how you’re able to talk with them. Worlds and decades apart.”

  “My mind’s like a parachute, it functions only when it’s open. I only hope they grow out of it. The jargon, Adolonics in this case, is a poor substitute for the precision of the English language for communication of ideas, and it announces to the world that the purveyor is, pardon the expression, a slacker. Three pins short of a strike.”

  Lola smiled indulgently at Jacob. “You’re a very disturbed man.”

  During their early days, Lola kept up her psychotherapy practice and managed Jacob’s office, but soon tired of the intractable despair, frustrating narcissism, and interminable banal neuroses. She found herself caught in a web of mental fatigue, empty and drained of energy. Convinced she couldn’t help, she opted to save herself and her marriage. The clinic gave her the opportunity to help young women and maintain her sanity.

  Chapter Six

  Two and a half years ago, while Jacob was finishing up for the day, Margaret Cohen came into his office. “I have a Dr. Bernard Spelinsky on the phone. He says he’s an old friend.”

  Jacob’s mind flashed back to his early days on the lower east side of Manhattan where two young immigrants began the practice of medicine.

  “Spelinsky, you old fart, you’re still alive.”

  “I said I’d outlive you, and I meant it.”

  “What are you doing with yourself? I heard that the New York Post printed banner headlines the day you retired: FINALLY, THE CITY IS SAFE!”

  “So, you’re still at it. Haven’t you done enough damage?”

  “I’m hanging on as a community service. Somebody’s got to keep these young doctors honest.” He paused for a moment. “I was so sorry to hear about Rebecca. She was a gem.”

  “You and I got better than we deserved when we married. The worst part, Jacob, is the loneliness. Living with someone you loved for so many years then, in a moment, she’s gone. How’s Lola?”

  “Too mean to die.”

  “I’ll be coming to the bay area in the fall. My granddaughter Zoe is moving to Berkeley this summer. Her husband’s accepted a position at the University of California.” He hesitated. “That’s why I called. I’d like you to meet with Zoe and give her some perspective on medical practice in Berkeley. She just completed her residency in Family Practice at Columbia. If you’re not too senile, Jacob, you’ll convince her to join you in practice.”

  “I’ll meet her, Bernie, but I’ve practiced alone for too many years. Change at my advanced age may be difficult. Partnerships are like marriage...and they’re tough enough.”

  “Speaking of marriage, meet Zoe. You’ll love her. In many ways, she’s a modern version of Lola.”

  “I’m getting chest pain, Bernie. I barely survived Lola as a young man.”

  “I’ll ask her to call you. Her name is Zoe Spelling.”

  “Spelling? You must be kidding.”

  “Don’t ask me. She changed it for professional reasons.”

  “Professional reasons?”

  “What can I say? She’s young.”

  “Well, Bernie, I’ll meet her, but denying her heritage equals strike one.”

  Three weeks later, Margaret Cohen came into Jacob’s office smiling. “Dr. Zoe Spelling is here to see you.”

  “What are you so happy about?”

  “Nothing.” She smiled again.

  Jacob rose from his desk and walked toward the door to greet Dr. Spelling. Before he could utter a word, a beautiful and very tall woman looking like a fashion model embraced him.

  She kissed him on the cheek. “Dr. Weizman, finally we meet. The way grandpa talks about you, I feel like I’ve known you my whole life.”

  Zoe paused, then sniffed Jacob’s cheek. “You smell like grandpa...that tangy-spicy cologne, what is it?”

  “It’s Pinaud. You smell it in most barbershops. It’s older than your grandfather and me.”

  Jacob was a little shocked by her informality. He straighten
ed his bow tie then looked up into her dark brown eyes. “It’s nice to meet you too.”

  She had chestnut hair to her shoulders and pulled back over her ears to reveal multiple earrings. Her teeth were so bright, he felt himself squinting from their reflection. She wore a form-fitting sundress with spaghetti straps that accentuated her well-toned arms and shoulders. She had a small tattoo of a hummingbird over her left upper arm.

  Jacob absorbed her appearance and felt himself reddening. Thank God I haven’t lost my appreciation for a beautiful woman, he thought.

  Zoe caught him staring and laughed. “It’s okay, Jacob.” She hesitated. “Can I call you Jacob?”

  “Of course, Zoe.”

  “I mean that I’m used to it...men staring at me...and not just the young ones.”

  “I didn’t mean anything improper, Zoe, and anyway, I choose not to spend what’s left of my life on an analyst’s couch.”