No Cure for Murder

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No Cure for Murder Page 8

by Lawrence Gold


  Ahmad confronted his father. “How can you work with them? They’re killing us. It’s every Palestinian’s obligation to wage war to the death against the Zionists.”

  “It saddens me to think that after all I’ve taught you that you choose to absorb the shallow, destructive beliefs of the ignorant jihadists. You’re a Christian, not a Muslim. How do you think they feel about you?”

  Ahmad’s face turned red. He stared at his feet, and in the tradition of this patriarchal culture, said nothing.

  “The struggle against aggressive Zionism is legitimate, but our means are worlds apart.”

  In the months to come, Habib resigned his position at Al-Athar University and moved his family to Nablus where he accepted a new position at Al Najah University. He had few illusions about his son and his beliefs or Ahmad’s frequent unexplained absences, as militancy abided no geographic limits in the occupied territories.

  After medical school at Yale, Ahmad planned to return to the Middle East to complete his training, but the ongoing intifada made him decide to remain in the states. The Kadir family was among the 1.6 percent of Palestinians who were Christians and suffered as Arabs in the west and as Christians among the Islamists. The entire family eventually fled to the U.S.

  Ahmad noted the discomfort among his classmates to his Arabic appearance, but this became insignificant compared to the reaction to him after 9/11.

  Ahmad sat with his roommate, Jerry Towns. “It’s getting impossible. Some people cross to the other side of the street when they see me coming. They stare at me in public places like I’m carrying a bomb.”

  Jerry smirked. “What did you expect? America’s shock came with faces like yours.”

  “What’s worse, several patients took one look, and refused to see me as their physician.”

  “It’ll pass.”

  “I love this country, Jerry, but I can’t stand how it treats Arabs and how it blindly supports the Jews over the Palestinians.”

  “Be smart, Ahmad, don’t say Jews, say Israelis. You can get into this with your close friends, but otherwise, I’d keep my mouth shut.”

  When an opportunity in the internal medicine program at UC San Francisco arose, Ahmad decided to move to the more tolerant bay area. Once in the program, Ahmad became fascinated with the excitement of intensive care. He was fortunate to discover an opening in their intensivist program.

  Marion Krupp knocked on her nursing care coordinator’s door.

  “Come in,” said Gail Sergeant. “Marion, what can I...”

  “I demand an answer to my complaint against Weizman,” she interrupted.

  “If you think rude behavior will get you anywhere with me, Marion, you’re nuts. If you can’t be civil, then get the hell out of my office.”

  Marion paled as she took the chair beside Gail’s desk. “I’m sorry.”

  “For an intelligent, experienced nurse, you’re amazingly self-destructive. Your anger will get you nowhere.”

  “It’s an ongoing problem with several physicians, but Weizman’s the worst. I try to avoid his patients whenever possible.”

  “I’m afraid I don’t have good news for you, Marion.”

  “That doesn’t surprise me. These damned doctors always stick together.”

  “I talked with Arnie Roth, the chairman of the QA committee. They discussed your complaints and dismissed them. Physicians remain responsible for prescribing medication and most health professionals don’t deny the risk in sedating an elderly hospitalized patient. Absent some adverse effect from prescribing or not prescribing medication, they’ll always come down on the side of the doctor’s autonomy.”

  “Weizman...look at the old guy. He doesn’t know what he’s doing half the time. They’re allowing him to practice at Brier...ridiculous.”

  Gail stared at Marion and saw the glassy-eyed stare of the true believer. “I don’t know where all that’s coming from, Marion. Jacob may be old, but his mind is twice as quick as yours and mine put together. He has his own way of doing things, but if I or anyone in my family was sick, Jacob Weizman is near the top of my list for a physician.”

  “I think your friendship with Weizman is blinding you.”

  “Your position at Brier is already tenuous, Marion. Nobody wants to work with you. I’ve had several patient complaints. You may be a good nurse, but you’re so disruptive that I may have to let you go.”

  Marion rose, sneering at Gail. “Should I call my union rep?”

  Gail reddened. “Your union rep? Do as you damn well please. Now get out.”

  Chapter Seventeen

  Ginny Harrison was just about to enter the medication room on the fifth floor medical ward when Thomas Wells closed the door behind him. “Tommy, what are you doing in there?”

  “Oh, hi, Ginny,” he replied, eyes narrowing, “I just needed some alcohol wipes for my tray. I need to draw Mrs. Cohen in 512.”

  “The supply cart in the utility room has a ton of wipes, Tommy. You shouldn’t be in here.”

  Tommy reddened. “No big deal. Check the medication cabinet. It’s still locked. I didn’t take anything, and I resent your implication.”

  “I’m not implying anything, Tommy. The medication room is off limits to anyone but physicians and nurses. You know that.”

  “I’m sorry. It was just more convenient. I won’t do it again...all right?”

  “I’m sorry too, Tommy. Nursing administration is paranoid about medication theft at Brier. I have a stack of memos to prove it. Let’s just forget about it.”

  “Thanks Ginny. I’m not looking for trouble. It won’t happen again.”

  As Tommy turned to walk away, he reached into his pocket, felt the key to the medication cabinet, and smiled.

  When Ginny entered the room, she scanned its contents and checked the doors on the medication cabinet. They were all locked. If anything’s missing, Ginny thought, it would show up in the medication count done at the beginning of each shift.

  Sarah Hughes and her most recent boyfriend, Kevin Meeks, were parked in his family’s Land Cruiser on Grizzly Peak in the Berkeley Hills. They were so busy groping each other they didn’t notice the car, headlights off, approaching from the rear.

  The rapping of something hard against the steam-covered driver’s seat window brought them back to reality. “Open up. Berkeley Police.”

  Kevin tucked his shirt back into his pants and rolled down the window. “What can I do for you, officer?”

  The patrolman smelled the marijuana at once and turned to his partner. “I’ll take care of him. You get the girl.”

  The officer stood back from the door. “Raise your hands where I can see them, then step out of the car.”

  When Kevin exited, the patrolman grabbed and pushed him against the car and applied handcuffs.

  Sarah fought against the patrolman as he pulled her roughly from the car. “Leave him alone! We weren’t doing anything wrong.”

  “Cuff her too.”

  When the phone rang at 11:30 that night, Marilyn Hughes picked up the handset at once. Sarah had again defied curfew. “Mrs. Hughes? This is Sergeant Peterson, Berkeley P.D. We have your daughter Sarah under arrest for an open container violation and possession of marijuana.”

  “We’ll be right down.”

  “Don’t bother. She’ll be visiting with us overnight.”

  Marilyn turned to Robert. “Your daughter’s in jail. We can’t get her until tomorrow.”

  Robert managed a slight smile. “Maybe this time, she’ll learn.”

  After they bailed her out the next morning, their sullen and angry daughter sat in silence, arms crossed, in the back seat as they drove home.

  “Don’t say anything,” Sarah suddenly shouted. “This is bullshit. We weren’t doing anything wrong.”

  “Good,” said Robert, “Then you can handle this yourself.”

  The Robert Hughes hired an attorney and he got the court to agree to refer Sarah to the Berkeley Woman’s Mental Health Clinic for evalu
ation and treatment in lieu of prosecution.

  On their way out of court, Robert turned to his daughter. “Please, Sarah, try to do something constructive with this opportunity.”

  “Some great opportunity. I don’t know how much more of this crap I can take.”

  Chapter Eighteen

  Lola sat with Jacob at breakfast. “What’s happening to Joshua Friedman?”

  Jacob stared through their west-facing window. Dark clouds drifted toward the city, covering the Marin highlands, and blanketing San Francisco Bay. He shook his head. “His family couldn’t handle him at home. He’s back at Brier.”

  Josh Friedman was one of Jacob’s first patients. They had grown old together.

  When they first met, Josh worked as a park ranger. He lived in Berkeley, but spent weeks at a time in the Sierras. He’d been a vigorous, athletic man who stood six feet four inches and weighed a solid two hundred forty pounds.

  He retired as regional director and lectured locally at all levels from elementary school to the university. Eighteen months ago, he came to see Jacob complaining of trouble swallowing. He pointed to the lower edge of his breastbone. “Whatever I eat stops here.”

  “Is it everything, or just solid food?”

  “Just solids, like a chunk of steak or a piece of chicken.”

  Jacob was alarmed at once by the often-deadly symptom. “We’re going to need some tests.”

  “What is it, Jacob?”

  “I don’t know for sure, but I’m concerned.”

  “Don’t tell me it’s cancer.”

  “It could be any number of things, most of them benign.”

  “Well, let’s get to it.”

  Three days later, Margaret Cohen came into Jacob’s office. “I have the radiologist on line two.”

  Jacob’s hand hesitated over the handset.

  “I’m so sorry, Jacob. Mr. Friedman has advanced carcinoma that involves a good part of the lower third of his esophagus.”

  “There’s no possibility...?”

  “None.”

  I’m so sick of this, Jacob thought. Sixty years of small victories and big disappointments...swimming the currents of hope only to drown in a senseless sea of savagery...God’s negligence or nature’s cruelty...a distinction without a difference.

  Josh and his wife Joanie sat across from Jacob’s desk. When Josh heard Jacob’s words, he paled and withdrew into silence. Joanie sobbed softly.

  Joanie blew her nose. When she regained control, she stared at Jacob. “Today, with modern medicine, there must be something we can do.”

  “I’m not saying that we won’t try to treat this. It’s just that our best falls terribly short. We’ll try chemotherapy and radiation and we have techniques to ameliorate problems caused by the tumor.”

  Josh studied his old friend. “You’re omitting something, Jacob.”

  “I know.”

  “What is it?” asked Joanie.

  “Cure...Jacob hasn’t used the word cure.”

  Two months after completion and recovery from radiation and chemotherapy, Josh felt much better. “At least I’ve survived the treatment, Jacob. What’s next?”

  “Watchful waiting. Enjoy your life, Josh. None of us really knows how long we have.”

  “Right,” Josh responded. He paused and stared at Jacob. “I’ve signed an advanced directive for health care and a living will. I’ll sign or etch anything into my skull so that when the time comes, I can die in peace.”

  “That should do it. It helps if you and Joanie are on the same page with this.”

  “We made vows to each other, promises we intend to fulfill.” Josh reached over to his friend and physician. “We put our lives in your hands, Jacob. Now, I’m placing my death there, too. Don’t let me down.”

  “Never.”

  When Jacob entered Brier 515, Josh Friedman’s room, a sour-faced Marion Krupp followed. Joanie sat next to Josh’s bed, her head resting against his arm.

  The once powerful man was skeletal. His weight had declined to 120 lbs. The tumor had recurred, completely blocking his esophagus, and forcing Jacob to place a tube above the mass, to remove Josh’s normal salivary secretions.

  Jacob turned to Marion. “Why do you have his arms in restraints?”

  “I was afraid he’d pull at his tube or his IV.”

  “Take them off.”

  “But, Doctor...”

  “Damn it, I said, take them off.”

  Marion sneered. “Yes, Doctor.”

  When Jacob leaned over, Josh felt his presence and opened his eyes. His mouth formed a gentle smile. His lips were encrusted and dry, teeth stained with blood.

  “When did he have his mouth care?”

  “I was just about to do it,” said Marion.

  Josh lifted his hand, making a come here gesture. When Jacob leaned over him, he whispered, “It’s time, Jacob. I can’t take any more of this...it’s time.”

  “Is it the pain?”

  Josh smiled. “It’s pain or coma. I can’t find anything between. Tubes, IV’s, restraints, spit running out of my mouth, and my own smell...I reek of death. I can’t stand it. Let me go, Jacob. I’m ready.”

  Jacob turned to Joanie. “Joanie?”

  She trembled. “Don’t ask me this, Jacob. I know what I want...what he wants...please don’t ask me.”

  Jacob turned to Marion. “Let me have a word with you, outside.”

  They stood in the corridor. Marion folded her arms firmly across her chest.

  “I want you to replace the 50 fentanyl narcotic patch with the 100. How much morphine is he taking?”

  “I’m giving him 50mg every three to four hours.”

  “I’m amending the orders so that you can titrate his morphine dose up to 100mg every three to four hours. We have no reason to let him suffer.”

  Marion reddened. “Absolutely not! I won’t be a party to your desire to kill Mr. Friedman.”

  “I have no such intention. He’s suffering, don’t you think he’s entitled to relief?”

  Marion placed her hands on her hips. “Don’t take me for a fool, Doctor. I’ve been around here long enough to recognize orders that will kill a patient. Those large doses of morphine will stop him from breathing...I won’t take part in that...it’s immoral.”

  “If this disease isn’t frustrating enough, I have to deal with...” Jacob counted to ten. “Show me one study where a patient treated with high dose morphine for control of pain showed depression of respiration...you can’t...it doesn’t.”

  Marion placed her hands on her hips. “I won’t do it. Get someone else.”

  It’s later that evening when I arrive. I planned this timing with care, knowing that the night shift had just begun. They’ll be busy for at least fifteen minutes giving report. I walk down the hall looking over my shoulder then enter room 515.

  How peaceful Josh looks.

  He’s right on the edge.

  Just a small step away.

  This is too easy, I think, as I pull the syringe and insert the needle into Josh’s IV port.

  Josh awakens. His eyes wander as if still dreaming then they fix on me.

  He looks at the syringe then back at me.

  “What are you doing here?”

  “It’s okay,” I say. “It’ll be over in a moment.”

  I watch his eyes widen as the syringe empties into his vein and he says, “No...no, it can’t be.”

  As he closes his eyes, I lift his lids and watch as his pupils contract to the point of a pin and his breathing stops.

  You’re free now!

  When the night nurse entered Josh’s room, she knew. She touched his icy hand, listened to his chest, and shined her penlight into his dilated and fixed pupils. She dialed Dr. Weizman’s answering service. They told her that Dr. Spelling was on call.

  Moments later, Zoe was on the phone. “Mr. Friedman’s gone. Do you want me to call the ER doctor to pronounce him?”

  “No, it’s all right. I’m nearby. I�
�ll come up and do it.”

  When Marion Krupp arrived for her shift the next morning, and heard of Josh Friedman’s death, she went at once to Gail Sergeant, the charge nurse. “I demand an investigation of Mr. Friedman’s death.”

  “What are you talking about?”

  “You may call it physician assisted suicide or euthanasia, or any damn thing you please, but I call it murder. You think that the staff doesn’t know what goes on at those ethics meetings. Somehow, the good Dr. Weizman always sides with death. I’ll see to it that your esteemed Jacob Weizman doesn’t get away with it this time.”

  Chapter Nineteen

  “Dr. Byrnes, Dr. Jack Byrnes, call ER stat,” blared the Brier Hospital speaker system.

  Jack grabbed the nearest phone. “Dr. Byrnes, here. What’s up?”

  “Dr. Hughes says it’s urgent. I’ll get him for you.”

  Robert Hughes, director of the Emergency Department at Brier, trained in emergency medicine at UC with Jack and frequently referred patients to him.

  “Sorry to do this to you, pal, but I have a Mrs. Mavis Smith down here that has overdosed.”

 

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