Dr. Knox

by Peter Spiegelman

  “He’s my cousin.”

  “Your cousin? So he’s…Kyle’s son?”

  “Maybe now you can excuse the rashness. I mean, what wouldn’t a parent do for a child?”

  “Kyle’s more than just rash.”

  “You’ll get no argument from me. Next question?”

  “That girl you mentioned…”

  “Elena.”

  “Who is she?”

  Mandy’s smile vanished, and her eyes fixed on something in the darkness. “An opportunist. Someone who thinks she sees a big payday. She may also be…disturbed.”

  “She’s not Alex’s mother?”

  She shook her head. “Sometimes she claims she is; she may have even told Alex some story to that effect; maybe she told you the same thing. Who knows, she might even believe it herself.”

  “Wouldn’t Alex know the truth?”

  Mandy’s voice softened. “He was young when his mother died—too young to remember.”

  I caught a scrap of Mandy’s perfume. Magnolia and something else. “So Elena’s not related to him?”

  “An aunt. But she doesn’t know anything about him, except she may’ve seen him once when he was an infant.”

  “Back in Romania?”

  Mandy gave me a sharp look. “You do know her.”

  “I heard her speak.”

  She nodded. “Yes, she’s from Romania.”

  “So what’s going on here? A custody dispute? Some kind of shakedown? A kidnapping?”

  “All of the above, maybe; we’re not sure. And, honestly, we don’t even care that much. We just want Alex back, safe and sound.”

  “Then why haven’t you called the police, or the FBI, or someone? You’ve made it pretty clear that you’re seriously connected.”

  Mandy leaned forward and rested her elbows on her knees. She pressed her fingertips to her eyes. “It’s not that simple. Alex has been through a lot in his life. Nobody wants to make him the center of protracted legal warfare or—God forbid—a media circus. And we certainly don’t want to make him a target for more…” She ran a hand through her cropped hair and sighed. “Look, I’m authorized to make a deal with you, not to air my family’s laundry. The bottom line is, we want to get him home—quickly, quietly, and safely.”

  “You think he’s in danger?”

  She looked at me. “You probably know more than I do about that.”

  I shook my head. “You think he’s in danger with Elena?”

  “He’s a little boy, doctor. If he’s not with his family, he’s at risk. Does that take care of your questions?”

  “For the moment.”

  “Great. Then, getting back to mine…”

  “I don’t know if I can help you, Mandy.”

  She drank some of her coffee and smiled knowingly. She put her hand on mine. Her nails were smooth and glossy; her fingers were hot. “Don’t say anything, then. Take some time and figure out what you might want. Something for the clinic, maybe, or for yourself—it doesn’t matter to us.”

  Mandy finished her coffee, squeezed my hand, and rose. She placed a cream-colored business card with her name on it next to the coffee carafe. “Our only concern is time, doctor—we want Alex home ASAP. You’ve seen how impatient Kyle can be, and who knows what harebrained ideas he might come up with. Calling people we know at Immigration, maybe, or at the state medical board, or having your malpractice insurance yanked—and let’s not even contemplate his felonious notions. Tiger tries to rein him in, and so do I, but we can only do so much. I can keep him quiet for a few days, maybe. After that…”

  She brushed off her pants, adjusted the lines of her jacket, and walked to the elevators. A door slid open as soon as she touched the button, and she stepped inside. She mimed a telephone with her thumb and pinkie and put it to her ear. “Call me,” she mouthed as the door slid shut.

  CHAPTER 25

  “I wondered why your car was parked in the same spot for so long,” Ben Sutter said, and he blew a long plume of cigar smoke into the night sky. We were drinking beer on the roof of my building, and I’d just finished telling him about the earlier part of my evening. Sutter was sprawled on a mesh-and-metal lounge chair, and I was perched on the coping of the low wall that ran around the rooftop. Two bottles of Populist IPA had begun to leach some of the fear and adrenaline from me. The night was warm, and there was a breeze that carried off Sutter’s smoke.

  I squinted at him. “How’d you know how long my car was parked?”

  “The tracker I put on,” he said.

  I thought for a moment about being angry with this, but decided I was touched instead. I nodded at Sutter and drank some beer. “Were you ever going to check out why?”

  “I was curious, but then you called. Speaking of which, let me see your phone.”

  I dug my phone out of my pocket and tossed it to Sutter. “Why?”

  Sutter took the cover off my phone and examined the edges. Then he took out his key ring, and selected a slim tool from it. He slipped it into the phone casing, twisted, and lifted the back off. Then he pulled a penlight from his cargo shorts.

  “I’m checking for spare parts,” he said. “Like trackers.”

  “Shit.”

  “No worries there,” he said as he slid the phone case back on and tossed the phone back to me. “How about your backpack?”

  “Under your chair.”

  After ten minutes searching through the pack, Sutter held up what looked like a gray pen cap. He looked at it for a moment, then crushed it under his heel. “Tracker,” he said.

  “Shit,” I repeated, and let out a long, shaky breath.

  Sutter smiled ruefully. “That Kyle guy sounds like a dick.”

  I nodded. “Without a doubt. Too much money, everybody around him saying yes all the time…”

  “Always a healthy mix. The cousin seems like fun, though. She cute?”

  “If you like naughty elves.”

  “My favorite kind. She smarter than Kyle?”

  “Smarter; more manipulative. She had a nice way of offering the carrot, but she never let me forget about the stick.”

  “You buy her story?”

  I shrugged. “It explains why the Brays are after Alex.”

  “And that business about why they haven’t called the cops or the feds, or the National Guard?”

  “That makes less sense. I know the Brays are private people—that’s what everything I’ve read about them says, anyway. And, given what they’ve got with PRP—their own little army—they clearly have no problem cutting the authorities out of things when it suits them. But bypassing the cops seems like a damn big risk to take when your son or your grandson is missing. And then there’s Elena.”

  Sutter shifted in his lounge chair and tilted the back down farther. “Is she or isn’t she the kid’s mom?”

  “That’s the question. When Alex’s airway was closing up, Elena was freaked in the way that only parents get. But Lydia’s had her doubts from the start—how she left her kid with total strangers, et cetera. I chalked that up to fear and desperation—being chased, wanting to protect Alex—but now I’m wondering.”

  “You’re not going to have an answer until you find her.”

  “No shit. But I’m still waiting for a brilliant idea of how to do that. Mandy said she’d give me a little time to think things over, but that’s measured in days. Or less.”

  Sutter smiled. “Mandy—that’s nice. She have a pet name for you?”

  “Not that she mentioned.”

  “Probably waiting for the second date.”

  “Which I’d prefer to pass on. She may be cute, but she’s also scary, and I take her threats seriously.”

  Sutter nodded slowly. “Yep. These folks haven’t been the slickest operators so far, but it’s not for lack of trying. Eventually, they’ll get lucky.”

  CHAPTER 26

  By Friday morning, no ideas—brilliant or otherwise—of how to find Elena had announced themselves, though a headache, as g
ray and dispiriting as the marine layer that squatted over the city, had. Advil did a little something to cut the pain, and coffee did a little more. I poured a third cup and drank it, and thought about Amanda Danzig and Kyle Bray and carrots and sticks. Then Lucho called from downstairs to tell me the waiting room was filling up, and I turned on the shower.

  It was another busy day, with more norovirus cases in the morning, and in the afternoon the principals in a pickup-versus-SUV collision a block away, who very nearly came to blows at the reception desk. Lucho was threatening violence to the pickup driver, and I was ushering an SUV passenger into the exam room, when Mia came in. She was wearing jeans and a halter top, and she crossed the waiting room to catch my sleeve.

  “I need to see you, doc,” she whispered.

  I looked her over quickly, and saw nothing beyond pallor and nervousness.

  “Check in with Lucho, Mia—it’s crazy today.”

  She was pacing by the front door next time I passed through the waiting room, looking paler and jumpier.

  “What’s Mia in for?” I asked Lydia.

  She shrugged. “She wants to talk to you.”

  “About what? The cut on her leg bothering her?”

  “She just said she needed to talk.”

  I looked across the waiting room. Mia was buried in her cell, worrying her lower lip. “Okay,” I said. “After the UTI in Exam Two.”

  —

  The urinary tract infection was barely out of the door when Mia swept into the exam room, her usual flirty cool nowhere in sight. I motioned her to the exam table, but she didn’t sit. Her sandaled foot tapped nervously.

  “What’s up, Mia? The leg okay?”

  “It’s fine, doc. You need to come with me.”

  “What?”

  “You need to come with me, like on a house call. Like now.”

  “A house call? I’ve got patients out there.” She pressed fingers to her temples and sighed. “What’s the matter?” I asked.

  “It’s…it’s Jerome, doc—he’s not doing good.”

  “What’s wrong with him?”

  “I…I’m not sure. That’s why you need to look at him.”

  “He can’t find another doctor?”

  “He needs to see somebody now.”

  “If it’s an emergency, he should call 911.”

  “He…he can’t, doc. He just needs…”

  She rubbed her temples again. She was paler and more frightened than I’d ever seen her. I checked my watch. “Let me see if I can get away.” Relief crossed Mia’s face like the sun coming out.

  Lydia said she could cover the rest of the day’s patients, and I grabbed my backpack. “Let’s go,” I said to Mia.

  She smiled and nodded. “Let’s use the back door. I got my car in the alley.” I nodded and led her down the hall.

  Mia’s car was a Golf that was once red, with a soft top that was once not mostly duct tape. Inside, the Golf was surprisingly tidy, and Mia played electronic dance music at a deafening volume as she angled expertly west and then north. We were nearly in Little Tokyo when she pulled into a spot in front of a shuttered store that used to sell soccer equipment.

  “This is where Jerome lives?”

  Mia locked the car. “On the second floor.”

  We went through a metal door and up a dim staircase. There was a short hallway at the top, with flimsy-looking doors at either end. Mia paused.

  “Which way?” I asked.

  She shrugged her broad shoulders and looked down at the mildewed carpet. When she looked up, her face was red. “I…I’m really sorry.”

  My pulse spiked, and sweat prickled across my forehead. “Sorry for what?”

  “I owed, doc, and I had to pay off.”

  “You…Mia, what did you do?”

  She shook her head and turned and ran down the stairs. I started to follow but froze when the door to my left opened. “Don’t blame her,” a voice said from the darkened doorway. “She didn’t want to lie to you. I made her do it.”

  It was a small, tired voice, and it came from a small figure with bleached-blond hair streaked blue in front. Her left arm was folded across her chest, and her left hand pressed to her right shoulder, where her shirt was crusted with dry blood.

  She stepped into the hall and I caught her as she sagged against the wall. “Jesus, Shelly, what happened to you?”

  “It hurts like a bastard,” she said, “but she’s in deeper shit.” She pointed into the apartment, and I looked past her, to a spavined daybed and Elena upon it, beneath a thin and bloody blanket.

  CHAPTER 27

  Shelly had a contusion, purple and swollen, under her left eye, and a flap of skin like the sole of a shoe hanging from her right deltoid—painful, ugly, and possibly infected, but, with cleaning, stitching, and meds, not life-threatening. She was conscious, coherent, and ambulatory. She was the lucky one.

  “Call 911,” I said, and left her in the hall. I crossed the room, knelt at the daybed, and pulled back the blanket. Elena lay on her left side, hunched around her pain. She was white—almost gray—and her breathing was fast, shallow, and desperate. I snapped on my gloves.

  Elena’s eyelids fluttered when I touched her neck, and she shrank from my hand. She tried to roll away, but pain or weakness stopped her. I found her carotid and felt her pulse careening beneath my fingers—120 at least.

  “It’s all right, Elena,” I said softly, “I’m going to help you. Remember me from the clinic—Dr. Knox? I took care of Alex.” Her eyes opened wide at the mention of his name, and darted about. She tried to speak but had no breath.

  “I need to check you out,” I said, and turned her onto her back. Her jeans were dark and damp with blood at the beltline, and so was her Little Mermaid tee shirt—darkest and dampest around the long slash on its left side. I tore the shirt open from hem to collar.

  Elena’s breasts were small and blue-veined, her nipples like dark-red beans. The skin of her torso was paper white, and painted all over with tea-colored daubs—blood from a laceration across the lower left quadrant of her abdomen, from above her hip to her navel, and from a smaller wound—a puncture—on her right flank, just below the sixth rib. I slipped on my stethoscope, and placed the chest piece above Elena’s left breast. I heard breath sounds—fast and labored. I moved it to the right side and heard…nothing.

  Shit.

  I pulled the stethoscope off, splayed my left hand on Elena’s chest, just above her left breast, and rapped my middle finger with the middle finger of my right hand. There was a dull thock. I moved to her right side and percussed her chest again. It sounded like a hollow gourd.

  Shit.

  Elena had a tension pneumothorax—an air bubble in her chest cavity, between the chest wall and the lung, that was pushing against her right lung, squeezing it and starving her of oxygen. Killing her, if I didn’t pop her chest. I rummaged in my pack. In another world, I felt Shelly behind me.

  “Last ten minutes, she’s been panting like a dog,” Shelly said. “She gonna be…okay?”

  I found Betadine, tape, and packs of sterile gauze. Where was the needle? “What happened to her?”

  “Motherfucking Russians happened. One of them had a knife like you clean fish with, and went at her like she was a tuna, the fucking prick.”

  “When was this?” Where was the needle?

  “This morning, around seven, maybe. Is…is she gonna be okay?”

  Seven a.m.—more than enough time for pressure to build, and for a simple pneumo to become a tension pneumo. Shit.

  “The knife probably nicked her lung, and now it’s collapsed,” I said. Shelly gasped. I dug deeper into my pack and found it—a syringe with a fourteen-gauge needle.

  I looked at Elena’s chest. Her ribs were plain beneath her white skin. I touched her clavicle on the right side, slid my finger to the midline, and counted down to the second intercostal space. I squirted Betadine over her second and third ribs, and wiped the area with a gauze pad. Then I spray
ed lidocaine on the same spot. I tore open the syringe and tossed the plunger away.

  Elena stared at the needle. “Close your eyes,” I told her. She nodded and closed them.

  “You want to take a step back,” I said to Shelly. “There may be spray.” Then I pushed the needle slowly into Elena’s chest, at a ninety-degree angle, in the space just above her third rib.

  Push, push, push, and there it was: a pink mist in the barrel of the syringe, and a hiss, strong and steady. Almost immediately, Elena’s breathing deepened and slowed. I slipped on the stethoscope and heard breath sounds from both sides of her chest now. Her color began to return. I checked her pulse again: ninety-five and slowing. I released a long-held breath of my own, and taped the needle in place.

  “Better?” I asked, and she nodded, panic fading from her eyes.

  “Alex,” she said in a hoarse whisper.

  “He’s fine,” I said. “Let me look at those cuts.”

  I took a squeeze bottle from my pack, ran sterile saline over her wounds, and wiped away dried blood. The puncture wound had closed. The belly cut was thin and clean-edged—almost surgical—a single curving stroke made with a very sharp blade. A film of clotting blood had begun to form over the seam. I had no idea how deep the cut went, or if there were bleeders inside, or if—worse still—her abdominal cavity had been punctured and her gut was leaking. I pressed my fingertips into her belly to check for rebound tenderness. There was none, and that was a good sign, though the folks in the ER could tell for sure. They could also see to the fresh cut on her lip, and the new bruises on her head, her arms, and God only knew where else. A shiver ran through Elena’s pale body. I pulled the thin blanket over her, careful not to cover the syringe. She sighed deeply and closed her eyes again. I sighed too, and looked at Shelly.

  She’d retreated to a corner—to one of the folding chairs set around a card table. Her gaze flicked between the dusty screen of a television perched on a plastic crate, and a bar of greenish light that came through a window. I carried my pack to the table and knelt at her side.

  “Is she okay now?” Shelly asked.

  “She can breathe again,” I said softly. “The rest of her problems will keep till she gets to the ER.” Shelly stared at the floor. “Let me see the shoulder.”