First, Do No Harm (Brier Hospital Series Book 1)

by Lawrence Gold

  First, Do No Harm

  Lawrence W. Gold, M.D.

  Lawrence Gold mingles our deepest fears about a trusted physician who harms patients with those who do everything possible to heal us.

  Joseph Barron, author of The Last Witness.

  Lawrence Gold has a great knack for telling a terrifying story in an elegant manner. Makes you take a second look at ye olde family doctor.

  Donna Eastman, editor emeritus.

  First, Do No Harm 2012 © by Lawrence W. Gold, M.D.

  All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without permission in writing from the publisher.

  This book is a work of fiction. Characters names, places, and incidents either are the product of the author’s imagination or are used fictitiously, and any resemblance to any actual persons, living or dead, events, or locales is entirely coincidental.

  A Grass Valley Publishing Production

  To order additional copies of this book, e-mail

  grassvalleypublishing@gmail.com

  Cover Art©2012 by Dawne Dominique

  Edited by Donna Eastman

  ASIN: B004Y7A834

  Dedication

  To my wife, Dorlis. Her dedication and unrelenting support made this work possible.

  Acknowledgments

  Donna Eastman of Parkeast Literary Agency, a great editor who made this possible.

  Joseph Barron, a true renaissance man, my writing buddy. Gone but not forgotten.

  Writers groups on both coasts. WOW in Palm Coast, Florida and Sierra Writers Fiction Critique Group in Grass Valley, CA

  The Origin of First, Do No Harm

  It is a widely held misconception that the familiar dictum “First, do no harm” comes from the Hippocratic Oath physicians take when they enter medical practice. The Oath does not and never did contain those words. Hippocrates did, in fact, originate the phrase, but in another of his writings, Epidemics, Bk. I, Sect. XI. One translation reads: “Declare the past, diagnose the present, foretell the future; practice these acts. As to diseases, make a habit of two things—to help, or at least to do no harm.”

  The more ignorant, reckless and thoughtless a doctor is, the higher his reputation soars even amongst powerful princes.

  Desiderius Erasmus

  The doctor is often more to be feared than the disease.

  French Proverb

  Prologue

  Laura Larsen stared at her watch in disbelief, she was late. She hated being late.

  Dark clouds moved across the San Francisco Bay into Oakland where they nearly touched the pavement creating an image of dusk at ten in the morning. Heavy traffic on rain-slick roads, and a delayed start caused her late arrival at the airport.

  While turning the key to lock her front door that morning, Laura’s boyfriend Steve McIntyre appeared. They’d fought again last night, the same-old fight, still unresolved, and they had spent the night apart.

  “Give me a chance to apologize, to explain,” he begged. “I love you so much that sometimes it makes me a little crazy.”

  When Mac accepted the position as airport grounds crew supervisor, he considered his daily exposure to an array of attractive women a bonus. He’d dated many, loved a few, but failed in long-term relationships until he met Laura early one morning in the crew’s lounge. Her heels and wrinkled flight attendant’s jacket lay next to her on the lounge sofa as she sat rubbing her feet.

  She glanced his way. “A six-hour flight. My feet are killing me.”

  He’d seen her before scurrying to and from flights, but they’d never spoken.

  “I’m Steve McIntyre.” He paused. “Can I rub those for you?”

  “I know who you are, and no, you can’t,” she said smiling brightly and returning his gaze with bright hazel eyes.

  She pushed away a lock of short auburn hair then returned to her rubbing her feet.

  Steve loved Laura’s warm genuine smile gave her and earthy quality, far removed from the detached, icy-cool image of many flight attendants. The whole package reflected her joy in life and in the work she loved.

  Mac had been so captivated by Laura that he allowed himself to become stupid and obsessive. He’d committed to Laura, but he’d managed to jeopardize the best relationship he’d ever had, and the one he’d valued most.

  She wheeled her suitcase toward the front door of her building “We don’t have time to get into this again. I’m going to be late for my flight.”

  “Call in sick, switch flights with someone or whatever, but we have to talk,” Mac pleaded as he trailed behind.

  Laura stopped and turned to face Mac, “I’m not calling in sick, and it’s too late to switch flights. We’ll talk about this when I get back home, Friday.”

  Mac turned away, dropping his chin to his chest. I’m losing her, he thought. What a way to discover how much I love her.

  Laura loved him dearly, but his smothering threatened their relationship. She reached for his face, lifted his chin, feeling the stubble of his unshaved cheek and placed a kiss on his lips, “I love you Mac; ease up, everything will work out. See you Friday.”

  The Yellow cab waited at the curb.

  Laura rushed down the puddled front steps suddenly feeling weak and short of breath. She settled in the rear seat of the taxi and began sweating. In moments, she’d soaked her clothes, as if she’d completed a long run. Her heart pounded.

  What’s wrong with me? She thought.

  “I’m late for my flight. Twenty bucks if you get me to the airport by 10:30,” she managed to say.

  Laura watched through the rain-speckled cab window as the driver earned his bonus. He raced and twisted through the stop-and-go traffic, alternating braking and accelerating.

  By the time the cab reached Oakland International Airport, she felt much better. She’d suffered through several similar episodes during exercise over the last few weeks, but her physician, Joseph Polk, examined her, took an EKG, and said everything was fine.

  Laura exited the taxi, grabbed her flight bag, and weaved her way through the crowded terminal hurrying to the gate where she raced through the employee’s security checkpoint.

  Laura retrieved her flight bag from the conveyor belt and started down the corridor. Immediately, she felt a strong pressure building in the middle of her chest. Sweating returned, profuse this time, soaking her clothes. The chest pressure increased. It was a heavy weight pressing down, squeezing her chest then instantly radiating into her jaw and left arm. Suddenly, Laura was profoundly weak. She couldn’t catch her breath.

  Terrified, Laura struggled to breathe. The lights and sounds of the noisy terminal were fading, and then suddenly the world went black as her legs failed, and she tumbled to the floor.

  Chapter One

  “It just doesn’t get much better than this,” Chuck Martin said as he leaped out of bed at with the first glow of sunrise.

  Helen, not a morning person, shook her head in disgust at this ghastly display of good humor at that 5:15 a.m.

  Chuck reached over with his large calloused hand, and he shook his wife gently.

  Helen moaned, “Gimme a break…got plenty of time.”

  Helen and Chuck Martin were living their dream. High School sweethearts, they married following her graduation from nursing school, settling into a life filled with confidence that good things were to come.

  Chuck, an experienced construction project supervisor, finally started his own company. Ten years and two children later, the business and their lives were fl
ourishing.

  They felt comfortable and secure.

  No one would say that Helen Martin, now forty-three, was beautiful, but with short curly brown hair, clear hazel eyes, and a gymnast build, people just liked looking at her. She had the right mix, a wide smile, a great sense of humor and an infectious optimism. Her patients were crazy about her as they watched her pass in a blur on the ward, somehow finding enough time to spend with each of them.

  “Helen, sit down. Take a break, you’re making me tired,” was one of the more common lines uttered by patients, nurses and physicians as they watched her in action.

  Patients were disappointed when they discovered she wasn’t their nurse for that day. Helen was oblivious to it all. Much of her conversation with friends and patients, centered on her husband, their children, and their lives. Patients frequently opened themselves to Helen, sharing private personal details of their lives. This information often proved useful in caring for them.

  Before her first day of school, Helen, the second of five children, had played the role of mother. She soon found this was no game. Charlene, her mother, spent most days, her migraine days, in a darkened room, lying in bed, a washcloth over her eyes.

  “If that wasn’t enough,” she told Chuck, “I’ll never forget my father’s intense stares and his abrupt retreat when our eyes met. Although a child, I understood the message, and thanked God, he had not come after me to satisfy his more physical needs, small praise for a pathetic man who took solace in a bottle and vented frustration with his fists.”

  On the surface, Helen felt strong. With discipline and determination, and entirely through her own efforts, Helen went on to college and nursing school. Her caring and sensitive nature completed the reality of what she was; you are what you do, but this was only a façade of what she felt herself to be. Could anything fix the dents and bruises to her self-esteem, the legacy of a loveless, abbreviated childhood?

  Chuck was a great counterpoint to the outgoing and supercharged Helen. He could be friendly and social when expected, but his wife, their children, and his business formed the foundation of his existence. At six feet four inches, he looked like a model in the Big and Tall commercials.

  Helen was in good shape and knew that Chuck had been keeping it down for her when they ran together. “Come on, sweetie, get a move on.”

  Helen loved Chuck for his inner calm. “I don’t know how you put up with it,” she said. “Those subcontractors, their broken promises, and outright lies; the constant demands of your clients for faster and cheaper. It would drive me crazy.”

  “I don’t know how you deal with sickness and death every day,” he said, “it would leave me a basket case. In construction, you only deal with money, not lives. If I do my job, construction problems work themselves out. I won’t allow any of it to give me an ulcer. It’s not worth it.”

  While usually a man of few words, Chuck held nothing back from Helen. “I love you in a way I never thought possible.”

  Helen didn’t need his words as they still made love three or four times a week, and they knew, after all these years, how to please each other. On occasion, they’d sprinkle in a little twist or a little fantasy.

  “Time to get crakin’,” Chuck said, smiling and gently shaking her again.

  Helen willed herself to the sitting position. She shook her head trying to clear her mind and then dragged her leadened legs to the floor. “I dreamed that I worked out all night. My muscles are achy and sore as if I’m coming down with something, possibly the flu. Maybe I should call in sick today?”

  “Not even a good try, sweetie,” he laughed, gently grabbing her arm and pulling her up from the bed.

  She raised her eyes, shook her head in disbelief, stood, stretched, and then staggered to the bathroom.

  What can you expect from a day that begins with getting up in the morning, she thought.

  Helen collapsed onto the toilet, giving thanks the seat was down—what a good guy that Chuck.

  Nobody, especially Helen, liked surprises this early in the morning, so it stunned her to see dark-brown urine, the color of cola, in the white porcelain bowl. “Chuck, come here, something’s wrong!”

  Chuck rushed into the glare of the bathroom’s bright fluorescent lights, took one look at his wife, and said, “Sweetheart, your eyes are yellow!”

  Helen spun toward the mirror, staring. It’s the Big C, Cancer, a typical reaction from a nurse, surfaced immediately. Her eyes widened as she brought both hands to her mouth. She took a deep breath, paused, and then considered a more inclusive set of diagnoses, including gallstones or maybe hepatitis that could explain her yellow jaundice.

  The threat of illness was a first for Helen. She’d thought that her experience with patients had given her a good grasp of what it meant to be seriously ill, but her visceral response proved this a lie. In spite of all her knowledge and experience, or perhaps because of it, this illness, whatever it was, frightened her. At the earliest stage of this illness, uncertainty stoked the fire of her fears. Her mind raced with a flow of random thoughts. They were intrusive, painful, and superimposed themselves upon her life. Suddenly, Helen’s well-entrenched optimism was in full flight.

  “Let’s call Dr. Polk,” Chuck said.

  “No, it’s too early. I’ll call after the office opens.”

  “You’re too considerate. Put yourself first for once.”

  “I thought you liked me the way I am.”

  Helen watched the hands of her kitchen clock move ever so slowly as she waited for Dr. Polk’s office to open.

  Helen knew that good office nurses performed a balancing act. They manage to keep patients happy and protect the office and doctor from excessive demands on the practice. Gladys Wolff, however, was a Rottweiler-bouncer combination, and had the protection part down pat.

  “Gladys, this is Helen Martin. I’m jaundiced and need to see Dr. Polk right away.”

  “Good morning, Mrs. Martin,” Gladys said in her most officious tone, “Let’s see, I can get you an appointment in about ten days, that would be next Thursday at four in the afternoon.”

  “Gladys, I need to see him today.”

  “I’m sorry, Mrs. Martin, but doctor’s completely booked for the next ten days.”

  Helen’s patience ran out. “Gladys, you can’t turn away one of your established patients who is suddenly jaundiced. Dr. Polk would never permit it. Trust me on that.”

  After a long pause, Gladys said, “Can you get here by eleven?”

  “I’ll be there. Thanks.”

  Dr. Joseph Polk had been the Martins’ family doctor for most of their adult lives. He delivered both children and saw them through all their routine medical needs from bumps and bruises to colds, flu, and broken bones.

  Polk, now sixty-three years old, had no interest or even a passing thought of retirement. “They’ll have to pry the stethoscope from my dead hands,” he’d tell his wife.

  He kept himself in great physical condition, needed for the hours he worked and the lost sleep he endured as part of his active medical practice. On an average day, he rose at five a.m. for an hour of exercise, a quick bite, and then he made early hospital rounds. Polk returned to his packed office by nine a.m. where he’d see an average of twenty-five patients before noon, rushing from exam room to exam room. Noontime brought him back to the hospital for lunch, meetings, and educational conferences. Afterwards, he’d see patients all afternoon, finally finishing by six p.m. He thrived on the pace and took great pride in his ability to put out so much work.

  In spite of the frenetic activity in his practice, Polk kept things under control. He maintained his desk, like his life, clean and organized as an office furniture display.

  “I can’t believe the complaints I hear from those new docs who see only three to four patients an hour as required by the HMO,” he told his wife. “With such a schedule, that stack of books and articles on my desk would disappear, and I’d have the time to learn something about the Internet. H
ow long does it take to look down a throat, check ears, listen to heart and lungs, or feel a belly, three to five minutes? Explain and write a prescription for medication or diagnostic testing, two to three minutes?”

  What are they doing with all that time? He thought.

  To Polk, the pressures to produce from the HMO were laughable, and his practice, under this system, grew larger and more profitable than ever.

  The HMO loved Joe Polk. He’d become their poster-boy.

  Joe had a great memory for all the details of his patients’ lives, helped by notes discreetly placed in their charts; “Has Robert graduated yet? How’s the restoration on that Corvette coming? Sorry to hear about grandma.”

  The personal touch. Patients loved that.

  They loved Joe Polk.

  They trusted Joe Polk.

  He was a small, thin man, less than five feet five inches tall yet his perfect erect posture and raised chin, created an illusion, adding two to three more inches to his height. He dressed well, always meticulous in his appearance. Nobody had ever seen Joe Polk at the office or the hospital, no matter the time of day or night, without his coat and bow tie.

  “I think he sleeps in those clothes,” said one night nurse.

  Joe Polk railed against the commonly held opinion that those who wore bow ties were somehow odd. His protestations served only to reinforce the perception he’d tried hard to avoid.

  Helen and Chuck Martin strolled toward Polk’s office located in a small medical arts building two blocks from Brier Hospital. It was a few minutes before eleven. The sun shone, and a soft breeze blew from the northwest carrying the salty scent of the San Francisco Bay, only three miles away.