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

by Lawrence Gold

  While driving back, we said few words, each lost in thought.

  I drove Beth directly to the hospital and walked with her to ICU. Before turning to leave, she rushed into my arms, burying her head into my neck. We did not need words to express what we felt tonight.

  Since I wasn’t on call, it could only be bad news as my phone startled me awake at four a.m. My arm flailed out to find the phone and when I finally brought the receiver to my ear, I immediately recognized Beth’s voice through her sobbing and assumed the worst.

  At first, I couldn’t understand her through this emotional eruption and the flood of words, “She’s breathing on her own! She’s waking up! Chuck just called ICU with the news since he knew I worked tonight. I can’t believe it. You must have been right about her thyroid.”

  Overjoyed and having difficulty in comprehending the significance of this information, I said, “Tell me again, slowly this time, exactly what Chuck said.”

  Calmer now, she paraphrased Chucks words.

  “I can’t begin to tell you how relieved I feel,” I said, as I breathed in deeply relishing the air as if for the first time. After a moment’s reflection, I continued, “There’s no way I’m getting back to sleep now. I might as well go over to University Hospital to visit and keep Chuck company until I have to leave for morning rounds.”

  “I’d love to come, sweetie, but I’m stuck here until my shift’s over,” Beth said. “I’ll come over afterwards.”

  I showered, shaved, and dressed, and when a McDonald’s glowed through my windshield along the way, I drove through, ordering an Egg-McMuffin and a coffee. The evening fog had passed into the central valley and the skies were clear, the air cool. I rode through the quiet streets reliving the many nighttime emergency drives I’d made over the years and I couldn’t recall one made in the face of good news. Although nobody liked having to get up in the middle of the night to work, once up, I found travel through the silent streets, so noisy and congested in daytime, evoked feelings of peace and solitude. I felt reluctant to abandon these feelings for the stress, frustration, and disappointment frequently awaiting me beyond the hospital’s portals.

  By the time I arrived at the SICU, the surgeons were completing early rounds to make their morning surgeries. When Dan Cohen and his entourage appeared, I crossed the room to join them.

  “Jack, you son-of-a-bitch, you were right.” Dan shouted at full volume. He’d succeeded in embarrassing me. I was speechless.

  “You’re making us look bad, Jack,” Dan said smiling. “The TSH level came back and it’s sky high, confirming your diagnosis. I don’t know how the first test came back, normal.”

  “How does she look this morning?” I asked.

  “She’s so alert, we have no choice but to remove the tube from her throat right away and get her off the respirator.”

  When I entered the waiting room, Chuck rushed up and crushed me in a bear hug, taking my breath away. “You did it, Doc. She’s gonna make it.”

  I couldn’t express what I felt at this moment. I worked in a world where successes were too often distant images, mirages, never reachable. Making it all worthwhile; that was one platitude I could live with tonight, especially about Helen Martin.

  Helen recalled lying supine on the operating room table covered by a thin smooth white sheet. The table and the room were freezing. Her nipples were erect so she adjusted the sheet to hide them—modesty even here in surgery. Eight or nine green clad, masked and capped nurses and technicians, milled through the operating room preparing for surgery. The anesthesiologist, Dr. Margaret Hong stood at Helen’s side inserting an IV into her left arm, “This will pinch for a second.” It did, but to Helen this was but a minor concern.

  Dr. Hong, with her warm dark almond-shaped eyes, explained her plans for anesthesia, “First I’ll give you intravenous medication that will put you to sleep, then I’ll place a tube into your throat for general anesthesia. You’ll be asleep when I placed the tube, and I’ll remove it before you fully awaken after surgery.”

  Helen assisted in surgery often and had little concern about the anesthesia itself. The transplant was the focus of her attention. “If you begin counting backward from one hundred,” said Margaret Hong, “we’ll get this show on the road.”

  Helen watched as Dr. Hong inserted the small syringe containing clear fluid into a port in her IV line. She began counting, “One hundred, ninety-nine,” she felt her head swimming; “ninety-eight, ninety-seven, ninety…” was the last thing Helen remembered as all went black.

  Am I sleeping—am I dreaming? Helen thought.

  It was unlike any awakening from sleep she’d ever experienced before. It was so brutal, like rough hands grasping her body shaking her awake. Helen fought to stay asleep, but gradually somebody lifted her eyelids, shining bright painful light through to her brain.

  Where am I? , she thought.

  Helen tried to speak, but couldn’t. Her tongue and lips finally detected something in her mouth and into her throat. Gradually becoming more alert, suddenly, Helen’s body recognized the foreign body in her throat. She began choking and coughing in an attempt to expel the intruder.

  “Helen ... Helen,” a voice said urgently. “It’s Dr. Hong. You’re just waking up. I’ll get that tube out in a few seconds.”

  A few seconds was far too long for Helen, as she gagged, retched, and coughed repeatedly trying to rid herself of that awful thing down her throat. She would have ripped it out if they had not restrained her hands

  “Take a deep breath then cough,” Dr. Hong commanded, and suddenly the tube was gone.

  Ten minutes later, they wheeled the ventilator away. The nurse cleaned Helen’s face of adhesive tape surrounding her nose and mouth, and finally they allowed Chuck, Beth and me in to see her.

  Helen, now fully awake and holding Chuck’s hand, said in a voice somewhere between a whisper and a croak, “Great to see you Jack. Why is everyone looking so tired and stressed?”

  I squeezed Helen’s arm. “You gave us a bit of a scare over the last few days. We’re glad you’re back.”

  “How’s my liver doing?”

  “It’s doing great,” I said. “We found you are hypothyroid and you’ll have to continue on thyroid replacement indefinitely.”

  “Mom had low thyroid too,” Helen said. “She took thyroid pills for most of her life.”

  “I have to run back to the hospital to make my morning rounds,” I said. “Beth will be here when she completes her shift. She’s overjoyed. I’ll see you guys later tonight.”

  When the elevator door parted at the lobby level, Rick Adams stood in the lobby.

  “Hey, Rick, what are you doing here?”

  “I’m making a quick visit to Laura Larsen. She just had a ventricular aneurysm removed.”

  “How’s she doing?”

  “She’s great, but she barely made it to surgery, the heart failure was so bad, another Polk casualty.”

  “Speaking of the good doctor,” said Rick, “how’s Helen Martin?”

  “She’s finally awake. Hypothyroidism caused her coma.”

  “Maybe we should ask the university to establish a Polk annex,” Rick said, “to clean up after the Joe Polks of the world.”

  “You know, Rick,” I said, “the Polk situation, has disappointed me more than anything I’ve faced since leaving training. I didn’t expect paradise, but also I never expected that a physician, so incompetent and so evil, could practice in a medical community, especially a sophisticated one like Brier’s.”

  “It’s nearly over, Jack, thanks to you and Warren.”

  I thought for a moment then said, “I know we have a bunch of good docs who, on an individual basis, wouldn’t tolerate a Polk for a moment, but as a group, we all sit there, shaking our heads, and playing lip service to our responsibilities. What’s missing from the equation is simple outrage, an outrage that says enough is enough.”

  We stared at each other for a moment then Rick said, “Hang in
there Jack. Gotta run. See you later.”

  Good news spreads as quickly as bad, so when I arrived at Brier Hospital, everyone greeted me warmly. I moved around the hospital where everyone had questions about Helen Martin’s condition. They had expressed their concern and compassion for her, and what she’d been through, and issued a great institutional sigh of relief.

  The foggy day, brightened by Helen’s recovery, slid by quickly. Everything was going right and nobody mentioned Polk’s name.

  By five-thirty, I returned to University Hospital in time to see Helen moved out of SICU to the general surgery ward. Beth spent the day with Helen and Chuck. Bright and cheerful, she grabbed me as I entered the room and gave me a big kiss.

  “Take it easy you two,” said the thick-voiced Helen.

  “Dr. Cohen says we can go home in six or seven days, can you believe it?” Chuck said.

  Flowers, cards, and a few stuffed animals filled the room. The phone rang every few minutes and after a while, Beth and I said our farewells and headed for home.

  On our way back from the city, and suddenly ravenously hungry, we stopped to eat at the venerable Spenger’s Seafood restaurant in Berkeley. Dinner was relaxed, conversation light and easy, euphoria and tranquility in the aftermath of the storm.

  I must have been smiling continuously during dinner, unaware until Beth, stared at me and forced me take notice.

  She smiled seductively, and said, “Jack, are you okay?”

  I blushed.

  I felt like a jerk. I’d live with that because Beth had somehow made me feel better about myself, my life, and, a first for me, our lives. I loved her. I wanted her. I held her hands across the table and said, “I have this need, this urge that you understand the depth of my feelings for you, but I can’t find the right words.”

  “In the very way you look at me, speak to me, touch me, and listen to me,” she said, “I understand. Words aren’t necessary. They’re no substitute for what I experience when we’re together.”

  “Come home with me tonight,” I asked.

  “Are you sure?”

  I laughed, “More than at any time in my life.”

  “Love to,” she replied instantaneously.

  I felt anxious as we entered my apartment. “I’m sorry the place is a mess. Give me a minute to straighten up.” The apartment was organized chaos but clean. Books were everywhere, with clothing carefully positioned on the furniture.

  Beth walked up to, studied the large map on my wall, and said, “What kind of map is this?”

  I approached, encircling her with my arms from behind. “That’s a Robinson Projection of the world. See how much better it represents the continents and their proper proportions? I spend many a moment in front of this map, fantasizing about all the places I’d love to see someday, maybe by sailboat.”

  She turned to face me and before she could comment, we embraced.

  Beth had been cultivating this fantasy, anticipating this moment from the second she turned her head and looked at Jack that first night in ICU. Simple lust then had grown into an all-encompassing desire to be with him. Now so close and feeling his arms around her, she knew they were nearly there.

  He wore no cologne or aftershave, but Beth knew his scent, loved his scent. Some lovers could identify each other by smell, and she knew, without a doubt she’d know Jack’s anywhere.

  She would have been disappointed if his approach had been deliberate and practiced, but not to worry, as he fumbled with her blouse until she managed the buttons herself. She straddled between the urgency of her own desire and the delight of the slow, intense prelude. Later, they would know how to proceed, but for now, it was all exploration and discovery.

  We moved into the bedroom when the loud ringing of Jack’s telephone shattered the moment.

  “I don’t believe this,” I said, “I’m not on call tonight.”

  It was Jack’s answering service, and the operator began with an apology, “Sorry to bother you, Dr. Byrnes. I know you’re not on call and it’s not an emergency, but you said I could put Dr. Davidson through any time.”

  “I’ll take this call, but no more tonight, Dr. Hartman is on call.”

  “Have I caught you at a bad time, Jack?” Warren asked.

  “As a matter of fact, you have.”

  “It’s not important,” he said, “I’ll talk to you in the morning.”

  Jack put the phone down, and unplugged it from the wall. He turned toward Beth, rotating his palms out to her and raising his shoulders saying, “It’s unplugged.”

  Beth smiled, patting the bed with her hand. We stood together by the bedside and she quickly shed the remainder of her clothes.

  Jack managed to shed his own clothes and now embraced Beth’s narrow waist, his head against her flat warm abdomen. Jack raised his head and began kissing and sucking on Beth’s breasts.

  Warmth spread all over her body with the tingling of fine drops of perspiration. She had a brief moment of anxiety as she slid past her point of control, watching it as it passed over the horizon of her desire.

  Jack lowered her to the bed and they joined in the creation of their new joyful world.

  They were in harmony with each other, in a world of surprising delight. Heightened awareness, most accurately described our consciousness as they made love. Existing in space where the physical boundaries between us had become amorphous, they were so finely tuned and focused by the primitive, erotic brain, the seat of smell, touch and taste, that sight and hearing retreated into the background–white noise.

  Physically as close as possible, they wanted more–to to consume each other—to become as one.

  While risky during lovemaking, our journey ended with outright laughter and the sense they’d never felt better or more alive than they did at that moment.

  Afterwards, I lay on my back. My arm was around Beth as her face rested between my shoulder and neck, her arm across my chest. Somewhere between sleep and awareness, I’d shattered my initial disbelief, and savored the intimacy and the closeness only possible after the physical and emotional release unique to lovemaking.

  When she opened her eyes and looked up at me, I whispered, “I was going to say I could easily get used to this, but I know I never will.”

  She smiled, winked, and said, “You’re more right than you think, sweetie. You ain’t seen nothin’ yet

  The next two weeks were the best of my life. Caught in the intense heat, the seduction of new love, we spent virtually all of our free time together. It never was enough. How could she be so perfect?

  Dr. Dan Cohen discharged Helen Martin from U.C. one week ago with a rigid clinic and laboratory appointment schedule, a basketful of medications, and a five-page instruction list.

  “I can’t recall ever feeling better,” Helen said when she and Chuck were in to see me. “I don’t know if it’s the euphoria of surviving a near-death experience or the effects of medication, and I don’t much care. You should see what I’m eating.”

  “Enjoy it while you can,” I said. “You’ve lost so much weight it’s going to take a while for you to catch up. Be careful though, since some of your meds can increase appetite well beyond your body’s nutritional needs. Soon you’ll be asking me for a diet.”

  “Jack, I feel so much better now,” Helen said, “that only in retrospect do I realize how sick I was. My decline was so gradual that physical changes were mostly imperceptible, especially as I wasn’t thinking too clearly in those days. With my newly reconstituted grey matter, I see it all plainly now in my energy level and my appetite.”

  Helen looked at Chuck, and then back to me. “We were wondering if it’s possible for me to return to work in about a month, but only on a part-time basis?”

  “I don’t see any reason why you can’t work, as long as you don’t plan on running yourself into the ground.”

  I was escorting them out of his office when Chuck turned to me. “We’ve discussed legal action against Polk, and we’re not going fo
r it. It was a difficult decision, but we see a downside for us to be involved in the stress of litigation. We’ve chosen to put aside our anger and focus on getting our lives back in order. One way or another, we hope, justice will be find its way to Polk.”

  Chapter Fifty-Two

  Now that the Polk vs. Brier Hospital lawsuit was on track for litigation, the day-to-day preoccupation about it within the hospital had subsided. The demonstrators had picked up their signs, and the media had moved onto more fertile grounds.

  Jason Phelps was not a man easily discouraged. He walked toward Joe Polk’s office in the warmth of the bright Northern California sunshine. He’d braced himself, and decided to take another crack at the doctor. Phelps was an old litigation pro and had never seen the likes of Polk. He had more than his fair share of experience with egocentric physicians, but ultimately, when he finally got through the bravado and defiance, he’d always managed to coax them into reality. Polk remained intransigent.

  “We have them on the run now,” Polk said. “They won’t dare take this to court and expose their dirty laundry.”

  What case is he referring to? Jason thought.

  “I wouldn’t be so certain, Joe. They’ve produced a mountain of material justifying their action, and I don’t know how far we’ll get pushing the technical deficiencies of their process.”

  “They’re blowing smoke. My cases are largely no different from the majority of Brier physicians if they had their work similarly spotlighted.”

  Phelps continued in amazement. “Sir, as it stands, you’re the one standing in the spotlight. The hospital and medical staff have made their case for expulsion based both on your performance, Doctor and especially on your behavior. We should be negotiating your way out of this situation. Maybe we can get the loss of privileges time-limited. Maybe you should consider the Physicians Assistance Committee. Agree to talk to a shrink or whatever is necessary to prevent them from kicking you out for good.”