HARMED - Book 1: First Do No Harm

by L Jan Eira

  Quentin continued as she slowly made her way toward the other remains on the floor. “He also shot and killed this woman, Heather McCormick, a nurse on the unit. She was caring for him.” She paused once again, bent at the waist, and picked up the sheet. Fuller repeated the previous steps. Her fatal wound was to the head, the bullet disfiguring her face. Both detectives stood as the white sheet fell on the nurse’s corpse.

  “A waste of life, indeed,” Fuller said.

  “After these two went down, there was an exchange of gunfire between this man, Mike Huber, a security guard here at Memorial, and the shooter.” By the time Quentin murmured these words, they had circled around the small area, stopping by the third covered, bloodied body. The detectives picked up a corner of the sheet as they had done before.

  “What do we know about the shooter?” asked Fuller.

  “Arthur Butterworth,” said Quentin, making her way to the hospital bed in the center of the small room. “We don’t know much about him yet.” She once again lifted the blood-soaked white sheet covering the deceased patient. Fuller eyed the body. Multiple gunshot wounds were visible on the man’s torso, dressed in a typical hospital gown, now soaked with bloodstains. Fuller grabbed the corner of the linen to pick up the proverbial smoking gun, located next to the body. This would allow inspection of the pistol without placing unwanted fingerprints on the weapon. The typical smell of a recently fired gun permeated the air.

  “Why did you go and kill these nice folks?” asked Fuller rhetorically, his eyes on the dead body. His gaze then slowly connected with Quentin’s. He gave a silent nod. Both detectives slowly backed away from the bed.

  “The gun was fired six times,” said Quentin.

  “And that’s only because there were no more bullets,” said Fuller. “I suppose.”

  “We know who shot whom. We have plenty of witnesses. What we need now is to find out why.”

  “We need to establish the routine around here,” said Fuller. “We should get someone from the hospital to help us with that.”

  Quentin concurred. “Someone who knows medicine, who knows the routine here at the hospital, who knows which records we need to see.”

  “We’ll pick somebody,” said Fuller. “One of the doctors.” He stepped out of the small cubicle and into the CCU proper. “We’ll watch him closely until we’re sure we’re not getting a wolf to help us shepherd our sheep. What’s the new kid’s name?”

  “Jim Franklin?” said Susan.

  “Yeah, him,” said Fuller. “He just joined the detective force a few days ago. This will be the perfect first job for him.” Fuller winked at Quentin. “Ask young Mr. Franklin to follow our medical helper and report any suspicious behavior. Now, to pick the right one!”

  CHAPTER 12

  A crowd of medical personnel of all types loitered just outside the yellow tape enclosing the entrance into CCU and the waiting room just outside it. Jack had talked to the police officers guarding the entry to the crime scene, hoping to take a glimpse inside CCU for a final look at his best friend John and the others. He wished he could be part of the investigative team and, better yet, be selected as the person responsible to dole out punishment to the offenders. Whoever killed you will pay dearly for it, John and Heather, mused Jack. You monster from hell, you will pay with—

  “I bet you’re Dr. Jack Norris!” said a woman from behind him, interrupting his thoughts. Jack turned to face her.

  “Yes, I’m Jack Norris. I’m one of the doctors here,” he replied.

  She was tall with deep-blue eyes. Her hair was light brown, almost blond. She looked to be in her early to midthirties. She wore a striped pantsuit and a white shirt. A police badge hung on her chest from a chain around her neck.

  “I’m Detective Susan Quentin of the Evansville Police Department.” The two shook hands firmly.

  “What happened in there?” asked Jack. “Is there anything you can tell me?”

  “Four people died. One of the patients became agitated and started shooting,” she said.

  “Where did he get the gun?”

  “We don’t know. We’d like to ask you some questions.”

  “I just got here. I don’t know anything about what happened.”

  “Yes, I know,” said Quentin. “You were flying your airplane.” Jack looked puzzled, amazed, and intrigued by her knowledge of his whereabouts. Noticing his astonishment, she continued, “I’m a detective; that’s what I do.”

  “I was at seven thousand feet when the killings took place,” said Jack. “But two of the people killed were my close friends. I’ll do anything I can to help you. What do you want to know?”

  Quentin smiled. “We need to know about usual routines around here. Also about the patient, Arthur Butterworth.”

  Jack nodded his head. “Sure, not a problem. I’m glad to help any way I can.”

  “Where can we go to have some privacy?” asked Quentin.

  “My office?”

  “Sounds good,” she said with a smile. “Let me get my partner.” The policewoman entered the yellow-taped Do Not Cross area and disappeared into the crowd of law-enforcement agents.

  Jack noticed the multitude of officers walking in and out of the area, the professional-sounding walkie-talkie lingo emanating from multiple belts, all in unison. Two men wearing jackets labeled Coroner came across Jack’s area, guiding an empty stretcher.

  “Excuse me, coming through,” they murmured repeatedly, inching their way toward the entrance into CCU. Jack helped the men by lifting the yellow tape so the two could pass. He found himself on the other side of the tape and slowly walked into CCU, unnoticed by the busy sentinels. Knowing he shouldn’t and that he would later regret it, Jack became overwhelmed by curiosity and walked toward the crime scene. As he entered the unit, his eyes first focused on the two bodies on the ground, both of which had been uncovered to allow pictures to be taken. For a split second, Jack fixated his gaze on the empty, lifeless eyes of his best friend, John Connor. He didn’t tolerate this long, bothered mostly by the blood-drained pastiness in John’s face. He had to look away. His eyes unconsciously moved to John’s chest, now completely covered in blood, an obvious bullet hole right in the middle. The nightmarish scene only worsened when Jack’s gaze unintentionally shifted to the young woman. Though in his mind he could still see Heather’s beautiful, youthful face, his vision returned a head with a faceless expression, the bullet having disfigured grotesquely all the elements of her attractive features. Instead, a large hole in what used to be her forehead and nose was now surrounded by blood and brain matter. A sense of dread and disgust overcame Jack, and he hurriedly retreated to the waiting room right outside the CCU entrance door. He found a chair and sat down, his whole body trembling as it had never done before. It took several minutes for him to even begin to feel a little better. He walked slowly to a nearby cooler and had a big gulp of cold water. Then another. This soothed the intense fire inside but only infinitesimally. Susan emerged with an older man bearing an almost out-of-place smile.

  “This is my partner, Detective Herb Fuller,” introduced Quentin. Fuller extended his hand and shook Jack’s, looking him squarely in the eye. Fuller was in his sixties, with balding gray hair with islands of some black. He sported a comfortably loose-fit, dark-brown jacket and light-brown pants with a white shirt and red-and-brown tie. Just like Quentin, Fuller dangled a police badge suspended by a chain around his neck.

  • • •

  In all his years as a detective, Fuller had learned to look people in the eye. He knew the eyes were the windows into the soul, heart, and brain. He had made a vocation out of interpreting eye contact. Looking into Jack’s eyes, he saw concern, kindness, gentleness, and strength. A little bit of horror, too. Just like that, he knew he could count on this young man for help.

  “How are you, Doctor?” asked Fuller.

  “Not too well.” Jack had tearful eyes.

  “I’m sorry for the loss of your friends and all this mess.” Fu
ller took a deep breath. “Detective Quentin told me you were willing to talk in your office. We can step away from here right now, while the crime-lab people take their photos and collect their specimens.”

  “No problem. Follow me.” The three walked in silence, Jack leading the group. They excused themselves as they wound in and out past many groups of people, mostly hospital staff and police personnel. Quentin held a small notebook.

  When they arrived at the staircase, reassured that they were no longer around people who might overhear their conversation, Fuller resumed the exchange. “What we know so far is that the patient, Arthur Butterworth, a man in his sixties—”

  “Sixty-three,” offered Jack. “I admitted him yesterday.”

  The cops nodded, Quentin wrote something on her notebook, and Fuller continued his narrative. “Butterworth was admitted yesterday. This morning, and without provocation, he went berserk. Somehow, he managed to find a small-caliber gun and took a nurse hostage in his CCU room; the other staff summoned hospital security and the police. When the security officer arrived, the man was described as wild and paranoid. The result was that the nurse and one of the doctors were shot and killed as they were retreating from the bedside. They had tried in vain to persuade the patient to give himself up. The man didn’t appear to understand and pulled the trigger. Shots were exchanged with the guard, culminating in Butterworth’s death as well as the security officer’s.”

  They arrived at Jack’s office. Jack nodded at Beverly, who was on the phone. She remained motionless with mouth agape, her eyes tracking the newly arrived. They entered Jack’s office.

  “Coffee, soft drink, water?” asked Jack as he took his chair behind his desk, a small table almost completely buried with stacks and stacks of medical records. In the midst of all that, like two tiny islands about to be swallowed by the immenseness of the vast sea of paperwork, were a mug and a name sign afloat. It read, Jack Norris, MD, Chief of Fellows, Department of Cardiology, Section of Electrophysiology.

  “Nothing for me,” said Fuller, as he sat and looked over at his partner.

  “No, I’m fine,” said Quentin.

  “Dr. Norris,” said Fuller, pausing as if to choose his words just right. “We have a lot of witnesses as to who pulled the trigger and caused all these deaths. What we need to do now is try to understand why. We need to find out where the gun came from. We’d like to start by gathering some information about routines here at Newton Memorial and about this patient.”

  “Sure, I can help you with that,” said Jack.

  “What time did you last see Butterworth?” said Fuller.

  “I was with him at around five; I helped with the admission process before I went home.”

  “Did he have a gun on him?” said Fuller.

  “Not that I noticed, but I didn’t go through his personal things,” said Jack. “The nurses do that when patients are admitted. They take a complete inventory of all the possessions. Did you review that document?”

  “Yes, we did look at the paperwork and no mention of any weapons,” said Quentin. “We didn’t talk to the nurse who admitted him, since she ended her shift at seven o’clock yesterday evening. We’ll talk to her later today.”

  “Do you know anybody who owns a gun?” said Fuller. “Can you think of anyone who works here who might have brought in a gun for any reason?”

  “No, not really,” said Jack.

  “How was the patient’s demeanor when you spoke with him last?” said Fuller.

  “He was calm,” said Jack. “A bit concerned given his chest pains, but nothing out of the ordinary.”

  “What about his chest pains? Do you think he could have been faking his symptoms?” said Fuller.

  “His EKG was abnormal, and his troponins were elevated.” Jack smirked and took in a breath. “There were abnormalities suggesting a heart attack on the EKG as well as in the blood work. I don’t think that can be faked.”

  “Is there any way at all that he could have fooled you?” said Quentin. “Somehow cause a false reading on those tests?”

  Jack paused for a beat. “There may be drugs that mimic the EKG changes we saw, but the blood test…” He paused again.

  “Like what? What kind of drugs?” persisted Fuller.

  “If it were a drug, that drug would have also potentially caused the severe psychiatric disturbances.” Jack bit his lower lip. “Let me research that and get back to you.”

  There was a long moment of silence. Jack contemplated, Quentin wrote in her notebook, and Fuller reflected on the line of questioning. Quentin finished scribbling and looked up at Jack and then at Fuller.

  “As far as the typical routine around here, did anything seem out of place or unusual this morning?” asked Fuller.

  “No, but I got here later. I don’t know that I can say yet,” said Jack.

  “Tell us what a typical day is like for the doctors,” said Fuller.

  “Well, let’s see,” began Jack. “Everything starts with morning reports at eight in the morning. Then we split into teams and go up to the wards and make rounds.”

  “Got it,” said Quentin. “Please continue.”

  “Medical rounds start around nine to nine-thirty in the morning. The trainees are grouped and assigned a certain ward to round on. Each team consists of a few med students, an intern, a resident, and a fellow. So at the time the murders occurred…” Jack paused. “What time did the murders occur?”

  “Around six fifteen,” said Quentin.

  “That early in the morning, there is typically nothing going on,” said Jack. “The nurses don’t change shifts until seven. There are people in the unit drawing blood, setting up portable x-ray machines, and getting EKGs on patients.”

  “Do you know if the patient had any visitors?” said Fuller.

  “Yes, his wife and daughter were with him yesterday,” said Jack. “They were with him when I left. They seemed concerned and like a close-knit family.”

  “Do you know if the patient had any visitors this morning?” said Quentin.

  “I don’t know about this morning,” said Jack. “But surely not at six fifteen.”

  “Do you know if anyone unusual came to see him since his arrival in the hospital?” asked Quentin.

  “I really don’t know.”

  “Do you have any theories or thoughts about why this man might have wanted to commit these murders?” asked Fuller.

  “Dr. John Connor was a research fellow,” said Jack. “I know they use and sacrifice many animals down in the research lab. My first thought was some animal activist group, but that seems farfetched.”

  “We thought of that angle as well,” said Fuller. “And we’re looking into the possibility.”

  “I’ve been thinking about this a lot,” said Jack. “Sure, the patient could have had some terribly unusual psychiatric disturbance from God knows what, but that’s unlikely. Or, yes, he could have faked his cardiac problem to come in and kill my friends. Again, not probable! More than likely, he was under some type of spell. Since I don’t believe in juju, I’m betting some drug made him crazy and made him pull the trigger.”

  “That’s how we’re thinking as well,” said Fuller. “We appreciate your help with finding out what that drug might be.”

  “We’ll concentrate our investigating, first of all, on where he got the gun,” said Quentin. “I think that’s going to be key.”

  The detectives got up, shook Jack’s hand, and left the small office, having made plans to meet again at four o’clock that same afternoon. As he watched them depart, Jack remained standing by his desk, motionless and in silence, his eyes gathering moistness again. He gritted his teeth together with newly built rage percolating. He felt his own tears flowing down his cheeks and clouding up his vision. Jack vowed to keep working the problem until he understood what led the murderous patient to pull the trigger and kill his friends. If Butterworth was under the influence of some drug, Jack vowed to labor doggedly until that drug was discovered.
He hoped this would then lead police to the parties responsible. Only then would he rest. Only then would he put behind him the horrific aftermath today had begotten.

  CHAPTER 13

  Jack spent three hours in his office. He read textbooks and searched databases of medical information on the Internet. A list of drugs that could have affected the EKG changes was predictably and repeatedly shown in every source he examined. But none of these interfered with the blood-test results. A list of agents known to interfere with the blood-work findings weren’t known to cause changes on the EKG that would mimic a heart attack. Worst of all, none of these drugs had been described to instigate psychiatric disturbances of the magnitude displayed by Butterworth. So he kept on searching.

  He worked through lunch. At two o’clock, he realized there were several inpatients on whom he had to round. He knew the medical students and residents had been sent home at the recommendation of the police as the murder scene was probed and inspected. But there were hospital patients to be seen. He would do that quickly without students to teach and residents and junior fellows to guide. The last thing he wanted to do was to be late for his meeting with Detectives Fuller and Quentin.

  It was 3:58 p.m. when the two cops arrived.

  “What did you come up with?” asked Quentin.

  “I came up with nothing. There is no known drug known to fake the objective cardiac signs displayed by this patient and cause acute dissociative delusional disorder.” Jack paused, realizing the cops needed a hand with the lingo. “The cute name psychiatrists came up with to explain the condition that caused Butterworth to commit the atrocities he caused.”

  Quentin and Fuller nodded.

  “So, this man really did come in with a serious, bona fide heart problem,” said Fuller.

  “That settles that issue,” said Quentin.

  “No, not yet,” said Jack. “I said there are no known drugs that cause this. But Butterworth might have been given an experimental agent, one that’s not in the books yet. I want to continue to search, but I need more time. I need to visit the medical-school library and do a more extensive search.”