Medical Judgment

by Richard L. Mabry M. D.

  The silence on the other end of the phone lasted too long for Kyle’s comfort. Finally, he said, “Did I catch you at a bad time? I just wanted to check on you.”

  “There may never be a good time,” Sarah said. “I appreciate your concern, but I’m afraid that my trust level for just about anybody is pretty close to zero. Now I really have to go.”

  After the call was over, Kyle leaned back, put his hands behind his head, and thought about what Sarah had said. It was pretty evident that she included him when she referred to her zero trust level for everyone. Was this just hyperbole, or had she truly reached that point? And, if that were the case, how could he change her mind?

  * * *

  Sarah looked at her watch. She’d gotten bogged down running errands and straightening around her house, and now it was time to head for work. Had she eaten lunch? No matter. She wasn’t terribly hungry. She decided she’d pick up something at the hospital food court on her break this evening.

  She went through the routine of disabling the security system, pushing a button to raise her garage door, backing her car into the driveway, lowering the door, and arming the system again. To do that for a day or two was a nuisance. To do it for a couple of weeks would be an inconvenience. But to continue this way for the foreseeable future—that was something she didn’t want to consider.

  Then again, was it really the routine she disliked? No, she could adjust to it, inconvenient as it might be. It wasn’t the routine, it was the constant fear of what she might find when she came back, of what would happen to her next. She’d learned in medical school that one definition of anxiety was fear of the unknown. Well, that was what she faced every day now.

  Surely it wouldn’t be long before Bill Larson learned the identity of the person behind these attacks and brought him to justice. She had to believe that, because Sarah was certain she couldn’t go on this way.

  * * *

  He was parked in a different spot today, not directly across the street from Dr. Gordon’s house this time. His car was a bit farther down the street, tucked into a space between two others—too far away for a shot from his pistol to hit her, but close enough that he could see her when she left. Was it his imagination, or did she seem a bit harried when she backed her car out of the driveway and pushed the button on her remote to lower the garage door?

  After she was satisfied the door was fully down, the doctor reached toward where her ignition keys would be. That probably meant she was finding the fob on her keychain to arm her security system. Before she left the driveway, she picked up her phone and punched several buttons. She waited a few moments, silently shook her head, put down the phone, and drove away. Whoever she was calling didn’t answer, and it seemed to frustrate her. Frustration was good.

  So far, it looked as though she was using the alarm system regularly. He figured it wouldn’t be long before someone or something set it off. Enough false alarms and perhaps she’d stop using it. Or maybe she’d forget to set the alarm as she left. That happened quite often with these systems. In either case, when that happened he’d pay her another visit. Would it be the final one? Too soon to tell. For now, he’d just let her stew.

  8

  I appreciate you taking the time to see me,” Bill Larson said. He sat at a corner table in the hospital’s food court, a cup of coffee cooling before him. Although people were coming and going all around, the tables nearby were empty and the low buzz of conversation was like white noise, masking their conversation from the ears of others. This setting was probably as good as any for this meeting.

  Sarah took a bite of her tuna sandwich, chewed, and swallowed. “So what’s going on?”

  “You gave me a list of adult patients and parents of children you saw in the ER who might have a reason to hurt you. Detective Johnson or I have checked out every one of them. So far none of them seems likely to be the person we want. I’m going to need you to sit down with me again and help me get more names from the emergency room records.”

  Gordon picked up the remaining half of her sandwich but held it without eating. “Why?”

  “Because my gut tells me the person who’s doing this to you is somehow related to a decision you’ve made in the ER.”

  Dr. Gordon chewed another bite of tuna sandwich, following it with a swallow of milk before saying, “I’m an ER doctor. The patients I see think they have an emergent medical condition, whether they do or not. Many of them I can treat myself, for some of them I have to call in a specialist, and a few I send home with medications and as much reassurance as I have to give them.”

  “I get that,” Larson said.

  “It may surprise you to hear this, but doctors aren’t perfect,” Sarah said. “We make mistakes. But I . . . actually, all the doctors working in that ER, exercise our best medical judgment every day. But are there patients who get so upset when we make a mistake that they want revenge? So far, I haven’t encountered any.”

  “Tell you what. Will you give me another hour tomorrow, going over ER records? If we don’t turn up anything promising, I’ll let that end of it drop while we pursue some other areas.”

  “Such as—”

  “Right now, Detective Johnson is taking a deeper look into your personal affairs. He’ll be checking relationships, tradesmen with whom you’ve done business, anyone we can think of who might be carrying a grudge.”

  “No problem,” Sarah said. “I’ll meet you in the records room about one p.m. tomorrow. And as for digging into my private life, have at it. I don’t think there’s a chance in the world you’ll find anyone there who’s out to get me—certainly not anyone who’d set my house on fire or take a shot at me.”

  “Let’s hope not,” Larson said. “But we have to look.”

  * * *

  Kyle Andrews sneaked a peek at his watch. He’d wanted to talk with his pastor, but when he made the call he hadn’t realized that Dr. Farber met with the Board of Elders of the First Community Church on the first Wednesday evening of each month. And that was today. Kyle offered to let his visit slide until another day, but the pastor insisted they meet at his house after his meeting was over.

  “Tell you what,” Farber had said. “I’ll call you when I leave the church. By the time you get to my house, I’ll have some fresh coffee started, and we can finish off the pound cake one of the ladies of the church dropped by a few days ago.”

  Now it was nine thirty—not yet too late for a chat between friends, but if the pastor didn’t call soon . . . Then Kyle’s cell phone rang. He checked the caller ID. “Dr. Farber?”

  “Kyle, how many times have I told you calling me ‘doctor’ or ‘pastor’ isn’t necessary when we’re in a social setting? Just call me Steve. Anyway, I’m leaving the church right now. I should be home before you get there, but if not, I won’t be far behind you.”

  It took Kyle fifteen minutes to reach Dr. Farber’s . . . er, Steve’s home. Sure enough, the pastor’s garage door was just going down as Kyle parked his car at the curb. By the time he reached the front door, the pastor had it open, beckoning him inside.

  “Come in, come in,” he said. “I just got here myself. I’ll start the coffee, then get rid of this tie and change into some comfortable shoes. Make yourself at home in there,” he said, pointing to a room down the hall to Kyle’s right.

  The room was probably where Farber studied, prepared his sermons, and counseled visitors. The walls were lined with bookshelves. A desk in the corner had open books and sheets of notes scattered over its top. But the room also appeared to be where he relaxed and read. There was a comfortable wing chair in one corner with a lamp behind it to the right. A small table to the left of the chair held a few magazines and a couple of novels. Sections of today’s newspaper were scattered on the floor beside the chair.

  Kyle eased into a leather-covered club chair facing the wing chair and crossed his legs. In a few moments, Steve came through the door. The pastor was tall but by no means thin. His silver-gray hair was combed strai
ght back, his moustache neatly trimmed. Blue eyes behind metal-rimmed glasses managed to seem both guileless and inquiring at the same time.

  The pastor had exchanged his dress shirt and tie for a golf shirt and replaced the shoes he’d worn earlier with slippers worn over bare feet. “The coffee should be ready in a moment,” he said, before taking a seat facing Kyle. “While we wait, why don’t you tell me what’s on your mind?”

  “You know about Sarah Gordon’s situation.”

  “Of course,” Farber said. “She lost her husband and two-year-old daughter about eight or nine months ago. Then she had a fire at her house recently. She’s certainly had her share of problems.”

  “More than you know,” Kyle said. “There’ve been other incidents beside the fire. It appears that someone is making an effort to frighten her . . . perhaps to kill her.”

  The pastor whistled silently. “I didn’t know. I saw Sarah in the service with you on Sunday. I was glad she came. I hope that was your doing. I’ve tried a few times to call her but got no answer. I wondered if she saw my name on caller ID and didn’t pick up. I mean, that would be the reaction of a lot of people, getting a call from their pastor after a loved one dies.”

  “What do you mean by that?”

  “They’re too busy with their feud with God to talk with me. ‘Why did God let this happen? Why didn’t God intervene?’ Surely you had thoughts like these when your fiancée died. I certainly did when I lost Mary.” He held up his hand. “Let me bring in the coffee. I think this may be a long conversation.”

  * * *

  “You’re working late,” Cal Johnson said as he spied Bill Larson hunched over his desk, squinting at the screen of his computer.

  Larson eased back in his chair and stretched. “I lost track of time, I guess. Then again, I don’t have anyone waiting for me at home. You, on the other hand, should be there with Ruth.”

  “She had a meeting at the church tonight. I was home for supper, but I got tired of watching TV so I thought I’d check back and see if you’ve made any progress.” Cal eased one hip onto Larson’s desk and peered at the computer screen. “But if you’re still here . . . ”

  “I’ve used the various databases available to us, looking for some reason our mystery man is trying to scare Dr. Gordon, but nothing so far. Then I decided to do a plain Internet search.” He pointed to the computer. “On Google there were thirty-five million hits for the name Sarah Gordon alone, but that will drop as I add the various filters. And I haven’t even begun looking for things that have to do with her late husband.” Larson stretched. “I’m probably going to ask you to do some of this. But not tonight.”

  Cal looked at his watch. “Well, if you don’t need me, I’ve got to head home so I’m there to meet Ruth when her meeting’s over. So far, I’m doing pretty well at making this marriage work.” He eased off the desk. “I’d ask if you wanted to have a drink with me before I head home, but I guess you’re still on the wagon.”

  “Day at a time,” Larson said. “Let me give you some advice, Cal. Sometimes it’s a temptation to reach for booze to help you forget a bad day. Cops do it all the time. It’s an easy way to distance ourselves from some of the things we encounter. But don’t do it. Instead, talk with your wife.” He shook his head. “I wish I had.”

  Cal nodded. “I’ll try.” He turned to walk away, then said over his shoulder, “See you tomorrow.”

  * * *

  Steve Farber looked regretfully at the plate of cake crumbs sitting on the low coffee table in front of him. He reached out to pour a bit more for himself from the pot that rested on a tray beside the remains of the cake. “Help yourself to more coffee,” he said to Kyle. “I’m sorry there isn’t more cake.”

  Kyle Andrews filled his cup, added sweetener, and stirred. “No problem. I normally don’t have dessert with my evening meal.”

  Farber patted his stomach. “Unfortunately, I attend enough meetings that include coffee and sweets that I’ve had to make a conscious effort to leave off desserts if I’m going to keep my weight from ballooning.” He smiled. “But sometimes I make an exception.” He brushed a few crumbs from his moustache, took a sip of coffee, and looked at Kyle. “Now let’s get back to the subject of our conversation. You seemed surprised when I talked about being angry with God for letting a loss or a death happen. Were you shocked that a pastor would go through that himself?”

  Kyle didn’t respond immediately. He put down his cup, pursed and relaxed his lips, and thought about the question. Finally, he said, “I guess I was.”

  “Didn’t those thoughts cross your mind when your fiancée died? After all, a crossbeam fell on her while she was on a mission trip helping build a church. There she was, doing the Lord’s work, and she was killed by a freak accident. Didn’t you want to lash out at God?”

  Kyle bowed his head. “Yes. But I figured that would be somewhere between disrespectful and sacrilegious. So I kept things bottled up, said all the right things, and eventually I came to accept my loss.” He looked up at Farber. “You didn’t do that?”

  “Nope. You may think that’s the Christian thing to do, but I can tell you it’s certainly not the way most people react.”

  “I guess I didn’t know about your loss. What happened?”

  “Mary, my wife of twenty-five years, went to our family doctor for a physical. The doctor apparently missed a lump in Mary’s breast. When it was big enough for her to find it herself, she called him, and he sent her to a surgeon. She had surgery, chemotherapy, radiation—the works—but she died. After that, I asked for a three-month leave of absence from the pastorate, because I figured it would take that long for me to get over the loss. Frankly, I wondered if I could ever be a pastor again. The church was generous—they gave me the leave of absence.”

  “I agree. Most churches wouldn’t be so generous,” Kyle said.

  “Especially after the other problem the elders knew I had when they called me.”

  “What was that?”

  “Not important right now.” Farber shook his head. “Let’s just focus on the way I handled Mary’s death. I spent the first six weeks of my leave railing at God. I really thought I had no business being a pastor.”

  “What changed your mind?”

  “I decided my constant complaining to God wasn’t getting me anywhere. I needed to give Him a chance to respond. So I opened a dialogue with Him.”

  “How did you go about that?” Kyle asked, seeming genuinely interested.

  “I began by studying the Scriptures,” Farber said. “Not just cherry-picking the ones I wanted, but reading whole sections, whole books of the Bible: first Psalms, then Job, then the Gospels. Finally, I started praying again. And, although I never heard a disembodied voice or saw handwriting on the wall, I was aware God was speaking to me. So I stopped talking to Him long enough to listen. And that’s when it dawned on me.”

  “What?”

  “What I’d been preaching all these years was true. I just hadn’t believed it enough to apply it to my own life. What happened to me wasn’t His judgment. He didn’t cause it, but He was there to help me through it. And when I turned back to Him, He was still right where He was before I lost Mary.”

  Kyle shook his head. “You know, I came here hoping you’d tell me the secret of helping Sarah get over her loss and the stress she’s under now. Instead, I found that what she’s been feeling, what she’s doing, isn’t unusual. I guess the time frame varies for different people to get past their loss, and it’s not abnormal for her to react the way she has.”

  “So what are you going to do?” the pastor asked.

  “I guess that instead of worrying that Sarah isn’t recovering the way I think she should, I’ll work on being her friend, however long it takes,” Kyle said. “And maybe I’d better let out some of the feelings about my own loss that I’ve buried.”

  * * *

  Sarah had heard it all her professional life: Working in an emergency room was predictable only in it
s unpredictability. It had been a relatively quiet Wednesday evening, but that changed about the time she was scheduled to go off duty. Sarah had given her report to Chuck Crenshaw, the doctor relieving her, and was headed for her locker when the double doors into the ER crashed open.

  A female paramedic, one Sarah recognized as being relatively new on the job, pushed and guided a stretcher while a more senior EMT hurried alongside doing chest compressions on an elderly man. An IV was in place and an oxygen mask covered the patient’s bloody face.

  Right behind them came another team. The patient on this stretcher was a girl, probably a pre-teen. She was bleeding from cuts on the face and scalp. Her blonde hair was matted with dried blood. Her eyes were closed. Sarah wasn’t sure if she was unconscious or lying still in a vain attempt to shut out the horror of the situation.

  “MVA,” the female paramedic pushing the first gurney said in a loud voice, heading toward an open cubicle. “He was driving. Didn’t have his seat belt on. Air bag didn’t deploy. Blunt trauma to the chest from the steering wheel, cuts where he hit the windshield. He went into cardiac arrest while we were getting him onto our stretcher.”

  “I’ll take this one,” Chuck said.

  That left the young girl for Sarah. “Same motor vehicle accident?” she asked.

  The EMT guiding the stretcher nodded. “Mainly cuts from flying glass, but she hit her head on the vehicle’s dash. She’s been in and out of consciousness since we picked her up.”

  In a cubicle, Sarah did a quick assessment. The bleeding had slowed, but at least one scalp laceration would require stitches, and a couple of the facial cuts might, as well. The girl kept her eyes closed, but opened them on command, only to shut them tightly again afterward. A preliminary neurologic exam showed no localizing signs. She knew who she was. She knew today’s date. But when asked repeatedly what had happened, she didn’t respond. Sarah couldn’t decide if she was blocking out the accident or if this was a consequence of her head trauma. She asked for a CT scan of the girl’s head and neck.