Gregg Hurwitz - Do No Harm

"More than you know," he muttered.

"What?"

"Nothing." David shook his head. "What happened this morning-the entire division not stepping in to provide care-I've never seen anything like it."

"People react violently when friends and colleagues have been injured."

David looked up, shocked. "You're condoning this?"

"Hey!" She pointed at him with the end of a banana. "Direct that righteous Spier anger elsewhere, David. I'm on your side here. If I condoned your staff's behavior this morning, I'd be perfectly capable of expressing that sentiment, so don't get pissy with me over implications."

"All right. I'm sorry. I apologize."

"If you'll pardon the equestrian metaphor, David, you're one of my Thoroughbreds. You were the youngest division chief in the history of this hospital, and I leaned like hell to get you that post, not because your mother was my mentor and dear friend but because you are that good. You're one of maybe three department heads here whom I trust implicitly, across the board, without question." Her voice was hard and driving, as if she were still being challenged.

"Would you like me to apologize again?"

Her lips pursed and pulled to one side in her distinctive smile. "No. Once was sufficient. Now, I agree that your staff's behavior was egregious. I'm merely pointing out that, however misguided and asinine, there are extenuating circumstances here. Now let's talk about this. First of all, what's this man's name? The patient."

"Clyde."

"Clyde? Who the hell's named Clyde?" She looked at David, miffed, as if he were somehow responsible for naming him.

"That's all he'll give up," David said. "No last name either."

"All right. How many staff members refused to help you?"

"Everyone."

"David, if the radiology tech or a desk clerk didn't pitch in, that's not relevant to this discussion. I'm interested in how many members of ER staff who receive and treat new patients refused to help you."

David thought for a moment. "Seven. Four nurses, two interns, and Don Lambert."

"All right. So legally, we're concerned with seven people here."

"My concerns are ethical, Sandy. Not legal."

She finished chewing a bite of burrito. "Hurrah, David. However, what I'm concerned with, in running this facility, is the area where your ethical concerns cross the boundary into legal concerns."

"Or PR concerns."

Her penciled eyebrows pulled up as she appraised him. "You inherited your mother's moral sense, but it's a shame you didn't inherit her overriding grasp of politics. It's the only thing that stands between you and a future post as chief of staff."

David ignored the dig. "How do you intend to handle this issue, Sandy?"

"Well, we've long known that Dr. Lambert is a lazy SOB, but when he's focused he's actually quite competent, and he is very popular among the staff. Do you really want to push this? It'll be a big stink. Do you feel your patient's care was compromised?"

"Well, I couldn't get to him as quickly-"

"Truly compromised?"

He bit his lower lip. "Probably not."

"All right. Now let's bear in mind that we are dealing with a very specific situation. This man was attacking ER workers. While the behavior of your staff is inexcusable, I'm not concerned that they'd withhold care from other patients. And the likelihood of someone else attacking ER workers and then needing medical care at the hands of that same staff… well, we know how remote a possibility that is. You have to pick your battles. Now let me ask you again. Do you really want to push this?"

David suddenly felt quite nauseous. "I want them to be formally reprimanded, yes."

A woman trudging slowly past glanced over at him, and he realized the intensity in his voice was making it carry.

"Don't get me wrong, David. I'm as pissed about this as you are. In fact, I'm planning on personally meeting with all seven employees and tearing them each a new orifice. What I'm asking is, do you want to involve the Ethics Committee? Risk Management? The California Medical Board?"

He rolled the soft lining skin of his bottom lip between his teeth. "No."

"All right." She smiled curtly. "I'm quite good at being furious. By the time I'm through with those seven, they'll have the Hippocratic Oath tattooed on their foreheads."

He nodded, somewhat formally, and she returned the gesture, amused.

"Now I've got another tangentially related headache," Sandy said. "As I mentioned before, the media's been crawling all over the hospital, jamming the phone lines. It's not the kind of press we like, but, even worse, it's interfering with the hospital's effectiveness. When can you get this… Clyde on his way to the Sheriff's station?"

"It's complicated."

"No, David, it's not. Get him stable and get him moved."

Sandy leaned back and crossed her arms, an amused, attractive little smile playing across her face. "One of the rules when dealing with Thoroughbreds is that you don't rein them in too much. They lose some of their fire, their passion. So I'm making a suggestion, not a directive, and you can throw it out if you'd like."

He knew what was coming, and he knew he deserved it.

"More people look up to you here than you're aware," Sandy said. "You're part of the bedrock of this hospital. I heard you lost your cool pretty badly this morning. That unsettles people. Whether we like it or not, your division is under intense scrutiny because of this case-both internal and external scrutiny."

David took this in, trying to strip away his anger and defensiveness, and find some utility in the information. "Your suggestion?" he asked.

Sandy rose, picked up her tray, which was littered with gutted food containers and fruit rinds, and winked at him. "Keep your clay feet covered."

Yale emerged from Exam Room Fourteen, jotting something in a worn black leather notepad. A rubber band held several yellow sheets to the top cover, marking his place. As David approached from the cafeteria, Yale flipped the pad shut and slid it into his sport-coat pocket. The two LAPD officers had been replaced by UCLA PD cops, who now stood guard at the door.

"Dr. Spier," Yale said. He took a few steps toward David, perhaps so the officers wouldn't overhear the conversation to come. "We'd like to get the suspect moved to the jail ward at Harbor. As I'm sure you're aware, the ward there is a high-security treatment zone, and we think it will be safer for everyone involved when we get him moved there. Is he stable?"

"I'd like to continue irrigation for a few hours. Alkali continues to burn deep within the skin, even when it looks like it's been cleaned off."

"Yes," Yale said. "We've learned that the hard way."

"I also need to get him stitched up."

"Can't that wait and be handled at Harbor?"

The last time David had checked, Clyde was still reporting pain. David had his hesitations about releasing a patient in a fragile state into the hands of officers who were less than concerned about his health and safety. He thought about how slowly they'd sauntered into the ER with Clyde screaming and burning in their hands. Jenkins's execution pose with his pistol. "I need to keep an eye on him for a few more hours, see how things settle. I don't want him moved in this condition."

"I'd really prefer-"

"Maybe tonight."

"What time?"

"We'll see how he's doing at eight, nine o'clock."

That would give David more time to observe the burn's course and make sure the gashes were stitched and cleaned up. Plus, Jenkins's shift should be over by then. David would be less concerned about turning Clyde over to a more impartial officer.

Yale glanced over his shoulder, and the two officers at the door looked away quickly, pretending they hadn't been eavesdropping. "I'm gonna be honest with you," Yale said. "It's not going well in there. He won't talk to me."