Gregg Hurwitz: Do No Harm

Cupping his limp penis in his hand, Clyde crossed to his bed and pulled the strewn sheets up into rough position. When he climbed in, his bulk took up most of the width of the bed, his shoulders pressing back into the child's headboard. He dug for a pack of cigarettes beneath the sheets and squeezed it until the top popped open. Only two cigarettes remained. Placing them in his mouth side by side, he lit them together and smoked them as one unit.

The blackness outside his window had lightened to a grayish cast. Smoking his cigarettes and plugging his leaking wound with a fat thumb, he waited for morning.

The modern Greek-style house peeked out from behind bunches of pampas grass and fan palms, the leaves throwing perfect shadows against the white stucco. Between the home's windows, vines of split-leaf philodendron snaked up the walls, the glossy dark-green leaves flapping in the breeze like atrophied wings. On the front lawn, two large palm trees crisscrossed like necking flamingos. Situated on Marlboro Street in Brentwood, David's house was a few blocks south of Sunset but still close enough that the occasional passing semi ever so slightly vibrated the paintings on the walls. The house seemed almost shy, set back a good twenty yards from the street.

A blaring car horn in the distance awoke David at 5:30. He turned beneath his comforter, removing his earplugs and placing them in a nightstand drawer. He heard the traffic immediately, and wondered if there was a more effective brand of earplug that might rescue him from the all-hour sounds of Sunset Boulevard.

His king-sized bed sat centered beneath a window that overlooked the thin side yard. No blinds or drapes dressed the window; he liked to awaken with the gathering sunlight. Aside from a solitary padded chair in the corner on which David hung his white coat, the room was entirely bare. He still slept on the right side of the bed-he'd never felt comfortable making the migration to the middle. The sheets on the left side remained almost perfectly smoothed. He found something immensely depressing about the blank strip of still-made bed beside which he slept every night.

David reached for the phone immediately and dialed the ICU.

"Yes, hello, Sheila. Dr. Spier here. We sent a woman upstairs yesterday, and I wanted to check in on her. Nancy Jenkins."

"Oh." Sheila exhaled loudly. "What a thing. Such a sweet woman." The tone of her voice was not heartening. "She was doing better in the late evening," she continued. "She even regained consciousness and spoke briefly with some detectives, but then things went to hell in the middle of the night. Her temp shot up; we took a portable upright chest, saw she'd developed free air, and rushed her to the OR."

Despite David's efforts, the alkali had won out. Dr. Woods's endoscopy yesterday evening had revealed that Nancy had sustained 3a grade esophageal injury. It had been a mess down in her throat. Exudates gooping the membranes, deep focal and circumferential ulcers, and black blisters of necrotic tissue, waiting to slough, heal over, or simply give way. One of the focal necrotic patches in her esophagus had finally blown out in the night, allowing air and infection to escape into her body.

David swung his legs out of bed and rested his feet on the thin beige carpet, careful not to disturb the perfect pattern the cleaning lady's vacuum had left last Wednesday.

"Unfortunately, Dr. Freedman had to do a subtotal resection of the esophagus," Sheila continued. "I believe he pulled up a segment of small bowel to replace it." She paused, and David heard a sheet rustling. "Small bowel?" she said. "Why not colon?"

"The small bowel has more active peristalsis," David said.

"Oh." He could hear the nurse breathing during the long pause. "We did everything we could," she said, more sadly than defensively. "As you know, everyone's really following her closely. I've had more phone calls checking up on her. Nurses, lab techs, docs, reporters calling every five minutes… " When she spoke again, the sharp anger in her voice startled David. "What kind of a bastard does a thing like this?"

"Well," David said, letting the hypothetical question hang and fade, "I'm glad she's in your hands now."

"Yeah… " Sheila sighed again, and David heard the phone rustling against her cheek. "To tell you the truth, Doctor, I'm getting tired of giving out bad news on this one. Dispensing misery is a tough way to make a living."

He rubbed one eye with the heel of a hand. "Pretend you're an IRS agent."

Her laugh was soft, but genuine. He said good-bye and hung up the phone, then stared at it for a moment. Three minutes into Monday, and he already felt like shit.

By now, with all he'd seen, perhaps he should have grown desensitized to medical emergencies. Suicide attempts where the bullet blows out the cheekbone but leaves the brain intact; motorcycle wrecks ending in near-decapitation-by-stop-sign; children beaten so frequently about the mouth that their frenula are torn, the stringy halters no longer connecting the upper lips to the gums. But every time he thought he'd seen it all, something found its way through the swinging ER doors to push the limits of his experience a few inches further. His experience was his strongest ally and darkest companion, a pupil ever dilating. Yesterday morning had once again proven that the world had an inexhaustible hoard of surprises. What kind of sickness had to fester in the coralline whorls of a human's brain to cause him to direct a viciously corrosive substance into another human being's face?

Heading into the shower, David scrubbed methodically from his forehead to his toes, washed his hair, and let the hot water steam him for a few minutes before getting out. His feet perfectly centered on the white bath mat, he stared at his reflection in the mirror. By most estimations, he was a handsome man-the kind of handsome that comes not from distinctive or striking looks, but from features that are even and predictable, and therefore pleasing. A square, masculine jaw, light brown hair cropped short and worn slightly mussed, not-too-thin lips with a pronounced Cupid's bow, and two eyes that were a light shade of blue, just short of interesting. His crow's-feet were not quite visible from this distance unless he squinted. His neck seemed less firm and muscular than it had been five years ago, but he wasn't sure if that was based on a glorified remembrance. He decided he was holding up okay. Still attractive, if a little ordinary.

Drying his back, he headed into his bedroom and placed his pajamas neatly in their drawer before dressing in his scrubs. He lifted his white coat off the chair in the corner and pulled it on, then removed his stethoscope from the inside pocket, and laid it across his shoulders. Until he felt the weight of the stethoscope around his neck each morning, he felt partially unclothed.

Walking into the study, he admired the perfectly even shelves, the rows of books organized by size and genre. Diplomas lined the far wall, framed in a cherry wood. Harvard undergrad and medical school, equally pompous with their scrolled Latin, started the row, followed by his UCSF residency certificate and board certification for Emergency Medicine. One of his Outstanding Clinical Instructor plaques hung slightly crooked. He straightened it with the edge of his thumb.

Turning to the large brass birdcage in one corner, he sighed before removing the drape. The Moluccan cockatoo awakened instantly on its perch, shifting from one black claw to the other. A bright salmon-pink crest protruded from behind its head, a flair of color on its otherwise cream body.

"Hello, Stanley," David said flatly.

"Elisabeth?" it squawked. "Where's Elisabeth?" David's wife had spent three painstaking weeks one summer training the cockatoo to ask for her when it wanted to be fed. Stanley's repertoire of comments had not since been expanded.