Michael Palmer - The Last Surgeon

“Do you recognize Umberto in this picture? Do you?”

“Go away!” Ferris shouted, pushing Nick backward with force. “Go away from me!”

Nick stumbled against the counter and nearly fell. His eyes caught a blur of movement and he ducked, just as the glass jar filled with combs sailed over his head, shattering the mirror behind him.

“Manny, stop it!” Nick shouted.

“Can’t stay. Must run!”

The man’s eyes, once dead, had ignited with a feral frenzy. His strength was astounding. Stiff-arming Nick as he tried to follow him out of the bathroom, Ferris barreled into a cocktail waitress carrying a tray full of drinks. Nick managed three steps in pursuit before being grabbed from behind by the tattooed bouncer. Pinned face-first against the club’s velvet-lined wall, Nick watched helplessly as his only link to Umberto disappeared through the fire exit door.

The two biggest shortcuts to disaster in medicine are arrogance and everything else.

Nick knew his focus was compromised. The warning about medical mistakes, from one of his former surgical professors at Brown, ran through his head like a Möbius strip. Arrogance wasn’t the problem with him. It never really had been. But even under the best of circumstances, his thoughts had a tendency to wander. And twenty-four hours after his bizarre encounter with Manny Ferris, this was hardly the best of circumstances.

The RV was back in D.C., and the warming weather had brought with it a flood of patients. Routine… routine… routine… disaster masking as routine. The shattering of a medical career was as simple as a one-minute loss of concentration-a swollen lymph node missed, a rectal exam not done, an abnormal neurologic sign ignored, a telltale answer in the medical history passed over or not asked for at all. It was that easy. And for Nick, the danger increased in direct proportion to his SUD score, which tonight continued hovering around five.

They were on the third and final stop of the evening, parked on the street in the Anacostia section of D.C. Nick and Junie had the help of an experienced volunteer nurse named Kate, who was working beneath the lightweight canopy that served as their annex and at other times as their triage area and waiting room. Slowly but surely, the crush of patients had vanished, and not a moment too soon. Fatigue and Manny Ferris were taking over Nick’s body and mind. For a few brief moments after entering Lucky Bill Pearl’s, it had seemed some answers to Umberto’s disappearance might be at hand. Instead, there were only more questions and more frustrations.

“So, have you had the chance to think about Ferris?” Nick had asked Junie during the ride in from Baltimore to their initial stop at Jasper Yeo’s used car dealership.

“Booze,” she said simply. “When in doubt, always bet alcohol. My money’s on wet brain.”

“Maybe, but for someone who is as much of a zombie as Ferris was, I didn’t see too many of the stigmata that go along with alcoholism-you know, spider veins on the cheeks, a W. C. Fields nose, ascites, liver palms, weakness, impaired gait. Should I go on? Then there’s those scars and lumps on his face. It’s like he was the big loser in a gang fight.”

“What, then?”

“I don’t know. Probably alcohol. I also wonder if someone might have been preparing him for plastic surgery. But how do you explain his reaction to the photo of me and Umberto? It certainly wasn’t me he was reacting to. You should have seen him, Junie. In about a second, he went from Night of the Living Dead to Rambo . Does that seem like wet brain to you?”

“Maybe drugs.”

“I suppose.”

Now Nick was listening to the chest of an anxious twenty-year-old woman who lived in the nearby projects. Junie cleared her throat and shook her head at him disapprovingly.

“Hear anything?” she asked-her way of telling him that he might want to start that part of the exam over again.

“Nothing yet,” he muttered, and focused in.

Their patient had evidence of a loose mitral valve and no other good explanation for her recurrent chest discomfort. Nick asked Junie to run a cardiogram on her. They would have scheduled an echocardiogram and blood tests if she had insurance, but that was wishful thinking. Nick gave her a sheet on obtaining health coverage, and Junie promised to follow up with a phone call to see if she had any luck. That was the best they could do.

Running a clinic like Helping Hands involved compromises, especially when patient cooperation and follow-up were constant variables. Specialist involvement in their cases was more dependable. Through study and courses, Nick was decent at reading cardiograms, but they had several cardiologists who donated their services to Helping Hands. Finally, there was the handout dealing with mitral valve prolapse that one of their heart people had prepared.

“Either of you want coffee?” Nick asked the nurse and patient. “It’s going to be instant, but we have decaf and high test, and white stuff in the fridge.”

Both declined.

“Is that woman out there on the driver’s seat with you?” Junie asked their patient.

“Nope, just my boyfriend. He’s the one sitting at the table.”

Nick glanced toward the front of the RV. He had noticed the woman several times in passing. It was hard not to-very good-looking with short, sand-colored hair and a light spread of freckles across the tops of her cheeks.

“As far as I can tell,” Junie added, “she never signed in to be seen. It’s been like forty-five minutes. I thought she was here with one of our patients.”

“I’ll ask. She doesn’t look like she’s in any trouble, but it is a little weird she hasn’t spoken up. Maybe she’s a reporter or one of MacCandliss’s secret agents.”

Nick, doing his best to appear nonchalant, stopped by the refrigerator for a Coke. Now that he could look directly at the woman in the driver’s chair, he wondered how he had ever made it past her in the first place. She was wearing jeans and a white barn jacket with a brown collar-from L.L.Bean or Eddie Bauer or someplace like that, he guessed. She was facing slightly away from him, gazing out of the massive windshield. Then, as if sensing his attention, she turned and smiled-not a broad smile, but still enough to light up the whole front of the RV.

Special . That was the word that came initially to his mind, followed closely by interesting , intelligent , and unusual . As he approached her, Nick stumbled enough to slosh some Coke onto the carpet. Nice start. Leave it, or mop it up? Grinning sheepishly, he went back to the galley and returned with some paper towels.

“Hi,” he said, looking up from one knee and sensing he was speaking an octave higher than usual.

“Hi, yourself,” she said, seeming totally at ease.

It felt awkward to be so close to her. As incredible as was her smile, her eyes, an unfathomable blue-green, were even more so. He made it to his feet and braced his leg against the console between the front seats to gain some breathing room.

“Are you here to be seen by the medical staff?” he asked.

Medical staff! Give me a break! he chastised himself. Just tell her you’re the doctor .

“Nope,” she said. “Healthy as a horse. But you can help me with this.” She reached into a thin brown paper bag and held up a copy of Nick Fury and His Agents of S.H.I.E.L.D . “My name’s Jillian Coates. I’m a psych nurse at Shelby Stone Memorial. Got a moment to talk, Dr. Garrity?”

IT TOOK forty-five minutes to pack up the canopy and wipe down the interior of the van. Jillian pitched in and got to know Junie as she did. Nick stayed close to the women and entered the conversation when he could. “Special” was right. There was a femininity and wisdom to her, coupled with a sharp wit that he found totally appealing. Nick, who hadn’t really broken through his PTSD enough to become interested in any woman since Sarah, was surprised to find himself making some comparisons. Junie exchanged enough glances with him to make it clear she was thinking the same things.