Robin Cook: Harmful Intent

Robin Cook- Harmful Intent

ACKNOWLEDGMENTS

As with all my projects, I have benefited significantly from the experience and expertise of friends, colleagues, and friends of friends for the writing of Harmful Intent. Since the story bridges two professions, it is understandable that professionals have been the primary source. Those whom I would particularly like to acknowledge are:

Physicians.- Tom Cook Chuck Karpas Stan Kessler

Attorneys.- Joe Cox Victoria Ho Leslie McClellan

Judge.- Tom Trettis

School-based therapist. Jean Reeds

All of them generously donated many hours of their valuable time.

Once again for Audrey Cook, my wonderful mother

"The first thing we do, let's kill all the lawyers." -Henry VI, Part II

PROLOGUE

SEPTEMBER 9, 1988

11:45 A.M.

BOSTON, MASSACHUSETTS

From the first twinges of cramps that began around nine-thirty that morning, Patty Owen was sure that this was it. She had been worried that when the time came she wouldn't be able to distinguish between the contractions that signaled the onset of labor and the little kicks and general discomfort of the final trimester of her pregnancy. But her apprehension proved groundless; the twisting and grinding pain she was experiencing was entirely different from anything she had ever felt. It was familiar only in the sense that it was so classically textbook in its nature and regularity. Every twenty minutes, like clockwork, Patty felt a steady stab of pain in her lower back. In the intervals between, the pain vanished only to flare again.

Despite the increasingly acute agony she was only beginning to endure, Patty couldn't repress a fleeting smile. She knew little Mark was on his way into the world.

Trying to remain calm, Patty searched through the scattered papers on the planning desk in the kitchen for the phone number of the hotel that Clark had given her the day before. He would have preferred to have skipped this business trip since Patty was so close to term, but the bank hadn't given him much choice. His boss had insisted that he follow through with the final round of negotiations that would close a deal he'd been working on for three months. As a compromise, the two men had agreed that no matter the state of the negotiations, Clark would be gone for only two days. He'd still hated to leave, but at least he'd be back a full week before Patty was due to deliver...

Patty found the hotel's number. She dialed and was put through to Clark's room by a friendly hotel operator. When he didn't pick up by the second ring, Patty knew Clark had already left for his meeting. Just to be sure, she let it ring five more times

in hopes that Clark was in the shower and would suddenly answer, out of breath. She was desperate to hear his reassuring voice.

While the phone rang, Patty shook her head, fighting back tears. For as happy as she'd been to be pregnant this, her first time, she had been troubled by a vague premonition from the start that something bad would happen. When Clark had come home with the news that he had to go out of town at such a critical juncture, Patty had seen her sense of foreboding confirmed. After all the Lamaze classes and exercises they'd done together, she would have to tough it out alone. Clark had assured her she was overly concerned, which was natural, and that he'd be back in plenty of time for the delivery.

The hotel operator came back on the line and asked if Patty wanted to leave a message. Patty told her that she wanted her husband to call her as soon as possible. She left the number for Boston Memorial Hospital. She knew that such a terse message was bound to upset Clark, but it served him right for going away at a time like this.

Next, Patty called Dr. Ralph Simarian's office. The doctor's booming, high-spirited voice momentarily quelled her fears. He told her to have

Clark take her over to the BM, as he humorously referred to the Boston

Memorial, and get her admitted. He'd see them there in a couple of hours.

He told her that twenty-minute intervals meant she had a lot of time.

"Dr. Simarian?" Patty said as the doctor was about to disconnect. "Clark is out of town on a business trip. I'll be coming in by myself."

"Great timing!" Dr. Simarian said with a laugh. "Just like a male. They like to have the fun, then disappear when there's a little work to be done."

"He thought there was another week," Patty explained, feeling like she had to defend Clark. She could be irritated at him but no one else could.

"Just joking," Dr. Simarian said. "I'm sure he will be crushed not to be involved. When he comes back, we'll have a little surprise for him. Now don't be a bit alarmed. Everything's going to be okay. Do you have a way of getting to the hospital?"

Patty said she had a neighbor who had agreed to drive her in case there were any surprises while Clark was away.

"Dr. Simarian," Patty added, hesitantly, "with my Lamaze partner gone, I think I really am too nervous to go through this.

I don't want to do anything to hurt the baby, but if you think I could be anesthetized the way we discussed..."

"No problem," Dr. Simarian said, without letting her finish. "Don't you worry your pretty little head about these details. I'll handle everything.

I'm going to call over there right this minute and tell them that you want the epidural, okay?"

Patty thanked Dr. Simarian and hung up the phone just in time to bite her lip as she felt the beginnings of another contraction.

There was no reason to worry, she told herself sternly. She still had plenty of time to make it to the hospital. Dr. Simarian had everything in hand. She knew her baby was healthy. She had insisted on ultrasound and amniocentesis, even though Dr. Simarian had advised it was unnecessary since Patty was only twenty-four years old. But between her ominous premonition and genuine concern, Patty's determination carried the day. The results of the tests were extremely encouraging: the child she was carrying was a healthy, normal boy. Within a week of receiving the results, Patty and Clark were painting the baby's room blue and deciding on names, ultimately settling on Mark.

All in all, there was no reason to expect anything but a normal delivery and a normal birth.

As Patty turned, intending to retrieve her packed overnight bag from the bedroom closet, she noticed the dramatic change in weather outside. The bright September sunlight which had been streaming through the bay window had been eclipsed by a dark cloud that had blown in suddenly from the west, plunging the family room into near darkness. A distant rumble of thunder sent a shiver down Patty's spine.

Not superstitious by nature, Patty refused to take this storm as an omen.

She edged over to the family room couch and sat down. She thought she'd call her neighbor as soon as this contraction was over. That way they'd almost be at the hospital by the time the next one began.

As the pain reached a crescendo, the confidence that Dr. Simarian had engendered disappeared. Anxiety swept through Patty's mind just as a sudden gust of wind raked across the backyard, bending the birches, and bringing the first droplets of rain. Patty shuddered. She wished it were all over.

She might not be superstitious, but she was frightened. All the timing-this storm, Clark's business trip, her going into labor a week earlyseemed off.

Tears rolled down Patty's cheeks as she waited to phone her neighbor. She only wished she weren't so afraid.

"Oh, wonderful," Dr. Jeffrey Rhodes said sarcastically as he glanced up at the main anesthesia scheduling board in the anesthesia office. A new case had appeared: Patty Owen, a delivery with a specific request for an epidural. Jeffrey shook his head, knowing full well that he was the only anesthesiologist currently available. Everyone else on the day shift was tied up on a case. Jeffrey called the delivery area to check on the patient's status and was told there wasn't any rush since the woman hadn't arrived from admitting yet.