First, Do No Harm

by Larry Karp

  “I was wondering…” I said.

  Samuel half-turned his head.

  “Mr. Fleischmann—Jonas. His hand was so warm. I thought you didn’t get rigor mortis until the body cools off.”

  “Good point, Leo. Usually you don’t. But when a person’s in excruciating pain right at the moment his heart stops, all his muscles are clenched, and that’s how they stay. Terrible way to go.”

  I said the okay that means this is as far as I can go right now. Come morning, I’d do some reading.

  Samuel stopped in front of a small frame house up a hill behind a crumbling waist-high concrete wall. The wooden steps groaned under our feet. Samuel motioned toward a hole in the porch flooring, nudged me gently to the side. He rang the bell, waited, rang it again. From inside I heard, “Yeah, yeah, I’m comin’. Hold your pants.” Then a man opened the door.

  Talk about being created in a father’s image. A forty-years-older edition of Murray Fleischmann filled the doorway. Light from a bulb in the porch ceiling reflected off Oscar Fleischmann’s oily brow; behind his high forehead a gray thicket ran rampant. An unlit cigar dangled from beefy lips. Black grease all over his undershirt, chest hair grease-caked into whorls and tangles. Dirty khaki pants held at the waist by a string, a ragged hole at the left knee. I counted five buttons in his open fly. Piggy eyes moved slowly from Samuel to me, then back to my father. Oscar pulled the cigar from his mouth with two sausage-fingers, then rumbled, “The fuck you doin’ here, Sammy?”

  Never in my life had I heard anyone speak to my father in anything like those words and that tone. And “Sammy”? I’d never heard anyone even call him Sam, not his friends, not my mother. But he didn’t seem to notice, just said lightly, “How’re you doing, Oscar?”

  Oscar laughed disparagingly. “How’m I doin’, he wants to know. At two in the mornin’ how should I be doin? An’ why’s he all of a sudden give a hoot in hell about how I’m doin’?”

  By the time I realized he was talking to me, Samuel said, “I’ve just come from Murray’s, Os. Sorry, but I’ve got bad news for you.”

  “What, Murray ain’t dead, is he?”

  “Not Murray,” Samuel said quietly. “Jonas. I’m sorry.”

  A laugh, more disparaging than the last. Oscar turned around, then waddled back inside the house. Samuel followed. I kept at a safe distance behind him.

  When we reached the living room, Oscar stopped, shoved his cigar back into the corner of his mouth, looked both of us up and down. The room was a pigsty. Few lumpy chairs, a sofa with springs protruding through the seat. All over, dust. Papers and odd chunks of metal here, there, everywhere. A half-eaten plate of food sat on a battered three-legged table to my left. Oscar shot a stream of brown saliva, ping, into a grimy steel spittoon. “Jonas, Christ! Thank God it was him, not Murray.” He peered at Samuel, trying to make contact beneath the brim of my father’s Panama, which he hadn’t removed. “Hell’d he die from?”

  “Massive coronary artery occlusion.”

  “Fuck’s that supposed to be?”

  “Heart attack. And I thought you just might be sorry to hear it.”

  Oscar cackled, poked Samuel in the chest with his cigarless hand. “Ol’ Os never was one for big fancy words,” he said. “Plain fact, Jonas was a cunt first-class. Talk, he was good at, but I hadda kick his ass ’least once an hour to get a decent day’s work outa him.” Oscar launched another missile into the spittoon, then squinted at Samuel. “Now, if you’re all done here, kindly get your cheesy ass outa my house and keep it out. Tomorrow, while you’re gettin’ paid for finger-fuckin’ the mayor’s wife, you can think about me havin’ to go find some half-wit nigger or spic or dago who ain’t been drafted, who might just put in maybe half a day’s work for two days’ pay.”

  “I’ll think of you limping up to the poorhouse, Oscar.” Samuel’s voice was surprisingly soft. “You old reptile! You’ll hire some poor southern kid at fifteen a week, then put twelve in his pay envelope and if he has enough balls to complain, you’ll tell him there was fifteen when you gave it to him. And you’ll take home half of what would’ve been Jonas’ share.”

  Oscar fired a wad onto the floor, squarely between Samuel’s shoes. “Jonas, that goldbrick! I don’t even want to hear his name no more. Now take your kid an’ get the hell out.” The fat cigar stump wiggled between Oscar’s lips. “Maybe I can get a few hours’ sleep before the goddamn night’s over.” He stamped to the front doorway, motioned with his hand. “This’s called a door. You know how to use it or do I gotta show you?”

  Samuel tipped his Panama lightly. “If I can help, give me a call.”

  Oscar snatched his cigar from his mouth; I thought he was going to throw it into Samuel’s face. “Give you a call? Shit! Willkie’d be president before that ever happens. I don’t care if every schmuck in this stupid town thinks you’re one-up on Jesus Christ, or if Murray an’ that floozie-wife of his think you’re the swellest Joe ever came down the pike.”

  Samuel took my elbow, led me to the creaky front steps.

  “You and me both know you’re a goddamn wooden nickel,” Oscar shouted after us. “You already done to me all you’re ever gonna. Be fuckin’ snowballs in hell before I’d ever call you.”

  Samuel’s face was tight, deep lines etched at the corners of his mouth. “How about you drive me home,” he said. “Let’s see if you’ve learned anything the last six months.” He opened the passenger door, slid in.

  I fumbled in my pocket for the key. “I’ve been wondering—when I turn seventeen, how’re you going to explain to Ramona that I don’t need driving lessons?”

  He smiled, fatigue lines vanished. “Probably just tell her you’ve already had them. What do you think, something magical happens on a kid’s seventeenth birthday, and bingo, it’s all right for him to drive a car? I figured you were ready six months ago, so that’s when I started teaching you. Now, let’s go. I wouldn’t mind getting a few hours’ sleep myself before it’s time for morning rounds.”

  I trotted around the car, sat in the driver’s seat, slipped the key into the ignition. As I reached for the choke, Samuel said, “Don’t need that—motor’s still warm, remember?” I nodded, turned the ignition switch, then pushed the ball of my foot against the starter button. The motor caught. I brought my heel down on the accelerator, pulled away from the curb in first, moved nicely into second, then third. “Good, Leo,” Samuel said. “Looks like you’ve got the hang of shifting.”

  “How could you manage to be so polite to him?” I asked. “Old Mr. Fleischmann.”

  Samuel smiled. “Were you listening to what he told us?”

  “Sure. He actually sounded glad Jonas died. How can a father talk like that about his son?”

  I pulled up neatly at a stop sign, then turned the steering wheel and leaned on the accelerator. We putted up Roosevelt, past darkened shops and houses. “That’s what Oscar said, Leo. But what he told us is he’s nearly seventy years old, his two wives died young, he works like a horse every day in that junkyard, lives in squalor, and now he loses a child. All that considered, he’s still a son of a bitch, but that’s not a medical diagnosis. You’re a doctor, you always need to do whatever you can to help someone. And you start by trying to hear what the son of a bitch is trying to tell you.”

  I said, “All right,” and kept driving. But I had more on my mind than being careful to keep the accelerator coordinated with the clutch pedal, thoughts I couldn’t bring myself to turn into speech.

  Back home, I slept fitfully, finally woke about ten o’clock, still thinking. Samuel was long gone, and when I went down to the kitchen I found a note from Ramona, “Going to the hairdresser’s.” All through a slow breakfast an idea disturbed me, danced around my edge of consciousness.

  Chapter 3

  Dad drained his glass. The waiter snatched it up practically before it hit the table top. Dad sat silent, motionless, staring into his past. Pain and determination battled ac
ross his face. Finally, determination took over the field.

  I realized I’d been hearing music, a saxophone…Harmony—her name, Harmony Belmont. Girl next door…we were friends…no, more than friends…but not just…you know…

  I’d never seen Dad rattled, hinges about to come off. He looked on the verge of aborting his mission. When the waiter gingerly set another Manhattan in front of him, he snatched the glass, took a gulp, sighed, then cleared his throat.

  We were born within days of each other, grew up together…we were always together. Told each other everything. She was nuts for saxophones, adored Tony Parenti, worshiped Coleman Hawkins. All that summer she entertained the neighborhood, blew hell out of her horn, every chance she got. Her parents made her practice in the basement, right across their driveway from our kitchen, so that morning at breakfast I had a front-row seat. “Blues My Naughty Sweetie Gave to Me,” loud, brassy, a little raggedy but no apologies. Harmony. I swallowed my last mouthful of cornflakes, ran water over the bowl and spoon, then charged out the back door, across the driveway, down through Belmonts’ wooden cellar door. Harmony didn’t hear, went right on honking, peering at the music on the stand in front of her, trying to make out notes in the crummy light from an unshaded overhead bulb. I coughed.

  She turned, saw me, blinked, then slowly lowered her sax.

  Deja-vuey feeling. I’d seen that girl, where?

  “You’re not at the Red Cross,” I said.

  She blew a disgusted razz with her tongue against her upper lip. “I’m going in at one today. Gauze shipments were late, so no bandages to roll ’til afternoon. But why aren’t you out with your father?”

  “I was,” I said. “Until three A.M. So I slept late.”

  She turned her eyes on me, full power. Oh, Martin, her eyes…wonderful nearsighted green eyes, shining like emeralds through huge round glasses. Those eyes could be beacons or guideposts, alert signals, warning flares. Right then they were searchlights. “What’d you see?”

  I told her about the little boy with the dislocated shoulder, then hesitated. She picked right up. “And?”

  I recited the story of our stop at the Fleischmanns’. “Keeps bothering me,” I said. “Rigor mortis, while the body was still warm? I didn’t think—”

  “If Samuel said, it must be.”

  “If Samuel said.” Harmony wanted to go to drama school, write plays and act, which her parents thought was ridiculous. But Samuel encouraged her. “You’ve got talent,” he once told her over dinner at our house. “Get yourself into drama school. If your father won’t pay, I will.” Ramona dropped a dish of mashed potatoes. Samuel chuckled. Later, in the living room, after Harmony went home, Ramona really gave it to Samuel. “That girl’s full of crazy ideas, and you egg her on. Telling her you’ll pay her way through school? Never mind where the money would come from, it’s none of your business.”

  “Helping people is my business,” Samuel said. “She’s going to end up in trouble,” Ramona snapped. Samuel shrugged. “Let it be her trouble.”

  Harmony ducked through the leather neck strap, set her sax on a little wooden table, then stood. She was tall for a girl, five-nine, almost gangling. Long sandy hair flew around her face, first hiding freckles, then revealing them. “You don’t think Samuel was right? Let’s go look it up in his books.”

  This girl—where the hell had I seen her?

  Back across the driveway, into my house, to my father’s study, a large room with floor-to-ceiling shelves interrupted only by twin windows on the front wall, looking out onto Roosevelt Avenue. Samuel read everything—medicine, history, economics, philosophy, psychology, auto repair, novels. I went to the medical section, pulled down the heavy Textbook of Medicine by Dr. Edgar Grant, set it on Samuel’s desk, flipped through the index. “Rigor mortis, page 47.” Harmony peered at the book over my shoulder; her hair tickled my cheek. “Rigor mortis,” I read. “Muscles initially relax after death. The body is limp. Coagulation of muscle protein begins in four to ten hours after death.”

  I stopped reading, turned to Harmony. “Murray said his brother walked into the house and died on the way into the living room. Samuel and I got there less than fifteen minutes after Murray called, so Jonas couldn’t have been dead more than half an hour, and he was literally stiff as a board. And his hand was warm.” I looked back at the book. “See algor mortis, cooling of the body after death, page 51.” I zipped four pages ahead, read aloud. “After death, the body cools at about three degrees per hour.”

  “So?” Harmony still sounded defiant.

  “So if rigor mortis doesn’t kick in until at least four hours after death, the body should be down to about eighty-six degrees by then. I’d have noticed that when I picked up Jonas’ hand.”

  Harmony leaned forward, turned back to Rigor Mortis, pointed at a list titled EXCEPTIONS. “Let’s see if heart attack’s there.”

  It wasn’t. Strychnine Poisoning headed the short column. I got up, walked to the shelves, grabbed Wentworth’s Handbook of Toxicology, opened to Strychnine. “Strychnine,” I read, “is used primarily as rat poison, but in extremely small measures can be prescribed as a stimulant. A poisonous dose in humans produces muscle stiffness, then spasms, finally terrible tonic convulsions, all the muscles contracting until the victim is pulled into arch-back posture. The slightest stimulation—a sound, a motion, a light being switched on—worsens the convulsion. Finally the victim dies of asphyxiation, eyes bulging, face in ghastly contortion. Because the poison keeps muscles contracted after death, rigor mortis sets in immediately.”

  By the time I finished reading, my hands were shaking so badly I could hardly hold the book. I lowered it to my father’s desk, then looked at Harmony. “That was Jonas Fleischmann—arched back, eyes bulging, face contorted.”

  She rested a hand on mine. “Samuel said it was a heart attack.” Defiance still in her voice, but now tempered by a little defensiveness. Harmony didn’t back down easily. She never…well, behaved like a girl. In school, they made her wear a skirt and blouse, but the minute she got home she was into a man’s shirt and dungarees. Didn’t wear makeup, unusual in those days. Boys liked to tease her, see how riled they could get her. They called her Harmful, or Harmless, or Hearty-har-har. Once, right in front of me, a boy called her Harlotry. I threw a punch, pure reflex; the boy’s nose exploded in claret. When the principal called me on the carpet Samuel went storming in, told the principal if I hadn’t hit that kid, he’d have broken my nose.

  Dad ran a finger slowly across the bridge of his nose. I’d’ve bet every cent in my pocket he had no idea he did it. He looked at his drink as if his next line might’ve been inscribed on the cherry.

  “Samuel wants me to think for myself,” I said to Harmony. “And I think Jonas Fleischmann looked exactly like Wentworth’s description of strychnine poisoning. But Samuel signed him out as a heart attack. Samuel’s the best diagnostician in town, maybe in the state, maybe the whole country. Why did he insist it could only be a heart attack?”

  She focused those green torches on me, didn’t say a word. I picked up the books, reshelved them, checked my watch. “Eleven-thirty—got an hour?”

  “What for?”

  “Get your bike.”

  In those days, doctors’ offices were usually right in their own houses, but Samuel said he didn’t want patients bothering Ramona, so he rented office space six blocks down Roosevelt, in an older one-story house with a big wraparound porch. Harmony and I left our bikes against the side of the building and walked into my father’s office. The door was always open. No nurse, no receptionist, no appointments. When Samuel finished afternoon rounds at the hospital he drove or walked to the office, said hello to the people waiting, then went through a door into the back. A few minutes later the door opened, and there stood Samuel, sleeves rolled up, looking around the waiting room. “Who’s first?” Then somebody got up and walked back into the exam room. Never an argument over who was before wh
om.

  But Samuel wouldn’t come for another three or four hours, so the waiting room was empty when Harmony and I got there. We went back to the consultation room, to the four-drawer file cabinet that held patients’ records. I opened the second drawer from the top, looked through the Fs, found Fleischmann, Lily and Murray, but no Oscar or Jonas. My throat felt dry, bad taste in my mouth. I flipped a few charts forward, a few back, no luck. Samuel’s charting was as meticulous as the way he dressed. If he’d ever treated Jonas Fleischmann, there’d be a chart, and it would be right there.

  “Let’s check the desk,” Harmony said.

  I closed the file drawer, walked to the paper-strewn desk, looked at every sheet, careful not to disturb any of them. No file labeled Fleischmann, Jonas. Nothing in any way to do with Fleischmann, Jonas. My mind tried to invent reasons for the missing chart, but only one held water. Samuel simply didn’t have a chart for Fleischmann, Jonas. Samuel wasn’t treating him for a heart condition or anything else.

  “Samuel lied to me,” I said to Harmony.

  She looked away for a moment, then put a hand on my arm. “Let’s go back.” She flashed an up-to-something grin. “I’m thinking.”

  Riding home, my pedal mechanism made a rhythmic sound somewhere between a swish and a click, strych-nine, strych-nine, strych-nine. I tried to ignore it by counting silver and gold stars in windows along the way, taking my usual hard look at the big white house between Twenty-fourth and Twenty-fifth. All three Vermeulen brothers enlisted right after Pearl Harbor. Bill’s silver star went gold at Guadalcanal, Harold’s at El Alamein. Arnie was somewhere in the E.T.O. His star was still silver, good. Would the war go on long enough for Ramona to put a star in our window? I stopped counting, rode the rest of the way home to strych-nine, strych-nine, strych-nine. Harmony waved back at me as she turned off on Twenty-seventh Street to go to the Red Cross. Rolling bandages every day with a bunch of old ladies—I felt sad for her, and a little guilty. Would Samuel have gotten me to extern for him if I’d been a girl? And if he had, would Ramona have let me do it?