Lethal Practice

by Peter Clement

  “Why didn’t you warn me?” I asked, incredulous at what I’d just heard.

  She laughed, leaned back, and said, “Hey, I’m your secretary, not your mother. Besides, you didn’t need warning. You weren’t going to do anything about it. Everyone knew that.”

  “What do you mean ‘everyone’?”

  “Well, not everyone. Just some of the more observant women in the department who could see what was going on.”

  Jesus Christ! I thought. My old nemesis. Denial. Maybe that was why I’d become so aware of her sexuality recently, since it was safely directed at others. I’d spent years denying her overtures to me.

  I needed no reminder of the demonic rage Jones had exhibited while straddling me back at the cabin. Good. Hate me! I’m taking away your miserable high-class fucking life. I’d hear that shriek in my dreams the rest of my days.

  I looked back down at the unused ticket and the old picture of Janet and me in our evening clothes.

  “You see,” said Carole, leaning forward, “I think what Jones really coveted was this.” And she tapped the photo of Janet and me, decked out in the full regalia of a high-class fucking life.

  * * * *

  A few hours later I had the strangest visitor of all.

  Kradic.

  He stood at the curtain, fingering it, before giving a little cough. “Hi, Dr. Garnet,” he said hesitantly.

  “Dr. Kradic,” I acknowledged, genuinely surprised.

  “Can I talk with you for a moment?”

  He was so uncertain, almost shy, that I was actually curious what was up. I was also relieved he’d no idea how much I had suspected him.

  “Sure, have a seat.”

  I was back in bed; he took Janet’s chair.

  “How are you doing?” he asked, uneasy and obviously bad at small talk. He wanted to get on to what he came for.

  I answered, “Okay,” and waited.

  He coughed again, took a breath, and then started. “With Jones gone, I wondered if you’d give me her nights.”

  I gave a laugh in spite of myself.

  Kradic didn’t even look offended but pressed on with his case. “Look, I know it’s indelicate and that you don’t particularly like me, but I can do the job. You know patients are safe on my shift. Who else are you going to get to replace her?”

  He had me there. Carole and the others had all assured me they were muddling through, but without Jones, the schedule would be a holy mess, and with Christmas coming up, it’d be worse yet. Nobody would admit it, but even increased doses of Kradic would be acceptable if he did more nights, worked holidays, and kept the rest of us, me included, from having to double up on these difficult shifts.

  But I wasn’t prepared to pay any price for his help. I stared back at him, still not answering, and calculated my terms. “Since we are being frank. Dr. Kradic, let me say that the entire department, including myself, is fed up with your rudeness and your complete lack of professional behavior with your peers. I’ll give you the shifts on trial, for the holidays. Then the rest of the staff, nurses and clerks included, will decide if they want you around anymore.”

  He looked taken aback but said nothing.

  I continued. “I am offering you this last chance only because you are an excellent physician. I would trust you with the care of myself or any member of my family, but your skill doesn’t give you a license to disrupt the department. If anything, it gives you an obligation to help, not clobber, other physicians less gifted than yourself.”

  The compliment surprised him. His face flushed. He swallowed hard and started blinking a lot.

  I watched him as he regained his composure.

  “Thank you,” he said simply, but he was looking down at his hands so I wouldn’t see his face.

  “Al, I want to know why you’ve started to come late. Punctuality is part of the deal.”

  My question broke his reserve. I watched his whole body tense, his hands tighten into fists. “Because my wife divorced me and is suing for custody of my two little boys.” He was spitting out his words. “I took some extra shifts at other hospitals to help pay my lawyers.” He looked straight at me, and his voice softened. “The additional nights will give me the income I’ll need, and I’ll be free in the days to take care of them.” He took a deep breath, swallowed, and very quietly added, “I can’t lose my boys. Dr. Garnet, I can’t. They’re all I have.”

  Then, embarrassed, he got up and left. When I fell asleep again, I was worrying about the schedule. Things were returning to normal.

  The morning I was discharged, I walked out of the ICU and went directly down to the ER to work a shift. My doctors had been livid, but Janet had understood. “Go to it,” she’d whispered in my ear, giving me a hug on my last night as a patient.

  Susanne unceremoniously stuck a chart in my hand. “Welcome back. There’s a guy with multiple trauma in Resus A. The residents are losing him, and I mean losing!” We started for the room, and she told me the rest while we walked. “He’s a jumper. The medics said he must have fallen forty feet. He was still conscious when they found him, but he screamed when they tried to move his legs.”

  I glanced at the ambulance sheet and learned he’d jumped from Oratory Steps, a shrine that some faith healers had erected on top of a fifty-foot staircase in an escarpment overlooking the Niagara River. A lot of cripples crawl up there to try to walk again. Apparently this guy had reversed the procedure.

  When I stepped to the side of his stretcher, he was already half dead. The surgical residents had been fiddling with him an hour and fifteen minutes without calling their staff.

  “What’s his pressure!” I asked, snapping on gloves.

  “Sixty over zip,” hissed one of the nurses up by the guy’s head. “Like I been telling these two!” She glared at a pair of baby-faced kids in greens. New rotators. Lord help us.

  “Shit, he’s in shock!” I roared at them. “What the hell’s he still doing here? He should have been in surgery an hour ago.” I spoke quickly to Lisa, who was nearest the door. “Call a code blue.” Then I turned to my new residents. “Gentlemen. This is unstable multiple trauma. It needs a trauma team. No one, not even you two, can save this man’s life diddling over him alone. Now get me two more lines, big ones!”

  Thirty minutes later I stepped out to the parking lot. It was a clear morning. The small amount of snow covering the ground crunched under my shoes. My ears tingled. I could see my breath when I exhaled. All over the city, vertical white plumes were rising into the blue sky as Buffalo started its day.

  Half an hour on the job and already I had staff problems, inexperienced residents to worry about. And I’d barely arrived in time to save a patient’s life.

  Slowly I blew out another cloud of frost, and smiled. I was back.

  Epilogue

  Four Months Later

  It was a Tuesday afternoon at the end of March. The remnants of winter were at last reduced to a few crusty ridges of silt and ice and a gritty covering of sand left on the roads. Even the sun, for a few minutes at two in the afternoon, seemed to remember what it was there for. I couldn’t take my coat off, but I could open it, and the back of my neck felt warm if I stood out of the wind.

  I was driving north out of Buffalo. On my left the Niagara River surged toward its rendezvous with the falls. It had broken free of winter’s bondage weeks ago, though the currents here never really surrendered in the first place. The waterfront back in the city was still snarled with ice.

  I’d put off this trip, but his secretary had told me he was setting sail that weekend. His house was sold. His phone was disconnected. When the ice went out he’d moved onto his boat. Now it was stocked and seaworthy, and I was out of time.

  Power lines ran overhead; telephone poles ticked by on my right. An old freight train rumbled the other way. Everybody was going somewhere.

  The light danced across the water, giving it a sparkle and the illusion of being clean. A sign said it was twenty more miles to the
village of Youngstown, where he kept his boat.

  This morning Janet had actually put bedding on the new crib. Three weeks to go, but staring down at that little flannel sheet and quilt had made the arrival imminent for me.

  The ER was in better shape too. There were no more bed closures without my approval, and I’d been made chairman of the new financial ways and means committee. We didn’t have much means, but we’d shut down Arnold’s “pet farms,” and at least I was able to protect emergency from more idiocy.

  Kradic was still a pain in the ass, but he’d started teaching seminars for the staff. So far everyone was willing to let him stay.

  The parking for Watts’s yacht club was on a small bluff above a series of rickety steps leading down to the boat basins. To my right I could see the open waters of Lake Ontario. The smell of seaweed and dead fish got fresher as I descended. A bunch of boats leaned crookedly on dry land cradles.

  Most of the slots on the water were still empty. His was the only sailboat. No one else was there. They were all probably working at the jobs they needed to try to pay for this stuff.

  The wharf was a series of floating docks. My steps on the wooden slats and the creaking of the adjoining hinges announced my arrival. He’d been coiling and stowing ropes on the front deck, and he spun around at the noise. I hadn’t called ahead. He was clearly surprised. And puzzled.

  “Earl, what a pleasure,” he said with a big smile.

  I forced one in return. “I came to say good-bye, Robert.”

  “Well, come on board and let’s do it right,” he said with some real enthusiasm and a trace of relief.

  He helped me across the gap between his bobbing boat and the dock and onto the thirty feet of rich, glistening

  deck he planned to make his world. I couldn’t help my own twinge of excitement at the allure of it all.

  “Very nice,” I said, and meant it.

  “Sit down, sit down,” he replied, relaxing, and waving me toward an expensive-looking set of black canvas and teak deck chairs.

  Sitting in them warranted another even more enthusiastic “Very nice!”

  “How about a drink?”

  “Sure.”

  “What do you like?” He strode to an on-deck bar.

  “A Black Russian would be great.”

  “What’s a Black Russian?”

  I told him. He made it.

  I settled back and looked at him over the rim of my glass.

  He looked casual enough, what with his mackinaw over a white turtleneck sweater. And he looked a hell of a lot better than when I’d last seen him in his lab. He’d been discharged before me, and hadn’t come to visit. But now his eyes had the hardness they’d always assumed when he was standing over a particularly problematic case, scalpel raised and ready to start.

  I lifted my glass, took a sip of the liquid, and savored the icy warmth. I’d come to like Black Russians. It was time to begin.

  “I’m here to say I know.”

  He remained still, just staring at me.

  “Jones was your investment.”

  He was dead still.

  “The police dismissed a statement from one of Jones’s accomplices who claimed someone was blackmailing her, but I couldn’t. His story made too much sense and explained too well the events of that week. It even began to answer the questions I had about you.”

  I set my glass on the table, keeping my eyes on him. “You probably noticed the increase in DOAs before anyone else. You got curious. You got thorough. Anyway, long before Kingsly’s murder, you had discovered what Jones was up to.”

  Nothing moved. Not in his face. Not even in his eyes.

  “I can only guess why you then did what you did. I mean, besides for the money.”

  I hesitated. About this I wasn’t sure. “I figured it was your wife’s death. It must have left you devastated. Not only with grief but with anger. Anger at the very profession you had dedicated your life to.”

  Here he blinked. He looked a little startled.

  “For all your attention to detail, a lifetime of teaching us to be better doctors, no one had caught your wife in time. When she died, you had to have felt betrayed that your profession had let her down.”

  His upper body tensed.

  I went on. “But even this wasn’t enough to make you turn against what you’d served your whole life. There had to be another reason you hadn’t put a stop to Jones and why you chose to let her continue the killing and to blackmail her. It had to be a specific hatred to drive you to that.” I paused, then told him, “Before I came out here, I went down to the medical records archives and pulled your wife’s chart.”

  He started breathing through his mouth. His lips thinned, and he bared his clenched teeth. That familiar face suddenly looked ugly and sullen as he glared at me.

  I waited, felt the calm would hold, and went on. “I found the notes from her last admission before she died, when the cancer was diagnosed. They were straightforward, tragically so, but appropriate and in order. Then I leafed back through her dossier and came to the records of her visits to emergency. There, I found she’d presented to our department a full six months prior to the discovery of her cancer with a complaint of abdominal pain. The clinical notes were written by a resident. Quite complete, they described your wife having a month-long history of cramps and reduced bowel movements. The exam was unremarkable, and she was told it was constipation. The staff signature validating that ‘diagnosis’ was Dr. Valerie Jones.”

  He still didn’t move.

  “If the proper follow-up had been done then, the cancer in your wife’s colon might have been caught in time to save her. Or if she hadn’t had those false reassurances from Jones, maybe she would have mentioned her problem to you. For whatever reason, she obviously remained silent until it was too late. You chose to let Jones go on killing vagrants for more than a year so you could torment her with blackmail and punish her for your wife’s death ... punish her over and over.”

  No denials.

  “After Kingsly’s murder was discovered, you really tightened your hold on her. Feeding me the pathology evidence on the cardiac needles, first for Kingsly, and later for the DOA, you cocked and pointed me like a pistol. That’s why you delayed ‘finding’ the needle track in the derelict and reporting it to the police. The better to keep her terrified of being discovered and force her to give you a big final payment by first threatening to expose, then making good on your threat. Trouble was, she thought I was the blackmailer. You must have made your last demand the day after Kingsly’s murder. Maybe you anonymously slipped her a copy of my note to you. Remember? ‘Pigmented lesion vs. small scab at left xiphoid-sternal junction. Check it out’? I knew something had driven Jones to think she had to try to warn me off with the dogs later that same night. She didn’t see the ER statistics in my office until Tuesday morning.”

  The stare continued. I took another sip of the Black Russian. He hadn’t touched his drink.

  “When she was trying to kill me, she said something about me being your little pointer. I wasn’t paying much attention, considering the circumstances, but I thought it was just a general slur, part of her fury. You probably hadn’t counted on pushing her to actually try to knock me off. That day at the meeting, when Bufort announced the attempted hit-and-run, you were truly shocked, more than the rest of them. I’m sure it gave you pause. Hell, later in the cafeteria, I think you actually considered putting a stop to it, but in the end you let your play ride. Let me be the decoy while you turned up the heat.”

  I took another swallow. More warmth. He turned his glass by its stem.

  “Oh, and I figured out how you did it. Prior to Kingsly, you probably just mailed your threats and demands to her apartment. But after Kingsly, to save time, I bet you used that mailbox of hers, the one she hardly ever emptied. You could have delivered your anonymous notes through the hospital in-house mail or even slipped them in there yourself. By the time she got it, she wouldn’t know what day it h
ad arrived, let alone who’d been around to do it. That’s why she started to keep her slot clean. I ought to know. Her uncollected mail always used to fall over into mine.”

  His gaze had slid off me now and was somewhere out over the water. The sunlight was starting to thin. Now I needed the warmth of my drink.

  “Did you use the technique Bufort described as common to blackmailers? Have her send money orders to different post office boxes, pickups she couldn’t trace? At first I thought it was simple convenience that she used you as bait for me. But I think you’d screwed up. That Sunday you probably didn’t wait for the in-house mail to put another of your threats in her box. My tirade at the meeting that Fernandez wasn’t the killer must have convinced you I was on the verge of nailing her, so you wanted that last payoff fast, before I found her name and exposed her to the police. I’ll bet your note even told her that I’d challenged Bufort and wanted the case kept open, then made it look like the tactic of a blackmailer increasing the pressure on her. But she’d begun keeping an eye on her box and must have seen you slip the note in.”

  He didn’t answer. It didn’t matter.

  “I don’t suppose you ever got that final payment.” I paused and waited until he finally looked back and faced me. The hardness was gone. His eyes were dead.

  The sight of him hunched over in his chair suddenly disgusted me. I slammed my empty glass on the table between us. “You’d kept her too busy trying to kill me!”

  He flinched at my fury.

  I leaned across the table at him. His mouth opened. He made swallowing movements.

  “Don’t worry,” I said through clenched teeth, inches from his face. “I’m not going to the cops. I’m going to do something a lot worse. I’m going to leave you to yourself, with what you’ve become, and let you go crazy with it. You will, you know. All that instinct for nasty truths turned in on yourself, in this floating jail of yours.”

  He suddenly looked a little puzzled. Maybe I was wrong, perhaps he would let himself off the hook. I really didn’t care. “Even if you don’t drive yourself mad, I’m not going to tell the cops because there’s no good in it to drag your dirt into the open. Not for me, not for the hospital, not for anyone. And personally it doesn’t really matter to me what happens to you. I’m a physician, not some avenging angel or Lady Justice herself. I’ve got my .life back. That’s all I ever wanted.”