Medical Judgment

by Richard L. Mabry M. D.

  More praise for Richard Mabry

  Stress Test

  “It is easy to understand why Mabry’s popularity has been skyrocketing. He is a fine, fine writer.”

  —Michael Palmer, New York Times best-selling author

  Fatal Trauma

  “Asks big questions of faith, priorities, and meaning, all within the context of a tightly crafted medical drama.”

  —Steven James, best-selling author of Placebo and Checkmate

  Critical Condition

  “Mabry has the uncommon ability to take medical details and make them understandable while still maintaining accuracy and intrigue.”

  —Romantic Times Book Reviews

  Other Abingdon Press books by Richard L. Mabry, MD

  Prescription for Trouble series

  Code Blue

  Medical Error

  Diagnosis Death

  Lethal Remedy

  Fatal Trauma

  Miracle Drug

  Medical Judgment

  Copyright © 2016 by Richard L. Mabry

  All rights reserved.

  No part of this work may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage or retrieval system, except as may be expressly permitted by the 1976 Copyright Act or in writing from the publisher. Requests for permission can be addressed to Permissions, The United Methodist Publishing House, 2222 Rosa L. Parks Blvd., PO Box 280988, Nashville, TN, 37228-0988 or e-mailed to permissions@umpublishing.org.

  Macro Editor: Teri Wilhelms

  Published in association with Books & Such Literary Agency

  The persons and events portrayed in this work of fiction are the creations of the author, and any resemblance to persons living or dead is purely coincidental.

  Library of Congress Cataloging-in-Publication Data

  Names: Mabry, Richard L., author.

  Title: Medical judgment / Richard L. Mabry, MD.

  Description: First edition. | Nashville : Abingdon Press, [2016]

  Identifiers: LCCN 2015048015 (print) | LCCN 2016001264 (ebook) | ISBN

  9781630881207 (softcover : acid-free paper) | ISBN 9781630881214 (e-book)

  Subjects: LCSH: Women physicians--Fiction. | Women--Violence

  against--Fiction. | Man-woman relationships--Fiction. | GSAFD: Christian

  fiction. | Romantic suspense fiction. | Mystery fiction.

  Classification: LCC PS3613.A2 M435 2016 (print) | LCC PS3613.A2 (ebook) | DDC

  813/.6--dc23

  LC record available at http://lccn.loc.gov/2015048015

  For my family, with thanks for believing in me

  Acknowledgments

  When I began to write novels, I had no idea I’d get this far, and it wouldn’t have been possible without the help and encouragement of a lot of people along the way. At the start, two great writers and teachers, Alton Gansky and James Scott Bell, suggested I try my hand at fiction. Along the way I learned from numerous others—too many to name. Agent Rachelle Gardner saw something in my writing she liked and has helped guide my course for years. The folks at Abingdon Press, first under the direction of Barbara Scott and now Ramona Richards, have been a pleasure to work with. Cat Hoort and her team have made sure word gets out about the book. Teri Wilhelms supplied the finishing touches with her edits. My wife, Kay, in addition to being an encourager, has served as my first reader for all my novels, always pointing me in the right direction when I get off course. I appreciate every one of you. I couldn’t have done it without your help.

  My retirement from medicine has not gone according to my plan, but rather that of God. But that’s okay, because His plan, as always, has turned out to be much better than mine. I can hardly wait to see what He has in mind next for me.

  1

  The smell of smoke gradually nudged Dr. Sarah Gordon from a troubled sleep into semi-wakefulness. Hours earlier she’d finally given in and taken a sleeping pill. Now it made her feel fuzzy and uncertain, as though she were moving through cobwebs. At first, she couldn’t separate the odor of smoke from the dream in which she’d been mired. Sarah struggled to bring herself more fully awake. Had she really smelled smoke? Or was it a nightmare? She eased up in bed, resting on one elbow, and sniffed the air around her. There it was again. The smoke was real.

  Her brain, still numbed by sleep and Ambien, took a few seconds to make the connection. Smoke meant fire. Something in her house was burning—perhaps the whole house was about to go up in flames. She had to wake Harry. He’d take charge. After she awakened him, they’d hurry down the hall together and get Jenny. Then Harry would lead them to safety.

  Sarah reached to her left across the king-size bed, but when her hand touched a bare pillow, the reality hit her, forcing her fully awake more effectively than a bucket of ice water. Her husband wasn’t there. He’d never be there again. He was dead. He’d been dead for eight months now. So had Jenny, their two-year-old daughter. Sarah was alone . . . in a burning house.

  But was she alone? She had a vague recollection of hearing a noise about the same time she became aware of the smoke smell. Was someone out there, waiting for her? Or was that part of a dream as well? Should she stay here in the bedroom until she was sure? No, she needed to get to safety. The “someone” might or might not be real, but the fire wasn’t the product of her imagination. She had to get out, and quickly.

  She threw on her robe and shoved her feet into slippers. Sarah dropped her cell phone and keys into the pocket of the robe. She took two steps away from the bed before turning back to pick up the flashlight from the bedside table. Sarah flicked it on and checked the beam. It was dim—the batteries probably hadn’t been changed since before Jenny died—but it gave off enough illumination to let her see a few feet in front of her. She hoped that would be enough. In several strides that displayed more confidence than she felt, Sarah covered the distance to the door leading to the hall. Feel the door. If it’s hot, find some other way out.

  Cautiously, she pressed her palm against the door. When she felt no heat, Sarah let out a breath she didn’t know she was holding. She opened the door and looked around. No flames. Then she sniffed, and there it was again—a faint aroma of smoke wafting up the stairway—not enough to choke her, not an amount capable of blocking her vision, but sufficient nonetheless to send her hurrying toward what she hoped was a safe exit.

  Guided by the faint glow from the flashlight, she descended to the first floor. As she got lower, she coughed a little, her eyes watered a bit, but she could breathe, could see through the tears. The smoke still wasn’t bad. Maybe that was a good sign.

  At the bottom of the stairs, she stopped to listen. Was that a noise? She strained her ears but heard nothing more. Maybe there was no intruder. Maybe that was all in her imagination. Maybe.

  But the smoke wasn’t something she’d imagined. It was real, and where there was smoke, there was fire. But where was it? She heard no crackle of flames. She felt no pulse of heat on her face. She blinked away a few tears and sniffed again. The smoke was still there, and now it seemed to be increasing.

  The light from the flashlight had become so dim as to be almost useless. I need to see. Why haven’t I tried to turn on lights? Wasn’t there something about electricity failing if the fire got too near the supply line? Sarah flipped the switch at the foot of the stairs, and the overhead fixtures blazed into light. The power was still on. Good. She turned off the flashlight but held onto it. It might be a useful weapon.

  Sarah started to exit the house the way she habitually did, through the kitchen and into the garage. She turned to her right to go that way but stopped when she saw tendrils of dark smoke drifting under the door from the gara
ge and into the kitchen. The garage. That’s where the fire was. She couldn’t get out this way.

  She turned back and scanned the area straight ahead of her, the living room. No smoke. No heat. No noise of flames. Best of all, there was no movement or sound that signaled someone there . . . at least, no one she could see. She could hurry through to the front door and make her escape.

  Should she stop and call the fire department now? Was there any reason to further delay that call? Wasn’t it important to call them immediately? Get out of the house first. Call for help when you’re safe.

  Sarah hurried to the front door, threw it open, and felt the fresh night breeze on her face. Her instinct was to run, to get out of the house as quickly as possible, but she stopped as yet another rule heard long ago surfaced in her mind. Keep doors and windows closed. Air can feed the flames and make the fire grow. She shut the door behind her.

  Sarah hurried to the end of the sidewalk, her slippers making a soft shushing on the concrete. When she got there, she paused and turned back toward her house. At first she saw no one there. Wait! Had there been a flicker of movement in the shadows at the corner of the house? Or was it her imagination, fueled by the adrenaline of the situation, turning wisps of smoke into the shape of a prowler?

  She watched for perhaps half a minute more, trying not to blink, looking with unfocused eyes into the middle distance. Let your peripheral vision pick up faint images. She saw no figures, no movement.

  Enough. Get help. She pulled her cell phone from the pocket of her robe and stabbed out 911 before hitting send.

  “911. What is your emergency?”

  “This is Dr. Sarah Gordon. My house is on fire. The address is 5613 Maple Shade Drive.”

  There was the briefest of pauses, during which Sarah heard keys tapping. “I’ve dispatched first responders. Is anyone injured? Are you in the house?”

  “No injuries. And I’m outside, on the lawn.”

  “Is anyone else there? Or are you alone?”

  Sarah hesitated before she answered.

  “I’m alone.” At least, I hope so.

  * * *

  The call awakened Detective Bill Larson. He brought his wrist close to his face and squinted at his watch. Two fifteen a.m. The phone had interrupted a dream—not a pleasant one, but that wasn’t unusual. Troubled sleep and disturbing dreams were part of the pattern his life had taken on during his struggle for lasting sobriety.

  “We’ve got a fire at a private dwelling,” the dispatcher said. “The fire chief on the scene thinks it might be arson, so I wanted to notify you. If you like, I’ll send a patrol car by there now to do a preliminary. Then you can hook up with the fire marshal tomorrow. Would you like me to do that?”

  Larson yawned. “Probably. Where’s the fire?”

  “The location is 5613 Maple Shade, the residence of Dr. Sarah Gordon.”

  The name brought him awake. Larson had met Sarah Gordon and her husband shortly after the detective moved to town. He’d been introduced to them at church. Realizing that being part of a church family would be important as he tried to get his life back together, he’d joined the First Community Church shortly after moving to Jameson. It was one of the larger churches in town, and Larson figured he could lose himself in a congregation that size. He needed to be just a taker for a while. Maybe after he had a few more months of sobriety under his belt he could find a place to serve. Maybe.

  Larson called up his mental picture of Harry Gordon: a nice-looking man in his 30s, his blond hair always a bit tousled, a perpetual grin on his face. But the person his memory could more easily recall was Sarah. She had dark hair cut short, flawless olive skin, and always seemed to be laughing. Each time he saw the two of them together with their two-year-old daughter, Larson realized again what he’d lost when his own family was torn asunder.

  After his initial meeting, he’d seen Sarah a few times at church, always at a distance and generally with her husband. Then she’d suffered the tragic loss of both husband and daughter, a loss that seemed to devastate Sarah. After that happened, Larson figured he should express his sympathy to her, but the time never seemed right. Then it wasn’t long before she stopped coming to church altogether. He hadn’t seen her since.

  “Larson, are you there?”

  “Sorry. Just thinking,” Larson replied.

  “So what do you want me to do?” the dispatcher asked.

  “Tell you what,” Larson said. “I know her from church. I think I’ll head over there now.” He ended the call and began to dress.

  * * *

  Sarah sat huddled under a Mylar blanket in the fire chief’s SUV, her teeth occasionally chattering despite the warmth of the summer evening. One hand held an empty china mug, courtesy of her neighbor who’d brought coffee and offered to let Sarah spend the night—what remained of it—at her house. Sarah had declined with thanks. She wanted to be in her own home.

  Her home. The phrase resonated in her mind. It was the house she and Harry bought when they were married. It was the home into which they brought Jenny over two years ago. It was full of memories. And now, although both Harry and Jenny were gone, she wasn’t going to turn loose of those memories—or the house.

  Sarah wasn’t about to be driven from her home by fire or anything else. But was the house habitable? Just how bad was the damage inside? She’d soon know, because here came the chief. She decided that, no matter what he told her, she wasn’t going to easily abandon her home. Sarah wasn’t certain whether her attitude was based on pure stubbornness or a sentimental attachment, but whatever the cause, she was adamant.

  The chief climbed into the driver’s seat of his vehicle and half-turned to face her. Sarah had a vague recollection of meeting him at some point in the past, although she couldn’t recall his name. In her present condition, she wasn’t sure she could even remember her own.

  “Doctor, I’m Stan Lambert, the deputy fire chief,” he said, answering Sarah’s unasked question. “I know this is unsettling. Are you okay? The EMTs are here. I know you told one of my firemen earlier that you didn’t need any attention, but maybe you should let them check you over.”

  Sarah made a conscious effort to still the shaking she felt inside her, shaking due not just to her ordeal but to the emotions it set churning within her. She put the empty coffee mug on the floor of the SUV. “I’m fine, Chief. What I need to know is whether I’ll be able to get back into my house tonight.”

  “That’s the good news,” he said. “The fire was centered in a pile of oily rags burning in the garage near the door to the kitchen. It produced a lot of smoke, sort of like a smudge pot. Despite depositing soot around the area of the fire and leaving the smell of smoke in some parts of the house, the fire didn’t do any real structural damage.”

  “Even in the garage?”

  “There might be a little scorching of the wood in a place or two, but nothing that would make the house unsafe. By the time my men got to it, most of the rags were consumed. As soon as we arrived, some of the firemen unrolled the hose and hooked it to the fire plug down the street in case it was needed, but as it turned out, all we had to use was a hand-held fire extinguisher.”

  “So I can go back into the house?” Sarah said.

  “Yes, that’s the good news,” the chief said. “But I think there’s some bad news to go with it.” He looked up. “And I think I’ll let this man tell you about it.”

  The back door of the SUV opened. A man edged in and took a seat behind Sarah. In the illumination provided by the dome light, she could tell he wore a suit and tie. However, the suit was wrinkled and the tie askew. He closed the door, brushed his dark hair out of his eyes, and rubbed his unshaven chin. “I’m so sorry this happened,” he said.

  Sarah searched her memory. She knew this man. That is to say, she felt like she should know who he was. Then it came to her. She’d seen him at church, heard his name there. His name danced on the edge of her memory, and she found it at about the same time he held up
a badge wallet and identified himself.

  “You may not remember me, but we go to the same church. I’m Detective Bill Larson.”

  “Why are you here? Are you part of some group at the church that ministers to people who’ve had a fire?” She did a double take. “Surely you’re not here as a policeman. This was just a fire in some oily rags in my garage,” Sarah said.

  “No, I’m not here as a church member, although I’ll do anything I can to help,” Larson said. “And I’m very definitely here as a policeman. I’m sure the chief has already told you this was no ordinary fire.”

  “No, it was just some oily rags burning,” she said.

  “And where did those oily rags come from? They didn’t just materialize and set themselves ablaze.” Larson said. “Do you even keep such things in your garage?”

  “No,” she said. “I’m careful about that. They could catch on . . . Oh!”

  “That’s right,” Larson said. “That fire was set. This is arson.”

  * * *

  Bill Larson watched from the back seat of the fire chief’s SUV as firemen loaded their gear onto the truck. Sarah Gordon sat huddled in the front seat of the vehicle. Her dark hair was mussed, she wore no makeup, her eyes were red-rimmed. This was quite a different Sarah than the picture Larson had carried in his mind. Although she looked so miserable that he wanted to comfort her, the detective reminded himself that tonight he was here in his official capacity. To do his job properly he’d need to put aside any personal feelings.

  He pulled a notebook from the inside pocket of his summer-weight suit coat, clicked a ballpoint pen into life, and said, “Sarah . . . Dr. Gordon, can you think of any reason someone would want to do this?”

  She pulled the blanket tighter around her shoulders. “No.”

  Larson waited for her to expand on that answer, but she just sat silent, unmoving. He figured she was probably in shock, and it was unlikely he’d get any useful information from her right now. But he had to try. However, his assumption proved correct, as the answer to every question he put to her was the same—“I don’t know.”