Medical Judgment

by Richard L. Mabry M. D.

  She shook her head and walked slowly into her house. If only the boy hadn’t been drinking. For that matter, if only the person who’d crashed into Harry and killed both him and their daughter had been more careful. Couldn’t God have intervened? Why did good people have to die? Why had she been robbed of the joys of being a wife and mother? Why?

  The more she thought about it, the more Sarah decided she’d seen too many tragedies at this point in her life. And not all of them had been in the emergency room.

  * * *

  Night was falling when Tom Oliver found Sarah and said, “That’s it.” He indicated the home with a sweeping gesture. “I think the painting’s done. When it comes in, we’ll be back to install carpet in a couple of areas, but other than that, we’re through. If you see anything we need to correct or touch up, maybe some paint that needs another coat, just give me a call.” He handed her a card. “Tomorrow’s Monday. I’ll talk with your insurance agent then about payment.”

  Sarah took the card and shoved it into the pocket of the jeans into which she’d changed right after church. “Thanks. And whatever’s left after insurance pays, I’ll give you a check.”

  She stood at the door with Oliver and watched his crew load the last of the ladders and drop cloths into their panel van. “None of my business,” he said, “But have you considered a security system? You’re here alone, which would probably be enough to make most women get one. Now I understand someone set this fire.” He hesitated. “You know, my company doesn’t just do restoration after fires. A lot of what we do is construction and repairs, but we also install home security systems.”

  Sarah shook her head. “I’ve thought about it, but I’m not ready to install one. I’ve heard too much from people who hate theirs—false alarms, maintenance, all sorts of problems.”

  “Suit yourself,” Oliver said. “Some of my customers are happy to put in a system so they can get rid of the pistols they have for self-defense.”

  “I don’t have one of those, either,” Sarah said. “I know it’s foolish, and maybe I’ll change my mind on both counts, but for now, I guess I’ll depend on locks and lights.”

  Oliver took a minute to think about this. Then he shrugged. “Call me if you change your mind.” With that, he headed for his pickup.

  After he was gone, Sarah went through the house in what she was sure would become a nightly ritual. She closed the blinds. She made certain all her doors and windows were locked. She double-checked that the garage door was locked as well, the bars firmly into the slots in the track.

  Then she slumped into a chair in the living room, put her head in her hands, and wondered why she was fighting back the tears she felt damming up behind her eyes. There was no one to see them. But somehow she felt that Harry was watching—and she wanted to be brave for him.

  * * *

  Almost midnight, but the lights were still on throughout the house. He wondered if the doctor thought the illumination would scare him away. Was she in the house at this moment, cowering behind locked doors? Had she gone to bed, hiding under the covers like a frightened child?

  He felt the comforting weight of the pistol in his pocket. His hand traced the outline of the 9mm Beretta semiautomatic. It had cost him over four hundred dollars, but it was worth it—lightweight, compact, deadly— the ideal gun for his purposes.

  But he wouldn’t be using it tonight. No, it was too soon. The doctor had to sweat, to go without sleep, to feel her heart beating in her chest like a trip hammer until she was certain it was about to explode.

  She’d live every day not knowing when he’d strike next or what he’d do. And finally, when he thought he’d made her suffer as much as he could, he’d kill her.

  5

  Monday morning dawned bright and clear, the weather belying the cloud that seemed to hover over Sarah’s head. She’d had very little sleep the night before, and what she’d managed had been far from restful. Her head had hit the pillow for the last time at about two a.m. and by six she was out of her bed and headed for the kitchen to turn on the coffee maker.

  Her phone started ringing at seven a.m. The first call was from Dr. Chuck Crenshaw, the doctor who headed the group of physicians staffing the ER at Centennial Hospital. “Sarah, I was out of town this weekend, and I didn’t hear about the fire at your place until last night. Are you okay?”

  “Yes, thanks, Chuck.” She went on to explain about the minimal damage, deciding not to get into the emotional upheaval the event had caused. “I’m planning to work my shift as scheduled this evening.”

  “Well, let me know if you need someone to cover for you. And if there’s anything any of us can do . . . ” He let the sentence hang unfinished, but Sarah knew what the thought behind it was.

  “Thanks,” Sarah said, and ended the call.

  If there was anything that could be done for Harry’s widow . . . If anyone could help out in this stressful time . . . If she needed . . . The sentiments were the same ones she’d heard eight months ago when her husband and daughter were snatched from her by the auto accident. She’d appreciated the gestures then. She appreciated them now, but they also served as a reminder of her loss. More than that, they marked a change in her, a change that doubtless others saw as well. What’s happened to me? A woman doctor’s supposed to be strong. An ER doctor has to be independent. I still function adequately in my professional role, but I’ve lost the edge I once had.

  After she married Harry, Sarah had developed the habit of shedding her independence when she left the hospital. At work, she had to be decisive, in charge, always ready to take over. But when she got home, she relaxed. Here Sarah could be a wife and mother, part of a team, sharing responsibilities with her husband. Harry was a great husband and father, always there to help. After Jenny was born, Sarah didn’t have to be a supermom. In a manner of speaking, she’d learned to drop her cape at the door.

  Now Sarah was finding it hard to dig out of the pit of despair the loss of her husband and daughter had put her in. She still managed to do her job in the ER. There she made tough decisions and acted on them, although perhaps not as effectively as before Harry’s death. But at home, in the midst of constant worry and uncertainty, she sometimes found the smallest decision too much for her. Her personal life was in tatters. Why couldn’t things be like they used to?

  Why had God let this happen? When Harry and Jenny had been killed, Sarah’s first thought was that God had made a mistake. Why would He let the fatal crash take place? Why didn’t He intervene? Then, when the reality of her loss finally soaked in, Sarah tried to lean on her religion to help her through the troubled times. She’d heard and read all the sentiments when they came from others in times of distress. Lean on God, and He’ll uphold you. But that strength didn’t come. Instead, she found herself constantly asking God, “Why?”

  Of course, God wasn’t the only target for her anger. She’d never told anyone about this, but there were times—many times—when she was angry with Harry. Oh, she knew he didn’t want to have that accident. He didn’t plan to die. Harry didn’t plan to take their daughter with him, leaving Sarah alone. But she couldn’t help being angry with him. Sometimes, in the dead of night, alone in her room, she’d find herself saying again and again, “Harry, why have you left me? Harry, why did you do this? Why?”

  Her attendance at church yesterday marked the first time she’d sat through an entire service since she’d exited the building behind two coffins eight months ago. Was she ready to turn to God once more? Despite what everyone said about seeking Him in time of trouble, Sarah couldn’t bring herself to make that leap. Not yet.

  When her phone rang again, it startled Sarah. She looked at the caller ID and sighed. It was Kyle. Good old Kyle. He’d been the first person she thought of when she needed help, and she was glad to have him around for support. But recently she’d come to suspect that his closeness had more behind it than willingness to help his friend’s widow.

  “How are you doing, Sarah?” Ky
le asked.

  “I’m making it okay.” It occurred to Sarah that Kyle was acting just like Harry always had. He was trying to protect her. Kyle, you might have been my husband’s best friend, but stop trying to replace him . . . in any way.

  Sarah took a quick sip of coffee and tried to steer the conversation in a different direction. “Thanks for recommending Tom Oliver. He and his crew did a nice job of restoration. The house is back to pretty much normal.” Except that I know someone’s been in it. Did he touch anything? Did he sneak up the stairs to Jenny’s room? Who was it? Why did he do it? And . . . will he come back?

  Kyle’s voice brought her out of her musing. “Are you going to—”

  “If you’re wondering if I’m going to work today, the answer is yes.” She took another swallow of coffee, half emptying the cup this time. “Look, Kyle. I appreciate your concern, but at this point I have to gather up the pieces of my life and move on. I imagine I’ll hear from Bill Larson before I head to work this afternoon. If I think I need a lawyer, I’ll give you a call.”

  “I’m available anytime, Sarah.”

  The third call didn’t come until mid-morning. “This is Bill Larson. How are you today?”

  If one more person asks how I’m doing . . . “I’m surviving. And I’m glad you called. Yesterday I was talking with a man who reminded me that I was responsible for drawing the blood alcohol tests on his son and another teenager after they’d been involved in an accident. Apparently, one of the defense attorneys made the argument that I got the samples mixed up. I’m sure I didn’t, but I guess you were right. There are people who’ve come in contact with me through my emergency room duties who might have ill will toward me, if I can use an old-fashioned phrase.”

  “One of the things I planned to do was go through ER records looking for the names of people like that,” Larson said. “Because of the privacy laws, I’d have to get a court order to do it. If you’d be willing to go through the records and give me that list, it would be a lot easier. Would you?”

  Sarah didn’t waste a lot of time thinking about it. “If you think it might help, I’m ready. When do you want to start?”

  * * *

  Bill Larson had a pounding headache. It wasn’t that his eyes were tired from personally scanning hundreds of emergency room records. Sarah had done that, giving him names when she decided the person involved might have a grudge against her. But the repetitive task of writing down those names and contact information, consulting with her for details of her encounter with them, sitting in a stuffy medical records room under unforgiving fluorescent lights, squirming as he tried to find a comfortable position in an uncomfortable straight chair—that was enough to give anyone a headache.

  “Are you sure you want to do this?” Larson asked Sarah. He almost hoped she’d tell him she was ready to quit.

  “There are a lot of things I’d rather be doing, but if this is what it takes to give you some leads, I’m willing.”

  So he’d continued, jotting down names that might turn out to be Sarah’s “stalker.” Despite what appeared at first to be a hopeless task, Larson figured that good detective work—asking questions, looking for relationships, examining evidence, sifting through interviews—would eventually unmask the man.

  Sarah looked up at the clock on the wall of the hospital record room. “I have to go to work pretty soon. Do you need some more names? If so, I can meet you here again tomorrow morning.”

  Larson looked at the list of names he’d accumulated. “How far back in the records have we gone so far?”

  “About a year. Think that’s enough?”

  “Possibly. Let me make a note of the last date in the pile. Then I’ll start working on what we have. If I need your help again, I’ll give you a call.” He paused and looked directly at her. “And you know we’re also going to have to look into your personal life. I hope you—”

  “Whatever it takes. No apologies necessary.” She picked up her backpack, evidently what she used as a purse when going to work in the ER. “Truthfully, do you think what we did today might help you?”

  Larson rose and stretched, hearing his neck pop and feeling the muscles in his shoulders rebel at the movement. “We never know. I’ll just keep checking on all the leads. Meanwhile, what are you doing about security?”

  The two of them moved toward the door of the records room. When she reached it, Sarah stopped with her hand on the doorknob. “I’ve been locking my garage door manually since you showed me how the emergency release lever could be tripped with a coat hanger. I’ll get a security guard to walk me to my car when I leave the hospital tonight. I make sure all my doors and windows are locked. I think that’s about all I can do.”

  “Anything else?”

  “I’ve been thinking about an alarm system for the house,” she said.

  “Probably a good idea,” Larson said. “And don’t forget, you have all my numbers. Call anytime you want, even if you think it’s something trivial. I promise you won’t be a pest.”

  She thanked him and went out the door. He followed, then stood watching her walk down the hallway. Sarah, you could never be a pest. Why couldn’t I have married someone like you?

  * * *

  When Sarah entered the ER, she walked into what might seem to the uninitiated to be chaos set against a background of shouts, moans, beeps, and various other noises. To her, it was home.

  “Glad to see you,” Dr. Craig Perkins said as he passed her. “You sure you’re okay working today?”

  “I’m fine. What’s going on, and where shall I start?”

  After getting a quick update on the patients in the ER, Sarah said, “I’m on it. You take off.”

  As Sarah approached the first enclosure, she heard a child crying inside. She pulled aside the curtain to see a neat but plain-looking woman, probably in her early twenties, holding a young girl in her arms. The child looked to be about two . . . the same age as Jenny. Sarah blinked hard and swallowed to loosen the lump in her throat. She’d been warned there would be emotional triggers at random times, but so far she hadn’t encountered one during an ER tour. Now she had. Sarah fought back the impulse to cry.

  Sarah took a few calming breaths. “How can I help you?”

  “My daughter . . . my daughter fell this afternoon. I didn’t think much about it. I mean children are always falling. But she’s still crying, and I’m afraid her arm is broken.”

  Gently, Sarah touched the arm. The little girl jerked it away, but not before the doctor noted it was slightly swollen just above the wrist. She hadn’t been able to feel any crepitus, the grating sensation caused by ends of bone rubbing together, but that might not be present if the fracture were non-displaced. In any case, an X-ray was going to be necessary. If the arm were fractured, the mother would have to care for a little girl with a cast on her arm for four to six weeks. But at least her daughter’s alive.

  Sarah stuck her head out of the cubicle and called to Connie, who was working that shift. The nurse hurried over.

  “You want an X-ray?” she asked.

  “It’s a possible Colles’ fracture,” Sarah said. “I’ll put a short arm splint on it until we can get the X-rays. Maybe that will stop some of the pain and prevent any neurovascular injury.”

  Later, after Connie left to escort the mother and daughter to get the X-ray, Sarah leaned on the wall in the vacant cubicle and fought to calm the storm she felt inside. They warned me about triggers, but this one caught me off guard. How long will I have to be alert for them? Thus far, she’d had no such reaction when called upon to treat an adult trauma victim. But this child, who was about Jenny’s age, had made her heart feel like it was breaking. Jenny. I miss Jenny. I miss her so much.

  As it turned out, the little girl’s arm wasn’t broken, and a relieved mother left the ER with her daughter’s wrist supported by an elastic bandage. Sarah didn’t see them go, because she was already involved with the next patient. And she knew that would be the way things went for
the balance of her tour.

  It was almost midnight when Sarah, feeling rather foolish, walked beside the security guard to her car in the physicians’ parking lot. “You know, I appreciate this.”

  He touched the holstered pistol on his hip. “Doctor, it’s part of my job. Not many people want to tangle with an armed man, and I’d always rather prevent a problem than deal with the consequences after it’s too late.”

  Sarah kept her car doors locked as she drove through the deserted streets. At her house, she stopped her car in front of the locked garage door. She automatically reached for the opener clipped to her sun visor, then pulled her hand back. It wouldn’t work, because the door was locked. Sarah ran her choices through her head and decided a quick run to the front door was safer than getting out, unlocking the garage door, then pulling in. And it would be daylight when she left the next day, so getting into her car in the driveway shouldn’t put her at risk then.

  She started to breathe a silent prayer for safety but stopped, remembering the apparently ineffective prayers she’d offered when she got the news of the wreck that claimed the life of her husband and child. Maybe speed and determination would substitute for divine protection. Sarah shook her head, opened the car door, and dashed for her house, reaching over her shoulder to beep her car locked as she went.

  * * *

  The man was grateful that the color of his vehicle allowed the car to blend into the darkness. He’d found a parking place between two other cars, almost directly across the street from Dr. Gordon’s house. He was in a spot equidistant from the streetlamps at either end of the street. Black clothes let him merge with the shadows inside his vehicle.

  The houses on the block were all dark by now. The exceptions were what seemed to be nightlights. No bluish illumination from TV sets flickered through partially covered windows. Aside from the occasional bark of a dog, the neighborhood was quiet.