Medical Judgment

by Richard L. Mabry M. D.

  Common sense told him to give up, go home, try to get some rest. But he wasn’t in a mood to rest. He was as jittery as the cook in a meth lab right now, and he knew there was no hope of his getting to sleep until he came down from his nervous high. He could call Anna King—she’d probably still be awake—but for some reason he wasn’t ready for another conversation with her. Mark wondered if their conversation in the OR hadn’t revealed too much of her already.

  He had a few friends, most of them doctors, but Mark hated to wake them up. His parents wouldn’t understand, and his call would only upset them. He tried to think of someone else to whom he could talk, but Kelly’s name kept coming to the forefront.

  Mark knew that some of his colleagues drank to relax after a particularly difficult case. Anna was a case in point. Maybe he should call her, perhaps drop by her home to wind down with a drink. He squelched the thought as soon as it popped into his mind. That wasn’t any kind of a solution. It would only make matters worse.

  He couldn’t escape the feeling that what he and Kelly went through tonight had somehow tightened the bond between them. What did that mean about his relationship with Anna King? Maybe tomorrow he’d think about it. He had to take things one step, one day at a time.

  The clock on the wall in the break room hadn’t worked since the Reagan administration. Mark abandoned the practice of wearing a watch when he started working in the ER. He looked at the time displayed on his cell phone and discovered that it was almost one a.m. He shrugged into the white coat he wore to cover his scrub suit as he went to and from work, pulled his car keys from the pocket, and headed out the door. Common sense dictated that he drive directly home, maybe stopping at an all-night fast food place for a burger or malt. But he knew that wasn’t going to happen. There was no doubt in Mark’s mind what his next stop would be.

  * * *

  Finally, Kelly could put it off no longer. She crawled into bed, but sleep eluded her. All she could do was lie there and stare at the ceiling. She tried closing her eyes, but the images kept coming. A hot bath and a bowl of Blue Bell vanilla ice cream with chocolate syrup was her usual bedtime prescription for nights when sleep wouldn’t come, but tonight the remedy hadn’t worked. She read a Bible passage, but the words kept running together, and she got no comfort from them. Her prayers were a jumble of thoughts and incomplete sentences stemming from emotions running rampant in her brain.

  She’d seen the “missed call” messages on her cell phone: three calls from Mark. While she was in the tub, still winding down from her ordeal, she hadn’t been ready to talk with him. Afterward, when she started to call him back, she couldn’t bring herself to press the button. Was it too late? Or was she just not ready for the conversation? In either case, the call went unmade.

  Now Kelly tossed and turned, seeking sleep that wouldn’t come. She was about to get out of bed and turn on the TV, usually her last resort, when she heard a car pull up outside her house. That was unusual at this time of the morning in her neighborhood. The occupants of the homes around her were mostly older couples whose children had long since left home, and by this time of night the street was quiet and empty.

  Kelly eased from her bed, wrapped a robe around her, and slid her feet into worn, comfortable scuffs. She tiptoed to the front room and parted the blinds far enough to see the white sedan parked in front of her house. The lone occupant sat unmoving, shrouded in darkness, for several minutes. When he opened the driver’s side door, the car’s interior light came on, and she recognized Mark. He hesitated for a moment before striding toward her front door, his white coat highlighted by the light from the street lamp.

  He paused on her doorstep, and she could almost hear the thoughts going through his head. It was late. There were no lights on in the house. Should he wake her? What would she say?

  Kelly examined her own feelings. Should she remain quiet? If he knocked, would she answer it? Or would she let her inaction turn him away?

  Almost without making a conscious decision, she moved a few steps to the end table in the living room and turned on the lamp there. Apparently that was enough encouragement for Mark.

  He tapped lightly on the door. “Kelly, it’s Mark,” he called softy. “I know it’s late, but I need to talk to you. May I come in?”

  Kelly cinched her robe more tightly closed, then opened the door. She gestured him inside, still unsure of what to say, then locked the door behind him.

  They stood awkwardly for a moment, then each reached out for the other, and the embrace that followed seemed to last forever. Kelly found there was a lump in her throat that made speaking difficult. “I’m . . .I’m so glad you’re okay,” she said.

  “I know it’s late, but I’m having a hard time unwinding, and I wondered if you were, too.”

  “I was trying, but without much success,” Kelly admitted.

  “I knew I couldn’t sleep until I talked this out with someone.”

  Kelly’s heart thudded in her chest. Would the things Mark wanted to say be the same ones that had kept her awake tonight? She motioned him to the sofa and eased down beside him. “Then why don’t you tell me?” Kelly looked into his eyes and held her breath.

  3

  Mark sat on the side of his bed, groggy with lack of sleep after thrashing about for most of the night, unable to rest and emotionally wrung out. He’d left Kelly’s house about a quarter to two. Right now she’d be getting ready for church, but she’d promised to call him after the services. Until then, he was on his own.

  After the shooting, Eric had offered to take Mark’s Sunday evening shift in the ER, and Mark readily accepted the offer. At that point, he felt like he never wanted to see the inside of a hospital again. Now, less than twelve hours later, he wondered what he’d do to occupy himself if he didn’t go to work tonight. There was a time when his life revolved around his shifts in the ER: sleep, eat, go to work, come home, eat, sleep, repeat the cycle. Since he’d started dating Kelly, the pattern had expanded to include time with her, plus an occasional dinner with Anna for variety. One of those relationships might eventually demand more of his time. He knew which one, but he didn’t want to think about that right now.

  Last night had changed a lot of things. Mark’s thoughts seemed to be stuck on the shooting—and his emotions while it was going down. He hung his head, closed his eyes, and wondered why he hadn’t confessed to Kelly. Maybe today . . .

  The buzzing of his cell phone startled him. He picked it up and frowned when the caller ID showed “anonymous caller.” Could it be a reporter? None had managed to find him last night, but he had no doubt they’d remedy that today. Surely a telephone solicitor wouldn’t be calling at eight o’clock on a Sunday morning.

  Oh, well. He had nothing better to do. Might as well answer it. “Dr. Baker.”

  “Doctor, this is Detective Jackson.”

  Mark wished he could clear the cobwebs from his brain. Like slogging through mud, the synapses slowly clicked. Jackson was the lead detective investigating the shooting. Mark had met him and his partner, Detective Ames, last night—or, more accurately, early this morning. His mental picture of Jackson was of a short, stocky African-American in a wrinkled suit, the almost laser-like intensity behind his dark eyes a warning not to mistake a disheveled appearance for carelessness. Mark had decided to walk carefully around Jackson.

  “Doctor, are you there?”

  Mark sat up and swiveled around to perch on the bedside. “Uh, yeah. What can I do for you?”

  “I thought you might want to know that we’ve ID’d the two victims of last night’s shooting.”

  ID’d the victims? He already knew who the chief victim was: Sergeant Purvis. Then Mark realized the detective was talking about the gunman and the man—didn’t he call him his brother?—the man who’d been essentially dead on arrival in the ER. “Okay.”

  “They were brothers,” Detective Jackson said. “The older was Hector Garcia. The gunman was his younger brother, Ignacio, aka ‘Nacho.’�
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  The names meant nothing to Mark. “Who?”

  “Yeah, I’m sure the names aren’t familiar,” Jackson said, “but this may help you. They were members of the Zeta drug cartel.”

  That information opened Mark’s eyes like a cup of strong coffee. Generally, his newspaper reading was confined to the sports section, but almost everyone in Texas knew that the Zetas were the most feared drug cartel in Mexico. Even the Mexican police and military walked carefully around the Zetas. He’d heard they were operating in the state, but he figured it would be further south, near the border. On the contrary, these men had been in Drayton, right in the heart of north Texas.

  “I wanted to let you know,” Jackson went on. “Since Ed Purvis shot Nacho, we’re going to give some protection to the Purvis family for a while. We can’t do that for everyone involved in the incident, but I thought I should at least warn you. The Zetas have a strong sense of revenge, and you might want to be extra careful yourself.”

  “What about Kelly?”

  “Who? Oh, the nurse who first interacted with Nacho.” There was a rustle of paper. “She’s next on my list to contact.”

  “I’ll do it,” Mark said. “We’re supposed to talk later today.” He paused. “I don’t guess the people in the OR attending to Sergeant Purvis are at risk, though.”

  “We don’t think so, but you can never tell what kind of twisted logic these people have about getting even,” Jackson said. “Anyway, I’ve got to get going. I’ll call if we need anything more from you.”

  “Detective, one thing before you go. I know you generally keep information like this confidential, but would you give me Sergeant Purvis’s address? I want to go by later today and personally express my condolences to the family.”

  “Did you talk with them last night?”

  “Only briefly, and frankly after Mrs. Purvis heard about her husband’s death, I don’t think she took in anything I or the other surgeon had to say.”

  It took a good bit of cajoling, but eventually Jackson gave Mark the information he needed. “But be sensitive,” the detective cautioned.

  “I will be.” Mark remembered how it was when his brother died. There were a slew of people in and out of the house. Most were well-meaning and helpful, but some just wanted to focus on assigning blame. To Mark and his family, it didn’t matter that the other driver was drunk, was driving with an invalid license. Joe was still dead, and his family needed sympathy and support. Mark figured the Purvis family was in the same situation.

  After ending the call, Mark shuffled into the kitchen and put on a pot of extra-strong coffee. He had a hunch he’d need it—it promised to be a long day.

  * * *

  “Shouldn’t you be home?” Tracy Orton asked.

  “Why? To worry about what’s already happened?” Kelly said. “No, it’s Sunday, and I wanted to be in church this morning. Actually, I needed to be here.”

  The two women stood in a relatively quiet corner of the Drayton Community Church, out of the traffic pattern of people exiting after the Sunday morning service. Tracy’s dark hair was pulled back in a ponytail. Her makeup was understated. She wore very little jewelry. Her dress was a simple white sheath. But, as always, what most people noticed first was the hint of mischief that gleamed in the eyes of Kelly’s best friend.

  “Well, how about some lunch?” Tracy asked. “We can lust over the menu items we can’t have because they’re fattening, and you can tell me about last night.”

  Despite her somber mood, Kelly smiled. “I’m not sure about the lusting, but . . .yes, I think I’d like to talk to somebody about what happened.” She paused, considering her next words carefully. “And there’s something else I’d like to run by you.”

  “Want to ride with me?”

  “No, I’d better go in my car. I’ll meet you there,” Kelly said.

  They turned to go, but stopped when a voice behind them said, “Kelly. Surprised to see you here today, but I’m glad you’ve come. I’ve been praying for you and Mark.”

  Kelly turned slowly to face the pastor. “I’m glad I came. The sermon was just what I needed to hear this morning. And thank you for your prayers.”

  “Is Mark okay?” the pastor asked.

  “We talked late last night. He was pretty shaken, but I think he’ll be okay.” No need to go into details with the pastor beyond what she’d shared with him last night.

  “Well, keep me posted on developments.” He smiled and moved away.

  Kelly nodded. I will . . .with some of them. But not all of them. Not right now.

  * * *

  Kelly was already seated in a booth at the back of their favorite little cafe when Tracy walked in. “I ordered iced tea for both of us.”

  “Great.” Tracy sat down opposite Kelly and dropped her purse on the seat beside her.

  They made small talk until after the waitress took their order. Then Tracy said, “So, the account in the paper was pretty sketchy, and the TV reports didn’t tell me much more. I want to hear all about what happened.”

  Kelly was surprised that it took so little time to relate last evening’s sequence of events. “Mark got the gunman to back up toward the door of the trauma room,” she said in conclusion. “Sergeant Purvis burst through, knocking the man off balance, ordering him to drop the gun. Instead he fired, and we ducked. When we looked up, the gunman was dead, and Mark was calling for a gurney to take Purvis to the OR, where he died.”

  “Wow!” Tracy reached across and covered her friend’s hand with her own. “What was going through your mind when all this was happening?”

  “I tried to be calm, tell myself that if he pulled the trigger I’d end up in a better place. Of course, I'm not sure the same could be said for Mark, and I didn’t have any idea where the aide stood.”

  “So you prayed for them?”

  Kelly bit her lip. “Actually, no. Instead, I found myself thinking, ‘Mark can’t die not knowing.’”

  “Not knowing what?”

  “Not knowing that I’m falling in love with him.”

  * * *

  Mark hadn’t been to visit a family in mourning since a college friend died years ago. At that time, he and three of his fraternity brothers had driven almost an hour each way to pay their respects. He didn’t remember much about the experience, except that he was glad he had someone with him. The sickly-sweet scent of flowers, the people conversing in hushed tones, all made him wish he could hurry and get out of the house.

  A year later, his own brother had been killed in an auto accident, his life snuffed out by a drunk driver. Mark had virtually sleepwalked through that experience, letting his parents deal with the people who came by. A few of Joe’s friends wanted to talk, but Mark tried to avoid them. He didn’t want to talk about what had happened to his brother. He wanted it all to be a bad dream, and if that wasn’t possible, he just wanted to get through the experience.

  Since that time, the closest Mark had come to death was in the emergency room. Visiting the bereaved and attending funerals weren’t on his list. Nevertheless, for reasons he couldn’t explain, Mark felt the need to express his sympathy to Sergeant Purvis’s family in person. He figured that most people there would be dressed informally, but after he’d donned khakis and an open neck knit shirt, Mark decided that felt wrong. He wasn’t the average person coming to say, “Sorry for your loss.” No, Mark was there to say, “I’m responsible for your husband getting shot.” Somehow, it seemed that called for him to wear something different.

  He pulled his dark suit from the closet. He found a clean white shirt in his dresser drawer. His stock of ties was laughably small, but he finally found a muted maroon-and-gold striped one that should be solemn enough. Mark looked in the mirror and decided that he was as dressed for the occasion as possible. If he ended up going to the funeral—and that was a very big “if”—he’d wear the same thing. He doubted that the Purvis family was going to notice much about his attire, either today or later. No, they ha
d other things on their mind.

  As Mark turned the key in the ignition of his white Toyota Camry, he wondered if he really should make this visit. Would Purvis’s widow even talk with him? Would the family be in church this morning? No, it was more likely that if they weren’t home they’d be at the funeral home, making final arrangements.

  Mark decided that if he didn’t do it now, he’d worry about it until the visit was behind him. He punched the address he’d wheedled from Detective Jackson into his car’s GPS and pulled away from the curb. Suddenly, his collar was too tight. His throat was dry. He adjusted the car’s climate control, but still he felt rivulets of perspiration running down his back.

  Mark wished he could believe that praying would help. No, it had been too long since he’d even tried. Instead, he called on a meditation exercise he’d learned from a med school classmate. In a few moments, he decided that it—like so many other things in his life—wasn’t working.

  * * *

  As soon as her declaration that she was falling in love with Mark was out of Kelly’s mouth, the waitress served their lunches. Tracy was almost beside herself by the time the dishes were on the table and the waitress gone. She ignored her food, leaning forward toward Kelly and dropping her voice. “You’re in love with him? Are you sure?”

  Kelly picked up a half of her tuna sandwich, then returned it to the plate. “Pretty sure.”

  “And you suddenly decided this last night while a man was holding you and Mark at gunpoint?”

  “I know,” Kelly said. “It sounds crazy. Mark and I have been dating for several months. I knew I was growing fond of him, but finally, last night, when our lives were in danger, I discovered . . .” She grimaced. “This is hard to say out loud, to hear myself admit it.”