Doing Harm (44 page)

“Thank you, Dr. Mitchell,” Dr. Collier says. “Next case, please.”

One of the other chief residents springs up to the lectern. I slide into my seat, and over the next hour discover that Mrs. Samuelson’s death was but one of many bad things that had happened to the patients in our department last month. Postoperative bleeding, infections, strokes; even a surgical sponge inadvertently left in a patient after an operation—enough bad things, in fact, that before conference is over, Dr. Collier ends up using a variation of his elevator-shaft line:
Doctor, you might just as well have shoved this unfortunate woman down an open elevator shaft from the top floor of the hospital. You would have achieved the same result
.

At the end of the meeting, Dr. Collier dismisses us and reminds the residents and med students about the research-study injections, waiting to be administered in the hallway immediately outside the lecture hall. By the door, I pass by Larry, who is listening intently to one of the other residents. He hasn’t talked to me in weeks. Our eyes meet. He nods slightly, twists his lips into a configuration vaguely reminiscent of a smile, and mouths, “Thanks.” I nod and smile weakly in return.

The other residents and I fall into line. The old guy with the creepy smile isn’t around tonight—just the young guy, who, harried and overwhelmed, fumbles and mutters under his breath. At one point, he drops one of the drug vials on the floor, and I help him pick it up as the med students (including GG, whom I notice out of the corner of my eye standing near the back of the line) and the other residents chortle and roll their eyes.

It takes twice as long as it normally does for everyone to receive their shots; the residents and students, distracted and annoyed, fidget impatiently in line. Nobody notices when, after receiving my shot, I slip back into the now-empty auditorium. The door closes soundlessly behind me. I grab my laptop from a bag underneath my seat, take it up to the lectern, plug it into the projector, and open a series of files. I then flip on a screensaver, a picture of Katie and Annabelle hugging, and return to my seat. I rummage through my computer bag, performing a final check of the rest of the equipment I brought with me tonight, confirming that everything I need for what comes next is there before shoving the bag back underneath my seat.

And then I wait.

I can’t see the door to the auditorium from where I’m sitting, only the screen and lectern on the dais at the front of the room. But I can hear the murmur of voices from under the crack in the door, which soon fades, then disappears altogether. This auditorium is located in one of the oldest sections of the hospital, far away from the patient-care floors, and quickly empties out this time of evening.

Then I hear the door open, the rhythmic click of a woman’s shoes on the marble floor, and the protesting squeal of an auditorium seat in the row immediately behind me as it sags under the weight of a new occupant.

“Great job, Steve. The attendings were clearly impressed. Your career seems to be getting right back on track.” Her lips brush against my right earlobe, her hot breath washing playfully over the rest of my ear. “I always knew it would.”

“You played me pretty well that night. With Mrs. Samuelson.”

“It almost didn’t work. You got back down to the SICU faster than I’d anticipated.” She starts stroking the back of my neck lightly with her fingers. Several weeks ago, her touch would have sent electric jolts down my spine; now it makes my skin crawl, but I make no move to stop her. “I underestimated you.”

“You still won.”

“Yes. But win or lose, it doesn’t matter. What matters is patient safety.”

“So you’ve told me. But why a pulmonary air embolus?”

“Why not?”

“Because it already had happened before at University Hospital. In May.”

“I like your logic. The problem is, I didn’t get the Safety Committee’s full attention the first time. In May.”

“What do you mean?”

She removes her hand from my neck as I twist myself around to face her.

She smirks. “After the first patient suffered his unfortunate accident, the Committee said it was a fluke. Nothing changed. I thought that was the wrong response.”

“So you did it again. To Mrs. Samuelson. To make the point.”

“Well, I certainly couldn’t do anything as obvious as hack an ICD.”

I must look as pissed as I feel, with my lips pursed and hands coiled into fists, because she pats my hand and smiles indulgently. “I take that back. I led you into that one. And to be fair, I’d been toying around with using that approach before deciding to use Mr. Schultz as a decoy. Actually, I’m impressed that you worked out all the details on your own. You don’t have much of a background in cardiology.”

She drapes her arms provocatively across the backs of each of the chairs on either side of the one in which she’s sitting and crosses her long, slim legs. Her short white med student coat is unbuttoned and falls away from her flowered sundress, the hem of which is now sitting halfway up her bare thigh. “So,” she purrs, “you decided to play the game after all, Steve. And you lost. Remember our rules.”

This banter seems obscene, what with the trail of bodies she’s left in her wake.

“I remember.” I rise, remove my white coat, and drape it over a nearby chair. I walk to the lectern at the front of the room and check my watch. “I have something I want to show you, GG.”

“I’m intrigued.” She sounds anything but.

I push a button on my laptop. A familiar, soundless scene materializes on the screen at the front of the auditorium. The view is from above. Mrs. Samuelson is lying in her bed, sleeping; I’m dozing next to her in the armchair with my computer sitting on my lap. I peek at GG over the top of my laptop. She’s smirking knowingly.

I look again at the video I’ve been feverishly preparing since Sunday, now playing to its audience of one. If my plan’s going to work, I need her undivided attention for the next ten minutes; so I’ve increased the playback speed in order to reach the most critical portions, the ones that should really jolt her and maintain her interest, more quickly. The now familiar series of events thus unfolds in seconds rather than minutes: I awaken; I answer the page; I make a hasty exit; Mrs. Samuelson slumbers on.

“Is that it?” GG says lazily. “Because otherwise—”

The words die on her lips as a new figure creeps into Mrs. Samuelson’s room. The face is clear in the vivid, high-definition image.

GG.

I steal another glance at her.

And I finally see it.

A crack in her calm façade; a fracture in that imperturbable armor of hers; a flicker of uncertainty flitting across her features. She retracts her arms from the backs of the chairs and sits up very straight, limbs tense, eyes alert, like a predator that’s caught a scent.

Meanwhile, her two-dimensional avatar, wearing latex hospital gloves, unhooks Mrs. Samuelson’s central line from the IV machine next to her bed. The high-speed playback renders a subtle jerkiness to GG’s motions, but it’s easy enough to follow every move she makes. She looks over her shoulder before pulling a large syringe out of her pocket. She attaches the syringe to Mrs. Samuelson’s central line, depresses the plunger, looks over her shoulder again, detaches the syringe from the central line, pulls back on the plunger, reattaches the syringe to the central line, and depresses the plunger again. She repeats the process three more times before taping a note to the syringe, slipping it into my white coat pocket, and stealing away.

The screen darkens.

“Where did you get that?” she asks neutrally. “Is this some kind of a joke?”

The next portion of the video, also sped up, begins before I have a chance to answer. A bird’s-eye view of a different hospital room now fills the front of the auditorium. A patient is asleep in a bed in the center of the screen.

Mr. Bernard.

He awakens as GG enters the room. They talk for a bit, their mouths moving rapidly and noiselessly. GG smiles and nods as she pulls a large, plastic syringe filled with clear fluid from her white coat pocket. She points to it, then to the tangle of wires surrounding the TPN bag hanging on the IV pole next to his bed. He says something. She laughs and pats him on the shoulder before donning a pair of latex gloves, connecting the syringe to the IV emerging from underneath Mr. Bernard’s right collarbone, and injecting the fluid.

Mr. Bernard grimaces, and with his left hand rubs his right chest underneath the IV line. She sits down at the edge of the bed, stroking his right forearm, her lips puckered in a
shush
configuration. He closes his eyes as she continues to massage his arm. His body twitches several times, violently, then stills. GG moves her hand from his forearm to his wrist, fingers lightly touching the radial artery, and nods.

A second syringe appears in her hand, this one with a long, slender needle attached to the tip of it. She wipes a rubber-capped port at the bottom of the TPN bag with an alcohol pad, inserts the needle into it, and empties the contents of the syringe into the thick, milky white fluid. She withdraws the needle from the bag, caps it with a plastic safety tip, and places the needle in her pocket. She then checks Mr. Bernard’s radial pulse one final time before depressing the bright red code-alarm button located on the wall next to his bed.

“You know what happens next,” I say as the screensaver of my daughters reappears. “I could also show you the one of the first patient you killed with an air embolism. The one back in May. But I think I’ve made my point.”

GG places her hand on her chin and stares past me at the portrait of my daughters on the screen. Her expression is unreadable. “Where did you get that second video?”

“The one of Mr. Bernard? From a University Hospital server.” I step out from behind the lectern and discreetly check my watch.

Five minutes down. Five more to go.

Folding my hands behind my back, I slowly pace the length of the room as if giving a scholarly lecture to a class in the auditorium. “Through your work with the Safety Committee, you knew about the SICU cameras. But that was only the beginning of a much bigger project. What you didn’t know is that, last spring, University Hospital Security secretly installed cameras in
all
of the patient rooms. Think about it: every single patient at University under video surveillance. Because of the sensitive privacy and security issues involved, only hospital leaders and select members of the Safety Committee knew the existence of these cameras. You weren’t one of them.”

A paroxysm of guilt rattles through me as I reflect on how I had acquired that particular bit of knowledge, as well as the codes I needed to collect the videos from the secure University Hospital server: by analyzing the stolen keystrokes on Jason’s computer. I was careful to cover my digital tracks, so that anyone who tries to trace the breach—as they surely will after tonight—shouldn’t be able to follow the trail back to him.

“Why hadn’t anyone looked at these videos before you?”

“Why should they have? People die in hospitals every day. There was nothing overtly, um,
nefarious
about the way Mr. Bernard or the patient with the air embolism died, certainly nothing that would have raised Security’s suspicions enough to retrieve the video from the server and analyze it.”

“But—what about Mrs. Samuelson? What about her video?”

“Ah. Yes. Mrs. Samuelson. We have Luis to thank for that.”

“
Luis?
”

“As you probably know, the video surveillance system in the SICU uses an encrypted wireless network to transmit its images to a University Hospital server. Before he died, Luis had tapped directly into the wireless network and was downloading copies of the original videos.”

A brilliant maneuver on Luis’s part. The router for the videos was sitting behind the poster of the kitten in the call room, next to the plastic baggie with the computer password. It was connected to an ample power source and remotely linked to the Internet. “The difference between you and Luis was that while you inserted an altered version onto University Hospital’s server—a very sophisticated one, I might add, so kudos for that—Luis stored the original, unedited version on a hijacked server overseas.” It was a decent-sized cache of data, sitting beyond that twenty-character code on the Web site in Eastern Europe—ten days’ worth of continuously accumulated, twenty-four/seven digital footage from all those different cameras. But everything was dated and time-stamped, so finding the relevant image of Mrs. Samuelson hadn’t been too difficult.

She laughs. Is it my imagination, or is it laced with just the faintest whiff of uncertainty? Uncertainty on her part would have been unthinkable only a few short minutes ago. “It doesn’t matter. You’ll never use those videos, Steve.”

“Why?”

“I still have my own video. Remember? The one that shows you
fucking
”—her use of, and emphasis on, that particular vulgarism is unexpectedly jarring—“a woman who just happens not to be your wife.”

“I told Sally, GG. About us.”

The curve of her smile flattens ever so slightly as she spends the next several seconds studying my face. I will my eyes to remain locked with hers. It’s an intense experience, kind of like trying to stare into the sun. “Why?”

“Because it was the right thing to do.” Because I owed Sally that much and had realized that, otherwise, things would never have been right between us again.

Her mouth forms an unabashed
O
of surprise. I don’t think I’ve ever seen her genuinely caught off guard before. I gaze calmly back, straining to keep my expression perfectly neutral, glad for the air-conditioning vent in the ceiling directly over my head that’s the only thing preventing my brow from becoming slick with sweat.

Then she throws back her head and laughs, long and loud.

“Nicely played, Steve. Nicely played. You took it all the way to the brink, and I blinked. You know, you really don’t see it, do you? How much alike you and I are?” She shakes her head, and adds with a touch of regret, “That’s why I find you so appealing, Steve. Why I still think we would make such a great team.”