Do No Harm (19 page)

Yale regarded David with contempt. "I don't give guarantees." He walked away, leaving David and his proffered handshake behind.

When David stepped out of the ambulance bay, a man with slicked-back hair and a florid madras shirt confronted him, readying a notebook and sliding a pen from behind his ear. "Hear you're having some problems with your staff."

"Who are--? No. Everything's fine."

David kept walking, but the reporter followed him, hovering off his elbow. He held up his notebook and declaimed, "Sources inside the hospital indicate that there are growing tensions between Division Chief David Spier, members of his own staff, and the police."

"Please," David said. "Not now."

"I can make you look better if you talk."

"You can make yourself look better if you change your shirt."

The man pulled to a halt, grinning. David was happy to leave him behind. He paused on the dirt path near the PCHS structure. A small blue puddle continued seeping into the ground near one of the trees, and David recognized the few surrounding shards as Pyrex. The kicked-up dirt betrayed the recent struggle between Clyde and the officers. The area was partitioned off with yellow police tape.

Just ahead, a police car idled at the curb on Le Conte. As David drew near, Bronner exited the passenger side, heading across the street toward a coffee shop, picking up his feet in a heavy jog. Jenkins sat behind the wheel, flipping through some fliers with grainy black-and-white photos.

David leaned toward the open passenger window, hands on the sill, his position and the painted Ford LTD making him feel, ridiculously, like a prostitute. "Excuse me."

Jenkins did not look up. "Dr. Spier," he said.

"Mind if I . . . ?" David gestured to the passenger seat.

Still no eye contact. Jenkins jotted something in his pad. "You can sit in the back."

After a moment's hesitation, David opened the rear door and climbed in. The backseat was composed of a solid plastic mold, with no cracks into which suspects could stuff drugs or weapons. A crime alert flier sat on one side, a displeased African American male with FUCK LAPD tattooed across his forehead peering out from the fuzzy photo. David scooted across to the middle and viewed the back of Jenkins's head through the protective Plexiglas shield that separated the front and back seats.

Jenkins had been kind enough to leave the small window open in the Plexiglas shield. A strip of his face peered at David from the rearview mirror, but David could not make out his eyes through his Oakley blades.

"The ICU nurse told me you've had a rough time going in to see your sister, so I wanted to let you know she's making good progress. The skin grafts are taking so far, and plastics is feeling quite confident. She fought off an internal infection pretty well, and--"

"Something tells me you didn't come all the way out here to talk about my sister." Jenkins's voice, deep and resonant, betrayed little emotion.

David realized just how claustrophobic the backseat of a cop car was. The strip of Jenkins's face remained perfectly centered in the rearview mirror. He had mastered silence as a weapon, and David found it a powerful one.

He wasn't sure how to find the balance between condescension and communication. "What happened to your sister was horrible. And I know . . . and if there's anything I can ever do . . . But the patient is a--"

"Patient," Jenkins sneered.

"The suspect is a very sick man. Disturbed."

"Sick enough to wear a fake tattoo to throw off our investigation? Sick enough to use surgical gloves because they leave a less distinctive print than leather gloves? Don't buy the dummy routine, Doctor. Our boy's pretty clever for someone sick in the head."

"People can be smart and still be unbalanced. Imagine how ill you'd have to be to do the kinds of things he's done."

"That doesn't interest me."

"Even if this guy is guilty, he's still got rights. You don't want to give his future attorney any ammunition against the DA, do you?"

Jenkins shifted in his seat and then finally turned his head. David stared back at his own distorted reflection in the broad band of Jenkins's sunglasses. "My sister is blind. She has to barf up into napkins for the rest of her life. Dead skin falls off her face in gray patches. And you're more concerned about the guy who did it."

Across the street, Bronner emerged from the shop, holding two cups of steaming coffee.

"I'm extremely concerned about Nancy. But she isn't my patient anymore. The suspect is."

"Then go back to the hospital and take care of him so we can take him off your hands."

David slid toward the door on the hard plastic seat. "I can't," he said sheepishly.

"Why not?"

"The door handle won't work."

HER careful arrangement of designer-styled, blond-highlighted hair bounced as she leaned back on the gurney. Her hand, set aglitter by deep maroon fingernails, clutched a cell phone to her ear. Her lips stretched full and amorphous, blown out of proportion by collagen injections. Dark eyeshadow filled the hollows beneath her eyes, where long-vanished tears had deposited it.

"Oh yes," she said into the phone, in a socialite's singsong cadence, "it's been awful. I tried to kill myself this morning. . . . Um-hmm. Prozac, codeine, and a bad Bordeaux. Threw it all up by the time the paramedics arrived. You'll never believe where they brought me. The UCLA emergency room. I was terrified. Thought I'd get doused with alkali on my way through the doors." She picked at a cuticle. "What's that, darling?" She glanced up at the resident at the bed beside hers, drawing blood from another woman. "One of them is, I suppose, in a Billy Baldwin sort of way."

Carson looked up from his chart and nudged David. "Welcome to West LA."

"Think compassion, Dr. Donalds. Where else do you think a lonely, depressed woman could get this much attention?"

"On Jerry Springer."

David coughed to cover his smile.

Dashiell Nwankwa suddenly filled the wide doorway to Exam Ten. "You rang?" he asked, his booming voice causing Carson to drop the chart he was holding. David walked over to greet Dash as Carson crouched to gather the scattered papers.

Dash had to duck slightly to get through the doorway. At 6'8", 280 pounds, Dash's was an imposing presence. His face, so dark it diffusely reflected the lights of the room, was partly blocked by an overflow of thick-braided dreadlocks. Like most psychiatrists, he wore a dress shirt and tie, but during medical school he'd had to slit the already-wide sleeves of his scrub tops a good two inches to get his arms through.

Dash's appearance was so remarkable that several psychiatry programs had rejected him on that basis, claiming it would compromise his ability to interact with patients and put them at ease. After he failed to match in a fellowship program, Dash sued each of them in a widely publicized series of cases, winning admission to each department. The cases were decided in large part by his near-perfect grades through Columbia Medical School, and his excellent recommendations. The chair of UCLA's psych department had stepped in early in the proceedings and offered him a spot, and though he had not originally applied to UCLA, he'd elected to sign on. His performance through the four-year program had been so impressive that he'd been offered a teaching position immediately afterward, and he'd quickly become a prominent member of the department.

He was also a favored expert witness for the defense. He looked tough but spoke convincingly about mental illness--a good combination for winning the jury's trust. Most expert psych witnesses, thin-necked and bespectacled, were quickly painted as wimps soft on crime. Because of Dash's experience with violent patients and criminals, he'd been David's first choice to assess Clyde.

"What do we have here?" Dash's voice, so deep it found resonance in David's bones, was mitigated with a musical lilt--the faintest whisper of a Nigerian accent. He glanced over at the woman on the bed behind David and Carson, who continued to chat on the cell phone. "Suicide attempt?"

"How'd you guess?" Carson said.

"Carson, why don't you take over," David said. "Dash, our guy is in Fourteen."

As they moved toward the door, the woman's purse, just beyond her reach on a metal tray, began to vibrate.

"Is that your pager?" Carson asked, reaching into the purse. The woman froze, silent for the first time, her mouth a lipsticked O near the phone's receiver.

Carson withdrew an eight-inch vibrator and stared at it, mortified. Dash's laughter, even choked down, made the light casings rattle overhead.

As they reached the end of Hallway One, David shot a nervous glance at the two officers guarding the door to Clyde's room. He turned to Dash, lowering his voice. "It was all I could do to slide you past the cops. Everyone's on edge. Anyone asks, you're assessing his need for antipsychotic meds."

"Got it."

"And keep tight-lipped. Some tabloid schmuck faked a concussion this afternoon just to get in here and poke around."

David breathed evenly and deeply as he approached the room, gathering himself. His stomach churned, a morass of yet-unidentified emotions--fear, anxiety, duty of some ill-defined sort. Anger was in there as well, he realized, in no small amount.

He nodded to the officers and paused for a moment, hand on the doorknob, searching for compassion. He fought past Nancy's face, and Sandra's, past the blue liquid that burned and ate flesh, past the disgust that caked the edges of his perception--the disgust that sprang, innate and full-formed, when he pictured Clyde's acne-scarred face. When he turned the doorknob, he felt calmer, more detached.

He was ready to see his patient.

He swung the door open quietly, and he and Dash entered. Clyde lay on the gurney, bound, eyes closed, drawing deep breaths. David and Dash approached him and stood a few feet back from the gurney rail. "Hello, Clyde. It's Dr. Spier again."

"Spier," Clyde murmured. "Like the building."

"Yes, but spelled differently. I'm here with Dr. Nwankwa from the Neuropsychiatric Insti--"

Clyde's eyes opened, a ripple of terror transforming his features from placid to violently agitated. He screamed, straining with his limbs against the restraints, bucking and thrashing. Dash calmly took a step back and signaled David to do the same.

"You said!" Clyde bellowed. "You said you'd help me!"

"I'm trying to," David said.

Clyde's frantic eyes flickered to Dash. "Get him away."

"Dr. Nwankwa is here to help y--"

"Get him away!"

Dash took another calm step back and sat down in a chair against the far wall. Clyde stopped thrashing and lay flat on the gurney, his chest heaving.

"Don't let him near me," Clyde said. He tucked his chin to his chest, hunching his shoulders, his eyes turned to the wall.

"I won't come near you," Dash said softly. "I'm just going to sit right here."

Clyde flopped over, his eyes darting to David and then quickly away. "Where were you? You went away. You said you would help me, but you didn't. Why is he still here? Have him go away. You said he would--"

"Dr. Nwankwa is here to try to help you. There are just a few--"

With renewed strength, Clyde thrust his torso at the ceiling, his arms bent back like wings. "Don't let him near me!" Veins stood out on his neck as he let forth a forceful, lengthy scream. His entire body strained. David waited for him to stop to catch his breath, but he only sucked in air and screamed again. His eyes were scrunched shut; his face was turning red.

Dash rose and stepped forward, touching David on the shoulder. He had to put his mouth to David's ear for David to hear him over Clyde's continuous, wavering scream. "I don't think we'll make much headway now." He tilted his head, indicating the door, and David followed him out. The officers outside regarded them with raised eyebrows.

Dash and David walked silently down the hall and into the empty doctors' lounge. David closed the door behind them. Dash sat heavily on one of the couches, resting his hands on his knees, and David took a seat opposite him.

David said, "Maybe he's got an aversion to psychiatrists."

"Or to black people," Dash said. "I got that reaction in a Denny's once."

David laughed. "Maybe it is race-based. But if we assume he's venting some hostility toward the hospital or its employees with his attacks, it's also relevant to see which staff members agitate him the most. He was largely cooperative with the ER staff--the first real fear and anger I've seen from him was directed toward you."

Dash pushed his fingertips together, musing. "He's too agitated right now for me to push him. It's unfortunate we don't have the luxury--or the opportunity--to wait for him to settle a bit so I can attempt a prolonged interview or formal assessment."

"Any guesses?"

"Obviously, I can't glean much from that little exchange, on top of which the environment is less than conducive to interpreting his behavior, but I'll throw around a few hypotheses if you promise not to quote me." Dash settled back on the couch. "Deterioration of hygiene could indicate depression or schizophrenia, and means he's probably not well assimilated into a peer environment. Low-set ears might be a red flag for developmental problems or might not--at some point, one might check for spacing between his first and second toes. He seems to be fixated on you."