Oath of Office
To Aunt Shirley Rabinowitz, and in loving memory of Aunt Bea
and
To Robin for her laughter, loyalty, and love
ACKNOWLEDGMENTS
Once again, my deepest gratitude goes to Jennifer Enderlin, my remarkable editor at St. Martin’s Press, as well as the rest of the gang at SMP, especially Matthew Shear, Sally Richardson, Matt Baldacci, and Rachel Ekstrom.
As with all of my books, agents Meg Ruley, Jane Berkey, and Peggy Gordijn of the Jane Rotrosen Agency have been guiding lights.
When my research needed more, I was lucky to have advice from author Jeffrey M. Smith, Dr. James Gerber, agronomist Aaron J. Lorenz, railroad man Michael Sypulsky, geologist Dan Delea, neurologist Dr. David Grass, author Daniel Palmer, USFS diplomat Matthew Palmer, scholar Luke Palmer, and chef Bill Collins.
And finally, extra-special thanks to ER doc Catherine B. Cuotalow, M.D., Ph.D.
A scientist knew of a species of Arctic flounder that was resistant to freezing in cold temperatures. He wanted his tomatoes to resist cold temperatures so they wouldn’t die in frost. The scientist didn’t have to wait for the unlikely event of the fish mating with the tomato. Instead, he figured out which gene in the fish keeps it from freezing and then inserted that gene into the tomato’s DNA. The anti-freeze gene has never ever, ever existed before in a tomato. But now it’s in the scientist’s tomatoes and all their future offspring.
Jeffrey M. Smith,
Seeds of Deception
CONTENTS
PROLOGUE
I’m finished.
I can’t believe this has happened again. I just blew up at one of my patients. The last time, when I screamed at Calvin Summers for continuing to smoke despite a massive heart attack, my medical license was suspended for six months, and I had to go away for treatment. The board of medicine said there was no excuse for that kind of behavior from a doctor, no matter how pure my motives.
Now it’s Roberta Jennings. She just stormed out, shouting at me that she was not going to tolerate that kind of abuse, and that she was going to contact the board as soon as she got home. My office staff heard her. The patients in the waiting room heard her.
What am I going to do?
I’m alone. On the wall, beautifully matted and framed by Carolyn, is the signed Hippocratic oath—my oath of office, pledging kindness and compassion to all my patients.
What in the hell have I done?
Jennings’s tires just screeched on the pavement as she sped out of the parking lot. I can picture her at the wheel, her face all flushed and angry.
The door to the hallway is closed. I can’t simply sit here like a lamb waiting to be dragged to the slaughter, especially when I didn’t do anything that wrong. I love my patients, but there’s not a chance in the world the board of medicine would understand that. They won’t care that Roberta Jennings is eating herself to death.
Hypertension … type 2 diabetes … ankle edema … varicose veins … arthritic knees … hiatal hernia … carbon dioxide narcosis …
They won’t know how many times I begged her to change—how many diets, how many referrals, how many discussions. They won’t see that I had every right to scream at her the way I did. They won’t care that I have been at work for hours, seeing my patients in the hospital, which no other docs even do, attending medical rounds, doing paperwork. I haven’t even had lunch. I have to do something to save myself—to save my career.
I gaze at two pictures of my family on the corner of my desk. My favorite is the one taken in springtime—Carolyn and our three daughters, huddled together on our front porch swing. The girls are raven-haired beauties, just like their mother. The milkman’s kids, I’d often half joke, because they didn’t look much like me. The other picture is of Chloe, my youngest. I know I’m not supposed to have a favorite child, so it feels horrible to admit to myself that I do.
Must do something.
Everything I’ve worked so hard for is in danger. My breathing is coming hard—shallow and more rapid. It’s like I’m trying to suck in molasses. I know exactly what’s going on inside me. Chemical signals from the amygdala area of my brain are instructing my heart to beat faster. Adrenaline is being pumped into my bloodstream like rocket fuel.
Witnesses.
Everyone out there is a witness to what happened. They will all be called before the board. That would be the end. A lamb to the slaughter. I must do something to prevent them. I don’t remember unlocking my desk drawer and bringing out my pistol. It’s still in the locked box I put it in when Joe Perry’s office was held up last year.
Now, it’s here in my hand.
I release the safety. Everyone out there in the waiting room will testify as to what they heard. And that’s all it will take to finish me off. Nobody cares about my patients the way that I do.
Can’t believe this happened.… What choices do I have? How else can I save my career … my family?
People heard. It would be their word against mine. He said/they said. The board would never pull a doctor’s license on a flimsy claim like that—especially one as dedicated to his patients as I am. Or would they?
Must do what’s fair.
No witnesses.
I open my office door and step out into the hallway. The fluorescent overhead lights are hurting my eyes. With the pistol hanging at my side, I head down the corridor into our newly furnished patient waiting area. My heart is pounding against my sternum. Blood is churning in my ears. The room has begun to spin.
I wish there were another way.
Two women are in the waiting area—Margaret Dempsey and Allison Roundtree. They both look restless, disturbed by what they heard. I wonder if they were talking about just leaving—deserting my practice and transferring their records to another doctor—probably to my partner, Carl.
Sunlight in the foyer is illuminating dust motes circling in the air. Small details, yet so clear. I double-check that I’ve got two additional clips tucked inside the pocket of my white coat.
“No witnesses!” I cry out.
Ashley is sitting behind the reception counter, looking distressed. The new nurse, Crystal, is behind her. Ashley is thirty. Two kids. Her glasses hang over her breasts, suspended by a gold lanyard that sparkles against her tight-fitting black sweater.
Details.
There is no other way. I need to protect my career.
For a moment I feel uncertain … confused. Then my resolve returns. Must act before they see the gun.
I raise it in front of me.
I’m doing this for us, Carolyn. It’s the only way to save the children—to save you and our way of life. Any doctor threatened like I am would handle things the same way. The first shot explodes in my ears. The gun recoils. I fire again and again and again. There is blood everywhere.
Glass shatters.
Ashley looks up at me wide-eyed.
I shoot her in the forehead. She flies backwards and lands on top of Crystal. I feel calm now. In control. I’m a doctor, and I always will be. I begged her to lose weight. I had every right to yell at her. In fact, I didn’t even really yell—just raised my voice a little. I walk with determination back down the hallway and turn toward our tiny kitchen. Teresa and Camille are there. They were undoubtedly discussing what to do about me when they heard the shots. Now they are on their feet, screaming.
“No witnesses!” I shout again and again. “No witnesses!”
My office manager tries to speak, but I can’t make out what she’s saying. My finger tightens, then loosens, then tightens again. The pistol spits fire. Teresa is hit in the throat, Camille in the chest. The women crumble like rag dolls. Camille tries to get up. A shot to the back of her head settles her down. I replace the clip.
Almost done.
Back to the hall. Carl Franklin is in his office. He may not have heard what went on with Roberta, but maybe he did. Carl was never much of a doctor to begin with. He’ll probably be ecstatic when they pull my license and tell him to take over my patients because I’m never going to be allowed to be a doctor again.
His office door swings open just as I arrive. Two feet separate us. I can smell his fear. For a moment, I hesitate. I can’t get my brain around things. My thoughts are without focus. Is he going to be a witness or isn’t he?
“John, what in the hell—?” Carl cries.
I empty the entire clip into his chest and face. His blood splatters over me. Fragments of his bone cut into my skin. I want to tell him it’s all Roberta Jennings’s fault, but it’s too late. I slump against the wall, breathing heavily. They never would have understood. They never would have cared how much being a doctor meant to me.
All at once, I stop.
My God, I’ve done something very bad. Now the board of medicine will be hard-pressed to let me keep my license at all. I’ve made a terrible mess of everything. I replace the clip a final time. Then I close my eyes and press the muzzle of the gun to the side of my temple. I picture Chloe in my mind. I’m going to miss her most of all.
Wondering how it all unraveled so quickly, I pull the trigger.
CHAPTER 1
One hour down. Three hours to go.
The afternoon was turning out just as Lou had hoped it would. Enough traffic through the ER to keep things from being boring for Emily, but nothing that would leave her with a lifetime of nightmares and therapy bills. Not that the teen wouldn’t be able to handle just about anything that came down the pike. But in an inner city emergency room—even a small satellite facility like the Eisenhower Memorial Hospital Annex, the pike, on occasion, might be carrying violence of the highest order.
“Okay, Em, Mr. Schultz is being a perfect patient. Ten stitches and not a peep out of him. Two more and we’ll get him bandaged, up, and home.”
“Thank you, Doc,” the man beneath the saucer-shaped light said in a raspy voice that could have cut stone. “I didn’t feel a thing. Your dad does great work, miss.”
“Thank you. I know,” Emily replied. “He loves sewing my jeans when they tear, and he was always stitching up my stuffed animals, even when they weren’t ripped.”
“My son’s school has Take Your Kid to Work Day, just like yours,” Schultz said, “but I’m a roofer. Three stories up with the wind blowing doesn’t seem like a great place for a nine-year-old, so Marky went to the nursing home with my wife and helped her put the trays together. What does your mom do, miss?”
“My name’s Emily, Mr. Schultz,” she reminded him. “Emily Welcome. My mom’s a psychologist. Mostly couples therapy. She didn’t think her patients would enjoy having her thirteen-year-old kid sitting in on their sessions.”
“I can see why she might feel that way.”
“But for a second choice,” Lou said, tying off the final stitch, “I believe Mom might have chosen to send Emily up on the roof with you, rather than into this place.”
In fact, the first argument he and Renee had gotten into in months was about her belief that there had to be a rule against bringing a doctor’s family member into an emergency room—even one with only three nurses, a licensed nurse’s aide, an armed security guard, a receptionist, one ER resident, and one board-certified emergency specialist. The Annex essentially served as a walk-in center to reduce the volume of the massive mother ship, just six blocks away.
“Let me send her into the office with Steve,” Renee had pleaded.
“Steve’s not her father. I am. Besides, how interesting could it be for her to hang out surrounded by a bunch of starched shirts and musty law tomes? I can hear her now reporting to her class: ‘I spent my day with my mother’s new husband, Steve, watching him making piles of money off a bunch of unfortunates who are suing a bunch of other unfortunates. Or you might as well send her to my brother’s office. Graham does even better at making money than Steve. Plus it might actually give him something to talk to me about besides my lack of a 401(k).’”