Doing Harm (21 page)

“And anyway, who would ever believe you? What are you going to tell people? That some psychotic med student is running around the hospital killing patients? Come
on.
Listen to the way that sounds. People would think you were crazy.”

She takes out her smartphone, touches the screen, and hands it to me. “All the same, though, I’m not the kind of person who likes to take chances.”

The video images playing out on the screen are clear and irrefutable. Perfectly positioned on the bedside table of the call room, her smart phone captured every vivid detail of our intimate rendezvous of last night with what looks to be some kind of slick, wide-angle lens camera app. Even the kitten on the clothesline is clearly visible in the background. All dated and time-stamped with a running clock in a corner of the screen.

“Here,” she says, reaching over and turning up the volume. “You don’t want to miss the best part.”

First there’s her screaming, which I’m startled to realize doesn’t sound nearly as sexy on the video as it did last night. In fact, it’s tough to tell whether she’s enjoying the experience or yelping in pain. But what follows is even worse.

So, do I get that ‘A’ now, or what?

Yeah, I think you earned it.

What do I have to do for extra credit?

I’ll try to come up with some, uh, extra assignments for you.

Cold sweat erupts across my forehead.

“I know,” she says. “The dean of the medical school, and the hospital lawyers, would hate to deal with another high-profile sexual harassment case.” She pauses, then adds softly, “And then, of course, there’s Sally.”

“Don’t say her name.” It’s like listening to rough fingernails scrape across a blackboard, hearing Sally’s name coming out of her mouth.

“Suit yourself. But, after last night, a little late for righteous indignation on your part. Don’t you think?”

I ignore her and stare at the phone. I’m seized by an impulse to run away with it.

But GG is one step ahead. “I’ve already downloaded the video, obviously. And selectively edited it for content.”

The words “utterly defeated” don’t even begin to describe the way I’m feeling right now. I resignedly place the phone in her outstretched palm.

“Why me?” I ask. My voice sounds tiny and insignificant.

She regards me with something approaching sympathy.

“Opportunity, Steve,” she says, not unkindly. “Pure and simple. Before I’d met you, I’d already decided that I was going to kill a patient using potassium. I was waiting for the right opportunity. I needed the right combination of factors to allow me to accomplish my goal. Unfortunately for you, you unwittingly provided me with them.” She ticks them off on her fingers, one by one. “Access to your ERIN account. Mr. Bernard’s Cefotetan-induced renal failure. The potassium order in the TPN. Your mishap in the OR with Mrs. Samuelson, which distracted you and Luis long enough for me to inject the potassium.

“So now you know the how. Which brings us to the other important question: the why. Why did I kill Mr. Bernard?” She licks her lips. “Do you want to know?”

I nod. It takes a surprising amount of effort. My head feels as heavy as lead.

“To serve a greater purpose.”

“Which is?” I ask dully.

“To make hospitals safer.”

“
What?
”

“Each year in this country nearly one hundred thousand patients die in hospitals from medical mistakes. Needlessly. That’s the equivalent of a jumbo jet crashing every single day for a year with everyone on board dying. It’s inelegant. Perverse.”

“Perverse. Inelegant.” Interesting word choices for her in this particular situation. “Okay—so, what has that got to do with Mr. Bernard?”

“We engineer systems that keep jumbo jets from crashing. Why can’t we do the same with hospitals? Mr. Bernard is the first step. You told me yourself: The potassium overdose forced University Hospital into reengineering a dangerously outdated pharmacy system. Think how many more deaths Mr. Bernard’s sacrifice will prevent.”

The absurdity of this conversation is growing exponentially by the second. “Let me get this straight—you killed Mr. Bernard and made it look like an accident to … make University Hospital safer for patients?”

“Absolutely. And not just University Hospital. All hospitals, eventually. The Safety Committee loves my ideas.”

I blink, hard, at the mention of the committee.

“Don’t look so surprised,” she says. “I’ve been involved with it since my first year of med school.” She leans forward, her face shining with excitement. “I’m going to change things. Change the world.”

I’m about to answer when one of our senior professors, a gregarious, beefy man with a bright red face offset by a shock of snow-white hair, appears at our table holding a doughnut. GG literally jumps out of her seat to greet him. I remain seated, too anesthetized by what’s been happening to think of doing much else.

The professor vigorously pumps GG’s hand, his eyes twinkling with grandfatherly affection.

“I’ve seen a lot of good medical students in my day, Steve,” he beams, directing his considerable girth in my direction and winking. “A lot. And GG here is one of the best, if not
the
best.”

GG blushes. She actually
blushes.
Blushes! Right on cue.
Amazing.

“Thank you, sir,” GG murmurs bashfully. “Coming from you, that really means a lot to me.”

“It had better,” he booms. “Keep an eye on this one, Steve. She’s going to be famous one day.”

I mumble a halfhearted response into my coffee.

GG sits back down and, smiling vacantly, watches the professor amble away.

“Think about it,” she says thoughtfully, once he’s out of sight. “People can go through their entire lives without needing a lawyer. Or an accountant. Or a stockbroker. But everybody,
everybody,
needs a doctor. That’s power, Steve.
That’s
how you change the world.”

She stares over my shoulder again, unblinking, as if in a trance. The peaceful, dreamlike look on her face is eerie. Having finally shared her story with someone else, she looks perversely satiated, and I half expect her to reach into her pocket for a cigarette.

“No,” I sputter with as much resolve as I can muster. “You’re wrong. I didn’t become a doctor to have power. I just want to help people.”

She looks momentarily surprised. And then she laughs.

“You don’t care about making people feel better. You became a surgeon because you love surgery. For you, the patients are a means to an end. They’re a drug that fuels the high you get from operating. In the end, it’s still all about the power. It’s all about you. You and I really aren’t so different.”

Maybe as some kind of mental safety feature—like an automatic reflex of my brain that unconsciously kicks in to shield my psyche from these bizarre body blows and keep me from completely losing my hold on reality—my medical training takes over, and I find myself remembering back to my psychiatry lectures on psychopaths and start ticking off the list of characteristics.

They’re pathologically deceitful.

Check
.

They show complete lack of remorse for their actions.

Check
.

They demonstrate a reckless disregard for the safety of themselves or others.

One big (and rather ironic, given her twisted career goals) check
.

I don’t bother to run the whole list, since she’s already three for three for the first three criteria that pop into my head.

GG is watching me shrewdly. “I know what you’re thinking. You’re thinking that I’m a psychopath. Such an ugly word. And so simplistic. Okay, sure, I might fall somewhere along the antisocial-personality-disorder spectrum. But I want to
fix
things. I’m one of the good guys.”

“I doubt Mr. Bernard would agree.”

“If he knew what his death had achieved, he’d be grateful for being a part of it.”

“Grateful!” She really
is
crazy. “This can’t be happening. This
cannot
be happening.” I close my eyes and put my head in my hands. Ten minutes ago, I thought my life couldn’t get any worse. But now I find myself pining for the relatively simple, straightforward dilemmas posed by an extramarital affair and a few bad career moves.

She leans across the table, pushes our coffee cups aside, and grasps both my hands in hers. I jerk my head up and recoil. She maintains a gentle but firm hold on my hands. I check our surroundings. The cafeteria is almost completely empty. Aside from an exhausted-looking nurse hunched over a newspaper and a janitor emptying a trash bin, we’re completely alone. Neither one of them is paying any attention to us.

She tilts her head in toward mine and speaks in a low, soothing voice. “Shhh. It’s okay. Shhh. You and I are more alike than you might think.” Her breath is warm on my face and smells like peppermint mixed with French roast coffee. “When I first met you, I saw you as nothing more than a means to an end. But then you started to grow on me. I wasn’t lying last night when I told you that I liked you. Your ability to focus—to concentrate on an operation without worrying about what might happen to the patient—is amazing. It’s … a turn-on, actually. I wish I’d been there to see you take on Mrs. Samuelson’s tumor. You almost pulled it off on your own.”

She strokes my hands. “You know, we’d make a great team. Help me with the next part of my project. I can help your career. Not to mention the … fringe benefits.” She slips one of her shoes off and begins to run her foot up the inside of my leg.

I regain some semblance of my senses and shove her away, a bit more roughly than I’d intended. “No!”

The commotion attracts the attention of the tired nurse, who gives us a curious once-over with her red-rimmed eyes before returning to her paper.

GG nonchalantly leans back, shrugs, and carefully straightens out her ponytail.

“Too bad.” She rests her hand on her right chin, places her right elbow on the table, and gazes at me tranquilly. Several uncomfortable minutes tick by.

Help me with the next part of my project.

“What did you mean?” I finally ask. “About helping you? With your project?”

“Hmmmm?” she responds dreamily without taking her eyes off me.

“You asked me if I wanted to help you with your project.”

“Yes.”

“What did you mean? What project?”

“Why do you care? You already told me you weren’t interested.” She starts stroking her ponytail. Her mouth unfurls into a sly grin.

“What did you mean?” I persist.

She looks up at the ceiling, grinning.

“Yes. Why not?” she says to the ceiling. “Let’s make things more interesting. Mr. Bernard was way too easy. I need a challenge. So why not?”

Her eyes drift back down to me. “Mr. Bernard was a start. But there are more problems in University Hospital. And Mr. Bernard has taught me how to fix them. Another patient is going to die. Like Mr. Bernard, it will be from a completely preventable medical mistake.” She pauses. “I dare you to try to stop me, Steve.”

I frown. “I don’t understand.”

“Think of it as a game.”

“A
game
?”

“You predict who’s going to die, then prevent them from dying. If you win, the patient lives, and there won’t be any more accidental patient deaths involving me.”

“And if I lose?”

“The patient dies.” She smirks and strokes her ponytail. “And then you and I pick up again where we left off last night. Until I say it’s over between us.”

I laugh, in spite of all this craziness. “Right. Or else?”

“Or I show that video to Sally.”

I wince.

“Steve.” She pretends to pout. “Don’t you realize how many guys around here want to sleep with me? And I’ve picked
you.
”

Hooray for me.
“And if I don’t want to …
play
?”

“Another patient dies. Followed by more.” She stretches her arms, like a cat unwinding from sleep. “Anyway. I promise that the patient won’t die until the last week of my rotation. Right before the next Morbidity and Mortality conference.”

I count the days in my head. “That’s two weeks away.”

“Exactly. Plenty of time for you to work things out. And then, right after Morbidity and Mortality conference, we’ll meet face-to-face to discuss the results. In the Dome. Fair enough?” She stands up without waiting for an answer. “I need to get going. Oh, and I don’t think I should go upstairs and put those orders in ERIN. As you pointed out, med students can’t enter medication orders.”

She bends down and places her lips to my ear. Her ponytail tickles my neck.

“One last thing,” she whispers seductively. “About our
game.
It’s for you. Only you. Asking for help will earn you a penalty.”

“A penalty? What kind of penalty?”

But she’s already gone, sauntering toward the exit with that unshakable confidence of hers.

I stare into my half-empty coffee cup, considering my options.

It doesn’t take too long. I don’t have any.

GG’s right, of course. Nobody would ever believe me. How could they? I’m not sure I believe it myself. I have no evidence and even less credibility. Even if I were crazy enough to try to tell someone, they’d think I was making up some ridiculous story about a med student just to save my own skin.

And, of course, there’s that video …

As for her dare—well, let’s face it, the only reason why GG even bothered to throw down a gauntlet is that she knows I won’t pick it up. The thought of playing her game, of trying to prevent her from killing again, seems even more ludicrous than telling other people about what’s been going on.

I can’t tell anyone that she killed Mr. Bernard.

I can’t stop her from killing again.

Ergo, I’m screwed.

She’s a great med student all right, I grimly reflect as my cell phone hums with a text from Sally, reminding me about the barbecue this afternoon.

I think nobody really realizes just how good GG really is.