Doing Harm (28 page)

He’s just as I remember him.

He’s waiting for me, tensed and ready to pounce, sitting perfectly erect in a chair opposite the door, back straight, both feet on the floor, his lanky, gaunt frame unbent by his ninety-odd years, his gray eyes bright and cold and hard as granite. His nose, broken God knows how long ago or how many times, juts off at an odd angle from his long and skeletal face. His tired skin hangs limply from his jaw and neck, reaching toward the floor like the saggy paunch of an elephant at the zoo; age spots and scars dot the generous expanse of bald palate stretching between the few remaining tufts of wispy white hair. Even though it’s ninety degrees and as humid as a tropical jungle outside, he’s wearing thick brown corduroy pants and a frayed long-sleeve flannel shirt buttoned all the way up. A city bus pass nestled in a clear plastic carrier dangles from a strap around his neck.

His eyes narrow as I walk through the door, and he scowls. I’ve never really seen him do much of anything else in terms of facial expressions, but the one he greets me with today is particularly unpleasant.

“Hi, Mr. Abernathy. How are you?”

“Screw you, Doctor. You know how long I’ve been waiting?”

“Good to see you too again, sir.” I drop heavily onto a rolling stool opposite his chair.

“Don’t you get smart with me, sonny.” He vigorously shakes a long, wraithlike finger at me. “I killed Japs in the Pacific for smart-mouthed little shits like you. I watched my platoon buddies get blown to all hell on Iwo Jima. I took a bullet in the belly thirty-five years before you were even born. So don’t you go getting smart with me. You and your goddamned smart mouth.” Then follows an impressive string of expletives, sprinkled intermittently with the words “Iwo Jima,” and punctuated liberally by bony flourishes of his extended index finger.

I wait, with a mixture of resignation and self-pity, for him to finish. Some days it’s Guadalcanal, others Okinawa. Today it’s Iwo Jima.

Eventually he stops midsentence, retracts his finger, folds his arms, looks down at his lap, mumbles something I can’t hear (nor really want to), then looks up again at me expectantly.

“What can I do for you today, Mr. Abernathy?”

“You can start by goddamn telling me what kind of goddamn pills your quack friends gave me the last time I was here.”

I check the clinic notes on the computer screen sitting on the table in front of me, which is currently displaying Mr. Abernathy’s electronic patient information. “Ahh, that would be finasteride, sir,” I say, scanning Luis’s note from the previous week’s visit. A very reasonable choice, in my opinion. “It’s a pill to shrink your prostate and hopefully keep you from getting up ten times a night to pee.”

“Those goddamn pills gave me the shits.”

“Hmmm. I haven’t heard of that particular side effect before, Mr. Abernathy.”

“Well, then, you’ve goddamned heard it now. I’ve been squatting on the goddamned shitter all day and all night since I started those goddamned things last week. And they haven’t made me piss any better.”

I grind my teeth together.

“Those pills take at least three months to start working, Mr. Abernathy. And even then, they’re not going to help you pass your water as well as the last pill we gave you—the one that you didn’t want to take anymore. Besides, you don’t even know if it’s the finasteride that’s giving you the intestine problem. It’s probably something else, like a stomach bug. Have you talked to your family doctor?”

“Yeah, I called her.”

“What did she say?”

“She told me to talk to you.”

“Of course she did.”

“Besides, I know it’s those goddamned pills, ’cause when I missed a day, I stopped shitting. I’m not waiting three months. Especially with these shits the way they are. I want you to do something now. Can’t you give me something else?”

“Well, I can give you the pill that we tried before this one. The one you decided to stop taking.”

“Which one was that?”

“It’s called tamsulosin.”

“Is that the one that made my eyes all blurry?”

“No, that was the pill you tried before the tamsulosin. You told us that the tamsulosin made you sweat.”

“Oh yeah. That goddamned sweating. Almost forgot about that. I was soaking my goddamned sheets for three weeks. Ya got something else then, Doc?”

I sigh. “We’ve already tried just about everything else, Mr. Abernathy. The only thing I can offer you now is the surgery.” I don’t bother to remind him that we’ve been recommending surgery for his condition for the last several years.

“Ohhh, no. No you don’t.” He starts shaking his finger at me again. “I’ve already told you goddamned quacks—you ain’t gonna cut on me. I ain’t goin’ under no knife. Not for my prostrate. Not for anything.”

“It’s a very minor procedure, Mr. Abernathy. Low-risk.”

“I ain’t goin’ under no goddamned knife!”

And so it goes for the next half hour. Eventually, I somehow manage to convince Mr. Abernathy to keep taking his pill. For me it’s a Pyrrhic victory, thirty minutes of my life I’ll never get back, and I’m certain he’ll be back next week with a whole new set of complaints. Mr. Abernathy grunts his good-bye as he shuffles away, and Jane races out the door to pick up her kids from day care, leaving me all alone in the clinic.

I hurry to one of the examination rooms, close the door, pull out my laptop, and remotely log into the encrypted keystroke logger account. My hands shake with anticipation, and I have to concentrate to keep from hitting the wrong keys. Once I’ve accessed the account, strings of neatly arranged code immediately appear on the screen.

Yes!
The keystroke logger secretly recorded everything GG typed into the computer over the course of the morning. I’ve dug up an absolute gold mine of juicy data: e-mail address with her account login and password; bank account login with password; credit-card number—for someone so smart, GG seems to be no more computer savvy, or wary, then the average Internet-surfing American. Not that she necessarily should be. The University mainframe is reasonably secure. To
outside
threats.

Allowing myself a slight smile, I sign into GG’s e-mail account and rapidly sort through her messages over the past month, which are striking in their general lack of social connectivity. She seems to have very little correspondence with friends or family—not unusual for a psychopath. Most of the messages pertain to school and her classwork. Certainly nothing related to planning a murder. It’s not much. But at least it’s a start.

Satisfied, I’m about to snap my laptop closed when something else in the code catches my attention.

It’s a link to another Web site, with a corresponding login and password.

Curious, I follow the trail to its source.

And just about fall out of my chair.

GG apparently links her smartphone and home computer to a centralized server; a service that backs up data and enables users to access it, with a login and password, from any computer linked to the Internet. The Web site I’ve just entered is her account on the server: which, from what I can tell, she uses as a repository for all of her smartphone and computer files.
Including the videos.

It doesn’t take me long to find our sex tape, the one she made that night in the call room. It takes me even less time to determine that there are only two existing copies: the one on the server and the original one on her phone.

Grinning, I reach for the delete command …

… and pause, my finger hovering over the keyboard.

Shit.

If I delete the file, she’ll be on to me, and she still has the original copy on her phone. Unless I find a way to hack or physically steal her smartphone, I’m still screwed.

But that’s okay. You and I have just gotten started, GG.

I sign out of the system, close my laptop, and savor my small victory.

Game on, GG. Game on.

CHAPTER 12

Wednesday, August 12

Mrs. Samuelson’s bloodstream now teems with a fungus caused by a contaminated IV catheter. Despite the antibiotics, it has fed and multiplied and spread like wildfire through dry brush, setting in motion a terrible process called sepsis.

Sepsis is what happens when the body’s immune system short-circuits. Normally, the immune system fights infections through a complex mechanism overseen by white blood cells and proteins. Like soldiers in a microscopic army, the white blood cells and proteins talk to each other through an elegant communication network as they fight off the infection. As with all battles, there’s usually some peripheral damage. Fevers, muscle aches, runny noses, nausea, headaches—these are symptoms called into service in the fight against the infection; a scorched-earth approach representing the body’s way of transforming itself into an inhospitable environment for the invaders.

But with sepsis, the communication network short-circuits, and the immune system goes haywire. The collateral damage becomes catastrophic: a massive shock-and-awe campaign that indiscriminately destroys healthy as well as unhealthy tissue. The medical term is “multi system organ failure”—an underwhelming phrase that, like most medical terminology, describes little of the human suffering that accompanies it.

When the infection first started spreading, Mrs. Samuelson’s blood pressure dropped precipitously, and she required ever-greater amounts of powerful IV medications to keep it at life-sustaining levels. She swelled up like the Michelin Man, her bloated, fluid-filled body pressing outward against her frail skin, stretching it taut like the surface of a drum. The contours of her body gradually faded; her knees and ankles and elbows disappeared; her face bulged; her fingers grew to the size of sausages.

Then, one by one, like a line of toppling dominoes, her major organs began to give up the ghost.

Her lungs went first, flooding with fluids as she began to drown in her own secretions. The oxygen levels in her blood plummeted. In response, the SICU doctors cranked up the pressure setting on the ventilator, squeezing air into Mrs. Samuelson with ever-greater force. But the lungs are fragile organs, and Mrs. Samuelson’s creaked and moaned under the incessant pounding of the ventilator, threatening to rupture like overfilled balloons.

Her one remaining kidney went next. Oxygen-deprived and exhausted, it shut itself down and refused to filter blood. Her body stopped making urine. The toxic substances the kidneys normally remove from the body piled up to dangerously high levels in her blood. So the SICU doctors rammed a huge dialysis catheter into a large blood vessel in her neck, which now intermittently sucks the blood out of her body and runs it through a larger dialyzing machine positioned next to her bed. The machine removes all of the waste products before dumping the filtered blood back into her body.

Meanwhile, Mr. Samuelson sits there every day with his three daughters, patiently keeping vigil in the SICU waiting room (the sons-in-law have long since disappeared) or at the bedside during the few hours allotted to visitors, their hands frequently linked in prayer, all of them serene in their conviction that Mrs. Samuelson will wake up anytime now. Mr. Samuelson keeps her wedding band, the one she was so reluctant to take off before the operation, in his front shirt pocket. He’s taken to rolling it absently in his thick, nicotine-stained fingers as he keeps vigil by her bedside.

“Circling the drain,” one of the anesthesia residents working in the SICU says to me that evening as I’m sitting in Mrs. Samuelson’s room. She’s squinting at the computer monitor next to Mrs. Samuelson’s bed, studying her latest test results.

“What?” I look up from my laptop.

“Her.” She points at Mrs. Samuelson with her pen. “Circling the drain. If she doesn’t clear this infection soon, she’s not going to make it.” She taps out a quick note on the computer and moves on to the next patient without glancing back.

Despite my temporary banishment from the OR, I’m free to come and go as I please in the SICU. I don’t know exactly why I’m sitting at her bedside. Is it for her sake? Or mine? To make myself feel better? To assuage my guilt? To exert some measure of control in an otherwise completely uncontrollable situation? I’m not really sure. Certainly, it’s not for the human interaction, or for the satisfaction of developing a stronger doctor-patient relationship. I’m in the same room with Mrs. Samuelson, but not really. She’s removed, distant, separated from me by the impressive array of technology keeping her alive, cut off from the rest of humanity like an astronaut or deep-sea diver.

The nurses, many of whom have known me for years, leave me alone as they go about their nightly business: adjusting medication drips, repositioning patients, monitoring ventilators, recording vital signs. A few stop their work long enough to say hi. Earlier, I watched as one of them wordlessly rolled a cart carrying a creaky TV monitor and DVD player into the cubicle next to Mrs. Samuelson’s, turned the monitor toward the cubicle’s comatose denizen, and switched on an old concert video of Shania Twain. Weird.

I twist my head slowly around: first to the left, then to the right. The kink in my neck unknots itself with a loud and satisfying pop. I absently rub my sore shoulder, where I received another injection this morning for the research study, and look back down at the screen of the laptop perched on my knees. I click on a file. Several documents, the products of my research thus far on GG’s background, appear. With my banishment from the OR, I’ve had a lot of extra time to do research this week.

I open all of the files. One of the larger documents contains everything I’ve collected on her state of mind: mainly snippets from research articles and textbooks. As best I can tell, GG is a “semipsychopath”: Ruthlessly self-centered, she possesses many—but not all—of the traits necessary for being classified a full-blown psychopath. Clearly, she’s highly functional, capable, and shrewd, someone able to project a veneer of reassuring sanity to everyone around her.

There’s even, I begrudgingly recognize, a certain method to her madness, a pitiless resolve to achieve success, no matter the cost. In fact, as I read again through all of the materials, I realize how blurred the line can often be between psychopaths and the rest of us; and I wonder how many other highly successful people there are like her in the world—political leaders, Wall Street traders, lawyers, even other doctors—who secretly, or maybe not so secretly, harbor psychopathic traits.