Doing Harm (6 page)

Jeez, she is
good.

She murmurs something I can’t hear.

“Sorry. I didn’t catch that,” I say, leaning toward her.

“Strong hands,” she repeats softly. “You have strong hands.” She shrugs and glances up shyly. “It seems like … I mean, I think it’s important for a surgeon to have strong hands. Don’t you?”

“Ummm” is all I can manage. My cheeks burn, and I’m grateful for the surgical mask covering them. My eyes dart self-consciously toward the scrub nurse, but she’s completely preoccupied with counting and sorting the surgical instruments.

I’m still trying to figure out how to respond to GG when the anesthesiology resident (I still can’t remember his name) diverts my attention.

“Hey, Steve?” he calls.

“What’s up?”

“I just rechecked the patient’s chart, and, ah, it looks like he’s allergic to penicillin.”

“So?”

“We gave him Cefotetan at the beginning of the case.”

Shit.
About 5 to 10 percent of patients who are allergic to penicillin are also allergic to Cefotetan. Mr. Bernard shouldn’t have gotten the Cefotetan. It’s a violation of hospital protocol.

“Okay. How’d we miss that?”

“I’m not sure. I guess … I don’t know. I didn’t see it on the front of his chart.”

Stupid anesthesia resident.
In my opinion, it’s his job, not mine, to pick up on that kind of stuff. But my bosses will still blame me. If the patient has a reaction to a drug he shouldn’t have received, it’s the kind of thing that will make me look bad. Underneath my mask, I bite my lip and hold my temper.

“What’s the allergy?” I ask mildly.

“Hives.”

“Hives. Okay.”

“I’m going to give him 50 mg of diphenhydramine. You want a steroid, too?”

I think it over for a moment before answering. “No. Wound-healing issues. He doesn’t need it.”

“Okay. Whatever you say.”

“Is that going to be a problem?” GG asks me, her eyes wide with concern, two brown orbs suspended over the horizon of her surgical mask.

“Nah,” I reassure her. “It’s no big deal. He’ll be fine. Besides, what we really need now is some good closing music.” Andrews doesn’t like to listen to music when he operates. I do. Since it’s his patient, he gets to call the shots as long as he’s in the operating room. But he’s not in the operating room anymore. “What’ve we got? Anybody? Anything?”

“I’ve got some stuff,” the anesthesia resident replies, scrolling down his iPOD menu. He rattles off some options, and we eventually compromise on Norah Jones, whose sweet, organic lilt wrestles with the metallic, artificial snap of the staple gun as GG and I finish the operation by firing stainless-steel staples into Mr. Bernard’s skin to hold the edges of the incision together.

God, I love operating.

Life is good.

The languid strains of “Don’t Know Why” chase away my residual annoyance over Mr. Bernard’s botched antibiotic.

And, at this point, I’m blissfully unaware of how that simple mistake marks the beginning of the end of Mr. Bernard.

*   *   *

The surgeons’ lounge, a spacious room adjacent to the OR, is unusually quiet for early afternoon on a Monday. Two heart surgeons I recognize but don’t know by name are engaged in a hushed, intense conversation on a black leather sofa situated in front of a flat screen TV tuned to CNN with the sound off. On the opposite side of the room, a surgery resident with two days’ worth of stubble and wearing scrubs with three days’ worth of wrinkles snores thunderously in a broken massage chair. Nobody notices me walk in, grab a can of Diet Coke and a package of peanut butter crackers from the free supply in the refrigerator, and drop heavily into a chair in front of one of several computer screens lined up on a large table.

I try to concentrate on checking some patient labs and verifying Mr. Bernard’s medication orders, but GG’s comment in the OR lingers in my thoughts.

Strong hands.

Was she actually flirting with me?

Flirting.

The word sends electric jolts rattling down previously abandoned highways of my spine, an ego-stoking rush I haven’t experienced since long before I was married. But I probably totally misread the signals. It’s been so many years, I can hardly remember what flirting feels like; and, in any event, it’s not like girls were exactly throwing themselves at my feet before I met my wife. I’ve always thought of myself as the average-looking kind of guy you see in beer commercials, the ones improbably hanging out with hot women. Not ugly. Just, you know, pretty much average. Okay, so maybe a
little
above average. GG’s comment might have been completely innocent.

Besides, why am I even having this conversation with myself? Even if GG was flirting with me, it’s not like I’m going to do anything about it. Right?

Right?

I glance over my shoulder. The heart surgeons, still whispering urgently with one another, have gotten up from the couch. Oblivious to all else, they move past the unconscious surgery resident in the massage chair and out the door.

No one else is around.

I turn back toward the computer and gently stroke the smooth, worn keys without depressing any of them. My mind wanders back to the countless late nights I spent in college with my fellow geeks, hunched in cheap, wooden dorm chairs in front of our computers, strung out on beer and Mountain Dew and Fritos, amusing ourselves by slipping in and out of supposedly secure systems with impunity. These days, distracted by the burden of more adult pursuits like work and fatherhood, I’ve grown a little soft, and my skills aren’t quite as sharp as they once were.

But they’re good enough.

Despite all of her formidable talents, Sally isn’t the most organized of people. In fact, she’s constantly writing reminders to herself on sticky notes and posting them all over the house: which, of course, usually ends up defeating their purpose, since who can possibly keep track of them? Most end up carpeting the front of our refrigerator, merging into a multicolored quilt of phone numbers and to-do lists, bits of which flutter and drop to the floor like autumn leaves every time someone opens the refrigerator door.

Back when Sally was still working in Human Resources at University, part of her job was to oversee the electronic personnel files of all of University’s employees—a position which, she confided to me at the time, gave her access to sensitive data on just about everyone from the hospital CEO down to the guy who waxes the floors. So when I happened one day across Sally’s University computer ID and password, scrawled on a bright purple note stuck to the side of our home computer, I just couldn’t help myself: My hacker instincts immediately kicked in, and I surreptitiously, if not a little guiltily, copied them down. I didn’t use them, of course. For the most part, the University IT guys were, and still are, a bunch of idiots. Their security is a joke. But on the off chance I ever got caught breaking into the system, Sally would have been fired; so instead, I tucked them away for safekeeping. Just in case.

And then, right after Sally quit her job, I signed in to the system using her account, before the University IT folks had shut off her access. The rest was laughably simple: I made a few minor adjustments to the account so that it couldn’t be traced back to Sally; and then, just to be sure, arranged the access to automatically run through a commonly used computer at a nursing station located on one of the busiest patient care floors in the hospital. That way, if anyone ever became suspicious, they’d trace everything back to that one computer, which dozens of different people use every day.

I’ve had unfettered access to the personnel files, and a whole bunch of other confidential information that runs through the Human Resources Department, ever since. Disciplinary actions. Malpractice suits. Medical-board inquiries. Patient complaints.

I’m not a creepy guy. Really. I’m just jazzed by the fact that I’ve pulled one over on the powers that be. I think it appeals to my basic hacker sensibilities. Just knowing that I have instantaneous access to this kind of data anytime I want is enough. It’s not like I troll around the system, digging up dirt on my colleagues, or anything. In fact, even though I know exactly where to look, I’ve never before pulled the personnel files on any of the people I work with.

Until now.

Strong hands.

My head buzzing, I steal one more peek at my insensate companion in the massage chair, crack my knuckles, sign in to the system, and access GG’s file.

Born in Pasadena, California. Undergraduate degree from MIT in electrical engineering, with highest honors. Marshall Scholarship to study bioengineering and organizational systems at Oxford University in England. Honors in every single one of her classes thus far at University Medical School. Truly, an overachiever’s overachiever.

My cell phone abruptly buzzes in its hip holster. I take it out and look at the screen. The caller ID reads “Home.”

“Hi, sweetheart.” I clench the phone to my ear with my shoulder as I quickly close GG’s file.

“Hi, sweetie. What are you up to?”

I study my Diet Coke and peanut butter crackers. “Lunch. How about you?”

She sighs wearily. “Lunch was a disaster. Tantrums. Food throwing. I have no idea what’s with them. I sat them in front of a video a little while ago just to regain my sanity.” Her voice softens, regaining a comfortable intimacy that pushes any remnants of GG from my thoughts. “
Anyway
 … How are
you
feeling? Are you ready for the meeting?”

“I think so. It’s in about an hour. I was just about to get changed.”

“Are you going to ask him about the job?”

“After last Saturday night, I don’t think I have a choice.”

In the background, I hear Katie shriek, “Mine! Mine!”

“
Good God,
” Sally growls. “We’ll talk later. Good luck, okay? I love you.”

“Love you, too.”

I put my phone down just as a hand claps me hard on the shoulder from behind, hard enough to make me wince in pain.

“Hey, Slick, what’s up? Chatting with the old ball and chain?”

I scoot around to face the owner of the hand, whose bulky frame towers over me.

“Hey, Larry. Wait, what are you doing here? Are you operating today? Was I supposed to help you?”

He laughs good-naturedly. “Easy, Slick. Always on top of things, aren’t you? Don’t worry. You didn’t miss anything. I was just checking on some new laparoscopic equipment coming in. Pretty cool stuff. Wait until you get to play with it.”

Larry is my primary mentor and far and away my favorite professor. He has close-cropped, jet-black hair and a homely, open, amiable face that’s dotted with old acne scars. Even though he tops out at well over six feet, four inches, Larry is surprisingly quick—so quick, in fact, he was an all-American linebacker at a Division I college. In the OR, as anywhere, Larry radiates a vibrant, manic energy: darting around constantly, always moving, always talking. I’ve never seen him sit still. He can’t stand inactivity. Inactivity to him means inefficiency and wasted time. “Momentum!” He likes to exclaim in the OR when things aren’t moving fast enough for him, “We need more momentum!”

And, man, he is an
awesome
surgeon. One of the best I’ve ever seen. He makes getting through the toughest operations seem like spending a sunny day lounging around at the beach. I’ve never seen him break a sweat or lose his cool—and I’ve seen him in some pretty tough situations. Even the other faculty members quietly acknowledge how good he is: a big deal for surgeons, who are usually reluctant to subject their egos to the kind of bruising it takes to admit someone else might be better in the OR.

Someday, I want to be the kind of surgeon that Larry is. I want to command that kind of respect.

He frowns at me, concerned. “Hey, you okay, Slick? You look kind of … I don’t know, wiped, or something. A little pale.”

“Nah, I’m okay. I just haven’t been out in the sun enough lately.” After talking with Sally, I’m now a little wound up by the prospect of my upcoming meeting with Dr. Collier, which is probably why I’ve lost some of my color. But I would never admit that to Larry. I don’t want him to think that I’m weak—physically
or
mentally.

“Good. Hey, Steve, I saw a sweet case this morning in clinic. A big right adrenal aldosteronoma.”

The prospect of a highly unusual and interesting surgical procedure is enough to temporarily quiet the butterflies knocking around my stomach. “Oh yeah? An aldosteronoma? I don’t think I’ve seen one of those.”

“It’s a pretty rare beast. Even with my referral pattern, I’ve only seen three others over the last few years.”

“Laparoscopic adrenalectomy?”

“Yeah, baby.”

“Do you know when you’re going to do it?”

“She’s on the schedule for next week.”

“Awesome.”

“Yeah. Hey, by the way, how’s that job hunt going?”

“Okay. I think Northwest Hospital might be getting ready to make a firm offer.”

“Good for you. They’re a strong group. Great reputation. Any other options?”

“Not really. No other bites so far.”

“Have you met with Dr. Collier yet?”

“Later this afternoon. Why?”

“Just let me know how it goes,” he answers cryptically. He punches my shoulder and speeds away.

The snoring resident mutters to himself in his sleep and rolls toward the wall.

Bemused, I rub my aching shoulder and turn back to the computer.

There’s one more person I need to check on in the personnel files.

Luis Martínez, it seems, took a less traditional route than GG, or myself, or most other residents I know, to becoming a doctor. From his hometown of Los Angeles, he went straight from high school into the Marine Corps. No details on what he did or where he was stationed while in the Marines, but he was honorably discharged after ten years. Undergraduate degree from the University of California, Berkeley, with a double major in biochemistry and philosophy.

Philosophy?

I snort.

That’s
interesting. He never struck me as the philosophy type.