Do No Harm

David leaned over, but Clyde's left arm was locked down by his waist, blocking the cut. He turned to Clyde, again doing his best to avoid what could be perceived as threatening eye contact. "I'm going to untie one of your arms to get at the cut. I'm doing this so I can help you. Remember, you promised not to give me any trouble."

Carson took a half step forward. "Look, I don't know-"

Clyde's sweaty head moved up and down in a nod.

David untied the restraint and raised Clyde's arm, the thick leather band remaining around Clyde's wrist. He bent down, navigated the forceps carefully into the wound, and removed the piece of Pyrex. He lowered Clyde's arm back to the metal rail and secured it again, threading the leather strip through the hasp.

Carson let his breath out in a rush.

Clyde raised his head weakly and stared at David as the others continued to flush his wounds with saline. His voice hitched in his chest. "Thank… thank you," he said.

David thought of the Xeroform bolsters stitched into Nancy's face and strongly resisted the urge to tell him to go fuck himself.

Chapter 22

"TO say I'm pissed off would be an understatement." By the time David entered the doctors' lounge his rage had turned to disgust. He had pulled most of the staff who had been on the floor during the incident into an impromptu meeting, leaving Carson and a few nurses to oversee the floor. Pat had apparently followed his orders and left. Nurses and interns crammed onto the cheap vinyl couch, leaned against the coffee-stained sink, and sat cross-legged on the floor.

He looked blankly from face to face. Almost all of them lowered their eyes from his stare. "A patient comes into our division in acute pain, requiring emergency treatment, and we withhold care. A top-notch medical facility withholds care. I can't… " The words were jumbling in his mouth, so he paused and took a breath. "I'm meeting with Dr. Evans today, but I can't even begin to figure out how I'm going to present this."

A few of the interns stiffened at the mention of the hard-nosed chief of staff.

He couldn't recall ever seeing the staff so uncomfortable. Nervous shuffling, regretful expressions. One of the nurses looked up to stop her moist eyes from leaking. A medicine intern raised a fist to stifle a cough.

"Outside these doors, the world can be as vicious and cold as it wants. People don't help each other. People don't have to help each other. In here, we take care of them, trite as that may sound."

"That man is a vicious mutilator of women who got a taste of his own medicine." The anger in Don's voice surprised him.

"That man is a suspect" -David emphasized the nouns with jabs of his open hand- "but that's the cops' concern. To us, he's a person with a serious injury, like any other."

"Just doing our job, huh? That's the philosophy you want to rely on?"

David's stomach was awash with acid and rage. "The Hippocratic Oath, Dr. Lambert, is the philosophy I rely on. We took an oath, every one of us, that we would work by our medical ethics and hold them above everything else. What does it mean if that oath ends beyond the point that someone is appealing, or mentally sound? Or likable?"

"It's not that black and white."

"It is precisely that black and white. If we can reduce the pain of another human being, we do it."

"How can you want to show that man compassion?"

"Compassion? It has nothing to do with compassion. This is our job. If you don't like it, go be a goddamn accountant. But you can't stay here and think you can call your own shots."

The others watched the exchange with stunned expressions.

David took another moment to gather his composure. "It is not our place to question our patients' morality. Do you really think you can keep your footing on that slippery slope? What next? We stop treating criminals? How about people who cheat on their income taxes? Do we let them lie in pain? The mentally ill? Do we deny them medical care? Do we?" David's arms were tensed before him. "That man in Fourteen could very well be mentally incapacitated. Leave judgment to the courts, and do the jobs you swore under oath to do."

"I never abandon my own instincts," Don said. "Not for any code of ethics."

"Fine," David snapped. "If that code of ethics doesn't work, try this one. I'm the division chief, and you will listen to me. So do your fucking job. All of you. Now."

He walked out and left the door standing open, the murmurs following him a few yards up the hall. Whether the confrontation had done any good or not, he felt considerably better.

He returned to the CWA and checked in with Carson, noting the emptiness of the ER's main axis. Aware that he had just acted like the kind of manager he'd sworn he would never be, he focused on the board as the other staff members trickled back to work.

Preoccupation stayed with him for the next few hours. His concentration wandered; his movements were mechanical. He forgot a patient's name during an examination for the first time since June of

1987.