Thursday, April 21, 2016

Flash Fiction Friday, Week 34: First, Do No Harm...

The prompt this week was to write a story that is set in a hospital. My story is about a doctor who tries to do the right thing.

First, Do No Harm…

What a week this has been. There’s no telling how my weekend will turn out though. It all began with me being assigned to the hospital’s research department. I would be reviewing studies that have been done here. None were currently on-going, but clinical research has always interested me, and I was grateful to be able to review the records. I was hoping information would be available showing whether the drugs had received FDA approval, and if we were utilizing any of them.

Mossville Memorial Hospital is a small institution, but Dr. Martin Harcourt, Chief of Medical Staff, still contacted pharmaceutical companies and volunteered to be Principal Investigator on drug trials that would require a small group of participants. There were usually no more than 50 patients in this hospital on any given day, but their diagnoses and medical histories varied greatly, so occasionally, clinical trials fit in nicely with the population.

I was born and raised in Mossville, and Dr. Harcourt had always taken care of everyone in town. When I was a boy, the closest hospital had been 75 miles away in Brownfield, and Dr. Harcourt was always talking about how some of his patients’ lives could have been saved had a hospital been closer. Through his efforts obtaining state funding and using some of his own finances, Mossville Memorial was built and became fully operational within a few short years.

Perhaps we didn’t have all the modern equipment hospitals in large cities had, but patients could be treated and sent on their way, or if necessary, stabilized and prepared for the trip to whichever big-city hospital was appropriate for their emergent situation. Dr. Harcourt’s level of caring was what being a small town physician was all about, and what inspired me to want to complete my residency, and open my own private practice, here.

The study files were stored in the basement. I discovered a box under some pipes that contained a protocol about an investigational drug to treat respiratory infections, and notes confirming patients had been enrolled, but no records. I decided to check with Marie Shumbert, an R.N., who had been working here since the hospital opened. If anything did, or did not, happen at Mossville Memorial, Marie knew about it.

“That one was a disaster,” Marie said. “Dr. Harcourt worked on studies by himself, so he would have to give you the details. He enrolled four people, but before long, one by one, they had a stroke at home that left them unable to move or speak.

“Dr. Harcourt said it had nothing to do with the study drug. He said it had helped with their breathing. But, since everyone in the study had been admitted to the hospital, he couldn’t continue. He told me to box it up and put it in storage.”

That made no sense. The protocol said it was a Phase I trial, which is done only to determine safe dosage levels – not treat the condition. There were no consent documents or patient records. What had he been doing to these people? Since Marie was loyal to her boss, I decided to tread lightly.

“Marie, do you remember their names? I’d like to contact their friends or family to get their current status.”

“I can give you their names, but that’s as far as you can go. After they were admitted, they all developed an infection no antibiotic could tackle. They lapsed into coma, their organs failed, and they all died. It was upsetting that the same thing happened to them all.”

Upsetting? What’s upsetting, Miss Marie, is that no one questioned Harcourt’s findings. What I found even more disturbing was the identity of the participants. One was Harcourt’s ex-wife, Jeanine. Even though they weren’t married at the time, it didn’t seem ethical to enroll her in a trial he was conducting. The other woman and the two men in the study were hospital employees. Sally Vanderlin was a Lab Assistant, Jack Sterling, a Pharmacist, and Thomas Coulter worked in Maintenance. I decided to do a bit more digging about the strokes and untreatable infections that affected only those four before I confronted the man about his questionable recruitment practices.

I began with ex-Mrs. Harcourt’s sister, who had lived next door to the Harcourts, and who was more than willing to speak ill of the dead.

“Jeanine was a whore. She was lucky to be married to a doctor and what did she do? Fooled around with the Hospital’s Pharmacist. She told me she didn’t start up with him while she was married, but she was lying, and I told Dr. H all about it.

“It didn’t take long for her to catch something from that man she was whoring with. Dr. H left after visiting her on a Tuesday morning, and I found her that afternoon on her back, staring into space. Same thing happened to her boyfriend the next day. Within a week, they were both dead. Serves them right.”

I thanked her for her candor and quickly made my exit. Dark and terrifying puzzle pieces were beginning to fit together all too well. Was Jack Mrs. Harcourt’s lover? Was it possible the doctor cooked up some killer bug in the Lab under the guise of research with Sally’s help? If so, why did she have to die too? How did Thomas fit into all this? Was he cleaning up one night and saw or overheard something he shouldn’t have? Did the physician I’ve looked up to all my life make these people ill at home, and then finish them off in the hospital? I had to get back to those files.

Reading through the protocol of Dr. Harcourt’s ill-fated drug trial confirmed my suspicions. That’s why there were no consents or charts. The protocol was phony. Some of the language seemed legitimate, but overall, it made no sense. It read as if parts of it had been copied from other protocols he found online. He made up the story about the study in case someone saw him near his victims’ homes. That was where he administered the drug to bring on the stroke-like symptoms. I tried not to think of the pain and fear they must have felt while their bodies were being ravaged by infection and their organs were unable to continue functioning until mercifully, brain death occurred, and their self-appointed executioner pulled the plugs.

“My God,” I said. “Harcourt, you monster.”

 I felt the needle stick in the back of my neck. I turned to see Dr. Harcourt standing behind me holding a syringe, as the room began fading to black.

“Just relax,” he said. “It will all be over soon.”

When I opened my eyes and tried to look around, I couldn’t turn my head. I knew I was lying down, and judging by all the white that surrounded me, I knew I was in a room at the hospital.

“The machine is breathing for you,” Dr. Harcourt said. “I’ve given you a little cocktail I dreamed up that immobilized you, but you will be able to see, hear, and feel. Too bad you had to be so curious; although, I always told my students to keep asking until they found the truth. By the way, the truth is that I did kill them all. I had to. If people in town found out my wife was having an affair with someone in my hospital, they would have laughed at me.

“At first, Sally thought we were developing a harmless sedative, but she figured out the solution was deadly, and threatened to expose me. I used the same drugs on her that I just gave you, and took her home. I knew her roommate would find her. Later, the janitor said he saw me inject her and wanted money to keep quiet. I told him I’d bring the cash to his apartment. I’m sure you know what I brought instead. My ex and her boyfriend were the easiest – an at-home visit for my drug study.

“I’m going to inject the virus now, as I did with the four of them. I’ll be back later with morphine which should ease some of your pain. It wouldn’t give me pleasure to see you suffer. Sorry it had to come to this. You had such a bright future ahead of you.”

He emptied the syringe with the deadly virus into the IV line he’d set up next to my bed. I assumed he left when the deed was done. Why hang around? The bacteria was capable of killing me all on its own.

So, here we are, right back where we began. I can’t push the call button or scream. Being the physician of record, Harcourt can write whatever he wants on my death certificate. Neat and clean. Free and clear. All I can do now is wait. Wait, and pray for a miracle, or morphine…