Do No Harm

Ed grimaced. "A day at Kinko's gone terribly awry." His skin was almost impossibly pale; the blue cubital veins forked through the soft underside of his forearm like roads on a map. Ed studied the ceiling for a moment. "I won't bullshit you," he finally said. "I'm on parole, and I've been making good for me and my little girl. I shouldn't have gotten involved the way I did, breaking up that robbery. I wanted to protect the workers in there, but I don't know how this'll play to my PO. It'll probably be fine, given the eyewitnesses and all, but I'm not eager to find out. I'd appreciate your help here."

David studied his face, searching for signs of dishonesty. He decided he liked what he saw. "If I report the gunshot wound, you're going to limp out of here before the cops show up. Given that your injury was sustained on the right side of the law, I'd rather have you walk out upright." He nodded once, slowly. "Deal?"

Ed ran a hand over his bald scalp. "Deal."

He lay back down and David parted the gown in the back and examined the wound. "Someone's been prying at this," David said.

"My buddy got the slug out with a pair of snub-nosed pliers."

"A. 38?"

"Yeah. But it wasn't a full slug."

"How can you tell?"

Ed looked up at him, blank-faced.

"Okay," David said. "Stupid question. So we're dealing with fragments."

David spread the wound slightly to examine it, and Ed didn't so much as flinch. David removed a blanket from a cupboard and tossed it to Ed. "I'm going to have to get you down to fluoroscopy."

"Is it on this floor?"

"Yes." David kicked the foot paddle on the gurney to the right, releasing the brake, and slowly backed the gurney out the door. Lying on his side, Ed pulled the blanket up tight to his chin so it blocked most of his face, and turned his head into the pillow.

David signaled Diane to follow him when he wheeled Ed past the CWA, and she came quickly, tapping a chart against her thigh. He immediately noted the firm set of her mouth. "What's the problem?"

"Fifty-five-year-old Greek woman came in with some acute anxiety. I'd like to hold her until she settles but her insurance won't cover it." Diane looked down at the gurney as it rolled along, noticing Ed for the first time. "Hello."

Ed nodded, a brief movement of his half-buried head.

David took the chart from Diane and glanced it over. He pulled a pen from behind his ear, crossed out acute anxiety, and wrote acute shortness of breath with a secondary diagnosis of anxiety. He handed the chart back to Diane and winked at her. "Problem solved."

They banged through some double doors and weaved their way through the labyrinthine corridors of Level B.

"One of the great advantages of ER medicine is our freedom to exercise our own discretion." David glanced down at Ed. "Isn't that right, Mr. Pinkerton?"

Ed's beady eyes watched him with amusement from the Ewok swathing of the sheets.

"Not always," Diane said. "The Director of Health Sciences Communications just issued a memo to all employees reminding us of the 'long-standing policy that all media interaction is to be conducted through the HSC office.' "

David whistled. "The board must be leaning pretty hard."

"Having lye flying around probably provides a good pucker factor," Ed said.

David banked the gurney right into the fluoroscopy suite, and he and Diane donned leads to protect themselves from the radiation. He positioned Ed on his back, swung the X-ray arm over his right buttock, and stared at the small screen of the monitor. The two bullet fragments stood out white against the gray bones, just medial to the head of the femur.

"You were right," David said. "Two frags."

From the look on Diane's face, she had put together the patient with the news story. She took a moment to grab the silver forceps David was offering her.

"The wound is superficial enough that I think we can handle it here," David said. "A lot of tissue protecting the bone back there. Does it hurt?"

"It's not pleasant." Though beads of sweat dotted Ed's bare scalp, his face showed no sign of pain. When Diane inserted the metal forceps into the wound and angled down toward the first bullet fragment, they too showed up white on the monitor.

David directed Diane with a gesture, then indicated how she could hold the forceps for better control. She followed his instructions perfectly, her tongue poking out her cheek in a point.

"How old are you, Mr. Pinkerton?" David asked.

"Thirty-nine."

"Have you been screened for prostate cancer?"

"If this is an excuse for giving me a rectal, I don't date doctors." Ed's first grimace lit his face as Diane dug deeper with the forceps. "No," he said. "I haven't."

Diane glanced up at David, one eyebrow raised in an unasked question. Probably wondering why he was raising the issue when prostate screening usually didn't start until age fifty. "Any family history?" David asked.

"No."

"Well, sometime in the next few years, you might want to get checked out. Think of it as the fifty-thousand-mile tune-up on your car."