Do No Harm

"Bullshit," Clyde hissed. His breath was paradoxically rank and sweet-there was an almost medicinal scent to it. His right foot waved back and forth, a pendulum ticking off seconds. "You left me. You left me and didn't come back."

David pulled over a chair and sat, to put his head lower than Clyde's. Maybe Clyde would be more comfortable talking if David assumed a submissive posture. "I have other patients I need to see. Other patients who need help the way you needed help."

"I don't need you."

David drew closer. The blisters on Clyde's chest were resolving. Though still raw, they had either popped or ceased swelling. Again, David was amazed at how well Clyde's scrub top had protected his flesh from the alkali.

"I'm not here to harm you, Clyde. I'm here to see that you get the medical attention you need. That's why I brought in the other doctor. Why didn't you like him?"

The room had not been prepared for Clyde-David and Carson had dragged him in because it was the nearest unoccupied exam room, and David had given it only a cursory once-over. Now he stood and searched the room more extensively for unsafe objects, just in case Clyde managed to work an arm free. A lumbar puncture kit, stained amber by Betadine, leaned from the trash can. That meant there were needles, probably down in the trash liner. The unit of blood he'd spotted earlier remained on the counter nearby, among several packages of gauze. Clearly, it had been out of refrigeration for more than the admissible thirty minutes. He'd already removed the scissors; now he glanced in the drawers beneath the counter for scalpels but found none. An oxygen source box protruded from the wall. The flow meter was made of glass, but it was hard and small, like a test tube buried in the unit. It would be difficult to break.

"I hate you," Clyde said. "I fucking hate you." His lips quivered slightly. "The nurses came in here, told me you would leave me. They said you were saying bad things about me."

"I didn't say anything bad about you."

Relief washed across Clyde's face. "That's what I told them. I told them you were a great person, a great man, and you would never do that. I defended you."

David carried the trash can outside and set it by the door. "This has needles in it," he told one of the cops. "And could you please tell a clerk to call the blood bank, have them send someone down. We have a stray unit of O-negative that needs to be spoiled."

The officer nodded, and David returned to the room, sat, and faced Clyde. "I don't believe the nurses said those things about me. Do you think you're imagining some of the things they said?"

"No. No way." His breath whistled and wheezed. "If they take me away, will you come with me? You said you'd stay with me."

"I'll make sure you get the help you need," David replied evenly.

"You. I want you. You helped me. You helped cure me when no one else wanted to." Clyde's right foot continued its restless motion back and forth.

"I'm an ER doctor. I have to stay here."

Clyde strained against the restraints, and David noticed again the swelling of his hands. His wrists were chafed, one hand up over his head, one down by his side, like a playground monkey. David noticed an old stain on the cuff on Clyde's lower wrist. Probably semen. Sometimes they had to put guys on amphetamines in restraints, but they'd be hypersexual from the drug, so they'd turn on their sides to get at their penises and masturbate themselves bloody.

"Do you know why you're here?" David asked.

"Because I'm tied down. Where else am I gonna be?"

Concrete thinking. Pulling on a pair of gloves, David pressed forward into the Brief Mental Status Examination. "Clyde, do you know what month it is?"

His eyes beaded until they looked like small spots of oil. "Of course I do. You think I'm fucking stupid?"

David began applying Silvadene to the blisters on Clyde's chest, spreading the antibiotic cream with a fingertip. Clyde winced at his touch. David took care to lean back out of Clyde's space so he wouldn't feel crowded.

"No," David said. "I think you're sick. I want to help you."

Clyde laughed, a low snort. "They're running around the hospital scared of me. They have guards here because of me. I'm not sick. I know what I'm doing."

His vacillation between swaggering self-righteous criminal and emotional catastrophe was staggering in its range and rapidity. "What are you doing?" David asked.

"Making them sorry."

"Sorry for what?"

"For locking me up in the darkness. Not letting me out."

"Were you locked up? As a child? Were you kept locked up by your parents?"

"Noises and lights and snakes. They put the lights out on me. They put me alone. I just want… I just want them to be sorry. For the flashes and the noise."

Locked in the dark with snakes-it seemed too stereotypical to be real, like a serial killer's childhood case study. Perhaps the fantastic stories were an indication of delusions or hallucinations caused by LSD, PCP, or speed. Maybe even schizophrenia.