Do No Harm

"Do other people think you have crazy ideas?" David asked. If the question was worded subjectively, Clyde would be more likely to answer it honestly.

"I don't… I don't know. I don't stay around people anymore." Clyde's speech was slightly slurred, as if he were speaking around a thick tongue. "Not people that can look at me back."

"You said you weren't taking any drugs. Are you sure about that?"

"I don't take any pills." The same defensive note David had encountered from him previously on the topic. David noted that he had changed drugs to pills. He seemed to be concerned with the issue of taking medicine, not illicit drugs.

"Did someone do something wrong to you?"

Clyde breathed hard for a moment, catching his breath. "I don't like the way they look at me. They always look at me like that here."

"Here? As in here at this hospital?"

"Yeah," Clyde said. "Yeah. But not anymore. Now they're afraid. You shoulda seen their faces after they got the stuff on them." His fingers, swollen knuckle-wide down their lengths, quivered as his hands twisted in the restraints. His fingernails were yellow and pitted. "I have plans. I'm smarter than you think. I can do things too. I know they're wrong, but I can do them and not get caught."

"What plans? What are your plans?"

"Maybe you can stop me. I couldn't. I couldn't stop me."

A slightly obese female tech stuck her head in the door. Clyde's head snapped up, the loose flesh of his cheeks and jowls taking a moment to still.

"I'm here from the blood bank to pick up-"

"Please, not right now," David said.

"Look, I came down here all the way from-"

"Not now."

With a scowl, she withdrew.

"See?" Clyde said. "Like that. Did you see how she looked at me?" He drew a ragged breath. "I just marked her. Marked her face, her eyes. She's there now, in my mind. Green dangling earrings. Freckles across her nose. Birthmark on her right cheek." David couldn't even recall the woman's hair color, but Clyde, in the four seconds she'd been in view, had drunk her in.

Clyde raised his head, examining the thick leather cuff that bound his wrist to the railing. "Now I see how you guys are clever, trying to catch me. I can be clever too. I have ways, I have better ways to get at people." Clyde began sobbing quietly. "I don't mean to. I don't like it. It's awful but I have to." He winced suddenly, squinting.

"Are you all right?" David asked. "Does your chest hurt?"

"God. Oh God. Dim the lights. Can you dim the lights?"

David crossed to the light switch and turned off the bank of lights directly over the gurney. The room glowed with light from the X-ray box, which someone had left on.

The only sound in the room was that of Clyde's labored breathing. David watched him in the soft-lit darkness. Clyde's request stemmed from either a headache or a sudden phobia, he wasn't sure which.

"When I go out," Clyde said, "the mask goes on. It protects me."

"Why do you need a mask?"

A single tear rolled down Clyde's red and swollen cheek. "I want their faces to be gone. I want them to be destroyed and ruined and no more."

Clear homicidal ideation, available means and well-formulated plans for continued attacks, lack of compassion, self-view as victim-the red flags were rising one by one. David said, "Do you think-"

The door swung open, flooding the room with light. Dressed in jeans and a Gap button-up, Diane entered. "There you are," she said. "What the hell has been-"

David sprang toward her, trying to block her from Clyde's view. "Not now. Get out! Who told you you could come in here?"

She shuffled backward as he pushed her. "The cops said it was okay, that you were just-"

"Keep this door shut," David growled at the officers. He slammed the door and leaned against it, one palm spread over an anatomical diagram of a lung.

Clyde's voice drifted around him, a miasma rising. "That one's special to you, huh?"

"No," David said. "I just don't want anyone disturbing us."

"Didn't see you jump to when that little pig from the blood bank showed herself to me. Not like you jumped for this one. Don't blame you. She's a pretty nurse."

David crossed the room and stood over Clyde. The glow of the X-ray box turned his skin a sickly blue, darkening the pits in his cheeks and the twinning tufts of hair that protruded ridiculously like an offset garland. He stared at Clyde, and Clyde turned away with a soft, dying whimper.

Empathy is not innate. It is a learned emotion, conditioned through trial and error, defeat and reward, forged in a Skinnerian oven. David sifted through forty-three years of instinct and socialization, searching for the string of a buried argument. The only way a person can know that someone else's pain matters is if someone has taught them that their own does. If no one ever showed that to Clyde, as a baby, as a child, then he had learned that his pain did not matter. And, more acutely, he would have learned that things in pain did not matter.

"Your pain," David said. "The awful pain on your chest. I'm sorry that happened to you."