The Hound of Justice Read online

  Remembering the watchers, I hooked my arm through Sara’s and drew her close. We continued on in silence.

  * * *

  SATURDAY. Ten A.M. For once I was glad I had no regular duties at the hospital. Sara had vanished before I woke up, leaving me with a carafe of cold coffee and some stale bagels. I grumbled and cursed, then realized I was acting like a spoiled child. What my mama would say to me now. Maybe today I would treat myself to Hudson Realty’s concierge service. Or maybe I could toast some bread myself.

  Time to settle down, drink some coffee, and write a damned abstract.

  ***

  SUNDAY. One A.M. Where the hell did the time go? Around two P.M. yesterday, I remember thinking to myself, Hmmmm, recovery rates for traumatic injures . . . Before I knew it, I’d jumped down that rabbit hole and into the glory land of statistics. Twenty gigabytes of search data downloaded. Several false starts jotted down. I think I ordered takeout for dinner, but I can’t swear to that.

  Time for a glass of wine and sleep.

  No sign of Sara.

  * * *

  Tuesday morning, Georgetown discharged Athena Washington into the care of her cousin and an ambulatory home care service. Ain’t single-payer insurance a beautiful thing? My father told me about the old, old days, when only the rich could afford decent health care and the politicians gave lectures about how the lazy poor deserved whatever happened to them.

  Then along came Alida Sanches and the Democratic Progressives. Will anyone remember her bloody fight to make single payer happen?

  Sorry. My bitterness must be leaking through.

  The mainstream media feeds were all lit up this morning about Donnovan’s latest speech. The GOP called single payer a burden to society. They claimed we couldn’t afford such fancy extras as home health care and uncapped benefits. Donnovan said the GOP had a point. He said we all needed to make sacrifices in these difficult economic times.

  I wondered what kind of sacrifice Mr. President had in mind for himself.

  But at least for now, Athena Washington had her medication, and her grief counseling, and her cousin from New Jersey. I made a note to myself to contact my federal representatives about Mr. Donnovan’s remarks, then turned my attention to the next medical day.

  Morning rounds. Uneventful.

  OT with Sydney Okora, an extended session where I made my first attempt with Lazarus’s custom programming. Sydney had provided me with a flank steak, thawed, and ordered me to cut ten-millimeter slices. My results . . . were not as good as I had hoped. Not as embarrassing as I had feared.

  Late-morning therapy with Faith Bellaume was canceled because her daughter had gone into labor six days before her due date. I thumbed back a message that expressed concern and hope but paused before I pressed Send. Why had I not bothered to learn Faith had a daughter? Maybe I should write my own paper about doctors and empathy.

  By five P.M., I was ready for afternoon rounds.

  First patient, a ten-year-old named Javier Arroyo. Teresa Navarette, the chief resident, was in charge. Anna Chong was presenting the case. Javier himself was drowsy with sedatives. He looked like a tangle of wires and limbs.

  “Patient Arroyo,” Chong said. “Admitted January twenty-ninth with symptoms of appendicitis. Surgeons Carter and Letova were on duty. Letova removed the appendix within the hour. Patient was discharged two days ago with a recommendation for follow-up visits to his primary care physician. He was readmitted this A.M. with high fever and a swollen abdomen.”

  “What scripts were given to him on discharge?” Navarette said.

  “Standard antibiotics and painkillers.”

  “Anything outside the ordinary with his surgery or recovery?”

  “Nothing,” Chong said.

  “Then why the relapse?”

  Yassin had one explanation, Bekker another. Others chimed in with answers straight from the medical textbook. Only Chong wore a dissatisfied frown, as though she wanted to say more but felt it wasn’t right. Maybe I was reading too much into that frown, but I made a note to talk to her about groupthink and taking the easy explanation as the truth.

  Then again, example made the best lesson.

  “Why should we assume it’s a relapse?” I said.

  That cut the chatter. Even Chong, who loved to challenge me, had nothing to say.

  Once again, Allison Carter had joined the afternoon rounds. “Why not assume it’s a relapse?” she said. “Infection isn’t unusual after surgery.”

  I glanced toward the chief resident. These were her rounds, after all. But Navarette had subsided with a tight little smile. Oh yes, let the attending surgeons provide a show for her students. I couldn’t really blame her.

  I folded my arms and faced Allison Carter straight on.

  “It’s not unusual,” I said, “but we can’t assume anything. At the very least, we need an MRI to make sure we aren’t looking at blood clots. We should run as many tests as we can, so we don’t overlook anything. Confidence makes carelessness, as my old friend Saúl Martínez would say. However, there’s a bigger question here, in my experience.”

  I turned away from Carter to the interns. “What is the usual rate of readmission for Georgetown? Anyone?”

  Anna Chong had the stats, of course. “The average readmission rate within thirty days for hospitals through the Federal States is just under fifteen percent, but seventeen percent for terrorist-related injuries. Georgetown’s average rate is thirteen and fifteen percent.”

  “And for our patients from January twentieth?”

  Yassin provided the answer for that. “Nineteen percent.”

  Higher than I had expected, but not outside the range of probability.

  I nodded, as though I had memorized the stats myself. “Very good. Now, let’s take our results a step farther. What about statistics for the length of hospital stay versus the severity of the injury versus the patient’s personal circumstances?”

  Carter shrugged. “Apples and oranges, Watson.”

  “Goats and monkeys,” I snapped back. “Or don’t you know your Shakespeare?”

  Carter’s lips thinned, and we regarded each other warily. Everything about this confrontation was wrong. Wrong for hospital etiquette. Wrong for how I’d come to expect my fellow surgeons to talk to me. Or I to them.

  It’s the war. Even here behind the lines, we’re not immune.

  Then Carter blew out a breath. “Fair enough. Time for the next patient, Dr. Navarette?”

  Time and past time, Navarette’s expression said, but she politely indicated that the interns and residents should precede her down the row of beds. I fell in behind, only to find Allison Carter at my side.

  “Do you have a few moments?” she said quietly.

  “Rounds aren’t over. Can it wait?”

  “I’d rather not. I have surgery scheduled shortly.” Then she added, “It’s not as though you are required to attend.”

  Ow. Was this a jab at my in-between status?

  But I was curious enough to decide I didn’t care. “Lead on, Dr. Carter.”

  We took the elevator to the fourth floor, then crossed over the walkway to the administrative wing. Carter’s office was next to Hernandez’s, another sign of her rank in the hospital hierarchy. She tapped the ID plate with her thumb and motioned me inside.

  Her office was not the luxurious suite that Hernandez commanded, but close enough. A bright airy space, with floor-to-ceiling windows. The Potomac was a wide gray ribbon in the distance. Beyond lay Northern Virginia and its government buildings, which had overrun the earlier suburbs. Between Georgetown and the river, DC made a patchwork of gray concrete and parks glittering with frost, outlined by Lafayette’s squares.

  Carter indicated a small table next to the window.

  “I’m sorry,” she said as we took our seats. “We began wrong, and it’s my fault.”

  Oh. Not what I’d expected.

  “We were both at fault,” I said carefully. “And for that, I'm sorr
y too.”

  Her smile was more a grimace. “Perhaps we were. But I’d like to mend that if I can.”

  By now I was wary. Oh, she used all the right words—though she’d been mighty damn quick to share the blame—and her offer to make amends was everything the employee manual and Ms. Professional Etiquette would recommend. Even so, I could not rid myself of the memory of Carter shouting at me that I was a gimp with an attitude.

  My expression must have shown something of my thoughts because Carter gave me an uneasy smile.

  “Yes, I was wrong,” she said. “I used words that . . . that I regret. I should have expressed my concerns better. We’re alike in many ways. We both get angry. We both care about our patients—all the patients here. We don’t want them dying because of mistakes we could avoid.”

  Because you wanted to prove yourself.

  That was like a punch to the gut. Because it was true.

  I let a breath trickle out.

  “You’re right. We don’t want them to die. For any reason.”

  “I’m glad to hear that.” Carter stood and held out a hand. “I’m also glad we had this talk. We might never be friends, Watson, but we can certainly be allies.”

  ***

  I made a quick retreat from that exercise in hospital politics and headed immediately to my office. My face felt stiff from the effort to be calm, polite, and friendly. Inside, my gut roiled from suppressed anger. Good thing I wasn’t really a surgeon these days, because I had the freedom to hide from the world until I ironed out my emotions.

  I locked the door and keyed the “Private Meeting” indicator.

  Private Meeting is right. Time for a little talk with yourself, Dr. Watson.

  All right. Let’s start. Therapy style. How are we feeling? Angry? Furious.

  Goddamned furious.

  Give me a name, a face. Who’s the lucky soul this time?

  Me. Carter. Both of us.

  My hands curled into tight fists. I eyed the door, wondering how much damage I would do to myself if I punched as hard as I wanted to.

  Not a productive line of thought. I unclenched my hands and started pacing. One of the tricks Faith Bellaume taught me. Walk and think. Talk out loud if you need to. Yell at the world.

  Yelling out loud would not be a good idea, what with the thin walls and curious neighbors. So I walked, walked from one side of my office to the other, and yelled inside my head.

  Stupid, stupid, stupid. Carter was right. I was stupid and selfish, thinking I could march right into that operating theater just on my say-so. If I can’t manage to braid my own hair, I can’t take a scalpel to someone else’s body.

  I bumped up against the opposite wall. Kicked it for good measure and spun around.

  She didn’t need to be so goddamned uppity herself though. Dr. Goddamned Allison Carter. Dr. I’m In Charge. She didn’t need to take over rounds the way she did. She just likes to make sure everyone knows she’s the alpha doctor.

  Back to the other side of my office. I aimed another kick at the wall but stopped myself in time. Not productive, Dr. Watson, I told myself. Faith would have had a few words about trigger points. She would have calmly reminded me to practice my breathing drills, and had I skipped a few days this week?

  I was still standing there, staring at the wall, when a knock sounded at the door. Oh god. I didn’t want to talk to anyone just yet.

  “Janet? Are you all right?”

  Christ. Letova. For once I wished my friends didn’t care so much.

  I sucked in a breath, wiped a hand over my face, and opened the door.

  “Hi,” I said. “What’s up?”

  Nina Letova folded her arms and regarded me with deep suspicion.

  Oh. Hell. She’d probably heard me kick the wall.

  “I’m fine,” I said.

  “Huh. Could’ve fooled me.” She glanced up and down the corridor, then stepped inside my office and eased the door shut. “Something happened, I can tell. Or is it more like someone happened? Was it Carter?”

  Double Christ. The grapevine had already started to chatter about our little argument during rounds.

  “Nothing all that dramatic,” I said. “Carter pointed out a couple flaws in my integrity, is all. I didn’t like what she said, but she was right.”

  “Oh, that,” Letova said. “Been there myself, my friend. It’s not so much what she says, it’s how she says it.” Her mouth twisted into a smile. “She’s not all that bad, you know. She’ll make a grand CMO once she gets her ego under control.”

  “Heh. I thought ego was one of the job requirements.”

  We laughed. The tightness in my gut eased.

  “So tell me,” I said. “What kind of lecture has Carter delivered to you?”

  Letova flinched. All the humor drained away from her face.

  “Hey,” I said softly. “You don’t have to tell me.”

  She blinked. Managed a smile. “Sorry. It was . . . It was today, as a matter of fact. You remember that kid, Javier? A simple appendectomy. No complications. All the indicators were good. We discharged him early. Then this morning . . .”

  I laid a hand on her shoulder. I didn’t hug her—Letova didn’t care for hugs. I definitely didn’t tell her any such fool thing as He’ll be fine. Don’t blame yourself.

  “Go see your patient,” I told her. “You’re a good surgeon. You care about your patients. There’s nothing wrong with that.” Then I went ahead and said it anyway. “Don’t blame yourself, Nina. The boy will be fine.”

  ***

  Letova did not stay long. She had patients to examine, charts to review, another surgery to prep for. I tried to drown my doubts in research for that damned medical abstract, but I was too jittery to concentrate. I finally gave up and shut down my workstation.

  A brisk walk would do me good, I decided, so I set off on foot for my apartment. The cold, dank February night matched my mood. Guilt was such an insidious emotion. Letova, distressed over her patient. Me, distressed over my uncertain status at the hospital.

  Letova would recover. She had to. But I knew why she blamed herself. A patient had nearly died, in spite of everything. Ergo, it had to be her fault. Hidden complications that tests had not uncovered. Or the follow-up care was not as meticulous as needed. Or God herself, and why not blame the surgeon, because they were next in line?

  You are not God, Angela had said. Neither am I.

  Angela Gray would be in attendance at the conference. Perhaps I could discuss the matter of blame with her then.

  My breath caught between laughter and a sob. Terrible idea. We would, both of us, end up weeping or raging. Or evicted by the conference security guards.

  The steady drizzle turned to sleet, tiny specks of ice that stung my face. God’s tears, one of my old teachers, back in grade school, had called it. As if God ever cried over the dead. I wish she had. I wish she did.

  The sleet came down harder and faster than before. I dug my hands deep into my pockets and cursed myself for being such an impetuous child. I could’ve—I should’ve—walked out my jitters at home, in the warm bright parlor that was 2809 Q Street. Privilege 101, Black Edition. Limited, you might say. Yes, I had a hard time flagging down that cab, but less than other folks. And however much I complained, I could and did have a refuge.

  Survivor’s syndrome, Faith called it. Doesn’t make your anger any less real.

  Doesn’t make it any more useful.

  The neighborhood around Thirty-Fourth Street didn’t look quite as broken as the last time. Cracks in the street had been patched with asphalt, and the traffic lights blinked yellow, red, and green the way they should have. Most of the shops were closed, their metal shutters lowered and locked. Even the bookstore was dark, and a sign on the door said, CLOSED. EXTENDED HOURS TOMORROW.

  The next block showed evidence of light and life. I remembered a coffee shop one of the nurses had recommended. I could sit at the counter and warm up, before hunting down a cab.

  ALICE
’S COFFEE BAR, read the sign on the frosted glass doors. BEST DAMNED COFFEE IN DC.

  A blessed cloud of heat wrapped itself around me when I stepped inside. I breathed in the scents of strong coffee, of cinnamon and vanilla and almond, while bits of sleet and snow from my hair dripped onto the welcome mat. No one even seemed to notice me. I found an empty stool near the front and ordered a cup of their premium brew.

  The coffee came in an oversize mug—strong and hot and smoky, just the way I liked it. The waitress left me a pint-size jug of cream and a bowl of sugar. I mixed in a generous helping of cream and drank slowly, letting the heat soak through my skin and deep into my bones. Voices hummed in low conversation all around, punctuated by the clatter of spoons and cups.

  So. Are we all done with the jitters? All it takes is a long walk and some nasty cold weather to give some perspective?

  Maybe. Could be. My mother always said a dose of hard work was enough to drive away her blues. Too busy to fret, she would tell me and Grace. Usually right before she gave us a list of chores.

  Even so, I wasn’t quite ready to face the cold. I was about to signal the waitress for a refill when I caught sight of a woman walking down the aisle. Her face looked vaguely familiar—the round glasses, the hair tinted dark gold and barely contained by a brightly colored head wrap.

  Adanna Jones paused and stared back at me, frowning. Then she recognized me, and her expression cleared.

  “Hello,” she said with a smile. “Did you enjoy the book?”

  “I did. Thank you.”

  She wore a dark red sweater, knitted in a complicated pattern, and sensible black trousers. The sweater’s yarn was dense and fluffy at the same time. The word luxurious popped into my mind. I wanted to say something profound about the Rumi, but then I caught a whiff of Jones’s perfume—a mix of jasmine and cedarwood that sent my brain blank with unexpected attraction.

  Oh god. Not now. Not here.

  The last time I’d felt so damned awkward was in high school, right after I discovered I liked girls, not boys. I sucked down a deep breath, but the flutter in my stomach only got worse.