Enough to be dangerous

Sam fell back against the wall outside of the OR. The case took hours longer than she expected. For the better part of two hours, she could only partially see what was happening. She was barely able to carry out her duties of sucking smoke and blood from the operative field. Still, her day was not done. When her chief resident called her to the OR to help out, she was wrapping up random floor “scut.” “Scut” encompassed the endless patient care tasks assigned to the first-year doctors, the interns, who know just enough medicine to be dangerous. Scut was the entry level of learning, not quite mindless, seemingly infinite. The trauma service was a 24-hour nonstop specialty, but tonight, she was not on call and she had plans. She was scheduled to be at the free clinic at 6:30pm. Her work there, not unsimilar to her work at the hospital, somehow recharged her. Taking care of the people there, uninsured and underserved, helped her reconnect to why she became a doctor in the first place.

She reached in her back pocket for the small black notebook she used to collect labels from the cases she scrubbed and her daily list of scut. The book was a gift from her mother the day she matched into general surgery residency. Her mother, a surgeon herself, claimed to still have her book from residency. Sam’s book wasn’t in her pocket. She walked to the front of the operating suite and grabbed her coat from the hook. In one movement she put her arms in the coat and reached inside both side pockets. No book. This is bad. Not only was it a cherished gift, but it contained scores of private health information for patients on whom she had operated. Before she went to the OR… she was doing dressing changes on the floor. Jace Daniels on 3East, gunshot wound to the thigh, rule out compartment syndrome. She recalled emptying her pockets looking for trauma shears. If she hurried, she might have enough time to eat before clinic.

Jace gripped the rails of his bed as the nurse packed gauze in the open wound left by the bullet that tore through his right thigh. The doctors said nothing was broken but the swelling of the muscles and soft tissue needed to be watched. This was not “watching,” this was torturing him twice daily. He winced when he had to lift and bend the leg so she could wrap his thigh from knee to groin with an elastic bandage. At least the morning dressing change was done by the angel-faced doctor, Dr. Samantha Edwards. He heard the others call her Sam. She seemed kind, her movements were gentle. She checked his face often for signs of discomfort and he thought this made her seem sorry for the pain she was inflicting. His thoughts of Dr. Sam almost distracted him from the throb the elastic wrap was causing. He was pre-medicated with morphine for the dressing changes, but it didn’t help.

“Can I have more pain medicine?” Jace asked.

The nurse looked at her watch. “Sorry honey. You can’t have more for another two hours.”

Sam stood outside of room 306. Jace Daniels was a young, successful appearing man, easy on the eye her mother would say. His soft gray eyes were just part of the mystery. She couldn’t piece together how he got here- young, professional, shot. She couldn’t help locking gazes with him every morning during his dressing changes. He seemed to be in so much pain, pain out of proportion to what she was doing to him. She knocked, but before she could open the door, it swung open.

“Headed out doc?” the nurse spied the oversized bag on Sam’s shoulder.

“I have clinic at St. Francis tonight.” Sam replied. “I think I left something in here earlier.”

“Well, I Just finished his dressing change. He could use something for breakthrough pain.”

“Okay. I’ll add something.” Sam offered. “He’s had 24 hours of compartment checks.”

“Thanks. Just put it in the computer.”

She nodded and walked in. “Mr. Daniels?”

He could hear Sam in the hallway talking to the nurse. “Yes?”

The way he looked at her always threw her off for a second. “Uh, your nurse said you needed more pain meds?” She looked around. She spied the book on the windowsill among the extra saline and gauze. She walked over and pocketed her notebook.

“Yes please. The dressing changes hurt quite a bit.” He used his hands to move his leg, trying to get comfortable.

“Sure. I’ll add Percocet. Give me a few minutes.”

His slight smile conveyed his gratitude and genuine discomfort. She nodded and left the room, feeling a slight and unfamiliar mix of sympathy and attraction.

Sam was in her absolute element in clinic. She was seeing her final patient for the evening, a homeless man with a growth on his ear. He was a regular at the shelter. The social worker there had noticed the growth getting larger and brought him over. The growth looked concerning. It was Asymmetric, had irregular Borders, multiple Colors (several shades of black), and a Diameter larger than a pencil head. The ABCDs of skin cancer were unmistakable. Tonight, she would biopsy the area, and share both truth and reassurance. It was a tough sell. She explained that the area had several features concerning for cancer, and that the biopsy would determine for sure if it was cancer or not. She explained if it was cancer, there were treatment options, including having it removed. She silently prayed she could make that be true. Free surgery for someone without insurance, and without a home, well, it would take something of a miracle. She finished her note in the computer, then reached for the little black notebook to write herself a reminder about following up on the pathology results. When she opened the book, she did not recognize what she saw. These pages were filled with random numbers, dollar amounts, dates. This wasn’t her book. Confused, and now concerned for an entirely different reason, she placed the book in her bag and headed to her car. She’ll deal with it tomorrow.

Dante closed the little black notebook and examined its covers.

“Jace, man. This ain’t the book.”

Jace opened his eyes, made heavier by the recent addition of pain pills. Dante was his longtime friend and doer of all things that needed done. He could always rely on Dante for simple yet important tasks like personal protection, delivery or acquisition of stuff. He usually stopped short of asking Dante for complex thought.

“What do you mean that’s not the book Dante? It’s the book Ahide is asking for.”

Jace closed and opened his eyes again slowly. He looked at the book in Dante’s hands. The book had a soft black cover, rounded corners with an elastic closure. He could see the black ribbon below its bottom edge. “That’s the book,” Jace insisted.

Dante opened the book again and looked just inside the front cover.

“Yo Jace. Who is Samantha Edwards?”

Jace felt abruptly sober. “What did you say?”

“This book says, ‘In case of loss, please return to: Samantha Edwards, 404-225-0399’. As a reward: $ generations of healing karma.”

Jace shook his head and balled his fists up in his eyes. No amount of karma could cover this. That was not his book, or more accurately, that was not the book he was supposed to deliver to Ahide, a man with no sense of humor and even less patience.

“Dante. You have to get that book back. I think the doctor has it.”

“The doctor? What doctor? Man, you’re trippin’ right now. Those meds are messin’ with you.”

“Samantha Edwards. She’s my doctor. She was just here, a few hours ago.”

“Jace, she could be anywhere by now. Plus, the boss is waiting for me to bring him that book TONIGHT. He seemed in a real hurry to get to it when he heard the cops brought you to the hospital.”

“I know.” Jace felt a sudden panic wash over him. “You gotta help me get out of here. I think I know where she is.” Breaking through the haze was a conversation he overheard.

“Man, you can’t go runnin’ after some lady doctor all bandaged up and doped out. You seem crazy.”

Jace was slowly, painfully dangling both legs off the edge of the bed.

“I’m not crazy. You have to get me out of here.” His eyes were now pleading with his friend. “As long as that book is missing, I’m in danger. I think we all are.”

Dante wasn’t convinced that this was a good idea. But was not the mastermind. He was more like the muscle, and right now, his friend was asking for muscle. Against his better judgment, he started to make moves. It was way too easy to slip Jace out of the hospital. Security was a joke. And maybe they could have shared a good laugh had the night ended differently. When they arrived at St. Francis, the parking lot was empty, and dark. Jace had only one idea left.

Sam was well into her morning routine of checking labs and repleting electrolytes of the patients on the trauma service. One patient, Jace Daniels, was missing from her list. He left overnight, without a word, without being seen. His disappearance was as mysterious as his being there. Yet, the most troubling part was what this meant for retrieving her notebook and returning the one with gibberish inside. A text broke her daydream. It was St. Francis.

Please call the clinic ASAP. Sam called immediately.

“St. Francis clinic. Ellen speaking.”

“Hi Ellen. It’s Samantha Edwards. I got your text. Something going on there?”

“Oh hi Dr. Edwards. Somebody left something for you here last night. We found it this morning in the mail slot.”

Left something? Who knew to reach her there?

“What is it Ellen?” asked Sam.

“Well, it looks like a book. Small, black. But there’s something else. I opened it to see who it belonged to. And well, there’s a check inside. It’s got your name on it.”

“A check?”

“Dr. Edwards it’s a check for $25,000. It’s from Jay-cee Daniels.” Ellen spilled all her tea at once.

Sam froze in complete and utter disbelief. Why would Jace Daniels leave the hospital against medical advice, then give her $25,000? What does he want? She was stunned.

“Dr. Edwards are you there?” Ellen asked into the void.

“Yes, I’m here. I’m just a little surprised. You said it was inside a black book?” Sam suddenly remembered her notebook and felt a flicker of relief amidst her grave misgivings.

“Yes dear. It’s got lots of patient information in it and doctor type notes. I’m sure you’ll want this back.”

“Yes please.” Sam still hadn’t found her words. Another pause.

“Dr. Edwards are you okay?” Ellen asked.

“Sorry Ellen. Yeah, I’m okay. Hey, I’ve to get back to things here. I’ll be by tonight to get the book. 6:30 okay?”

“Sure 6:30 is fine. But just the book? What about the check? You want that don’t you?”

“I’m not sure.” Sam said flatly. “Can you, just, hang on to it for me? Until I figure out..some things?”

“Of course, Dr. Edwards. I know it’s none of my business, but you aren’t in any trouble are you. You don’t sound like yourself.”

“No Ellen. I’m just confused that’s all. I’m not in any trouble.”

“Okay that’s good. I was getting a little worried. We’ll see you tonight.”

“See you tonight Ellen.” Sam hung up the phone.

Trouble? What trouble could she be in? What was Jace trying to buy? Her mind ran from one possibility to another- home visits, her silence, was he just grateful? Then she remembered the imposter notebook she took from his room. This check was either an unsolicited ransom, or it was a trap.