First, Do No Harm
First, Do No Harm
First, Do No Harm
Larry Karp
www.larrykarp.com
Poisoned Pen Press
Copyright © 2004 by Larry Karp
First Edition 2004
Library of Congress Catalog Card Number: 2004107499
ISBN: 1-59058-130-X Hardcover
ISBN: 9781615951055 ePub
All rights reserved. No part of this publication may be reproduced, stored in, or introduced into a retrieval system, or transmitted in any form, or by any means (electronic, mechanical, photocopying, recording, or otherwise) without the prior written permission of both the copyright owner and the publisher of this book.
Poisoned Pen Press
6962 E. First Ave., Ste. 103
Scottsdale, AZ 85251
www.poisonedpenpress.com
info@poisonedpenpress.com
Dedication
For Myra
The Song Is You
Epigraph
Know then thyself, presume not God to scan;
The proper study of mankind is man.
Placed on this isthmus of a middle state,
A being darkly wise and rudely great...
Created half to rise, and half to fall
Great lord of all things, yet a prey to all;
Sole judge of truth, in endless error hurled;
The glory, jest and riddle of the world!
Alexander Pope
Contents
Dedication
Epigraph
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
More from this Author
Contact Us
Chapter 1
In the light of blue moons, certain doctors appear and blaze into legend, medical sports of nature with diagnostic acumen beyond uncanny, healing powers just this side of miraculous. I’m not talking about the likes of Pasteur, Semmelweis, Walter Reed, healers whose heroic campaigns against the double-headed dragons of disease and human stupidity won them seats as Knights of the Hippocratic Round Table. Legendary docs are not knights, but Merlins, watching over fiercely bubbling cauldrons full of dark ingredients. Dark ingredients, strong magic. Darker ingredients, stronger magic, but greater risk of the pot boiling over—disaster. Unspeakable ingredients…
My grandfather was one of those Merlins, though I didn’t know it until just a couple of days ago. I didn’t know anything about my grandfather until a couple of days ago, and I’m twenty-eight years old. Dad never would talk about his father, strange, but Dad is Leo Firestone…yes, that Leo Firestone. The painter. Refusing to mention his own father’s name is way down on the list of Leo Firestone’s oddities.
Way up on that list is Dad’s art. Nightmarish, bizarre. A teddy bear with barbed-wire fur next to a small disembodied hand, fingers gouged, bleeding. Couples embracing through jagged shards of glass. Doorknobs shaped like grenades. Spring-loaded knives poised to fly up through the seat of a well-used armchair. A mother putting her baby to her breast, the nipple a minefield of tiny blades. Worst are the faces, never shown directly, features shadowed and indistinct, a compelling ambiguity that never fails to pull me, resisting, into the damn paintings, to be slashed and stuck and gouged.
Dad first caught notice in the Fifties, one of those stormy young postwar artists in New York who somehow managed to find time to work despite a full schedule of brawling and carousing. Some of Dad’s early companions flamed out in alcohol; some went out on the wrong end of a hypodermic needle. Others gave up, bought a suit and tie. But Dad prospered. Critics pronounced his work as brilliant as it was troubling. Gallery owners fought to feature his canvases. The more Dad called them leeches and vultures, the more they pursued him. Brilliant timing, the perfect Sixties artiste, he left a legacy of angry insults and bloodied faces that may never be matched by any painter, sculptor, writer, or musician.
By the early Seventies, Dad could call any shot he wanted. He sold his little place in the Village, bought a piece of property on Peconic Bay, way out on Long Island, and built a house and studio for himself and his pianist-friend, Tanya Rudolph. Maybe music really does soothe savage breasts, but more likely Tanya just had what it took to stand up to my father. Early on, their fights were the stuff of tabloid headlines, but the only people who ever came away injured were those who tried to get between them. A year after they moved to Peconic, Tanya became Mrs. Firestone, and two years after that—following some loud and serious discussions—I made my appearance. Mother wanted two children. Dad finally agreed to start with one and see what happened. The fact I remained an only child speaks for itself. That, Dad would talk about. My grandparents, never.
Our house was a white stucco-coated Chinese puzzle, all intersecting acute angles, lots of glass. Inside, teak and mahogany-paneled walls covered with paintings, Dad’s, his friends’. My favorite was a five-by-four canvas of Mother, hung directly above her Steinway grand in the living room. Typically cryptic face, but Mother, no doubt. Dad really caught that particular way she angled her hip when she stood, the familiar tilt of her head, her flowing platinum hair. Mother went white in her twenties, had the great good smarts to never dye it.
Personality encounters were frequent at our house, artistic skirmishes routine. But space wars, never. Mother’s kitchen was immense, bright with copper and steel. Her Steinway seemed dwarfed in its corner of the massive living room. I had both bedroom and private playroom. At one extreme of the house stood Dad’s airy painting studio, at the other, his den, a small room with no windows. Dad kept that room locked whether he was inside or not, and Do Not Disturb was understood. No one but Dad went in there, ever. Not Mother, not the cleaning lady, not me.
Wild…first word to mind for my childhood memories. Winter nights, wind-whipped sheets of water against floor-to-ceiling windows, heavy percussive beat of waves slamming into the shore. One weekend when I was seven or eight, Norman Mailer came to visit. Picture me under the round glass coffee table, watching two men with dark raging eyes, beefy faces, crowns of wild black curls, going nose-to-nose, at least half-crocked, over some artistic particular I couldn’t begin to understand. Mailer was no pygmy, but Dad was three or four inches taller, with more muscle and less fat. Mother sat at her piano, hands gliding over the keys, white hair dancing around her face. Every now and then she stopped playing long enough to sip at a drink and study the combatants over the rim of the glass. Laugh lines traveled from the corners of her light blue eyes, then she tossed out a line that stopped Dad and Mailer cold. They all laughed, laughed, laughed.
I was no honor-roll student, worked only at what interested me, responded with equal indifference to carrots and sticks. I refused to learn anything by rote, accepted no givens—a pesty kid, always with a “Why?” or a “How?” Dad called me Professor Skeptikos, used to tell Mother they should’ve used birth control on that trip to Greece the year before I was born. “He drives me nuts. Asks a question, I give him an answer, here come ten more questions.”
One Saturday when I was eleven, Dad came back from a day in New York carrying a carton and wearing a smile straight off the Sphinx. He set the carton on the kitchen table, kissed Mother, then turned to me. “Well? Aren’t you going to open it?”
Christmas in March? I
tore into that carton, and when a thick manual fell out I thought I’d burst. “A computer. For me?” I ran over, hugged my father.
“Atari-ST,” he growled. “Supposed to have the best color graphics. And some new system where you can compose music, then hook up a synthesizer—”
“MIDI,” I hooted. “Oh, wow!” I scanned the room, a little man trying to spot a cab in a downpour. Dad jerked a thumb toward the front door. “Rest is in the car, you can help me schlep it in. Monitor, printer, bagful of books. It’s a kind of kit. You’ve got to put it together.”
I drew in a breath. I’d been a model-builder since the age of four, when I got a Lego set. At eight I built a model car that ran, at nine, an airplane that flew.
“Maybe that’ll keep him out of my hair for a little while,” Dad muttered at Mother.
Mother smiled, slipped me a wink.
Dad got me out of his hair, all right. He clearly knew nothing about computers, no point asking him questions. But if he was trying to nudge me toward a career in the arts with that Atari, he failed miserably. Color graphics and MIDI ports were fun, but the computer itself was a whole new world. I found out about bulletin boards, spent a chunk of my savings on a 1200-baud modem, tied up our phone for hours, equal parts software and smut. Not long ’til I began to tinker with the software, putting together programs that by all rights should’ve blown higher than Everest, and sometimes did. But more and more often, they performed as I intended, usually pointing the way to a new challenge. Add, upgrade, ad infinitum. My childhood playroom became a jungle of wires connecting components set on shelves among books, floppies, tapes, CDs. I worked after school, weekends, and summers to support my habit. When I finished college, I signed on as program designer with Custom Softies, a company in a little office on the tenth floor of an old office building on East Fifteenth, near Union Square. Took a week to move all my stuff into my new apartment in Manhattan.
Five years, no problems, but then my bosses overextended. A couple of weeks after employees voted to accept an across-the-board pay cut, Dad came in to New York to supervise an exhibit setup. Afterward, he took me to dinner. When he asked what was new, I told him about the salary cut. He shrugged. “You’ll get by.”
“I suspect,” I said. “But just in case, I took a night job.”
Dad looked amused. “What kind of night job?”
“At Bellevue…” I paused as Dad’s face settled into a scowl, clay hardening. “Bellevue’s Cardiology Department is one of Custom Softie’s biggest accounts, so I spend a lot of time there. Last week, I saw an ad on a bulletin board for part-time nurse’s aides. O.J.T.—”
Dad sprang to his feet roaring. “Jesus Christ. A nurse’s aide? At Bellevue? Most ridiculous goddamn thing I ever heard.” He reached into his pocket. “How much do you need?” Wallet out, open, fingers pulling at bills. “Shit, Martin, I’ve got more money than I can ever spend.” He held out five hundreds. “Here. Quit that fucking job.”
People around us turned to look. I brushed the money away. “Thanks, Dad, but I’d rather try to do it on my own.”
The rest of the meal was a disaster. I don’t think Dad spoke ten words. After that, I always took care to avoid mentioning my second job, and Dad never brought it up. I worked three partial shifts a week at Bellevue, and a full shift on Sunday. I checked vital signs, gave medications, made sure charts were up to date, emptied bedpans. I even met a girl at Bellevue, married her last year. When I introduced her to Dad and Mother, I told them we’d met at a party.
I watched the Bellevue doctors carefully, listened just as hard. Sometimes they took me aside to explain points. Dr. Charles Donovan, an internist, kept encouraging me to apply to medical school. I talked it over with my wife. Helene gave me that soft smile, the one that had sent me out to buy an engagement ring. “I think that’s wonderful, Martin. I do. We’ll have no trouble managing on my income.”
“But we’ve talked about children—”
“We’ll just keep talking for a while. Do it, Martin.”
So I took the M.C.A.T., had an interview at N.Y.U. Med School, and got accepted. Helene was thrilled. “Let’s go to Palais Royal. It’s Friday, but maybe we can get a late table…oh, wait. Your parents?”
“I never told them I applied,” I said. “If I didn’t get in, easier to not have to explain why.”
Funny look. Helene handed me the phone. “Well, now you don’t need to explain. Just call them. See if they’d like to come in and join us.”
No way around it. Three tries before I punched the right numbers into the phone. Dad answered. “Firestone.”
“Dad? Martin. I’ve got something to tell you.”
“Somebody’s a little late this month?”
“Not that, no. Dad, I applied to medical schools this year, and I’ve just been accepted. N.Y.U.”
Silence…well, not quite. Better, no words. I heard a choking sound, almost strangling. “You what?” Dad finally said.
I wished time into rewind. “Got accepted to medical school. I’m going to be a doctor. Start the day after Labor—”
Dad cut me off with a volley of language as foul as I’ve ever heard, made steelworkers sound like sixty-year-old schoolmarms. I tried a couple of times to break in, but it was like holding a sheet of cellophane up to the stream from a firehose. Finally, Dad barked, “You know where Manny’s is? Restaurant.”
“Well, sure. You’ve taken me there a lot. Second, near Fifty-fourth.”
“Meet you there tomorrow, one-thirty. Lunch.” Not a question, not even a statement. “I…I’ve…”
First sign of weakness, but I knew better than to take advantage. Just waited.
“Got a story to tell you.” Slam.
Helene looked up, brows together, as I set down the phone. “Martin, what on earth happened?”
“I walked into an ambush, that’s what. For some reason, Dad’s more than unhappy. Sounds like I’ll get the score tomorrow. Lunch, command performance.”
“Your father’s very strange, Martin. Sometimes he scares me.”
The words were out of my mouth before I completed the thought. “The scariest people are scared people.”
This was not like Dad, not at all. A story to tell, barely able to contain it? Dad never told me stories, not about birds and bees, not about anything. Aphorisms were more his style, one-line zingers, right to the heart of the matter and the gut of the listener. As I waited outside Manny’s, I couldn’t imagine what was coming.
One-thirty sharp, there was Dad in his favorite gray work shirt, splotch of bright green paint above the pocket. He nodded, motioned me inside, not a word.
Lunch hour waning, several highbacked mahogany booths empty. Dad motioned to one all the way in back. “We’re going to be here a while,” he told the headwaiter. “We’ll order, then I don’t want anyone bothering us.” He pulled a fifty from his wallet, handed it to the maitre d’, who slipped it in one smooth motion into his shirt pocket. “I understand, sir. I’ll let your waiter know.”
As we slid into opposite seats I snuck a look at Dad. Cheeks finished with rough sandpaper, skin slack over the bones. Fatigue lines etched at the corners of his eyes. Dark eyes bloodshot, muddy. Hair tumbling over his forehead and ears. How much sleep did he get last night? How much did he drink? Seventy-six years old, still knocking down the sauce from dark to dawn, then going all-out the next day. He flipped the menu open, scanned it, set it down, looked around.
The waiter, a slim young man in white shirt and snappy plaid tie, caught Dad’s eye, scurried over. “Yes, sir? You want to order already?”
Nod. “New York steak sandwich, rare. And a Manhattan, heavy on bitters. Martin?”
I tried not to think about Dad’s liver. “Same sandwich,” I said. “And iced tea.”
The waiter scribbled. “Got it.” He slipped his order pad inside his cummerbund. “Headwaiter talked to me. I’ll bring your orders soon’s they’re ready. Then, you want som
ething else, you call me. Right?”
Dad allowed himself the tiniest trace of smile, not pleasant. “Right.”
The waiter left quickly. Dad drummed fingers on the table top, looked one way, then the other. Slowly, those black eyes turned toward me, focused, locked into place. “All right, Martin. What’s with this crap about medical school?”
I learned as a young boy, flinch and I was a goner. “No crap,” I said. “I applied, I got accepted, I’m going. If there’s crap, it’s coming from your side of the table, and I don’t understand. I’m not asking you to pay my way. I’m not asking you for anything. What the hell’s your problem?”
“What’s my problem? I’ll tell you what’s my problem.” Head cocked, left eye half-closed, mouth twisted like a badly healed scar. “I ask my son a simple fucking question and he won’t give me an answer. Martin, why…the…hell…do…you…want…to…go…to…medical school?” Every word punctuated with a sharp nod of his head. Then the ultimate shrug, hands extended toward me, palms up.
Where was he going, my crazy father? I cleared my throat. “All right. Computers are exploding in medical use. Horizon’s endless. In ten years doctors will use them every day. Diagnosis, treatment, consultation. Research, devising new paradigms—”
Dad’s huge fist hit the table so hard I jumped. “Goddamn, Martin, you’re not at an interview and I’m not a dean, so spare me the bullshit. First, you take a lousy night job for peanuts to work at a hospital. Now, all of a sudden, at twenty-eight, you’re going to medical school. I’m asking you why, and I want an honest answer. Is that too much to expect?”
Dad watched me like a hawk taking aim at a poor salmon, flopping its way upstream in shallow water. “Dad… I’m not sure I can tell you exactly why. All those years I played with computers, I thought I was making science fiction real, and then I started working with the cardiac team at Bellevue. I saw them put new valves into hearts. Dad, I watched a heart transplant—they put a new heart into a man’s body, he was dying. Three weeks later he walked out of the hospital. What could I ever do with a computer to match that? If a computer crashes, no big deal, just start over, but a doctor gets just one chance, and he’d better do it right…no, he’s got to do it right. I felt hollow, Dad, trivial. Like the big game’s going on, people pitching, batting, catching, throwing, the crowd’s cheering…and there I am on the bench in the dugout, a lousy batboy. When I saw that ad on the bulletin board, I had to take it. And you were right. Nothing to do with my pay cut.”