The Assailant (2 page)

“Sounds great,” the man said.

He walked her to his car. He opened the door and shut it after she got into the front seat.

It was when she got into the car that she started to worry. Because the car didn't really fit the man. It was a secondhand Ford Crown Victoria. Stripped, utilitarian, and plain. She expected him to have a Jaguar or a BMW. A secondhand car, but the man was wearing a nice suit and a Burberry raincoat. They didn't go together. A small alarm went off then. She could hear Bobbie's counsel from the earliest days:
You sense danger, you get out of there
. . . .

Reesa said, “Where did we meet before?”

The man kept his eyes ahead, on the road. They were south of the I-64 overpass now, heading toward the loading docks beyond Laclede's Landing.

The man said, “The pharmaceutical wine-and-cheese party. It was a couple of weeks ago.”

“Oh,” she said. And now she was looking at him again. “So you're a doctor?”

He nodded, smiling again. Pleased with himself.

And Reesa said, “Is this your car?”

“It's a loaner,” the doctor said.

Soon they were stopped. And she could sense the Mississippi River not far off. Dark and cold and abandoned buildings were on both sides of them. And he had shut off the ignition to the car, and Reesa was not liking this at all. She was not the sort to work in cars. Hotel rooms, homes, apartments, that was her thing. She thought about her purse and the small mace dispenser inside, hoping she was wrong.

“Hey,” she said, putting some harshness in her words because often that tone could put guys like this in their place. Particularly the professional ones who worried about exposure and scandal.

“Hey,” she said, “I don't like this.”

That's when she noticed him pulling on the black gloves. Not looking at her as he pulled them on, and then when they were pulled tight, he turned and punched her in the face.

The force of the blow did not knock her unconscious. In her last few seconds, she started to wish that it had.

Dr. Raymond Sheffield arrived at the emergency room at St. Mary's Hospital ten minutes before the beginning of his shift. It was a twelve-hour one, midnight to noon. He went to the locker room and changed into medical scrubs. On some days, he wore his business attire with a doctor's smock over, the tie showing. Today he chose not to.

In the locker room were Dr. Ogilvy and Dr. Tassett. They were interns in their late twenties. Dr. Sheffield was thirty-three. He was not an intern. He was a regular working emergency-room physician. His contracted annual salary was a little under four hundred thousand dollars.

Dr. Sheffield regarded the younger physicians. Robert Ogilvy, graduate of the University of Missouri medical school. Chubby, loud. A mediocrity. Slightly more intelligent than the typical shaved bears one saw out of state schools, but not much. Liked to repeat jokes he heard on cable television, get the laughs as if he deserved the credit. A fool.

Harry Tassett. Another mediocrity. Only he didn't know it. Graduate of the University of Texas medical school, but had gone to Penn undergrad. Ivy League, but the school you went to if you couldn't get into the others. It was no Dartmouth. Harry
came from Dallas and he seemed not to be ashamed of it. Harry was not loud like Robert was, but too self-assured.

When they first began working together, they had shown some deference to Raymond. They did this even though he was not the director of the ER and didn't hold a teaching position. He was merely older by a few years and had concluded his internship. In Boston. In a real hospital. They had tried to be friendly to him at first, but he hadn't responded to their jokes. He found them tiresome and immature. It took them a while to figure out that Raymond Sheffield was not shy but perhaps superior. Above things. This suited Raymond.

Yet, as much as they may not have liked it, they did think he was a better doctor. And when they needed help, when they genuinely thought they might be lost, it was Raymond whom they consulted. Raymond could tell that they didn't like doing this and it pleased him all the more.

•

St. Mary's Hospital was located in North St. Louis, a high-crime area of the city and county. Near interstates, construction sites, industrial workplaces, and not a few crackhouses. St. Mary's emergency room rarely suffered for lack of business. The ER was supposed to be used to treat medical and surgical emergencies. But patients and doctors alike treated it like a clinic.

The “working” physicians and interns generally logged twelve-hour shifts, while the nurses worked eight-hour shifts.

An hour into his shift, Raymond Sheffield was suturing a laceration to a teenaged boy's calf. He was being assisted by one of the staff nurses. Sheffield kept the sutures tense but not too tight. He wanted to avoid scarring or edema.

“Dr. Sheffield?”

Raymond tilted his head.

“Dr. Sheffield?”

It was Helen Krans, an intern. She stood far enough away to prevent infection to the patient.

Raymond said, “Yes, Helen.”

“I have a patient, a woman in her early thirties, came in saying she fell down the stairs and thinks she may have cracked a few ribs.”

“And?”

“Well, the X-rays don't show any rib fracture. But she's complaining of considerable upper-abdominal tenderness.”

“Muscle guarding?”

“I think so.”

“Get a flat plate of her lower abdomen. Stat.”

“Yes, sir.”

Raymond Sheffield smiled. “Don't call me sir. We work together.” He turned to the nurse assisting him and said, “Give him a tetanus booster plus intramuscular penicillin. Okay?”

“Yes, Doctor.”

He cleaned and met with Dr. Krans later. Together they looked at the flat plate. Raymond Sheffield said, “That's what I was afraid of. A ruptured spleen.”

It was bleeding under the capsule but had not yet come apart. Once it did, the patient would either bleed to death or die of peritonitis. She could also suffer paralysis of the intestines.

Helen Krans said, “Is she going to have to have a splenectomy?”

“Yes,” Dr. Sheffield said. “Or she'll die. The capsule's on the verge of exploding now.”

Dr. Krans said, “I'll call the attending surgeon to assist.”

“Who is it?”

“Dr. Lipkin.”

“Okay,” Dr. Sheffield said. “Why don't you assist me as well?”

“I'd like that,” she said. “How did you—”

“We need her authorization, don't we?”

“Yes, Doctor.”

Dr. Sheffield said, “I'll speak to her.”

The patient's name was Tilda Mercer. She was heavyset and unattractive, and she looked like she wanted to go home.

The physician said, “Mrs. Mercer, my name is Dr. Sheffield. We've been looking at your X-rays and we believe we need to remove your spleen.”

The woman's lower lip quivered. She said, “Why do you need to do that?”

“Because it's been ruptured, and if we don't do it soon, there's a good chance you're going to die.”

“But it's just . . . all I did was fall.”

“Fall where?”

“On the floor.”

“I thought you said you fell down the stairs?”

“Yeah. The stairs.”

She was looking away from him.

Dr. Sheffield said, “Mrs. Mercer, where is your husband now?”

“He's at home.”

“You drove yourself to the hospital?”

“Yeah. I mean, he's busy.”

“Mrs. Mercer, pardon me for being blunt, but I don't think you've given us an honest history. Did you really fall down the stairs?”

“Yes. Yes.”

“Or did you and your husband have an argument?”

“Well . . .”

“Mrs. Mercer, we can't help you unless you give us an adequate history. Did your husband hit you?”

The patient sighed. She said, “He didn't . . .
mean
to. He'd been drinking and I called him something and he pushed me down.”

“Was that it?”

“And then he kicked me.”

“In the stomach?”

“. . . Yeah.”

After a moment, Dr. Sheffield said, “Okay, then. We'll need
you to sign some forms, and then we're going to conduct the surgery. I don't foresee any problems.”

•

The surgery went well. After it was finished, Dr. Sheffield instructed the ER chief nurse to notify the police and report Mrs. Mercer's husband for assault and battery. He further instructed her to notify him when the police arrived so that he could give them a statement for their report.

Dr. Helen Krans caught up with him in the hospital cafeteria. He was sitting at a table by himself with a cup of coffee and reading the
New England Journal of Medicine.
He looked up at her and gave her a gentle smile and said hello.

“Hi,” Helen said. “I just wanted to tell you that you were terrific. I didn't know—I didn't think about the spleen being ruptured. What I'm saying is, you saved that woman's life.”

Dr. Sheffield said, “She's a patient.”

“I know,” Helen said. “But you followed it up and called the police and—well, it was very impressive. May I sit?”

“Of course.”

Helen said, “How did you know?”

“How did I know that the spleen was ruptured?”

“Well, yes, that. But what I meant was, how did you know that she's been abused?”

Dr. Sheffield said, “That was simple. Obviously the trauma had to come from somewhere. She could have fallen, but that
didn't really comport with her injury. I presumed she'd either been punched or kicked. She was kicked.”

“Yet she tried to protect him.”

“Tried to protect her husband, you mean?”

“Yes.”

“Yes. Well, that's very typical.”

“Of women in general?”

“Yes. Of victims, I suppose.” Raymond Sheffield smiled. “I don't mean to sound callous about it.”

“You don't . . .”

“I suppose I do. I'm in my early thirties, by no means old. Not even middle-aged. But it wasn't that long ago that I did my internship. In Boston. And I came out of there a much different person than when I went in.”

“I understand.”

Raymond frowned, paused. He wanted to convey that he was a sensitive, thoughtful person. He held the pose for just long enough. Then he said, “You learn to form a shell. Not just to sickness and trauma, but perhaps to human trauma as well. Spousal abuse, child abuse. When I first started, I wondered if Boston was the most violent, hateful place in the world. But then I found out that it was no worse there than it was anywhere else. St. Louis or Bedford Falls, Pennsylvania. It's not the place, it's the species.”

Helen said, “Don't you worry?”

“About the patients?”

She smiled, seeming to believe in that moment that he was selfless.
She said, “No. I mean, about yourself. That you're getting too hard.”

“Yes. There's always that concern. That you can become inured to it. But if you give in to those feelings, you won't be much good as a physician. What you have to do is find that line. That midpoint. Find it, become comfortable with it, and somehow straddle it. It helps to have faith.”

“Religious faith?”

“Yes. And faith in humanity as well. And your work. We did something good, didn't we?”

“
You
did,” Helen said. “Do you go to church?”

“Not as much as I used to,” Raymond said. “Not the Catholic Church. But I feel myself searching for something. I believe I'm a spiritual person, if not an orthodox one.” He smiled. “I suppose that makes me sort of an anachronism.”

“No,” Helen said. “I think it's nice, actually.”

Raymond gave her a brief look. His expression became shy, perhaps even embarrassed. He said, “We should probably get back to work.”

Carol McGuire opened her eyes and closed them. Opened them again to see the numbers on the alarm clock take form. A little after eight o'clock. Her alarm was set to go off at six thirty, but she had not set the alarm last night. It was Saturday. Saturday morning.

Saturday morning. Hadn't . . . George stayed with her last night? He had. They had made love after they got back from a party. The party had been hosted by a schoolteacher who was married to a public defender, and they had both invited friends from their respective workplaces. The teachers and the lawyers had not mixed well. The teachers being decent, upright sorts who laughed at clean jokes and the lawyers being morbid and cynical. George had found one or two people he thought were tolerable if not interesting and then stayed in conversation with them to make the evening pass more quickly. Carol knew that George was not much of a socializer. His stomach was too sensitive for wine, and he had never been much of a drinker. Plus he was quiet in the way that some cops are quiet. While the loud ones were like cowboys, the quiet ones always seemed to be watching. George was a quiet one, his eyes not resting even when they seemed to be.

Carol would say, “You're always judging, aren't you?”

“I don't judge,” he'd say. “Sometimes I watch, but that's not the same thing as judging.”

Carol did not consider him restless. She would not have wanted to spend much time with someone like that. But the more she got to know him, the more she came to believe that he was the sort who could relax only on his terms. He would go to a party with her and not complain about being bored or put off by people, but she could see that he was doing it for her. Not enjoying himself, but being dutiful. She knew that policemen were tribal and, in their own way, quite snobbish. She had known that going in.

One of the differences between them was that he was incapable of sleeping in.

This morning, she knew that he was still in her apartment. Indeed, she could hear him moving around the kitchen now. Probably he had already made a pot of coffee and was sitting at her kitchen table reading the newspaper. He could be in bed with her, but she was asleep, as far as he knew. On a weekend, she could sleep to eleven or even noon. He seemed incapable of that.