Do No Harm Page 3

“No problem.” Nate picked up the folder and handed Dyson the baggie of pills. “I need this filed from an overdose earlier. I’ll get you the report later.”

  “Sure. Tell Kia to come in. I need her to give the D.A.R.E. talk at the elementary school.”

  Nate strode out of the office, smirking as he told Kia what Dyson had planned for her day, and headed for his cruiser. He drove past the library, the flower shop, the bank, and the hospital, turning into the Mill Creek neighborhood for the second time today.

  The gloomy, tattered building before him was the worst excuse for a house he’d ever seen. Cracked windows, chipped and peeling paint, white long since dulled to gray. Overgrown bushes choked with weeds almost obscured the sagging front porch.

  The wooden steps groaned under Nate’s weight. He shielded his eyes to peer through the cracked front window, but it was too dark to see inside.

  Nate knocked on the door. “Hello?” he called. “Mr. Martinez?”

  No answer.

  Nate knocked again. “I’m Detective Sweeney from the Skamania Police Department. Can you come outside for a moment?”

  Nate waited, listening. Silence. He glanced over his shoulder, feeling eyes crawling over his back. He knew he shouldn’t try the handle, but he wasn’t going back to Dyson with no news. He was surprised to find the door unlatched. He nudged it open with his boot, convincing himself he had probable cause to enter. Besides, his Spidey sense was going all kinds of crazy.

  “Hello?” The door creaked open, an inch at a time. Nate peered inside. In front of him was a living room decorated in shades of brown and yellow. The ceiling bulged with damp, the plaster cracked down the middle.

  Somebody was sitting on the couch, facing away from Nate, a TV flickering quietly in front of them.

  “Mr. Martinez?”

  He pushed the door open a little more. A sudden prickling oozed over his neck and back, a headlong rush of fiery adrenaline kicking inside his veins.

  That’s when the smell hit him.

  CHAPTER 3

  TUESDAY WAS GRAY AND DAMP. By afternoon a soft fall rain had settled outside, making the clinic look tired and dirty. Sagging chairs leaned against murky beige walls. A garbage can overflowed with empty paper cups. Wet jackets were hung on the coatrack, dripping onto the grimy linoleum. Reception was a crush of damp bodies that smelled of urine and feet and unwashed hair.

  Some of my patients were from the eastern side of Skamania, where the yards were cut into neat squares of green, the bushes professionally trimmed. But most were poverty-stricken, immigrants, homeless, addicts, or all of the above. They had little or no access to health insurance, suffering agonizing pain instead of seeing a doctor because they couldn’t afford it. These were the people I’d gone to medical school to help.

  The more cynical accused us at the clinic of having a savior complex, but I knew we were making a difference in these people’s lives. We were helping.

  I yawned as I walked toward the shared medical-staff office. It had been a busy day with patients, doing wellness exams, checking X-rays and lab results. And all on very little sleep. Josh had come into our bedroom too many times to count last night. When we’d first woken this morning, his fever had been too high to send him to school, so I’d called Nate’s mother and she’d agreed to stay with him. Fortunately, I was good on very little sleep. It was sort of a prerequisite to being a doctor.

  I dug my cell phone out of the closet where I stashed my purse. Nate had texted me an X. I smiled and shot an X back to him, loving that he thought about me during his day. I then dialed Moira before my next appointment.

  “Hello, Emma.” Moira’s voice was brisk, the tone she always used with me. I could hear the pursed-mouth exhale of the cigarette she thought nobody knew about. I imagined her draped in her cashmere and pearls, slate-gray hair smoothed perfectly into place, a cigarette dangling out the window in secret. I gritted my teeth but kept quiet. It wasn’t like we had a lot of choice of babysitters.

  “Hi, Moira. How’s Josh?”

  “He’s sleeping now. I gave him some ibuprofen.”

  “If he wakes up—”

  “I’ve raised four children, and I stayed home with all of them. I know how to take care of a sick child.”

  I swallowed a sharp retort, resenting the insinuation that I was a lesser mother than her because I worked. I tried hard to be grateful for my mother-in-law. She was a wonderful grandma to Josh, and she and Nate were very close. I didn’t understand why she didn’t like me, although I suspected she was unhappy Nate and my relationship had moved so fast.

  “Sure, of course. Sorry, um…”

  Julia, a nurse practitioner I’d become friends with, tapped me on the shoulder. “Sorry!” she whispered when she saw I was on the phone. She held a cup of black coffee out to me. “Your four o’clock is in room four.”

  Thank you! I mouthed. “Sorry, Moira, I’ve gotta run. Tell Josh I love him.”

  I grabbed the coffee and swallowed a giant gulp before hurrying to the exam room. I scanned the patient’s chart as I walked. She was a new patient. Fifty-four years old. Normal temperature. Slightly elevated BP. I rapped gently on the exam room door and entered.

  “Mrs. Jones?”

  “Yes.” Alice Jones was small and frail. Her pale hair was threaded with gray and tied into a messy ponytail. Spiderweb wrinkles framed the corners of brown eyes clouded with pain. Her clothes were threadbare, a faded sweatshirt over ripped jeans, scuffed canvas tennis shoes with no socks.

  Her husband, or who I assumed was her husband, sat next to her, a short, burly-chested man with shiny red cheeks, oily dark-gray hair, and a pair of round glasses on a bulbous nose.

  “Her back’s hurting,” he said, his voice too loud in the small space. “It’s been going on a long time now. It’s from all that damned gardening.”

  I sat at my desk and turned to Alice. “I’m so sorry to hear that. I like gardening too. I have a whole freezer of vegetables I grew this summer. It’s pretty tough on our back and knees, though, isn’t it?”

  I opened Alice’s patient file on my computer and typed notes as her husband explained her symptoms.

  “I need to examine you now, Alice. Can you show me where the pain is?”

  Alice struggled to stand, her husband holding her elbow firmly. She bent forward at the hips and touched a hand to her lower back.

  “Sometimes my legs go a little numb,” she whispered.

  I felt a heavy tug of pity in my stomach, the kind you’d feel for an injured bird. I examined her spine, assessed her ability to sit, stand, and walk. There was no redness or obvious swelling. The erector spinae muscles were smooth and strong, her reflexes normal. She wasn’t moving with enough pain to indicate a tear in the disc or enough restriction to show sciatica. But the numbness concerned me.

  Doctors are scientists who work in an uncertain world. We use statistics, odds, and probability to diagnose and treat. Good or bad, we make the best-informed decisions we can.

  “I’m going to order an MRI.” I typed more notes in her file.

  “Can you give me something for the pain?” she asked. “I’ve heard OxyContin is good for back pain.”

  I kept my face neutral. The opioid crisis had made it difficult for doctors to know where the line was, when to prescribe pain medicine and when not to. It was a doctor’s job to help people, to assuage their pain, and yet I’d watched other doctors’ patients succumb to addiction. I knew about addiction firsthand, from my brother. I refused to let my patients become another statistic.

  “I’ll write a prescription for naproxen to help the pain.” I smiled gently at Alice. “Once we get the MRI results, we’ll know better how to treat it. In the meantime, ice it, and stay off your feet for the next few days, okay?”

  I handed Alice a leaflet with advice on how to treat back pain, gave her arm a compassionate squeeze, and left to see my next patient.

  * * *

  AFTER MY last patient of the day had left, I went to f
ind Julia. She was clearing up one of the exam rooms after seeing a patient. Tendrils of dark hair were falling out of her ponytail. Julia was conventionally pretty, with sea-glass eyes and a slight overbite that somehow made her look even more adorable. She smiled faintly, and I noticed her wrist was bandaged, her movements slow, a little delicate.

  “You all right?” I nodded at her wrist.

  “Oh, carpal tunnel syndrome. Lucky me.” She laughed wryly. Julia was lively and cheery, a nurse practitioner who somehow did more work than all the doctors combined.

  I told her about Alice Jones, and she scowled, her freckled nose crinkling. “The husband was here last week. Said he’d sprained his wrist.”

  “He wasn’t wearing a wrist wrap.”

  “I think Dr. Watson saw him. She might’ve prescribed some OxyContin, although check his chart to be sure. Maybe he was back for more? I seem to remember he was pretty aggressive. She was glad to see the back of him, I know that.”

  I’d come across my fair share of angry men in the ER during my residency at Harborview in Seattle. I could still remember stitching open wounds with shaking hands, dodging drunken fists, standing near the exit to make sure I had a quick escape route.

  I pulled a fresh sheet of medical exam paper over the table while Julia swiped the edges with an antibacterial wipe. We headed down the hall to the staff office. The rectangular area was bisected by a long desk with multiple charging points; on one side was a wall of cupboard space, and on the other a coffee-making station. Dr. Wallington was writing reports into a file while two of the other doctors were speaking earnestly about a patient. I pulled my coat out of the closet and turned to Julia.

  “I’m glad I didn’t prescribe any oxy, then.”

  I’d learned that what healed wasn’t always in a doctor’s drugs or a surgeon’s blade. Sometimes it was the quieter things, like compassion, being heard and shown you mattered. I was confident I’d made the right decision with Alice. We’d wait and see what her MRI said.

  “It’s a tough call these days,” Julia agreed. She lowered her voice and glanced around. “Speaking of oxy, watch out for Marjorie. She’s on the warpath right now.”

  Marjorie was the medical administrator of the clinic, which was situated within the auspices of Cascade Regional Hospital. She’d worked here forever and was unnecessarily crotchety as a result. I’d only worked here for three years, after taking over for a doctor who’d decided to partially retire, so she basically scared the crap out of me.

  “What’s wrong now?”

  “People keep leaving the medical supply room unlocked. She keeps all the samples from our pharma reps in there.”

  “Yikes. I’ll keep an eye out.”

  “Hey, wanna grab a drink?” Julia slid her coat on. “It’s happy hour. We can get one of those derby thingies you like.”

  I laughed. Sometimes I was still surprised by the collegial nature of my job. “It’s a Brown Derby. Wish I could, but Josh has been sick. Rain check?”

  Her reply was cut off as our receptionist, Brittany, burst through the door, her eyes almost comically wide.

  “Dr. Sweeney! You need to get downstairs! Josh’s been admitted to the ER!”

  CHAPTER 4

  IT WAS PAST TIME to go home when Nate finally finished his report. Skamania was a small town, but it still had its share of domestic assaults, breaking and entering, and drug offenders. Murder was less common, however. The office was still buzzing with the news a day after it happened.

  Two detectives were standing near Nate’s cubicle gossiping like a pair of old fishwives about the murder, about the vacation to Toronto Mike Spillane was planning, about how Harry Chen had done on the sergeant’s exam, and about one of the many addicts who’d been booked earlier today.

  “He was so fucking on the nod it took him a full minute to realize I was shouting at him!” Chen spluttered into his coffee. “I went over and shook him to see if he had any dope. Sure ’nough…”

  Nate usually loved the joviality of his fellow cops, but now he tried to block them out. A murder in his town. It was on. Nate had been exposed to all the terrible things people did to each other. He sure as shit wasn’t letting a murderer walk the streets of his town.

  He stared at a Post-it Note he’d stuck to his computer monitor. The numbers had been written on a scrap of paper that was tacked to Santiago Martinez’s refrigerator. Nate had jotted them down, thinking they might be important to his investigation.

  323 454

  What were they for? Did they mean anything?

  He rubbed his jaw thoughtfully, no closer to the answer. It couldn’t be a phone number, which was seven digits, or a bank card’s PIN, which was four. What was six digits?

  If only he had some news, a break in the case, but after the last twenty-four hours processing the scene and interviewing potential witnesses, he was at a dead end. He chuckled at his own pun. Ah, good ol’ detective humor.

  Nate pulled a Snickers from his desk drawer and popped the top on a warm can of Coke. He’d texted Emma earlier to say he’d be home late again, but he hadn’t had a chance to check if she’d replied. He reached for his phone just as Lieutenant Dyson came out of his office, forcing him to leave it in his pocket.

  “You still here, kid?”

  “Yup.” Nate tried not to care that Dyson still thought of him as a kid. Years as a beat cop in Seattle, then promoted to detective here, and he was still just Matt Sweeney’s kid. He peeled the wrapper off his Snickers and took a huge bite. “Just finishing up these reports.”

  “Tell me what we know.” Dyson leaned against the desk next to him. He was a good lieutenant, always willing to talk out a case or jump in when needed. The way Nate’s dad used to be before the stroke fifteen years ago.

  Nate put his hands behind his head and leaned back in his chair. “Okay. Name was Santiago Martinez. Alias El Pulgar, the Thumb, because years ago he got his thumb cut off. Damned if I know how that happened, but he moved oxy, cocaine, and fentanyl around Seattle, so probably one of his associates took it for him. He was running fentanyl and heroin for one of the cartels, working the supply chain from Mexico up I-5 and east to Yakima, Spokane, and beyond. He got caught selling in Seattle, did a few years in jail, and when he was released two years ago he moved out here. No sign of him dealing since then. Seattle PD are coming out tomorrow, although they haven’t been super specific about what time.”

  “The crime guys definitely saying it was murder?” Dyson asked.

  “They found a puncture at the back of his neck. Tox screen will show what killed him, but I expect it’ll be an overdose of some sort of drug. And nobody injects themselves in the back of the neck.”

  “So somebody else did it?”

  “Maybe. We found a baggie of a white substance on the floor in the laundry room. There were also digital scales, a pill press, and those little orange prescription bottles in there. A whole fucking drug factory, just without the drugs.”

  Dyson tapped his finger on his teeth. “Maybe the drugs were the motive for the murder.”

  “It’s one theory so far. The back door was unlocked. Maybe someone came in, killed Santiago, grabbed the drugs, and took off.”

  “The guys get any useful evidence?”

  “Lots of prints. We’re running them now. There were a few women’s things there, no clothes in the closet, but a bottle of shampoo in the bathroom, a pink toothbrush, that sort of thing.”

  “Girlfriend?”

  Nate gulped some Coke and set the can on his desk. “Neighbors said they’d seen a woman there. We’re looking for her.”

  Dyson rubbed his mustache, bushy eyebrows drawn tight. “What about hair and fiber analysis?”

  “Working on it. No blood at the scene to analyze. Just the puncture mark in his neck. He didn’t fight it.”

  “Maybe he knew his attacker.”

  “Or he was ambushed, didn’t expect it. Maybe the girlfriend—”

  “Excuse me.” A woman’s voice, shri
ll and nasal, cut into their conversation. “Is one of you Detective Nate Sweeney?”

  Nate and Dyson whirled around. All the other cops’ heads swiveled, the bustle in the place suddenly stopped. A woman and man were standing just outside the detectives’ area. Cops, Nate could tell.

  The woman, clad in a black pantsuit and crisp white shirt, was about Nate’s age, midforties, sharp features, thin lips. Her blond hair was pulled into a tight bun, and she had the downturned mouth of an angry carp. The man was a tall, broad-chested black guy with a military-style buzz cut. The tailored navy suit he wore looked like it cost more than Nate’s annual salary.

  “I’m Detective Sweeney.”

  The woman shook first Nate’s then Lieutenant Dyson’s hand. “I’m Special Agent Lisa Hamilton. This is Special Agent Phil Greene. We’re from the Seattle division of the Drug Enforcement Administration. You’ve been in contact with some of our colleagues at the Seattle PD. Sorry it took so long for us to get in touch. There were some… politics that needed to be sorted out.”

  “Why don’t we talk in my office?” Dyson led the agents across the room, his lopsided swagger more pronounced than ever. Nate followed.

  Dyson closed the door. Agent Hamilton sat in one of the small plastic chairs, but Agent Greene leaned against the door, his arms crossed.

  “How can we help you?” Dyson asked.

  Hamilton tossed a thick file on Dyson’s desk. “With oxycodone use and mortality rates at an all-time high, we’ve been using local informants to try to find the dealers responsible. Your guy, Santiago Martinez, was one of our confidential informants. He turned state’s witness a few months back to avoid jail time, and we were getting information from him until he dropped out of contact a few days ago.”

  Nate flipped through the file. There were police reports, news articles, a few pages detailing Santiago Martinez’s past convictions. Crime scene reports, handwritten notes, printed emails. Evidence.

  “A few months back he pleaded guilty in federal court to smuggling fifteen hundred grams of fentanyl and selling to an undercover agent,” Hamilton continued. “He transported the fentanyl from Seattle around western Washington. After we arrested him, he agreed to help us go after a larger supplier in the chain, so we sealed the case.”