Do No Harm Page 4

  Nate glanced at Dyson. “A larger supplier?”

  “He told us about this gang he works with out here. Said they got themselves a bunch of fentanyl and oxy. The black-market oxy business is booming, right? And fentanyl is cheap. So this gang, they decided to take advantage and sell both. But they’re smart. They’ve kept it small, so they’ve stayed off the radar. They don’t get involved in land wars or killings or any of that cartel shit.”

  “Did he tell you who it was?” Nate asked.

  “Nope. He died first,” Hamilton said. Her partner leaned against the wall, hulking and silent. “We figure somebody found out he’d been talking to us.”

  Nate’s phone buzzed against his leg, but he ignored it. He closed the folder and set it down, then leaned his butt against Dyson’s desk. He studied Hamilton and Greene. They were holding something back. Their posture, as if they were waiting on a knife’s edge, gave it away.

  “Why me? There are four other detectives here, but you asked for me by name. What aren’t you telling me?”

  Hamilton crossed her arms. “Do you know much about your wife’s brother?”

  Nate straightened, suddenly alert. “Ben? Ben’s been in and out of jail for drug dealing, petty theft, did a few years for assault. Emma hasn’t heard from him in years.”

  She nodded. “Mr. Martinez mentioned his name a few times.”

  Nate gaped at her. He’d never even met Ben. From what he could tell, Emma was the smart, successful one, while Ben was the total fuckup.

  “Ben Hardman might be linked to the head of this gang. Hell, he might even be the head, for all we know. Either way, we need to find out who’s running it before more oxy and fentanyl hit the streets. We want you to be the lead detective of our local task force. You’ll have additional search and seizure powers under your new federal authority, and you’ll liaise with us through occasional visits and calls.”

  Nate gave a bewildered snort. “I can’t investigate my wife’s brother! That’s a complete conflict of interest.”

  Agent Greene unfolded his arms, smoothing his fingers down a paisley-print silk tie. “We just want you to help us stop more drugs flowing into the area. Yakima’s just a few hours from here, and right now it’s the main drug distribution center in North America. We’ve got drugs being smuggled up in bodies, cars, trucks, children’s toys, paintings laced with narcotics. We have to get a handle on this before more people die.”

  “All we need is for you to report back to us what you find when you’re investigating this case,” Hamilton added. “And if your wife has anything to say about where Ben is, all the better.”

  “You want me to use my wife to get to her brother?” Nate was incredulous.

  “We don’t know for sure Ben’s involved,” Greene said. “We’re just asking you to report back to us what you find. You saw Mr. Martinez’s place. This gang is cutting oxy with fentanyl. Do you have any idea how dangerous that stuff is?”

  Dyson rolled his eyes, not bothering to hide his sarcasm. “I assure you, even out here in Hicksville, we know how dangerous fentanyl is.”

  Hamilton and Greene exchanged looks. After a minute, Agent Hamilton dropped a card on the folder and stood. “Think about it and call me in the morning. Time is of the essence here.”

  When they’d left, Dyson’s office dipped into silence. A vent kicked on somewhere, a low gurgle and hum. Nate’s gaze drifted to the picture of Dyson and Matt Sweeney just over Dyson’s shoulder. If only he could talk to his dad—but the stroke had stolen speech from him too.

  He took a toothpick from his pocket and rolled it between his fingers before popping it between his teeth. “What do you think?” he asked.

  Dyson frowned, stroking his mustache. “I’m not saying it’s strictly against policy. He’s Emma’s brother, not yours. But I’m not saying it’s right either.”

  “People could die if we don’t find this gang.”

  “Yeah.”

  “But investigating Ben, interviewing him, that opens us up to legal challenges down the road if he’s involved.”

  “Yeah, it does.”

  “But if we don’t investigate him, fentanyl could become an even bigger problem.”

  “Yeah.”

  Nate scowled at Dyson. “Are you gonna help me here or just agree with everything I say?”

  Dyson sighed. “Look, Nate, you know yourself the budget cuts we got here. The truth is, we could use a case like this to prove we deserve more funding.” He hesitated. “You could use a case like this.”

  Nate drew back. “Are you saying my job’s on the line?”

  Dyson blinked, startled. “Course not, son! You’re my best detective. I’m saying, I’m retiring next year. It’s time for me to pass this job on to someone younger. I want you to apply. I’d put a word in for you, of course. More money, more regular hours with your family.”

  Nate’s mouth fell open, a curl of pride twisting in his middle. Lieutenant? Him?

  Dyson grabbed his cowboy hat and shoved it on his head. “You can help investigate your wife’s brother, impress Chief O’Neill, and make your mark with the mayor, or you can let our community continue to be ravaged by fentanyl and oxy. I think you know the right answer.”

  Nate’s phone buzzed against his leg again. He pulled it out as he left Dyson’s office. It was a text from his mother.

  COME QUICKLY. JOSH IS IN THE ER.

  CHAPTER 5

  JOSH’S BEEN ADMITTED TO THE er.

  The words snapped me into action. I sprinted past my colleagues, through reception, and out of the clinic. I took the stairs two at a time, the soles of my shoes making a hollow, vibrating sound against the metal surface. An elderly woman was struggling to open the door at the bottom of the stairwell. I pushed past her and barreled through.

  The emergency room was on the ground floor, at the opposite corner of the hospital from the clinic. By the time I reached the front desk, I was sweaty and out of breath.

  “My son… Joshua Sweeney…” I gasped at the admitting receptionist.

  “Go on in, Dr. Sweeney,” she said, buzzing me through the locked doors.

  I found Josh in the last exam room. One hand was grasped tightly in Moira’s. Her face was wet with tears. Josh had a bloody bandage taped to his forehead, an IV attached to the back of his hand. But his eyes were open. He was okay.

  Relief hit me hard. My legs went numb, made of nothing but air, and for a second I teetered there, feeling like I would collapse. “Josh!”

  I tugged Josh into my arms, hot tears pressing against my eyelids.

  “Mommy, I fell down the stairs,” Josh said.

  I looked at Moira.

  “He just…” She started crying. Her usually sleek hair was a complete mess, her eyes rimmed with red. Her cashmere sweater was wrinkled and smeared with blood. “He fainted, right at the top of the steps. I couldn’t catch him!”

  Her sobs became hysterical. Mascara oozed down her cheeks, embedding into the wrinkles on her face. Her hysteria snapped me back to myself.

  “It’s okay.” The words gusted out of me.

  I touched my son’s cheek and took a deep breath. Josh’s head dropped against my chest, and I just held him, his hot little body pressed against mine. He stuck his middle and pointer fingers in his mouth and after a minute dozed, his breath coming in short little bursts.

  The blue curtain swung back, the scraping metal rings making me jump. A doctor I didn’t know entered the cramped exam room. He was young, with curly dark hair, a strong nose, and a manila folder clutched in his hand.

  “Hello, Dr. Sweeney. I’m Dr. Adelman. We’ve put some fluids into Josh’s IV to start hydrating him, but we are going to need to investigate a little more to find out exactly what’s going on.” He pulled over a low stool with wheels so he was next to us. “We’ll take some blood, do an MRI, of course.”

  Josh moaned in his sleep, a small sound at the back of his throat. I tightened my hold on him, felt the heat of him seeping through my
clothes and warming my skin.

  “He started feeling unwell a few days ago,” I said. “Sunday. He was a little warm, but nothing to be concerned about. He had a bad cold a few weeks back, and I thought maybe he’d just gotten overtired. He, uh…” I closed my eyes. “His back…”

  I gently lifted Josh’s shirt, exposing the pale skin of his back for the doctor to look at. Moira gasped. The bruises marching up his spine were even darker now.

  “He said he got slide-tackled at school,” I whispered, horrified.

  The doctor’s face didn’t change, but I saw the tightening around his eyes. “Let’s run those tests.”

  * * *

  WE WAITED for hours. The doctor took a few vials of blood, whisking it away to the lab for immediate analysis. Josh went in for an MRI. Another bag of fluids. More blood tests. Nate arrived at some point. My phone was still at the clinic, but Moira had called him, although only after snidely commenting that I should’ve thought of Nate sooner.

  I ran to him and let him fold me in his arms. We sat in silence next to Josh’s bed, our fingers laced tightly together. I couldn’t seem to bring myself to consciously think about what those bruises might mean.

  Finally a new doctor, Dr. Johnson, came in with Josh’s chart. He was older, round, with fat cheeks and orange stains on his lab coat, as if he’d been wiping Cheetos dust down the front.

  “Hi, Mom, Dad, why don’t you come out here, and we’ll have a chat. Let’s let Josh keep resting.”

  “Go on. I’ll watch him,” Moira said.

  Nate and I followed Dr. Johnson down the hall to a family room, our hands still laced together. It was bland, the carpets a pale brown, the walls even paler brown. Ikea couches were pressed against the wall, a wilted spider plant on a table in one corner. A clock hung over the door, ticking ominously.

  A slight man with creased, weathered skin and rosy cheeks was standing next to the plant. Someone I knew from a very long time ago. I inhaled sharply. His face was etched into my memories of the worst days of my life.

  “This is our oncologist, Dr. Edward Palmer.” Dr. Johnson introduced us.

  “Emma.” Dr. Palmer nodded, not seeming at all surprised to see me. “I heard you were working here. Good to see you again, although I’m sorry, of course, for the circumstances.”

  It had been twenty years since I’d seen him. He was probably in his late fifties now, smaller and more stooped than I remembered. His hair was stark white, as were his eyebrows and beard. On second glance, the flushed cheeks were swollen blood vessels, the telltale sign of rosacea. But his eyes were the same warm amber, and his manner was grandfatherly.

  “Nate, this is… Dr. Palmer.” My voice was flat and wooden.

  “Dr. Palmer is one of the best oncologists in the state,” Dr. Johnson added. “He moved here to Cascade Regional from Harborview last summer. We’re lucky to have him on the team.”

  Nate’s gaze landed on me, heating me like an accusation. “Oncologist?”

  Tendrils of panic coiled around me. Both doctors were silent for a beat.

  My husband’s fingers crushed the bones of my hand, and all I could do was cling to him. And then it was there, the diagnosis, coming at me slowly, and then all at once.

  “The blood count came back,” Dr. Palmer said gravely. “I’m afraid Josh has leukemia.”

  CHAPTER 6

  THOSE WORDS—JOSH HAS LEUKEMIA—hovered in the air like wisps of smoke. Nate couldn’t seem to grasp them. The diagnosis seemed as unlikely as Chewbacca walking through the doors right then.

  Josh had a cold. The bruises were from being slide-tackled.

  Leukemia.

  It must be a mistake.

  “Here. Sit.” Dr. Palmer motioned them to a pair of cheap Ikea couches and sat across from them. Emma put one hand on Nate’s knee, the warmth of her skin grounding him. He placed his arm around her shoulders, pulling her tight, as if they could ward off the doctor’s words if they stayed together.

  Nate studied Dr. Palmer, who reminded him of Santa Claus. In Nate’s experience, most surgeons and specialists were hugely talented, with egos to match. But Palmer didn’t swagger or bark orders. He smiled softly instead of grinning. He hunched his shoulders, but when he looked at Nate his eyes were calm, assured. Intelligent. The type of man you could underestimate.

  Emma had gone ashen, but she didn’t look surprised by the diagnosis. “How do we treat it?” she asked.

  Like most habitual worriers, Emma was great in a crisis. It was one of the things that made her such an excellent doctor. But Nate knew this was simply because when the worst happened, she had sort of been expecting it all along.

  “Josh needs treatment immediately.” Dr. Palmer was speaking. He adjusted the silver tie at his throat, smoothed it flat against his chest. His gaze was apologetic. It made Nate anxious. “We’ll do further tests and set a treatment plan.”

  He started talking about bone marrow and spinal fluid, but all Nate could think was that his son had leukemia, and didn’t people die of that? How could he stop it? He felt impotent against the onslaught of medical words. It was his job to provide for his family, to keep them safe, and somehow this thing, this enemy, had sneaked into his son.

  Nate watched Emma speaking with the other doctors. Her hair had come unclasped, glossy, dark tendrils hanging around her ears. Mascara was smudged under her eyes. And yet she still seemed so calm, asking all the right questions. She was detaching herself. But he could tell by the white of her lips, the pinch between her brows, and the hard clench of her jaw that she was terrified.

  Dr. Palmer grasped Emma’s shoulder, an overly familiar gesture. She leaned toward him. Just a hair, but enough that Nate noticed. This was someone so familiar that Emma could lean on him now, in the midst of their son’s leukemia diagnosis. And yet she’d never mentioned his name.

  Emma caught Nate’s baffled expression and stiffened. She shook her head. Not now.

  “How did I miss it?” In the harsh lights Emma’s porcelain skin was so pale it almost looked translucent.

  Nate thought he saw a glimmer of a tear on her cheek, a fierce sucker punch to his gut. He suddenly felt scared. Emma never cried. She was self-contained, self-reliant. He didn’t know what it would mean if she fell apart.

  “It’s not your fault,” he murmured.

  “The bruises… I’m a doctor!”

  “Em…” Sometimes she was her own worst enemy.

  She whirled on him, her eyes blazing, raw with pain, but Dr. Palmer interjected, “Your husband’s right. Those bruises could’ve been anything. It’s easy to miss the symptoms at first. Being a doctor had nothing to do with it. You know how these things go, and that your life is about to change. With luck, we’ve caught it early, and can start treatment right away.”

  He was sharp and focused, giving them a sense of what they were dealing with and how to fight it. Nate liked that about him.

  Nate cleared his throat. “Does Josh need chemo?”

  Dr. Palmer looked at him, his eyes flicking up and down, as if assessing Nate’s character. “First we’ll need to do a bone marrow test to confirm our diagnosis.”

  “You don’t know.…” Hope burst in Nate’s chest.

  “We do know that it’s leukemia,” Dr. Palmer said patiently. The kind but firm manner in which he said it spoke to his experience. “We found blast cells in Josh’s blood. Based on the blood tests, we suspect that it’s acute myeloid leukemia.”

  He went on to describe leukemia subtypes and consolidation therapy and bone marrow transplant, the likely outcomes and possibilities. His words knifed Nate in the lungs. His brain clouded, his eyes blurring. He nodded over and over, pretending that he understood, when he only wanted to know one thing: “What are Josh’s chances of survival?”

  Dr. Palmer hesitated. “We won’t know for certain until we have the test results back. However, acute myeloid leukemia is very aggressive and requires quick decision-making.”

  Nate closed his eyes. He could
hear the clock above the door ticking. It seemed to have gotten louder. How long had they been in here? How long did Josh have left?

  Emma’s hand snaked over to his, winding her fingers through his. Her hand was ice-cold. He squeezed it and drew an X on her palm with his index finger.

  “There is one other treatment we could do,” Dr. Johnson spoke up from where he’d been standing silently near the door.

  “What is it?” Nate looked between the men. When they didn’t answer he looked at Emma, but she seemed as clueless as he felt.

  The tick-tock of the clock suddenly grew more insistent.

  “Chimeric antigen receptor T-cell therapy. Or CAR T-cell therapy,” Dr. Palmer finally said. “It’s a type of immunotherapy that’s been approved to treat children and young adults with acute lymphoblastic leukemia. Recently it has shown some impressive results treating acute myeloid leukemia.”

  “I’ve read about it,” Emma said. “You withdraw T-cells from a patient, genetically modify them, and reinject them to identify and attack cancer cells.”

  “Yes, it’s been very effective—” Dr. Palmer began.

  “Then what’s the holdup?” Nate asked. “When can we start this T-cell thing?”

  “This type of treatment is still emerging.” There was a warning note in Dr. Johnson’s voice. “And most insurance companies don’t cover it.”

  “Josh and I are both covered by the hospital plan,” Emma said.

  “The hospital insurance only covers about ten percent of the total cost of CAR T-cell therapy—” Dr. Palmer said gently.

  “It doesn’t matter,” Emma said fiercely.

  “—which is five hundred thousand dollars.”

  CHAPTER 7

  LATER THAT NIGHT, we settled Josh in a private room on the pediatric oncology floor. It was small but clean, decorated in cheerful shades of blue and orange. One wall was covered in a childish mural, leafy trees and a mountain with little rabbits hopping along the bottom. The window looked out in the direction of the waterfall.