One Doctor's Hippocratic Oath

(Short story from anthology Beyond the Pale, by Blog's author.)

It had been a particularly hard night at the emergency room for Dr. David Rutzke—two cardiac arrests, three bad traffic accidents, one fatal, and the usual number of Central American immigrants, many undocumented, no doubt, whose only recourse for medical attention was the emergency room, as they had no health insurance nor the money to visit a regular doctor. Through a translator Dr. Rutzke would inform them, or their families —the immigrants always came in families—that as a trauma specialist he was not qualified to treat their chronic illnesses. He tried to explain to them that coming to him was like taking their car for repairs to a gas station attendant instead of a licensed mechanic. But they politely declined to believe him. To them a doctor was a doctor, and being a doctor, whatever his specialty, he had to know how to diagnose any ailment and treat it.
Dr. Rutzke finished his shift that night and left the hospital totally bushed and frustrated, wondering if he had not made a mistake by specializing in emergency medicine instead of going into the more lucrative practice of reconstructive surgery, in the footsteps of his father and elder sister.

For a while he sat in his Toyota gathering his thoughts. From his reserved parking place on a gentle knoll, he had a full view of the well lighted parking lot.
He was about to turn the ignition key when he saw the man come out of the intensive care wing and into the parking lot. He had seen the man before, a number of times, pacing up and down the hospital corridors, and on his face the sorrowful, bereft look of someone with a terminally-ill loved one. He watched the man head for his car on the visitors’ side of the parking lot. At the same instant, he glimpsed the two teenagers emerge from behind another car.

The pair approached the man, hands extended, making threatening gestures. A mugging. But the man did not cower. Angrily shaking his head from side to side, he shouted something to the muggers, then, from his jacket, he pulled out a small revolver, its silvery barrel glinting in the parking lot lights. One of the mugger stepped back and reached for something in his pocket, but before he could get it out, the man with the revolver shot him, once, twice, and the mugger crumbled to the asphalt. The second mugger turned to flee, but the man took careful aim and shot him too, in the back, and he, too, crumbled to the asphalt. Scanning the parking lot, making sure that no one had witnessed the incident, the man put the revolver back in is pocket, calmly got into his car, and drove off.

Dr. Rutzke had on many occasions administered first treatment to shooting victims, but he had never seen anyone shot before. The sight of someone standing whole one moment and a heap of wounded flesh the next was something he’d never forget. His eyes went by turns to the two figures on the asphalt. He could tell by their movements what kind of wound each had sustained. The gasping of the first one indicated that he’d been shot through one or both lungs. The frantic upper body flopping and lower body immobility of the second one indicated that he’d been hit in the spine.
The initial reaction of the doctor in him was to reach for his cell phone and summon the paramedics at their station just across the street from the hospital. They would arrive with their life-support gear in matter of minutes. In the meantime, he would administer first aid as best he could and later, when the police arrived, bear witness to the incident.

But Dr. Rutzke hesitated. Remembering the sad, bereft look on the face of the man who had shot them, his heart went out to him. If he told the police that he had witnessed the shootings, he would have to identify the man, and the impersonal arm of the law would compound the man’s misery. And if one or both of the muggers survived, they would be able to identify the man who shot them as well as the car the car he was driving.
Dr. Rutzke further surmised from the way the first mugger had reached into his pocket that both he and his partner were armed. So if the man had not shot them first, they would no doubt have shot him instead. Also, judging from the stealth and efficiency with which the pair had approached their would-be victim, it was evident that they were no first-timers. They must have had a long history of violence and, if they were as young as they seemed, they likely had been getting away with it for years, and would continue to do so into adulthood. As an expert witness in several criminal trials, Dr. Rutzke had seen how easily juvenile offenders get off on account of their age or some legal technicality, leaving the family of the victims wondering if there was such a thing as justice in America.

As for the man with revolver, the fact that he was armed and knew how to use the weapon suggested that he or someone close to him had been victimized before and had sworn that the next time he would fight back. Then there was that sad, bereft look on his face. Whatever was causing it had rightfully rendered him intolerant of further grief. The two wounded youths on the asphalt had made a huge mistake.

Through the windshield Dr. Rutzke took one last look at them. Their movements had become noticeably weaker. By the time someone found them, they would be dead or dying. Inserting his favorite Mozart piece in the CD player, he turned the ignition key of the Toyota and drove out of the parking lot on to his bachelor apartment across town. No sooner had he got in bed, than he fell into a deep, restful sleep.

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