Good Medicine - Residency II
Copyright© 2025 by Michael Loucks
Chapter 1: And That's When All Hell Broke Loose
While this story was inspired by actual people and events, certain characters, characterizations, incidents, locations, and dialog were fictionalized or invented for the purposes of dramatization.
NOTHING IN THIS STORY SHOULD BE CONSIDERED MEDICAL ADVICE! You should always consult a medical professional in your country or region before starting or stopping medication, changing your diet, beginning an exercise program, or taking any supplements.
February 20, 1990, McKinley, Ohio
" ... and that's when all hell broke loose."
"You didn't see the shooter?" Deputy Kenseth asked.
"Not until later. As I said, I was in Trauma 1, treating the seventeen-year-old victim."
"Walk me through what happened next."
"Shelly, that is, Doctor Lindsay, had just left the room when I heard the first shot."
"You knew that immediately?"
"I've been around guns long enough to know a pistol report," I replied. "And there is nothing in the ED that would make any similar sound. Deputy Sommers reacted instantly to the sound and ordered all of us to get down."
"Did you do that?"
"Not immediately, because we were treating the patient. When we heard a second gunshot, she ordered us to move behind the trauma table."
"What did you observe?"
"Deputy Sommers crouched, drew her service pistol, and carefully opened the door. Almost immediately, another shot rang out, striking her in the temple. Before I could move, I heard at least five rapid gunshots from at least two guns."
"How do you know it was multiple guns?"
"Different reports," I replied. "I suppose it could be location or echo or whatever, but there were at least two distinct reports."
"What did you do then?"
"I moved to Deputy Sommers while Doctor Nielson attended to the patient on the table."
"Did you see anything that happened in the corridor?"
"No. The door had closed when Deputy Sommers was shot."
"Is there anything else you can tell me about the incident?"
"Not really. I was in Trauma 1 the entire time during which shots were exchanged."
"OK. I think that's all I have for you at the moment. I'll be in touch if I have further questions."
"Thanks."
I got up, left the consultation room, and walked into the corridor. It was 2:12am, and the ED was still closed to trauma, as it was a crime scene. That meant VERY long transport times to Columbus for almost anyone in Hayes County and the surrounding counties to the south and east.
"Mike, go home," Doctor Cutter said when he saw me. "Your next shift is canceled."
"I can get a few hours of sleep and come back," I said. "Normally, I'd just crash in the on-call room, but my wife is waiting up."
"No. Take the day. I'll call you and let you know when you can see Psych."
"Given my relationship with them, I'd prefer an outside counselor, if you don't mind."
"Did you have someone in mind?"
"Doctor Fran Mercer, in Milford. I've seen her off and on for the past nine years. She's a clinical psychologist."
"OK. Call her first thing in the morning."
"Do I need an assessment to come back to work?"
"You work at the Free Clinic on Wednesdays, right?"
"Yes."
"Do that. I'll speak with Gale Turner, but that's mostly routine physical exams, right? No procedures?"
"Correct. I'm morally opposed to elective abortion, so I don't participate in those procedures."
"OK. You're on the surgical service, so Owen can clear you to perform procedures. Make sure you speak to him tomorrow."
"I will. Thanks, Doctor Cutter."
"Go see your family."
I nodded and went upstairs to the surgical locker room, where I stripped off my scrubs, showered, and dressed in street clothes. Before I left, I put my hand on the door of Shelly's locker, said a silent prayer, and then headed home.
February 20, 1990, Circleville, Ohio
"Hi," I said wearily when I walked into the house at 2:47am on Tuesday morning.
"How are you, Mike?" Kris asked.
"The adrenaline started wearing off in the car on the way home."
"Do you want to go right to bed?"
"Even though I'm physically and mentally drained, I don't think I could sleep right now. I'm going to make some chamomile tea."
"There's hot water in the kettle," Kris said. "I thought you might want some. Is there more news?"
I sighed, "Yes, but none of it good."
I put loose tea in a tea ball and set it in a mug, then poured hot water over it.
"Shelly is in critical condition in the ICU; Loretta was still in surgery at 2:10am; Deputy Sommers died from a gunshot wound to the head."
"Lord, have mercy," Kris said quietly. "And the attacker?"
"Shot dead by Deputy Turner and Detective Kleist."
"Was anyone else hurt?"
"No."
"Do they know why it happened?"
"I can piece together some things from the original patients and what was said, so this is by no means certain. The young woman with the three gunshot wounds was impregnated by an older next-door neighbor. The young woman's father took exception and confronted the neighbor. In the process, there was an exchange of gunfire between multiple people. The girl was shot, along with her brother; the neighbor who impregnated her was shot, and his wife was killed. The attacker at the hospital was the son of the woman who was killed."
"You Americans and your fetish for guns!" Kris said in exasperation.
"First of all, you're an American," I said with a wan smile. "Second, blaming the gun is like blaming a pencil for Mein Kampf. I'm not opposed to reasonable restrictions on gun ownership, such as prohibiting violent felons or the mentally ill from owning them. I also think permits are a good idea, but I would never support a ban on guns."
"Even after your two friends were shot?"
"I didn't think cars should be banned when Jocelyn was nearly killed in an accident, nor did I think that when Lee was murdered using a car. Can we please set this debate aside for another time?"
"I'm sorry," Kris said. "I shouldn't have brought politics into it. Will Shelly and Loretta live?"
"I don't know," I sighed. "Shelly is in what the newspapers would call 'extremely critical' or 'grave' condition. She lost a lot of blood, and there was damage to her liver. If she survives the next twenty-four hours, she has a good chance of recovery. As for Loretta, the last I heard was that she has a possible spinal cord injury. I wanted to scrub in, but wasn't allowed."
"What happened to the patients?"
"Two of the three weren't in any real danger and were sent by ambulance to Columbus. The young woman coded before we could get her to surgery."
"You were in a treatment room the whole time?"
"Yes. I didn't go into the corridor for almost ten minutes after the shooting stopped because Becky and I were trying to save Deputy Sommers while Doctor Nielson was trying to keep the young woman alive. I didn't see either Loretta or Shelly because they were taken to surgery before I threw in the towel in trying to revive Deputy Sommers."
I removed the tea ball, put it in the sink, then sat down to sip my tea, with Kris sitting across from me at the dinette table in the kitchen.
"What happens now? The news said the hospital was closed."
"To trauma," I replied. "The ED is closed until they finish the investigation. When I left, the shooter was still on the floor, covered with a sheet, and evidence technicians were swarming the place. Doctor Cutter instructed me to take today off and to speak to a counselor. I'll speak to Doctor Mercer because the last thing I want to do is talk to anyone from Psych at the hospital."
"When will you go back to work?"
"Wednesday, at the Free Clinic. I'll speak to Owen Roth after I speak to Doctor Mercer. He has to clear me to perform procedures. That's normal for any psychological or physical trauma. I don't think it'll be a problem."
"How do you feel? I mean, besides tired?"
"OK, I think. But I'm probably not the best judge of that right now. My initial reaction was as a physician. I suspect the more time I have to think about it, the more it might affect me. Strangely, I was never afraid, just concerned for my patient and then Deputy Sommers."
"How long do you plan to sleep?" Kris asked.
"Until I wake up from the nightmare," I replied with a heavy sigh.
"My class today is at 1:00pm, so I have no reason to get up early, though Rachel will certainly be up at her usual time."
"Does she know?"
"No. I didn't turn on the news until after I put her to bed. She was unhappy that you weren't here, but I explained that you were helping sick people and would be late. Thank you for calling right away."
"It was after I tried to revive Deputy Sommers," I said.
"I can't reasonably object to that," Kris replied. "You called as soon as it was practical. And you're safe. I think it's best not to watch the news in the morning, which I do sometimes after you leave for the hospital."
"Probably. We can't hide all the evil in the world from our children, but I think it's better she hears it from one of us than sees the news. At her age, who knows what's going through her little head? Back to sleeping, I think I'll sleep until around 7:00am and nap later. Is Rachel on her usual Tuesday schedule?"
"Yes. I'll take her to Abi's house on my way to the university and pick her up on the way home."
"Then I'll nap while you two are out."
"Are you sure you'll be OK?"
"I think so," I replied. "I'll call Doctor Mercer first thing, that way you and I can discuss any concerns she might have."
I finished my tea, and Kris and I said evening prayers, then went upstairs. I completed my bedtime routine, then got into bed with my wife, set the alarm, and snuggled close to fall asleep spooned together.
I woke with the alarm at 7:00am and felt as if I'd been run over by a truck. I knew it was the aftereffects of the adrenaline rush, and there wasn't much to do about it except begin my day and wait for my body to recover. Kris and I got out of bed, took a shower together, and after we had dressed, I dialed Doctor Mercer's private number while Kris went to get Rachel.
"Fran Mercer," she said when she answered.
"It's Mike Loucks," I said.
"I heard what happened! Are you OK?"
"Physically, yes; Doctor Cutter instructed me to speak to a counselor."
"That's normal in this kind of situation. Are you off work until you're cleared by someone?"
"Yes and no. Tomorrow is my day at the Free Clinic, and because I don't perform any procedures there, I can work my regular shift. I have to speak to Owen Roth, the Chief Surgeon, to be cleared for procedures."
"I take it from this call you want to speak to me rather than someone in Psych at Moore?"
"You take it correctly and for what I think are obvious reasons."
"This kind of thing has to be done face-to-face because it's the only way to judge the answers. I know it's a long way to come here, but I could meet you in Rutherford at 4:30pm if that works for you. That way, I don't have to reschedule anyone."
"I could do that," I said. "My normal work schedule would have me on until 9:00pm, so it's not taking me away from any plans."
"Then I'll see you at 4:30pm in the same office in the medical building as we met before. How are the two doctors who were shot?"
"One is in the ICU in critical condition; the other was still in surgery when I left the hospital around 2:30am. I'm going to call and check as soon as we hang up, then I need to call my parents."
"They know you're safe, right?"
"Yes. Kris called them both last night after I called her."
"Good. See you later today."
We said 'goodbye', I hung up, then went downstairs and let Kris know the plans.
"Will you get enough sleep?" she asked.
"Yes. I'll take a two-hour nap, and I can sleep later tomorrow due to my usual Wednesday schedule. I need to call and check on Loretta."
"Of course."
I picked up the kitchen extension and dialed the number for Surgery.
"Surgical Nurses' Station," Kim Carter said.
"Hi, Kim," I said. "This is Doctor Mike. I'm calling for a status on Loretta Gibbs and Shelly Lindsay."
"Doctor Gibbs is in the CCU and is stable; Doctor Lindsay is in the ICU and is still listed as critical."
"Any word on Doctor Gibbs' injuries?"
"Neuro has to wait for the swelling to go down to make an assessment."
"Right. Thank you, Kim."
"Are you OK, Doctor Mike?"
"Better than they are," I replied. "If there are any significant changes, would you call me at home, please?"
"Of course, Doctor."
I thanked her, said 'goodbye', then hung up.
"No change on Shelly," I said to Kris. "Loretta is in the Critical Care Unit with stable vitals, but they can't assess her neurologically until the swelling goes down."
"What's the difference between that and intensive care?"
"For the most part, it's simply a matter of staff-to-patient ratio. It's much higher in the ICU, where a nurse typically has only two patients, or sometimes three, whereas in the CCU, it's four to six. In Loretta's case, it's because she could have further neurological effects, so putting her in a ward where the ratio is about eight or ten to one is too risky."
"But she's breathing on her own?"
"Yes. If she were on a vent, she'd be in the ICU for the first forty-eight hours. But that's not etched in stone. Another thing about the CCU is that they dim the lights at night, whereas the ICU is always brightly lit. Given that ICU patients are nearly always heavily sedated or comatose, that doesn't affect their sleep."
"You should probably call your parents," Kris said. "I'll make breakfast."
"Thanks."
I dialed my mom's house first, and Elaine answered. She asked how I was, then handed the phone to my mom.
"Hi, Mike. Thank God you're OK!"
"Hi, Mom," I said. "I'm sorry I couldn't call last night. I didn't get home until nearly 3:00am."
"Kris called, which I'm sure she told you. How is everyone?"
"The two doctors are out of surgery and are what I would call 'guarded' if I had any mind to speak to the Press for any reason. We'll know more later."
"The news said it was a domestic dispute."
"Yes, though I know very little about what actually happened before the person walked into the ED with the gun. I didn't see anything that happened except Deputy Sommers being shot, but all I saw was her collapse."
And seeing blood splatter the wall, but I didn't need to tell my mom that detail.
"The news said the gunman was a former Army Ranger," Mom said.
Which explained how he managed to shoot Deputy Sommers in the head with the door only open a few inches.
"Well, Deputy Turner and Detective Kleist took him down with five shots," I said. "All of them hit center mass, according to Deputy Kenseth."
"Have you spoken to your father?"
"He's next. I assume you told your parents and Liz?"
"Yes."
"Thanks. I'll call Grandfather in a bit. I'll be in Rutherford, and I'll probably stop in to see him."
"Rutherford? Why?"
"I'm meeting Doctor Mercer for a counseling session. It's mandatory before I can be cleared to perform procedures. It's all standard. The ER is closed until at least noon."
"What happens to people who need the ER?"
"EMS would transport them to the nearest hospital, which for McKinley would be in Columbus, but in the western part of the county, they'd take them to Rutherford. Other areas are more problematic, as there are no Level II trauma centers in the counties to the south and east. The rest of the hospital is open and operating normally, though I suspect there is a large law enforcement presence."
"I'm just glad you're OK, Mike."
"Thanks."
I said 'goodbye', then called my dad and had a similar conversation with him. I called my grandfather, and when he heard I was going to be in Rutherford, he asked me to come to dinner. After checking with Kris, I agreed. My final call was to Internal Medicine.
"How are you doing, Petrovich?" Clarissa asked when she came on the line.
"Like I'm on the back end of an adrenaline rush."
"I tried to come see you before I left, but they wouldn't let anyone into the ED because it's a crime scene. They did tell me you weren't hurt."
"Did they say when they'd open to trauma again?"
"2:00pm. Are you coming in?"
"No. I was told to take the day off and to see a counselor. I'm going to see Doctor Mercer later today. I'm allowed to work at the Free Clinic tomorrow, but Owen Roth has to sign off before I can perform procedures. Supposedly, that's standard practice."
"I can see it," Clarissa said. "Mental, emotional, or physical trauma could easily impact your work. Did you hear the latest on Doctor Gibbs and Doctor Lindsay?"
"Yes. I called the Surgical Nurses' Station this morning. I take it the place is still swarming with cops?"
"They're checking IDs of everyone who comes in at every entrance; there are at least a dozen squad cars and cruisers at various places — McKinley PD, Hayes County Sheriff, and State Troopers. Do you know anything about what caused it?"
"No more than what was on the news. Fortunately, I was in Trauma 1 during the whole thing. Shelly was there but left to triage the other two patients, which is when she was shot. Deputy Sommers was shot right in front of me, though."
"Jesus, Petrovich! But how?"
"She drew her service pistol, crouched down, and opened the door to respond. A round was fired, striking her in the right temple. We tried for ten minutes, including intubation, bagging, and CPR, but it was useless. She never had a pulse, and I'm fairly certain her pupils were fixed and dilated before Becky and I got to her a few seconds after she was shot."
"And you're really OK?"
"I am. I'm sure it'll hit me at some point, which is why Cutter ordered me to see someone. Fortunately, he let me slide on seeing someone in Psych."
"Smart move. Those headshrinkers would use it to exact revenge."
"Fortunately, all they could do would be to make a recommendation. It's up to Owen Roth. But the last thing I want is something like that in my medical records at Moore."
"I hear you. I need to go, Petrovich. Call me if you need anything."
"Thanks, Lissa."
We said 'goodbye', and I replaced the handset on the hook, only to have the phone ring immediately.
"Korolyov-Loucks residence; Mike speaking."
"Oh, thank God!" Maryam Khouri gushed. "I was so worried when I saw in the newspaper that two doctors had been shot in the ED in McKinley! Who?"
"Shelly Lindsay and Loretta Gibbs."
"Lord, have mercy! How are they?"
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