Author Topic: Occam's Razor  (Read 442 times)

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D. Compton Ambrose

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on: 10:16 AM, 11/17/18
"Sir," said Officer Donnelly over the walkee, which Sergeant Richard Dixon promptly activated.

"What is it, Tom? Kinda in the middle of something."

"We're getting a report of an attempted break-in at the bank downtown. People said it was... disturbing."

"In what way?"

"You better get over there, now."

"On my way."

* *
Terry Blackstone was feeling good about the new neurosurgeon he'd found to repair his neck. The pain from the pinched nerve was blinding, and he had trouble functioning in normal day-to-day life. For the past decade, Terry had been living on disability, barely able to drive over slightly bumpy roads - let alone have full function of his periphery and vision. But, Terry had been unable to find a doctor that would accept his Medicare insurance.

Until Doctor Francis Baltes.

"I'm the most professional, least-invasive surgeon in the area," he'd said with charm and a flash of pearly-whites.

"He's the guy," Terry had said to his wife Julia. Terry hadn't a worry about the man or his future in the world.

Until the day of the operation.

As they passed through the dilapidated neighborhood, his wife almost wrecked into the curb as a black cat darted in front of the car. It stopped briefly as they sat in shock, eyeing them cautiously, before zipping into the woods.

Terry and his wife exchange a glance, and laughed hysterically.

Not being a superstitious man, Terry didn't think much of their near collision with the animal.

Not even after running into a second one.

"Oh, my God," his wife shouted, all humor on her face gone.

And as they rounded the corner, they saw this black cat joined by a third.

"We need to just turn around and go home,” said Julia. Once at the hospital, Terry and his wife waited.

And waited.

The waiting room smelled of chemicals and body odor. A man walked by with what looked like dried mucus caked around his mouth and under his nose. A nurse was pacing and reading over documents which seemed to be putting on the verge of a full-blown panic attack. Their odds were not looking good, Terry thought, even before they'd been there for two whole hours.

As the third hour finishing dripping by, a taxi pulled up in front of the door.

"That's... bizarre," Julia said.

"What?"

She pointed at the yellow vehicle as a man with torn blue jeans, 5-o-clock shadow, and a stained white jacket hobbled out of the car.

"Oh... oh no," said Julia.

Terry gripped her hand.

"Its okay, its okay, he's a good man."

Doctor Baltes entered through the front entrance with a smile as charming as ever. Terry stood and shook his hand.

"So, I guess you're about ready then," said Baltes without a flicker of fear, worry, or concern in his eyes. Confident as ever.

"Yes, yeah I think I am."

His wife looked at him, stupefied.

* *
Dr. Francis Baltes had always wanted to make something of his life and contribute to society in a big way. His parents, Marge and Ted Baltes, had always encouraged this. Being from a priveleged household, they always never failed to stress him to "make the most of it," since very few in this world were given the chance to do so.

But that was only one of the reasons they mentioned.

Whatever it was, whatever reason of the week or year it was, Francis was never letting go of making a name for himself. But, perhaps he took it a bit too far.

His coach for the football team upon graduating high school a bit below the requirement to join a college team always told him he was pushing himself too hard. But still he pressed onward. Francis set his sights on the Tennessee State Titans his sophomore year and made it as one of the few walk-on players. Frank Dunlap, a fellow linebacker with the Titans, recalled Baltes struggling, even with basic drills, but begging to run them over and over.

“He’d be, ‘Coach, I promise I can get this, let me do it again.’ He’d go through; he’d screw it up again,” Dunlap said. “I gathered very quickly that everything that he had accomplished in sports had come with the sweat equity. When people said, ‘You weren’t going to be good enough,’ he outworked that and he made it happen.”

Despite his determination and work ethic, Dunlap could tell this wasn't merely a commitment to being responsible... this was an obsession.

Homesick, Baltes left Tennessee after a year and transferred again to what was then Florida State University, now the University of Florida. He had hoped to play football, but he tearfully told Dunlap his multiple transfers had taken away his eligibility.

It was then, Dunlap recalled, that Baltes set his sights on his next goal: to be a doctor. And not just any doctor — a neurosurgeon, operating on injured backs and necks.

"I knew that somebody, at some time, was going to have to tell him to stop it."

* *
When the Sergeant arrived, what he saw shook him to the marrow.

A man was screaming, over and over again, in white scrubs, his hands in fists and therein leaving streaks of crimson across the glass. As Dixon drew his gun and approached, ordering the suspect to stand down, he could hear in his words, "HELP! THEY'RE GONNA GET ME AND MY FAMILY! THEY'RE GONNA KILL US! THEY'RE GONNA FUCKING KILL US DEAD!"

"Put your hands where I can see them and step away from the glass!"

He did so, and as he turned, Dixon's heart sank into his gut.

His hands were crimson and slick with blood.

* *
Francis Baltes got his undergraduate degree in 1995, after enrolling in an ambitious program to get both an M.D. and a Ph.D. While doing his surgical residency, Francis collaborated with two Italian scientists to explore commercial potentials of utilizing stem cell technology to revitalize ailing backs.

But as his residency continued, and his progress accelerated, Francis continued to indulge more and more in alcohol and - in time - drugs.

Francis went to work six days a week, working ten-hour shifts. And every Sunday, he would imbibe in spirits and cannabis. And as the months wore on, Francis expanded his horizons to other drugs and stimulants. Eventually, he found himself doing cocaine and soboxone.

And not just on Sundays. But twice a week.

And, eventually, every day.

* *
"So, what do you do for a living," the charming, handsome and smooth-talking neurosurgeon inquired to Diana as he lifted the glass of wine to his mouth.

"I'm a painter," she said bashfully. "Nothing serious, or... you know..."

He chuckled after the drink.

"You know, there really isn't much to this surgery stuff," he basked confidentally.

"Oh?"

He shrugged with a smirk. "Yeah, the human body is a lot like a game of hide and go seek, or... you know... dating."

Diana laughed a bit loud, having already had three glasses and being a lightweight.

They went to his apartment, made love, and did some crack and meth.

Diana herself wasn't much into drugs, but something about Francis made her feel comfortable.

She felt safe.

They never found out much about one another's professional lives, preferring to sustain the fantasy of two young lovers madly falling for one another, and living their lives in utmost eternal ecstasy.

Until, one day, she woke up as he was leaving.

"Hun, going to work," she asked wearily, as she noticed him putting on a lab coat.

He stopped dead in his tracks, as though he'd been caught doing something criminal.

"Uh... just popping in."

"You said you were off today," she half-stated, half-inquired.

Another moment of silence hung in the air. He returned to the bed, gave her a kiss, a smile, and a wink. And with that, without saying anything further, he was gone.

Most people, when they binge all night, they don't function the next day to be at work. Let alone being a surgeon. A fucking neurosurgeon. Spending a night using cocaine, methamphetamines, and other drugs would normally leave one paranoid the following day, to the point they were unable to leave their house.

But Francis seemed perfectly fine. This didn't impress her. It horrified her.

* *
During medical school, it is typically between 800 to 1200 times that a student has practiced operations, but Francis - he believed - was good enough with fewer than 100 of these under his belt. He figured he was good enough, and despite some complaints from his colleagues that he was an 'arrogant know-it-all,' probably due to jealousy over his work ethic, his supervisors recommended his assignment at Ribbentrop-Smith Medical Associates. He was hired on the spot with a 600,000-dollar advancement.

He immediately got to work, his first patient being one Robert Evermore, a financial investigator for the City of Brownsville, Arkansas.

"I've had successful spinal surgery before," Evermore explained, "but the pain has returned, and my pain specialist, Malcom, said he had lunch with you a few weeks ago, and you seemed like a man who 'knew what he was talking about,'" he continued.

Francis nodded with a smile as Evermore explained the issue, always charming, always smiling.

"Well, I can assure you that we'll get this sorted out."

Rob narrowed his eyes.

"I'm sorry, 'we'?"

"Oh yes," he said with exuberance. "Its actually common practice to have multiple surgeons operating on a patient. I'm going to be working with a vascular surgeon by the name of Mike Weber."

Francis could detect a hint of unease in the air, and swallowed a dry wad of dehydration that had collected in his throat after doing some ecstasy pills the night before.

"We will get this sorted out, I can assure you."

Rob's previous experience had involved only a single surgeon and several nurses, but he held his tongue for fear of not being able to find another opportunity. So, he merely smiled, and nodded.

"Thank you, so very much," he said, standing with some effort.

"Trust me," he said, gripping the man's hand tightly. "You are in good care."

* *
Mike was indifferent to Dr. Baltes, but he still didn't trust him. Not that that's saying much, since he didn't trust anyone. Not even his own parents.

At first, the operation was going swimmingly. All of the procedures and policy were followed to the 'T,' ...but then Dr. Baltes started messing with something Weber was absolutely 100% positive was incredibly, horrifically, wrong.

"Umm... what are you doing," Weber asked shakily as Baltes handed him the scalpel.

"Hold that," he ordered, without answered Weber's question. Mike felt his blood run cold as Baltes handled a large impact drill, and directed it at one of the main screws in Evermore's spinal column.

He began to drive the power tool directly into the screw at full speed, warping and stripping the screw to the point that sparks began to erupt from the surgical opening and Baltes's hands were shaking.

Mike was unable to move a muscle, so much as utter a sound, until it was too late.

Baltes put the screwgun down and extended his hand for the scalpel.

Mike didn't react at first, until Baltes opened and closed his fingers a few times, and Mike snapped into consciousness.

"I'm sorry, but do you-"

Baltes held up a finger, and began doing something else horrific.

He began cutting into a central artery.

Blood cascaded and blossomed in thick torrents from the surgical wound, spilling out onto the table.

That was it. Mike couldn't stand by while this amatuer ended up possibly killing someone due to whatever psychological issues the man was having. Weber forcefully shoved Baltes aside, grabbed the scalpel, threw it onto the table, and marched out of the room.

He quit the following day.

* *
Doctor Derry Dalton was a vascular surgeon at Ribbentrop-Smith back when Dr. Francis Baltes had just started working there.   He'd see him briefly once a week at the scrub sinks or in the lounge area.

He'd heard little about the man, so decided to humor him for once after weeks of trying to get Dalton's attention.

"Come on, I don't bite," he said, almost facetiously.

Dalton sighed. "Alright, I'll sit and talk a bit," he said as he sat. "What is it you want to know?"

"Just wanted to get to know you a bit, if that's alright," he said as he took a big sloppy bite of his sandwich.

Dalton sighed once more. "And, what is it you could possibly want to know?"

"The spine surgery here is outdated and primitive," said Baltes, much to Derry's surprise and shock.

"Do what now," he asked, almost stammering.

"I want to clean it up, make this town better for its medical practices. Was wanting to know if there was any way I could maybe work my way up the ladder in a month or two."

Dalton stared at the man.

"Do you have any fucking idea what the actual hell you're getting yourself into."

Francis froze, and sat down his meal. But he didn't say anything, he just... stared.

"Okay, I'm leaving, because you're starting to freak me out."

Baltes's next patient was a pool manager from out of town by the name of Elijah Wilson.

Wilson was prone to taking on more than he could handle. Despite his supervisors telling him he couldn't possibly take on so many heavy-lifting responsibilities by himself, Wilson insisted on re-stocking and re-cleaning the pool every day upon the month.

Eventually, his back gave out on him.

Although his previous surgeon recommended exercise and taking a break from his pool job, Wilson insisted on seeing a neurosurgeon due to his incredibly-debilitating pain originating from his back.

One of his pain specialists happened to recommend Francis Baltes at the Ribbentrop-Smith Medical Centre.

Wilson's research about Baltes was phenomenal. His supervisors desrcribed him as hard-working, a multitude of reviews described him as 'outstanding,' and Wilson read up about everything he could about the guy. When he finally met Doctor Baltes, Wilson was thrown off by his easy confidence.

"I loved the guy," Wilson said to the nurse-practitioners, as he exited the facility.

His experience under the knife, however, was vastly different.

"You've never even done an anterior lumbar spinal fusion, have you, Baltes," Dr. Dalton inquired, one of the head-and-neck surgeons the patient had requestioned to assist on the case.

It was January 11th, 2012, well into Baltes's beginning career into neurosurgery.

"In the realm of what a neurosurgeon does on a daily basis, this is the utmost simple thing you will do on a regular basis," he taunted Baltes. "Do you get me?"

Only he wasn't taunting, as Baltes quickly realized.

He was serious.

Baltes, nevertheless, pretended like he hadn't.

Instead of using a scalpel, he tried to pull Wilson's problem disk out with a pair of plyers, attacking the source with the level of aggression and brutality a carpenter would a rotting plank of wood in the way of building a new one.

"What in the entire fucking FUCK are you DOING," screamed Dalton.

"I KNOW WHAT I'M DOING," screamed Baltes in defiance, blood and gore splattering his mask and scrubs.

Dalton left the room.

Two days later, Wilson awoke in the flames agony.

Francis could swear he saw the future.

He saw himself at a podium, running for political office, or even President.

He saw himself ushering in a new era of healthcare reform, where everyone could be of benefit to his knowledge and caring grace.

Dr. Baltes took a rolled up dollar bill and caressed the surface of the glass mirror, along the predetermined line of drug and chemical that gave him the third-eye-gaze he so deserved, the hidden knowledge of the medicinal practices of the ancient.

Each and every day he saged the operating room, to ensure the pain demons could not touch his patients.

But, still, there was a conspiracy brewing.

He knew that Dalton and his former team were colluding to bring him down.

They always doubted him.

They always hated him, consistently fantasizing and masturbating to his downfall. Nevertheless, Batles would emerge victorious, with the spirits of the ancestors and God Himself Above as his loyal aides, Baltes would win yet.

Oh, yes.

He would win.

And now, he'd heard tale of an old teammate of his, one Billy Winters who had been one of the athletes who had always mocked and humiliated him (Like a demon. Like an evil fucking demon) would soon be going under the knife.

He had asked Winters to go with him to Arkansas when he'd gotten the job, but he was now beginning to see that this was a mistake.

Baltes laughed hysterically to himself within the confines of his mind.

He laughed.

He laughed and laughed until the laughter become an ear-splitting, mind-numbing, caterwauling and deafening scream.

"I can't tell you how thankful I am," said Winters, signing the patient-doctor confidentiality form. "I'm sorry I ever doubted you, Francis."

He handed the doctor back his pen and form.

"Its no trouble, really. See you back here on..." he checked his watch. "Wednesday at 8 AM?"

Winters nodded exuberantly. He'd fallen to a football injury in High School back in the 1990's, and it had resulted in chronic back pain which had only gotten worse after he got into a car wreck in 2012.

When Billy arrived at Ribbentrop-Smith that Wednesday, laid down on that table, and recieved his anasthesia, he had no idea what he'd gotten himself into.

Francis made sure to schedule the surgery as early as possible before anyone was really awake enough to know something was up. Dr. Baltes locked the doors to the operating room and closed the blinds as soon as Winters was under the effect of the drugs.

Although he himself was at the tail end of a drug binge, Baltes felt as though he was able to clear his mind of his prejudice and get to work trying to make something of himself via this surgery. But even now, Baltes could feel something tugging at his mind's subconscious.

And after he snapped Winters's vertebral artery, causing his patient to spew blood across the wall and operating theatre, Baltes knew that his patient was going to become yet another victim.

"I want to die," groaned Winters, having been paralyzed from the neck down for days after the surgery. His wife, Vicky Winters, has stopped crying but leaked tears uncontrollably.

"I want to die," he repeated. These four words were the only thing he'd been saying for the past five days he'd been living like this. The surgeon who'd gone in and attempted to correct the botched operation spent most of the time with Vicky in silence.

"It seems the previous operator had attempted to stop the bleeding with profuse amounts of anticoagulant," he explained, pointing to the dark, ominous voids that showed up on the X-ray. "It squeezed his spine, shutting off all contact between the brain and the rest of his spinal column."

Derry watched in silent horror and rage as the patient's wife began to sob uncontrollably once more. It shouldn't have taken so long to get the results of the operation back, Dr. Dalton kept thinking to himself. Someone up top, one of the regulators or one of his bosses, was sweeping these botched surgeries under the table, covering his ass.

"They're trying to not lose money for the institution," Derry explained as calmly as he could to his colleage, Dr. Greg Rosenstein. "But if this guy keeps doing this... if we don't speak up and say something and *do* something-"

"Look," said Greg, flatly, finally at long last looking up from his paperwork. "There is a process," he began with a sigh, "when dealing with issues concerning incidents of medical malpractice-"

"THIS ISN'T MEDICAL MALPRACTICE THIS IS MEDICAL FUCKING MALICE, GREG!"

Greg seemed to jump back in his chair, although he'd merely remained unmoved, except for the concerned and horrified expression now washing over his features. He let out an exasperated chuckle.

"Boy, you're working yourself to death."

And that's all he said as he got up from his desk. As Dr. Rosenstein exited the room, he was alarmed to see former Dr. Weber standing there, leaned against the far wall, staring blankly at him.

Rosenstein spread his arms. "Got a problem?"

But Mike didn't answer. He simply stood there, staring, taking another bite of his apple.

Rosenstein sighed for a final time and exited the room.

Little did neither Rosenstein nor Dalton realize, Weber had been doing extensive research into Dr. Baltes, and found that he used to take steroids during his time playing football, and quickly began to engineer a plan.

"You're being drug tested and psychologically evaluated, Doctor Francis Baltes, due to an anonymous tip from a 'friend' of yours from college, who claims you had a habit of drug abuse," said Superintendent Olivebranch.

"Sir, I... I don't know what to say." He quickly darted around in his mind, trying to search for the most minimal of half-truths to spit out at his superior. "I... " he feigned a sigh. "I had a bit of a problem with performance enhancing drugs in high school," he paused.

"I... that was a long time ago, sir."

Another pause, as he eyed Baltes narrowly.

"I'm good now. I'm clean."

Olivebranch nodded tenderly. "I believe you."

"Trust me, I wouldn't do this-"

"But, we're still gonna have to test you," he added quickly, leaning over and clicking his pen, scribbling on papers.

He handed him one.

"You'll be here, at this day, on this time. If you want to keep practicing medicine."

The walls were talking. They said walls had ears. But not talking.

No matter, they gave him good advice.

"STALL," the statue on the entertainment center screamed. "STALL, DAMMIT!"

Baltes screamed into a pillow.

"WhatdoIdo!? WHAT DO I DO!"

"Tell them you got lost. TELL THEM!"

After passing a separate psychological evaluation and passing the drug test, Baltes was dismissed for three weeks. About a week after his return, the department got a patient suffering from extensive back ailments.

Brad and Jennifer were veterans of the ED. While Brad had gotten there a year after Jen, he had still experienced some fairly harrowing things, and with the commotion hurtling through the department, he destinctly remembered his anus puckering at the thought of what he, Jen and the others went through six months ago.

One night Brad got to the hospital and they were dealing with what was at the time vaguely referred to as a 'perirectal abscess.' Needless to say, the entire crew was less than thrilled.

Brad went down to the Emergency Room to transport the patient, and the only thing the ER nurse said as she handed him the chart was, "Have fun with this one."

So, they'd got the lady off to sleep, put her into the stirrups, and Brad began washing off the rectal area. It was red and inflamed, but it was all pretty standard. Her chart had noted that she'd been injecting IV narcotics through her perineum, so this was obviously an infection from dirty needles or bad substances. But overall, it didn't seem to warrant her repeated cries of, 'Oh Jesus, kill me now.'

Jennifer stepped up with a scalpel, sinks just the tip in, and at the exact same moment, the patient had a muscle twitch in her diaphragm, and just like that, things went downhill.

Unbeknownst to them, the infection had actually tunneled nearly a foot into her abdomen, creating a vast cavern of fluids that had seeped outside of her colon. This godforsaken mixture came rocketing out of that little incision. They all wore waterproof gowns, face masks, gloves, hats, the works -- all of which were as helpful was rainboots against a firehose. The bed was in the middle of the room, an easy seven feet from the nearest wall, but by the time we were done, bits of flesh pasted against the back wall continued to be found.

As Jen continued to advance her blade, the torrent continued unrestrained. The patient kept seizing against the ventilator (not uncommon in surgery), and with every muscle contraction, she shot more of this brackish gray-brown fluid out onto the floor until. Within minutes, it was seeping into the other nurse's shoes. I was nearly twelve feet away, jaw dropped open within my surgical mask, watching the second nurse dry-heaving and the surgeon standing on tip-toes to keep this stuff from soaking his socks any further.

The smell hit them first. 'Oh god, I just threw up in my mask!' The other nurse was out, she tore off her mask and sprinted out of the room, shoulders still heaving. Then it hit Brad, his mouth still wide open, not able to believe the volume of fluid this woman's body contained. He couldn't breathe, his lungs recoiled against his body's attempts to pull in any more. The anesthesiologist went down next. He was an ex-NCAA D1 tailback, but his six-foot-two frame kept shaking as he threw open the door to the O.R. suite in an attempt to get more air in, allowing Brad a glimpse of the second nurse still throwing up in the sinks outside the door.

In all operating rooms, everywhere in the world, regardless of socialized or privatized, secular or religious, big or small, there is one thing the same: somewhere, there is a bottle of peppermint concentrate. Everyone in the department knew where it was kept, everyone knew what it is for, and everyone prays to their gods they never have to use it.

Brad sprinted to the central supply, ripping open the drawer where a vial of ambrosia was kept, only to be greeted by an empty box. The bottle had been emptied and, by god, out there was an apex dickhead who had used the last of the peppermint oil, and not replaced a single drop of it.

He darted back into the room with the next best thing he could find at that time -- a vial of Mastisol, which is an adhesive rub somestives used for bandaging. Not as good as peppermint, it would do considering that over one-third of the floor was now thoroughly coated in what could easily be mistaken for a combination of bovine after-birth and maple syrup. Brad started rubbing as much of the Mastisol as he could get on the inside of my mask, just glad to be smelling anything else. The anesthesiologist grabbed the vial next, dowsing the front of his mask in it so he could stand next to his machines long enough to make sure this woman didn't die on the table.

By this time, the smell had permeated out of the O.R. suite, and down the 40-foot hallway to the front desk, where the other nurse still sat, eyes bloodshot and watery, clenching her stomach desperately.

Brad stepped back into the O.R. suite, not wanting to leave Jennifer by herself in case she genuinely needed help. It was like one of those overly-artistic representations of a zombie apocalypse you see on fan-forums. Here's this one guy, in blue surgical garb, standing nearly ankle deep in lumps of dead tissue, fecal matter, and several liters of syrupy infection. He was performing surgery in the swamps of Dagobah, except the swamps had just come out of this woman and there was no Yoda.

She and Brad didn't say a word for the next 10 minutes as she scraped the inside of the abscess until all the dead tissue was out. The front of her gown was a gruesome mixture of brown and red, his eyes squinted against the stinging vapors originating directly in front of him. Brad finished his required paperwork as quickly as humanly possible, helped Jen stuff the recently-vacated opening full of gauze, taped this woman's buttocks closed to hold the dressing for as long as possible, woke her up, and immediately shipped off to the recovery ward.

As they left the locker room, Jen and him looked at each other, and she said the only negative sentence he'd heard her utter in two and a half years of working together; "That was bad."

The next morning the entire department (a fairly large floor within the hospital) still smelled. The housekeepers told him later that it took them nearly an hour to suction up all of the fluid and debris left behind. The O.R. suite itself was closed off and quarantined for two more days just to let the smell clear out.

Brad laughs when he hears new recruits talk about the worst thing they've seen. While he'd seen this and other horror stories, Jen's personal encounters had been a bit more... psychological. "I'm wasn't a nurse, but I was a CNA and telemetry technician for many years," Jen said upon getting through that previous ordeal, "I floated from my 'home unit' of medical neurology to the ER at least once or twice a month when they were short."

"We had a man drive himself to the hospital because he was having delusions, and decided it would be a good idea to cut off his own member. According to him, after said removal, he regretted the decision. To remedy the problem, he stuck a pencil through the severed member, stuck it back on the stump, and attempted to superglue the whole thing back together.

He tried for a while, and then when it didn't work drove on over to the ER. He said that God had told him that if she completed this act as a sacrifice, he would stop global warming. I guess it was a noble reason for him to do it, and the next night when I returned to work, he had been admitted to my home unit and was one of my patients. Yay.

He was a difficult patient to have for the next month because we couldn't seem to find a combination of medication to stop his delusions. When he was lucid, he was a well-spoken, kind, intelligent man. But, you could have a good conversation with him, leave the room for five minutes, and come back to a man screaming that he was going to do horrible things to you in graphic detail. He ended up having to be restrained. He escaped the restraints one night while I was working, knocked a nurse unconscious, and broke her nose. At that point, it was decided that he was 'well' enough and the hospital pressed charges on him for the assault, and he was taken by the police to jail."

Brad shook his head. "Unbelievable, why the hell... nevermind."

Jen chuckled. "Yeah! They were able, by some huge miracle, to reattach it to him. They didn't know if it would ever be 'fully functional' again, but he could go to the washroom."

But another story, despite having not talked about it with anyone, she decided to share it.

"We had a husband and wife come in, utter hysteria following, in the middle of a miscarriage," she didn't look up as she kept washing her hands, somewhat obsessively. "They took her upstairs to deliver the deceased... baby, and," she shook her head. "Her husband was a veteran and started having stress-induced PTSD flashbacks, and early tests showed signs of tuberculosis. You know what happens, then, right?"

"Ya'll had to quarantine him until you could confirm its status."

She nodded, starting to tear up a little.

"So we had him locked in one of the rooms down there while upstairs his wife was having a miscarriage." Jen caught herself, collecting her thoughts. "Yeah," she chuckled. "Its a tough job, you'll get used to it," she added with a slap on Brad's shoulder.

The day they met Dr. Baltes, they were having lunch in the establishment's break room, which flanked an indoor window that ran alongside a forensics class that was in session. Dr. Jennifer Benson's colleagues were all seated, eating the meals of tuna sandwiches, barbecue chips and cans of soda, while observing the demonstration of an autopsy upon a seventy-year-old man who had been alive and well and gardening a mere two hours before.

As they sat and watched, the surgeon made an incision along the top of the man's face, along his hairline. As he cut the length of his face, Jen's friend Bob Dettweiler pointed and through a half-full mouth said, "that right there."

Jen took a sip of her drink and turned in the direction of his finger. The surgeon then folded the man's face down around his neck, peeling the face back like one would an orange skin. The face came to rest at the bottom of an exposed, liver-colored musculature like a mask.

"That is the color we're going to paint our new house," he said with a smile.

Jen mirrored his expression and immediately got excited. "You and Laura got the place?"

He nodded.

She congratulated him and hugged her friend. Filled with a new burst of energy and excitement, Jen decided she was going to get to work on her rounds a bit early.

As she was rounding a corner, she almost collided with Brad, who seemed in a hurry.

"What's wrong," she inquired.

"We got another one, she's coming down the hallway now."

They intercepted an entourage of nurses, doctors and other hospital staff ferrying an older woman to the ED.

"Name's Cassandra O'Hare, preschool teacher, she was getting some Christmas decorations from the attic when she fell off a ladder."

Jen thumbed through the X-Rays.

"Compressed nerve. I want in on this."

As they neared the operating room, Jen saw familiar faces. Some of them she knew from residency, and other she'd just met within the past month or so.

But one man she didn't recognize, and before she could get a good look at him, he was putting on a surgical mask and ferrying the woman in agony into the room with a few others.

Before Jen could speak up, he had disappeared into the room and locked the door.

Brad was one of the nurses attending to and cleaning the patient when she regained consciousness. As he pulled back the thin shit, he almost dropped his sponge tray.

Her skin was a discolored, mottled brown, and as O'Hare became fully aware of her surroundings, she began to scream, slap and scratch at her awful-looking legs. She flailed and thrashed, sending medical instruments hurtling like confetti. She became so violent that Brad had to call in Jen, and the patient had to be sedated.

Several hours went by, and she never woke up.

"Pull up the X-Rays again," Jen said to the doctor by her side. He did so, and Jen noticed two black voids along the spine that were clearly not supposed to be there.

"Okay, what... the... hell," Jen exclaimed silently, motioning for the scalpel.

When she incised, she was greeted by a torrent of blood from what was undeniably a cut artery that should have been left alone.

The Investigator slid the glass bottle of Vodka before Jen, "Is that the kind of bottle that Doctor Baltes had under his desk at Ribbentrop-Smith?"

"It's been so long, it's - I dunno - it looks similar."

"Did Doctor Baltes have a bottle of clear alcohol under his desk, at Ribbentrop-Smith," he reiterated.

"I don't know if they make any other type of handled clear alcohol there, but yes, it was there, it was under his desk..."

"At Ribbentrop-Smith," the Officer asked once more.

"There was a bottle of Vodka under his desk at Ribbentrop-Smith, yes, sir," she acknowledged nodding.

"Did you ever see cocaine, or white powder, in the office at Ribbentrop-Smith," he asked, moving on to his next question.

She hadn't bore witness to the second evaluation of Doctor Baltes, but she remembered his face once she got a look at it. Jen had asked Brad to keep an eye on him, and the latter had done so diligently for days.

"We found, RN Bradley Jameson and I, found a bag of white subtance in the patient bathroom at Ribbentrop-Smith," she explained. "Brad came to my office and said, 'there's this bag in the bathroom, would you come check this out,'" she struggled to utter the next sentence.

"We flushed it in the toilet, sir. We-we didn't, we flushed the-the whole thing down the toilet system, sir."

Brad had told her of the smell of chemicals, possibly hinting at the use of methamphetamines or other substances besides what he'd found under the sink.

The next thing the officer had asked her to go over was quite possibly the most disturbing part of the testimony.

"There's this e-mail I got from Doctor Baltes," she began, shuffling through the pages to find the first one, "that is dated December 11, 2011, and it is to me." But as she attempted to read it aloud, she felt herself tensing up, and beginning to recoil into fits of tears.

"He says... he..."

Jen caved in on herself, unable to sound out a single word of the horrifying document before her.

Baltes resigned on April 20, 2012, with a lawyer-negotiated letter saying, “All areas of concern with regard to Francis A. Baltes have been closed. As of this date, there have been no summary or administrative restrictions or suspension of Baltes's medical staff membership or clinical privileges during the time he has practiced at Smith Regional Medical Center at Ribbentrop.”

Since Baltes's departure was technically voluntary and his leave had been for less than 31 days, Ribbentrop-Smith was under no obligation to report him to the National Practitioner Data Bank.

His incidents weren't properly reported. The board did not conduct an investigation. And Baltes was allowed to temporarily operate at Little Rock Health Institute while going over his references.

Another RN to bear witness to Baltes's terror was a man by the name of Chris Carrington, who claimed that on July 24th, 2012, botched a cervical spine surgery on a 61 year old Maurice Finn to repair increasing neck and shoulder pains.

Roughly twenty minutes into the surgery and Baltes was already having trouble seeing her spine due to the amount of bleeding. The crimson of Finn's blood saturated the blue draping around her body and even as Carrington yelled for more towels.

"More sucking, get that blood out of here, now," shouted Baltes as he continued to cut into the tissue and artery around the spine. Even as the suction techs worked dilligently, the bleeding took more toweling than they had available on that level, and there were an upwards of two teams-worth of techs running back and forth to grab more towels. Carrington swore as the blood was now soaking through the towels and onto the floor.

A few hours later, with Finn still in the ICU, Carrington was startled to hear that Baltes had taken on another patient and begun surgery. The patient’s name was Mary Efurd. She was an active 71-year-old who’d sought Duntsch’s help because back pain was keeping her off her treadmill.

Meg Franco was an active 68-year-old seeking help with back pains that were keeping her off her treadmill. And when Baltes arrived nearly an hour late, he saw something that would haunt him for the rest of his days.

Baltes's pupils were the size of pin-heads, and he rarely blinked.

"Finn's in critical condition," Carrington said, "the staff wanted me to inform you as soon as possible."

As Baltes began to cut into Franco, he turned to Carrington and told him, "let them know we're going to need to perform a procedure on her called a craniotomy, meaning to drill a hole in her skull to release the pressure within."

Carrington didn't know how to respond, he merely froze.

That's when Baltes turned a gaze on him he'd never seen worn by a human being before. More akin to a suspicious dog, or a wild animal.

"What are you waiting for?"

"We don't do those."

"What," he interrogated, his voice elevating all the while the doctor kept drilling and removing screws and other hardware along the patient's spinal column.

"We don't do craniotomy's here. Hell," he waved his arms. "We don't even have the right tools."

"Are you putting that material in at the right places," asked Joseph, one of the operating room staff.

A neurosurgeon was hired to review Finn's case, after she was moved to another hospital and fell into a coma. The findings would later determine that Baltes had both pierced and blocked her vertebral artery with a misplaced screw, and that Baltes had misdiagnosed the source of her pain and was operating in the wrong place.

*
A trio of holes had been drilled in at odd angles, likely where Baltes had made multiple failed attempts to insert the screws. One of them was crammed right into her spinal canal, which had also spitroasted the nerves that control one of her legs and the bladder.

Doctor Marcus Tillman, who had been assigned to investigate, spent the next six hours cleaning bone fragments out of the surgical zones. As he was doing so, Mark found something that made his hair stand on end. One of Franco's nerve roots that connected the upper and lower body parts of the spinal nervous system, had been completely amputated.

"This man is an impostor," Tillman said to himself out of utter disbelief.

By week's end, the administration informed Baltes he would no longer operate at Little Rock Medical.

"We will no longer be needing your services, if you resign now, we will not report you to the National Practitioners," said Doctor David Nelson.

"Well, I appreciate your candid verdict, it's been a pleasure," Baltes said with a smile, standing to shake the man's hand.

"Have a good evening," Dr. Nelson stated flatly, refusing the handshake.

Of course, the same thing that happened at Ribbentrop-Smith happened here. Baltes was allowed to resign and keep practicing medicine.

In fact, his reign of terror and blood was only half over.

Then, in December 2012, Kirby was asked to help Jacqueline Troy, a patient suffering from a severe infection. (The Troy family would not comment for this story.) Troy was being transferred to a Dallas hospital from a surgery center in the suburb of Frisco. She’d had neck surgery, but the surgeon had cut her vocal cords and one of her arteries. When Kirby learned the details, he asked the doctor who referred the case to him about the surgeon: “Is it a guy named Christopher Duntsch?”

A few months later, Dr. Dalton's knowledge was requested to help with a patient suffering from a severe infection, being transferred to a hospital out of state from a surgery center in the suburbs of Little Rock. She'd had neck work, but the surgeon had severed her vocal cords and one of her arteries.

"Who was the surgeon," Dalton asked.

The Doctor on the other line paused.

"I'm not sure, let me check."

"What is a man named Francis Baltes?"

There was a cough followed by a longer pause.

It was.

Soon after his most recent act of barbarism, Baltes was at long last finally reported to the Data Bank. A report dated January the fifteenth, 2013, obtained by an attorney of one of Baltes's 'patients,' shows that Methodist Medical Center in the suburbs of Memphis had reported Baltes after denying him privileges six months earlier. The rejection was based upon Baltes's, 'substandard and inadequate care,' at Ribbentrop-Smith.

But even after this report, Dalton was horrified to discover that Baltes had been invited to a dinner honoring the arrival of their newest neurosurgeon... none other than Dr. Francis Baltes himself! Derry immediately called them and raised Cain.

"Mrs. Blackstone," said Doctor Baltes, entering the waiting room. "I'm so sorry," he began, but before he could get anything else out, Julia collapsed into his arms sobbing. "We-we've found a tumor in his neck, we're going to have to do a deep-surgery, and move him to a more intensive unit." When Julia went to see Terry a few hours later, he was in bad shape. "I-I.. where's the Doctor, I need to see the Doctor!"

She stroked his hair out of his face. "What's wrong?"

"I-I can't move my arm! Or my leg... I- can't," he could barely talk.

"Some-something is-wrong, something is-is wr-wrong!"

"SOMEBODY HELP!"

According to doctors who reviewed the case, Baltes mistook part of his neck muscle for a tumor and abandoned the operation midway through — after cutting into Blackstone's vocal cords, puncturing an artery, slicing a hole in his esophagus, stuffing a sponge into the wound and then sewing Blackstone up, sponge and all.

On June 26, Baltes was ordered to stop operating. The head of the medical board at the time, San Angelo family physician Dr. Irvin Zeitler, said the investigation took a while because “it’s not uncommon for there to be complications in neurosurgery.”

When Jennifer Benson read the email aloud before the court, there wre nothing but silence and shocked expressions

"Unfortunately, you cannot truly understand that I really am building an empire, and that I am so far outside of the box that the earth is small and the sun is bright," she pronounced.

"Yessir that is

"Anyone one close to me thinks that I am likely something close to God, Christ and Einstein. Because how can I do anything I want and cross any disciplined boundary like its a playground and never lose. I am ready to leave the love and kindness and goodness and patience that I mix with everything else that I am and become a cold blooded killer. The sad fact is that I can go faster, do better, and catch more respect and honor by fucking everyone in the brain, emotionally and mentally controlling in a manner that borders on abuse. Taking no prisoners and sending everyone in my way, and especially everyone that fucks with me, to hell."

"Do you know what he is talking about here?"

"No sir"

"Do you know what he is"

"No sir... what do you mean?"

"What is the problem Kim, everything is somewhere between human and something else, DO YOU THINK I AM SOMETHING CLOSE TO THE ANTICHRIST"

"No sir,"

"SO I PICK AND CHOOSE MY HUMANS LET THEM CHOOSE OR SHOW THEM I AM. YOU MY CHILD ARE THE ONLY THING BETWEEN ME AND THE OTHER SIDE. I AM WILLING TO LET GO OF EVERYTHING I-"

"I AM NOT YOU!"

"I'm sorry?"

"I'm not you," she said, repeating over and over again.

"I'M NOT YOU, I'M NOT YOU!"

"I'M NOT YOU!"

"I'M NOT YOU."

Then, finally, Jen realized she and Doctor Francis Baltes had been the same person all along. Her career as a surgeon. Her operations, all murders committed by her alternate personality - a man by the name of Doctor Francis Baltes, a man she'd studied under in residency. A man she'd looked up to, and been raped by.

This was her subliminal payback, an area of her personality she'd taken into the darkest corners of her mind.

Dr. Jennifer Benson re-read the email she'd sent to herself, and felt herself overcome with rage.

"I am ready to leave the love and kindness and goodness and patience that I mix with everything else that I am and become a cold blooded killer. The sad fact is that I can go faster, do better, and catch more respect and honor by fucking evberyone in the brain, emotionally and mentally controlling in a manner that borders on abuse. Taking no prisoners and sending everyone in my way, and especially everyone that fucks with me, to hell."

She re-read it, over...

...and over, and over, again.

---

A potential alternate ending I'm thinking of involves Jen realizing she was Baltes, and is in fact not the Jen we encounter earlier in the story. I wanted to make it recognizably based upon the infamous Dr. Christopher Duntsch while still clearly not a re-telling of that same story, which is what I believe I'm struggling with the most here.