Do No Harm by Gregg Andrew Hurwitz

“The power of accurate observation is commonly called cynicism by those who have not got it.”
— George Bernard Shaw

Terrifying. Compelling. Gripping. Unsettling. That is how the cover blurbs describe Do No Harm. The description isn’t entirely inaccurate, but were truth in advertising a standard in the publication industry, Whacking Bore might be a required addition to the cover.

Clyde is the thoroughly unsympathetic villain. He is both criminal and insane, and he’s taken to throwing industrial strength alkaline at Emergency Room nurses at the UCLA Medical Center. The first time he tries this, he really does a job on Nancy whose brother, Jenkins, is a uniformed LAPD patrolman.

When Clyde pulls the stunt a second time, the police notice a pattern, stake out the place, and promptly catch the little slime ball. In being caught, however, Clyde gets a dose of his own medicine, an alkaline bath all over his chest and stomach. He is taken into the ER where he is treated by Dr. David Spier, the attending physician who is intent on doing his job, and an ER staff that is less than enthusiastic about giving Clyde the attention their profession demands.

David Spier, a recent widower, is a brilliant ER doctor and a fast rising star in a teaching hospital where the auditorium is named after his parents. He’s privileged, arrogant, spoiled, self-righteous, and meddlesome. But he did do right by Clyde, and he’s worried about what the police, specifically the rash and unstable Jenkins, will do to Clyde when they get their hands on him. Over police objections, David holds Clyde overnight, and Clyde pulls off a spectacular escape. David takes a lot of flack for this and resolves that it is his responsibility to catch Clyde.

The purported theme of the book is medical ethics. How does a medical staff treat someone as loathsome as Clyde? Clyde is so loathsome, we learn, because as a hapless child, he was the victim of a particularly heinous medical experiment. Clyde’s just trying to get even. The “perp” becomes the victim, but in fairness to Clyde, the other kids who went through the experiment aren’t in much better shape. Worse yet, David’s mother terminated the experiment and then helped cover up the scandal.

Ethically, David isn’t clean enough to be all that self-righteous. Among his transgressions, he treated Ed, a ne’er-do-well, for a gunshot wound without properly reporting it. Even helped him evade the police. Lacking “street knowledge”, David turns to Ed, and incredibly, Ed turns out to be a low-life with the skills of a James Bond and resources to match the CIA’s. Unbelievable.

Lack of credibility is one of the novel’s major the flaws. Ed is incredible. Clyde’s escape and then evasion of the police is incredible particularly since he was burned so bad that sparrows can perch on his ribs. Clyde’s criminal skills are incredible and just don’t jive with Hurwitz’s portrait of him in the first 100 pages. Jenkins’ continued involvement in the case is incredible even for the LAPD which has real credibility problems.

The lack of attention to legal detail is incredible given that the theme of the book is ethics. When Clyde is taken into the ER he is, in fact, under arrest, as any reasonable person would see. He has some rights, including the right to a lawyer though it is unlikely that Clyde would have thought to retain one in advance. If David is concerned about Clyde’s fate in the hands of the police, a quick call to the DA or Public Defender’s Office might help. Might not have too, given that this is California, but the idea of getting any form of legal direction never occurs to David, period.

David continually treats the law with gay abandon and blithe indifference. He runs up an impressive list of misdemeanors and felonies without being held accountable, and the reason is that he is who he is. Legal ethics don’t seem to apply to physicians born with silver spoons in mouths. In fact, there are broad hints of class awareness and a class struggle between the medical profession, the police, and skid row but Hurwitz never develops the theme. A good Marxist Hurwitz is not. Still, readers might appreciate a little more direction from the author in interpreting the protagonist. He’s not admirable, and it is unsettling that the author seems to want him to be admired. In fact, people like David alone explain Cuba’s continued commitment to communism.

The novel is also too long by half. Hurwitz, unnecessarily afflicted with adjectives and adverbs of all sorts, is a determined describer of all manner of irrelevant detail. There is also interminable psycho-babble that pretends to explain the obvious. It is repetitive and sophomoric; a sad failure the editor should have scratched.

What Hurwitz does very well, particularly in the first hundred pages, is to describe complex medical procedures in the Emergency Room. He does this with medical science’s full technical vocabulary, and he beautifully translates it into layman’s English, building along the way rich images while capturing the excitement of the medical profession at its best. That is the grabber in this novel, what seizes our attention and makes us want to continue.

Unfortunately, that excitement isn’t sustained. By the last hundred pages the reader just wants to get it over. In an ethical world, this novel would slide into well deserved obscurity a week after publication, but unfortunately, it smacks of a novel intended for one thing only, immediate conversion into film where credibility is even less demanded. Everyone involved will undoubtedly make shameful amounts of money from this splendid example of western decadence without ever questioning the ethics of what they’ve done.