Do No Harm

by Gregg Hurwitz

Overview

The doors to the UCLA Medical Center Emergency Room burst open and a young nurse stumbles in — blinded, her once-beautiful face hideously blistered and burning from a savage attack by an unknown assailant. A dedicated physician, E.R. Chief Dr. David Spier is no stranger to the terrible ravages of senseless violence. But this tragedy hits too close to home; the victim is a colleague.

A second violent assault suggests the unthinkable: a disturbed man is stalking the Medical Center, and specifically the women who work there. It’s up to Dr. Spier to keep the emergency room running smoothly and efficiently, even as his terrified co-workers wonder who might be next. But destiny is about to place him at the very center of a media frenzy that erupts in the wake of the attacks — when the brutal assailant himself is dragged into the E.R. in handcuffs and placed under Dr. Spier’s care…as a patient.

Hindered by a mutinous staff that refuses to administer to the damaged man, up against angry L.A. cops who would rather see the criminal dead than imprisoned, and alarmed media hungry for a lead story at any cost — David Spier must now make the most difficult ethical decision of his career. But by doing so, he underestimates the power and cunning of the man he is sworn to heal, and inadvertently unleashes a bloody wave of horror that threatens to engulf everyone and everything he cares about. A single act of humanity has made him a pariah in the eyes of the city — and the target of a twisted, tormented madman’s hope and vengeance. David Spier’s most sacred oath as a healer has become his death sentence. To save a city under siege and himself, he must descend into the blackest depths of a twisted and vicious mind…to unlock an unspeakable secret that has been hidden away for decades behind closed hospital doors.

A breakneck-paced novel that coils and turns, surprises, chills, and mesmerizes, DO NO HARM is a stunningly accomplished work by a powerful new talent. For any true lover of nerve-jangling psychological suspense who has yet to make the acquaintance of Gregg Hurwitz, the time is now.

Sample Chapter

Awards & Accolades

Booksense 76 pick for September/October 2002
Booksense Top 10 Mystery Selection
Featured Alternate Selection for The Literary Guild, Doubleday Book Club, Mystery Guild, and Book-of-the-Month Club

“DO NO HARM is a terrifying and savage descent into the darkest corners of evil and madness.”
JONATHAN KELLERMAN

“The perfect blend of suspense, pacing, strong storyline, compelling characters, and a villain who will knock your socks off. Great combination and a great read!”
SUE GRAFTON

“Gregg Hurwitz knows how to write a thriller! DO NO HARM is a gripping page-turner packed with an insider’s knowledge of the practice and politics of medicine. Hurwitz has put together a medical/psychological detective story that sticks in mind long after the last page is turned.”
MICHAEL CONNELLY

“Hurwitz has done it again, with this spooky, surprising and unsettling thriller. Good character, a suspenseful plot and a shock of an ending. Hurwitz gets better with every book.”
T. JEFFERSON PARKER

“Convincing and disturbing…Hurwitz’s careful attention to…the very fine villain…Clyde sets up the most unusual aspect of DO NO HARM: the author’s and the protagonist’s compassion for a perpetrator. This runs so contrary to the temper of our time that it shocks. I admire it.”
SAN JOSE MERCURY NEWS

“In his most ambitious book to date, Hurwitz delves convincingly into the world of medicine, psychology, and investigative techniques…[An] adeptly researched, well-constructed tale about science gone awry…The action comes fast and steady.”
PUBLISHERS WEEKLY

“Hurwitz is a brilliant storyteller…He has written a fast-paced plot with nicely defined characters.”
LIBRARY JOURNAL

“Compelling…Gregg Hurwitz is the heir apparent to Robin Cook.”
BOOK BROWSER

“Enticing…A smoothly written, gripping fabric of believable incidents ethical questions and changing relationships.”
BOOKLIST

“A fast-paced, often frightening story that will appeal to fans of Robin Cook, Michael Palmer, and Tess Gerritsen…Do No Harm is colorful, authentic, and incredibly hard to put down…[Hurwitz] is a rising star among thriller writers.”
BARNESANDNOBLE.COM

The best book that I have read in a long time. It is deeply satisfying on many levels. A novel of psychological suspense, an unsettling medical study long kept secret, a man trying to do the right thing in a world gone wrong, and a pathological killer. With all of those ingredients that make up a compelling thriller, Mr. Hurwitz has added a depth to his characters that makes them real, not cardboard cutouts. The reader understands and can empathize with every character, from the LAPD, the staff, Dr. Spier and the madman.”
RENDEZVOUS MAGAZINE

“DO NO HARM, a big, fast-action thriller by the heir apparent to Michael Crichton and Robin Cook, is perfect beach reading—gleefully violent and compelling.”
LAS VEGAS MERCURY

“A break-neck paced novel whose twists and turns will chill you to the last page. Great psychological suspense.”
BOOK SHELF

“Famous writers have already used just about every superlative to describe DO NO HARM, physician and bestselling author Gregg Hurwitz’s macabre thriller…This novel is all of those and heart-breaking, too….A volcano of a book.”
ST. CROIX SOURCE

“The thriller explodes…Hurwitz’s intensive research of medical procedures, law enforcement protocol and technical elements of investigation give the reader an insider’s view of their world.”
AMARILLO GLOBE NEWS

Interview

DO NO HARM is of a piece with MINUTES TO BURN and your first novel, THE TOWER—but they are also all quite different books. What went into the making of DO NO HARM that differed from the other two?

“Write what you know” is the advice that gets handed out to young writers, so I quite willfully do the opposite. Because writing for me is an excuse for continuing education, I often pick fields to research that have always fascinated me, but about which I don’t know much when I start out — psychological profiling in THE TOWER, Navy SEALs and evolutionary biology in MINUTES TO BURN.

DO NO HARM is a much more personal book for me, though. And I am, in fact, writing to a certain extent about what I know. I grew up in this intensely medical household. Everyone’s a doctor — my grandfather, great uncle, my father, my sister. For Minutes I spent the better part of two years trying to really understand the mindset of, say, a demolitions expert. But for Do No Harm the character stuff—how doctors think and speak—came quite easily, in part thanks to the family connection. At dinner, my dad would discuss various cases he’d seen, and how he was able to assess the symptoms and make diagnoses. It was apparent to me at a young age (as an avid reader of The Hardy Boys and The Three Investigators) that there is an aspect to medicine much like investigation. Doctors are detectives, in a way. As I grew older, I noticed that most medical thrillers deal with intrigue around medicine—stolen organs, evil surgeons, etc. And so I wrote a book in which the diagnostic process is actually the investigative process. The closer my protagonist, Dr. David Spier, comes to understanding his former patient’s condition, the closer he is to tracking him down.

But I still had to do a great deal of research to get all the details right. Maybe more so, because I couldn’t have my character grabbing the wrong instrument during surgery, or I’d never hear the end of it from my family.

How about the plot?

This book addresses certain topics that I’ve been turning over in my mind for a long time. Its themes evolved directly from conversations, ethical codes, and fascinating medical cases I was exposed to all through my childhood. But more than that, I’ve written a book that’s really about something close to me. The villain, Clyde C. Slade, isn’t a drooling maniac or witty psychopath. He’s a terribly disturbed, violent, pathetic individual, as most people who perpetrate violent crimes are. And so the conclusion I strove for wasn’t “We gotta find this guy and shoot him dead!”—it was much more philosophical. What do we do to end this type of violence? What does the system do with a man like Clyde, who is psychologically insane but legally sane? No pat answers work, nor do regurgitated liberal or conservative viewpoints. Much of the inspiration for Clyde came from a personal position of mine that I have trouble clarifying. I’m opposed to the death penalty, but I also believe there are people who cannot fundamentally be fixed, who will never be anything but a burden to society. These are two seemingly contradictory views, and this book was, for me, an attempt to work them through.

The Hippocratic Oath figures largely in the book, right down to the title.

It’s always fascinated me—having a code of ethics where you have to heal people, and sometimes save their lives, whether you like them or not. It’s sort of like a cop hauling in an established murderer, maybe someone who’s beaten the rap a few times, instead of administering street justice. Because the Law must prevail. Ethics over emotion.

Here we have a man throwing lye in the faces of nurses outside the UCLA Medical Center. During a stakeout, he’s captured, but he spills some lye on himself and is badly burned. He’s dragged into the ER, where the furious staff refuses to treat him except for ER chief Dr. David Spier who must uphold his code of ethics and provide care. These sorts of dilemmas are ones my father acquainted me with as a young boy—I remember one case in which he had to treat a patient with a huge swastika tattoo. And it fascinated me, because it taught me a lot about how ethics function. Ethics are easy to uphold when there’s no sacrifice to be made. But when you have to uphold your ethical code even when you least want to, well, those are the only times your ethics mean anything.

Back to the research for a minute; let’s not leave that. What was required here?

Well, I shadowed in the UCLA Emergency Room on and off for two months, hanging around wherever I could, following doctors into exam rooms and watching procedures. But also going to lunch with them, grabbing a beer after shifts, hearing them bullshit and complain about their cases. To follow up the continuing care of our alkali-burn victims, I had to get to plastic surgeons, ICU nurses, ophthalmologists, gastroenterologists and more. To get Horace McCannister right I spent some time with a true Lab Tech II. Visiting over segmented bodies and the whine of a saw was a unique experience. By the end, I’d observed some pretty harrowing stuff.

I also made sure to spent a lot of time with LAPD guys (talking, drinking, driving around)as well, making sure I was acquainted with the lingo, the procedures, the beefs that they have and the bullshit politics that come into play as a case evolves.

The most fun aspect of my research for DNH was dealing with a former spy, who helped me extensively with Ed Pinkerton’s character, and who taught me a lot about investigative technology. For the stunts Ed pulls in the book, I had to learn how guys get things done off the record, out of the system. My contact was really fun to work with, and took the time to show me precisely how, say, a digital transmitter looks and works, so by the time I needed to plant it in the story for one character to eavesdrop on another, I knew just how to make it authentic. Guys like that don’t like to talk, and you have to spend time earning their trust and respect. So by the time they talk—if they talk—they usually like you pretty well. And this contact really developed into a good friendship. So I could call him up and say, “Let’s take a ride over to the UCLA Medical Center, stroll through the ambulance bay” — where Clyde hurls the alkali — “and tell me what you see.” And just walking around town, this friend of mine would notice a gardener wasn’t sweaty enough. He’d say, “It’s ninety degrees out. That guy’s not working. What is he doing? Casing the place? Waiting for someone?” He just had an eye for noticing things and people out of place. I started developing it too, hanging around him. Now I’m tending more paranoid than oblivious.

Let’s talk about the opening of the book, and two that really affected me as I read them, are Clyde’s Chapter 12 and Chapter 13. Ghastly stuff, but well and honestly told. What was required of the writer to produce pressurized, violent scenes like those and others that follow?

I strove to make this book as gritty as possible. It’s a medical novel, and so I felt a responsibility to make the injuries and the violence progress with scientific precision. And that holds true for Clyde’s chapters as well. He’s not a drooling, scheming madman petting a white cat—he’s a real, unhinged, pathetic man, as are most people who perpetrate violent crimes. One thing I learned in the writing of this book was: the more real the violence, the less over-the-top it is, the greater the impact. And so I kept pulling back the violence, making it less emotional, and it kept ratcheting up the tension of the read.

Another thing I found with Clyde is that I had a real intuitive handle on him and how his mind worked. When I was talking to psychiatrists at the NPI [UCLA's Neuropsychiatric Institute] I was describing Clyde and trying to find some neat DSM-IV classification to fit him into [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition]. Is he schizophrenic? Is he this? Is he that? And an NPI doctor kept gamely trying to help me with this, but then I’d argue with him. “Well, that sounds good, but Clyde’s really more like this.” And finally, the doc looked at me and said, “Listen, most of our patients don’t fit neat classifications, anyway—the classifications are just there for guidelines. It sounds like you have a real handle on this guy in a way that makes him seem much more like a real patient.” And I realized he was right—my view of Clyde was already intact, and it made it better than picking a classification and working backward to invent character traits.

Chapter 55 amply demonstrates the kinds of heroic tests a doctor can be put through. The “cold, vengeful rage” that David feels for Clyde late in the book, I’ve got to tell you, I would have felt a lot sooner in his circumstances. But maybe that’s why David’s a doctor and I’m not.

David, as a doc, is much more inclined to view Clyde as a man with a sickness than to meditate on whether he’s evil. Who cares if he’s evil? He’s clearly disturbed, clearly ill. Why spend time cultivating a hatred of him? However, at the point in the text when David feels a “cold, vengeful rage” is when Clyde’s violations become extremely personal. At that point, David’s reaction is more universal, because Clyde’s actions have jarred him out of a physician’s mindset.

Is Clyde’s end inevitable?

Tough question. No character’s fate is inevitable when you begin writing a book, because then all you’ll do is railroad that character to said fate. But if you draw realistic characters, and if you allow them free reign within your prescribed plot, the choices at their disposal narrow until one ending can be said to be more or less organic than another.
Do you see thrillers as today’s morality play?

I absolutely do. I think thriller protagonists have a lot to teach us. They strive for truth, they make mistakes but always learn from them, they get beat up but keep coming back, and they have to evolve constantly and grow as humans. My books are largely about the ways that the human personality can shift when horrible events occur. Often my characters find out that what they believed of themselves isn’t always true.

I think it’s immensely gratifying to see a character confront the ultimate reality—death, mayhem, destruction, take your pick—and either triumph over it, or learn from it, and take something away in victory. In that regard, I think thrillers are contemporary morality plays.

If you could invite five fictional characters to dinner, whom would you chose and why?

Will Graham in Red Dragon—my favorite protagonist in my favorite thriller. Graham fascinates me not just because of his ability to apply his knowledge to criminals being sought, but for his willingness to examine his own dark nature and motives.

Quentin Compson in The Sound and the Fury. He is so brilliant and so disturbed and—like Will Graham—not afraid to shine the light of perception inward. He has a lot of clarity on his own psychopathy, much of it revolving around his dysfunctional family. He’s too sensitive and quite willing to examine harsh realities—a volatile combination which leads to his suicide.

Justin Quayle in Le Carre’s The Constant Gardener. This book is an absolute gem. Justin is so witty, so shrewdly intelligent, so courageous, and so insightful that by the end of the book, I found I had taken on his quest to discover his wife’s killers as my own. I can’t remember another book I’ve read where I so much wanted to be the main character. I just loved this guy. For me, he defines what it means to be a man.

Shakespeare’s Coriolanus. Okay, so I’m sneaking in someone from the theatrical tradition. I’ve never read a character with such shattering egotism who I still couldn’t help but love. T.S. Eliot thought Coriolanus was the most perfect of Shakespeare’s tragedies, and I’d have to agree. In many ways, it’s because Coriolanus’s tragic flaw is the most compelling.

Hannibal Lecter. To cook the meal, of course.

Ever toy with the idea of becoming a doctor yourself?

Not recently, much to the chagrin of my Jewish parents. When I was younger it was something I contemplated, in part because severe injuries and blood don’t faze me tremendously. I suppose that quirk of mine aids in my career as a novelist as well — flipping through crime scene photos or standing in on a gory procedure aren’t pleasant tasks, but I can handle them. But I think the primary obstacle to a career in medicine is that I like writing novels too damn much.