“DO NO HARM”? DOCTORS ALWAYS DO HARM.

Ladarat looked at her watch twice, realizing with some surprise that it was past four p.m. Unsure where the day had gone, she felt very tired nonetheless.

True, she hadn’t made any progress on the case of Richard April’s disappearance, except to conclude that he hadn’t disappeared. And she hadn’t made any headway in solving his case, except to admit that there wasn’t a “case.” Still, that was progress, of a sort.

She’d even made progress on the strange case of Dr. Taksin. Not progress toward a solution, it was true, but a very clear recognition that there was, in fact, a problem. And that there, at least, was a “case.” That was a relief, of sorts.

Ladarat had often noticed that doctors were relieved when they found an abnormal laboratory result for a patient with mysterious symptoms. Even when that lab result didn’t point to a diagnosis or dictate a treatment, it was nevertheless reassuring—to the doctor, at least—proof that something was, in fact, wrong. And sometimes it reassured the patient, too.

Now Ladarat knew that there was something that Dr. Taksin wanted to hide. Wasn’t that equivalent to finding that something was wrong? It was. All she had to do now was to find out what that something was.

Yet in other ways, Ladarat had to admit that her day had been less than productive. Apart from her wasted effort at the Magic Grove Hotel, there was the matter of her ongoing review of hospital deaths, for instance. There, truth be told, she had accomplished, well, nothing. She’d promised herself a review of fifty charts this week, and here it was Wednesday, and she’d done fewer than twenty.

And, of course, there was the impending presentation to the Medical Ethics Society meeting on Friday, just two days away. True, she had the slides prepared, and Sisithorn would be responsible for the majority of it. They had practiced several times. That impending event, at least, was well in hand.

So she would use the rest of the day to review charts. She had made that promise to herself, and she would do her best to review all fifty charts before she left for Bangkok Friday morning. Ladarat picked one chart off the pile and began to read, leafing quickly through the patient demographic information in the first section, then slowing down to learn more about the patient’s medical history. Finally, she read line by line about the patient’s last days in the hospital. She read through thirteen charts in the next hour and a half, her eyes getting increasingly tired.

Some would be called good deaths, perhaps. Patients were given medications like morphine to treat their pain, for instance. Some were even awake and alert enough to talk with their families.

Of course there were opportunities to improve. Such opportunities were, unfortunately, very easy to find: The man with lung cancer and shortness of breath who wasn’t given morphine to make him more comfortable. The woman with liver disease and nausea who had a tube placed through her nose and into her stomach for liquid feeding. Ladarat knew that would have been very uncomfortable.

Perhaps deaths were better among patients who died in the palliative care unit. Or perhaps not. That was the problem. There were hardly any of those patients. In the entire stack of fifty charts, there were only the three she’d found yesterday.

Again, Ladarat found herself wondering how that could be possible. A hospital unit dedicated to the care of dying patients that had no deaths? Or almost no deaths? How could you care for dying patients but have none of your patients die? It was a statistical anomaly, was it not? It was a mystery.

Well, not a real mystery, of course. On the scale of mysteries, this was no more than a mild one. A weak mystery.

It was not a mystery like a serial murderess was a mystery, or like disappearing tourists could be a mystery—except that it wasn’t—or even like jade smuggling was a mystery.

Speaking of which, perhaps she’d been too quick to dismiss her assistant’s theories about what Ladarat had come to think of as the Parrot Gang. Surely there was something suspicious going on there. Perhaps not smuggling, though. Almost certainly not smuggling. But then what?

Ladarat closed yet another chart, setting it on the pile of charts that she’d reviewed. That pile, she was pleased to note, had grown in height to be approximately equal to the pile of charts that were yet to be reviewed. It was actually a little higher, in fact, thanks to a few patients she’d just read about who had been in the hospital for a very long period of time, months, in one case. Thanks to those very thick charts, if one were assessing pages read, Ladarat was more than halfway done. That was certainly a more optimistic way to look at this process, so that’s how she would look at it.

Still thinking about the mysterious jade smuggling ring that probably wan’t a jade smuggling ring at all, Ladarat packed up her bag, turned off the lights, and locked her door. It wasn’t too late, not even six p.m. She had time for a detour on the way home. It was not significantly out of her way. Besides, it was a detour that would make her assistant pleased.

As she drove across town, the traffic was still heavy. Cars and tuk-tuks and taxis and sengteos (pickup trucks repurposed as communal taxis) were busily navigating the congested streets. Her slow progress across town gave Ladarat a chance to think. And it gave her car a chance to keep up a steady stream of warnings about dire threats to its paintwork approaching from all four quadrants.

With so much to think about—including sleepy doctors and smuggling parrots and disappearing authors—Ladarat was surprised to find herself still thinking about those charts she’d reviewed, and the others that she’d looked at. They were good deaths, as far as that went. That is, there were not many glaring errors or examples of bad care. Certainly there were some opportunities for improvement, but nothing worse, she thought, than what you’d find in any American hospital.

No … what worried her most was—

The shrill sound of a horn cut into her thoughts. Several horns, in fact.

Ladarat waved and smiled apologetically. Couldn’t these cars see that she needed to turn left? Kaeo Nawarat Alley would take her straight to the bus station. If she didn’t turn here, she would have to go all the way to the waterworks. And she really didn’t want to go to the waterworks.

Ladarat waved again, and a kind taxi driver let her cross in front of him. Then a sengteo driver—with less good grace, it should be noted—let her cross as well. Then she was on Kaeo Nawarat Alley, with no further turns or drama and therefore more time to think.

Her thoughts turned from the deaths themselves to where those deaths were happening, or, more specifically, where they weren’t happening. No one seemed to die in the palliative care unit. Or hardly anyone.

It wasn’t because that unit was very good at saving lives, of course. That’s not what that unit did. It made people comfortable. And yet no one was dying there. How could that be?

Ladarat remembered hearing a story, years ago, about hospitals in some country that had to close for some reason. Perhaps a strike? Anyway, for the period of time that those hospitals were closed, the mortality rates in that country went down. People seemed to be living longer without the benefit of hospitals.

The explanation that Ladarat remembered hearing was that hospitals cause complications and problems—infections and the like—and those problems are often fatal. But without the hospitals, and without those complications, the theory went, people were living longer.

Professor Dalrymple noted a similar phenomenon. “The admonition to do no harm doesn’t make sense,” she pointed out. “Do no harm? In medicine, doctors always do harm. They give medications with side effects and give treatments that make patients feel bad. We just need to try to ensure that those harms we caused are outweighed by benefits.”

Perhaps something similar was happening in the palliative care unit? Without the aggressive treatment so common in the rest of the hospital, perhaps Dr. Taksin’s patients were living longer?

Ah, but they were still dying eventually. People like Melissa Double didn’t recover. There was no question of a different philosophy of care—even a much gentler philosophy of care—curing the cancer that had apparently spread so widely.

No, if people weren’t dying in the inpatient unit—very, very sick people—then that meant that the inpatient unit was helping those people to die somewhere else. But where? And how? She would have to find out.

Now, though, she would just make a slight detour to check on the possibility—the very slight possibility—that a parrot gang was smuggling jade.

So it was without any real expectations of finding anything that Ladarat flicked the turn signal lever that would allow her to to turn into the bus station parking lot. At this time of day, the entrance was crowded with cars and taxis dropping and picking up passengers. None of those vehicles, it seemed, was willing to wait for even a moment to let her by. This was certainly not the Chiang Mai that she remembered from when she and Somboon moved here fourteen years ago. Back then, Chiang Mai was little more than a large town. People were polite and friendly. But now, no. Now, most people didn’t know each other. Certainly there was an appalling lack of politeness. And the traffic, well, that was the worst. Now it was every driver for herself.

With that disturbing thought in her mind, Ladarat urged her little car out into the intersection, into the path of a sengteo and, next to it, a tuk-tuk that was pondering a turn into the bus station. The tuk-tuk driver yelled something not particularly polite, and both drivers honked at her. But they did stop in the end, even before her little car could work itself up into a frenzy of shrill proximity warnings.

Then she was in the parking lot, although what she was looking for there, Ladarat couldn’t really say. She just felt like she had to see the Parrot Gang with her own eyes. Even if there was a plausible, logical—and entirely innocuous—explanation for these parrot smugglers, it would help if she could at least see one of the gang in action.

She drove slowly along the loop road that circled the parking lot and led past the front doors to the station, too slowly, perhaps. The same tuk-tuk driver who had grudgingly let her pass now seemed inordinately frustrated by her pace.

Such a hurry. Why all the rush?

But then she saw the young farang in the back of the tuk-tuk. The man looked at his watch. Of course, they were late for a bus. That, at least, was reasonable.

Ladarat spied an opening by the curb to her left and turned into a spot that would at least give her a good view of the main entrance. If the Parrot Gang was operating here, this is where they would be. But there were no parrot bags. None at all.

Ladarat waited for a few more minutes, determined to do this correctly. It was not a stakeout, of course, not a proper example of the art of detection. Ladarat thought of Khun Timothy’s Detective Poke and immediately admitted her own inadequacies of detection. She didn’t have the skills for a proper stakeout, nor, honestly, did she have the time, as she’d promised to cook dinner for Wiriya—with some help from Duanphen, of course. This was presumably a problem that Detective Poke never faced.

So now Ladarat could spare only a few moments for detection. Of course that was not enough. Real detectives presumably had to be patient, and they needed lots of time.

Ah, well. It had been worth a try.

Just as she was about to pull back out into the stream of cars and tuk-tuks circulating past the main entrance, Ladarat saw the two farang who had been in the tuk-tuk behind her. The driver had let them off on the far side of the entrance, and now they were making their way back to the glass sliding doors.

Loaded down with luggage, they seemed ungainly. As seemed to be the fashion among young travelers these days, they wore large backpacks on their backs and smaller daypacks in front. Why did they do that? Young travelers were otherwise reliable sources of the latest fashions. This custom made them look like pregnant camels, a strange farang camel epidemic that was sweeping Thailand.

Yet there was something odd about their progress. It took Ladarat a moment to realize what was wrong, though.

It was their pace, she realized eventually. They were moving much too slowly for a couple who had been in danger just a few minutes ago of missing a bus. They were walking slowly and carefully, looking around them as they walked toward the main entrance. Once there, they stood for a minute more. Waiting for something? Looking for someone?

At this point, Ladarat had forgotten entirely about her search for members of the Parrot Gang. Now she was not a detective—or even an amateur detective—but just a curious person.

She was curious, because there was something odd, too, about the way that this couple was waiting. It took a moment or two of observation for Ladarat to identify exactly what seemed odd. Then she had it.

They were looking for someone or waiting for someone. That much was clear.

But they weren’t scanning the crowds around them as if for a familiar face. They weren’t looking this way and that in search of one person. They weren’t doing the things that we normally do when we’re looking for someone in particular. They weren’t turning around and studying the faces of people who passed. If they were looking for someone—and by now Ladarat was convinced that they must be—they were looking for that someone surreptitiously. It was almost as if … they didn’t know precisely who it was they were looking for.

But Ladarat knew who they were looking for. She wasn’t particularly surprised when a tuk-tuk pulled up in a cloud of blue exhaust smoke and a middle-aged Thai woman hopped out. Then she did something very strange.

The woman reached into an oversize handbag, which was really just a large canvas bag. She pulled out a much smaller bright blue bag. She unfolded it carefully as the tuk-tuk driver waited. Then she reached into her large bag, removing several paper parcels that she transferred to the blue bag. As she did, the sides of the blue bag flattened out, and Ladarat could make out the image of a parrot on the side that she could see.

Then, as Ladarat watched, the woman strolled along the sidewalk in front of the bus station, as if she were on a leisurely walk, accompanied by a dog rather than by a parrot. She hesitated as she passed the couple, then sped up. She stopped when the man of the couple said something to her.

Ladarat was too far away to hear what was said, but she saw quite clearly a paper package emerge from the parrot bag, which the man deposited in the daypack on his chest. Then there was a little more conversation, a pause, and the Thai woman pointed at the tuk-tuk behind her.

The farang woman shrugged. She reached into the bag on her chest and pulled out something that she handed to the woman.

All of this happened in less than thirty seconds. In another half minute, the couple had vanished inside the station, and the Thai woman was back in the tuk-tuk. She and the driver seemed to know each other. They were talking and laughing, as if they shared a joke.

Ladarat wished she had more time, to … what, exactly?

Well, she could wait to see whether the Parrot Lady gave more packages to other tourists. Her bag was certainly large enough to contain many such packages. But what would that accomplish? Her assistant had already determined that one member of the Parrot Gang—because now it almost certainly had to be a gang—would pass contraband jade to several farang at a time. If this was the same gang, it was only logical to assume that here, too, it was jade changing hands.

She could park her car and go ask that farang couple whether they had purchased those bracelets, and what the farang woman had given the Parrot Lady. Money? A receipt?

But what would they tell her, even if she found them? Besides, they would almost certainly be getting on a bus.

Ladarat decided to curtail her detection activities for the evening. She let her thoughts turn instead to the evening’s menu, featuring yam khor moo yang—a salad of marinated pork, lemon, onion, and chilis. Duanphen had kindly agreed to provide her with the grilled pork and the salad ingredients; even the sticky rice and dipping sauce. All Ladarat would have to do, Duanphen had promised, was to assemble everything. Of course Ladarat would pick up dessert as well: perhaps kanom maprao, since she’d left the entire serving for Melissa. Yes, definitely kanom maprao. And maybe something more substantial from Duanphen, too. Perhaps kai jiew moo ssap, a deep-fried omelet. It would be a more solid accompaniment to the yam khor moo yang.

Having settled the evening’s menu to her satisfaction, Ladarat started her little car and was about to turn back into the flow of traffic when the parrot woman again hopped out of the tuk-tuk. She didn’t seem to be following any sort of signal that Ladarat could see. She just got out and strolled the width of the front of the bus station. She passed from Ladarat’s view for a moment, but soon she was back. A few seconds later, she was stopped by a young farang man who approached her and offered a clumsy wai.

Again the woman reached into her parrot bag, and again a paper parcel was passed to the man. And again, the same pause, the gesture at the tuk-tuk, and a shrug from the man, who reached into his bag and handed something to the woman. Then he was gone, and the woman resumed her stroll. Back and forth, like a palace guard, she’d walk from one end of the front walk to the other, a distance of perhaps twenty meters, then she’d turn around and come back.

As Ladarat watched, her dinner menu forgotten, the Thai woman made the same exchange with nine more farang. Most were couples, although a few were lone travelers. Each time there was the exchange of a newspaper-wrapped parcel that seemed to be expected and then another discussion, which wasn’t. Most of the time that second discussion resulted in the farang handing something to the Thai woman, but not always. In fact, the last interaction Ladarat saw looked to be on the verge of turning into an argument. This was a farang man traveling alone. Bearded and unkempt, he shook his head violently at the point in the conversation when the other farang had reached into their bags for what Ladarat was becoming convinced were baht. This last farang wasn’t having any of that, though. He just shook his head again, stowed the wrapped parcel in his backpack, slung the bag over one burly shoulder, and marched into the bus station.

That seemed to break a spell, and the tuk-tuk driver shouted something to the woman, who shrugged. Then she nodded and hopped into the tuk-tuk, which took off in a cloud of blue smoke.

Ladarat thought of following them. Surely that’s what a detective would do. But truth be told, her car, however worthy and well suited to blending in unobtrusively, had no hope of catching up with a tuk-tuk that could slip between cars and sneak down narrow alleys.

A real detective would have a motorcycle, she thought. A real detective would hop on her motorcycle and track this couple—surreptitiously, of course—to their lair. But a real detective hadn’t worked a long day and probably didn’t have to rush home to make yam khor moo yang for her boyfriend.

Ah, well. Ladarat felt as though she’d just discovered a clue that would lead to a solution of the Parrot Gang case. It had been lucky that she’d stopped at the bus station when she did. Perhaps her luck would last long enough to allow preparation of dinner without disaster.