You start out by working in a busy emergency department.

You see patients with all sorts of complaints: abdominal pain, headaches, and chest pain. Vomiting, diarrhea, and dysuria. Ankle sprains, bug bites, and allergic reactions.

Domestic violence, rape, and child abuse.

You don’t ever let the stress of the job take away your humanity. You treat your patients with empathy and respect. You listen to their stories, treat their symptoms, contact the police, fill out paperwork, transfer them to a facility that performs rape kits, and get the social worker involved.

Then you go home, drink a glass of wine, watch television, and forget about your day.

But then one day you see a forty-year-old woman presenting with a “trip and fall.” Bruises and cuts cover her face, and she wants an x-ray to see if any facial bones are broken.

You know she’s lying, but that doesn’t bother you. Working in the emergency department, you quickly get used to lies—from patients seeking narcotic prescriptions, morphine shots, work excuses, or just plain sympathy.

But you know this woman is different.

Her tells: passive demeanor, hushed voice, inability to keep eye contact, erratic behavior — calm one second, irritable the next — and a physical exam inconsistent with her history.

Then the abuser shows up.

Her husband: a little older than she, tall, well built, with a jewel-studded ring on his slugging hand.

Before long, she decides not to wait for the x-rays and wants to leave against your medical advice.

You’re having a busy shift. The ER is filled to capacity, and so is the waiting room, but you pull her aside anyway and find a private space to talk.

“I’m concerned you’re being abused.”

She doesn’t deny it.

“I’m calling the police.”

She starts to sob. She doesn’t want the police involved. Her husband will find a way to kill her, she tells you. She’d gone to the police before, and it just resulted in things getting worse at home.

Then she runs back to him.

You watch as they leave the ER. Right before they disappear, the husband turns and smirks at you.

A smirk that you will never forget as long as you live.

You go home that night. Instead of having a glass of wine and turning on the television, you sit and seethe over that smirk. You wonder if you could do anything to help this woman. Then you begin to daydream.

You wish you could be a superhero. You wish you could put on a cape and go after the wife beater. You want to end the woman’s cycle of abuse, rescue her from her captor. You want to punish the wife beater. You want to make him suffer the same way he’s made his wife suffer for years.

Instead of putting on a cape, buying a gun, and doing something you’ll regret, you walk over to your computer and start writing.

At first, it’s just a page. You visualize a modern superhero: emergency physician by day, vigilante by night. You make him smart, tough, and caring. You have him treat abused patients during the day, and then go after the psychopaths who hurt them at night: the wife beaters, rapists, and child molesters. You make him cunning enough to be able to gather information during his shift, and use that information at night to target the psychopaths.

You add depth to this character, place him in a city where you used to work, and add a love story.

Soon you realize that one page has led to two hundred. You send it to friends for review, find a professional editor, and then publish it.

You dedicate it to the courageous men, women, and children who have survived sexual, psychological, or physical assault and who are soldering on.

Alberto Hazan is an emergency physician and author of Dr. Vigilante and The League of Freaks series.  

Image credit: Shutterstock.com