"Four a.m.," Ed said. "Exactly." He marked it on his chart as the official time of termination. Then he peered back into the operative field.
The heart was out, lying on the donor's sheet-draped chest, now little more than a deflated balloon full of carefully cut holes. The surgeon inspected it a moment, then handed it over to a technician, who packed it in a bed of ice.
Three minutes later the Ottawa team was gone.
"Let's close 'er up," Tucker said wearily. He looked at Ed. "You should scram, man. You look like hell."
Ed nodded. Reflexes again, he thought, finding it difficult to leave ahead of the surgeon. Hesitating, he glanced around him. There was a single flat line on the oscilloscope; he reached up and switched it off. Then, bidding his colleagues good night, he left the OR
When he got to the change-room Ed found it abandoned, the only evidence of the Ottawa team's presence a litter of bloodstained greenery on the floor.
"Fast," he said aloud, a hint of admiration in his voice.
He went to the coffee machine and poured out a brimming cupful. It would keep him up, he knew, but somehow he'd lost his taste for sleep. Something about crossing into that void, itself so much like death, struck him as. . . unappealing just now.
He sat and sipped and felt like a superstitious idiot. But it sure felt good to be out of there. And he didn't care if he ever got involved in this kind of thing again. Who needed it? Christ, he'd had himself half-convinced that the guy had been aware, feeling the whole thing. It was a crock, of course. He'd examined the poor sot himself preoperatively. Not that he'd needed to. One glance into the dead pools of those eyes had been enough.
But. . .
But nothing.
He grabbed a magazine and flipped noisily through it.
Ten minutes later Ken Tucker and his assistant filed wearily into the change-room. The assistant changed quickly and left. Ken poured himself a coffee and joined Ed on the threadbare couch.
"That was quick," Ed commented.
"Aesthetics are not a major concern in a case like this," Ken replied bluntly.
Ed nodded bleakly. Then something occurred to him.
"Oh, shit," he grumbled, turning visibly pale. "I forgot my beeper in there." He remembered taking it out of his pocket at the start of the case and setting it atop the heart monitor. He stood. "The nurses still in there?"
"I think they broke for coffee," Ken said. "I don't envy them having to clean up that mess." He gulped his coffee and stood. "Let's hope that's it for tonight, eh, Ed?"
"Yeah," Ed replied, watching Ken leave. "You bet." He looked down at his blood-spattered shoes.
Then he turned and walked back to the OR.
The nurses were indeed at coffee; Ed could hear their nervous chatter from where he stood in the central corridor. Reluctantly, he trudged back to Room 5, pausing outside the open doors.
Jesus, what a scene, he thought with disgust. It looked like a slaughterhouse in there, an abattoir for the nearly dead. Stained instruments scattered everywhere, a gallon suction bottle brimming with clotted crimson, blood tracked over the floor in bootie-shaped footprints.
Ed avoided looking at the still-draped corpse as he crossed the room to the anesthetic machine. He grabbed the pager, pocketed it, and started away.
Then he heard a noise, so slight he might have imagined it.
But Ed's ears were trained to pick up even the most inconsequential whisper in this environment. He knew he hadn't imagined it. It had been soft, a sort of. . . whicker.
Not wanting to, he looked at the corpse's face.
That new-bruise cast was gone now, replaced by a waxy, almost yellow paleness, like very old cheese. The features, which only hours before had been robust and strong, seemed ancient and unimaginably weary.
There was a reason for this dramatic color change, Ed knew, more from watching TV than, from anything he'd learned at medical school. The patient's blood (corpse, he corrected himself, the corpse's blood), whatever small amount of it was left, would already be settling out under the influence of gravity, down into the dependent parts, the buttocks, the back and the neck. . .
What is that noise?
Ed's gaze shifted to the breathing circuit still hooked to the E-tube in the donor's throat. Automatically, he found himself running through a stepwise safety check, one he followed when suspicious of a leaky hookup or a spontaneous disconnect.
Back along three feet of corrugated tubing, through a mixing chamber, up along a separate length of tubing to the ventilator bellows. . .
The bellows was moving, up and down, ever so slightly.
Uttering a small, mortified shriek, Ed Skead snatched the circuit and ripped it from its link with the corpse, stilling the shifting bellows.
Breathing?
He gaped over the drapes at the rudely sutured chest. . . unmoving, still as August pond water. He sighed.
Couldn't be, he thought giddily. This, guy's cooked. Just a fluky flow pattern in the gas line. Yeah. Some sort of rhythmic stutter in the flow. He'd seen it before, with, nothing hooked to the circuit at all.
Ed left the room without looking back. He didn't want to see that slack yellow face again, not ever.
But the whole way out to the change-room, he got the uncanny feeling someone was walking behind him. Too close behind him.
Unable to console herself at home, Eve Crowell took a cab to the University Hospital. She arrived there shortly after sunrise. By then, then had already transferred her son's remains to the morgue. She managed to bottle her fury—although as the morgue attendant approached her, the urge to claw at his face was a compelling one. But this close to her son, the fury seemed unimportant. She could deal with that later. Oh, yes, there would be hell to pay later—plenty of it. Right now, though, she needed her peace of mind.
She needed to pray.
"I'm sorry, Mrs. Crowell," the attendant said as he drew open the stainless steel drawer. "It's. . . a very hard time."
"Leave us alone," Eve said tonelessly, avoiding the man's lying eyes.
Nodding, the attendant undraped the corpse, starting a little when he noticed the wads of cotton where the eyes should have been. He'd seen this sort of thing before, but it never failed to rattle him. He backed away, as, repulsed by this peculiar, flint-eyed lady as he was by the corpse. Her bent, overweight body seemed coiled in that wheelchair. . . like a snake's.
"Just knock when you're done," he told her, indicating the door they had entered by. He waited a moment for a response, then moved quietly away when none was forthcoming. The door snicked shut behind him.
Trembling with disbelief, Eve gazed into the coffin-length drawer, at the ruin they had made of her son. For an instant, her clear eyes darkened to the hue of blue steel, and the fury sprang up once again. . . then tears bleared her vision, and she sobbed like a frightened child.
"Oh, my poor, precious baby," she moaned. "How could they do this to you? You were sleeping. . . They took you in your sleep. . ."
A hand flitted up from Eve's lap like a startled bird, hesitated, then caressed her son's lifeless cheek. Its coldness caused her to shudder.
And for the first time in a life of unwavering faith, Eve Crowell felt lost. Lost and utterly helpless. In that moment she saw that her son was dead, understood that his life was over and that she and Bert must go on. In that moment she looked back on his life as one must, with love and cleansing forgiveness. He had not been a bad boy, only confused by a father who had expected too much. He was a gentle soul really, a lonely child who'd been drawn into sin much as Eve had herself, by the raptures of the flesh, the sweet euphoria of alcohol. It was Bertrand's fault, he had pushed too hard, kept back his love, blamed his son for his own failure as a father.
But in that moment Eve might have been able to go on, perhaps even forgiven her husband his imagined transgressions. . .
Had one groping hand not in that same moment found the Bible, and hefted its weight like a verdict. She pressed the Book to h
er breast, scarcely able to breathe as its leather-bound wrath pulsed through her.
She flipped it open at random. And read.
"And though worms destroy this body, yet in his flesh shall he see God. Marvel not at this, for the hour is coming in which all that are in the graves shall hear His voice, and shall come forth whole. . . they that have done good unto the resurrection of life. . ." Eve closed her eyes and paused, the power of the Word coursing through her like life's-blood. In her mind she pictured all the murdering heathens, then quoted the rest from memory. "And they that have done evil, unto the resurrection of damnation."
Feeling fortified, Eve let the Bible fall closed. She leaned forward and placed a lingering kiss on her son's forehead, no longer perturbed by its frigid pallor.
"Let me see thy vengeance upon them," she whispered into one, dead ear.
And ran the drawer closed on its runners.
She turned, wheeled her way back to the door, and knocked. The attendant rolled her out to the lobby.
Chapter 3
For a while it seemed she'd been forgotten.
They had given her an injection the instant she'd arrived, something to relax her, the nurse had said. But it hadn't relaxed her; on the contrary. Now her mouth was dry, her insides felt crampy, and her head had begun to pound with the beat of her heart. She felt as she imagined a condemned prisoner must feel as the rope snugs slowly round his neck.
Everything had happened so fast—the telephone call, the tense drive down here from the country, the admission formalities, the half-stoned stretcher ride through the cold and foreign fun house of hospital corridors, the last minute queries of faceless nurses. . .
And then nothing.
Now she was parked somewhere in the operating area, lying flat on her back on a too-hard stretcher, nothing about her but noise. On hold. "We're waiting for Dr. Hanussen" was the last thing anyone had said to her.
Wouldn't that be great, she thought now. Everyone assembled, some poor man's eyes slowly deflating inside a jar. . . and the doctor doesn't show.
She wished her father could have come up here with her. Being alone, feeling so disoriented, that was the worst. It made her think of the anxiety attacks she'd suffered as a child growing up blind. The hideous, unexpected moments of total dislocation when she would lose her way and there was nothing in front or behind but darkness, when a single step in any direction might topple her off a crumbling phalanx into the yawning abyss of hell. During these moments she would stand rigid with fear and shriek her father's name, scream and scream until he came running out of the ink to hold her.
She wanted to scream for him now. She wanted to be that little girl again and cry his name through the air vents, hear his familiar footfalls rounding a corner, coming to her. She wanted him to hold her and rock her and make the darkness seem more bearable, if only for a minute.
But she could not do that.
God, the noise! The constant clattering din!
Getting ready, she thought, feeling the drug more deeply now, worming its way through the knots of tension and loosening them. Getting ready for me.
She had actually begun to drowse when someone spoke her name.
"Karen?"
It's him.
She knew it immediately; his accent was unmistakable.
"Yes," she slurred. "Dr. Hanussen."
She thought she could hear him smiling.
"The accent?" he said.
Karen nodded.
"How do you feel?" His voice sounded good, strong, capable.
"Afraid."
"It is good to be afraid," he said, his frank words surprising her. "It is nature's way of protecting us. But we will face this fear together, Karen. You and I."
She felt a cool, smooth hand on her feverish forehead.
Then the stretcher was moving again.
Too fast. Everything happening too fast.
"You'll feel a needle here in your hand."
Fire exploding in her skin.
"Take a deep breath now, Karen."
Oblivion creeping up her arm, its maw widening to consume her.
"You'll taste. . ."
Then a new breed of darkness, absolute, without texture or dimension.
She remained there for a long time.
In a separate unit in the same hospital, swift preparations were being made for the transplantation of the donor's heart. The recipient was a sixty-two-year-old skid-row alcoholic named Tommy Kelly, whose own heart had been transformed over the years into a flabby, booze-soaked sac. Though afraid, Tommy felt lucky as he lay waiting in the outer corridor. In the recent, past a small but vocal social-consciousness group had focused its collective eye on the system of recipient determination. Their findings, though erroneous, received full media coverage, suggesting that members of a certain social stratum (namely the underprivileged) were being overlooked when it came to recipient selection. Unwilling to engage himself in what he knew would prove a ludicrous argument, the program director decided—against his own better judgment—to go ahead with the surgery on Tommy Kelly. He fully expected to see the man back again inside of a year, with a quarter of a million of the taxpayers' dollars pickling inside of his chest—but his hands were tied. The organ was available, but a more appropriate recipient was not. The woman he had hoped to graft this heart into had expired only a half-hour before.
To Tommy, that meddling group was a Godsend. He did not want to die. . . and he sensed that without this transplant, he almost certainly would.
Presently, when a gowned-and-masked nurse swept down on him with all the compassion of an alien anthropologist, Tommy Kelly blessed himself.
And secretly looked forward to his next drink.
At the Children's Hospital across the city, a helicopter settled smoothly onto the rooftop heliport. A door slid open and the perfusionist stepped out, the cooler containing the donor kidney clasped tightly in one hand. He strode quickly across the tarmac, head bowed below the sweep of the blades, shielding his eyes against the dust-devils the rotors threw up. Once clear, he paused for the space of an eyeblink to glance eastward, where a thin wedge of crimson thickened in forecast of the coming dawn.
Then he hurried inside.
In a waiting room papered with tumbling clowns, Bob and Mary Bleeker sat in orange vinyl chairs and waited. A half hour earlier they had stood watching as the gurney carrying their seven-year-old daughter diminished along a white-tiled corridor, then vanished around a corner.
Mary Bleeker's eyes were puffy with tears. Bob Bleeker's chest heaved with failing efforts to avert tears of his own. They did not speak, though their thoughts were the same. To have their child free at last of the dialysis machine would be a miracle, a gift from a merciful God.
The Bleekers had divorced four years ago, amicably enough, but even then the sole thing binding them after five mostly bad years of marriage had been Shirley, their only child. Born with a rare and progressive renal disease, Shirley's love and courage knitted the three of them into an eternal weave.
When Bob's tears finally came, Mary took his hand and held it.
And the wait wore on.
Chapter 4
As he worked, the surgeon's recurring regret was that he would not be there when Karen first beheld herself in a mirror. He would be returning to Germany long before that way, wondrous occasion and, in a vaguely, paternal sort of that disappointed him. He had been present with all of the others, back home, and the rewards had been incalculable. But there would be others still, many with stories more tragic than Karen's
As a newborn, Karen Lockhart had been the victim of an acquired condition with a name as cumbersome as the disease was tragic: retrolental fibroplasia. Born nine weeks prematurely, Karen had developed a respiratory complication known as RDS, predictable in the premature, yet potentially devastating. By rights, she should have been transferred to a major pediatric center, Toronto or Ottawa, where the treatment of such problems was commonplace. But, through either negligence
or gross inexperience, the rural doctor responsible for the infant's care insisted on treating her himself. Hanussen knew the type. Young and headstrong, full of good intentions, they inevitably got their egos mixed up with sound clinical sense. Karen's respiratory condition was adequately dealt with—there was no lasting damage to her lungs. But the high oxygen tensions used in the treatment led to insidious changes in her retinas, which inevitably resulted in scarring. Nine times out of ten this was a wholly preventable condition. . . if you were aware of its existence.
That was the tragedy.
Hanussen had a nurse wipe his brow. The work was delicate, so delicate. But it was going well, perhaps the best yet. His time on the first graft had been nine hours, a full hour under his previous best. And his hopes for this girl were high. She would see. For the first time in her lightless life she would see. He felt certain of it.
He worked tirelessly, already partway through his second shift of nurses, joining nerve-bundle to nerve-bundle with sutures so fine that without the microscope, they were practically invisible.
Seven hours later, it was done.
Weary but satisfied, Hanussen retired to the lounge, where he helped himself to a cup of hot coffee and put up his feet. Later he showered, slipped into a neatly pressed suit, and made his way to the hospital's main auditorium. A press conference was scheduled there, and he was its primary focus.
It was pure chance that Danny Dolan caught the press conference on TV. He had been about to go out rodding in his rust-pocked Charger when his mother hollered, "Danny, come look at this!" and then dashed to the phone to alert the countryside.
The doctor doing most of the talking was not the one who had called Karen earlier that morning. This guy had an accent, like the Krauts in the war movies. Half of what he was saying made little sense to Danny, but the gist of it came through toward the end of the clip, when the surgeon summed up.
"The procedure went well," he said into a cluster of microphones, which to Danny looked like penises. Based on my experience in Europe, I have every reason to believe this girl will see. It will be a joyous experience for her, I am sure."
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