by Carl Shuker
‘And what was the pressure at that point?’ Jason said. ‘How much gas was actually in her abdomen? I mean, to be frank, was it safe to go sticking things in her?’
‘Um, I don’t know,’ said Robin.
‘You don’t know,’ said Jason. ‘Is that right.’
‘No, I don’t know.’
‘She cannot know,’ said Vladimir.
The surgeons looked up.
‘Sorry?’
Elizabeth breathed through her nose and seemed to relax.
‘She cannot know,’ Vladimir said. ‘The indicator, indicator on the insufflator, this is gas tower, reads enough or not enough.’
He slowly, gently shrugged.
‘It reads enough or not enough?’
‘Yes.’
‘For a trocar to be inserted?’
‘Yes.’
‘What do you mean?’
‘Yes, or no. Go, don’t go. Enough or not enough. There is not a level.’
‘So you can go ahead or you can’t. A full tank. Green means go.’
Elizabeth sighed loudly.
‘Yes.’
‘So you actually can’t know if you have some degree less pressure or what degree. Beneath 10, which you need to be safe. You can’t know if you have 8 millimetres or some other number and decide to go on the basis of that.’
‘No you cannot.’ He shrugged again.
‘You explicitly said there was 8 millimetres of pressure, Liz,’ said Jason.
‘There was direct visualisation of the organ space,’ said Elizabeth. ‘Excuse me, but at whatever actual pressure it was I could see and my clinical judgement was that there was sufficient pressure—’
‘—to insert the next trocar?’
‘That’s right.’
‘At the left iliac fossa.’
‘No, I had already done that one before the problems with the gas,’ Elizabeth said.
‘So there were two’—Andrew flicked through the notes—‘two ports already inserted into Lisa.’
Elizabeth stared at him for using the name.
‘That’s correct, Andrew,’ she said.
‘By you.’
‘Yes.’
‘And then there were problems with the gas.’
‘Yes.’
‘And then the last trocar.’
‘Yes.’
‘Who inserted that last trocar, Liz,’ said Andrew. Everyone at the table but her own team looked up at her. ‘Who put the last trocar in?’
Babies die in hot cars, left behind by tired parents in workplace carparks. It’s called forgotten baby syndrome. In the US there were 677 children dead from vehicular heatstroke since 1998; 49 in 2010 alone. Roughly half were less than one year old. Average circumstances: 54 percent caused by child forgotten by caregiver. Only one survivor, in 2011, who suffered permanent brain damage. The father was convicted by a jury of misdemeanour child endangerment but the judge did not give him any jail time, because, he said, he had already sufficiently suffered. Who measures this? What is sufficient?
‘I did.’
Robin looked up and over at her. Vladimir still didn’t move. The entire table was silent. Vladimir seemed strangely pleased.
‘You inserted the last trocar that caused the internal damage to this girl. Uh—’ He leafed through the pages. ‘A rent in the inferior vena cava. A cut in the posterior abdominal wall. A tear in the lumbar artery within the—’
‘Yep.’
‘Okay.’
‘Look, it was slightly more complicated than that,’ Elizabeth said. ‘I remember it all clearly and completely. Under my instruction, Richard Whitehead—’
‘Again I’d like to wonder aloud why in fact he is not here today,’ said Jason.
‘—I instructed Richard to insert the last trocar. I recall this completely and my team will corroborate this.’
‘Hold on,’ said Andrew.
‘I am the team leader and I am the lead surgeon. I am the leader. I instructed Richard to make the incision and to insert the trocar. I determined the timing.’
‘Wait, Richard inserted the trocar?’
She could see herself in the reflection in the safety glass and she was straight-backed and good and she spoke to herself.
‘Richard inserted the trocar on my instruction and it failed to penetrate. I told him to push harder.’
Andrew looked at Robin, at Vladimir.
‘Told Richard.’
‘That’s right.’
‘You instructed him to push harder.’
‘I said give it some welly.’
‘At that point, can I confirm, neither Richard nor you were aware of whether there was enough pressure—’
‘I instructed my registrar for whom I am responsible to insert the last trocar and he did and at that point we noted internal bleeding on the screens and I called for instruments.’
‘You decided to open.’
‘We had to open.’
‘Do you know what you’re doing, Liz?’
‘Yep.’
‘Nursing?’ said Andrew.
Robin’s head snapped up as if from a dream. She looked from Andrew to Elizabeth in reflection, then down at her notes. ‘Um—um. I, at that point I heard Mrs Taylor say mesenteric something. And then I heard her say quick we have to open.’
‘Did Mrs Taylor instruct Richard to push the trocar harder?’
‘Yes—’
‘You converted to laparotomy. That’s for you, Liz.’
‘That’s correct.’
‘And you, Liz, you stemmed the bleeding and you sutured the cuts to the posterior abdominal wall, the IVC and the tear to the lumbar artery.’
‘That’s correct.’
‘You performed those repairs?’
‘That’s correct, Andrew.’
‘And it’s your position that you are responsible for the insertion of the third trocar that caused the internal damage?’
‘It was the sepsis that killed her, Andrew, and everybody here knows that.’
He looked at her and she looked back at him.
‘It was my operation that caused that damage,’ she said.
‘That’s your position.’
‘Yes.’
‘Thank you.’
They all sat very quietly for a time.
Elizabeth stared at her own reflection.
When she looked away she saw Robin watching her in the glass.
Smile on me.
And then Robin turned away.
The nose section had ripped away from the payload bay cleanly, although a mass of electrical cables and umbilicals were torn from the cargo hold, fluttering behind the crew cabin as it shot through the thin air, still climbing.
Challenger’s fuselage was suddenly open like a tube with its top off. Still flying at twice the speed of sound, the resulting rush of air that filled the payload bay overpressurized the structure and it broke apart from the inside out, disintegrating in flight. Challenger’s wings cartwheeled away on their own but the aft engine compartment held together, falling in one large piece toward the Atlantic Ocean, its engines on fire.
The TDRS satellite in Challenger’s cargo bay and its solid-fuel booster rocket were blown free as was the Spartan-Halley spacecraft. All this happened as the external tank gave up its load of propellant, which ignited in the atmosphere in what appeared to be an explosion. It was more of a sudden burning than an explosion. In any case, the two solid rockets emerged from the fireball of burning fuel and continued on, bereft of guidance from the shuttle’s now-silent flight computers.
—Challenger disaster timeline
High winds aloft
She moved through the house, brushing her teeth. The wind outside blew. The house cracked in the pressure wave before the gust, as if it were tensing up. She stood in the doorway of the guest room that no one ever used, and continued brushing her teeth. She looked at the single bed and the chenille bedspread. A rosewood sideboard, and a bedside table by Arne Wahl Iversen. The room no o
ne used. In the living room she stood in the middle of the thousand-dollar Afghan rug and brushed her teeth, looking at her bookshelves. Montaigne. Marcus Aurelius. Her epi textbooks, her textbooks. Mason by Rachel Barrowman. The flaw on the wall. On the facing wall the giant poster of a young Bruce Springsteen from Nebraska. The Bosch gas-electric cost her two and a half thousand dollars when she redid the kitchen and she’d only ever used the hob. On the bench sat the four dishes of their little dinner. She padded through to the patio, and her feet made sticking sounds on the boards. Outside a quarter moon up over the hockey stadium and clouds heading south. There were dead leaves in the chaise. White stains on the barbecue cover where standing water had pooled and dried undisturbed a thousand times since she bought it. Inside the toilet flushed. There was a snail on the brick and she flicked it into the garden with her toe and went back in. She locked the French doors and took down the Montaigne from the shelf. Robin was at the mirror in Elizabeth’s pyjamas brushing her teeth and Elizabeth leaned past her to rinse her toothbrush and drop it in the Agee jamjar with the interdental brush she’d never used after the first time when it drew blood. The floorboards were cooler in the hallway. A bubbling grumble outside—a Satan’s Slave on his big Harley opening up the throttle at the hill home to Berhampore. They called them Satan’s Little Helpers. They were all old men now.
She climbed into her bed and sighed.
She could hear Robin’s little ablutions, her neat spits. Hisses of brushing and pissing. The mysterious silences. Pad of her feet. She came in almost hunched, and closed the door quietly. Opened the right-hand wardrobe door to put her folded clothes on the shelf Elizabeth left clear for her clothes. Her toilet bag, her subsonic nursing Nikes. Robin climbed into bed. Diligent nurse, she was reading studies: checklist protocols and systematic reviews by some hot shit at Brigham and Women’s, some astronaut from the VA.
Elizabeth inhaled sharply through her nose and breathed out again slowly.
Cicero, footnoted in the Montaigne: As the scale of the balance must give way to the weight that presses it down, so the mind yields to demonstration.
Silence. The house cracked. Then came the muffled roar. Elizabeth checked the alarm on her phone and put the phone on the nightstand and read on. Robin turned a page and the bed shifted as she scratched her calf with the toenails of her other foot. Smell of her handcream. The house cracked, and roared.
‘Do you want lights out?’ Robin whispered.
‘No.’
The pōhutukawa rattled and scraped the roof. Muffled static. Vast, dark activity. Robin licked her fingertip and turned the page by dog-earing the top right corner and dragging it down across the printout. Hard on her books too. Spines white with lines where she cracks them open to lie beside her, to float flat upon cushions when she sits in the sun in yoga poses.
Elizabeth sighed.
‘What time you up?’ Robin said very quietly.
‘Six.’
‘Okay.’
‘All right?’
‘Yep for me.’
‘Only got eggs.’
‘That’s good for me.’
Elizabeth closed her eyes and pushed her glasses up on her forehead and rubbed her nose where the pads left pale imprints in her skin that were almost permanent now. She opened her eyes and looked at the page of Montaigne, blurred and doubled.
‘There’s no more toast.’
‘Yep. That’s all right.’
‘Butter. No toast.’
‘Yep.’
‘Useless.’
Robin reached out and put her hand on Elizabeth’s thigh.
A second, even two, later than usual.
When Elizabeth woke the light was still on and Robin was turned away, breathing slow. Elizabeth had dreamed badly. Climbing through foul-smelling intestines that gave and gave beneath her. She got up, turned off the light and went and sat on the sofa in the living room in the dark.
At Mission Control they are observing dozens of monitors, dozens of data sources. Initially they are as confused as the rest of those on the ground, looking up into the vast exhaust of the rockets.
At T+89.000 Jay Greene in mission control utters the first words since the explosion 13 seconds before, directed to the flight dynamics officer, known by the acronym FIDO:
‘FIDO, trajectories . . .’
FIDO: ‘Flight, filters got discreting sources. We’re go.’
(Filters meant radar. Discreting sources meant that radar was now tracking multiple objects, in this case, fragments.)
Greene: ‘Okay, all operators, watch your data carefully. Procedures, any help?’
Someone unknown: ‘Negative, flight, no data.’
To the butcher’s
The next day off with no on-call was Sunday. She woke early, read, washed all her things and hung them out in the garden. She reread the 1000 words of her response to the peer review and added a few here and there and went back to bed and masturbated. When she rose again she had eggs for lunch and lay on the chaise in the sun reading studies. When it was too hot she went inside and answered emails. Requests from agencies for consultations on capability building, requests to join expert advisory groups, and to co-author papers, requests for extensions, requests for revisions, requests for peer review.
And the phone was ringing.
‘Elizabeth Taylor,’ Elizabeth said.
‘I think you mean Elizabeth Taylor, bitch.’
‘Jessamine. How are you.’
‘Excellent, excellent.’
‘Oh, you’re not.’
‘What?’
‘Oh Jess.’
‘What?’
‘You’re scraping the last bits of a chocolate dairy food out of the tub with a teaspoon.’
‘No I am not.’
‘I can hear it. This is what you do when you call me.’
‘I’m not.’
‘You’ve stopped.’
‘All right but I was finished before you said that anyway.’
‘Well.’
‘Weeeell. You’re home.’
‘Yeah. How did you know?’
‘I called the hospital first.’
‘Oh.’
‘Yep.’
‘What’s up, Jess?’
‘What’s up. Well. I actually have a favour to ask you. That may well benefit us both.’
‘Hmm?’
‘Well. We were wondering if you might be interested in a little friend for a while. Well, not so little. But just a while.’
‘Hmm?’
‘So. Here’s what it is. Peter and I’ve found a place in town and it’s just no good for a big dog. It’s an apartment just off Tory Street and there’s just no way to make it work. It’s too small and it’s third floor in town. Really nice.’
Elizabeth held her breath and then breathed out through her nose.
‘So—oh Jess.’
‘No, it’s just for a while. The house is on the market and there are open homes and he’s working all the time and he just won’t take him.’
‘Stephen won’t.’
‘He won’t. Point break. That’s just the way he’s gone.’
‘Where are the kids?’
‘They’re with his parents. Peter’s daughter Sarah is at his mum’s until we get the renovations done and we’ve organised her room.’
‘So wait, she’s moving in?’
‘Yes. We’ll share her with her mother. Which is fine.’
‘I can’t.’
‘Atticus is really old, Liz. He’ll be your friend. Totally house-trained. He just sits around in the sun all day and sleeps. Just a few weeks. He doesn’t need anything. No needs. The occasional ear squeeze. A little jowl squeeze. I said jowl.’
‘I am never home.’
‘It doesn’t matter. He’s used to it. We’re never home anyway.’
‘Oh fucking hell Jess.’
‘I knew it. I knew it. Thank you. Thank you. Just a couple of weeks.’
‘Jess. Jess.’
�
��I—love—you.’
‘I don’t love you. I don’t.’
She sat at her laptop with the draft of her response to the peer review until the light changed. There was no more food in the house and Robin wasn’t coming over. She got her keys and went outside to take the Camry to the Island Bay Butchery for three lamb and mint sausages.
The sun was setting but it was still hot. She made a tight, fast U-turn and accelerated up the long slow hill and then she kept accelerating, pushed her foot down hard until the engine was on the very edge of a sound that could plausibly be blamed upon the slope, until she hit the flat by MacAlister Park and was driving at 90 kilometres an hour past the villas of the old people’s home called Village at the Park.
She braked at the top of the rise and was back to 30 kilometres an hour the moment she crossed into the slow zone of Berhampore.
The lights stayed green and when she crossed the zebra crossing at the Romanian Church there was still no one around and she put her foot down hard again and the Camry seemed to hunch and gather itself and then it screamed as she did 80 past Wakefield Park into Island Bay and there was still no one on the roads and she was at 100 when she drove through the first Island Bay roundabout, ignoring the side streets, the Camry’s tyres squealing on the ghost markings left behind by the new cycleway.
Down in Island Bay lived Mary Leonard, an anaesthetist, with her husband John, an English intensivist on the same team as Ben Matthews. Mary and John ran down Severn Street together, comparing their speeds by the radar speed signs that were everywhere now, that on Severn Street register runners if they can run fast enough. Mary and John had embroidered LIVE LOVE LAUGH cushions. Down here lived a retired professor of public health who taught her in Dunedin. Down here lived colleagues.
She turned left off the Parade up Tamar Street, crossing the edge of the cycleway, flattening the temporary plastic bollard and it hammered under the chassis as if far away.
Up the hill to the steep streets named after rivers.
Avon, Hudson, Volga, Thames.
She accelerated so hard the engine howled but the streets were so steep she was not breaking the speed limit.
A man mowing his lawn turned to look at just another silver station wagon passing by.