by J. R. McLeay
“Mac,” Rick teased, “I know you’ve always fantasized about wielding this kind of power. You’re just ticked about having the lowly job of sedating the patient.”
Rick chose his words deliberately, knowing Mac would bristle at the suggestion he was merely sedating the patient. They both knew the business of administering general anesthesia was far more complicated than that. It was critically important for the surgeon to ensure utter relaxation and stillness of the patient during the operation. One millimeter of movement at the wrong time would almost certainly mean instant death.
But he also knew his anesthesiologist was smart enough to know when the neurosurgeon was messing with him.
Mac peered across the operating table with mock indignation. “You know you couldn’t perform this operation without me—I’m one of the main reasons for your perfect record.”
It was largely true, Rick had to admit. Administering the general anesthetic was one of the riskier elements of the hypophysectomy procedure. It rendered the patient not only unconscious, but also temporarily incapable of breathing on his own. If the patient were deprived of oxygen for as little as a few minutes, he could experience irreparable brain damage or cardiac arrest. A breathing tube had to be inserted into the trachea to ensure the lungs and blood supply were sufficiently oxygenated, and the anesthetic team had to closely monitor that his vital signs remained stable at all times.
Other surgeons had experienced serious complications from similar procedures, but these two worked seamlessly together and had never lost a patient.
“Are you two going gab all day, or were you actually thinking of finishing this job?” interjected Nurse Benson, who was all business in the operating theater. “I swear—I should report you two someday.”
“For what?” asked Mac. “Wittiest banter in the operating room?”
“Or sexiest duo in scrubs?” Rick added.
“Hey, don’t use ‘sex’ and the two of us in the same sentence, pal.”
“I was talking about the lovely head nurse and me, you fool.”
Nurse Benson rolled her eyes. “Just get on with it, will you?”
Rick knew she was right, and he had no intention of dragging this procedure out. After all, a child’s life lay in his hands, and this was deadly serious work. The operating room humor just helped to ease tensions and make the surgery less stressful for everyone involved.
Rick focused the endoscope’s light and slowly steadied the laser cutting instrument at the anterior end of the infundibular stalk. The incision needed to be far enough from the hypothalamus to minimize trauma from the separation of the pituitary and also far enough from the pituitary to prevent any spontaneous regrowth. He knew the human body had a remarkable healing capacity and the ability to regenerate severed or damaged body parts. There could be no doubt about the finality of this particular separation of parts. An undetected regrowth of the pituitary gland at any time in the future could have grave and unexpected results for this juvenile.
With all attending medical personnel prepared for the next step, Rick nevertheless always had to ask.
“Everyone ready?”
“That’s what we’re here for,” said Dr. Scott, the assistant neurosurgeon.
Rick fired a short and tightly focused beam of concentrated laser light and cleanly severed the pituitary from its connecting stalk. Milliseconds later, a clamp applied by Dr. Scott constricted the flow of blood from the severed stem. Rick ejected a small drop of surgical fibrin glue onto its end to seal the wound.
Grasping the tiny gland in a claw at the tip of his operating instrument, Rick slowly and very carefully began to withdraw the equipment from the child’s upper sinuses. The exit from, and the entrance into, Turk’s Saddle was the most dangerous part of the procedure. He wasn’t about to risk jeopardizing another perfect operation now.
Virtually all the operating equipment was computer controlled and guided by ultra-sensitive joysticks. But Rick knew every patient’s physical configuration was slightly different. It still needed his expert guidance and interpretation of the intricate pathways into and around the cerebral cortex. Watching intently through the endoscopic lens, he retracted the razor-sharp equipment mere millimeters from the internal carotid artery and optic nerves.
Three hours later in the recovery room, Rick went to see his patient as he slowly awoke from a deep slumber.
This was often the most terrifying part of the operation for every child. Waking up to see if your mind and body will be the same after having a major part of your brain removed could be a little unnerving for an eleven-year-old.
Rick should know—he’d been through it himself, like everyone else. Though the passage of over fifty years had blurred his memories somewhat.
“How’s our youngster doing, Jane?” Rick asked, upon seeing the post-op nurse attending to his patient.
Jane smiled when she saw the handsome doctor stride into the recovery room.
“All his vital signs are normal, Dr. Ross, and he’s sleeping peacefully. Would you like me to wake him for you?”
“Even though I’m sure you’d be a welcome sight for sore eyes,” Rick said, “I’d prefer he sees a familiar face when he comes to. I’d like a couple of minutes alone with him if I may.”
The young nurse left the room reluctantly. She admired Dr. Ross, and would have liked to stay as he worked his bedside magic. He had many pretty admirers among the hospital staff.
Dr. Ross placed his hand gently on his patient’s forehead. The child stirred slowly, and raised his heavy eyelids.
“Good morning Jason—how’s my courageous patient?”
“Uh… a little dizzy, Dr. Ross,” Jason mumbled, his head still spinning from the lingering effects of the anesthesia.
“You’re still a bit sedated while you recover from the operation,” Rick nodded assuredly. “It’ll go away soon.”
“Did you get the little bug?” asked Jason.
Rick smiled. That was their code word for the tiny pod in his brain that would someday make him very sick. Except this bug was a little more insidious than most germs or infections that attacked the body’s natural defenses. This one had a universal and destructive intent: to activate the internal clock that would slowly wear down and wear out every living cell in his youthful body.
“Yes, we got the little sucker, and it’s not going to do you harm any more. But I want you to rest now and let your body regain its strength. In a little while, a very pretty doctor is going to come see you and give you some medication to replace some of the important energy you’ve lost.”
As he stood to leave, Rick took the young patient’s hand in his own.
“You’re going to be just fine, young man. Now that we’ve got that nasty little devil out of your system, you’re going to live a very, very long time.”
As he gently shook the youngster’s hand upon parting, there was more than just the usual professional confidence in his gesture. As the young child glanced at Dr. Ross one last time before they separated, he could clearly see the much older doctor’s hands looked exactly like his. They were the same size, and just as youthful, as his own.
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Acknowledgments
Writing a book readers will enjoy is no easy task.
The first step is coming up with an interesting and original theme. Sometimes it’s hard to find inspiration for a new book, but the best ideas always come from real life experiences. For this, I’d like to thank my friends and one or two adversaries for providing the underpinnings for this book.
The next step is developing a workable outline that will provide immediate engagement and maintain reader interest all the way to the end. A number of resources provided invaluable assistance in this endeavor. K. M. Weiland’s book Outlining Your Novel was my go-to reference to ensure I had all the bases covered. Syd Field’s book The Screenwriter’s Workbook provided the central foundation for establishing the necessary three-act structure for any good story.
/> Then the really hard part begins. Which is actually writing the story. It takes a superhuman effort to create an engaging piece of literature that works from beginning to end. There are so many elements to balance: the opening hook, building conflict, pacing, chapter endings, overall length, diction, character development, dialogue, point-of-view switches, secondary plot lines, finishing with a smart ending, etc.
Whew! How can any normal mortal weave all these elements into a cohesive and compelling story? For me, the best guidance comes from readers. I’d like to thank the many people who reached out and contacted me or who posted reviews for my first book The Cicada Prophecy. I learned from honest and candid readers what works and what doesn’t work. I have tried mightily to correct the stipulated shortcomings from my initial foray into publishing and hope this book raises the bar.
Of course, the best way to be a successful writer is to listen, watch, and read what other successful writers do. Stephen King’s instructional book On Writing provided many excellent tips. Katherine King’s book Plot with Character provided many good ideas for developing rich and compelling characters. Nabokov’s Lolita showed me how to write beautiful and elegant prose. Robert Patterson’s and Dan Brown’s hugely successful books showed me how to structure and pace my books to create page-turners. All of these writer qualities are a work-in-progress for me.
Once the first draft of the manuscript is finished, the difficult job of editing begins. Some of this can be done by the author himself, but not exclusively. I found the software application Hemingway particularly helpful in controlling my sentence length, overuse of adverbs and adjectives, and minimizing use of passive voice. Another application, Grammarly, corrected my improper comma usage, repetitive words, and spelling and grammar errors. How did writers function in the days before word processing programs and specialized software applications?
Of course, self-editing—even with sophisticated software tools—only goes so far. Every writer gets too close to his/her work and loses sight of both the forest and the trees from overthinking every single word. For this reason, arms-length editors are essential. They bring fresh eyes and see things only new readers can see. My good friend and ever-faithful reader Alicia Dougherty provided helpful feedback from a reader’s perspective on how my novel could be tightened and improved. My cousin Sophia Maras helped bring an authentic Italian flavor to Chapter 4. Shin Saikyo can always be counted on to find typos that seem to evade most other readers and editors. And Patricia Hadding, who is a prolific and detailed book reviewer, provided invaluable guidance on the technical ballistics and public security elements of my book. Check out her excellent book review blog at piratepatty.wordpress.com.
Once the manuscript is finished and vetted, it’s ready to be published and uploaded to the major book marketing sites. The book formatting software Vellum took my rough Microsoft Word document and transformed it into a beautiful piece of literature. Thanks also to my friends at Amazon Kindle Direct Publishing and CreateSpace for all their assistance in uploading and configuring my ebook and paperback.
Did I mention earlier the hard part? Yeah, well forget that. The REALLY hard part of being a successful author is marketing your product. There are thousands, probably millions, of really good self-published authors who never got picked up by a major publisher and never figured out how to move their books on the primary e-commerce forums.
I’ve learned a tremendous amount about successfully marketing my book in the roughly two years since my first title was published. It’s impossible to share all my learnings here, but suffice to say that no book will sell unless it attracts eyeballs. Getting eyeballs to your Amazon product page is an art and a science and is an extraordinarily complex moving organism. I’d like to thank my good friend John Dreese for partnering with me after my first book floundered for almost a full year to help me understand how to get optimal results.
Being a writer can be a lonely and frustrating job. If you don’t have a strong support network, it’s too easy to give up and sell out for a corporate job. None of this would be possible without the unconditional love and support of my amazing wife Tricia. Thank you, babe, for believing in me and never letting me let go of my dream.