by Harry Kraus
Charlotte turned down the radio. “Why would she speak to a stranger? Abused women don’t just tell random people their problems.”
Tori rubbed her eyes. “I know what I heard.”
“Arms of Love. It’s a women’s shelter. Maybe you just had a stroke of intuition.”
Tori took a deep breath. “The way she stepped away from that man, makeup that could cover a black eye, the fear in her expression … all of it spoke to me.”
“Has this happened before?”
She nodded. This morning. I felt the lost.
“Tori, that’s a gift.”
“No. I’m falling apart. I’ve got nightmares. Now people talk to me without words.”
“You’ve been up since four. Have you eaten?”
“No.”
“Your meds?”
“I left them at your place.”
“Okay, kid, let’s get you home, get your meds, feed you, and let you nap.”
Tori nodded again. Maybe that’s it. I just need food and a nap.
But somehow she knew things had changed. Life was different somehow. Effervescent trouble bubbled from the surface of her life like the sparkling gas escaping from soda on a summer day.
She brushed a tear from the corner of her eye. This trouble was far, far deeper than anything that could be cured with a sandwich and a nap.
For most teenagers, Saturday morning meant a chance to sleep in, but for Christian Mitchell, Saturdays meant a chance to go on hospital rounds with his father. They’d fallen into a comfortable routine, including a stop in a little hospital cafeteria where Christian ate mandazis, the almost-doughnut-sweet fried Kenyan bread washed down with chai, sugary tea steeped in half milk and half water.
After that, he would follow his father, Dan Mitchell, as he saw patients on the men’s and women’s wards. Often, a Kenyan intern and a medical student or two accompanied them. Today, the team was Dr. Mitchell, Christian, an intern named John O’mollo, and a medical student, Charity N’ganga.
John greeted them warmly. “We have a patient in ICU.”
Dr. Mitchell nodded. “We’ll start there.”
As they walked up the long hallway, John explained. “This is our lymphoma patient.”
“Mr. Wanjiku?”
“Yes. He began struggling to breathe. He has cough and fever. I thought he might have had a pulmonary embolus.”
Christian’s father paused. “It would be a relief, really. I don’t want him to suffer.” He looked at his intern. “He shouldn’t be intubated. We can’t use up a ventilator on him.”
Christian met his father’s gaze. “Why?”
“He has AIDS, son. And an advanced cancer that has spread throughout his abdomen and, I suspect, to his brain. There is no cure for him.”
Christian followed the team into the small high-dependency unit. In the third of six beds, Jeremy Wanjiku was clearly struggling to breathe.
Dr. Mitchell used his stethoscope, placing it on the patient’s chest, front and back, on both sides. “Diffuse rales. He sounds wet to me.” He then uncovered the patient’s lower legs. “Equally swollen, but not tender, so I don’t think he has a venous clot. He probably hasn’t had an embolus.” He added quietly, “If he has, it would be a mercy.”
A nurse, a female whose name tag identified her as Purity, approached the team.
“Let’s try Lasix,” Dr. Mitchell instructed. “Use morphine generously to keep him comfortable.” The team stepped away as the intern wrote the orders. When they were out of earshot of the patient, Dr. Mitchell spoke to the nurse. “No ventilator for him. He doesn’t have long.”
She nodded.
Outside the door to the ICU, Christian paused. “I think I’ll stay back with Mr. Wanjiku. He doesn’t have any family here.”
His father shrugged.
Christian pushed back through the door and looked at Mr. Wanjiku. He seems so lost. He felt an urgency. I want to give him one final chance to know the Savior.
Christian made his way to the bedside where the nurse injected the man’s IV with a syringe full of clear fluid.
“Lasix,” the nurse said. “It will help him get rid of extra fluid. Maybe he will breathe easier.”
Mr. Wanjiku’s eyes widened. Muscles in his neck flared as he braced his arms against the mattress, struggling for air.
“Does he understand English?”
Purity shook her head. “Kiswahili and Kikuyu.”
Christian sighed. “Will you talk to him with me then?”
Purity moved closer.
How to start?
“Mr. Wanjiku, I am Christian Mitchell. My father is your surgeon.”
Christian waited as Purity interpreted.
“It doesn’t look like you will survive very long.” He paused. “Do you know what will happen after you die?”
The patient seemed annoyed. Or perhaps it was only because all of his effort was in grabbing for his next breath and he couldn’t be bothered.
Christian continued, pausing to let the interpreter follow each phrase. “You are going to face God’s judgment for all of your earthly activities, good and bad. You will be sent to heaven if you put your faith in Christ and the cross.” Christian struggled, wondering if the patient could understand such terms. “No one gets to heaven by being good on their own. It is only because Jesus paid for our bad deeds by dying on a cross.”
Mr. Wanjiku looked at Christian and grunted out a few phrases in Kikuyu.
Christian looked at Purity. “What is he saying?”
Purity reached up and silenced an alarm with the push of a button on the cardiac monitor. The patient’s heart rate raced along at 155 beats per minute.
Sweat drops beaded the patient’s forehead. The air around him was thick with the smell of his breath. It was an odor Christian hadn’t yet learned. An odor of death. Decay, sour and bittersweet, mixing in with the antiseptic odors of the cleaning solutions used for disinfection.
“What does he say?”
Purity stared at Mr. Wanjiku. “He says he’s made choices. He’s made his decision long ago.”
“So he’s already a Christian?”
Purity shook her head and looked back at Christian. “No. He does not believe.”
Christian took the man’s hand. “It is not too late. Even a criminal who died on a cross next to Jesus turned to God in his final moments and was admitted to heaven.”
The nurse translated.
Mr. Wanjiku pulled his hand away.
Purity touched Christian’s arm. “He doesn’t want to believe.”
Christian shook his head. “He will burn in hell.”
The patient grunted out a few more phrases.
Purity looked down. “He wants you to leave.”
The heart-rate alarm sounded again, a high-pitched note keeping time with the patient’s racing heart. Christian watched the monitor and slowly backed away. Regular narrow blips, sharp and jagged, were replaced more and more often with widened ones. First one, then in twos and threes.
Christian sat in a chair behind a counter in the center of the unit. He felt useless. He’d failed.
Purity came to his side and placed her hand on his shoulder. He looked in her face, a nice face the color of coffee with milk. Her complexion was smooth and her teeth even and white. Her lips were full, the kind that in Hollywood, women pay to emulate. “Perhaps the Lasix will work.”
But the monitor didn’t lie. Blip, blip, blip, each one running toward an inevitable free fall from the precipice between life and death.
Christian stayed an hour.
To pray.
But heaven was closed.
He watched the patient, the monitor above the patient’s head like a gravestone proclaiming his final mome
nts. A second alarm sounded, this one a register of a critically low oxygen in the blood.
Mr. Wanjiku’s right hand lifted to his chest. His mouth twisted in a snarl of fear. With eyes wide, he collapsed against the sheets that were stained with an outline of his sweat. His chest rose and fell in diminishing heights. Two minutes later, an eerie cry parted his lips one last time.
Christian imagined the patient leaning over hungry flames of eternal separation from God.
The rhythmic dancing line of Mr. Wanjiku’s heart ceased, ironed flat by the invisible hand of death.
Purity turned off the monitor and looked back at Christian. “Asante.”
Thank you.
He rose and walked from the unit. He needed escape. Into the African morning with sun on his face and the dust of a rocky path beneath his feet, Christian stumbled forward beneath a silent sky.
17
Just after sunrise on Saturday morning, Tori sat on a bench waiting for the city bus, the first leg of a day trip to Baltimore to find out more about Dakota Jones.
As she sat, she replayed her argument with Charlotte from the night before.
“Don’t do this, Tori.”
“I didn’t imagine you’d understand.”
“Her family could be hurt.”
“They deserve to know the truth.”
“You’ve had a heart transplant. You’re on multiple drugs. These things affect the mind. Your nightmares could mean anything.”
“Then investigating this won’t hurt anyone, will it?”
“You’re going to get hurt.” Charlotte put her hands on her hips. “Or you’re going to hurt yourself.” She walked toward Tori and placed her hand on her shoulder. “What about finding out about your own childhood? You’ve seen some tough times. Maybe—”
“I never had these nightmares before! You knew my mother.”
“Tell me about kindergarten.”
Tori scoffed. “What does that have to do with this?”
Charlotte held up her hands. “I’m just asking.”
“This isn’t about my past. It’s about a debt I owe to a woman who gave me her heart.”
“I wish you’d slow down. You’re not ready for this.”
“I’m a big girl.”
A big girl. Tori sighed at the memory. Sitting on the bench, she felt anything but.
She tried to think about kindergarten, but it was a big, empty black box. Why on earth did Charlotte want to know that, anyway?
She let the number 21 bus pass. She needed 19 to take her to a downtown bus terminal. In truth, she hated to take a bus, but she’d been warned not to drive for another week, and she feared that if there was any problem and her surgeon got wind that she wasn’t cooperating, it could only come back to sting her. All she needed was Dr. Parrish telling the chairman that Tori couldn’t be trusted to follow instructions.
A few minutes later a gray Honda Accord approached and slowed with the passenger window rolled down. “Hey, stranger, where are you headed?”
She looked up to see Phin MacGrath, smiling and motioning her to get in.
A bus was approaching behind him. “My bus is here.”
“Come on, get in. I’ll take you.”
She looked once at his smile, glanced back at the approaching bus, and yielded, opening the passenger door.
Inside, there were two cups of Starbucks coffee in a cupholder between the bucket seats. “Phin, what are you doing?”
“I hope I’m taking you to Baltimore.”
She thought back to their last encounter. Phin had been Mr. Professional—distant and direct. “I’m taking the bus, Phin. You don’t need to do this.”
“I know. I want to.”
“Let me guess. Charlotte?”
“She asked me to help out.”
“She refused to take me herself. She wants nothing to do with my search. She thinks I’m stirring up trouble, concentrating on distractions when I should be trying to recover.”
“She loves you. She didn’t want you to go alone.”
“She wants to keep tabs on me.”
“We should all have friends like Charlotte.”
“But you’re my counselor. This doesn’t seem much like something a counselor would do.”
He nodded. “Agreed.”
“That’s it? You agree?”
“So maybe I’m crossing a professional line.” He shrugged. “You want to report me?”
She smiled. “Maybe.”
He handed her one of the cups. “I’m willing to risk it. If it gets too crazy, I’ll just refer you to someone else for counseling.”
“Or you could stop crossing the line.”
He glanced at her. His face said he’d rather make the referral.
He sipped his own coffee as they sat at a traffic stop. When the light turned green, he put it back in the holder. “So, Sherlock, what’s your game plan? Why are you suddenly so sure you know your donor’s identity?”
“I got the information from the resident on the transplant team.” She positioned her cup just below her nose so she could savor the rising smell of the coffee. “A little beer and a few carbohydrates did the trick.”
“I’m still part of the transplant team, remember. Maybe I don’t really want to know.” He hesitated, and she could tell he was irritated. “This was a violation of patient confidence. You know that.”
“I also know that if an attending surgeon asks a resident a question, there is too much pressure to stay in the attending’s good graces not to answer.”
“You took advantage of your position as an attending.”
She shrugged. “Perhaps.”
“I hope not. You shouldn’t have told me.”
“Hey, you’re a part of this now. If I go down, I’m taking you with me.”
He chuckled. “Well, if it’s just the same to you, we have to be very careful not to let the donor’s family, or anyone else for that matter, think that the transplant team is giving out confidential information. That could spell huge trouble for us. The program could get suspended.”
Tori tapped her thigh with her fingers and thought about Phin’s statement.
She stared out at the passing traffic, trying not to look at the faces. Wow. If that happened, I won’t just be on temporary leave, will I?
They drove on in silence for a few minutes before Tori spoke again. “If I’d known you were going to rescue me, I wouldn’t have needed to leave so early.”
“So we’ll take our time.” He glanced in her direction. “You could fill the time by telling me about your family.”
She shrugged. “Is this a question from a friend or part of our counseling?”
“I want to know for me.” He hesitated. “But it’s both, I guess.”
“I’ve told you about my family.”
“You told me about your mother. How about your dad?”
Tori felt her gut tighten. “I don’t remember that much. He died when I was twelve.”
“Certainly you have memories.”
“He was fun. He took me to the movies. But he was deployed a lot.” She sighed. “I remember thinking I should cry when he died, but I didn’t.”
“Your father died and you didn’t cry?”
She continued staring through the window. “I guess I wanted to be strong for my mother.”
“When was the last time you cried?”
“I cry all the time now.” She hesitated before adding, “Since my transplant.”
“How about before?”
“I didn’t cry.” She looked back at Phin. “You think that’s weird?”
He seemed to be choosing his words carefully. He looked as if he was rolling something around in his mouth, perhaps trying it out for tast
e before responding. “Unusual. Not exactly weird.”
“I used it to my advantage. While others are getting bogged down in their emotions, I’ve been able to move forward. As a cancer surgeon, it was a plus. I didn’t let all that baggage interfere with the decisions I needed to make to cure cancer.”
“Hmm.”
She didn’t like the way he responded. It sounded judgmental. “What do you mean, ‘Hmm’?” She imitated him.
“You’ve been closed down.”
“Maybe losing your parents can do that.” She sipped her coffee. “Don’t make a big deal of it.”
“But you were closed before that.”
“Okay, Mr. Counselor, what do you make of that?”
“Not sure,” he said. “But I’d say it’s a protective response, usually a defensive mechanism to prevent hurt, caused by exposure to some sort of bad experience. Something traumatic.”
“Well, that’s where you’re wrong. I had a happy childhood, parents who loved me.”
“Your dad was deployed a lot. Maybe you closed down to prevent yourself from missing him. Maybe you’d been worried so long that he would die that when he did, you were already proficient at protecting your heart.”
“I think you’re reaching. I think I was just made tough.”
Phin tapped his fingers on the steering wheel. “And I think twelve-year-old girls aren’t supposed to be that tough. Did you have lots of disappointments?”
“Disappointments?”
“You know—your father was away in Iraq, missed your birthday, that kind of thing.”
“I don’t remember. He was gone a lot, so he probably missed my birthday, but my mother always had a gift that was from him and told me he was such a hero. I think I understood.”
“Did you cry when your mother died?”
“I told you I didn’t cry. Not till I got this new heart.”
“What do you make of that?”
She sighed. “Only that I got a lot more than I imagined when I got this heart.” She let her hand rest on his as it gripped the gearshift. “I think Dakota Jones was a crier.” She squeezed his hand. “And a toucher. That wasn’t me before, but now it just seems … natural.”