Heartbeat

by Joan Johnston

  “I’m waiting to hear what this is all about,” Isabel said when the elevator door closed, leaving them alone together.

  Jack wasn’t sure what to say. If Isabel was a murderer, she was about the coolest killer he’d ever seen. Because his heart had been in his throat with fear, he’d gone off half-cocked and blown his cover bigtime. He met Isabel’s forthright stare and said, “I’m a Texas Ranger, Isabel.”

  “I didn’t figure you were Batman.”

  Jack laughed and said, “Don’t make me laugh, Isabel. This is serious.”

  “As a heart attack,” Isabel agreed. “What did you think I was going to do to that kid?”

  “Kill her,” Jack said.

  Isabel’s eyes goggled. “No shit?”

  Jack felt the urge to laugh again and stifled it. If Isabel Rojas was a murderer, he’d eat his new Resistol. ’Tm here to find out—”

  The elevator doors opened with a chime, and Isabel brushed past him and went whizzing down the hall to the ER. Jack was grateful he’d gotten himself a hospital ID that gave him access everywhere, because a couple of orderlies were serious about keeping unauthorized folks out.

  The ER was nowhere near as quiet as the rest of the hospital. Here was the center of the hive, where watchful worker bees guarded the heart of the place and never slept. People and machines were crowded into too small a space, and the cries of the wounded and their families filled the air with an anguished cacophony. Jack stayed close to Isabel, figuring she knew where she was going.

  He was unprepared for the sight of three-year-old Amy Hollander lying in the center of a metal hospital gurney, IVs taped grotesquely to the right side of her neck and her wrist, her tiny body hooked up to monstrous machines that beeped and blipped and hissed and hummed.

  Roman Hollander stood beside his daughter wearing a white doctor’s coat open over his bare chest. Jack wondered if Hollander was dressed at all and stepped close enough to see the doctor was wearing a pair of zipped but unbuttoned black jeans and mismatched tennis shoes.

  Jack was amazed to see Lisa Hollander in the ER, considering the goons at the door, but even more astonished to note that she was standing on the opposite side of the gurney from her husband, glowering at him, instead of at his side, being comforted by and comforting him.

  Jack backed up along the wall, close enough to listen to the questions Isabel was asking—Cardiac monitor? Pulse oximeter? Arterial line? Foley catheter?—and to hear the answers she was getting—all affirmative—but not close enough to intrude on the family’s anger and grief.

  “What’s the prognosis?” Isabel asked Roman.

  Trust a nurse to get to the point, Jack thought.

  Hollander seemed to be in some kind of trance, and it was the ER physician who answered, “She’s slipped into a coma. We’re keeping her on a respirator—”

  “And I want her off,” Hollander said authoritatively.

  “Don’t any of you touch her!” Lisa said, dark eyes alert, guarding her daughter like a lioness with her cub. “I won’t let you do this, Roman. I’ve read every word you’ve ever written, and I don’t care what Amy’s like when she wakes up, so long as she does wake up!”

  “A breathing apparatus is only prolonging the inevitable, Lisa. I’ve seen cases like this too many times—”

  “This isn’t a case,” she hissed, leaning across the gurney to confront him. “This is your daughter. How can you not want to do everything you can to save her?”

  “Don’t you understand? There’s nothing I can do to save her!” He shoved both hands through his short-cropped hair. “There’s not a goddamned thing I can do for her!”

  Jack understood, all right. The almighty Dr. Hollander, who had the precise skill and knowledge to save other people’s children, did not have the precise skill and knowledge to save his own. Whether Amy Hollander came out of the coma hale and hearty depended on how long her brain had gone without oxygen before she was discovered and resuscitated. Five minutes was about the limit before brain cells started to die.

  “How long was she underwater?” Isabel asked, apparently having followed the same line of reasoning as Jack.

  “I don’t know!” Hollander said. “Lisa and I . . . I don’t know!”

  “It couldn’t have been more than five minutes!” Lisa insisted. “It couldn’t! I was watching the time all morning! The smoke alarm went off so quick—”

  “Smoke alarm?” Isabel said.

  Jack saw the byplay between Hollander and his wife before the doctor said, “It was nothing. Some French toast got burned.”

  “How did Amy get outside to the pool without either of you noticing?” Isabel asked, looking from one of them to the other.

  “We . . .” Hollander stopped and stared at his wife, his mouth grim. “We were upstairs, and we thought she was, too.”

  “She wanted to play with Donald, and I told her no. I never thought . . . I never thought. . . .”

  Jack’s heart went out to her. Why doesn’t Hollander hold his wife? What’s wrong him? Can’t he see how much pain she’s in?

  But the two of them seemed very far apart.

  “I knew Amy was smart,” Hollander said, brushing tenderly at the dark, still-damp curls on his daughter’s forehead. “But the security lock on the sliding glass door . . . It’s so complicated . . . .”

  It was gut-wrenching to watch Hollander battle to control his quivering chin. Jack looked away as the doctor’s features crumpled.

  Lisa took a step toward her husband, but stopped when Isabel reached him first.

  Jack had never seen a more tortured look than the one on Lisa Hollander’s face as her husband wrapped his arms around Isabel Rojas, pressed his face tight against her shoulder, and sobbed.

  Maggie had slept like the dead. It was no wonder after the night she had spent with Jack. She had woken feeling wonderful—until she glanced at her watch and saw that if she didn’t get a move on, she would be late for the Monday morning bioethics committee meeting . . . again.

  As she inched out of bed, she realized she was sore in places she had forgotten she had. There were bruises on her inner thighs, her arms, and—she knew from a midnight visit to the bathroom—a hickey high enough on her throat that she was going to have to do some creative dressing. She didn’t remember getting any of the marks, only the joy and the passion and the pleasure of the night just past.

  When the phone rang, her heart leaped, because she was certain it was Jack. He had told her in the early morning hours—after he had made love to her for the third time—that he would have to leave before she woke up. But he had promised to call her. She picked up the phone expecting to hear his voice.

  Instead, Victoria Wainwright said, “You’d better get to the hospital on time this morning. The committee has an important matter to consider.”

  “What is it?” Maggie asked, more irritated than interested.

  “Amy Hollander drowned. Dr. Hollander wants to take her off the respirator, but his wife is refusing.”

  Maggie’s legs buckled, and she ended up on her knees beside the bed. “Oh, my God.”

  “Don’t be late, Margaret. You know how Dr. Hollander likes to start on time.”

  The phone clicked in Maggie’s ear.

  “Nooooo,” Maggie moaned. “Nooooo.” She dropped the phone into the cradle and lowered her face into her hands. This can’t be happening. She knew exactly what Lisa and Roman were feeling right now-the guilt and the anguish.

  The phone rang again, and Maggie hesitated before she answered it. Please, not more bad news.

  “Maggie? Are you there?”

  “Lisa? Where are you?”

  “You’ve got to come to the hospital now, Maggie. Roman’s threatening to take Amy off the ventilator. He’s petitioning the bioethics committee this morning to get their consent. I need you to argue on my behalf at the meeting, Maggie. I need you to be on my side.”

  “Lisa . . . .” It was a clear conflict of interest for Maggie to speak
on Lisa’s behalf when she legally represented the hospital-who represented Roman Hollander. But there was no reason why she couldn’t speak up as a friend and a concerned party. “I’m on my way,” she reassured Lisa. “Don’t let them do anything without me.”

  “Hurry, Maggie. Hurry!”

  Lisa’s plea played constantly in Maggie’s head as she toweled off after a quick shower, grabbed a power suit from her closet—she was going to need it this morning—dragged a brush through her hair, and drove like a wild woman through rush-hour traffic to the hospital. She didn’t bother with the elevator, just hiked up her skirt and took the stairs to the second floor two at a time. As she pushed open the stairwell door a voice said, “You’re late.”

  Maggie whirled to find Jack Kittrick leaning against the wall, his arms and legs crossed.

  “I’ve been waiting for you,” he said as he straightened up. “Amy Hollander drowned.”

  “I know.”

  When Jack opened his arms, Maggie walked into them and held him tight around the waist, pressing her nose against his throat. “I know what Lisa’s feeling, Jack. It hurts.”

  “I know,” he said. “I feel it, too.”

  She leaned back and looked up at him.

  “I saw Amy in the ER,” he said. “They had so damned many tubes in her . . . .”

  Maggie searched Jack’s face and saw the dark shadows beneath his eyes. “You must be tired.”

  “Given the choice of sleeping or spending the night the way I did, I’d rather be tired,” he said with a tender smile. He caressed the bruise on her throat and said, “Did I do that?”

  Maggie groaned. “I was going to cover that with a scarf.”

  He leaned over and kissed the spot, then pulled up the collar of her blouse and said, “There. All gone. You’re ready to go to work, counselor. Here’s a little something for luck.”

  Jack kissed her on the lips so gently that Maggie scarcely felt the touch. Yet the kiss moved her more than all the passionate embraces he had given her the previous night.

  “Thank you, Jack,” she said. “I needed that.” As the two of them walked down the hall toward the conference room she said, “Roman wants to disconnect the ventilator.”

  “I know. Can he do that?”

  “Medically, he can recommend removal. Legally, if Lisa wants it on and he wants it off, it’s a problem. Ethically, he shouldn’t be treating his own family. But he has enough friends on the committee to get them to recommend what he wants. After that, Lisa’s going to have a fight on her hands.”

  “Where do you stand?” Jack asked.

  Maggie looked him in the eye and said, “I’m on Amy’s side.”

  The tension in the conference room was palpable. Instead of sitting in her usual seat, Maggie took the empty seat Lisa had saved for her near the head of the conference table. Jack took the only seat left—Maggie’s place at the foot of the table.

  The secretary finished reading the minutes of the previous meeting, and Roman called for additions or corrections. The minutes were approved as read, and the tension went up a notch as Roman began reciting the facts of Amy’s case.

  “We don’t know how long she was underwater—” Roman said.

  “Not for very long!” Lisa interjected.

  Maggie gripped Lisa’s wrist to silence her, and Roman continued without looking in his wife’s direction.

  “—before efforts to resuscitate were begun. The child began to breathe on her own, but stopped breathing on the way to the hospital and was put on a respirator when she arrived. The three-year-old victim is in a coma, and only time will tell whether—”

  Lisa leapt up and said, “She’s not ‘a victim,’ she’s our daughter!”

  “Sit down, Lisa,” Roman said.

  “Roman, you can’t do this,” Lisa pleaded. “You have to save Amy. You have to!”

  The committee remained silent as the two adversaries confronted each other across the conference table.

  “Don’t you see, Lisa?” Roman said in a voice racked with grief. “I can’t save her. That’s what this meeting is all about.”

  Maggie stood up beside Lisa, put an arm around her shoulder, and murmured, “Sit down, Lisa. Let me ask the questions that need to be asked.”

  “But—”

  “Trust me, please.”

  Maggie watched Lisa sink into her chair, then turned to Roman and said, “What about Amy’s brain wave activity?”

  Roman rearranged a folder of papers in front of him as though looking for the results of the brain scan, then said, “There are some irregularities.”

  “But she’s not brain dead, is that correct?” Maggie asked.

  “Yes, that’s correct. But—”

  “Then I don’t understand why you’re recommending removal of life-support systems,” Maggie said. “There’s no legal basis for it.”

  The conference table suddenly buzzed like bees around a particularly succulent flower.

  “I don’t believe life support will do any good,” Roman said, rising, as though being seated while she was standing gave her too much power in the argument.

  “Is that your medical opinion, or your opinion as the father of a child who’s been the victim of a tragedy?” Maggie challenged.

  “I’ve seen cases like this before,” Roman said ominously.

  “And?” Maggie prodded.

  “Sometimes the victim’s condition deteriorates so slowly, it takes months for the child to die.”

  “And other times?”

  Roman made a face as though to dismiss those statistics.

  “What happens in the cases where the victim’s condition doesn’t deteriorate?” Maggie insisted.

  “The child can recover completely, or recover with various levels of damage to her physical or mental capabilities . . . everything from a slight speech impediment or a limp to paraparesis,” Roman said.

  Maggie felt Victoria’s eyes on her at the mention of “paraparesis,” but refused to look at her mother-in-law. They both knew the physical and mental devastation that could occur. Maggie believed a life like Brian’s was worth living—that any life was worth living—to the very fullest of the individual’s abilities. Brian’s unfettered joy in life had helped Maggie to find the joy in her own.

  To Maggie’s astonishment, Victoria said, “Tell us about paraparesis, doctor.”

  Victoria knew full well what paraparesis was—her own grandson was paraparetic. She could only be asking the question to sway the committee to vote against keeping Amy Hollander on a respirator.

  “If a drowning victim suffers global brain damage, paraparesis may result. It can include speech and memory problems, poor muscular control, tremors—”

  “The quality of life Amy will enjoy—if she survives—is not the issue we are here to discuss, Dr. Hollander,” Maggie interjected.

  “Why not?” Victoria said. “It’s the duty of this committee to be the moral voice of this community. Why can’t Dr. Hollander make an ethical decision to remove his daughter from a respirator based on the kind of life she’ll lead in the future?”

  Maggie met Victoria’s pale blue eyes across the conference table and said, “Because the ethical issue is moot so long as the child has a medical chance of survival.” Maggie turned to Roman and said, “Will the respirator help keep Amy alive, doctor?”

  “I don’t think—”

  “Yes or no, Dr. Hollander. Will a respirator extend your daughter’s life?”

  “Yes.”

  “Then legally, she’s entitled to that support.” Maggie met Roman’s obsidian eyes for long enough to see the concession there before she sat down.

  The committee decided, by a vote of 11 to 9, that it was inappropriate to disconnect Amy Hollander from the respirator at this time.

  As soon as the vote was announced, Lisa rose and left without excusing herself. Maggie wanted to go after her, but the meeting wasn’t over, and she wasn’t sure what other shenanigans Victoria might instigate if she wasn�
��t there to keep an eye on her.

  Roman appeared distracted for the remainder of the meeting, and Maggie suspected he was at the end of his rope by the time the meeting was adjourned. As the committee, including Victoria, filed out of the room, Maggie took the few steps to reach the frazzled doctor, wanting to offer what comfort she could.

  “Roman, I’m so sorry about what’s happened to Amy. I know what you must be feeling right now.”

  “How the hell would you know that, Maggie? You’ve never even had a child of your own. How would you know what it feels like to lose one to drowning?”

  Maggie’s jaw dropped at the virulence of Roman’s attack and the unfairness of it. This was the price she paid for all the secrets she had kept. If Roman had known the truth, he might have been able to accept what comfort she had to offer. Instead, Maggie found herself facing a man whose impotence—when he was used to exercising almost godlike powers of healing—must have been particularly galling.

  “Excuse me for butting in, Dr. Hollander, but Maggie knows what it feels like because she has a son who’s paraparetic as a result of drowning.”

  Maggie’s heart skipped a beat. She turned to stare at Jack, whose steel-gray eyes were focused on Hollander.

  “Her sympathy was well-intentioned,” Jack said. “She knows exactly what you’re going through, and she knows what it might be like for you if Amy doesn’t fully recover. I think you owe her an apology, doctor.”

  “Maggie, I . . . I don’t know what to say.”

  Maggie tore her gaze from Jack’s face and turned to Roman. “It’s my fault, Roman. I should have told you about my son Brian a long time ago.”

  “Does Lisa know?”

  “No. No one knows except my family.”

  Roman shot Jack a quizzical look, as though to ask how he had become privy to the information, then asked, “Why keep such a secret, Maggie?”

  “Because, as I suspect you’re doing right now, I blamed myself for what happened.”

  The small sound Roman made was evidence that Maggie had guessed right. “From what you’ve said, it wasn’t anybody’s fault Amy drowned. It was just a tragic accident. It’ll help if you can keep that in mind.”