A Postmodern Love

by Nick Totem

  Of course Mike Nguyen noticed his demeanor and inquired very tactfully about what was troubling Thomas. He was Thomas’s longtime friend and partner. At the age of eleven, he had immigrated with his parents to America after the Vietnam War. His family had been sponsored by another family from Thomas’s church. Consequently the two boys had gone to the same church and had grown up in the same working class neighborhood, though they hadn’t become friends until a fateful day during high school when Thomas fought the bully who had been harassing Mike almost daily. They had become fast friends, a meeting of Mike’s gratitude and Thomas’s bashing in his new tough guy image. They had even gone to the same college. During their second year of college, when Thomas had no idea what he wanted to major in, it was Mike who gave him the idea of being a doctor. “I don’t know about you, Thomas,” Mike had said to him as they sat in front of Powell Library during a study break. “I don’t want to go crazy and try to be rich, but man, I’m so tired of being poor. As a doctor you’ll never be out of a job, and it’s good for your karma. That’s what I’m going to be.” Though they later went to different medical schools, they kept in touch and even goaded each other on to go into the same specialty. After residency, they got together and had been partners ever since, though Thomas had never told Mike the truth about fighting Bill, the bully.

  On the following Monday, Thomas decided to bring Mike into the fold, to sound out his thoughts, to have input from an outsider, hoping to retain something of his own sanity against the emotions that continued to churn and swell beyond his control. So after all the staff had left, they went to Mike’s office. Thomas leaned back in his chair, taking hesitant breaths, as Mike eyed him with his characteristic twittering way. A slight nasal twang rang in his voice. His black hair was salted with gray streaks, and his forehead was permanently etched with wrinkles. His dark brown eyes tended to dart side to side, as though he was intent on reading anyone he happened to talk to. Behind Mike, a bookshelf held various medical texts and framed photos of his family—a wife and two children—too many of them, shining and reflecting, linking together like a shield. A faint smell of disinfectant was everywhere.

  “So, what’s up, buddy?” Mike began.

  “You wouldn’t believe the last few weeks, Mike,” Thomas said. “A goddamn roller-coaster.”

  So Thomas proceeded to tell him the whole story, at times in minute details, though he said nothing of his emotions, the happiness that he still craved for, the re-living again after Iraq, being able to shake off the oppressive guilt.

  At last Thomas finished. A tense expression seemed beaten into the furrows of his forehead and lips.

  “No way,” Mike said again; he had said this almost automatically throughout the story, implying congratulations when Thomas described the beautiful girl, only to end in disbelief. “So you think they set you up? This whole elaborate thing was to set you up?”

  “What do you think? You’re the cool head here. You tell me.”

  “It does sound suspicious.” Mike looked squarely at Thomas. “You aren’t in love with her, are you?”

  “Hell no,” Thomas growled.

  “She borrowed money from you so naturally you concluded she must have borrowed money from this guy as well, or she was obligated to this guy.”

  “Yeah.”

  “I can see how you were thinking that you were saving her. That was probably the hook.”

  “Yeah.”

  “So she was part of the scam. Maybe to pay him back. Maybe they’ve been partners all along, just scoping around for people to con. It’s not that far-fetched. Things like this happen all the time. ”

  “I didn’t think about it at the time. I was so blind.”

  “When it comes to beautiful women, we all lose our heads. But you, my friend, if I know anything about you, you probably went blind the moment you set eyes on her. Remember Laura in college, you almost flunked out, you couldn’t eat, sleep, or study. You got to be careful with beautiful women.” Mike shook his head at Thomas.

  Thomas looked away.

  “Whatever happened to Laura by the way. She married a gynecologist, right? Huh, how can a man be a gynecologist. That served her right for ditching you . . .”

  “Mike,” Thomas hollered. “Can we stick to my problem?”

  “Sorry, anyhow. I was thinking that you’re too good. You’re a fucking saint, man,” Mike pronounced, raising his hands.

  “Cut it out, will you? This is serious stuff.”

  “I know. I know. I’d never joke about stuff like this, man. But you did something beautiful, man. Just hear me out. There are two sides to the equation here, forgive the math analogy, you know I’m a math geek. But on one side of the equation we have something that’s probably a scam, maybe even criminal. We probably will never know the whole truth. And on the other side of the equation, which is your side, you thought you were doing the right thing, you were trying to save her. It’s a beautiful thing, man. You’re a saint, Thomas. Not many people would do what you did in this day and age.”

  Thomas didn’t say anything.

  Mike gazed at him with serious eyes, bringing the matter back to reality again. “You have a picture of this guy’s license plate, right? Text it to me. Let me see if I can dig up something. I got a friend who’s a private detective. The guy used to be a cop. Let’s see who we’re dealing with. You said the man had a gunshot wound to the abdomen, right? Someone like that can be very dangerous. Let’s do a background search and be prepared, just in case.”

  “All right.” Thomas forwarded the picture from his phone.

  “What about the girl? Do you have a picture of her?”

  “You know what. I never thought to take a picture of her. The occasion just never came up.”

  “That’s all right. I’ll have him run the license plate and see what we can get.”

  “That’s a good idea. I didn’t think of that. What else can I do?”

  “Thomas!” Mike raised his voice suddenly. “Listen to me. You will do nothing. You understand? As for the girl, you know the good qualities that you noticed in her mean nothing. That she was well spoken and had good manners means nothing. They could just be a cover. Sometimes the worst type of people are the most polite.”

  “I hear ya. I know, I know. I won’t do anything.”

  “That’s right, nothing, okay? I don’t need to remind you that you have much to lose. Your practice. The twenty five grand you lost, it’s a big chunk, but it’s recoverable. Your ego is bruised but that’s survivable as well. You have to be very careful here on out. Don’t go back to that apartment. Don’t even try to find that guy, the guy with baseball cap. Just forget the whole thing. Promise me.”

  “Okay. Okay. I got it. I know you’re right.”

  “Well, if it makes you feel any better, this sort of thing happens all the time. And just the other night, I saw a National Geographic documentary about pretty girls hooking guys to be drug mules.”

  “I guess I’m still lucky in a way. But it pisses me off, you know. To be ripped off like that.”

  “You’ll just have to believe that they’ll be punished.”

  “Yeah, sometimes I think about it, and I want to shoot that motherfucker in the face.”

  “Just forget the whole thing, okay? Remember all those Sunday school lessons. How Christ teaches us to leave revenge to God. Believe that justice will be done. I don’t know how but just believe. Just get back to routine.”

  “Now that you mention it, that motherfucker also kept making references to Jesus and turning the other cheek.”

  “That’s what you’d expect, right?” Mike said. “The most evil sons of bitches are the ones who Jesus this and Jesus that, all the while screwing people over. I hope they’ll rot in hell.”

  10

  Early on Thursday of the following week, Thomas had to do a thyroidectomy. He got up at six in the morning, after another night of unrest and anger, and arrived at the hospital by seven, determined to get back to his rou
tine.

  As usual, the pre-op area bustled with monitors beeping, voices calling out for equipment, phones ringing, and shuffling of beds as patients were being rolled into operating rooms. Nine beds occupied the entire pre-op area. The patient in the corner, Jeffrey Marshal, lay flat on a gurney, staring at the ceiling. He was a big man, over six feet five and three hundred pounds; he had thick, bushy eyebrows over deep, dark eyes, a large nose, and a rough, full face. And seeing the enormity of Jeffrey Marshal overwhelming the bed, Thomas suddenly questioned himself. Had he done the appropriate work-up before taking the man to the operating room? He remembered faintly that Marshal had agreed to have surgery during those chaotic days when Lana had disappeared. In the chart he saw that Jeffrey Marshal had had knee surgery three months ago, so another surgery should be fine. He decided to proceed.

  Wearing scrubs, Thomas came up to Jeffrey Marshal. A nurse was taking his blood pressure.

  “Good morning, Doc,” Jeffrey bellowed. “How ya doing? Your hands steady this morning?”

  Thomas grinned. “Do you have any questions before we start?”

  “No, Doc. I trust ya.”

  “Do you have any family members here? Anyone I can talk to after the surgery.”

  “They left, Doc. I have someone to pick me up tomorrow.”

  Thomas nodded to him and turned to the chart, filled out the forms, and signed them.

  Then he went to the doctors’ lounge and waited. Even though he tried not to think about Lana, a persistent ache seeped outward from his chest, as persistent as though it were a burnt odor left over from a great fire. The pain simmered in the back of him, behind his face, behind his chest, forcing his mind in one direction, her direction. He found his mind drifting ineluctably toward her, confronting her beautiful face again. The phone rang, and the operating room informed him that they were ready.

  Inside the operating room, Thomas observed the setup. Everything appeared accounted for. Jeffrey Marshal was intubated, and the endotracheal tube connected to the nerve monitor, with a roll under Marshal’s shoulder, his neck hyper-extended, and his skin scrubbed sterile. The strong smell of sterilization fluid saturated the air. The heart monitor was beeping. The respirator that was breathing for the patient swooshed softly. The clank of metal instruments and the voices of the nurses calling out to one another, verifying each step, filled the operating room. Behind a surgical gown and gloves, a headlight, and a magnifying surgical loupe, Thomas stood over Jeffrey Marshal, who was completely covered under a blue surgical drape except for the opening around his neck. Various electric cables that connected to the monitors and intravenous lines sneaked out from under the drape. Thomas palpated the thyroid and felt the bounciness of the cyst that was full of fluid.

  “Marker,” Thomas said behind his face mask.

  The surgical tech handed him a skin marker, and he began to mark the anatomy of the neck: the supra-sternal notch, the thyroid cartilage, the cricoid cartilage, and finally the incision site, three inches long.

  “Injection.”

  The tech handed him a syringe with a mixture of lidocaine and epinephrine. He could hear the heart monitor beeping faster with the injection.

  “Fifteen blade.”

  The knife handle was placed in his hand. Holding it with a steady pressure, Thomas moved the surgical blade over the skin. Under the focused lights of the operating room, blood oozed from the skin edge as the shining blade passed. The intense red contrasted the white tissue beneath the skin. The platysma muscle came next, and after that, the strap muscles were divided and retracted laterally. There it was, the thyroid gland. Thomas freed it from the trachea and severed the connection between the left and right thyroid lobes. The cyst was on the right side, and he began to free the right lobe from its attachment. Everything progressed smoothly. Everything appeared as pristine as it should, ever since the day Jeffrey Marshal had formed in his mother’s womb. It often awed and reminded Thomas that perhaps the only wonders that remain on this planet are inside people. He was grateful that he could be a surgeon, that during residency he had held a human heart beating in his own hands, that he could now put his fingers where no light had ever shone.

  Suddenly, Thomas heard a commotion behind him. Being so focused on the dissection, he hadn’t noticed that something had gone wrong. He turned around, and the aghast face and frantic eyes of the anesthesiologist startled him. A monitor was beeping loudly. Nurses were bustling behind him.

  “Bring the crash cart now,” the anesthesiologist yelled as he kept his eyes on the screen where the greenish tracing of the patient’s heartbeat was jerking erratically.

  “What’s going on?” Thomas said loudly against the noises of other nurses and doctors coming into the room. An OR technician flung the door wide open and pushed the emergency resuscitation cart in.

  “He’s going into V-fib. You should stop and wait,” the anesthesiologist said as he pushed another drug into the IV line. Continuing to watch the heart monitor closely, he drew up different medications into syringes and lined them up. “Start up the defibrillator.”

  Thomas covered the surgical site with a green surgical towel and stepped away from the patient. On the monitor, frantically beeping, the heart fibrillated at over 213 beats per minutes. In another ten seconds, it slowed down; it was now beating at 172 beats per minutes. Then it slowly settled into something approaching a normal heart rhythm—90 beats per minutes. The hushed voices of the nurses and others doctors who had come in to help spoke with a hope that it was over. Relief swept over Thomas, and only now did he feel his heart pounding. Voices became a little louder as other doctors inquired about the patient. Another anesthesiologist was flipping through the chart. The heart tracing on the monitor continued to go into normal range; 75 beats per minutes—the number seventy five flashed on the screen. Then it slowed rapidly, to 55 beats per minute, then 30.

  Suddenly it stopped.

  “Oh my God. He flatlined,” a nurse cried out.

  The heart’s tracing on the monitor flattened out. All at once, the doctors jumped in. They ripped off the surgical drape to expose Jeffrey Marshal’s hairy chest. With a stethoscope, they listened to his heart.

  “He’s going into full cardiac arrest.”

  “Start CPR.”

  A doctor put his hands, one on top of the other with his fingers entwined, over Marshal’s chest and began pumping up and down hard, throwing his weight into it. He started to count, “One one thousand, two one thousand, three one thousand . . .” The thick, heavy chest didn’t move much.

  “Push epinephrine,” the anesthesiologist said.

  “Lower the bed.”

  “Is the defibrillator ready?”

  “Clear.”

  A nurse placed a defibrillating pad directly over his heart and another on the left side of his chest.

  “Clear.”

  Jeffrey Marshal’s body jumped as the defibrillator delivered the electric shock.

  The heart rhythm was still flatlined. Another two minutes passed and more epinephrine was pushed. The defibrillator was recharged and the ‘Clear’ was shouted. The six-foot-five, three-hundred-pound body of Jeffrey Marshal jumped with the discharge of the defibrillator, but the heart rhythm remained unchanged. Another doctor got in to continue the CPR. The cycle was repeated. The resuscitation went on for thirty minutes, with hope for life ticking away with each second.

  As though from a great distance, Thomas witnessed the event unfolding and saw the resuscitation team in action with no particular emotions. The judgment and the inevitable punishment would come later.

  “Let’s call it. Death at nine fourteen.”

  A shock pervaded the operating room as everyone stopped mid-action. Thomas came up next to the body, now as white as though all its blood had been drained.

  “3 O Vicryl suture, cutting needle,” Thomas said to the surgical technician.

  His hands were as steady as ever as he sutured the neck wound closed. Jeffrey Marshal’s family would wa
nt the body to appear as normal as possible for the funeral.

  11

  There is no failure worse than death. It had never left him; the death in Iraq had followed him home, and he was never more certain of this than now. He had caused Jeffrey Marshal’s death, if not intentionally, then at least by negligence, just as surely as he had killed the Iraqi boy. After he had sutured the neck closed, they had gathered four strong men to lift Jeffrey Marshal’s body from the surgical table onto a gurney to be taken to the morgue. Then he had had to sign papers. Finally, sitting in the doctors’ lounge, Thomas took off his glasses and rubbed his eyes. He looked through the chart one more time, searching for any glaring error that he had overlooked, but he found nothing unusual. The EKG, blood work, and the medical history didn’t have any abnormality. Jeffrey Marshal had undergone knee surgery just three months before, and it had been successful and uncomplicated. At last, Thomas called the postoperative nurse and asked if family members were waiting. No, Jeffrey Marshal had no one waiting. Thomas found two phone numbers in the chart and called them both. One number went directly to Marshal’s voicemail, and the other one went to an answering machine in his apartment. Other doctors passed through the lounge and nodded to him sympathetically.

  By the afternoon, news reached the office and caused a great shock to the nurses and to Mike. Except for the occasional surgical complications that occurred once or twice a year, all having been expediently corrected, they had never had a patient die in the operating room before.

  That night Mike came over to Thomas’s house, and they sat at the dinner table going over the chart, to see if anything could have been done differently.

  “Everything looks okay,” Mike said at last. Though the softness of his voice and the downcast eyes signaled something he didn’t want to say out loud.