“Okay, everyone, heart’s closed, let’s get ready to come off the pump. Dr. Holbrook, you still there?”
Brian flicked on the microphone at the same time as he checked the clock. Not yet three hours. A repeat quintuple bypass and mitral-valve replacement in 175 minutes. The diminutive Sikh was a magician.
“I’m here,” Brian answered.
“You have been very quiet.”
“I’m very worried.”
“You have every reason to be. The surgery has gone well technically, but I cannot promise what we will find when we try to start your father’s heart up again.”
“I understand.”
“And you want to stay?”
Brian glanced over at Freeman.
“I’d rather stay than wait someplace else,” he replied.
“We have inserted an esophageal ultrasound probe to give us continuous monitoring of cardiac muscle contractility.”
Brian picked up the binoculars and affirmed that he could get a good look at the ultrasound screen.
“Thank you for letting me stay,” he said hoarsely, gripping the edge of his high-backed stool.
“Begin to slow the pump. Pacemaker on,” Randa said.
“Coming off pump.”
“Pacer at seventy-five. No capture yet.”
“He’s fibrillating. He’s fibrillating.”
“Bad sign. Turn the pump up. Paddles, please. Twenty joules.… Clear!”
“Flat line.… No, wait, there are complexes. Paced rhythm at seventy-five.”
“Contractions minimal. No effective circulation.”
Through the binoculars, Brian examined the ultrasound tracing and felt his hopes sink.
“Bypass pump up,” Randa said.
The surgeon looked up at Brian and shook his head. Round 1 was over. Over and lost. Jack was not going to come off the pump easily. But even more disturbing was the ultrasound. There just didn’t seem to be enough heart muscle left to generate a blood pressure. Fifteen eerily silent minutes passed before Randa ordered the pacemaker to be turned up again and the bypass pump to be geared down. Again Jack’s heart fibrillated. Again it was shocked into a paced rhythm. Again there were weak contractions and no effective movement of blood. Again Randa called for the bypass pump to be turned up. Round 2, lost.
Twenty minutes more. Brian knew in his gut that this would be the last try. The ultrasound continued to show profound weakness of the pumping-chamber muscle. But a test was just a test, he thought. Every patient was different from every other, and Jack Holbrook had once played part of a football game with a broken fibula.
Come on, Pop. Come on, you can do it.
The voices transmitted from the operating room echoed through the observation area, as Laj Randa communicated with his team.
“Pacemaker up to ninety,” he ordered. “Pump down slowly.”
“Pacemaker at ninety.”
“Minimal electrical activity,” the first assistant reported.
“No contractions,” the other surgical fellow observed.
“Volume okay?” Randa asked.
“Perfect.”
“You’re certain?”
“Yes, everything’s working fine.”
“Everything except this heart.”
“Still nothing,” the assistant said.
Laj Randa slumped visibly and turned away from the ultrasound monitor screen. His coal-dark eyes gazed up at the observation gallery. Then he reached up his bloodied, gloved hand and pulled down his mask.
“I’m sorry,” he said. “I’m very sorry.”
PART TWO
CHAPTER NINETEEN
NBC NIGHTLY NEWS
The Medical Report
“The White House has confirmed that the President will be joining FDA chief Alexander Baird at the ceremony next week at which the highly publicized miracle cardiac drug Vasclear will be approved for general use. The drug, developed and manufactured by Newbury Pharmaceuticals of Boston, reportedly melts away the arteriosclerotic plaques that clog coronary arteries and cause heart attacks. According to sources at Newbury, the drug has cured seventy-five percent of test cases.
“White House Chief of Staff Stan Pomeroy says that the Vasclear ceremony will take place at White Memorial Hospital in Boston, site of most of the medication’s clinical testing.
“Senator Walter Louderman, a vocal advocate for early release of the drug, has expressed surprise and pleasure at what he calls the administration’s ‘sudden turnaround in policy regarding a treatment so desperately needed and awaited by so many Americans.’…”
BRIAN SAT SLUMPED ON THE COUCH IN THE LIVING room, chewing on a piece of day-old pizza, barely cognizant of the news program. The living room, dining room, and kitchen of the Reading flat were filled with flowers and baskets of fruit in varying states of decay, and the walls were covered with sad reminders of good days and bad. Teri had sent both flowers and an assortment of cheeses and crackers. She had called several times and expressed her sorrow that her boss at the FDA did not feel it was appropriate nor in Brian’s best interests for her to attend the funeral. Brian responded that her calls and concern meant much more to him than her presence at any ceremony.
A week had passed since Jack’s death—four days since his funeral. Except for the actual day of the funeral, the time had plodded by for Brian. There was no way that anyone except Freeman Sharpe could fully understand his inner turmoil and intermittent despair.
One bittersweet note during the week was that Phoebe had been a rock, bringing food over, tidying up the place, making certain Becky and Caitlin were available to Brian as often as he could handle them, and dealing with out-of-town visitors when he could not.
“A very classy act,” Freeman had called her.
“You mean very classy wreckage of my past,” Brian had corrected.
Over the nearly two years since their separation and one since their divorce, this was the most time they had spent around each other. And there were moments during the week when the pain of realizing what he had lost in Phoebe and his family life hurt almost as much as did Jack’s death.
Freeman emerged from the bathroom with his shaving gear and stuffed it into his overnight bag. Their NA group had made sure Brian had not spent a night alone in the flat since the funeral. But now, after staying with him for a day and a half, his sponsor felt he was ready.
“Did I hear something on the news about that drug?” Freeman asked.
“ ‘Miracle drug cures everyone on East Coast except one.’ ”
“Will you put a lid on it?”
“Sorry.”
“Poor me, poor me, pour me.”
“I know. I know.”
“You’ve got to stop blaming yourself, Brian. You made a choice—an informed choice—and it didn’t work out the way you had hoped. It isn’t like you were showing off quick draws with your gun and it went off and shot your dad.”
“I know. I’m just having trouble hanging on to it is all.”
“You going to be okay if I go home?”
“Fine. I’m a little uptight about being on the schedule tomorrow at work, but I don’t think they’re ready for me to stay out too much longer.”
Sharpe settled down on the far end of the sofa.
“You’re better off at work than hanging around here, anyhow, that’s for sure. Look at it this way—every meeting you’ve gone to this past year and a half, every minute you’ve spent meditating or talking with me or doing something else to take care of yourself and affirm that you’re a worthwhile person, has been like putting money in the bank. Now, for a time, you’re gonna be living off the interest on those deposits or whatever you need to withdraw.”
“What if I don’t have enough?”
“You do, Brian. I’ve been around for quite a while, and you’re just going to have to trust me on that one. You do. But you gotta stop beating up on yourself. That takes a toll. And for God’s sake, whatever happens, remember that there is nothing so bad going on in
your life that a drink or a drug isn’t gonna make it worse.”
Brian thought for a time, then crossed to the bookcase, pulled a thick volume out, and reached in where it had been. Then he flipped the plastic vial of painkillers over to Freeman.
“Jack’s old cardiologist had prescribed these for him. I hid them in there after the funeral … just in case.”
Sharpe glanced at the label on the vial, then calmly took the pills into the bathroom and flushed them.
“Good move, giving those to me,” he said. “Especially before you took any of them. Believe it or not, that’s the way it’s supposed to work. I think you’re gonna be just fine, my friend, as long as you promise to call me if you’re feeling shaky. Any hour.”
“I promise. And thanks, Freeman. Thanks for being there for me.”
Freeman shook Brian’s hand and patted him on the back.
“I only wish you could have met the badass dude who was always there for me when I was first coming around,” he said.
For a time, Brian paced the apartment, feeling nearly overwhelmed by the oppressive silence. He played and replayed the years of Jack’s illness over in his mind. Long before the decision to try Vasclear rather than surgery, there were so many steps, going back to the very beginning, where something could have been done differently. Would any of them have changed the ultimate outcome of his disease?
You made a choice—an informed choice … you gotta stop beating up on yourself.…
The phone had rung twice before Brian was even aware of it. For no other reason than self-pity, he decided to let the answering machine do its job.
“Brian, it’s Teri. If you’re there, please pick up.”
Brian dove for the phone beside Jack’s chair, taking out a brass table lamp in the process. Teri had called the day after the funeral, but they had not spoken since.
“Hey, it’s me. I’m here. I’m here.”
“Well, hi, there, Here. How’re you doing?”
“The truth? I’ve been better. Lots better, actually. I’ve been trying to decide whether to run a few miles, run the tub, run away, or run my car into a bridge abutment. All in all, not my best night.”
“Do you have company?”
“Not as of half an hour ago. My friend Freeman just left.”
“Want some?”
“Oh, lady, your timing couldn’t be better. I would like that very much.”
“I just checked into the Newton Marriott on one-twenty-eight. The people here tell me I can be there in twenty minutes.”
“You need directions?”
“I’ve bought a good street map. You’re on it. Do you really run, even with your knee?”
“I lope. And my knee sort of decides whether it wants to come or not.”
“Well, I brought my stuff along. Would you do a few miles with me?”
“That depends. Define few.”
Forty minutes later, they were jogging side by side through the darkened, largely deserted streets of the town.
“I’m very flexible when it comes to distance runs,” he had told her while they were stretching. “I have my two-mile, my two-and-a-half, my two-and-three-quarters, and my three with or without a rest stop. How far do you usually run?”
“It doesn’t matter. Let’s do the two-and-a-half.”
“I can tell you want to go farther. Three. I’ll be happy to do the three without a stop. Now, tell me. How far do you run usually?”
“Well, I don’t run all the time. We have a sort of loosely organized running club at the agency and—”
“Enough said. I know those running clubs. Twelve miles over the lunch hour, then a raw-egg-and-liver shake, a shower for those few who broke a sweat, and back to work. We’ll do the three.”
Teri moved with the lithe, easy stride of a seasoned runner, relaxed and beautifully coordinated. Brian worked to keep up, but he knew she was holding back. It was a perfect autumn night, moonless, cool, and still. And from the moment they took their first steps he knew that this was exactly what he needed to be doing.
“You can go on ahead if you want,” he said, slightly breathless after the first mile or so. “Maybe work up a sweat.”
“This is fine. Stop me if I talk too much. When I run with the club, we sort of do it in twos and threes and gab all the way.”
“So long as we don’t talk about the hospital. I’m going back in early tomorrow. That’ll be soon enough.”
“Deal.”
“You know,” he said, “when my mother died, I was so worried about Jack that I really didn’t have time to mourn her. Now, it seems like both their deaths have hit me at once.”
“Well, Jack wasn’t just your father, either. You took care of him. It was like losing a parent and a child at the same time. Two parents and a child, from what you say.”
“I’m really glad you’re here tonight. And I’m glad we’re doing this. It bothers me, though, that your shoes barely make a sound when they strike the pavement. Mine sound like a pair of beavers slapping out the warning of an approaching wolf.”
“Ten,” she replied.
“What?”
“Ten. That’s how many miles we usually run over lunch. Not twelve. If you ran that much, your feet wouldn’t make any noise, either.”
Throughout the three-mile loop, Brian’s feeling of connection to Teri deepened. And somewhere during the last mile, he realized that, purposeful or not, running together at night this way was foreplay. Two blocks from home, he sprinted past her.
“Hey, what’s the rush?” she called out.
“Guess,” he yelled back.
Teri beat him to the porch by ten yards, then had to hold him up by the waist and help him into the living room while he caught his breath.
“You are good,” he panted.
“You don’t know that, yet,” she said, as she made him bend over and peeled off his sodden shirt.
“I’m totally gross.”
“It’s okay,” she replied, raising her arms over her head so that he could do the same for her. “I’m a doctor.”
She slipped off her running bra, then knelt in front of him and untied his running shoes. Then slowly, slowly, she pulled down his shorts and his jock. He was instantly rigid.
“In case you can’t tell,” he said, “I’m a little out of practice and easily excited.”
She ran her lips up his body to his mouth. He hooked his thumbs in her waistband and lowered her shorts.
“I’m not so used to this myself,” she said, pressing his face against her damp hair. “I don’t know if I should be proud or embarrassed about how long it’s been for me.”
Standing there in the living room, their clothes still around their ankles, they kissed again and again, exploring each other with their fingertips. Finally, they kicked off their running shoes and rid themselves of the rest of their clothes.
“The moment I saw you at the hospital I wanted this to happen,” he said.
“So did I, in case you couldn’t tell. I’m just so sorry I couldn’t be with you this week until now.”
“You’ve made up for it already. But if you function better from guilt, feel free to hang on to it.”
He led her into the bathroom Jack had remodeled just a few years ago. The floor was carpeted. There was a good-sized, claw-footed tub and across from it a large stall shower, done in light blue ceramic tile. They chose the shower.
“Cold, warm, or hot?” he asked, unable to keep his hands off her.
She held his erection in both her hands and stroked him as she kissed his lips again.
“Whatever temperature will keep you just like this,” she whispered.
They soaped each other front and back, and shampooed each other’s hair. As the steaming water cascaded off them, he drew her up to him and kissed her deeply. Slipping his hands beneath her thighs, he lifted her up. She wrapped her legs around his waist and her arms about his neck.
“Can you do it like this?” she whispered.
“I
don’t know. But as long as there’s no Romanian judge giving out style points, I can try.”
He lowered her down onto him.
“A perfect fit,” she said dreamily. “And look, there’s a little Romanian-looking guy standing over there behind you, holding up a card with a ten on it.”
CHAPTER TWENTY
BRIAN ARRIVED AT THE HOSPITAL BEFORE SEVEN DESPITE staying up much of the night talking with Teri and making love with her. He still knew much less about her than she did about him, but he had learned that a long-term relationship with an Air Force pilot had soured about a year ago, and that since then she had spent more time avoiding men than she had dating them.
“I’m looking for quality,” she said. “Not quantity.”
Brian was missing her already.
He went directly to the ward and began his first day back by reviewing the charts of the seventeen patients being treated there. The staff was concerned and supportive toward him. Everyone, it seemed, knew the circumstances of his father’s death. When Brian finished his chart review, patient rounds were not yet ready to start. He went down to the mail room to claim the stack of mail they had been saving for him. Then he hauled it back to the ward and dropped it onto the coffee table in the small faculty lounge. Between Jack’s death and his newfound lover, he was having a tough time concentrating on much of anything. Maybe opening a few dozen envelopes and reports would bring him in for a landing.
Simple tasks, he reminded himself, repeating advice he thought he might have learned from his father. When all else fails, break life down into simple tasks and do them one at a time.
The mail pile included some dictations to be reviewed and signed, hospital bulletins, two thank-you notes from patients, and a dozen cost-free magazines, newspapers, and journals, all of them subsidized in one way or another by the pharmaceutical houses. In addition, there were a number of computer-generated laboratory and X-ray reports. Brian worked his way through the results one at a time, having learned from one bitter experience early in his residency the danger of losing focus, however briefly, when reviewing test reports.
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