"Yeah," I said, looking back at the house, "I know that."
Chapter 48
nnie lay on a reclining chair, surrounded by pillows and a blanket, a picture of Emma ten years ago. I sat down and she sat up. "Annie, I want to tell you a story."
Cindy sat close by, elbows on her knees, hands tucked under her chin.
"When I was your age, I fell in love with a girl whose heart was very much like yours."
"What? You mean sick?"
"No." I shook my head and smiled. "Full of love."
Annie smiled too, enjoying the game we seemed to be playing.
"As we grew older, we did discover that her heart was like yours in another way. It too was sick. Very sick."
"As sick as mine?"
"In some ways, worse. In other ways, not so bad. On a scale of one to ten, you two are bringing up the bottom end."
Annie nodded like she already knew that.
I continued. "So, thinking I could make her better, I spent most of my life studying how to do just that. Eventually . . . I became a doctor ... and got pretty good at fixing sick hearts."
Annie began to look confused and listened more intently.
I took her hand and placed it inside mine. "I even took good hearts out of brain-dead people and-"
Annie's face turned white.
"-put them in people who needed them."
Her look of disbelief grew.
I nodded. "Dr. Royer was my partner and-"
Annie interrupted me. "You're the miracle maker?" She looked around the room as the conversation swirled about her mind.
"Let me show you something." I held out my hand and led her to the office. She turned in a slow circle, looking all around. I started to speak, but she stopped me.
"How come you didn't ... why.. ."
I picked up a picture of Emma, taken just weeks before she died. "Because I made some mistakes and ... I've never really stopped paying for them."
Annie looked at the picture, then at me. "Did your wife die because of something you did?"
I stood for a moment while the question settled in me. "Yes."
"Did you do something wrong?"
I nodded.
Annie sat down and looked around the room for several minutes. Finally she stood and walked into my arms and laid her head on my shoulder. She was pale, tired, breathing shallow breaths.
I carried her out to the porch and set her in a chair. Cindy wrapped her in a blanket. Annie finally opened her eyes and looked at me. The look was transparent and deep, and both scared and soothed me. Finally she said, "Will you be my doctor?"
For the first time in more than five years, I took in a breath deep enough to fill me. "Yes."
Chapter 49
month passed. A month of long days, quiet nights, and every minute attuned to the possible rattling hum of a pager vibrating across the tabletop. To simplify all our lives, Cindy and Annie stayed at my house. With no mold in the air, Annie improved slightly, even regaining some strength. Cindy too. She relaxed, slept a little more, and some of the color returned to her face-a face that never failed to greet me with a smile. Charlie seemed to like his new neighbors, because most nights he'd entertain its with his humorous antics and harmonica.
I gave Termite a job planing the wood at my warehouse up in the hills and working with Charlie and me on the Hacker. He was good too. And when Annie, standing atop the boathouse, told him that I was going to be her doctor, he thumbed a cigarette and slammed the Zippo across his thigh. When he had drawn deeply, turning the tip bright red, he exhaled away from her and looked at me, his eyes misty. "That's good."
Sometimes I think that hell is two places: it's a place you end up, but it's also a place that you live before you get there. I don't know if the devil's got horns and a spear for a tail, but I don't think that's the point. The point is that hell is separate from love. If Lucifer knows anything, he knows that. And ever since Emma left, I'd known the same thing. It's a lonely, desolate place.
With Annie and Cindy roaming about my house, making things pretty, fussing over things that had never been a concern, something inside me stirred. It had a sweet smell. A sweet feeling. And every night, while they slept in the room next to mine, I walked to the dock and basked in the warmth of it.
Because Cindy had learned how to save money on just about everything, I sat on a chair atop the boathouse one afternoon and succumbed to a haircut. A real one. She cropped it close around my neck and ears. Emma would have loved it.
Charlie ran his fingers over my head and said with a smile, "I remember you. Seems like we've met somewhere before."
I also hung a mirror in the bathroom and shaved. And when I walked back downstairs where the girls were setting the table for dinner, I noticed Cindy watching me out of the corner of her eye.
Charlie returned to his old self and, despite his confession regarding rowing, met me every morning on the dock. Not a day went by that he didn't pop in unannounced and uninvited. He resumed his bingo nights and dancing lessons; one afternoon he waved his cane from his dock. He was dressed in the blue and white seersucker suit, top hat, penguin wingtips, hair slicked back.
"Your hair looks rather slick," I said. "You need some help changing that oil?"
He smiled and turned around like a model on the runway. "Nope, I change it every three thousand miles whether I need to or not."
We ate several times a week at The Well, where Davis created a new menu item called the Annie Special: grilled chicken, mustard, French roll, with a side of coleslaw and one scoop of chocolate ice cream.
I walked in and out of my office without ever locking it and took to the pager and cell phone as though I'd never put them down.
Royer came up once a week to eat, check on Annie, andprobably more important-check on me. After about three weeks of that I finally walked him to his car, looked at him, and said, "Royer, it's me. I'm okay."
He said, "You sure?"
"Well ..." I shrugged. "Given everything that's gone on, I'm not hooked on any drugs, don't want any, and ... other than a recurring dream, I'm sleeping at night."
That was good enough for him.
Chapter 50
y patients used to ask me why most transplants occur at night. It's simple, really. During the day, the loved ones are waiting for test results conducted by medical personnel who work primarily during the day. When those results show that the patient's body is not responding to large amounts of carbon dioxide buildup in their system, and the brain is no longer responding to the most fundamental of tasks, only then is the "brain-dead" declaration made. This is often a difficult diagnosis to accept, but the sight of a loved one kept alive solely by a piece of cold, hard machinery is often the final straw.
That final straw tends to fall at night, after the hospital has quieted and the family is left alone with their thoughts and the possibilities of the future. That's when they make their painful peace and contact their doctor, saying they'd like to donate. Then the hospital performs its own battery of tests, determines whether or not the patient is a viable donor, and lists him or her. By the time that's all done, it's somewhere around the witching hour.
Rarely did I get a call to go pick up an organ at nine in the morning. It just never worked that way. So when my pager and cell phone rattled simultaneously at 2:00 a.m., I wasn't surprised.
"We may have a heart. In Texas. A twenty-six-year-old woman. Husband says they were in a car crash. She wasn't wearing a seat belt. EEG's been flat since this morning, team down there wants to declare her brain-dead as soon as they've prepared the family for the possibility. Coordinator talked to the husband. He'll donate."
"They know how we want the body managed?" I asked. "Nobody does anything until you or I get there?"
Royer chuckled; it was as if five years had not passed without a phone call between us and we had made a midnight run as recently as last night. "Yeah, but I think it better be me. Annie needs you with her. The last face she sees before the drip tu
rns out the lights should be yours."
"Yeah, I'm with you."
"I told them which antibiotics to give and how we want the fluids handled. I'm waiting on urine output, and central pressure readings now. I'll call you back in five."
I hung up the phone and pulled an old pair of blue scrubs from the closet. They were a little baggier than the last time I wore them.
Cindy walked in and saw me staring at myself in the mirror. Her flannel men's pajamas looked warm and comfortable. She eyed the phone, then me.
"It was Royer," I said, but held out my hand in caution. "We don't know enough yet. Might be a false alarm. Anytime that phone goes off, chances are better that it's not a match than that it is. Remember that."
Cindy folded her arms and nodded at my scrubs. "That why you're wearing those?"
I shrugged and said, "'Course, it might be too." I looked at the phone, almost willing it to ring, and five seconds later, it did.
Cindy jumped, and I answered it.
"What do you know?"
"Liver and kidney functions all normal. Serologies on hepatitis and AIDS are negative. The girl's clean. We're a go."
"Dopamine?"
Dopamine was a great drug. In a donor, it made the heart pump harder, raised blood pressure, and increased blood flowing to the brain. But if used to excess, it could damage the heart.
"Currently, she's on a small dose, but as they rehydrate her over the next few hours, she'll be weaned off that."
"I've got.. ." I looked at my watch and unscrewed the pin to set it. "1:57 a.m ... right now." I heard the clasp snap shut on Royer's Omega Seamaster. Knowing we'd be in touch at least every thirty minutes during the next six hours, we had to be precise.
"Me too," he said.
"You take care of everything at the door? I don't want any delays when we get there. Nothing to cause Annie any stress. I want a rolling seat and a fast track."
"Done," Royer said. "They'll meet you at the door."
"Blood bank?"
"They've got sixteen units of packed red blood cells."
"Sixteen? We've never needed more than six."
"Yeah." Royer laughed. "I wish all of them were this easy. Folks around here have taken a liking to Annie. They want to make sure she's got all the chances she needs. A week ago, there was a line out the door of nurses and doctors waiting to give blood."
"That little girl has touched a lot of hearts," I said.
"You might say," Royer agreed, letting it sink in. "You all get down here, but you better not cut skin there until I'm sure of what we have in Texas."
"Agreed." I thought through our trip south to Atlanta. "And Life Flight?"
"In the air. Took off seven minutes ago. Should touch down in about thirty-eight, give or take a couple for wind and whatnot."
"Same pad as before?"
"Yup. You guys get dressed, take a few minutes to get comfortable with the idea, and then get on down to the pad. We'll talk in thirty."
I held the phone and realized that I had just had the conversation I had waited my whole life to have. Mixed emotion joy and sadness-fell on me in equal parts.
Royer heard it in my hesitation. "And Reese?"
"Yeah."
"I wish this was five years ago."
I looked out the window over the lake, which sat silent and unrippled beneath a quarter moon. My voice fell to a whisper. "Me too."
He took a deep breath, and I knew what was coming before he said it. "Hey, Doc?"
"Yeah," I said.
"It's time to put on your chinstrap, get off the bench, and get in the game."
The fatherly kick in the pants felt good, and brought me back. "Talk to you in thirty."
I hung up, and while Royer boarded a Learjet with a red-andwhite Igloo cooler, I walked into the room next door and shook the shoulder of a little girl who sold lemonade, raised crickets, and called most of a town by their first names.
Chapter 51
grabbed my just-in-case bag, Cindy grabbed their small suit case, and I carried Annie, wearing pink sweats and sockslippers, to the Suburban. Then I took one look at the lake and at Charlie's dock, because I knew he'd heard the phone ring.
Sure enough, Charlie, wearing his pajama bottoms, was leaning on a canoe paddle and scratching Georgia's head, listening to us load up. I walked slowly through the trees, the branches brushing my face, and onto the bulkhead.
Charlie heard my footsteps and pointed his chin at me.
"Hey, buddy," I said.
"That time?"
"Maybe. Won't know for an hour or so."
"When you do, holler. I'll spread the word." He waited to hear my footsteps walking away. When he didn't, he nodded, and we stood in the silence separated by the water. Finally he whispered, "Reese?"
"Yeah?"
Charlie wiped his eyes and scratched one arm. "Can you see?"
His words echoed off the water and then drifted off, following my sailboats onto the Tallulah, where they ignited, flamed, and then sank.
I knew what he was asking. "Working on it."
Charlie nodded, whistled Georgia up ahead of him, and climbed the steps to his house.
I got into the car, and we idled down the gravel drive to the hardtop that would take us the six miles to the hospital helipad. Annie and Cindy sat in back, huddled together, their eyes reflecting the dash lights through the rearview mirror. In my mind I began walking through the process, every stitch, snip, and reading. Every detail, no matter how small, held significance because there were no second chances.
I looked at my watch. Royer would be on the plane, talking to the coordinator, and he would be with the donor in an hour. In two hours, he would recover the heart, and be back at the hospital in four. Bottom line, we had time, but not much wiggle room. Once he placed the heart in that cooler, ischemic time started ticking. After four hours ischemic, too much damage had occurred to the heart to make it viable. We reached the outskirts of Clayton and pulled into the Rabun County Hospital. Life Flight was sitting at the pad, lit up like a huge white bird, the rotors slowly spinning. The pilot, Steve Ashdale, whom I had known well at one time, stood alongside, body erect and his clothes creased with starch. A product of several thousand hours' flying helicopters for the marines.
We parked, and I carried Annie to the helicopter. Steve shook my hand and smiled. "Good to see you. Royer filled me in. Let's get airborne."
Ordinarily, Life Flight helicopters are only large enough to accommodate two medical personnel-one of whom also happens to be a pilot and up to two patients, depending on the extent of their injuries. Due to the expansive sprawl of the Atlanta area and the need to fly greater distances, this bird had been designed a bit bigger. We had room to spare.
I placed Annie on the cot that lay down the middle of the helicopter, and Cindy and I took our seats on either side. Steve pointed to our seat belts and headphones, and we put both on. We lifted off, swayed backward, tilted forward, and sped through the night. He pulled higher, and within seconds Lake Burton stretched out beneath us.
Steve spoke. "Sure is pretty at night." He pointed at the trout hatchery and the green meadow next to it, now covered in darkness. "Set down there about three years ago. Good pad too."
Cindy gripped the handles, watched Annie, who was peeking out the window next to her head, and took purposeful and deep breaths.
"First helicopter ride?" I said.
She nodded. "And last, hopefully."
Annie grabbed my hand. "What's Dr. Royer doing right now?"
I wondered how to best answer her question. "He's flying to Texas, to go get your heart."
Annie pulled me closer and spoke quietly into the microphone that looped around her face from ear to lips. The sound of the motor and rotor blades made a dull roar above us.
"No," she said, "tell me what he's doing."
The heart was going inside her; I figured she had a right to know. "You sure?"
She thought for a moment, then nodded slowly.
> "Right now, Dr. Royer is flying to a hospital in Texas. Once there, he'll open up the donor, inject a solution into the heart to make it stop, and the doctor across from him will declare a time of death."
Annie swallowed hard, and a tear puddled in the corner of her eye.
"Then he'll pour buckets of ice-cold saline onto the heart to try to get it as cold as possible. About five liters of real cold stuff. What they call either Ringer's lactate or normal saline."
The detail seemed to lessen the personal and emotional blow for Annie, and for Cindy, who couldn't help but listen.
"It won't take him but a couple of minutes to cut out the heart. The instant it's cut free, ischemic time starts-when no blood flows to the heart. From then on, every second counts. He'll put the heart in a sterile bowl, rinse it thoroughly to get rid of the old blood, stick it in double plastic bags, and then into a red-and-white plastic container-like the ones you see at the beach."
Annie attempted a smile.
"Then he'll hop back on that same plane and jet back to Atlanta, where you and I will be waiting for him."
Annie swallowed. "What's going to happen to me?"
"We'll get you to the hospital, whisk you up to your room, put you to sleep, and in a few hours, you'll wake up with a new ticker."
"That's not what I meant."
I thought for a moment. "Do you believe in the tooth fairy?"
Annie shook her head.
"Remember when you used to?"
She nodded.
"Well, let's just say that I still believe in the tooth fairy, and sometimes the best things happen while you're asleep."
Annie looked out the window into the darkness that was speeding beneath us at just over a hundred miles an hour. A few minutes later she asked, "Do you know anything about the person in Texas?"
I nodded.
Annie's eyes waited expectantly while her shoulders tensed.
"Somebody who was in a real bad car accident, who's not ever going to wake up, who's alive because there's a machine keeping her alive, and whose loved one wants you to have a new heart."
(2006) When Crickets Cry Page 26