Noble Vision: A Novel

by Gen LaGreca

  The clapping ended as the wheels of the gurney stopped.

  “We’re in the operating room,” said her attendant.

  She felt hands sliding her onto a narrow table. A sudden warmth on her face was the only indication she had of the overhead lights.

  As a child, whenever her universe seemed to be collapsing, she would remember the music of her first ballet and the promise it held of a better world. She finally entered that world with the strength of her one abiding ally: her ruthless will to fight for her dream, whatever the struggle. But in her current battle, she would have to do something harder than fight; she would have to step aside. It seemed odd to relinquish the stage, and with it, her fate, to the performance of another. This time she heard two sounds calling her: the music of her first ballet and—

  “Where have you been, Nicole? I was beginning to think you made another engagement for the evening.”

  The Voice was somewhere in the room. It was not the things the Voice had said that gave her hope. The words of the Voice were grim: There were no guarantees; the treatment was experimental; her chances were slim; the odds were against her. However, the tone of the Voice was another matter. When it spoke of the animal experiments, the newly discovered growth protein, the outmoded beliefs about nerve repair, and the possibilities for the future, then the Voice possessed the same vigor as the music of the prince.

  “Are you ready to be a medical experiment?” The Voice bore no trace of gloom; it seemed to be coming from a ballroom, asking her to dance.

  “I’ll do better than your animals, Doctor, you’ll see. They didn’t want their nerves repaired as much as I do.”

  “And you’ll keep your vital signs steady. That’s your part of the bargain.”

  “My vital signs have always been steady.”

  He clasped her hand in his. “You’re not afraid anymore, are you?”

  “No.”

  “That’s quite a change from before.”

  “I trust your voice.”

  He squeezed her hand.

  “And you’re not afraid, either. Are you, Doctor?”

  “Why, no. But I am indignant. Those optic nerves of yours can’t just up and quit, not without a fight. And may the best man win.”

  She laughed softly, and the sound of it made him want to battle a hundred optic nerves, one hundred against one!

  She heard the first tone of regret when he touched her hair. “You remember we mentioned—”

  “It’ll grow back.”

  “I was going to say that to you.”

  She laughed again—a mere little puff of air expelled from her lips, a sound that he could make an occupation of evoking.

  “Are you ready to go to sleep, now, Nicole?”

  “Yes.”

  “I should be waking you sometime tomorrow morning, maybe not in time for breakfast, but surely before noon.”

  “There’s no hurry. I once played the role of a princess who slept for a hundred years.”

  “So, you think I’m that slow, do you? Well, I’ll show you. I’ll wake you while you’re still young and . . . beautiful.”

  She smiled in his direction. It was the radiant smile of someone who believed in miracles.

  He nodded to the anesthesiologist waiting at the side of the table. She placed a mask over the patient’s face. “Nicole, breath deeply, dear.”

  Nicole was clutching David’s hand. In an instant, her fingers loosened. She felt her hand slip away, and with it, the last, faint melody of the ballet.

  David scrubbed his hands at the sink outside of OR 6. Two doctors passed, talking about a case. A nurse asked someone for an instrument. A technician discussed an X ray. An intern quoted a baseball score. David heard nothing. He envisioned two long, fragile nerves, each containing a million fibers within the width of a child’s thumbnail. He thought of how he would realign and reattach the fine tissue, then implant the growth protein in the timed-release capsules. Tonight he would call nature back for an encore of the acclaimed performance that had played in Nicole’s brain before birth, when her nervous system had grown with abandon.

  The operating room was as quiet as the ether in space, except for the beep of Nicole’s heartbeat on the monitor. David’s body was completely covered in garments, except for the one feature left exposed: his eyes. They scanned the room that was both his battlefield and his altar. Three people were ready to follow his cues. The life of the slim form under the blue surgical cloth was in his hands. He was about to do something that he wanted desperately to do, had trained for years to do, and most gloriously believed was right to do. His eyes found their target on a shaved head covered with a brown antiseptic ointment and positioned firmly in a frame. The tension, pain, and anger had vanished from his body. He felt nothing but an arrogant self-confidence at the prospect of opening that skull. His eyes did not move from the bare head. They would remain fixed on their target through the long night.

  “Scalpel, please.”

  * * * * *

  At 6:30 the next morning, while David was still operating, word of the revolutionary surgery in OR 6 was spreading to the hospital staff members arriving for work. The anesthesiologist told her boyfriend, a cardiologist, when she stepped out to speak to him. The circulating nurse told a friend whom she met at the autoclave. The surgeon who had arrived to set Nicole’s broken nose told a resident at the scrub sink. The resident phoned his sister, a television news editor.

  At 7:00, when Randy Lang arrived for work, reporters were waiting. Having just called the OR, he knew that David was completing the operation, so he confirmed the rumors about the experimental surgery.

  “Can you comment on how this new procedure can come on the heels of the secretary of medicine’s crackdown on the doctors?” asked one reporter. “We’ve heard that the treatment uses untested drugs and—”

  “I’m glad you asked,” replied Randy, “and please mention this in your reports: The new surgery performed at Riverview Hospital was done with the knowledge and consent of the secretary of medicine himself. The surgeon personally received the secretary’s permission last evening.”

  * * * * *

  At 7:30, while the secretary of medicine was eating breakfast in his Manhattan penthouse, the phone rang. He alternated between working from an office at the state capital in Albany and another in Manhattan, keeping residences at both locations. Before he could speak, the caller railed at him.

  “What the hell do you mean by this double-cross, Warren?”

  “Why, Governor, what are you talking about?”

  “Have you seen the news this morning?”

  “Not yet. I was just having breakfast. Are you talking about the gas explosion?”

  “That was yesterday’s news, Warren. How do you expect to make the big leagues if you don’t check the news before you pee in the morning? I’m talking about an experimental surgery performed last night in Manhattan! What’s its price tag and how many people are gonna clamor for it?”

  “What?”

  “And you authorized it! Right after you made your little speech about strict adherence to the rules, about sacrifices, about stringent controls over surgeries—you caved in! Every reporter in the state will be laughing at us. What are you gonna do with the doctors now, when they know they can walk all over you?”

  “I didn’t authorize any new surgery. I don’t know anything about it.”

  “Come on! The surgeon said you personally approved it.”

  “I most certainly did not authorize any new surgical procedure.”

  “He says you did.”

  “He’s a liar.”

  The voice on the line paused, and then sounded calmer, even cheerful. “Can I quote you on that, Warren?”

  “Certainly, Mack. Tell the press, as I will myself, that I have given no doctor permission to do any new surgical procedure and that performing an experimental operation not authorized by CareFree is an endangerment to the public welfare.”

  “And you won’t make a
ny exceptions?”

  “Of course not! I stand by my word.”

  “Then I can count on you to take the course of action you discussed yesterday? You know, the matter of . . . severe punishment?”

  “The guy is automatically suspended as a CareFree provider, which means he can’t work in New York, and no other state will license him after my censure. Then we’ll review the case and decide on appropriate measures. We need to set an example, so the other doctors will know we mean business. Imagine forging ahead before we’ve reviewed the safety and effectiveness of his procedure! He’s unscrupulous.”

  “I’m glad we agree, Warren.”

  “By the way, who is he?”

  “David Lang.”

  The secretary of medicine gasped.

  Chapter 13

  The Morning After

  The August sun already hung high in the sky, and the operating rooms were busy with a full roster of morning surgeries when a nurse wheeled Nicole into the recovery room. A red-eyed man in hospital scrubs leaned over the frail patient with the bandaged head.

  “Nicole, can you hear me?”

  Her head throbbed beneath what felt like a turban. She opened her eyes but saw nothing. From a distant place, she heard the Voice calling her.

  “It’s over, Nicole.”

  She tried to reply, but the body that she daily pushed to its limit struggled to find its voice.

  “Can you hear me?”

  “Yes,” she whispered.

  “Squeeze my hand.” Two fingers tapped her limp hand. “Come on, squeeze.”

  Drifting in a fog between sleep and wakefulness, she forced her five limp fingers around the two intruding ones and softly pressed.

  “Very good!”

  The Voice was pleased, she thought dimly.

  “Now the other hand. Squeeze.”

  Continuing to pester her when she wanted only to sleep, the two big fingers rapped on her other hand. Again five weary fingers made the journey around the two persistent ones to give a little tug.

  “Excellent! Now wiggle your toes.”

  Ten toes flexed.

  “Outstanding!”

  The Voice seemed pleased with the strangest of things.

  “The nerves are reattached and the growth protein is in place, Nicole.”

  “This . . . means . . . I might . . . ?”

  “It means you have a chance. We won’t know until after the second surgery.”

  “How did . . . it . . . go?”

  “Very well! You kept your vital signs steady, and I finished in less than a hundred years. I’m pleased with both of us.”

  She felt the warmth of his hands covering one of hers.

  He held her hand still, but what he really wanted was to pull her up to dance. He thought of his first hopeless experiments seven years ago, of the lonely nights spent in a dingy lab, of the countless failures over the many years when he had nothing to kindle his dream but his own stubborn vision of what might be. Then he thought of the past night in the OR, of how he worked smoothly, precisely—almost effortlessly, were it not for the seven years of honing his efforts so that he could experience the most glorious moment of his career.

  “The procedure worked exactly as I had hoped,” he continued, his voice sounding as fresh as daybreak to her, his puffy eyes and unshaven face hidden from her view. “Everything went just—” He suddenly lost his voice when a figure appeared at the doorway. “—fine,” he finished an octave lower, staring at the block of ice that was his brother’s face.

  Nicole felt his fingers tighten over her hand. Something seemed to be wrong.

  “I heard footsteps,” she whispered. “Who is it?”

  Neither man answered.

  “Who’s there?” she repeated uneasily.

  “It’s someone I have to talk to, Nicole, so I’ll let you rest.”

  The cheerful tone of the Voice had vanished, and a disturbing thought seeped into the fog that was her mind. “Did you . . . get in . . . trouble?”

  “The operation went smoothly; neither one of us got in trouble.”

  “I mean . . . the . . . law.”

  He hesitated because the face staring at him from the doorway now looked like a portrait drawn by an enraged artist.

  “Doctor . . .” She pulled his hand toward her, crimping the IV drip and setting off an alarm that startled her.

  A nurse approached to assist. “Easy, Nicole. Don’t bend your arm, or it will kink the IV. Just move within the limits it allows.”

  “Doctor . . . tell me! Are you in . . . any . . . danger—” A cry broke her voice.

  “Don’t worry, Nicole. I’m sure everything’s fine.” David patted her hand and forced a laugh, while Randy’s violent eyes swept over the tender scene like a raging storm. “Now you must forget I mentioned that matter.”

  “Okay.” She smiled peacefully, ignoring her instinct that all was not right with the Voice.

  His words were the only beacon in the black ether around her. Her smile was the only ray of sunlight that would shine on him that day.

  * * * * *

  “So everything’s fine?” Randy tried to whisper, but his voice threatened to roar. “I see you lie to your patients, too!”

  David hastily grabbed Randy’s arm to push him out of Nicole’s earshot. The two walked into the doctors’ lounge. With the staff engaged in the morning’s surgeries, the brothers were alone in a room resembling the lobby of an inn after its guests had checked out, with plastic coffee cups littering the side tables and half-read newspapers tossed on the couches. Although he had not slept all night or eaten anything since the previous day’s lunch, David did not sit but stood straight, the way a convict faces a firing squad. Randy paced back and forth before him like a sentry.

  “Yes, pal, everything’s just fine! Word of the surgery got out at dawn. I told the reporters that you had the personal permission of the secretary of medicine. He heard the news and hit the roof. That’s how I found out that my brother is a liar—I and the rest of the city.”

  Randy paused to stare at David indignantly.

  “I’m sorry, brother,” David said quietly, closing his eyes against an unbearable pain.

  “CareFree suspended you as a provider, so the hospitals in this state are closed to you. Of course, the Riverview board revoked your staff privileges. Because you’re not licensed in any other state, you’re grounded.”

  “I see.”

  “You can kiss the director’s post good-bye. In the words of our chairman, he wouldn’t appoint you to chief of broom closets now.”

  Randy continued to pace like an armed guard in front of the accused man in blue scrubs.

  “Just this morning—what a coincidence!—CareFree denied Radiology permission to fix our Model 409 scanner, even though it just needs a routine repair that’s never been refused before. And the BOM decided that all the medical practices of this hospital are questionable, so every patient chart for the last year must be examined in a massive audit, costing six figures—with the hospital footing the bill.” He stopped pacing. “By the way, how did the surgery go?”

  “Very well.”

  “So what are the chances she’ll see again?”

  “Ten percent.”

  “You’re lying again, brother. Your face tells me better.”

  “That’s not to be repeated to the patient.”

  “It’s irrelevant because you can’t finish the job.”

  David sighed tiredly. “Is there anything else?”

  “Your wife switched to using her maiden name. She’s having her stationery redone.”

  “I see. Anything else?”

  Randy decided to omit from the litany the fact that his son, Stephen, an honor student, was suspended from school that morning for punching a classmate who called his uncle a butcher.

  “The hospital’s project to reopen the Stanton Pavilion has been stopped. Just this morning—another coincidence!—the Commission for Environmental Protection found that a rare
species of striped-tailed squirrel is living alongside the old building. It seems that our plans to reopen will endanger the critter’s survival, so bye-bye to the Stanton Pavilion, and bye-bye to you, pal, because you’re the most endangered critter of all!”

  “Anything else?”

  “The chairman of the board gave me an ultimatum: Either I publicly denounce you or I find another job.”

  “Certainly you’ll denounce me! I insist. We have a deal. You promised.”

  “Why did you lie to me, David?”

  “You know why.”

  “Did you ever lie to me before?”

  “No.”

  “How could you lie to your brother?”

  “I didn’t lie to my brother. I lied to the president of this hospital, who must enforce laws that would have condemned my patient to a life of misery.”

  “So instead you condemned yourself to a life of misery.”

  “But I didn’t feel miserable. Last night in the OR, I felt happier than I’ve felt in years.” His head dropped. “Except about what I’m doing to you.”

  “And what about to you, David? You’ll never see an OR again unless you’re wheeled in on a stretcher! You lost the only chance you had to complete your research. Think of it! Seven years of your life down the drain. But that’s not all. You pushed the wrong buttons at the wrong time. You flung the rulebook in their faces; now they have to make good on their threats. And if the patient dies, you’ll be charged with manslaughter.”

  “Nicole won’t die!”

  “Regardless, what you did was an act of wanton self-destruction. You ruined your career. You’re going to be kicked out of medicine. And you did this on the eve of an appointment that would’ve led to the completion of your research and raised you to the pinnacle of your profession. Why on Earth did you do it?” Randy raised his arms, as if looking to heaven for the answer. “Why?”