An Open Heart

by Harry Kraus

  An answer came, but not one he would admit to anyone just yet.

  My sister asked me to come.

  Heather Rawlings coaxed the two-hundred-pound mastiff up on the table. “Come on, Bo. Time for the brush.”

  She pushed a rebellious strand of blonde hair behind her ear and laid a towel on her shoulder. The towel, a kitchen towel in a former life, was now formally dubbed a drool towel. She used it to wipe away drool slingers from the walls after a session with Bo.

  As she worked, she talked softly to the gentle giant. “There, doesn’t that feel good?”

  While other women in the upscale Richmond suburb might have craft rooms for hobbies such as painting, Heather had converted their large laundry room into a grooming-feeding station to support her dog-walking business. She had started three years ago, needing to do something other than provide arm dressing for her cardiothoracic-surgeon husband at social functions. The dog walking came to her naturally. She loved animals, and after taking care of a friend’s beagle while they were on vacation, she thought, Why not? It was the most practical of solutions. She got her exercise and got paid to do it.

  Even Jace seemed pleased, except when she talked about it at parties.

  Bo was her Monday, Wednesday, Friday, ten o’clock. Because of his size, she always walked him solo. In the afternoon, she tripled up with a pair of Maltese and a miniature schnauzer. She took Tuesdays off completely and had only one appointment for a German shepherd on Thursday mornings.

  Heather’s cell phone sang out the theme to the Pink Panther. She looked at the screen. Mom.

  “Heather,” her mom began with a sigh. “Have you heard from Jace?”

  “Mom,” she said. “I’m not exactly expecting him to call.”

  “But certainly he’d—”

  “I asked him to leave, Mom. He’s not likely feeling much obligation to me right now. Besides, he just arrived yesterday. He probably hasn’t had a chance to get a phone or Internet connection.”

  “I’m rethinking this. Maybe you should have gone with him.”

  “Don’t start. I needed time to figure things out.”

  “What’s to figure out? It’s been all over the news.”

  Now Heather sighed. The last two months had been a whirl of attention, most of it the kind she despised. So much had been said about Jace, accusations that he was unwilling or unable to talk about. It seemed all their conversations in the last month had ended with raised voices and frustration. She’d finally come to the conclusion that if she was to discover the truth, she needed to do it with space away from her husband.

  What she hadn’t anticipated was his sudden departure for Africa.

  “Let’s not go there, Mom. I know what the media says. I’m just not sure.”

  “The only thing I’m not sure about is whether we ever knew who Jace Rawlings really was.”

  “Well,” she said, pulling a wire brush through the coat of the mastiff, “that’s what I intend to find out.”

  “Maybe you should come to Florida for a while. Your father would love to spend some time with you.”

  “I can’t. I’ve got the dogs.”

  “The dogs, the dogs.” She spoke with a rising and falling sing-song. “You wouldn’t have to do that. You don’t have to work at all. Jace made enough to keep you from—”

  “Mom, I want to do this. I’m doing something. I like it. It’s good for me.”

  More silence and a heavy sigh.

  Heather began to scratch Bo behind the ears. “Look, I’ll call you if I hear from Jace.”

  “Okay,” she said. “You do that.”

  The call ended. Heather’s mom wasn’t much for prolonged good-byes.

  She snapped a leash to Bo’s collar and walked him back to his owner’s home, conveniently only two doors down. Mr. Robbins loved Bo, but his arthritis kept him from giving the dog enough exercise. Heather put Bo in the backyard, latching the tall redwood fence behind her.

  She collected the mail, intrigued by a manila envelope without a return address postmarked from Richmond.

  Inside, at the kitchen table, she opened the envelope and slipped out a three-page document. It seemed to be a photocopy originating from a medical examiner’s office.

  She read the title with a growing discomfort. Autopsy Report: Anita Franks.

  Why would someone send me this?

  Anita Franks. The name alone was enough to bring bad feelings. The now-deceased woman had been the governor’s wife. A woman with a passion for helping Virginia’s farmers.

  And apparently a passion for Heather’s husband.

  Heather scanned the document. Most of it was anatomic, listing injuries. She wrinkled her nose at the description. The state’s first lady had been struck by a car while she knelt at the side of a Richmond street tending to Jace.

  Heather peered into the envelope. Nothing. The only item inside had been the autopsy report, with no explanation as to who’d sent it.

  Looking at the pages again, she saw two lines highlighted in yellow. The first was a toxicology report. Her blood-toxin screen was positive for ketamine.

  Heather shrugged. She’d heard of ketamine somewhere, but it didn’t register as important. The second item made her shudder.

  “Vaginal vault contains evidence of recent sexual intercourse. Motility of sperm place the timing within two hours of death.”

  Jace? Just what went on that night?

  That night, Heather lay awake as her mind seesawed between the Jace she knew and loved and the mystery that seemed to surround him since his accident. She clung to the former and drifted to sleep remembering their first “date.” It was a week after their first encounter in the dean’s office.

  Jace had handed her his assignment. “Could you see that Dean Welty gets this?”

  “Sure.” She studied his eyes and hesitated. “The dean told me what you did.”

  “So I suppose you think I’m cruel for stalking cute little innocent furry animals?”

  “I think you should have left him by the trash cans. No one would have known.”

  “I wanted the skin.”

  “I have a leopard skin.”

  “You?”

  “I grew up in Mozambique. I had it hanging on my wall at home. I brought it with me to school, but when I met my suitemates, I decided it best to leave it in the bottom of my trunk.”

  “Don’t tell me. They’re vegans or something.”

  She giggled. “Or something.”

  He looked at the paper in her hand. “I’m sure the dean will get a kick out of this.”

  “He told me to stay away from you. That you were trouble.”

  “Because I killed a raccoon?”

  “Maybe he knows more about you than I do.”

  He twisted a lock of curly blond hair beside his ear. “Let’s just say I carry an American passport, but I don’t seem to fit in my own country.”

  She nodded. I know exactly how you feel. “We’re having a suite charade night tonight. We’re supposed to invite a guest. Would you come?”

  “Will you show me the leopard?”

  “Promise not to tell the vegans?”

  He laughed. “Deal.”

  She held out her hand. “I’m Heather.”

  “Jace,” he said, shaking her hand.

  “I know.” She smiled. “I think I’ll introduce you as the great white hunter.” She laughed with him. “All the raccoons on campus have heard of you.”

  7

  The following day Jace awoke at six a.m., a clear sign he was making progress on resetting his clock to African time. He brewed strong coffee and wondered if adjusting his Western mind-set to the pace of Kenya would be as easy. That’s a joke. I’m not sure I could ever be patient enough not to resent the pace of change here.

  At ten, Jace knoc
ked on the office door of Kijabe Hospital’s medical director. Blake Anderson, MD, was a wiry blond Aussie with sideburns that sloped down his ruddy cheeks and met the corners of a mustache so long that Jace couldn’t tell if he had an upper lip at all. He spoke a Kiswahili greeting with a strong down-under accent. “Karibu, mate!”

  Jace held out his hand. “Jace Rawlings.”

  “Good day to ya. How’s the head?” he asked with a chuckle. “I’m always in a cloud the first week back from home furlough.”

  “I’m adjusting.” Jace shrugged. “I’m anxious to see the place.”

  The medical director pointed to a stack of papers. “Here’s your orientation packet. Our formulary is limited, but better than the government’s district hospitals. Here’s your pager,” he said, handing him the device.

  “Wow. I was hoping I’d seen the last of this in America.”

  “Yeah, well, we’d all rather do without the night business, wouldn’t we, mate?” He handed Jace a sheet of paper. “This,” he said, “is the call schedule. I left you off this first week so you could get your feet on the ground. Your first call is Monday night.”

  “Call?” Jace looked at the paper. “I didn’t anticipate much call until the heart program was up and running.”

  Blake raised his bushy eyebrows and stared at Jace. “Good joke. I like a bloke with a sense of humor.” He paused before proceeding without a smile. “Everyone here does his or her share of call. Since you were a board-certified general surgeon before you did heart surgery, you’ll be on the call schedule for general surgery. Perhaps later if the heart program gets off the ground and is busy enough to justify taking you off the general surgery call, we’ll let you take cardiothoracic call only.” He chuckled to himself as if to say, We’ll see if that ever happens.

  Jace felt a stab of anxiety. General surgery? How long has it been since I even saw an appendix?

  “Dr. Rawlings?”

  Jace looked up, suddenly aware that he’d been staring blindly at the call sheet. “Look, Blake, I thought we had an agreement about setting up this program. You talked to the minister of health. You even talked to the airline about my extra supplies. I thought everyone was on the same page about the heart program.”

  Blake smiled. “Of course. But things move slowly here. I can’t afford to house a capable surgeon for months while the wheels start to turn.”

  Jace forced himself to return a weak smile.

  “Shall we take a tour?”

  Jace followed quietly as Blake entered the long main hospital corridor and wove through a sea of patients. They seemed to be everywhere. Standing, sitting on wooden benches lining the halls, sitting on the floor, leaning in through the windows, and crowding the doorframes. There were Kikuyu mamas carrying babies on their backs in cloth slings called kangas. Somali women with head coverings peered out through slits revealing only glimpses of dark eyes.

  Blake edged past a series of stretchers lining a hallway leading to the X-ray department. Two men with bloody faces and twisted limbs looked back at Jace and muttered something in Kiswahili.

  “Sorry about the crowding. Seems we’ve just had a bit of a road traffic accident.”

  Jace nodded and plodded along behind him. The smell was a mix of human sweat, urine, and iodine. Funny. The smell is exactly the same as I remembered it. “I used to come down here and watch my father operate. It’s like nothing has changed.”

  Blake chuckled and kept moving. “Here’s the lab. We can do basic chemistries, blood counts, urine analysis, malaria smears, amylase, liver functions, bacterial cultures, and HIV testing. The crew is quite good at identifying TB.”

  “May I see the blood bank?”

  “This is it,” he said, pointing to a single refrigerator. “There is no separate room for the blood bank.”

  The blood bank is a refrigerator. Jace scratched his head.

  “Let me show you our new HDU, the high dependency unit. Not quite an ICU, but getting there. It’s just up the ramp here.”

  They walked up the long sloping hallway. Because there were no elevators, the hallways were long and graded so you could push a stretcher up a series of two long hallways to go from first to second floor.

  Could I really do open-heart surgery in a place so primitive it doesn’t have an elevator?

  Blake showed Jace around the HDU, introducing him to the nurses and pointing out supplies. The monitors above the beds looked modern but were already a few generations behind the ones he’d used in Virginia. Jace squinted down the row of patients.

  The medical director smiled. “Bed one is a head-injury patient from a road traffic accident. Bed two has cerebral malaria. Bed three is an HIV patient who presented with a perforation of the bowel from typhoid fever. Bed four is a chest injury from a hippo. Bed five is a patient who had esophageal cancer and a resection.” He paused. “Welcome to Africa.”

  Jace took a deep breath. It was clear that, as a general surgeon, he’d be expected to pull his weight. And he knew that if he didn’t, he wouldn’t likely swing the staff in favor of letting him do open hearts. He offered a weak smile in response, aware that he felt nothing positive. What did he feel?

  Scared. Alone.

  He was in the deep end of the pool and had forgotten how to swim.

  That afternoon, Jace sat at his computer, happy to have gotten his Internet connection. He needed to send some emails back home. His first message was to Heather.

  Heather, arrived safely, but my equipment is hung up in customs. I could have predicted this. I didn’t want to bribe the official, so here I am in Kenya without my bypass pump.

  I did meet with the Kenyan minister of health. Hopefully, he will grease the wheels and I’ll get my stuff. I also met with the Kijabe Hospital administrator. They want me to do general surgery until things can be sorted out with the heart program. I’m not sure I remember anything about general surgery. I’d better learn fast. I picked up a book at the library to help.

  I’ve been thinking a lot about us. I’ve never been one to analyze feelings and relationships, but perhaps this space will help me figure things out. I miss you. Strange, this place feels like home.

  Jace

  Jace clicked Send, then sighed and reflexively traced a small scar on his scalp. The bony indentation for a burr hole was filling in and soon would be hard to find. Two months, Jace thought. Enough time to recover from drainage of a subdural hematoma.

  Two months. A whirlwind of change, recovery, physical therapy, seeking approval to start a heart program, and securing donated equipment—details that fell magically into place like dominos tumbling down a line. The speed of the change amazed him, and he’d entertained thoughts that someone very powerful was pulling strings on his behalf. But in the end, he shoved those thoughts aside and wished his memory would return. But because those memories eluded him, Jace hid from the media and wondered if his own questions would ever be answered.

  In two short months, bone had reached out to bone to link and repair the small defect in his skull. But will my marriage ever heal?

  Will I ever remember?

  8

  Heather Rawlings sat in a booth in the Robin Inn, a restaurant in the west end of the Fan district of Richmond, enjoying the four-cheese ravioli and the company of longtime friend Gabriel Dawson.

  Gabby looked up from her salad. “How can you eat that stuff and maintain your figure? If I ate like you, I’d weigh three hundred pounds.”

  “Then you could ask Dr. Marks to operate on you.”

  “That’s not the way I’d like to get his attention.”

  Heather laughed. “You know my schedule. I need to wear a pedometer some week. I must do thirty miles a week with the dogs.”

  Gabby set down her fork and leaned forward. “Okay, honestly, how are you doing? The buzz in the OR is that Jace left you high and dry in a sudden need to get
back to Africa.”

  Heather took a deep breath. “Not exactly true. He had a sudden need to get to Africa, yes, but I’m the one who decided it was best to separate.”

  “You?”

  She looked down and nodded. “After the accident, things just weren’t the same between us. It was like everything that he’d spent so many years building didn’t mean anything to him anymore. Here he has this successful cardiothoracic practice, patients who practically worship him—”

  “Tell me about it, sister. I’ve seen the old ladies practically slobbering over him.”

  “Then, he gets out of the hospital and starts talking about the poor Kenyans without a heart doctor.”

  “A close call with death can change your priorities.”

  Heather shook her head. “It was more than that. It was mystical. In the end, he said his twin sister asked him to come back.”

  “Twin sister? I didn’t know Jace was a twin.”

  “Nobody around here did.” She chased a lemon section around her water glass with a straw, stabbing the fleshy fruit to release the juice. “Family secret.”

  Gabby raised her eyebrows. Her voice was laced with sarcasm. “Okay.”

  “I need some professional advice.”

  “You need a psychiatrist,” Gabby said.

  “Funny. I need an opinion from someone who knows cardiac anesthesia.”

  Now Gabby’s eyebrows lowered in seriousness.

  “I know you worked with Jace a lot. He told me you were his favorite pump tech.”

  “Flattery, my dear, will get you nowhere unless you’re picking up the tab.”

  Heather took a paper out of her purse, the name of the drug she’d copied off Anita Franks’s autopsy report, and slid it across the table to her friend. “What do you know about this drug?”

  Gabby wrinkled her nose. “Why do you want to know about ketamine?”

  “I just want to know. What is it?”

  “It’s an anesthetic drug. We use it all the time.” She shrugged. “I use it in combination with a few other drugs when I’m sedating pediatric cases.”