An Open Heart

by Harry Kraus

  “Did Jace use it for his patients?”

  “Maybe not Jace himself, but I’m sure he saw us using it on his patients.”

  “Is there any reason to have ketamine in the blood if you weren’t having an operation?”

  “Why are you asking this?”

  Heather took a deep breath and kept her voice low. “I’m just trying to find out some information. Someone sent me a copy of Anita Franks’s autopsy report.”

  “Somebody?”

  “Anonymous. It was weird. I just got this envelope in the mail with no return address. Apparently, someone wanted me to see some things about her autopsy report. They photocopied it and highlighted a few items. The first one was that she was found to have traces of ketamine in her blood.”

  “That’s weird.” Gabby stared off.

  “What is it?”

  “I’ve heard reports that ketamine can be slipped in a drink to use as a date-rape drug.”

  Heather swallowed. Hard. “That may go along with the second thing that was underlined on the report.” She hesitated. “You can’t tell anyone about this, okay? I’m not even supposed to know this stuff.”

  “Someone obviously thinks you should know.”

  “The report said that Mrs. Franks had evidence of sexual intercourse within two hours of death.”

  “So the governor and his wife are still young. Just because—”

  “Gabby, the governor was out of town. He wasn’t anywhere close to his wife that night. It was all over the news. He was in Williamsburg at a trade summit, meeting with some Kenyan leaders about exporting tobacco or something.”

  “What are you saying?”

  “Nothing. I’m just trying to find out what this means. And why someone would want me to know this.”

  “You think Jace had something to do with—” Gabby halted, her hand to her mouth. “Come on, Heather, Jace would never do something like this.”

  “I’m not sure I know what Jace is capable of anymore. I want to believe in Jace.” She paused. “Maybe this will erase my doubts.”

  “How can you doubt him? Just look at the guy. He wouldn’t need to sedate anyone to get them into bed. Just one look into those blue eyes …”

  “Yeah, thanks for the encouragement.”

  “Hey, I’m just saying what you already know in your heart. Jace was straight as an arrow. He wouldn’t cheat on you. And if he did, he wouldn’t need to use ketamine.” She paused and reached across the table. “Come on, Heather, Jace is a believer, right? He wouldn’t—”

  “So you think being a Christian keeps you from cheating on your wife?”

  “It should.”

  “Jace is from a missionary family. I made assumptions about what he believed just because of the family he came from.” She sighed. “But Jace has always been quiet about his faith. I’m not sure his parents’ faith ever took.”

  “He’s a good guy.”

  “Being a good guy is different from having true faith.”

  Gabby released Heather’s arm. “I’m going to pray for him. I think you need to give him the benefit of the doubt.”

  “So why the media speculation about Jace and Anita?” Heather quoted a newspaper tabloid, “‘When the cat’s away, the mice will play? Anita Franks out with husband’s heart doctor.’”

  “I don’t read that crap.” Gabby took a bite of salad and spoke with her mouth full. “What does Jace say about it?”

  “That’s the strange thing. He claims he has no memory of that evening. The accident erased it all.” Heather snapped her fingers. “How convenient. He is seen coming out of a downtown hotel with the governor’s wife, and he doesn’t even remember.”

  Gabby frowned. “What happened that night?”

  “All I know is the little Jace will say combined with what I got from the police. Jace was driving our car away from a downtown hotel with Anita Franks when he was broadsided by a drunk driver. Jace was knocked out. Apparently, Anita called 911 and pulled Jace from the car. She was kneeling over him when she was struck by another vehicle, a VCU student going home after a late night studying.”

  “He did have brain surgery. Maybe you should give him a break.”

  “Maybe the injury just prevents him from lying to me anymore.”

  “Heather!”

  “I don’t know what to believe—” a sob interrupted Heather’s words. “I want to believe in him, Gabby. I want to believe in Jace and me like we used to be.”

  Gabby squinted. “Then believe him, Heather. He’s had plenty of opportunities to stray in the past, but he’s always made it clear that he’s a one-woman man.”

  “Then why is someone sending me this?” Heather asked, pointing at the paper.

  “I don’t know.”

  Heather reached across the table and crumpled the paper before burying it in a Bottega handbag. “I don’t know either, but I’m going to find out.”

  That evening, Jace left his small flat in search of the Anderson house, where he’d been invited for supper. Blake said he’d invited a few of the other staff, including the general surgeon, so Jace would have a chance to meet them face-to-face. The other general surgeon. He remembered how the medical director had emphasized other as if reminding Jace of his expected position.

  Jace’s path took him below the hospital and along the dirt road beside the only place on the station Jace had avoided since his arrival: the Kijabe Station cemetery.

  Located right next to the hospital, the cemetery was a small memorial to missionaries, local Kenyans, and a few unclaimed patients along the way. Convenient location, Jace thought. If I have to do general surgery, my patients won’t have far to go to make it here.

  He paused at the back of the hospital, where a parking lot abutted the field next to the cemetery. A footpath cut the corner to a series of houses below the cemetery but took Jace through the center of the tombstones. The dirt road, to the right, skirted the border of the cemetery. Hesitating, Jace focused on the other side. This is crazy. I should just walk straight through.

  He took a step, then two, and felt his heart quicken. With a boldness in his stride he did not feel, he veered off the path and stopped at a small, flat memorial stone in the second row back. The little stone marked the one event that caused even his sister’s faith to falter. Timmy O’Reilly. A small cross was etched above the dates of his birth and death. Only eight years old.

  In the weeks following Timmy’s death, Janice’s faith, however battered, emerged with a renewed hope. From that point on, she seemed to be living with a palpable longing for heaven. For Jace, the pie-in-the-sky by-and-by seemed akin to shoving your head in the sand. Life was hard. Period.

  But Janice, more than anyone else he’d ever known, seemed to live in an awareness of her own yearning to be free of earthly restraint. That yearning colored everything she saw, even the evil, with a rose-colored optimism.

  “Look around,” Jace told Janice one afternoon as they walked down the hill from school. “Poverty. AIDS. Corruption. Death of innocent children. Where is God?”

  She looked up from the rocky path. “He’s in the pain, Jace.” She paused, her face taking on that faraway look he’d come to expect. “But one day, all of our tears will be wiped away. All of our pain will be gone.”

  Back in the present, Jace heard a twig snap and turned to see a large man rising from behind a memorial stone. As the man approached, he recognized the chaplain, John Otieno.

  Otieno’s eyes were glistening as he held out his hand. “Daktari Rawlings.” He looked down at the memorial stone. “All of us remember Timmy.”

  Jace wasn’t prone to flagrant displays of emotion but struggled to find his voice behind the walnut in his throat. Instead of speaking, he just nodded.

  The chaplain unfolded a sheet of paper from his coat pocket and laid it against the stone. Then he shade
d the paper, rubbing with the edge of a pencil, lifting the image of the cross from the stone to the paper. He stood in silence for a moment before handing the paper to Jace. “The O’Reillys wanted this to be the only message on the stone.”

  The chaplain smiled as Jace struggled to find his voice. “Uh, sure.” All he could see was the image of his sister’s little wooden cross as flames devoured it in his vow not to serve the God it represented.

  John Otieno nodded. “Kind of changes everything, doesn’t it?” He turned to go. “You take care, Daktari.” With that, he turned and walked down the path to the opposite end of the cemetery.

  Jace didn’t follow. He wasn’t ready. Not yet. Instead, he walked through the tall grass to the place the chaplain had been kneeling a few moments before. There was another flat memorial stone.

  Jace read the inscription. Mary Otieno. The dates revealed that she had died a dozen years ago, at age five. The chaplain’s daughter?

  Somehow, it didn’t surprise him. Death in Africa was so common. A family that had not suffered an untimely loss was the exception, not the rule.

  Common, but so unfair. Why does suffering have to mark this land?

  He looked at his watch. He was going to be late. He looked down the path that stretched through the remaining stones. No, not today. Instead of heading through, he turned around and backtracked toward the road.

  What was I thinking, passing through this place of death?

  John Okombo hated using the phone. He much preferred a face-to-face confrontation, where he could use his size to his advantage. But the phone was a necessary tool. He dialed and listened. As he waited, he twirled a hand-rolled Virginian cigar in his fingers, a small gift in anticipation of a huge deal he had made with Virginian politicians.

  On the other end, he heard Simeon. “Jambo, sir.”

  “You did well.”

  “You refer to the American doctor?” Simeon asked.

  “Of course.”

  “You sound surprised. I told you he would respond to my call.”

  “Have you made the other necessary arrangements?”

  “Yes. It will be untraceable. I have a friend in the Mungiki. He is only too willing to carjack a wealthy westerner.”

  The MP shook his head. He didn’t like working with the Mungiki, a radical political-religious cult, but he did like their efficiency. “I want you to call it off.”

  “Call it off? But payment has been made. It won’t—”

  “Delayed, not canceled. I have need of the doctor.”

  “Not your heart, I hope.” Simeon chuckled, and Okombo could hear something rattling. He imagined the witch doctor shaking bones in a jar, working on some new incantation. “If you are having problems, I may have an answer for you here.”

  “No, no, not for me, my friend.” Okombo hesitated. “Someone else needs him. After he is done, your Mungiki friend can make the American disappear.”

  “Fine, fine. I’ll make the change.”

  “Can you assure his safety until I call you again?”

  “Security and prosperity. An expensive proposition. It will cost you, Mr. Okombo.”

  The MP drew hard on the cigar and blew smoke rings at the ceiling. “Put it on my tab.”

  9

  Jace looked around the table laden with a Western feast of chicken, potatoes, rolls, and salad. To his right sat Ellen and Dave Fitzgerald—the other general surgeon in Kijabe. To his left and across from him sat Blake and Kim Anderson. Beside Kim was Sue Watkins, a nurse educator in the Kijabe Hospital school of nursing.

  Blake extended his hands to Kim and Jace. Great, Jace thought, another honored Christian tradition. We get to hold hands. He remembered how during high school, he used to try to sit next to a pretty girl, anticipating this very thing. But that wasn’t the case now. Hiding his discomfort, he took Blake’s and Dave’s hands. Blake smiled. “Jace, would you pray for our meal?”

  Jace blinked. Pray? Of course, pray! Out loud. Now. He opened his mouth. Nothing. His mind was blank. It had been years since he’d been put on the spot for what must have been a routine spiritual duty here in Kijabe. Surely he could pull this off. He looked around the table. All participants had their eyes closed. He cleared his throat.

  Before he could begin, his conscience assailed him. What a poser! You fraud!

  What could he do? He’d heard his father do this a thousand times. But how could he explain that what was routine to his father hadn’t worn off on him? How could he say it? It just didn’t “take”?

  Jace cleared his throat. As he began, a memorized childhood prayer fleeted across his mind. I can’t say that! He looked at the others, whose heads were bowed reverently, waiting for him to begin. Of course, he could do this. He paused. His memory did not fail. He would have to use the old prayer. “Dear Father, thank You for Your great blessings and the provision that has been set before us. Bless this food and may we use it in Thy service.” He hesitated again, this time for extra spiritual emphasis, the way his father had, before adding in a sober bass voice, “Amen!”

  Jace felt a stab of embarrassment. Stupid! Why did I say “thy?” I never talk that way. He’d just revealed his lack of Christian maturity to the boss. Fine work, Jace. He felt like he’d just shown Jeff Gordon how fast Jace’s VW Beetle was off the line. He wanted to excuse himself, but the damage was done.

  He avoided their eyes and loaded his plate. Meals like this would be a rarity in coming weeks as he fended for himself in the kitchen.

  Kim Anderson had a delightful Australian accent. “Well, Dr. Rawlings, tell us about your family. Do you have children?”

  Jace looked up from his plate, now heavy with chicken and mashed potatoes. “No, no kids.” It was a sore spot for Jace. But what was an irritation for Jace was an unrelenting ache for Heather. He felt Kim’s eyes on him, waiting for more. “My wife stayed at home.” He cleared his throat. “For now,” he chuckled. “I guess she wanted to see how things would go.” He smiled. “How about you?”

  “Three girls,” she said. “But they are eating with friends.”

  “So,” Dave Fitzgerald started, “I hear back in Virginia, you’re the surgeon to the stars.”

  Leave it to the surgeon in the group to be direct.

  Jace shrugged. “Don’t believe everything you hear.”

  “Don’t be modest. CNN reported that you saved the life of your governor.”

  Jace wished attention would turn elsewhere. If they knew about the governor of Virginia, they had to know about the swirl of controversy that followed. The Internet had made the world too small and uncomfortable for those wishing to hide in anonymity. “The governor is a fine man, a friend. But he is no more worthy of having a competent surgeon than the people of Kenya are.”

  Blake nodded. “Well said.”

  A shrill beeping interrupted the conversation. Dave excused himself to use the phone.

  Jace took a bite of chicken; it was certainly different from the tough Kenyan chicken he remembered from his childhood. He chewed, happy that the focus was off him for now.

  A minute later Dave came back to the table, shaking his head. “I need to eat and run, I’m afraid.”

  Blake nodded. “What’s up?”

  “A triple treat,” he said, laughing. “Head injury, perirectal abscess, and an old mzee who hasn’t been able to urinate all day.” He paused. “Say, if you’re willing,” he said, looking at Jace, “I could use your help.”

  Jace thought about the problems. He wasn’t a neurosurgeon. He wasn’t a urologist. But he had drained a perirectal abscess during his general surgery internship, and he was comfortable doing open-heart surgery. Certainly he could figure out a way to lend a hand. Selfishly, he wanted to observe Dr. Fitzgerald on the job before he faced the same problems alone during his first night of call. Jace nodded. “Sure.”

  Dave grunted.
“Eat fast.”

  Ten minutes later, Jace trailed Dave as they walked into the casualty department. Dave walked fast, and Jace felt as if he were a medical student again. They met an intern, Margaret Mwaka. “Show me the head-injury patient first,” Dave said.

  The Kenyan intern was professional and controlled. “Over here,” she said, pulling back a curtain. “Twenty-eight-year-old male thrown from the back of a pickup truck. Arrived conscious with a GCS of fourteen. We got a chest X-ray and C-spines and saw no fracture. Ten minutes after arrival back in casualty, he blew his right pupil and GCS dropped to six.”

  “Is theater ready?”

  “Waitin’ on you.”

  “What else do we have?”

  She pointed at an old man in a shuka, traditional dress for the Maasai tribe. “Hasn’t been able to void all day. Bladder palpable at his umbilicus. Nurses tried a Foley and failed.” She moved to the next stretcher. “This gentleman has a large perirectal abscess.”

  “Set our urinary retention patient up in recovery room. I’ll show Dr. Rawlings here how to get a catheter in while you prep the trauma patient for the burr holes.” Dave looked at Jace. “Think you can drain the perirectal abscess while we do the head trauma?”

  “Sure.” Jace spoke with feigned confidence and followed the seasoned general surgeon to the theater.

  Dave didn’t look convinced. “How long’s it been since you’ve done any general surgery?”

  Jace shrugged. “Residency.”

  “Do you want me to get the intern to drain the abscess?”

  “No. I, uh—I can do it.”

  Dave nodded. “Okay. I’ll be in the next room if you need help.”

  Jace changed into scrubs and watched as Dr. Fitzgerald deftly placed a Foley catheter using a flexible metal stiffener, resulting in over a liter of urine.

  The surgeon nodded. “Normal capacity of the male bladder is around 450 ccs. This guy will need to keep the catheter for a few days to let the bladder muscle recover. We’ll likely need to do a prostatectomy to help his flow.” He paused. “Do you have any experience in prostatectomy?”