An Open Heart

by Harry Kraus

  “We’ve got the autopsy report. What more would they want?”

  “DNA evidence.” He picked up a letter opener, a gift from the NRA, with a handle made from a white-tailed deer antler. He used the blade to clean beneath his thumbnail. “Fortunately, DNA is fairly easy to get.”

  “Easy?”

  “Sure. Kleenex. A beer bottle. A cigarette. Even an envelope that he licked.”

  “Dr. Rawlings doesn’t smoke.”

  The governor ignored him. “What we need is someone to collect the evidence.”

  “And if we get it, then what?”

  “Then we’ll make a case for the cooperation of Kenyan authorities to extradite him.”

  “If he’s helping their people, they may be reluctant to give him up.”

  Stuart Franks wiped the blade of the letter opener on his pants. “We’ve just made a multimillion-dollar trade deal with Kenya. I don’t think they’d want to jeopardize our relationship.”

  Ryan nodded. “I made quite a few friends during our tobacco trade deal. Do you want me to get them involved to collect the evidence?”

  The governor shook his head. “I don’t want to approach anyone in Kenya till we have the evidence in hand.” He stood and looked out the window over the lawn. “Maybe we can arrange for someone else to visit Mr. Rawlings.”

  Jace watched as Blake Anderson draped his stethoscope around his neck. “She sounds better,” he said. “Not so wet.”

  “For now,” Jace said. “But she won’t stay compensated for long. She needs a valve.”

  The medical director waited until they were in the hallway outside the HDU before he spoke again. “This isn’t the timeline we discussed. We talked of fundraising, installing new equipment in our HDU, maybe furnishing a new operating theater. The heart program needs to be instituted with full staff support or the whole thing will collapse. You have to give our African nurses time. If they don’t own this program, it will go nowhere.”

  Jace kept his voice low. “This girl is going to die without an operation.”

  “So send her to Nairobi. That’s what we’ve done for years.”

  “Kenya’s minister of health wants her here.”

  “And what business is this of his?”

  Jace hesitated to answer, but after a moment, he decided he needed to confide in the medical director. “Look, the girl is his daughter.”

  “What?” The Australian shook his head. “Are you crazy, mate?” He touched the side of his mutton-chop sideburns. “We need a nice quiet case to get this program started.”

  “No one knows about his connection to the girl.”

  “And if you lose her, what then? The MP will see to it that we’re shut down.”

  “He’s been supportive.”

  “You don’t understand Kenyan politics. It’s all about scratching the backs of the powerful.”

  “He waived the import tax on my equipment. In fact, when I called to tell him that I’d received a few items that I’d not brought along, he informed me that it was a gift. And we’re not talking small-dollar items. The endoscopic echocardiogram unit alone is at least fifty grand.”

  “My point exactly,” Blake said, lowering his voice. “How long have you been working on this?”

  “Two months.”

  “And your equipment? How does donated equipment get here so fast?”

  “Compassion Industries took care of the donation and the air freight.”

  “And only a few weeks for the Ministry of Health to approve a new program? Don’t you find that the least bit unusual? Nothing in Kenya moves that fast.”

  “I just thought the timing must have been right. I mean, what’s to decide? There’s a huge need here, and I offered to come and bring what I needed. So I just think the Ministry of Health stamped it approved without another thought.”

  “Or maybe, just maybe, someone powerful was pulling strings behind the scenes. Maybe the MP even manipulated the donation of your equipment in the US.” He paused. “Maybe the MP brought you here to do his daughter’s operation.”

  “Ridiculous. He couldn’t have known she’d need it.”

  “Don’t be so sure.”

  “Okay, maybe I did think it was moving fast. But everything lined up so neatly that I just felt it must be right.”

  “You think God had something to do with it,” Blake said.

  “Maybe I wouldn’t be bold enough to put it in those words, but … yes, maybe God wants me here, so He worked it out.”

  “Why would the MP just give you extra equipment?”

  “He wants his daughter to survive.”

  “Nothing comes free here.”

  “He wants me to operate on his daughter.”

  The medical director sighed. “He wants to control us.”

  Jace massaged his forehead. “Look, I asked him about moving her to Nairobi. He won’t have it.”

  “He’s put us in a corner.”

  “This is what I came to do,” Jace said.

  “I hope you like pressure.” Blake Anderson combed his moustache with his fingers. “’Cause you ain’t seen nothing yet.”

  That evening, Jace answered a knock at the door to find the chaplain, John Otieno, holding up a small black plastic bag. “Dr. Rawlings, my wife sent some fresh chapatis.”

  “Thanks.”

  The chaplain seemed to hesitate. “I was hoping we could talk.”

  Jace motioned him in. “Sure. I’ll make tea.”

  John sat in a kitchen chair that groaned under his weight. He watched as Jace went about boiling water and milk and adding black tea leaves and sugar. “I hear you are planning to go ahead with the heart program. This is sooner than I expected.”

  “Perhaps sooner than I expected as well. But I still need a few things to fall into place before I can commit to doing our first case.”

  “Perhaps there are other obstacles of which you are not aware.”

  Jace raised his eyebrows and looked at the man. The chaplain was sober, touching his curly white sideburn as he stared at Jace. “Such as?”

  “You will need the chaplaincy office to bless this work before beginning. I’d hoped I’d get a chance to talk with you further before you barged ahead without consulting us.”

  “I was unaware of the need.” Jace paused and stared at the large man. “I had the preliminary approval of the administration and staff before I came to this country. I didn’t realize that your department also needed consultation.”

  The chaplain smiled. “Jace, of course you can go ahead with your program and ignore us.” He folded his hands. “But what I’m suggesting is that your way will be so much easier if you operate inside the mission of our hospital.”

  “Mission?”

  “The work of Kijabe Hospital is more than an outreach to sick bodies. It is an outreach to heal the souls of men.” He paused and accepted the mug that Jace set in front of him. “My job is to make sure everyone is on board with this approach.”

  Jace sipped his chai. He didn’t really feel like discussing his personal spirituality. Or lack of it.

  “Why do you want to start a heart program here?” Otieno asked.

  “There is great need in this country.”

  “So why not offer your services at Kenyatta? Why Kijabe?”

  The surgeon shrugged. “This was my home.”

  “So you admit that you do not have a burden for the souls of your patients?”

  The language was a put-off for Jace. Christianese, he called it. Just what was “a burden for souls”? Jace took another sip before answering. “I am not interested in the inefficiency of the Kenyan government hospital system. I am not interested in using a private Nairobi hospital that fleeces the rich. I want to help the poor. Is that burden enough for you?”

  “I am concerned that we a
ll be on the same page.”

  “The same page? What exactly are you referring to?”

  “Our orientation has to be a concern first for the eternal destiny of the patients.”

  “My concern is the physical health of my patients. I’ll leave their souls in your hands. How about that?”

  “That isn’t good enough.”

  “What do you expect of me?”

  “All of the doctors in this hospital are deeply committed to spiritual ministry. That’s the way it is done here.”

  “And why is the way I practice your business?”

  “The patients’ well-being is my business. I’ll not have Kijabe Hospital losing its focus. If all we do is treat the physical body, we lose our distinctive. We will just be another humanistic outreach.”

  “You will try to stop me if I press on while limiting my work to the physical?”

  “I am here to encourage you to think about the eternal. Life is short, Dr. Rawlings. What can you give them, twenty years? Thirty?” He pushed back the kitchen chair. “A life given over to Christ is affected for eternity. That’s the perspective we want to preserve at Kijabe.”

  “Perhaps I can keep my patients alive physically so that your team can prepare them in other ways.”

  “For me, it boils down to motivation. Why do you want to do this work?”

  Jace shifted in his chair. “I want to help Kenyans with heart disease. Particularly ones who can’t afford to pay private-practice costs.”

  “But why? I’ve been watching your adventure. You endure the games of politicians, the dangers of a new culture, the suspicions of those you came to serve with. Why put up with all these hassles?”

  “I’m not sure what to tell you.” He held up his hands. “I want to help.”

  “Most who give up so much are motivated by gratitude.” He paused and looked across the kitchen table at Jace. “Or guilt.”

  Jace wasn’t sure how to respond. Or even whether he should respond. He couldn’t seem to make his eyes meet the chaplain’s, so he stood and walked to the stove and added chai to his mug.

  John Otieno spoke with a soft voice. “Jace, the work we do at Kijabe Hospital is ‘get-to’ work, not ‘have-to’ work.” He stood and set his empty mug beside the sink. “It’s the difference between grace and wages.”

  “I get that. I’ve heard the song.”

  When the chaplain looked confused, Jace added. “You know, ‘amazing grace, how sweet the sound.’”

  “I know it well. But the concept seems lost on you. You are striving, performing.”

  “I’m a surgeon. That’s what I do.”

  “A wise man once told me that grace is God at work. Legalism is me at work. The difference isn’t in the work; it’s in the motivation.”

  “And you can take a spiritual scalpel and expose what is in my heart? How can you presume to know what motivates me?” Jace turned away. “Maybe I don’t know myself.” He paused and turned slowly back to Otieno, whose large hands were folded in his lap like a child praying. “Can I count on you to bless the work, even if you do not know the motivation? The work is needed.”

  “I have other concerns, Jace. Kijabe Hospital is known for compassionate, Christ-centered care. When the public hears that the famous, colorful, American heart surgeon is at work here, their opinion may change.”

  “So you’re really worried about me tarnishing the hospital’s reputation.”

  “It is my place to be sure that spiritual ministry is not hampered.”

  “Shall I pack up and go home? Is that what you want?”

  “What I want is for you to understand why you are working so hard. Are you trying to earn God’s favor? For what sin are you trying to atone?”

  Jace shook his head. He’d heard enough Christian language. Why not speak plain English instead of presumptuous, pious phrases?

  But the last phrase did make him think. Some sins deserve punishment.

  When Jace didn’t respond, the chaplain turned toward the door. “I’ll let myself out. Enjoy the chapatis.”

  16

  Jace opened his computer and clicked on the “Get Mail” icon. After watching the twirling emblem for a long minute, he saw that he’d finally gotten a reply from Heather. The message was brief. And too polite.

  Glad you’re safe. I hope that your time away is all that you need it to be. I know you want to figure things out between us. I’ve been thinking about the way it was in the beginning. We were young and full of hope, and determined not to end up like the rest of American couples who grow apart instead of together. So where did we go wrong? Can we find that hope again? I know if things are going to work for us, I need answers. Transparency, Jace. I need to know what was really going on between you and Anita Franks. I hope you get your equipment soon. If I know anything about you, you’ll feel lost without it.

  Maybe that’s part of the problem. For the last decade your identity has been your ability to be cool when hearts were in crisis. Well, Jace, maybe this is a heart crisis of sorts for us.

  Stay safe,

  Heather

  Jace shut his laptop and sighed. If only he knew what had really been going on with Anita.

  Had anything been going on? Had he slipped from comforting a patient’s family member into something else entirely? Had he crossed the line into dangerous territory with another man’s wife?

  He knew that at one time, not too long ago, he had dreamed of doing just that.

  It had begun innocently enough. An accepted invitation to talk, over lunch. Hands brushing, lingering a little beyond the friendly graze. A hug after walking her to her car. Comfort offered to a friend.

  Then, in a parking lot outside the hospital, he’d handed her a card with his private cell number. He remembered the look in her eyes: You are special to me.

  “Thanks. I won’t misuse this,” she giggled. She leaned forward to offer him a friendly hug and her cheek touched his.

  He inhaled her perfume. He felt heat. And desire.

  A male voice interrupted their good-bye. “Mrs. Franks. Your car is waiting.”

  Jace looked up to see the stern face of Ryan Meadows.

  “Oh, Ryan, you remember Dr. Rawlings? We were just saying good-bye. He tells me the governor is progressing.”

  “Of course.”

  When Anita turned away, the chief of staff met Jace’s eye and kept his voice just above a whisper. “Step carefully, Doctor.”

  Jace didn’t reply. He didn’t need to. His conscience was screaming the same warning. Instead, he nodded at Ryan and watched as he took the first lady’s arm, escorting her to a waiting limousine.

  Ryan helped Anita into the limo, then climbed in beside her.

  Once alone and behind the tinted windows, Anita turned to him. “Drink with me.” She poured golden liquid from a crystal decanter.

  Ryan sighed. “This has turned out so different than I’d imagined.” He watched the surgeon, still standing there, as they drove away. “For a while, I found myself imagining what would have happened if the governor hadn’t pulled through.” He looked back at Anita. “Then maybe we could have stopped hiding.”

  “Is that what you want?”

  “I want to be with you. You know that.”

  “Well, that’s a little impossible right now, regardless of what we might want. And I’m not about to break the news to the governor when he’s in the hospital.”

  “I get that, Anita. But it doesn’t stop me from wanting more.”

  She brushed his hair away from his forehead. “Nor me.”

  He drained his small glass, enjoying the burn of the alcohol in his throat. “You should be careful. The local media is starting to speculate about you and your husband’s doctor.”

  “You’re jealous.”

  “Should I be?”

  “Ah,
Ryan. Always lurking in the shadow of the governor.”

  “It wasn’t so long ago that I was touted as the party’s pick for their candidate.” He smiled. “That’s when you made your first play for me. When you thought I was going to be the governor.” He tapped his finger against the window, where a honeybee clung to the outside surface. “Maybe I would have made Stuart my chief of staff.”

  She shook her head. “He wouldn’t have done it. Too proud.”

  “Too proud to imagine his wife looking elsewhere? He’s a pig.”

  “He’s your boss.”

  He leaned over and kissed her earlobe. “Don’t remind me now. He’s still in the hospital. Anything could happen.”

  That evening, Jace made a long-distance call to Gabriel Dawson. “Gabby, it’s Jace Rawlings.”

  “Dr. Rawlings, the infamous African heart surgeon?”

  “Very funny.”

  “I didn’t expect to hear from you so soon.”

  “I didn’t expect to need you this quickly. Gabby, I’ve got an urgent valve replacement to do. I’m going to need you sooner than I’d thought.”

  “So how’s it going? Is everything set?”

  “I’m working on that.” He paused. “So how soon do you think you can come?”

  “I have some time off coming my way, but I’ll have to ask Evan. He makes the schedule.”

  “I already talked to our cardiac anesthesiologist. Dr. Martin marked off the week after next.”

  “You’re serious. I’m supposed to just drop everything and fly to Africa?”

  “We talked about this. You said—”

  “I’ll make it work, Jace. You sound stressed.”

  “It’s been a little crazy. I had quite the adventure getting my stuff through customs. And everyone around here seems to want to size me up and figure out why I’m doing this.”

  “So how is your sister?”

  He paused. “That’s not funny.”

  “What do you mean? Heather told me that the reason you left was because your sister had asked—”