Dying to Remember

by Glen Apseloff

  “That won’t happen. I just need—”

  “No, anything can happen. What if you’re doing a sequential graft and you connect it in the wrong places? In this business there’s no margin for error. If you’re not a hundred percent, forget it.”

  “Hell, at fifty percent I’m better than—”

  “Buddy, I’m not gonna argue with you. If it was me, I’d file for disability.”

  “Yeah, right.” Barnes shook his head in disgust. “After two weeks you’d be climbing the fucking walls. Let’s face it, Denny. You and I are two of a kind. We’ll never retire. Most people go to the office and push papers. We split open someone’s chest and hold their beating heart in our hands. I need to do that, Denny.”

  “I hear you, buddy. But I work alone. If I’d wanted a partner, I’d have teamed up with you a long time ago. But it ain’t my style. You need to give serious consideration to retiring. Before you’re forced into it.”

  “Are you kidding?” The only people in a position to force him out were his own colleagues, all of whom were well aware of the revenue and recognition he’d brought to the hospital.

  “There’s going to be a meeting sometime next week about your privileges. Administration’s concerned about liability.”

  He felt himself flush. “I don’t believe this. I’ve brought millions into this place, tens of millions, and they have the gall to consider me a liability?” He knew his voice carried all the way down the hall, but screw decorum. “I’m the reason this is a world-class cardiac unit!”

  “Keep it down, buddy. It’s not that simple.”

  “Not that simple? Those sons of bitches.”

  Denny glanced at a clock on the wall. “Listen, buddy, I need to get back to the locker room. My first case has been moved up half an hour.”

  “Fine.” He forced himself to be calm. “Who’s assisting?”

  Houston raised an eyebrow. “Willard. I already told you.”

  “Yeah, right.” Barnes returned his gaze. “Don’t look at me that way. I remember.”

  But he couldn’t remember, and he knew Denny was observing the signs of his disability. Now Barnes understood how patients in the early stages of senility must feel when they begin to lose their mental faculties but try to conceal it from their loved ones. Barnes could conceal his disability only as long as people let him. A few simple tests and he would be stripped of his facade, and stripped of his dignity.

  Gazing past Denny, he looked at the picture windows behind the nurses’ station. How easy it would be to walk over there and fling himself through one, into oblivion. The pain would be brief.

  Denny draped an arm around him. “Look, buddy, you only just got back. You can’t expect to just pick up where you left off. You should go home and catch up with things from when you were gone. Just take it easy.”

  He shrugged off Denny’s arm. “Screw that. I need to be here, working.” Even if it’s just pushing papers, he thought. And that reminded him of their research. “How’s our atherosclerosis study going? Anything happening, or did you put it on hold?”

  “We talked about that yesterday.”

  “Refresh me.”

  “Everything’s going great.” Denny looked at his watch. “I don’t have time to get into this now with my case coming up. Let’s talk about it later.”

  Barnes didn’t want to let him off the hook that easily. “Later today. I want to know everything that’s going on with that. Don’t think you can take it away from me.”

  “Don’t be paranoid, buddy. I’m not trying to steal your thunder. Look me up later, or maybe tomorrow, and we’ll talk about it again. Right now I have to go to the OR.” Houston opened the door, and they entered the hallway to the surgeons’ lounge.

  “I’ll do that,” said Barnes.

  Denny turned his back on Barnes and headed into the locker room.

  Barnes just stood there in the hallway, then took out his list. He added a note: Houston doesn’t want to work with you.

  Chapter 29

  Barnes left the surgeons’ lounge. He didn’t belong there. No cases had been assigned to him, and nobody would share any. Not today and probably not ever. Why should they? Surgeons just don’t do that. It’s like asking a pilot to let you fly the plane.

  He went to the nurses’ station and walked behind the main desk, heading for the nearest picture window—the solution to his problems, clear as glass. The unit clerks, nurses, and other staff members might just as well not have been there. He saw only the window.

  He steeled himself and took a last breath. Like jumping into a swimming pool, he told himself. You make up your mind; then you do it. Only a different kind of splash.

  “Dr. Barnes?” The feminine voice interrupted his thoughts, temporarily broke his resolve. He turned from the window.

  It was Stella Laskin, a third-year student. Her straight hair hung limply and accentuated a long but pleasant face. “I’m sorry to bother you, Dr. Barnes, but I was wondering whether I might ask you a medical question.”

  He remembered grilling her a few times in the OR during her surgery rotation in September; she’d surprised him with mostly correct answers. Now she’d surprised him even more simply by being there. Medical students seldom sought him out. “What is it?” he asked.

  She looked up at him, her eyes filled with sorrow. “My father went to see our family doctor for what he thought was laryngitis, and the doctor told him there’s a tumor on his vocal cords. I know that’s not your area of expertise, but I was hoping you might recommend a specialist.”

  That was easy. “Ian Williams.”

  She wrote the name on an index card. “He’s here at this hospital?”

  “Yeah. He’s the best. Anything else?”

  “No.” She put the index card in the pocket of her lab coat. “Thank you, Dr. Barnes.” She hesitated, as if about to say something else, then turned and walked away. Even when Barnes was helpful, medical students found him intimidating.

  Barnes looked around him, wondering what he was doing behind the nurses’ station. He must have come here to look at a patient’s chart, but who was the patient? Maybe one of the nurses knew and would hand him the chart or lab report or other information. But all of them seemed occupied with other things. He glanced at his watch. Examinez votre poche droite.

  The list in his pocket didn’t help. Instead it informed him that Denny didn’t want to work with him. He thought he recalled a piece of that conversation from not long ago, here in the hospital, but it had become clouded almost to the point of obscurity.

  He headed back to the surgeons’ lounge—he didn’t know where else to go—and poured himself another cup of coffee. Taking a seat near the television, he tried to figure out what to do next. More than anything, he wanted to be in the OR, but that wasn’t going to happen anytime soon.

  Billings hadn’t moved. When he saw Barnes sit down, he folded his newspaper on the conference table and turned to him, catching his eye. “The man wants nothing to do with you, does he?”

  The baritone voice, as much as the question, startled Barnes. “What?”

  “Your friend . . . Houston. Acts like you’ve got the plague.” He spoke slowly, deliberately, almost as though translating the words from another language. At the same time, his large forehead wrinkled into dark crevices, and his eyes reflected such a dark shade of brown they looked black.

  “He’s just busy,” Barnes replied.

  “He’s a jerk is what he is.”

  “What’s it to you?”

  “To me it’s just an annoyance. But to you . . . it’s a big problem. You associate with him.”

  Barnes took a long drink of coffee. Billings was right, but what could he do? It was too late to make new friends.

  Billings added, “I hope you’re not counting on him.”

  Barnes avoided the man’s gaze.

  Billings picked up his newspaper. He talked to it rather than to Barnes. “Houston would let pneumonia into his OR before you.”r />
  “Yeah, well, I don’t see you jumping at the opportunity,” Barnes countered.

  Billings put down the paper and glared at him. “Why the hell should I?” Those words came faster than his others.

  “Because I’m the best—” Barnes cut himself short, deciding to take another tack. “No, because you don’t like Denny, and you and me working together will piss him off.”

  Billings frowned. “Can’t argue with that.”

  “Hell, it may even improve race relations.”

  Billings said nothing, and Barnes knew the man was wrestling with the decision. He was probably weighing personal factors, such as whether working with someone more experienced than a resident would free up more time for him with his wife and kids—if he had any—or give him extra time to do Christmas shopping.

  “I’ve got a double bypass with a skip graft,” Billings said, “coming up in fifteen minutes. The skip is for the left anterior descending artery. The patient has a small proximal obstruction . . . and a larger distal one.”

  Barnes had performed more skip grafts than he could count. It involved connecting a bypass graft to two parts of an artery instead of just one, to bypass two separate obstructions. “No problem. I’ll be ready in five.” He stood up to go get changed.

  Billings raised a hand. “Hold on . . . First let’s get something straight . . . I don’t want you to scrub with me. I’m allowing you to scrub with me . . . Don’t think you’re doing me a favor.”

  “You’re right,” Barnes conceded. “You’re doing me a favor.” Yet he couldn’t help adding, “I never figured you as the altruistic type.”

  Billings stood up—tall and muscular. “You don’t know Jack shit about me, Barnes. If you want to be in the OR, this is your chance. You assist me, and that means . . . I’m going to micromanage you; you’re not going to start any procedure . . . without my okay. You’re going to follow my every direction and my rules. Otherwise . . . I’ll throw you out.”

  “What are your rules?”

  “My rules are . . . you act civilized and treat everyone with respect—nurses, residents, even medical students. You do what I tell you, and . . . you don’t raise your voice. You don’t make others uncomfortable.”

  The way you are now? thought Barnes. “Anything else?”

  “Yeah. I play classical music . . . on the radio. You have a problem with that?”

  Barnes shrugged. At least it wasn’t Christmas Muzak. “I can live with that.”

  As if on cue, two residents and two medical students entered the lounge.

  “Change of plans, Walt,” Billings said to the less senior resident. “Dr. Barnes is going to scrub with me on this one. You’ll do the next . . . I need you to follow up on Mr. Jansen’s X-rays. See if they’re done . . . and see if they’re clear. We want to be sure he isn’t getting pneumonia. And check on Mrs. Wilson’s labs. They should be back any time.”

  Walt tucked his chin to his chest and headed out of the lounge.

  The other resident, Peter Findley, approached them. He was a tall, angular man with a large nose and thick glasses. Barnes had worked with him before and knew him to be competent.

  “Welcome back, Dr. Barnes.”

  Barnes grunted a thank-you. He remembered the last time Findley had assisted him. Barnes had been in a bad mood and had chewed out the resident for everything from being too slow to making incisions that weren’t straight enough. Barnes had a reputation for never being satisfied with the help he received. The residents used to say, “There are two ways to cut suture on Barnes’s cases: too short or too long.” The residents had come to accept the notion that on Barnes’s cases they couldn’t do anything right. Findley was no exception. He was quieter and more polite than the other surgeons—he seldom spoke unless prompted—but Barnes figured that underneath the silence and obsequiousness, Findley hated him.

  That was okay. Barnes wasn’t there to please residents. Surgical procedures were performed for patients, period. And patients would be a hell of a lot better off if all surgeons had that attitude. Too many placed too high a priority on teaching, or worse—making money. Hell, some surgeons let residents operate unsupervised. That was legal because the consent forms said Dr. So-and-So “and/or his associates.” “Associates” could be residents, and “and/or” could be simply “or.” So residents performed some procedures unsupervised, and the staff surgeon got paid for the work. A surgeon could make hundreds of thousands of dollars a year that way, having residents do the work, and as far as Barnes was concerned, that was immoral. Others might consider him arrogant, but nobody could accuse him of being lazy or immoral. No one could accuse him of giving anything less than the best possible care to every patient. He wondered what kind of care Billings gave.

  Two medical students stood a few paces back. They knew their place. During surgery they would hold metal retractors to keep skin, fat, and muscle out of the way, and they would speak only when spoken to.

  “Why don’t you go get changed, Chris?” Billings suggested. “We don’t have much time.”

  “Yeah. I’ll do that.”

  Barnes hurried to the locker room. Like all the surgeons, he had an assigned locker. Finding his clothes later would be no problem. As he took off his watch, the French inscription caught his eye. He suddenly remembered the list in his pocket, without having to reach in and discover it. That meant his loss of short-term memory wasn’t complete. There must be some functional cells in that part of his brain, and although those cells would probably not multiply, they could create new links and maybe even recruit other cells to assist in the repair process. In a few weeks he should have a better idea about where things stood. Who knows—he might even make a comeback as chief surgeon.

  Anything was possible.

  Chapter 30

  After changing into scrubs, Barnes pulled out his list for a final review before putting away his clothes. He’d placed his watch and wedding ring in his right front pants pocket—no watches or rings are allowed in the OR—and in a moment his all-important list would go back there, too.

  He still couldn’t believe he was about to do a bypass surgery. Back in the OR, scalpel in hand. His fingers itched to hold the steel instrument. The nagging fear of never being able to come off the disabled list had been replaced by the thrill of anticipation.

  He unfolded the paper to refresh his memory one last time before the surgery. He remembered nothing on the page, not even item one. Elizabeth had been murdered!

  In his excitement over the upcoming surgery, he’d forgotten the fact that someone had killed his wife. He’d been thinking about her murder all morning, but it had slipped his mind long enough for it to disappear. The fact was, the prospect of doing surgery had, however briefly, overshadowed the loss of his wife.

  He put away the list. Thoughts of Elizabeth now filled his head—everything they’d done together, and everything they would never do again. He had to solve her murder, even if that became his sole purpose in life. This much, at least, he owed to her.

  He slammed his locker shut. Nobody turned a head. The reverberating clamor of metal on metal, and even fists on metal, was routine in the surgeons’ locker room.

  He headed out to the lounge. Then another unsettling feeling came over him. What exactly was he doing there? Surgery, yes, but with whom, and on whom? He looked around the lounge. It offered no insights—no gestures or even nods from the few surgeons there. Someone had asked him to assist on a case. That much he remembered. Most likely Denny, but Denny wasn’t anywhere to be seen. In fact, there was only one surgeon Barnes even recognized, an old-timer named Brennen, and the man’s specialty was head and neck.

  Barnes walked along the wall to the OR schedule posted near the door. Houston was scheduled to start on a repair of an aortic aneurysm in OR 6. But Barnes had been thinking about a bypass graft; that meant most likely someone had asked him, or assigned him, to assist on that particular surgery. Could the schedule be wrong?

  “You ready?”
The baritone voice came from over his shoulder.

  He turned to see Billings, who’d just come in through the door to the operating rooms.

  “We’re going to start . . . in five minutes.” Billings was talking to him. “OR 9. You ready?”

  “OR 9. Yeah.” He tried to sound self-confident, but he felt his face flush. Billings, not Houston, had offered to let him assist. Barnes remembered nothing about that, and he wasn’t sure why he’d accepted. He would have to trust his previous judgment, go with the flow. Best not to ask about the case. No sense taking the risk of appearing clueless if they’d already discussed it.

  He put on a head cover and paper shoe covers from boxes on the table by the door, then followed Billings out of the lounge and down the stark corridor, past the recovery room and a nurses’ station and past one operating room after another. Billings stopped at OR 9 and stuck his head in the door. Outside, Findley and the medical students had just finished scrubbing; they turned off the water faucets by moving knee-operated levers under the sink. For a moment Findley stood there with his hands at shoulder height, water dripping off his elbows into the sink. Then he walked a wide circle around Barnes. The medical students followed. Billings moved out of the way, and they walked backward past him. Findley pushed open the metal door to the OR with his buttocks and backed into the room.

  “Let’s go in and take a look at her films,” Billings said to Barnes.

  In the OR, they went to the viewing boxes along the wall. The patient’s X-rays looked unremarkable, but on the arteriograms, Barnes could see obstructions in the coronary arteries.

  “This is what we’re dealing with,” said Billings. “The patient’s name is Mrs. Rigsby, Dorothy Rigsby. I’ll get the graft from her leg while you open her chest with Findley.”

  Barnes preferred the chest, although he knew the most important part of the procedure was obtaining the bypass graft. This Billings would do by removing part of the greater saphenous vein from the inside of the leg, starting near the ankle. Even microscopic damage to the vein would compromise the entire procedure. Barnes found working in the leg to be tedious, but he always did it himself on his patients. Now Billings was going to assume that responsibility. Hopefully that wouldn’t be a problem.