Absolute Zero
Page 29
His town house had originally been chosen for its convenient location, a mile from the hospital and clinic. When he’d moved in two years ago, his deck overlooked wetlands and a woods. Now a golf course provided a deeper shade of sizzling chemical green.
He cared about the environment. He was not a flashy person, he reminded himself, as he walked through the comfortable two-bedroom unit. His furnishings were sparse and functional, well made but not extravagant.
He was not a bad person.
He was not shallow.
He’d made only one mistake in his life.
One.
And he was doing his best to learn from it.
He put a bag of popcorn in the microwave and set the timer. Cub Scout popcorn, sold door-to-door. Sure, here kid.
Not a bad person.
Not.
He left the kitchen, went into the bedroom, and selected a pair of freshly laundered blue scrubs from his dresser. Clothing kept turning up in his exercise bag and he kept forgetting to return it. When he was home alone and didn’t expect guests, like now, he wore them as lounging pajamas.
He put on the soft shirt and loose trousers, went back to the kitchen, transferred the popcorn from the microwave to a bowl, and went into the living room. The movie Garf had given him lay on the coffee table. Allen shook out the tape, inserted it in the VCR, and tapped the play button. While the leader played out, he turned The Blue Angel jacket over and read the tag line on the back. “A middle-aged professor is degraded and led to his destruction through his infatuation with a heartless café entertainer.”
Hmmm. He’d give it a try, to see if there was a point to Garf’s insolence. He settled back on the couch and began to eat his popcorn.
The movie was an early talky that creaked across the screen in seventy-year-old black and white. Dr. Immannuel Rath, a portly professor, fuddled his way through the pranks of his students and wound up following some of them to a seedy nightclub where Lola Lola, the Dietrich character, strutted her stuff.
Allen squirmed a little and licked the greasy popcorn residue from his fingers. Very funny. I’m supposed to be the socially maladroit academic being swallowed alive by the hot nightclub singer. Is that it, Garf?
But the character that stuck in his imagination was not the professor or the entertainer. As the doomed romance developed backstage in the nightclub, a clown wandered through the scenes with wistful eyebrows and a sad smile painted on his face. The clown’s purpose was to underscore Professor Rath’s folly. In fact, the professor, ruined by his love for the singer, joined the vagabond traveling troupe and wound up donning the clown costume himself.
The clown was the only character who knew what was going on.
The movie ended with a melodramatic death scene. Disgraced, Rath made his way back to the schoolhouse and collapsed on his old headmaster’s desk.
As the film rewound, Allen considered Garf’s intent; was it an ironic caution or a threat? Either way, it was a clue that more intelligence was cooking behind Garf’s blue eyes than Allen had previously assumed.
Garf had to go, of course. Milt was leery about underwriting Jolene as long as Garf was living under her roof.
And now it appeared that Garf was suggesting that Allen had to go. Allen smiled a tight little smile, got up, and experimented with a six-part silver box tango step. Garf underestimated him, of course. As had Hank.
Allen slid the movie back in its jacket, took the popcorn bowl to the kitchen, washed it, and put it in the cupboard. Then he spent half an hour going over his notes on tomorrow’s surgery schedule. Satisfied, he filed the notes back in his briefcase, brushed his teeth, flossed, washed his hands, and went to bed. As always, he fell immediately into a deep, dreamless sleep.
Allen woke punctually at 6:00 A.M., rolled out of bed, donned a wind suit and Nikes, stretched, drank a tall glass of water, and went on a five-mile run.
On his way back, at about mile four as he jogged past a long stand of fiery staghorn sumac, he had his revelation. It started with an awareness about the unself-conscious way his body was moving. For the first time in his life, outside of surgery, he felt fluid, as if his work brain had finally melted and now dripped warm and active down into the rest of his body.
The new perception was simple: the accidently-on-purpose-snuffing of Hank Sommer had not so much liberated Jolene as it had freed him. He, not Jolene, was more alive. Almost as if he sucked Hank’s ferocious life force out with a straw and digested it.
He’d finally made a mistake and the disaster had set him free. He didn’t need to possess Jolene. He didn’t need to do anything. He just simply had to be himself.
The red line had been erased.
Allen ran home, showered, and then, standing with a towel wrapped around his waist, razor held aloft, his lathered face centered in the steamy bathroom mirror—he thought, No. Let’s let it grow and see how we look in a beard.
On the damp tile bathroom floor Allen took a few stylized steps and bent over an imaginary tango partner. He dressed, ate cereal in a warm blur, and drove to the hospital.
It was Friday, which was his favorite day because he spent all day in surgery. As he parked and entered the building he mentally put on his work cap to begin to focus on the day’s procedures.
But he was not so intense that he forgot to take the time to smile at the nurses, to say good morning to a janitor. And the staff locker room didn’t feel like a decompression chamber this morning. Just a changing room.
Capped, wearing blue booties over his shoes, with a mask loose around his neck, he sipped a cup of black coffee in the staff lounge. A small audience had gathered at a table around Lenny Merman.
“So what does it mean if you find a lawyer buried up to his neck in cement?” Merman asked
“Groan,” Allen said.
“Shortage of cement,” Merman said. More groans.
Merman was a burly ortho guy, so passionate about his work that colleagues joked he’d probably tear his way into a body with his bare hands if the surgical tech was late with his instruments.
“Okay, here’s another one. Why are lawyers buried at twenty-six feet instead of at six feet?” Merman would not be deterred.
“Boo, hiss,” Allen said.
“Way down deep they’re really good people,” Merman said.
Allen rubbed the stubble on his cheek and smiled when he caught his reflection in the mirror next to the bulletin board. They wouldn’t approve at the Mayo Clinic.
The charge nurse came in and posted the room schedule, and the blue pack of surgeons went off to the surgery suites. Allen walked down the corridor not even paying attention to the red line, went to a sink, and meticulously scrubbed his fingers, hands, and forearms with antibacterial soap.
Allen was a belly man. His domain was the region located between the crotch and the diaphragm, the area in which lay the liver, the spleen, the pancreas, the colon, the small intestines, and the reproductive plumbing. The internal structure, shape, and color of these organs were more clearly visualized in his mind than the faces of the people they belonged to.
He walked into the surgery and held out his hands like a matador to be draped and gloved by the circulating nurse. The team assembled. Allen greeted them—first his resident, Durga Prasad from Bombay, the surgical tech, a circulating nurse, and an anesthetist. Allen, Durga, and the tech worked in direct contact with the patient and observed the sterile barrier. So they were gloved and gowned. The anesthetist, the circulating nurse, and the anesthesiologist—if she wandered in—were not sterile.
The first patient shuffled in, a middle-aged man wearing a hospital gown. Allen matched the face to the procedure on the surgery schedule: bilateral inguinal hernia repair.
They eased the patient onto the operating table. He looked up a little wary at the huge circular AMSCO quantum surgical lights hovering over him on jointed arms, like the wings of a robotic angel. Next, the patient eyed the anesthesia machine which sprouted pumps, dials, tubes, and digit
al screens.
“You’re going to be just fine,” Allen said.
Then the anesthetist ran his IV and hooked up his monitor leads and injected Versed in the IV, which he followed with a shot of Sublimaze. The patient was masked, pre-oxygenated, and then was put under with Pentothal.
All smooth, amid casual banter about The Blair Witch Project, which Jeannie had just seen on video.
“Really, really overrated,” said Jeannie, the circulating nurse.
“Fakey, I thought, the wooden stuff hanging in the trees,” said Jerry, the anesthetist.
“Smart, though,” offered Allen. “Remember the way they hyped it on the web?”
After Pentothal, the muscle relaxant, succinylcholine, was administered. The patient shuddered. Behind his mask, Allen clicked his teeth. It was the same kind of muscular spasm that he had caused in Hank Sommer.
Allen took a deep breath and waited as the patient lost control of his muscles and went flaccid. Expertly, the anesthetist fitted a plastic shield over the patient’s teeth, then inserted an instrument like a stainless-steel, right-angled trowel—a laryngoscopic blade—into the sedated man’s throat. The patient’s head shifted as the blade was levered forward and upward to elevate the epiglottis and expose the glotal opening. Then the anesthetist inserted a plastic tracheal tube, hooked up the breathing circuit to the machine, and pumped nitrous oxide into the patient’s lungs.
Allen directed everything that occurred in the OR with verbal instructions. Nonverbal cues were conveyed through the eyes, the only feature that showed above the surgical masks. Surgical teams were close watchers, especially of their surgeon leader. Now all the eyes in the room keyed on him, to sense his mood, to see what kind of day he’d have.
He heard them whisper that he hadn’t shaved this morning and what did it mean?
The patient’s stomach was draped with sterile blue sheets. Another sterile blue sheet separated the patient’s head from the operating field. The human shape became abstract. Allen’s target was an anonymous shaved square of belly which had been designated with a rubber stamp: LEFT.
The tech unwrapped and positioned a sterile tray that contained the instruments for hernia repair, the square of exposed flesh was washed with orange Betadine disinfectant. One last point of etiquette remained: the choice of music on the CD player that sat on a table along one wall.
The eyes over the masks turned to Allen who always selected the music.
“Jeannie, pick us some sounds,” Allen said casually to the circulating nurse.
Allen could feel the slight lift in the room as Jeannie spun some Sheryl Crowe. Allen held up a gloved hand, the scrub tech firmly put a scalpel in it, and he made the first incision.
And so the day proceeded under the hot surgical lights. In between procedures, Allen moved between the pre op suites, where he interviewed his next patient, and the consult room, where he spoke briefly with the family of his last procedure.
A hemorrhoidectomy.
A left-breast biopsy.
Time out to consult on a patient in emergency, then back down to surgery to remove another suspect lump from an elderly woman’s breast and run it though Radiology.
Lunch was interrupted by a page to consult on a man admitted with a numb, discolored leg and a history of heart problems. Allen jogged up two flights of stairs, saw the patient, and agreed with the internist to give the man a clot-busting drug.
The hours floated by with soft intensity like a long, almost weightless parachute drop.
And soon it would end, after the last scheduled procedure, a laparoscopic cholecystectomy. The lap choly was a routine gallbladder removal using a laparoscopic wand that contained a miniature video camera and lights.
After the patient was intubated and breathing on the machine, his abdominal cavity was inflated with carbon dioxide gas. A ten-millimeter sheath was poked inside through a port incision above the navel. Then the camera was inserted in the sleeve.
Two television monitors were positioned on either side of the operating table, so Allen and his resident could both easily view the liver and gallbladder.
Three other ports were incised higher in the stomach wall on the patient’s right-hand side, just beneath the liver. And sleeves were inserted. Two for the resident to handle his forceps and one midbelly, for Allen to use the dissecting forceps, in this case an electric cautery.
Laparoscopy was essentially a spatial-orientation video game played on a living person. Allen held the rotating, pistol-grip forceps controls in his hands and coordinated the working end of the forceps to the image the camera projected on the television towers.
The glistening coral-colored formations of human inner space reminded Allen of spelunking, going into underwater caves with Aqua-Lung and handheld lights—something he hadn’t tried yet. Maybe Milt would go for it?
“Lights,” Allen said. The powerful overhead lights were turned off.
“Music,” Allen said. Again Jeannie chose. Bruce Springsteen belted out “Born to Run” as the resident gripped the gallbladder with a forceps and positioned it against the liver. With exquisitely fine muscle control and timing, Allen clipped the cystic artery and duct with titanium staples, then severed them. He then carved the gallbladder free from the liver bed with the cautery. Before removing it through the umbilical port, as he tidied up some minor bleeders with the cautery, he had an attack of sheer whimsy.
Or perhaps inspiration.
To underscore the new boost in his mood, or perhaps to honor the secret transgression that had launched him out of his rut—Allen acted on impulse in a fleeting moment when no one was watching the video towers. With a deft whirl of the cautery controls he seared two letters into the patient’s abdominal wall:
AF
His own initials up on the screens.
No harm done, it would heal in a few days. It was just a tiny flourish. He would have preferred Vivaldi trumpets instead of Clarence Clemons’s saxophone, but, hey, what the hell . . .
Allen stripped off his last sterile gown of the day and tossed it in a hamper. Then he dictated his notes and was on his way to the locker room when he met Merman in the hall.
“So how do you code an ostrich kick?” Merman asked.
“What’s this, another joke?” Allen was mildly intrigued.
“No way. ER just admitted a guy with a transverse fracture of the left humerus. Bam. One kick.”
“Where did it happen? At a zoo?”
“No idea. C’mon, take a look at his arm, the nurse in ER said the kick tore a hole in a heavy leather sleeve and you can see the scale pattern of the bird’s toe knuckle in the mangled skin.”
“That’d be worth seeing,” Allen said, genuinely curious. He kept pace with Merman as they left surgery, went around the pre op admitting desk, and headed down the corridor to Emergency. They turned a corner and, ahead of them, a group of nurses and the ER doc were gathered around a man on a gurney and—
Allen immediately stood absolutely still and let Merman continue on alone.
The patient was Earl Garf.
And Phil Broker was standing at the edge of the medical huddle.
And right next to Broker, holding on to his elbow real friendly-like, was the nurse-anesthetist from Ely, Minnesota: Amy Skoda.
Allen’s surprise escaped his lips in a nervous stammer: “Wha-what . . . ?” Ashamed, he backed down the hall and around the corner with his hand clamped over his mouth.
What the hell was going on?
Chapter Thirty-eight
After getting Earl admitted to the emergency room at Timberry Trails, Broker used a pay phone in the waiting room to call Jolene.
He told her that Earl was her friend again, like she wanted, and he’d be moving his stuff out of her basement. And maybe she should send him some flowers because he’d just been admitted to the hospital after having his arm broken by an ostrich.
“That’s what I said,” he repeated. “An ostrich.”
He said he’d be at the
farm until Sunday afternoon, and then he was returning to Ely. He said he hoped everything turned out all right.
He said good-bye. Then he realized something and turned to Amy. “You have a plane to catch.”
Amy shrugged, grinned. “Let’s blow it off. We have an escaped ostrich to find, remember?”
“Right. How do you find an escaped ostrich?”
They laughed, then, remembering Rodney in the barn, Broker made a fast call to John Eisenhower at the Washington County sheriff’s department. After quick pleasantries, Rose, John’s secretary, said she could squeeze him in for ten minutes if he hurried.
Rushing through the hospital parking lot, Broker explained, “I know that other guy who ran. Rodney. I need to check something with the local sheriff.”
On the road, he said, “John and I go way back. I was working on his task force when I arrested Rodney three years ago. He’s supposed to be in jail.”
Pushing the Leper Colony, he drove eighty mph on back-county roads, leaving Timberry, skirting through Lake Elmo and Oak Park Heights, and turning onto Highway 36 where it made its turn approaching the St. Croix River on the outskirts of Stillwater. A few minutes later he turned into the parking lot for the Washington County Jail and the sheriff’s office.
“This will only take a minute,” he assured Amy. He jogged into the red-brick jail complex and was buzzed through a security door. Rose waved him in. “Make it quick, he has to talk to the Elk’s Club in ten minutes.”
John was standing in front of his desk in gray dress slacks and a T-shirt breaking starch on a fresh white dress shirt. Broker hadn’t seen him since last May when he’d come up to Broker’s Beach for the fishing opener. John was running for reelection next month and he’d been spending time in the gym. He had trimmed his blond mustache and the ten desk pounds that he used to wear around his waist had migrated back to his chest and shoulders as muscle.
They shook hands warmly. Then John’s hand went to his pocket and he handed Broker a campaign button: REELECT THE SHERIFF.