Jeremy turned to her and took her in his arms. It felt so right to hold her close, to feel her warmth. He couldn’t imagine being without her again. “Maybe it’s not so much the stuff you brought with you. Maybe it’s just having you here.”
She looked up at him. “I’m so glad things turned out this way. I never should have broken up with you.”
Jeremy leaned over and kissed her. She slid her warm fingers onto the back of his neck, pulling him even closer as she gently slipped her tongue inside his mouth. Then she suddenly pulled away, her face flushed.
“Upstairs,” she whispered, as she took his hand in hers and led him up the staircase and to their bedroom.
He started toward the bed, hungry for her, but she stopped him in the doorway. “Not yet.” She reached up, kissed him once on the lips, then lightly along his neck down one side and back up the other. She gently took his earlobe in her teeth. He could feel her warm breath on his skin.
“Now.” Driven mad, Jeremy reached down, scooped her up, carried her over to the bed and placed her on the soft down comforter. He knelt over her, pinned her arms, and kissed her neck, her ears, her eyes, and her mouth as if making up for every minute they had been apart. As she began to pant and writhe beneath him, he wanted her more now than he had ever wanted any woman.
He slipped his hands beneath her shoulders and raised her up. She pulled her T-shirt up and off and flung it to the floor. Then she lay back down, and he slowly unbuttoned, then unzipped her jeans. She raised her hips to help him slide them off. She wore no underwear.
Still clothed, Jeremy took his time kissing and licking Amanda all over until she became frantic and he could no longer wait. Then he quickly stripped off his shirt and pants and moved to enter her. But just before he could, she suddenly pushed him aside and ordered him onto his back. He complied with a frustrated groan.
She knelt over him and started to lower herself toward him. Jeremy lay back and closed his eyes, waiting for that moment when he would first feel himself inside her. And that moment came—briefly, oh so briefly. She barely let him inside, then pulled away. And then again. And after a tormenting pause, yet again.
Unable to stand it any longer, Jeremy reached for Amanda’s shoulders, flipped her onto her back and pushed himself all the way inside her, as slowly as he possibly could. Her teasing had heightened the sensation for him so intensely that nothing in the world existed except where their bodies met. They moved in a slow rhythm together for a time, their fingers entwined, then Amanda started to move her hips more urgently, and Jeremy stopped holding back.
Afterward, they lay exhausted and entangled on the bed. Jeremy whispered in her ear, “I love you, Amanda.”
She squeezed his hand. “I love you, too.”
Jeremy closed his eyes and smiled. He couldn’t remember ever being so happy.
CHAPTER 37
“Is the patient ready, Tim?” Jeremy glanced at the new kidney that lay in its bath of pinkish nutrient fluid in a gleaming stainless steel tray. It struck him how the unblemished, newly cultivated organs resembled precious gifts in their shiny receptacles. He supposed they were, in their own way.
“Yep, looks good. We should get started.”
“All right. Going in.” Glen picked up a scalpel and made the initial incision.
The client in this case, Mr. Abbott, was a ninety-year-old man with far more money than time. His kidneys had begun to fail, largely due to his advanced age rather than any specific disease process. He was fortunate to be able to afford in-home dialysis, rather than having to sit with other patients in a room full of machines for multiple hours per day. But of course, no one wants to be tied to daily dialysis if there is an available alternative.
So, money in hand, he’d approached SomaGene for the solution to his problems. And SomaGene had been more than happy to oblige him.
But Jeremy had concerns about taking this particular client. While it had become commonplace for SomaGene to safely and reliably produce suitable new organs for its clientele, Mr. Abbott was undoubtedly the oldest client to approach them so far. Jeremy worried that his overall condition presented a greater than normal risk. Of course, they required pre-op testing and evaluations of all prospective clients, but Mr. Abbott’s results had been just barely within the acceptable values. He was so very old and frail in general. In reality, his kidney issues were only part of his problem.
Jeremy tried to set aside his concerns and focus on the procedure taking place. They’d accepted him as a client, so there was no point worrying about it now. Besides, all clients had to sign a release that was supposed to limit SomaGene’s liability to providing competent surgery to implant a new organ derived from the client’s own tissues. Once that was done, even the post-op care was outside of SomaGene’s hands. It was so much simpler and cleaner that way.
Glen finished clamping off the offending kidney, removed it, and tossed it into a waiting steel bowl with a somewhat disdainful flourish. “Ready.”
Jeremy lifted the new kidney from its nutrient bath and guided it into place in the patient’s waiting cavity.
“That’s it. Thanks. Got it from here.” Glen bent over and prepared to resect the new kidney onto the blood vessels and awaiting ureter. He began to work, deftly and quietly.
“He’s flatlining!” Tim jumped up and reached for the paddles. “Step back!”
“Wait a second.” Glen quickly pressed a wad of sterile gauze into the cavity and slapped a strip of surgical tape over it. “All right.” He stepped back, hands raised in the air.
Tim applied the paddles and sent the lifesaving jolt through Mr. Abbott. He briefly arched on the operating table. Tim glanced at the monitor readout for a moment. “Again!” He applied the current. And again, Mr. Abbott arched forcefully on the table.
“Jesus, I only had that kidney partly resected.” Glen hissed through clenched teeth. “Hope nothing tears.”
Tim glanced at the monitor once more, and exhaled. “OK, he’s back. Better wrap it up fast as you can. I don’t trust him.”
“You got it.” Glen bent down, carefully removed the surgical tape and gauze and worked on completing the implantation.
Jeremy realized he’d been holding his breath through the entire crisis. He inhaled slowly and deeply to purge himself of the adrenaline burst that now caused his hands to shake. He made a mental note to review the records in this case against their client acceptance protocol to see if any adjustments should be made in the future. They’d dodged a bullet this time, but he didn’t want a repeat occurrence. They might not be so lucky next time, and it’s not as if they needed the business badly enough to take such risks.
He admired Glen’s cool as he watched him work. His hands were swift and sure as he worked to properly connect all the blood vessels to the new kidney, and to make sure the connection to the ureter was solid. The only remaining evidence of the crisis was the absolute lack of the usual banter among the three men as Glen worked.
After a while, Glen set down his instruments and let out a long breath. “Ready to close.”
Jeremy positioned the tray of suturing supplies within Glen’s easy reach. More silence ensued as he sutured Mr. Abbott shut, layer by layer.
“Done.” Glen stood straight and stretched his back.
“I’ll start bringing him out of it,” said Tim.
Jeremy stepped over to the operating table to apply a dressing to the wound. He vowed to adjust whatever protocols were necessary to avoid another close call like this.
CHAPTER 38
Jeremy’s hand shook as he hung up the phone. He could feel the blood draining from his face as the news sank in. It was Mr. Abbott’s personal physician, Dr. Callahan, and the report was grim. Indications of kidney dysfunction had resurfaced along with symptoms of necrosis. Emergency surgery revealed that the new kidney had begun to die. Mr. Abbott was not only back on dialysis but was also on massive doses of powerful antibiotics to ward off possible septicemia. He was in intensive care, and
given his underlying frailty, the prognosis was uncertain at the moment.
It had only been a week or so since the implantation. Given how that had gone, Jeremy was surprised Mr. Abbott made it through the emergency surgery. Two major procedures so close together would be rough on anyone; that old bird must be tougher than he looked. Jeremy was grateful for that much.
Callahan hadn’t sounded accusatory. He seemed to be merely reporting events as they happened. But Jeremy could connect the dots in his head. The next call would likely be from a lawyer.
A small, painful spasm slithered through his gut. He tossed it off as a reasonable response to the call he’d just received, and sent a quick internal message to Glen and Tim to come to his office right away. He wanted to have a word with them first, before calling in Brad Gilman, SomaGene’s general counsel.
They arrived quickly and took their seats. “Well, this is mysterious. What’s up?” asked Glen.
“Remember Mr. Abbott from last week? Well, I just got a call from his doc.” He then explained what Dr. Callahan had relayed to him.
“That kidney tested out perfectly before the procedure.” Glen then brought his hand to his chin, as if considering something very carefully. “But, when he had the arrest, I hadn’t yet completed my resection. I had to secure the kidney quickly just to try to hold it in place during the defib. I wonder if something was damaged during that brief interval when he bounced around on the table.”
Tim cast Glen a sharp glance. “Well, what was I supposed to do?”
Glen waved his hand in a dismissive gesture. “No, no. There was no choice. I know that. If anything, I held you up while I tried to secure it. I don’t know what we could have done differently. If only he hadn’t arrested right then—well, or at all.”
Jeremy asked the question that scared him the most. “What about his pre-ops? Do we have any exposure there?”
Tim thought for a moment, then answered. “Well, his blood values were certainly borderline for surgery like that. But they were still just within our guidelines. The man is ninety, for crissake.”
“But should we perhaps have more conservative guidelines? Could we have seen this coming if we’d looked more closely at the labs—or maybe at the lab values in combination with his advanced age?”
“No, I don’t think so. I know I didn’t see this coming. Sure, I took his age into account with the anesthesia, but he looked good enough going in that I wasn’t overly concerned. If you’re that worried about this happening again someday, then maybe we do tighten down what lab results we’ll accept before going forward. Maybe we wouldn’t have taken this one on, I can’t say. On the other hand, I’d hate to exclude others who are borderline simply because they need our services. Seems like it could be counterproductive for most of our clients.” Tim sat back and glanced at Glen.
“I agree with Tim. I think this was either unavoidable or something that, had we tighter screening criteria, might throw out the baby with the bathwater as far as our target clientele is concerned. We’ve had other cases where the labs were close to the line and this didn’t happen.”
“All right, I’ll brief Brad so he’s ready if Abbott lawyers up. Thanks.”
CHAPTER 39
Amanda took a sip of her Chardonnay and glanced at Jeremy. She didn’t like what she saw. Things had been going so well since his surgery, but today he looked preoccupied, as if something was terribly wrong. She sat back in the leather booth, set down her glass and cleared her throat.
“What?” Jeremy seemed to snap out of a daydream and fixed his gaze on her as if he’d just noticed her sitting there.
“We go out to a nice place, and you haven’t said a word since we got here. You seem to be worried about something.”
“Sorry.” Jeremy shook his head and stared down into his wineglass. “I didn’t mean to wreck the evening.”
A waiter dressed in trim black pants and vest and a blindingly white starched shirt whisked by, refilled their glasses, and placed a basket of warm bread and butter on the table.
Amanda waited for him to leave, then asked, “What is it? It’s obviously serious, for you to look like that.”
Jeremy took a piece of bread, halfheartedly buttered it, then set it aside. His movements seemed automated, devoid of focus or intention. “We had a problem in a procedure last week. We didn’t realize at the time how serious it would turn out, and I got a call today. Patient had to have the kidney removed due to necrosis.”
“Necrosis? Why?”
“We’re not entirely sure. He arrested during surgery, when the new kidney hadn’t yet been fully resected. We think it suffered some damage while we defibrillated him—but we didn’t realize it at the time. Got a call from his doc today that the kidney wasn’t functioning and had become necrotic. He needed surgery to remove it and massive antibiotics.” He took a small bite of his bread. “Looks like he’ll probably pull through, but I’m sure we’ll be hearing from his lawyer any time now.”
“Oh, I’m sorry. What are you going to do?”
“Well, first I need to see if he pursues it. I suspect he will, though, and that’s what worries me. Meanwhile, we’re re-evaluating our pre-op testing protocols to see if we want to tighten them up. Problem is, if we do that, we might cut out a lot of patients whose only hope is one of our procedures. It’s a tricky balance.”
Amanda took a sip of wine as she considered Jeremy’s dilemma. “I see what you mean. Frankly, I’m surprised something like this hasn’t happened before. Your clientele is by definition in serious condition—their only advantage is their ability to afford your services to solve their problems.”
“True enough.” Jeremy grimaced.
“Are you OK?”
“Sure, fine.”
“You’re not having stomach pains again, are you?”
“A couple here and there. I’m sure it has to do with this problem. I just don’t know how ugly it will get before it’s resolved, and I really don’t like being in that kind of situation.”
Amanda frowned. “But you’d been totally symptom-free since recovering from the procedure. Are you sure something isn’t starting up again?”
Jeremy shook his head. “I’m sure it’s not related to that. If you’d received the call I did today, you’d have a stress-induced twinge or two yourself.” He tried to smile.
Amanda wasn’t convinced. “I don’t know. Maybe. I’d keep an eye on it if I were you.” She took another sip of wine and stared more closely at Jeremy. She didn’t like the idea that he could be backsliding into Crohn’s symptoms after doing so well. She hoped she was overreacting.
CHAPTER 40
“Yes, Brad, what is it?” Jeremy had been dreading this call, and gnawed on the end of his pen as he waited for his in-house counsel to update him on the Abbott situation.
“No real surprise. Abbott got himself a lawyer and is threatening to sue. He’s asserting he paid his money, passed his pre-op tests, and should be happily done with dialysis now instead of still fending off possible septicemia after the kidney went necrotic.”
“Well, sure, he did pass the tests, but despite that, he went into cardiac arrest at exactly the worst possible moment for the kidney—it was partly transplanted at that point and we had to deal with the arrest first.” Jeremy realized as soon as the words were out of his mouth that it sounded like he blamed the patient for going into cardiac arrest. He grimaced in disgust at himself as he waited for Brad’s response.
“You don’t have to convince me. I get what you’re saying. But Mr. Abbott feels the money he spent on the kidney and procedure should have pretty much guaranteed a perfect result.”
“We don’t guarantee any such thing in our standard release. Where does he get off?” Jeremy tossed the pen down and slapped his hand to his forehead.
“We don’t make any such guarantee, true enough. But his lawyer will likely argue he was in a desperate situation, vulnerable in some way seeing as he’s elderly, and the high fee and SomaGene’s own
stellar reputation set up some reasonable expectation on his part.”
“You’ve got to be kidding.” Jeremy’s free hand clenched into a fist, seemingly of its own volition.
“I’m not saying I agree with that position. Not at all. I’m just walking through the argument they’ll likely present to us, and what we have to be ready to counter. Have you had a chance to review his pre-ops? Do we have a weakness there? Was something—anything—missed that would have made this a foreseeable outcome?”
Jeremy rubbed his forehead as the hot, painful tendrils of a budding headache snaked through his skull. “We’ve looked them over. Multiple times now. They’re on the edge, but still within our current standards. There was nothing that gave a clear indication this outcome could be foreseen. Just the same, we’re looking at maybe tightening the pre-op test criteria to give a little more margin for safety. Trouble is, that would cut out some more borderline clients who have no other choice and could really benefit from what we offer. I don’t like that tradeoff very much, but I don’t want another Abbott, either.”
“All right, sounds good. I’ll be in touch. Meanwhile, I’ll feel out opposing counsel and see what we might be able to negotiate to get this to go away—quietly.”
“Thanks, Brad.” Jeremy hung up the phone. His head pounded and he felt nearly queasy. He reached into his desk drawer for some aspirin.
“So, what do you have to report?” Jeremy glanced at Tim and Glen—and hoped they had something useful to share. They sat across from him in his office a couple of hours after his conversation with Brad Gilman.
“I think we have an idea that will address the risk and still not cut out potential clients.” Glen gave a self-satisfied smile, sat back in his chair, and steepled his fingers.
The Janus Legacy Page 12