Glen had left her alone with him a while ago after her bold announcement that she knew who she could call on to help. He didn’t seem to believe she would be able to pull it off, but at least he quit fighting her about keeping absolutely unbroken secrecy around the project. He’d just have to trust that she could handle the negotiation in a way that wouldn’t expose SomaGene. Hell, she’d been involved to some degree herself and any scandal would likely harm her reputation and employability as well. They all had plenty to lose if she screwed up—and Jeremy had everything to lose if she didn’t find help.
She leaned over and kissed his clammy, feverish forehead, then left the room to make her call.
Amanda sat at Jeremy’s desk and took out her cell phone. She set it down in front of her and gathered her thoughts before making the call. While Jeremy’s welfare was paramount, she wanted to be careful not to needlessly create any permanent repercussions. She anticipated this conversation would be very tricky to navigate.
She glanced at her watch. It was already late in the afternoon. She picked up her cell and hit the speed-dial while she still had her nerve up.
After several rings, voicemail kicked in. She gritted her teeth and punched Jeremy’s desk as she prepared herself to leave a message. It had to be just the right message.
“Hi, Rick. It’s Amanda. It’s really, really critical that I speak with you as soon as possible. Please call me.” She left her cell number and hung up.
She couldn’t sit still. She stood up and walked to the window and stared out for a few moments, then paced around the office. Adrenaline surged through her system and her heart raced. She knew this was a life and death call, and she was forced to wait, helpless. Would he even call her back, given how they had parted nearly two years ago now? Would he even remember her?
Even if he called back, would he call in time, let alone agree to what she planned to propose?
She sat back down and rifled through Jeremy’s desk drawers, hoping to find at least a stale granola bar. She realized she hadn’t eaten much in the last forty-eight hours—she’d only munched here and there on some hospital-type food Glen had brought to Jeremy’s room. Her hands trembled from stress and low blood sugar.
About a half hour after she’d left her message, her cell rang and nearly startled her right out of her chair. She grabbed it and looked at the display before answering. Her heart hammered so hard she could hear it in her ears.
“Hello, Rick?”
“Yeah. Didn’t expect to hear from you after all this time. What’s up?”
Amanda took a breath and tried to calm herself, then began. “Rick, I’m involved in a very strange situation up here in the Twin Cities. You’re the only one who can help.”
A pause, then Rick answered, his voice taking a guarded tone. “What sort of situation?”
“We need a highly skilled surgeon to at least assist, possibly lead, in an urgent procedure. The patient needs to have his entire intestinal tract removed.” She cringed as she waited for his response.
“What? Why is this an emergency and why do you need to recruit someone? Surely you have numerous capable surgeons in the Twin Cities.”
“The intestinal tract is dying—the tissue is quickly becoming necrotic and toxic. We need help because we’re down to only one surgeon who is familiar with the patient and the procedure, and he can’t perform the procedure unassisted.”
“That still doesn’t answer why there isn’t someone local who can assist—hell, there should be whole teams available to assist up there. Why would you attempt it with only two surgeons, anyway? I’m no more familiar with the patient than anyone else, and I’ve never performed such a procedure. Why the hell is the entire intestinal tract necrotic? I’ve never heard of that.”
Amanda realized she was going to have to risk revealing more information to have any chance of getting him to bite. “Rick, the patient is in this situation because of an experimental procedure. We can’t recruit just anyone to assist for reasons of confidentiality, and we need someone with exceptional talent in leading-edge procedures.”
“Who is ‘we’ and what sort of experimental procedure led to this?”
“The experimental procedure was a full intestinal tract transplant. Something has gone wrong and the transplanted organs are dying. For the time being, they must be removed to save the patient’s life. As far as the ‘we,’ I’m not actually part of the team that performed this. I’m a…very good friend of the patient’s. I can’t think of who else we could bring in to help, and we’re running out of time to save him. Please, Rick.”
“Who is this team? Are they part of an institution? I can’t just perform surgery wherever I feel like. My employment contract limits me, you know.”
“I’d rather not go into the details of the program. I’m probably not the best person to discuss that too deeply anyway. I can tell you a publicly funded institution is not involved. This is a skunk works project at a private company. Only a small staff was working on it, and one of them left—that is why we’re short a suitable surgeon.”
“So you’re asking me to drop everything and head up there to perform an urgent, extremely risky surgery on a patient I’m not familiar with—who’s part of some experiment that I’m not involved in and know nothing about?”
Amanda sighed. “You’re right. That about sums it up. For myself, I’m asking as a favor. I know I have no right to. The patient is the President and CEO of the company in question. He’s not in any condition to negotiate anything right now, but I doubt I’m going too far out on a limb to say if you saved his life he’d be very grateful and would compensate you appropriately. Pay, maybe a position on the team if you wanted. I can’t promise specifics for him, you understand.”
“Does this have anything to do with those visits to your alleged girlfriend who was having surgery?”
“Yes. It does. This has been going on for a while at various stages. Rick, I really need to know. Will you do it?”
“Save his life so he can try to live without an intestinal tract? Is that really doing him a favor?”
“This is not the first time this has happened. They do have a protocol for nutritional support after the removal. It’s not pleasant by any stretch, but it buys him time until they can try again.”
“That could be a long time. The chances of an organ donor with a good tract and a solid tissue match are not terrific.”
Amanda decided to keep the cloning aspect of the project in her pocket for now. “True enough. Rick, will you?”
Another long pause. “You caught me at a bad time. I have some things I can’t get out of. I need all of tomorrow to get matters in a state where I can leave for a few days. I can be there the day after tomorrow. Best I can do.”
“Thank you so much, Rick. I hope that will be fast enough. I’ll have Glen Hawkins, the other surgeon, contact you with specifics as to location and all that, OK?”
“All right. See you in a couple of days.”
“Rick, thank you. I mean it.”
“You’re welcome, but this had better be worth my while.”
Amanda hung up and let out a long breath. She’d promise just about anything right now to save Jeremy’s life, but she didn’t think she could speak for him on exactly how he would want to repay Rick for his efforts. They’d just have to work that out later. If Rick didn’t arrive in time to save him, it wouldn’t matter anyway.
CHAPTER 66
Amanda shut the door behind her and approached Jeremy’s bed. She was relieved Rick was coming, but still very worried it would not be in time. She gazed at Jeremy. He looked about the same as when she left him to make her call. She supposed that was about the best she could hope for under the circumstances.
She realized she didn’t know where Glen was or how to find him in the facility, so she simply pressed the buzzer to get him to come to the room.
He arrived several minutes later, looking tired and alarmed at the same time. “What’s going on? Did something
change?”
“No, he’s about the same as before. I just didn’t know how else to find you. I found a surgeon to assist.”
“You’re kidding.”
“No. It’s Rick Granada. He’s a regenerative medicine surgeon and research scientist down in Rochester. Soonest he can be here is the day after tomorrow, but at least he agreed to come.”
“I’ve heard of him. He has an amazing reputation. He’d be perfect. How much does he know?”
Amanda explained what she had and had not revealed to Rick. “So he’s going to have some questions, no doubt about that. And he’s going to want to know what’s in it for him. I didn’t promise specifics—I don’t think I’m in a position to. That’s something Jeremy will have to speak for. I told him to expect your call concerning logistics.”
“Sure. I’ll take care of that. Meanwhile, we’re just going to have to do our best with supportive care for Jeremy while we wait.” He turned to her with a quizzical look. “How did you know to contact him, anyway?”
“We used to date.”
CHAPTER 67
Glen led Rick into his office to meet and prepare for the procedure. He’d brought him in through a rear entrance, not only to dodge potential encounters with other SomaGene employees, but also to circumvent showcasing the high-tech lobby and spending precious time on any sort of distraction. He wanted to avoid anything that would delay getting the surgery underway as quickly as possible.
He sat behind his desk and motioned for Rick to take a seat. “I just checked on the patient, and he’s about the same. I think you’ve arrived not a moment too soon. We need to operate before he gets even more toxic.”
Rick held up a hand. “Before we get started on the details, I have some things I’d like to address.”
Glen felt the tension build in his shoulders. Of course it wouldn’t be so simple as having one of the most brilliant regenerative medicine surgeons take a little trip up to the Twin Cities to just do a little procedure for fun. There would be expectations, implications. Might as well find out what they were and deal with them as best—and as quickly—as he could. “Yes?”
“What exactly is going on here, and what led to this situation? I was not aware that SomaGene had developed a protocol for intestinal transplants. If you expect me to become involved, even by simply performing this procedure and nothing more, I need to know what I’m involved with.”
Glen stared down at his desk. “I can tell you, but I must ask that the information not leave this room. This is a highly confidential project within SomaGene, and must remain so for reasons that will become apparent. Even the rest of SomaGene is unaware of this project.”
Rick tilted his head, folded his arms, and sat back in his chair. “Why should I get involved in this? My skills are in high demand, and are under contract with my current employer. I’m likely about to violate the terms of my employment agreement—without any promised compensation—and you also expect confidentiality? Ridiculous.”
Every minute that ticked by felt like a palpable added weight on Glen’s shoulders. Every minute decreased the chances Jeremy would survive at all. He was afraid the great Rick Granada would come at a hefty price. If only Tim hadn’t left when he did… No point rehashing that. “Rick, tell me what you want. I don’t have the time or the inclination to play cat and mouse here.”
Rick considered his answer for a moment. “I need to know what led up to this, what I’m participating in by agreeing to perform this surgery. I can’t agree to it blind. There may be an ethical line I’m not personally willing to cross. I can’t know that without you being honest with me. That said, it’s clear that confidentiality is very important to you. But it comes at a cost. If your program interests me, I will want to join the team—appropriately compensated, of course. It sounds like you’re short a good surgeon, so there should be an open position. If your program is not of that much interest, I will perform the surgery for a one-time fee. If I choose to not perform the surgery because of ethical issues, I will accept a one-time payment for my trouble in coming up here, and will be on my way. In any of these scenarios, you would have my silence.”
Glen rubbed his face with his hands as he tried to think of a suitable response. He knew SomaGene was doing quite well, so money likely would not be a problem. But how much? That would be Jeremy’s call, but he was in no condition to deal with a negotiation right now. “All right, I’ll play.”
Glen explained the origins of the program, as well as the key milestones and the various procedures Jeremy had undergone to date. He decided to soft-peddle Tim’s reason for leaving—and what he had done to cause the first Subject’s death. “You must understand, Jeremy would be the one to decide the specific amount of compensation. I can assure you he would agree to appropriate compensation—it’s only right. I just wouldn’t want to make a specific promise I didn’t have the authority to make.”
“Fascinating. Absolutely fascinating. You know, one of the things that frustrates me about my current position is that they’re so conservative. There is no way on earth they would dare undertake a program like this because of the way they’re funded. You say your partner left some months back and you’re flying this project solo? You’ve got a lot of work ahead of you—beyond today’s procedure. You’re going to need a partner to work through that and determine how to make the next transplant the last Jeremy needs. I’d like to join the team, permanently.” Rick stood up and offered his hand.
Startled, Glen stood and shook hands. He was sure he could get Jeremy to approve the hire—if he survived the surgery. If not, all bets were off at SomaGene anyway.
At least Rick didn’t have the qualms that Tim had. Indeed, he’d make a great partner on this project. Glen smiled. “Welcome. Now let’s get this done.”
CHAPTER 68
Glen finished inserting the breathing tube and adjusted the anesthetic gases. He still didn’t like Jeremy’s EKG. They’d provided all the supportive fluids and meds they could throw at him, but the added delay in getting him to surgery had taken a toll. He looked borderline shocky, and he’d have to be monitored carefully during the procedure. Glen turned to Rick, who stood by the instrument tray, scalpel ready. “Let’s go. And we’re going to have to move fast, judging by these vitals.”
“Got it.” Rick bent to his work, starting with a rapid incision to expose the abdominal contents.
They had quickly conferred on how to approach the procedure before prepping Jeremy. Given that Glen was still so worn down from handling the prior surgery and ensuing post-op work alone, they agreed that Rick would be the primary surgeon and Glen would assist. Rick would be far fresher and likely to move through it much more rapidly and surefootedly.
“My God, I’m amazed he’s alive. I’ve never seen such extensive internal organ necrosis—in a living person. I like the idea of clamping the major vessels for easier resection next time. This should go pretty quickly.”
Keeping one eye on the monitors, Glen watched Rick work. He was like a machine. He’d pick up another clamp, seal off another vessel, clip it off, then repeat the process just as fast as seemed humanly possible. Glen had to admit to himself that even on his best day, he wasn’t nearly that fast.
Rick continued making good progress and had been working in silence for maybe another hour when Glen noticed some irregular beats on the EKG. “How close are you, Rick?”
“Maybe three-quarters of the vessels are clamped off. Still need to get at that last quadrant—and detach the tract at each end. Why?”
“There’ve been some irregular beats. Nothing big, but I have a bad feeling something may be coming.”
“I’ll keep going fast as I can. Let me know if you have to defib.”
“Yeah.” Glen pulled the crash cart closer so he could be ready. He didn’t like the feeling in his gut.
About ten minutes later, his gut was vindicated. “Get back! Clear!” Rick nimbly jumped out of the way, instruments still in his gloved hands. Glen gave Jeremy a
jolt with the paddles and checked the monitor. Still showed a chaotic heart. “Again!” Another jolt. He again glanced at the monitor. “Flatline!”
Rick tossed his instruments onto the tray and picked up a syringe with a long, thick needle. He quickly drew a dose of epinephrine into it from a nearby vial and moved close to Jeremy. He tugged the surgical drape down, felt for the intercostal space with his left hand, then, without the slightest hesitation, plunged the needle in up to the hilt and pressed the plunger. He yanked the needle back out, tossed it onto the cart and began to vigorously thump and compress Jeremy’s chest.
Glen stood back from the whirlwind that was Rick and stole another glance at the monitor. Miniscule heart rhythms appeared to replace the flatline. He alternately watched the monitor and Rick’s aggressive pumping.
“Come on! Come on!” Rick shouted at Jeremy as he frantically continued his compressions.
Glen took another look at the monitor, fearing the worst. A rhythm! “He’s back! Got a beat. Hurry, wrap him up and close.”
Rick shot a quick look at the monitor, stepped back in position, and quickly got back to work.
About twenty minutes later, he lifted the excised intestinal tract out of Jeremy’s abdominal cavity and hastily tossed it in the waiting receptacle. “All right, quick check for any leakers…good. Closing now.”
Several minutes later, Rick stood up straight and stretched his back. “Done. Closed for speed, not aesthetics. You can bring him out of it now.”
Glen breathed for what seemed to be the first time in an hour, and began to adjust the gases to bring Jeremy back out of the anesthetic.
CHAPTER 69
A couple days later, Jeremy lay in his bed in the recovery room. He’d been in and out of consciousness since the surgery. Today he was beginning to feel somewhat more alert, though he was still quite tired and in a fair amount of abdominal pain. His ribs hurt, too, and he didn’t know why—so much so, he didn’t like to take a deep breath.
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