MAYA HOPE, a medical thriller - The Dr. Nicklaus Hart series 1

by Timothy Browne, MD

  “What are you thinking?” Anna asked.

  Nick looked into her kind eyes and hesitated. He did not readily go to his heart. “What a day so far.” He bailed and took a bite of his sandwich.

  “I guess you’re used to this stuff?”

  “Well…I…uh. How about you?”

  “I have to admit, that last guy with the nasty wound on his shin almost got to me. Maybe it was the smell and the fact you could see the bone.”

  “Yeah, that was pretty nasty.”

  The man with the wound was middle-aged and had been hit by a car two years earlier. He had lived with an open, draining wound and a floppy, lower leg ever since.

  “Are you going to be able to help him?”

  “Well, even back home that would be a really tough one,” Nick said thinking out loud. “It would involve multiple surgeries with some pretty specialized equipment. Specialized and expensive. I bet in the States, that treatment would cost upwards of a quarter million.”

  “Dollars?”

  “Yeah. Unbelievable, huh?”

  Anna got very quiet. Then it was her turn to think out loud. “That’s bad.”

  “So the other option is to amputate the leg. It would instantly get rid of the bad infection and the deformity. But I have no idea how we would ever get him a prosthetic leg.”

  Nick took another bite from his sandwich. “You sure you still want to be a doctor?”

  Earlier, she had shared with Nick that she had applied to medical school.

  “Oh my gosh, yes, Dr. Hart. To be able to help people like this. I think this is what God made me for.” She smiled broadly at him.

  A football landed between them, and Nick grabbed for his soda before it tipped over. A fit young man ran up to retrieve the ball.

  “Hey, sorry about that.”

  Nick flipped the ball into his hands. “No worries.”

  The young man smiled at Anna and backed away flexing his arm as he threw the ball.

  Nick smiled at Anna. “Looks like you have a fan.”

  “Yeah, whatever.”

  “Tell me about your band of friends here.”

  “There are twenty-two of us, all from the School of Ministry at Living Waters. Ever heard of it?”

  “Can’t say as I have,” Nick shook his head. “What’s Living Waters?”

  “Living Waters is a church in northern California. It has a great school that trains people in the ways of God.”

  “You mean like a seminary?”

  “Well, sort of. We go for at least one year, and then at the end of the year, most of the students go on some sort of outreach. Kind of like, to share what we have learned for the past year.”

  “So, all these kids were in your class?”

  Anna laughed, “Yeah, these and almost a thousand more like them.”

  “A thousand? You kidding me?”

  “Well, that’s just the first year.”

  “There’s more?”

  “Many go on to do a second or even a third year.”

  Nick looked at the young people around him. They looked like very normal twenty-somethings.

  “What have you all been doing since you got here?”

  “Oh, all sorts of things. It’s been so great. Helping here at the Hope Center—painting, cleaning, playing with the kids. Things like that. Anywhere we can help. We have gone to a number of the villages. We actually helped another church team from Denver drill fresh water wells for a couple of them. It was so awesome.” Anna’s enthusiasm was palpable. “In fact, a lot of the patients you are seeing today are people that we met in the villages and brought here.” Anna smiled proudly.

  “Thanks a lot,” Nick teased, thinking of the complex cases he had seen that morning.

  “Anything for the good doctor.”

  They sat in silence for a couple of minutes as Nick pondered this group of young do-gooders.

  What was I doing at twenty-two? School, I guess. And chasing girls.

  “You go to church?” Anna interrupted his thoughts.

  “Well, I grew up in the Episcopal Church, but I…” Nick said, feeling self-conscious. “It’s been a while since I’ve been. I’m afraid I know more Dr. Seuss than I do the Bible.”

  Nick saw Maggie coming toward them and felt relieved that he didn’t need to say more.

  Maggie gave him a hug. “How did your first morning go?”

  “I’m hoping you had me see the hard ones first.”

  Maggie looked at Anna and smiled like they had a secret. “I bet you’re doing great,” she reassured him. “You ready for a quick tour before we put you back to work?”

  “That would be great,” he said, jumping off the table.

  “You want to go with?” he asked Anna.

  “You go ahead, Dr. Hart. I want to hang with my friends for a minute.”

  * * *

  The operating room was beautiful, just as Maggie implied, state-of-the-art. John had done an amazing job of fundraising, and it showed in the operating room equipment. Maggie reassured Nick that it had not always been this way. For many years, they had coped with the basics until a wealthy donor from Seattle came to serve with his church and saw their struggles. Scraping by ended that day. At the end of the year, they had a new fluoroscopy machine, anesthetic machine, laparoscopic equipment, and new surgical tools.

  On the other hand, the need was never-ending. Maggie and Nick strolled through the back half of the Hope Center to the orphanage, which currently housed seventy-three children. It was recess, and many of the children ran around the playground.

  They entered a modest building filled row upon row with bunk beds, all neatly made up.

  “You run a tight ship.”

  She smiled at him. “Yeah, kind of like controlled chaos. We only have room for around fifty kids, but we never turn anyone away, not ever. It’s the kids with disabilities that really strain the system. But Jesus says, ‘whatever you do for the least of these, you do for me.’ ” She looked at Nick to see if he understood.

  Nick started to speak, but his voice broke. He attempted to start again, and it broke again. “Maggie. I had no idea what you and John were up to down here. I would have…”

  Maggie put her hand through his arm. “Really, Nick, it’s okay. I’m just glad you’re here now.”

  “I am so sorry, Maggie. I don’t know how you are doing it. I mean, I miss John so much right now.”

  Nick looked at Maggie and regretted his words. The dam broke, and her emotions poured out. He pulled her close. She dissolved in his arms, her body quaking with grief. Her tears soaked his shirt. He paid it no mind and stroked her hair.

  “I am so sorry, Maggie. I am so sorry.”

  Even though he was uncomfortable, Nick let her grieve. She felt good in his arms, but it wasn’t supposed to be like this. He missed John fiercely.

  As her grief subsided, she pulled away from him. He was reluctant to let her go.

  She wiped her nose with one hand and her eyes with the other. “Oh my Lord.” She patted him on the chest where she’d left tearstains. She wiped at her face again and dried her hands on her pants.

  “I try to be so strong for everyone here.” Her tears flowed again.

  Nick tried to pull her close, but she resisted, so he held her by her shoulders instead. Maggie wiped her nose with the back of her hand.

  “I feel like my heart is going to burst open.” Her tears continued to fall. “I guess I needed a good cry.” She nodded to the wet spot on his shirt, and her tears turned to deep sighs. “I’m so glad you’re here. John would be so happy to be here with you right now. You know, you were his best friend.”

  Nick was speechless. He could never replace John, but he wanted to wrap her in his protection. Maybe this is what love feels like.

  They stood in silence with their own thoughts.

  Finally, Nick broke the silence. “I just don’t understand how someone could have taken John’s life. It doesn’t make any sense to me. What in the hell is th
at all about?”

  “Exactly.”

  Nick was confused.

  “Hell. That sort of evil only comes from hell.”

  Nick was still confused.

  Maggie straightened up and wiped tears from her eyes. Something was coming. He could tell she was choosing her words carefully.

  “You see, Nick, there’s a battle raging around us. You may not understand. I don’t know, but I pray that the Lord opens your eyes.”

  “I guess I don’t understand, Maggie.”

  “Oh my dear, Nick,” Maggie patted him on the chest again. “We have a lot to talk about, and you better hold on to your socks. You just might have your world rocked. Have you ever seen an angel or a demon before?” She looked at him seriously. Before he could answer, she went on. “Most people have no clue of the spiritual world around them, but you see enough miracles or ancient curses over peoples’ lives, and it will quickly make you a believer of the unseen.”

  CHAPTER 18

  * * *

  First OR Day

  Nick stood at the threshold of the operating room. The sign above the door read: “Peace To All Who Enter Here.”

  He smiled, thinking of John up on a ladder nailing it in place.

  Nick had had a restless night, tossing and turning. He knew it was, in part, because of the busyness of the full clinic the day before, the amount of pathology he had seen, and the anxiety of operating in an unfamiliar OR, but the main reason was the dream that he had about John.

  Nick only remembered part of it, the part where they were standing near the summit of very high mountains in the middle of a blizzard. It was a strong storm and they were in danger. John kept encouraging him to take shelter amongst the boulders, but Nick wanted to keep pressing forward. To what, he had no idea. That’s when he woke up with sweat rolling down his neck.

  Maybe the most unsettling part of the dream was that it was so real. It was as if John was alive. Nick had sat in the dark on the side of his bunk with his head in his hands and wrestled with the issue of heaven. He realized that if John existed in some cosmic realm, it meant one thing—his own love for Maggie had to remain platonic.

  But could he love her without wanting to love her physically?

  Nick looked at the sign above the OR. “You left big shoes to fill, my friend.”

  * * *

  It was mid-morning and Nick had already enjoyed a hearty breakfast of eggs, beans, homemade tortillas, and two cups of delicious, strong Guatemalan coffee. The coffee was the best part; he loved the way it infused life into his foggy brain.

  He had met the local surgical team that would help him today. They worked at the government hospital in Quetzaltenango, but they had promised Maggie to take a few days off to help Nick with any surgical cases.

  They were a friendly bunch—a middle-aged female nurse, a younger male scrub technician, and an attractive female anesthesiologist who was not more than five feet tall. Nick wondered about their capabilities, but with Maggie’s reassurance, he decided to proceed.

  The day started slowly with only a few scheduled cases. Nick realized that even though John had put together a fully functional operating room, it lacked orthopedic implants. Nick recognized that he would have to figure out a way to get implants from the States if he wanted to do significant cases.

  He looked over his shoulder at Anna. He had spent the last fifteen minutes showing her how to do a surgical scrub.

  “You ready?”

  He thought Anna looked cute in her surgical cap and mask that highlighted her bright blue eyes.

  “Uh, I don’t know. You sure this is okay?” she said holding her hands and arms in front of her. Her mask had crept up on her nose and pushed under her eyes, and she tried to move her chin to force it down.

  “Hard when you can’t touch anything, huh?”

  “That’s for sure.”

  “You’ll be great. I’ll get you all set, and you’ll have the best seat in the house. You’ve been in the OR before with your pre-med preceptorship, right?”

  “Yeah, but never scrubbed in before. I’m pretty nervous,” she said, still trying to move her mask down.

  “Do exactly what I do, and you’ll be fine.”

  “Yeah, right.”

  “Remember, don’t lock your knees, and if you do start feeling faint, just sit down or step out into the hallway.”

  “Oh great.”

  “Come on, Dr. Anna, you’ve got this. And I need you. Our team here doesn’t speak a word of English, and you know how excellent my Spanish is.”

  His humor made Anna relax. She took a deep breath, and they backed through the OR door.

  The well-equipped operating room was small, compared to U.S. standards, but it was brightly lit. Nick could hear the anesthesiologist talking with the patient. Whatever she said, the old woman practically sat up. It was the woman with the torn rotator cuff.

  “Dios te bendiga, Dios te bendiga.” The woman started chattering where she left off from the day before. The anesthesiologist encouraged the patient to lie back down on the OR table with her hand on her chest, but the woman continued to chatter.

  Nick had met with her and her family early that morning and talked to them about fixing the torn rotator cuff in her shoulder and what to expect. He had hardly gotten a word in edgewise. He laughed to think of the twelve family members all crammed into the waiting room and more waiting outside. Obviously, there was a lot of love in this family.

  Nick smiled at Carmen, the anesthesiologist, and gave a sleepy head nod, like ‘okay, time for her to take a nap.’

  Carmen raised a finger in agreement and gladly pushed the plunger on a syringe, injecting narcotics through the IV. Nick was impressed. Carmen had given the old woman a technically difficult shoulder block to avoid the danger of a deep anesthetic. The woman’s entire shoulder area was numb; she would have just enough drugs to slow the chatter and give her a wonderful nap.

  Nick watched the woman’s eyelids flutter closed as the narcotics hit her brain.

  With the help of the scrub technician and the nurse, Nick helped Anna gown and glove. He motioned to the nurse to pull Anna’s mask down out of her eyes. He told Anna how to hold her hands, to fold them in front of her. After the nurse had finished the prep, Nick placed the surgical drapes on the woman’s shoulder.

  He guided Anna up to the table and placed her gloved hands on the drapes.

  “Rest your hands here.”

  Juan Carlos, the scrub technician, was already busy putting the suction and cautery in place.

  Just like back home. Man, it feels good to be back in the OR.

  Nick used a surgical marking pen to show the anatomic landmarks and trace a line on the skin where he would make his incision.

  “Scalpel.”

  Juan Carlos looked at him blankly.

  “Uh, scalpel.” Nick looked at Anna.

  She looked stricken. “I don’t know that word in Spanish.”

  Nick thought for a moment. He had seen a number of machete wounds the day before. He put out his hand. “Machete?”

  That made the whole crew crack up.

  “Ah, bisturi.” Juan Carlos said and grabbed the surgical knife.

  Nick held his hand out waiting for the scalpel. Juan Carlos and Carmen talked back and forth.

  Nick looked at Anna. “Have I forgotten something?”

  There was an exchange between Anna and the staff.

  She turned to Nick. “They want you to pray. Dr. John always prayed. They don’t feel right unless you pray.”

  Panic rose in Nick’s chest.

  Except for the chirp of the heart monitor, a thundering silence stilled the room.

  “Well, the only prayer I can remember right now is grace.”

  Anna translated for the room.

  “What do you mean grace?” Anna translated for Juan Carlos.

  “You know, what you say before a meal,” Nick said sheepishly.

  Anna spoke to the staff. There was a long silence.


  Then everyone burst out laughing. Juan Carlos spoke, and Anna translated. “Okay, grace it is. Thank you for this food.”

  Juan Carlos handed Nick the scalpel.

  * * *

  Maggie joined the team for lunch. They sat in their scrubs on the same picnic table as the day before. The young adults from California were nowhere to be seen. Nick assumed they were off on a project or tracking down more patients for him to see.

  “How did it go?” Maggie asked Nick.

  “It was great. Just like back home.” Nick paused, thinking through what he had said. “Well, except I like your OR lounge better.” He lifted his face to the afternoon sun. “And your staff is nicer.” He smiled at the surgical team as Anna translated.

  “Wish my assistant was better,” he joked poking Anna’s arm, making her blush.

  “Hey, I think I did pretty well,” she retorted. “At least I never keeled over.”

  Anna translated for the team, and they laughed.

  Nick put up his hands. “Okay. You did great.”

  Maggie turned to Anna, “What’d you think?”

  “It was awesome. I mean, I was really nervous when I saw that scalpel go across the skin. But I kept reminding myself that I can do all things through Christ who strengthens me. I could really feel His peace.”

  Maggie watched Nick study Anna’s face and interrupted his concentration. “You have what you needed?”

  “Oh yeah.” Nick returned to the moment. “Maggie, I honestly can’t believe how well you have your little hospital decked out. I’ll need to figure out a way to get some ortho implants down for the bone cases, but otherwise, it was great.”

  “Well, it’s all John. He worked tirelessly to equip the place, and it wasn’t always easy. When we first started here, people would call us and tell us they had a donation. Sometimes we would fly or drive somewhere to pick it up, and, honestly, more often than not, it would turn out to be a worthless pile of leftover junk, stuff you wouldn’t even treat a dog with. We would have to find the nearest dump and put it where it belonged. We tried not to be ungrateful, but sometimes we wondered what people were thinking.”