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

by Timothy Browne, MD

  They used John’s office computer to check the web on syndactyly and to discuss Isabella’s surgery for the next day. So far, all the repairs had gone smoothly, but this was not the time to be overconfident; Isabella’s surgery was in a league of its own.

  Sitting at John’s desk was unsettling for Nick; Tod and Buck, aware that Nick and John had been best friends, understood how difficult it was but had insisted. Buck had been unafraid to wade into the heart of the matter when he expressed sorrow upon seeing the photo of the two on top of McDonald Peak. It was the identical picture that hung in Nick’s office back at the MED.

  “Thanks, Buck. This is the first time I’ve come in here. It’s been too hard.”

  Maggie came through the door with a tray of glasses and a pitcher of lemonade. She set the tray on the desk. Nick saw her look at him and then at the floor. Her face went sad, and her bottom lip quivered.

  Nick jumped out of John’s chair. “Maggie, I’m so sorry.”

  Buck put his arm around Maggie’s shoulders, and she leaned into his massive embrace, wiping a tear from her eye. She smiled at Nick. “Oh, sit down.” She waved him back into the seat. “I was just thinking that John would have loved to be here with you all. As much as he loved this place, I think he missed doctor camaraderie. He dreamt the Hope Center would be like this, with lots of friends coming in and out.”

  There was a long pause as the men absorbed her words. Finally, she broke the silence. “You guys help yourself to the lemonade and to anything else in here. John would have wanted it that way. I’m going to have myself some girl time.” She patted Buck on the chest and pulled away. “Kim and your girls are lovely,” she said to Tod. “We’re painting nails tonight.” She wiggled her fingers at them and left.

  When Maggie was gone, Buck was first to speak. “She’s something.” He smiled at Nick and raised an eyebrow.

  “Yeah,” Nick said, embarrassed by the topic.

  “And?” Buck egged him on.

  “And I don’t want to talk about it. I can’t even go there.”

  “Okay, okay.” Buck backed off.

  Tod rescued the conversation. “Look at this.” He turned the laptop toward Nick.

  “It’s a pretty good article in the Journal of Pediatric Orthopedic Surgery on early syndactyly repair. It divides the patients in the different types of syndactyly and says that the type that Anna Elena has does fine with early surgery. I think it really comes down to how comfortable Carmen is with putting an infant to sleep. What I’ve seen of her work, I’m pretty darned impressed. I think we should get it done while I’m here. What do you think?”

  “Agreed,” Nick replied. “It might make for a long day tomorrow, but let’s start with her. I wouldn’t want the baby to go all day without food.”

  “Perfect.”

  “I’ve been thinking about Isabella’s surgery a lot,” Tod was on to another case. “Her anatomy is going to be so weird. All the bones will be misshapen because her feet have been deformed for so long. I like your idea, Nick, of doing one at a time together. We’ll see how it goes, but we may be only able to partly correct them and have to do more surgery down the road. We’ll have to see how the tissues stretch.”

  “I’ll sure be praying for you guys,” Buck put in. “I’ve never seen anything like that in my life. Yesterday, Maggie told me what life was like for Isabella. She told me Isabella would never marry because no one would want a deformed wife that couldn’t work. Poor little thing. It breaks my heart.”

  “Thanks, Buck,” Tod said. “We need all the divine guidance we can get.”

  Nick pulled an anatomy book from John’s bookshelf.

  * * *

  Nick and Tod went over each step for more than an hour, meticulously writing them down, when Buck interrupted their concentration. Crouched over at the side of the room, he was looking at the back of the office door. “Hey,” he said, “where was John murdered?”

  Nick and Tod did not look up, and it took a minute for Nick to focus away from Isabella’s surgery.

  “Uh, it’s a place called Tikal. It’s up north where some of the old Maya ruins are.”

  “I asked Maggie about John yesterday,” Buck said. “No one really seems to know what happened.” He was still staring at the back of the door.

  Nick was tired and not sure he wanted to talk about this right now. “I don’t know, Buck. Wrong place, wrong time.” Nick recited what he had heard over and over again.

  “You ever think about going up there to see for yourself?” Buck turned toward him.

  “Well, uh…sometimes. Maybe. I guess so. I just wouldn’t want to go alone.”

  “That’s probably smart,” Buck agreed.

  Nick was fully in the moment now. He straightened his back. “Why you asking, Buck?”

  “I’m not sure, but look at this.” He shut the door so Nick and Tod could see what he was examining. It was a large map of Guatemala. Near the northern part of the map were a number of red and yellow stick-on dots. Some of the dots were nearly on top of each other. There were some yellow dots by themselves, but wherever there was a red one, a yellow accompanied it.

  “Do you know where Tikal is?” Buck asked.

  “Not sure.”

  Buck thumped his finger smack dab in the middle of the dots. “Tikal. It’s right here.” He stabbed his finger on the spot a couple of time to reinforce the location. Then he pointed to the yellow dots and traced his finger down to a yellow key at the edge of the map and read the text John had written.

  “It says ‘FOCO wells.’ Mean anything to you?”

  When Nick said nothing, Buck turned toward his friend. “Nick?”

  All of Nick’s attention was on the framed calligraphy above the door. He hadn’t noticed it until Buck showed them the map. His head swirled, thinking about his recurring dream of John. The calligraphy read:

  ‘The Lord is my rock and my fortress and my deliverer;

  The God of my strength, in whom I will trust;

  My shield and the horn of my salvation,

  My stronghold and my refuge;

  My Savior, You save me from violence.

  I will call upon the Lord, who is worthy to be praised;

  So shall I be saved from my enemies.’ 2 Samuel 22: 2-4.

  CHAPTER 34

  * * *

  Camp 22

  Professor Kwon knew that he didn’t need to go to Hoeryong Political Prison Camp 22. He could have given the vials to one of his lab workers to take to the infamous camp. Convincing Pak that it was a good idea for him to personally oversee the experiments did not prove difficult. Pak even offered his car and driver to take him to the northernmost prison.

  Kwon wondered if Pak suspected him, but had to take the chance, even if there was the slightest possibility of success. For all he knew, Pak was responsible for the arrest of his family.

  As Pak’s car passed through the town of Hoeryong, Kwon saw the prison against the mountainside. At that distance, it was impossible to see the entire boundary of the eighty-seven-square-mile prison. He could make out the massive wall of the southernmost entrance rising like an impenetrable castle from the surrounding rocks. Reports showed what separated freedom from the horrors of the prison was an inner wall, electrified with a 3300-volt electric fence and an outer razor-wire fence, with landmines and traps between the two.

  As the car approached the entrance, Kwon remembered the day he heard where his wife and son had been sent. He never asked what happened to them for fear his fate would be the same. It took all his strength not to react when Pak told him the news. He wasn’t sure if Pak had made a mistake in telling him, or if it was a well-calculated seed of manipulation. Even though Kwon thought of Pak as a friend, he knew what a dangerous man he was and never to be underestimated for shrewdness.

  It would be a fatal mistake to ask to see his wife and son. In a prison of 50,000, the odds of catching an accidental glimpse of his family were nil, but it was worth the risk. Any glimmer of hope was bet
ter than none.

  He cringed to think his wife and son might be part of this testing, but human experimentation at Camp 22 was well known. It was the perfect place to further test the virus.

  Although the virus was a mutation of modern-day mumps, he needed to be certain that people inoculated with the current mumps vaccine would not be immune to his new strain, the one he called M2H1. The abbreviation would be accepted in the scientific world, as it was a mutated mumps virus, (M2), combined with the influenza virus, (H1N1).

  Five months earlier, Kwon had asked that 200 people at the prison be vaccinated with the mumps vaccine, long enough for their bodies to produce immunity. Now they would be exposed to the M2H1 virus. They would be quarantined so as to not infect the whole prison colony and the guards. He should receive his own vaccine soon, but there was no reason to risk a premature release of the virus. He did not want to think about the fact that all the patients would be quickly eliminated once its effectiveness was established.

  Kwon had not expected the M2H1 virus would cause sterility in both men and women, but the discovery that it did was a pleasing bonus. It would result in an even faster halting of any population propagation.

  He adjusted the case on his lap that contained the virus and took a handkerchief from his pocket to wipe his upper lip as they pulled up to the first of a series of guard stations.

  Everyone in North Korea knew what these camps were like. It was one more measure of control for the government to remind its people what could happen if anyone so much as hinted at stepping out of line. Occasionally, the government revealed photos of skeletal prisoners working in coal mines surrounding the prison. The pictures showed prisoners with missing ears, broken noses, and smashed eye sockets from repeated beatings and torture.

  Camp 22 was the worst of the worst, reserved for anyone who criticized the government, anyone who had attempted to escape to China, South Korean prisoners, and, of course, Christians.

  * * *

  Pak was furious. Whoever had interrupted his time at the medical clinic would be reprimanded. New, young girls had been brought to the clinic, including Dr. Chul’s granddaughter.

  Chul had been sent to the Hoeryong Political Prison Camp for his insolence. Pak had been incensed. How dare that man question my decisions? That’s why he had sent him to be re-educated at Camp 22. Chul was better off dead and being in that camp was as good as dead.

  To interrupt Pak’s clinic time made him angry, even though he understood the reason why. Kim Jung-wook, a South Korean Baptist missionary captured and imprisoned the previous year, was about to be paraded on North Korean TV to confess his crimes against the government. One of Pak’s subordinates thought he would want to attend. He was right, of course, but the interruption came at an inopportune time.

  Last week Pak’s agency had arrested thirty-three people who appeared to be associated with the missionary. Pak knew Kim was trying to start underground churches in North Korea, but he’d told his agents to torture the prisoner enough to get him to tell them he was a South Korean spy. Pak’s agents were to convince Kim the lives of the thirty-three other prisoners would be spared if he confessed.

  They will all be sent to Camp 22 anyway, so they are dead, one way or the other.

  Pak knew how necessary it was to tighten security at the northern border with China. Except for the Amrok River, there were no fences or barriers that separated the countries, and there had been a five-fold increase in defections the past five years. Fortunately, North Korea had an extradition agreement with China, and many of these traitors were returned and sent to Camp 22.

  Just because they were trying to escape starvation was no excuse.

  The Christians were a problem. Not only did they help on the Chinese side by providing shelter and food for the defectors, but many of them slipped back into the country and brought their propaganda and literature. Pak’s government had decreed that anyone caught with a Bible would be tortured and shot.

  CHAPTER 35

  * * *

  Death to Rejection

  The children at the Hope Center were curious about the girl with deformed feet. Many of them were playing in the courtyard when the team from California brought Isabella and her family back for the pre-op day. They couldn’t help but stare at the girl as she shuffled into the clinic. News of visitors or anomalies traveled at the speed of light throughout the orphanage.

  Maggie had anticipated their reaction, and before Isabella’s arrival at the compound, she had gathered the children in the cafeteria and told them about the girl with the deformed feet. If anyone understood rejection, it was an orphan. Many of the children had been abandoned by their own mothers and fathers at the doorstep of the Hope Center; their families had run out of money and hope. It took a long time to break the children of the orphan spirit, but when it was done, the children flourished.

  Maggie also knew what prayer warriors these little saints were, and Isabella needed all the prayer she could get. Maggie realized that the prayers of children were often answered. She thought it was their innocence or their insight, something many adults grew out of, but whatever it was, their simple prayers seemed to have a direct line to the Father.

  These children would help Isabella. She had been amazed by their ability to respond to visitors in distress. She had once seen the children gathered around one of the visiting young women from California who had been a victim of sexual assault by an uncle. Guilt and shame had convinced her to keep the secret from her team. But the children had seen right through it. For them, it was like it was a sticky note posted on the girl’s forehead. Maggie had watched in awe as the children prayed for the woman and dissolved her heartache.

  In that spirit of hope, Maggie asked the children to pray for Isabella. The children knew Isabella was not allowed to eat on the morning before surgery, so they decided to fast that day and skipped breakfast in solidarity with her. They had also spent the last few days in school making banners and flags to celebrate Isabella.

  While Isabella was being prepared for surgery, the children gathered in anticipation along the covered walkway between the ward and the operating room. Maggie had kept their celebratory surprise a secret from the surgical team.

  When Nick and Tod, still wearing scrubs, came through the ward doors to the walkway, a loud shout surprised them. A louder shout greeted Buck who, carrying Isabella, backed through the door and turned to face the crowd of well-wishers. Isabella looked tiny wrapped in a surgical blanket in Buck’s massive arms. The children shouted encouragement and waved their flags and banners. The banners read: The Lord is my Strength and Be Strong and Courageous. At the Hope Center school, in addition to reading and writing, the children were taught the ways of God, and they learned their lessons well. Isabella couldn’t stop smiling. She waved to the children with her little hand held out like a triumphant queen, even though it was attached to an IV line. Healing had begun.

  As Nick and Tod paused at the door to the OR they heard the group of children outside break into a chorus of song in Spanish, ¡Grande es tu fidelidad! Great is Thy Faithfulness.

  Tod patted Nick on the back, speechless, but they also understood the difficult task at hand. “Come on. We’ve got work to do,” he said.

  * * *

  The first foot took over two hours to correct. As expected, the anatomy was anything but normal. The talus—the bone that sits under the ankle connecting the tibia to the foot and the cornerstone for correction—was oddly shaped from the years of deformity. There was, however, one hope. Although Isabella was chronologically twelve, she was physiologically much younger and had not yet had her first menses. That meant that her bones were still growing, and there was a possibility that her bones would remodel. Otherwise, her joints would not be congruous, making them more painful and in need of fusing down the road.

  Nick and Tod were surprised that once all the tissues were released, the foot could be stationed in a relatively normal position. But because of the severe stretch of the
skin and neurovascular bundle on the inside of the foot and ankle, they could not possibly keep the foot in that position. They splinted the foot halfway corrected. Nick would need to do serial castings to bring the foot more and more into position over the next few weeks. He decided that, even though he hated to fly, he would gladly come down every weekend if he had to over the next few weeks.

  Spending time with Maggie would be the bonus.

  * * *

  Buck stood between Nick and Tod with his arms around their shoulders as they stood in the ward at the end of three days of work.

  “You guys have done a good thing,” he said, squeezing their necks and wrinkling his nose. “But man, you stink. You both need a shower.”

  Tod held his scrub top to his nose and laughed. “Yeah, I guess we better shower before the party.”

  “I’m not sure I have ever sweated so hard standing still,” Nick said, “but what a day.”

  * * *

  Isabella’s other foot took under two hours and went smoother than the first, but concluded with the same problem. Nick and Tod explained the situation carefully to Isabella’s family, as they were disappointed that her feet were not perfectly straight like all the other children who came back from surgery. Satisfied with the treatment plan, Nick and Tod received hugs from the family.

  The doctors also received hug after hug from the grateful families whose children lay in cribs and hospital beds, wearing bright pink and blue casts.

  The doctors were especially thrilled to see baby Anna Elena nursing and wiggling all her newly separated fingers. Her surgery turned out to be a relatively uncomplicated fix, and Nick and Tod were able to close the skin with absorbable sutures so the stitches would fall off as the skin healed around each finger.