An Open Heart (15 page)

“Maybe Minister Okombo is behaving like Joseph.”

Evidently, Jace’s confusion showed. His intern continued. “Remember when his brothers wanted grain? Joseph sent them away with grain and put their money in the tops of their sacks as well.” He pointed at the boxes. “Maybe Minister Okombo has an interest in helping your program succeed.”

“He wants something. As I recall, Joseph was testing his brothers. Maybe this is another test. I’ll have to notify Minister Okombo of the items that aren’t mine.”

Jace stood. “I need to talk to the powers that be. Beatrice is better for now, but the only way to save her long-term is with surgery. And I’m not sure everyone around here will be happy to see this kind of surgery being done here.”

Paul shook his head. “Why wouldn’t they want you to operate on Beatrice?”

Jace sighed. “It’s not just about this one case. It’s about the whole program. When I first asked the hospital administration about starting a heart program, they gave me a provisional ‘go-ahead’ with a plan to revisit the issue after a few cases to see how the program impacts the hospital.”

“Oh, they will see. We can save thousands! Who wouldn’t want that?”

Jace appreciated the intern’s optimism, but could only shake his head. “If you knew all the misery we’ll attract if we open this program, you wouldn’t ask.”

15

Governor Stuart Franks looked across his desk at Ryan Meadows, his chief of staff. “Look, I’ve talked to the attorney general. Extraditing Jace Rawlings on any charge is going to be complicated and would require the cooperation of the State Department. What we need is more evidence.”

“We’ve got the autopsy report. What more would they want?”

“DNA evidence.” He picked up a letter opener, a gift from the NRA, with a handle made from a white-tailed deer antler. He used the blade to clean beneath his thumbnail. “Fortunately, DNA is fairly easy to get.”

“Easy?”

“Sure. Kleenex. A beer bottle. A cigarette. Even an envelope that he licked.”

“Dr. Rawlings doesn’t smoke.”

The governor ignored him. “What we need is someone to collect the evidence.”

“And if we get it, then what?”

“Then we’ll make a case for the cooperation of Kenyan authorities to extradite him.”

“If he’s helping their people, they may be reluctant to give him up.”

Stuart Franks wiped the blade of the letter opener on his pants. “We’ve just made a multimillion-dollar trade deal with Kenya. I don’t think they’d want to jeopardize our relationship.”

Ryan nodded. “I made quite a few friends during our tobacco trade deal. Do you want me to get them involved to collect the evidence?”

The governor shook his head. “I don’t want to approach anyone in Kenya till we have the evidence in hand.” He stood and looked out the window over the lawn. “Maybe we can arrange for someone else to visit Mr. Rawlings.”

Jace watched as Blake Anderson draped his stethoscope around his neck. “She sounds better,” he said. “Not so wet.”

“For now,” Jace said. “But she won’t stay compensated for long. She needs a valve.”

The medical director waited until they were in the hallway outside the HDU before he spoke again. “This isn’t the timeline we discussed. We talked of fundraising, installing new equipment in our HDU, maybe furnishing a new operating theater. The heart program needs to be instituted with full staff support or the whole thing will collapse. You have to give our African nurses time. If they don’t own this program, it will go nowhere.”

Jace kept his voice low. “This girl is going to die without an operation.”

“So send her to Nairobi. That’s what we’ve done for years.”

“Kenya’s minister of health wants her here.”

“And what business is this of his?”

Jace hesitated to answer, but after a moment, he decided he needed to confide in the medical director. “Look, the girl is his daughter.”

“What?” The Australian shook his head. “Are you crazy, mate?” He touched the side of his mutton-chop sideburns. “We need a nice quiet case to get this program started.”

“No one knows about his connection to the girl.”

“And if you lose her, what then? The MP will see to it that we’re shut down.”

“He’s been supportive.”

“You don’t understand Kenyan politics. It’s all about scratching the backs of the powerful.”

“He waived the import tax on my equipment. In fact, when I called to tell him that I’d received a few items that I’d not brought along, he informed me that it was a gift. And we’re not talking small-dollar items. The endoscopic echocardiogram unit alone is at least fifty grand.”

“My point exactly,” Blake said, lowering his voice. “How long have you been working on this?”

“Two months.”

“And your equipment? How does donated equipment get here so fast?”

“Compassion Industries took care of the donation and the air freight.”

“And only a few weeks for the Ministry of Health to approve a new program? Don’t you find that the least bit unusual? Nothing in Kenya moves that fast.”

“I just thought the timing must have been right. I mean, what’s to decide? There’s a huge need here, and I offered to come and bring what I needed. So I just think the Ministry of Health stamped it
approved
without another thought.”

“Or maybe, just maybe, someone powerful was pulling strings behind the scenes. Maybe the MP even manipulated the donation of your equipment in the US.” He paused. “Maybe the MP brought you here to do his daughter’s operation.”

“Ridiculous. He couldn’t have known she’d need it.”

“Don’t be so sure.”

“Okay, maybe I did think it was moving fast. But everything lined up so neatly that I just felt it must be right.”

“You think God had something to do with it,” Blake said.

“Maybe I wouldn’t be bold enough to put it in those words, but … yes, maybe God wants me here, so He worked it out.”

“Why would the MP just give you extra equipment?”

“He wants his daughter to survive.”

“Nothing comes free here.”

“He wants me to operate on his daughter.”

The medical director sighed. “He wants to control us.”

Jace massaged his forehead. “Look, I asked him about moving her to Nairobi. He won’t have it.”

“He’s put us in a corner.”

“This is what I came to do,” Jace said.

“I hope you like pressure.” Blake Anderson combed his moustache with his fingers. “’Cause you ain’t seen nothing yet.”

That evening, Jace answered a knock at the door to find the chaplain, John Otieno, holding up a small black plastic bag. “Dr. Rawlings, my wife sent some fresh chapatis.”

“Thanks.”

The chaplain seemed to hesitate. “I was hoping we could talk.”

Jace motioned him in. “Sure. I’ll make tea.”

John sat in a kitchen chair that groaned under his weight. He watched as Jace went about boiling water and milk and adding black tea leaves and sugar. “I hear you are planning to go ahead with the heart program. This is sooner than I expected.”

“Perhaps sooner than I expected as well. But I still need a few things to fall into place before I can commit to doing our first case.”

“Perhaps there are other obstacles of which you are not aware.”

Jace raised his eyebrows and looked at the man. The chaplain was sober, touching his curly white sideburn as he stared at Jace. “Such as?”

“You will need the chaplaincy office to bless this work before beginning. I’d hoped I’d get a chance to talk with you further before you barged ahead without consulting us.”

“I was unaware of the need.” Jace paused and stared at the large man. “I had the preliminary approval of the administration and staff before I came to this country. I didn’t realize that your department also needed consultation.”

The chaplain smiled. “Jace, of course you can go ahead with your program and ignore us.” He folded his hands. “But what I’m suggesting is that your way will be so much easier if you operate inside the mission of our hospital.”

“Mission?”

“The work of Kijabe Hospital is more than an outreach to sick bodies. It is an outreach to heal the souls of men.” He paused and accepted the mug that Jace set in front of him. “My job is to make sure everyone is on board with this approach.”

Jace sipped his chai. He didn’t really feel like discussing his personal spirituality. Or lack of it.

“Why do you want to start a heart program here?” Otieno asked.

“There is great need in this country.”

“So why not offer your services at Kenyatta? Why Kijabe?”

The surgeon shrugged. “This was my home.”

“So you admit that you do not have a burden for the souls of your patients?”

The language was a put-off for Jace. Christianese, he called it. Just what was “a burden for souls”? Jace took another sip before answering. “I am not interested in the inefficiency of the Kenyan government hospital system. I am not interested in using a private Nairobi hospital that fleeces the rich. I want to help the poor. Is that burden enough for you?”

“I am concerned that we all be on the same page.”

“The same page? What exactly are you referring to?”

“Our orientation has to be a concern first for the eternal destiny of the patients.”

“My concern is the physical health of my patients. I’ll leave their souls in your hands. How about that?”

“That isn’t good enough.”

“What do you expect of me?”

“All of the doctors in this hospital are deeply committed to spiritual ministry. That’s the way it is done here.”

“And why is the way I practice your business?”

“The patients’ well-being is my business. I’ll not have Kijabe Hospital losing its focus. If all we do is treat the physical body, we lose our distinctive. We will just be another humanistic outreach.”

“You will try to stop me if I press on while limiting my work to the physical?”

“I am here to encourage you to think about the eternal. Life is short, Dr. Rawlings. What can you give them, twenty years? Thirty?” He pushed back the kitchen chair. “A life given over to Christ is affected for eternity. That’s the perspective we want to preserve at Kijabe.”

“Perhaps I can keep my patients alive physically so that your team can prepare them in other ways.”

“For me, it boils down to motivation. Why do you want to do this work?”

Jace shifted in his chair. “I want to help Kenyans with heart disease. Particularly ones who can’t afford to pay private-practice costs.”

“But why? I’ve been watching your adventure. You endure the games of politicians, the dangers of a new culture, the suspicions of those you came to serve with. Why put up with all these hassles?”

“I’m not sure what to tell you.” He held up his hands. “I want to help.”

“Most who give up so much are motivated by gratitude.” He paused and looked across the kitchen table at Jace. “Or guilt.”

Jace wasn’t sure how to respond. Or even whether he should respond. He couldn’t seem to make his eyes meet the chaplain’s, so he stood and walked to the stove and added chai to his mug.

John Otieno spoke with a soft voice. “Jace, the work we do at Kijabe Hospital is ‘get-to’ work, not ‘have-to’ work.” He stood and set his empty mug beside the sink. “It’s the difference between grace and wages.”

“I get that. I’ve heard the song.”

When the chaplain looked confused, Jace added. “You know, ‘amazing grace, how sweet the sound.’”

“I know it well. But the concept seems lost on you. You are striving, performing.”

“I’m a surgeon. That’s what I do.”

“A wise man once told me that grace is God at work. Legalism is me at work. The difference isn’t in the work; it’s in the motivation.”

“And you can take a spiritual scalpel and expose what is in my heart? How can you presume to know what motivates me?” Jace turned away. “Maybe I don’t know myself.” He paused and turned slowly back to Otieno, whose large hands were folded in his lap like a child praying. “Can I count on you to bless the work, even if you do not know the motivation? The work is needed.”

“I have other concerns, Jace. Kijabe Hospital is known for compassionate, Christ-centered care. When the public hears that the famous, colorful, American heart surgeon is at work here, their opinion may change.”