An Open Heart (27 page)

“You can tell that just by looking?”

“In an African, yes.”

Jace shrugged. “Heart rate is one-sixty. He needs blood.”

Paul shook his head. “The blood bank is out of his type.”

“Get O negative then,” Grace said. She worked to place a second larger IV while the intern went for blood.

Jace scrubbed his hands, gowned, gloved, and waited for a signal from anesthesia that he could start. He dipped a gauze in brown Betadine and began painting from the middle of the abdomen in larger and larger circles.

Drape towels were squared off against the prepped abdomen.

Grace frowned. “We need blood now. His pressure is down.”

Jace hurried ahead. “I’ll open and pack. Maybe I can slow the bleeding until you get caught up.”

He opened through a midline incision, immediately releasing the floodgates. A river of heme spilled over the patient’s abdomen, down the drapes and onto Jace’s shoes. “I need more packs,” he said, his own pulse quickening.

Grace leaned over the drape screen separating her from the surgeon. “What do you see?”

“Blood. Lots of blood.” Jace fought a rising tide of panic. “I need more packs!” Over and over he shoved large white absorbent gauze packs into the abdomen to seal off the bleeding. Within a few moments, the white was painted crimson. “What’s the pressure?”

“Below measurement.”

Paul returned to the room empty-handed. “There is no more O negative blood.”

Jace’s throat tightened.

Paul shook his head. “This patient is the same blood type as Joseph Kosoi. We used all of the blood for him.”

“I can close over the packs. We’ll resuscitate him and come back when he has stabilized.”

Jace watched as Grace pushed back the drapes to get access to the patient’s chest.

“What are you doing?”

“Chest compressions. The boy has no pressure!”

“Squeeze in the IV fluids, Paul.” Jace looked at his assistant. “Give me a zero Prolene suture. I’ll close the skin over the packs to tamponade the bleeding.”

Jace sewed as quickly as he could, shoulder to shoulder with Grace, who was rhythmically pumping with the heel of her hands on the boy’s sternum. He looked at the monitor.
Ventricular fibrillation. The heart doesn’t even have enough blood to pump oxygen to its own muscle.

Jace looked at Grace and felt the accusation in her stare. “Do you have a clamp you can place on the aorta?” she asked.

Jace shoved his hand back into the abdomen, feeling for the patient’s aorta as it entered the abdomen through the diaphragm. “It’s flat, Grace. Clamping it will not help.”

She stopped compressions and locked eyes with Jace. “We shouldn’t have started without blood. Opening his abdomen allowed him to bleed out!”

“I thought we had blood.”

Grace peeled off her examining gloves and threw them to the floor. “You cannot assume anything around here! You bring me a patient and turn me into an executioner!” She stormed from the room.

Everything fell silent except for the swinging of the theater door, flopping back and forth, accusing Jace of failure … failure … failure!

Jace continued to sew the skin. “It was his only chance of survival. If we’d been able to operate sooner, we could have stopped the bleeding.”

Paul leaned against the wall and slid to the floor, his tall frame folding like a chair. “I told his mother to trust us. I told her we would save her son.”

Jace looked over and saw tears in his intern’s eyes.

Dave Fitzgerald walked into the room, stripping off his sterile gown from his case in the next room. “What happened here?”

“Ruptured spleen,” Jace said mechanically. “No blood. Dead patient.”

Dave picked up the chart. “Boniface? I know this kid. He’s always at the front entrance selling mangos for his mother.”

“I don’t understand,” Jace said. “I thought I’d solved the problem with our blood bank shortage.”

Dave coughed. “You really don’t get it, do you? You think you can throw money around and solve all of Africa’s problems?”

Taken back by Dave’s harsh tone, Jace didn’t reply.

Dave continued his tirade, a flood unleashed. “After your little plan to bribe donors, we couldn’t talk anyone into giving for free. Everyone wanted a free lunch and a store voucher!” He shook his head. “You didn’t solve this problem, Jace. You caused it. You and your wonderful open-heart program.” He paused and threw the chart back on the anesthesia cart. “Okay, you saved two heart patients. At what cost?” He turned and walked to the swinging door. “The cost of one ten-year-old boy!”

29

That evening Heather put on a black cocktail dress and her pearl necklace and let the valet park her car at the Jefferson Hotel in downtown Richmond. Known as Richmond’s finest historic hotel, its opulence was forever marred in her mind as the place her husband reportedly met up with the governor’s wife.

Heather came here to see for herself. She wanted to absorb the atmosphere and observe.
Did Jace come here because he was out of love with me? What do these walls know about my husband that he can’t or won’t tell me?

She walked into the lobby, admired the marble statue of the third US president, the faux marble pillars, and the multicolored rainbow of the Tiffany stained-glass skylight. She strolled through Palm Court, the historic location where live alligators used to swim in the decorative pool.

The marble staircase was said to have inspired the infamous scene in
Gone with the Wind
. She let her hand glide along the railing as she climbed. After walking through the Rotunda lobby, she decided to have a drink in the lounge at TJ’s restaurant, the less expensive of the hotel’s dining options, known for its single-malt scotches and over-the-top wine and beer selections.

She sat in a leather chair overlooking the lobby. A young waiter appeared. “Will you be dining with us tonight? Perhaps meeting someone?”

“I’m fine here,” she said. “Bring me a glass of your house white zinfandel.”

She sipped it slowly, taking in the downtown atmosphere and eavesdropping on yuppies and their dates.

She was halfway through her glass when she heard her name. “Mrs. Rawlings?”

A man in a gray business suit, black shirt, and silver tie nodded at the empty chair next to hers. “Expecting someone?” He smiled. Gorgeous. “Perhaps someone to accompany you while your husband is so far away?”

She shook her head. “Do I know you?”

“No, but I know you. May I sit?”

The man didn’t wait for her answer. He held out his hand. “Allow me to introduce myself. I’m Ryan Meadows.”

“Of course,” she said, realization dawning. “I’ve seen your picture in the paper.”

“So what brings you downtown?”

“Can’t a woman just enjoy a drink without a reason?”

“Not you.”

She smiled uneasily. He was spot on.

“You didn’t answer.”

She took a deep breath. The wine had already loosened her tongue. “I just wanted to see this place.”

He nodded and stayed quiet. After a moment, he swirled the golden liquid in his glass. Single malt. “Quite a place for a rendezvous, don’t you think?”

She sipped her drink and stared over her glass at the governor’s chief of staff. She shook her head. “Am I supposed to find that endearing? A reference to my husband, perhaps?”

“I read the papers too.”

“Don’t believe everything you read.”

“Why did you want to see this place? There must be closer places to buy a drink.”

She looked around, listening to the murmur of conversations around them, the clink of ice against glass and the quiet sounds of a piped-in symphony. “This place is just so not Jace.”

“Not Jace?” He smiled.

“Not at all. He may have operated on the rich and famous, but he was such a wog at heart.”

“A wog?”

“A slang term thrown around at his Kenyan high school. An American who adopts local customs and cherishes a simple life.”

Ryan sipped his drink and motioned for a waiter. “Another,” he said, “for myself and the young lady.”

Heather smiled at the compliment and reminded herself that she was a lightweight.

Ryan smiled back. “So Jace is a wog. I guess he’s found his home again, huh?”

She sighed. “I don’t know.” She held up her drink in a mock toast. “Here’s to my husband, off to save the world.” She felt the wine beginning to make her lips tingle. “Jace used to sleep outside in our backyard when he was in medical school. No sleeping bag, just a few blankets laid out by a campfire the way the Maasai would.” She shrugged. “A true wog.”

Ryan gestured to the opulent lobby. “I guess his tastes must have changed.”

Heather felt a stab of remorse. Or guilt. Sitting there talking about her husband with Ryan felt unfaithful somehow.

But more than remorse, she felt a growing apprehension. There was something unsettling about Ryan Meadows. He seemed so …
political
. Yes, that was it. More concerned about image than substance.

She paused as a second realization dawned. This man was exactly the opposite of Jace. Jace cared little for image.

A waiter delivered their drinks. Ryan took another swallow. “So you are a woman looking for answers?”

She nodded. “Perceptive, Mr. Meadows.”

“Anita had an agreement with the hotel management. They kept a suite available to her, so that she could entertain guests.”

Heather leaned closer. “You mean they kept a suite available for the governor and his wife.”

He smiled sweetly. The kind of smile that you give to a child who just failed an algebra test. “This one the governor didn’t know about.”

She sat back. “I see.”

She watched as he appeared to be scanning the crowd. “I’m sure someone on the staff could answer your questions.” He paused, looking back at her and crossing his legs. He leaned forward until his knee just grazed hers. “I’ll ask a few questions. I know how to be discreet.”

“It’s just that my husband can’t tell me. He suffered amnesia after his accident.” It sounded so lame, so contrived when she spoke it aloud.

“Of course.” Ryan tugged on the sleeve of his black shirt. “It’s only natural that you would want to know.”

“Why are you here?” she asked. “Meeting with the governor?”

He shook his head. “I’m just winding down after being at the office.”

“On a Saturday no less.”

He shrugged. “Politics.” He rattled the ice in his glass. “After a day in the mansion, I stop here to relax.”

“How is the governor?”

“Recovering. That goat can’t be killed.”

“I thought you were friends.”

“Ah, yes, we’re best friends. But we fight like brothers.” He fell silent staring into his glass. After a moment, he added, “I was supposed to be the party’s nominee. But Stuart gave my stump speech when I got the flu.” He held up his glass to mimic the mock toast Heather had given. “Stole the whole show, he did. Here’s to Stuart Franks.”

She smiled. “Big of you to support him.”

“Hey, he was electable. You need a few gray hairs to be successful.” He raised his eyebrows below a perfect head of thick hair and winked.

She suppressed a sudden urge to throw her drink in his face, and she smiled as she imagined doing just that. When she saw his positive response, she realized he must think she was enjoying his flirtation.

Perhaps Mr. Meadows has his own Achilles’ heel
, she thought, setting her glass aside. As much as she bristled at his arrogance, he might be a useful source of information. She put on her best I’m-just-an-innocent-schoolgirl smile. “Will you do it?”

“What?”

“Ask a few questions for me? Find out what happened the night of my husband’s accident. Is it like the media says? Was he meeting Anita Franks in this hotel?”

“Are you sure, Heather?” he said, dropping her name like they were old friends. “What if it’s painful?”

She lifted her glass again. “Especially if it is painful.”

That evening, Heather headed for home after dark, unhappy about the rain but happy that she’d made a contact who might assist her in her search.

As she drove, she sank back into the leather seat and thought about a similar summer evening when a sudden rain shower had sent her family running in from a picnic table in the backyard of her parents’ home. She grabbed a casserole dish of baked beans, lifted the mustard, and followed her father into the house.

David Montgomery, her father, looked out the window. “I guess that’s just Florida weather. Wait five minutes and it will change again.”

Once they were gathered again at the kitchen table to continue their picnic, Heather looked at her mom, Trevor Anne, and smiled.

“What?” her mom asked.

“I’ve got something to show you,” she said, hardly able to contain her excitement. She reached into her jeans pocket and pulled out a diamond ring solitaire. She slipped it on her ring finger and held it up for her parents to see.

“You—you’re engaged?” Her mother’s hand covered her mouth.

Heather watched as her parents exchanged “the look,” a silent communication of alarm. Her gut tightened. “Jace asked me to marry him.”

Her parents returned a collective blank stare.