An Open Heart (7 page)

Jace held out his hand. “Jace Rawlings.”

“Good day to ya. How’s the head?” he asked with a chuckle. “I’m always in a cloud the first week back from home furlough.”

“I’m adjusting.” Jace shrugged. “I’m anxious to see the place.”

The medical director pointed to a stack of papers. “Here’s your orientation packet. Our formulary is limited, but better than the government’s district hospitals. Here’s your pager,” he said, handing him the device.

“Wow. I was hoping I’d seen the last of this in America.”

“Yeah, well, we’d all rather do without the night business, wouldn’t we, mate?” He handed Jace a sheet of paper. “This,” he said, “is the call schedule. I left you off this first week so you could get your feet on the ground. Your first call is Monday night.”

“Call?” Jace looked at the paper. “I didn’t anticipate much call until the heart program was up and running.”

Blake raised his bushy eyebrows and stared at Jace. “Good joke. I like a bloke with a sense of humor.” He paused before proceeding without a smile. “Everyone here does his or her share of call. Since you were a board-certified general surgeon before you did heart surgery, you’ll be on the call schedule for general surgery. Perhaps later if the heart program gets off the ground and is busy enough to justify taking you off the general surgery call, we’ll let you take cardiothoracic call only.” He chuckled to himself as if to say,
We’ll see if that ever happens.

Jace felt a stab of anxiety.
General surgery? How long has it been since I even saw an appendix?

“Dr. Rawlings?”

Jace looked up, suddenly aware that he’d been staring blindly at the call sheet. “Look, Blake, I thought we had an agreement about setting up this program. You talked to the minister of health. You even talked to the airline about my extra supplies. I thought everyone was on the same page about the heart program.”

Blake smiled. “Of course. But things move slowly here. I can’t afford to house a capable surgeon for months while the wheels start to turn.”

Jace forced himself to return a weak smile.

“Shall we take a tour?”

Jace followed quietly as Blake entered the long main hospital corridor and wove through a sea of patients. They seemed to be everywhere. Standing, sitting on wooden benches lining the halls, sitting on the floor, leaning in through the windows, and crowding the doorframes. There were Kikuyu mamas carrying babies on their backs in cloth slings called kangas. Somali women with head coverings peered out through slits revealing only glimpses of dark eyes.

Blake edged past a series of stretchers lining a hallway leading to the X-ray department. Two men with bloody faces and twisted limbs looked back at Jace and muttered something in Kiswahili.

“Sorry about the crowding. Seems we’ve just had a bit of a road traffic accident.”

Jace nodded and plodded along behind him. The smell was a mix of human sweat, urine, and iodine.
Funny. The smell is exactly the same as I remembered it.
“I used to come down here and watch my father operate. It’s like nothing has changed.”

Blake chuckled and kept moving. “Here’s the lab. We can do basic chemistries, blood counts, urine analysis, malaria smears, amylase, liver functions, bacterial cultures, and HIV testing. The crew is quite good at identifying TB.”

“May I see the blood bank?”

“This is it,” he said, pointing to a single refrigerator. “There is no separate room for the blood bank.”

The blood bank is a refrigerator.
Jace scratched his head.

“Let me show you our new HDU, the high dependency unit. Not quite an ICU, but getting there. It’s just up the ramp here.”

They walked up the long sloping hallway. Because there were no elevators, the hallways were long and graded so you could push a stretcher up a series of two long hallways to go from first to second floor.

Could I really do open-heart surgery in a place so primitive it doesn’t have an elevator?

Blake showed Jace around the HDU, introducing him to the nurses and pointing out supplies. The monitors above the beds looked modern but were already a few generations behind the ones he’d used in Virginia. Jace squinted down the row of patients.

The medical director smiled. “Bed one is a head-injury patient from a road traffic accident. Bed two has cerebral malaria. Bed three is an HIV patient who presented with a perforation of the bowel from typhoid fever. Bed four is a chest injury from a hippo. Bed five is a patient who had esophageal cancer and a resection.” He paused. “Welcome to Africa.”

Jace took a deep breath. It was clear that, as a general surgeon, he’d be expected to pull his weight. And he knew that if he didn’t, he wouldn’t likely swing the staff in favor of letting him do open hearts. He offered a weak smile in response, aware that he felt nothing positive. What did he feel?

Scared. Alone.

He was in the deep end of the pool and had forgotten how to swim.

That afternoon, Jace sat at his computer, happy to have gotten his Internet connection. He needed to send some emails back home. His first message was to Heather.

Heather, arrived safely, but my equipment is hung up in customs. I could have predicted this. I didn’t want to bribe the official, so here I am in Kenya without my bypass pump.

I did meet with the Kenyan minister of health. Hopefully, he will grease the wheels and I’ll get my stuff. I also met with the Kijabe Hospital administrator. They want me to do general surgery until things can be sorted out with the heart program. I’m not sure I remember anything about general surgery. I’d better learn fast. I picked up a book at the library to help.

I’ve been thinking a lot about us. I’ve never been one to analyze feelings and relationships, but perhaps this space will help me figure things out. I miss you. Strange, this place feels like home.

Jace

Jace clicked Send, then sighed and reflexively traced a small scar on his scalp. The bony indentation for a burr hole was filling in and soon would be hard to find.
Two months,
Jace thought.
Enough time to recover from drainage of a subdural hematoma.

Two months.
A whirlwind of change, recovery, physical therapy, seeking approval to start a heart program, and securing donated equipment—details that fell magically into place like dominos tumbling down a line. The speed of the change amazed him, and he’d entertained thoughts that someone very powerful was pulling strings on his behalf. But in the end, he shoved those thoughts aside and wished his memory would return. But because those memories eluded him, Jace hid from the media and wondered if his own questions would ever be answered.

In two short months, bone had reached out to bone to link and repair the small defect in his skull.
But will my marriage ever heal?

Will I ever remember?

8

Heather Rawlings sat in a booth in the Robin Inn, a restaurant in the west end of the Fan district of Richmond, enjoying the four-cheese ravioli and the company of longtime friend Gabriel Dawson.

Gabby looked up from her salad. “How can you eat that stuff and maintain your figure? If I ate like you, I’d weigh three hundred pounds.”

“Then you could ask Dr. Marks to operate on you.”

“That’s not the way I’d like to get his attention.”

Heather laughed. “You know my schedule. I need to wear a pedometer some week. I must do thirty miles a week with the dogs.”

Gabby set down her fork and leaned forward. “Okay, honestly, how are you doing? The buzz in the OR is that Jace left you high and dry in a sudden need to get back to Africa.”

Heather took a deep breath. “Not exactly true. He had a sudden need to get to Africa, yes, but I’m the one who decided it was best to separate.”

“You?”

She looked down and nodded. “After the accident, things just weren’t the same between us. It was like everything that he’d spent so many years building didn’t mean anything to him anymore. Here he has this successful cardiothoracic practice, patients who practically worship him—”

“Tell me about it, sister. I’ve seen the old ladies practically slobbering over him.”

“Then, he gets out of the hospital and starts talking about the poor Kenyans without a heart doctor.”

“A close call with death can change your priorities.”

Heather shook her head. “It was more than that. It was mystical. In the end, he said his twin sister asked him to come back.”

“Twin sister? I didn’t know Jace was a twin.”

“Nobody around here did.” She chased a lemon section around her water glass with a straw, stabbing the fleshy fruit to release the juice. “Family secret.”

Gabby raised her eyebrows. Her voice was laced with sarcasm. “Okay.”

“I need some professional advice.”

“You need a psychiatrist,” Gabby said.

“Funny. I need an opinion from someone who knows cardiac anesthesia.”

Now Gabby’s eyebrows lowered in seriousness.

“I know you worked with Jace a lot. He told me you were his favorite pump tech.”

“Flattery, my dear, will get you nowhere unless you’re picking up the tab.”

Heather took a paper out of her purse, the name of the drug she’d copied off Anita Franks’s autopsy report, and slid it across the table to her friend. “What do you know about this drug?”

Gabby wrinkled her nose. “Why do you want to know about ketamine?”

“I just want to know. What is it?”

“It’s an anesthetic drug. We use it all the time.” She shrugged. “I use it in combination with a few other drugs when I’m sedating pediatric cases.”

“Did Jace use it for his patients?”

“Maybe not Jace himself, but I’m sure he saw us using it on his patients.”

“Is there any reason to have ketamine in the blood if you weren’t having an operation?”

“Why are you asking this?”

Heather took a deep breath and kept her voice low. “I’m just trying to find out some information. Someone sent me a copy of Anita Franks’s autopsy report.”

“Somebody?”

“Anonymous. It was weird. I just got this envelope in the mail with no return address. Apparently, someone wanted me to see some things about her autopsy report. They photocopied it and highlighted a few items. The first one was that she was found to have traces of ketamine in her blood.”

“That’s weird.” Gabby stared off.

“What is it?”

“I’ve heard reports that ketamine can be slipped in a drink to use as a date-rape drug.”

Heather swallowed. Hard. “That may go along with the second thing that was underlined on the report.” She hesitated. “You can’t tell anyone about this, okay? I’m not even supposed to know this stuff.”

“Someone obviously thinks you should know.”

“The report said that Mrs. Franks had evidence of sexual intercourse within two hours of death.”

“So the governor and his wife are still young. Just because—”

“Gabby, the governor was out of town. He wasn’t anywhere close to his wife that night. It was all over the news. He was in Williamsburg at a trade summit, meeting with some Kenyan leaders about exporting tobacco or something.”

“What are you saying?”

“Nothing. I’m just trying to find out what this means. And why someone would want me to know this.”

“You think Jace had something to do with—” Gabby halted, her hand to her mouth. “Come on, Heather, Jace would never do something like this.”

“I’m not sure I know what Jace is capable of anymore. I want to believe in Jace.” She paused. “Maybe this will erase my doubts.”

“How can you doubt him? Just look at the guy. He wouldn’t need to sedate anyone to get them into bed. Just one look into those blue eyes …”

“Yeah, thanks for the encouragement.”

“Hey, I’m just saying what you already know in your heart. Jace was straight as an arrow. He wouldn’t cheat on you. And if he did, he wouldn’t need to use ketamine.” She paused and reached across the table. “Come on, Heather, Jace is a believer, right? He wouldn’t—”

“So you think being a Christian keeps you from cheating on your wife?”

“It should.”

“Jace is from a missionary family. I made assumptions about what he believed just because of the family he came from.” She sighed. “But Jace has always been quiet about his faith. I’m not sure his parents’ faith ever took.”

“He’s a good guy.”

“Being a good guy is different from having true faith.”

Gabby released Heather’s arm. “I’m going to pray for him. I think you need to give him the benefit of the doubt.”

“So why the media speculation about Jace and Anita?” Heather quoted a newspaper tabloid, “‘When the cat’s away, the mice will play? Anita Franks out with husband’s heart doctor.’”

“I don’t read that crap.” Gabby took a bite of salad and spoke with her mouth full. “What does Jace say about it?”

“That’s the strange thing. He claims he has no memory of that evening. The accident erased it all.” Heather snapped her fingers. “How convenient. He is seen coming out of a downtown hotel with the governor’s wife, and he doesn’t even remember.”