Scarcity (Jack Randall #3) (33 page)

He looked up to see Dryer looking over his shoulder. Paula was working to clear a path for the second pump into the room.

“150 RPM . . . give or take.”

“Okay . . . now what?”

“I think the machine is okay for now. Whatever was burning has stopped. Let’s hook up the portable cooler to the oxygenator ports so we can control that. I don’t want to switch pumps unless we absolutely have to.”

Dryer took a moment to think it through, and it soon became obvious that Brian was a few steps ahead of him.

“Okay. If you think that’s best, I’m all for it. Anything else failing?”

Brian stuck his hand out and felt the number 4 pumphead again. It was warmer than the last time he had checked it, but not much.

“Four’s running a little hot, but nothing serious. I can switch to number five if I have to.”

Dryer stood up and surveyed the room. Paula had shut all the doors but one and was attempting to put the room back together. Dayo, Raina, and Jennifer were busy in the chest cavity. Knowing the problem was out of his hands and being addressed, the surgeon had pulled them back into the surgery.

“Mathew? You guys okay?”

Dayo replied without looking up, “Sure, why wouldn’t we be?”

His answer was the tension relief they all needed and it produced a nervous laugh. All but Brian. He sat on the stool and glowered at the malfunctioning pump like it was one of his kids and he had caught it misbehaving. He examined the speed of the number 1 pump, looking for any change, but it continued on as if nothing was wrong. Satisfied they were past the initial problem, he turned his attention to the overhead monitor. The patient’s temperature had fallen to 22 degrees while he had been busy and he reached out to the cooling unit to make adjustments.

“Temps down a little Brian,” Dr. Dryer observed from across the room.

“I’m on it.”

After making the adjustment, he checked on the POPS machine. The new heart continued to beat in the tray as if nothing had happened. After that he located his hand cranks and made sure he had quick access to them if the pump decided to fail. Wiping the sweat from his forehead, he felt a chill as Paula shut the door, fanning the back of his scrubs where the sweat had collected. He looked up to see her eyes smiling at him. She gave him a wink before returning to the desk.

They would both have a lot of paperwork to do when this was done.

What’s Your Liver Worth?
MAY 7, 2010—Smartmoney
 
 

—TWENTY-FIVE—

“I
don’t understand. How long?”

“I can’t give you a number . . . at least a month, maybe more . . . just to be safe,” Jimmy answered.

“Just to be safe? What does that mean?” Jessica wailed back.

Jimmy broke his gaze from her pleading face before sitting on the couch and burying his own in his hands. He’d been struggling to explain since he had burst through the door unannounced a half hour ago. Fortunately Cody was playing down the street with some friends.

“Look, I never meant for this to happen. But in my job you run the risk of making some enemies. Well this time around, I did. I screwed up. I screwed up bad and I pissed off some dangerous people.”

“They know where we live? How?”

“I have to assume that they do. These people, they make it a habit of knowing who they are dealing with. I can explain it better later. We need to leave . . . right now.”

“But Cody . . . his school . . . all his friends?” She stalled.

“You have to put that aside. Right now is all that matters. Look, Cody’s a kid. He’ll be confused. But he’s still a kid, he’ll roll with it. We need to get to a safe place and do it now.”

“But . . .” Jessica cut herself off and turned away from him.

Jimmy rose from the couch and slowly made an attempt to hold her but she twisted away.

“I’m sorry.”

“You’re sorry? You’re sorry! You show up out of nowhere and tell me we just have to pick up our entire lives and leave and that’s all I get? I’m sorry?” The tears were flowing now and she stood before him defiantly, a quivering mass of nerves and righteousness.

“It’s . . . it’s all I have.”

He slowly approached again and put his arms around her and this time she gave in, turning around and burying her head in his chest. He just held her and offered nothing, waiting for her to work it out for herself. After a moment, the sobbing stopped and she raised her head to gaze into his face. He gently wiped the tears away.

“Still love me?” he asked.

“I . . . yes, damn you.” She gently cuffed him across the chin before breaking away and wiping her nose.

“So . . . an early vacation? What do we tell him?”

“That’ll work, to go along with our retirements.”

That brought her head back around.

“You’re quitting? Really?”

“Yeah, I’m done. You can be, too, if you want.”

It took her only a few seconds to decide.

“I think I can live with that.”

She returned to his arms and wrapped hers around his neck for a kiss.

They had just come up for air when a noise behind them caused Jimmy’s muscles to coil like a spring. He spun them both in a circle as his hand groped the small of his back. He relaxed when he saw the source.

“Mommy?” Cody stood in the doorway, rubbing his head with a towel. His hair was wet from the neighbor’s pool. The dog was outside looking in, equally wet.

“Hey, baby, look who’s here!”

“Jimmy!” The boy quickly dropped the towel and ran to him.

“Hey, buddy.” Jimmy smiled and pried the boy’s arms loose from his leg before hoisting him up for a hug.

“How’s my little guy today?”

“Good. Are you staying for awhile this time? Please?”

Jimmy exchanged a look with Jessica. She nodded and covered her mouth before flashing a smile. Jimmy got the message. They would tell him later.

“No, I have to leave today.”

“Aww, really?” The boy immediately pouted.

“Yeah, but how about this? How about . . . you and mom come with me this time?”

Cody perked up. “Really!” He looked to his mother for confirmation.

“Really,” she echoed.

“Sam, too?”

“Sam, too,” Jimmy added.

“When?”

“Right now. Go pack a bag.”

“Cool!” Cody squirmed out of Jimmy’s arms and ran to the door to share the news with the dog. “Come on, Sam!” He ran down the hall toward his room with the dog hot on his heels. They both watched him go with a smile.

Jessica started off toward her room, but quickly turned around with a confused look.

“What do I pack? I mean . . . where are we going?”

Jimmy just smiled again.

“Pack for the beach.”

•      •      •

“Can I get a wipe please?”

Kye snatched a sterile towel from a nearby pile and carefully wiped the sweat from Dr. Fong’s brow without moving the lenses perched on his nose. The fiber-optic light tracked across her face and would have momentarily blinded her if she had not known to look away.

“That’s good. Thanks.” He turned back to the operating table in time to see Tony retrieve a suture from Stephanie. His physician’s assistant gazed into the chest to check her work.

“How do we look?”

“Considering how fast we did it . . . not bad. Minimal bleeding. The SVC is a little crooked, but it’s holding.”

“Good. How’s our temperature? Did you catch up to us okay, Mike?”

“We’re at twenty-five now.”

“Okay, labs?”

“Not great. She’s a little acidic so I’m giving some bicarb. We may have swung to the plus side on the fluids, also. Should I pull some off?”

“A liter,” Jacobs ordered.

“One liter,” Mike echoed as he adjusted his clamps. “You going to start the rest now?”

Fong considered the question as he watched Tony lay out sutures on the tray. Fifty-four-inch 3-0 prolene. Several of them. There was a lot of sewing in his future. Fortunately, it was what surgeons considered easy. Unlike a bypass surgery where he dealt with the smallest of arteries and veins, here he was dealing with the great vessels, the big pipes, and everything was large and easy to see. There was just a lot of it. He could begin removing the girl’s heart now, as the new heart would arrive before he was ready for it, but it was something he was never comfortable doing, even if they were committed to the new heart as they were now.

“Let’s take a break and get all her numbers back where they should be. That way we can scrub out and clean up a little. I still want to see this new heart before we install it.”

Stephanie nodded in ready agreement and quickly stepped away from the table. She lost no time in stripping off her gloves and peeling away the bloody gown. Her scrubs were soaked in sweat and stuck to her, and she gave an involuntary shiver in the cold operating room. Dr. Fong quickly followed her example and they were both about to leave when the overhead speaker squawked.

“Heart arriving for OR three, heart arriving for OR three.”

Fong stopped at the door and traded a look with his PA.

“You go change. I’ll wait for the heart.”

“Thank you,” she gushed. She lost no time bolting out the door and heading for the locker room.

Dr. Fong watched Kye follow her out to fetch the heart and slowly made his way to the desk in the corner. His mouth was dry. It was against the rules, but he opened the drawer and searched around for the bag of hard candy they kept inside. Finding it hidden in the back in a plain paper bag, he extracted it and searched till he found his favorite flavor, watermelon. Unwrapping it, he quickly snuck it around the edge of his mask and into his mouth. He was barely back in his chair when Kye burst through the doors again, towing a POPS machine behind her. She wheeled it over in front of him and plugged it in. The machine obediently switched power sources without missing a beat, as the representative liked to say, and he leaned in to see the heart in the tray on top.

“Any paperwork with it?” he asked.

“
No habla,
” was Kye’s reply.

“Figures,” he mumbled.

He watched the heart through the fogged glass as it pulsated in the tray. It was pink and healthy at first glance. His professional eye took in every motion and he changed angles a few times to examine the muscle’s movements. The chatter of his staff faded away as his brain and eyes looked for any flaw, any movement that could lead to a problem. There was something odd about the way it moved, something he couldn’t quite put a name to. Overall it looked fine, but something . . .

“Looks good,” Stephanie commented from over his shoulder.

Fong jerked slightly as she had startled him, but quickly regained his composure and returned his gaze to the heart. She was right, the heart looked fine. Still, he would check it again thoroughly before they installed it.

“Okay then. Everybody ready?” He got yeses all around while he glanced at the overhead screens. The patient was doing fine despite her rough beginning. Kye was waiting with a new gown, so he stepped forward and let her dress him.

•      •      •

Dr. Dayo carefully measured a third time before cutting into the aorta to begin separating it from the heart. The instant flow of blood was quickly sucked away by Jennifer and his view was never compromised as his scissors moved across the great vessel. He eyeballed its inner surface as he worked. She retracted the pulmonary artery away from his view while he worked, and he found himself wondering just how much she could see from her station on the opposite side of the table. He measured the placement of his hands in relation to her eyes and wondered if he was blocking her view totally, or if she could change angles and see around him. He tried angling his own head lamp away from his work to see just how much of a difference it would make. Not much. But then he really wouldn’t need much, would he?

The aorta separated and the heart settled back into the chest cavity as another of its anchors was cut away. Dayo shook his thoughts off while they repositioned for the next phase. But as Raina rinsed his gloves clean, the thoughts quickly returned, and the surgeon could not let it go.

This man he was operating on had threatened him and his family. He had threatened his entire surgical team right in this very room. He had killed countless people and poisoned millions with his drugs. He had blown up airplanes and assassinated judges.

And at the moment, the man’s heart was in his hands.

If he were a young surgeon just beginning his career, he doubted that the thoughts in his head would even be there. He would do the surgery without question, and try to put any thoughts aside afterward.

But he wasn’t young anymore, nor was he naive to the ways of the world. He was an established surgeon, at the top of his field. He had built a career and reputation among his peers that was unequaled. Could that reputation see him through this? Could he survive the questions that were sure to follow? What about his team? Would they be implicated, too? Would they agree with him, or find it beyond the level of their profession? What about the man’s threats? Were they serious? Was there really reason to believe that a dead man would take such precautions? Was it safer for them all to assume that he would?