Christmas for Joshua - A Novel

Christmas for Joshua

A Novel by

Avraham Azrieli

Also by Avraham Azrieli

Fiction:

The Masada Complex – A Novel

The Jerusalem Inception – A Novel

The Jerusalem Assassin – A Novel

Non-Fiction:

Your Lawyer on a Short Leash

One Step Ahead – A Mother of Seven Escaping Hitler

Author’s website:

www.AzrieliBooks.com

Christmas for Joshua

A Novel by

Avraham Azrieli

Copyright © Avraham Azrieli 2011

All rights reserved. No part of this book may be reproduced or utilized in any form or by any means whatsoever without written permission from the author.

Printed in the United States by CreateSpace, Charleston, SC

This book is a work of fiction. The characters, incidents, and dialogues are products of the author’s imagination and are not to be construed as real. Other than the known historic events and figures, if any, resemblance to actual events or persons, living or dead, is entirely coincidental.

For Steve Wall, who always delivers a perfect balance of critique, praise, and inspiration.

Part One

Thursday, September 24 – Rosh Hashanah Eve

Do You Hear What I Hear?

The dashboard gauge climbed to 96 degrees as I accelerated down the Squaw Peak Parkway in my convertible Volvo. The valley rolled out before me like a carpet with a pattern of streets and avenues in tidy little squares, except for the concrete-and-glass cluster of downtown Phoenix, which floated on a cloud of morning smog.

The phone rang and a monotone voice said, “Incoming call from,” pause, “Rebecca.”

I hit the Bluetooth button. “Why do you always,” I yelled over the wind noise, “
always
assume that I’ll forget?”

“
Experience,” she said.

“
Skype conference at two p.m. sharp. See?”

“
Debra just texted me again,” Rebecca said, referring to our daughter, a senior at Columbia University. “Apparently she has important news to share.”

“
News?” I took my foot off the gas, and the car slowed down. “I thought she was just calling to wish us a Happy Rosh Hashanah. What’s the news?”

“
That’s the point. She wants to tell both of us together. Will you make it on time, or should I come up with an excuse for you?”

“
No excuse. I’m not cutting anyone today. Paperwork until noon, lunch conference with some researchers from D.C., and I’ll be heading home.”

“
On time?”

“
You can count on it,” I said.

“
Famous last words.”

“
Love you too.”

Rebecca laughed and hung up. My workdays were long, often stretching into the night due to chronic understaffing at the hospital. She had reheated countless dinners for me over the years, but we had been together long enough to trust each other and nudge only when necessary. And Debra’s tip-off of important news definitely qualified for necessary nudging. Now in her last year of pre-med, Debra had to narrow down her list of possible medical schools and begin the application process. I hoped she would stay on at Columbia, as I had done, but Rebecca had been talking up the University of Arizona in Tucson, whose medical school was rising in national rankings.

We had no doubt that Debra would be admitted wherever she applied—her grades and skills placed her at the top of her class. I wondered if she had made a choice and was going to break the news to us this afternoon, disappointing either me or Rebecca. But as I considered the prospect of Debra’s returning to Arizona and living an hour away, rather than staying for another four years in New York, I was willing to give up my dream of seeing her graduate from my medical alma mater.

I turned up the volume on the radio. NPR’s Diane Rehm introduced her guest, the Reverend Alfred Dulton and his new book:
Jesus and I – Close Encounters of the True Kind
. The reverend thanked his host and said, “Two millennia ago, on this very day, our Savior was preparing to celebrate the Jewish New Year, which begins tonight. But when Christ died for our sins, he liberated us from the strictures of Old Testament rituals—”

I switched to Bluetooth and, for the first time in years of listening to the program, called in. After two rings, a recording told me to hold, and music came on. It was Handel’s
Messiah
, I could tell, but it took me a little while to discern the words and recognized
For Unto Us a Child is Born
, an early part of the work. The participation of flutes and clarinets revealed that it was Mozart’s arrangement they were playing, and my fingers tapped the steering wheel with the notes. Back in our church, during my teens, I had played
Messiah
on the rickety organ, though the only part that truly excited the parishioners was
Hallelujah
, which I had to play repeatedly while everyone was gathering for the Midnight Mass on Christmas Eve.

I lowered the volume and rehearsed my question, which was directed not at the guest, but at Diane Rehm herself: “Why did you choose to interview a Christian clergyman on the eve of the Jewish people’s high holidays? Would you have a Muslim imam as your guest on Easter Friday? Or a rabbi on Christmas Eve?”

At the exit ramp on Indian School Road, police cruisers with rolling lights created a bottleneck that directed all vehicles through a checkpoint, where officers inspected each vehicle. As I was waved through, I noticed Hispanic men and women lined up on the curb, guarded by deputies from the sheriff’s department.

Fifteen minutes later, still on hold, I drove into the hospital underground parking garage. Wireless reception was lost, and the music disappeared. I could call again from my office upstairs, but by now the beauty of Handel’s composition had cooled my indignation. In all fairness, how many Americans celebrated Rosh Hashanah? One or two percent of the population? Wouldn’t it be sheer chutzpah to force the other ninety-eight percent to listen to a rabbi just because it’s our holiday?

At the elevator door, I waved my ID card in front of the sensor. My name appeared on the LED display:
Rusty Dinwall, M.D.
I clipped the card to my breast pocket. It was time for a new card with a current photo. My rust-colored hair had turned dirty silver, and it had been a decade since I shaved off that corny mustache à la Tom Selleck.

My assigned operating room was out of commission with a faulty air-handler, which had left us soaked with sweat last night as we finished sewing up the last patient. With today’s surgeries postponed, I settled in front of my computer to approve prescription requests, sign off on charts of discharged patients, and respond to Happy Rosh Hashanah e-mails from colleagues. Next, I started on the performance reports for our residents, which tested the limits of my creativity. When it came to med-school graduates, training at a VA hospital didn’t attract the sharpest scalpels in the tray, who usually preferred to train at private hospitals, where moneymaking was an honorable part of the job. But those who came here got plenty of hands-on experience, and I made sure to be generous with my praise.

“But he’s as pale as a sheet,” a woman’s voice rang in the hallway. I saw her through my open office door, standing at the nurses’ station, her silver hair collected in a rubber band, her summer dress flowery and shapeless. “Something is wrong with him.”

“Nothing’s wrong,” said Nina, the Cardiothoracic ICU nurse-in-charge. “Your husband is recovering just fine.”

“He’s not the complaining type,” the woman said, “but I can tell he’s not feeling well.”

“No one feels well a day after triple bypass.” Nina must have done the midnight-to-eight shift and wasn’t feeling so peppy herself. “Dr. Brutsky saw him during morning rounds and was pleased with his progress.”

“
But—”

“
He’ll get his color back in no time.”

I returned to typing the report when the woman said, “He already got his color back. This morning, when he woke up, he looked great. But now he’s pale again.”

Nina mumbled something and walked away.

The woman sighed and went back into the patient’s room—not my patient, not my case, and not my responsibility. Aaron Brutsky was an excellent surgeon. He would have noticed if there was a problem.

I tried to keep typing, but my mind was already racing down a diagnostic track. Bypass surgery left patients weak and anemic. They were pale, and their color returned gradually. But this patient’s wife was telling of an initial recovery followed by an onslaught of paleness, and I had noticed a trace of dread in her voice. Was I imagining it? Nina had obviously heard nothing alarming, and it was her decision whether to alert the surgeon on the case or not.

I added another sentence to the performance report, but paused upon remembering Rabbi Rachel’s sermon last Sabbath morning at the synagogue. She had discussed the story of Moses sacrificing his pharaohic lifestyle when he struck down an Egyptian guard to save a Hebrew slave. This moral duty to aid a stranger in peril later inspired a Talmudic decree that a traveler who failed to stop and help a man fallen by the roadside was considered by God to have committed murder.

With the half-filled performance report still on the computer screen, I grabbed my white coat and stethoscope and left my office.

The patient in the bed wasn’t pallid. He wasn’t ruddy either. Rather, he was dark skinned, either from years in the sun or from having Hispanic or Native American genetics. It was hard to tell, especially because there was a grayness to his brown skin, as if he had spent too much time indoors—or had been losing blood. I didn’t know his baseline color and could make no informed judgment by what I saw. His wife knew him best, yet her impression could be tainted by stress.

“
Good morning.” I draped the stethoscope around my neck. “I’m Dr. Dinwall. How are you feeling?”

“
Like a flyer…who’s been hit by flak.” His voice was scratchy, the common result of having had a breathing tube in his throat for hours. “Been injured before,” he added. “Feels the same.”

The wife crossed herself. “Jesus be merciful.”

“
Amen.” I chuckled. It wasn’t the first time I heard a veteran compare bypass surgery to a battle injury, a tragic misfortune that’s out of one’s control and must be accepted with a fatalistic resignation, as if heavy smoking and a fat-laden diet had nothing to do with it.

“
Are you my new doc?”

“
Dr. Brutsky and I are the two CT surgeons on staff here. We cover for each other.”

“
Basically, yes.” I looked at his chart. Xavier Gonzales. Air force mechanic. One tour in Vietnam. Injured during the 1968 Tet offensive. Multiple shrapnel wounds. Eighteen months’ recovery, but no permanent functional disability. Stayed in the service for another twenty-two years, last station at Luke Air Force Base. After honorable discharge, he spent another twenty years as a jet-engine specialist for Southwest Airlines, finally retiring a month ago. Smoked for forty-six years, been married for forty-one. Admitted the day before yesterday with severe chest pains. Catheterization revealed 95 percent blockage of the left main coronary artery and lesser blockages in two others. Triple bypass surgery. No complications. Weaned off the ventilator without a hitch. All good—except for the wife’s complaint of worsening paleness, which could hint of internal bleeding. For my peace of mind, I had to rule it out.

“
So,” I said, “looks like smooth flying so far.”

“
Engine’s sputtering,” he said. “Feels like…sludge in the fuel line.”

“
You got new fuel lines yesterday. Shouldn’t be sputtering now.” I browsed the heart-monitor printout and the nurses’ notes. No meaningful fluctuations, but I noticed a subtle downward trend in blood pressure and a slight increase in heart rate—both very minor, but consistent with an early internal bleed.