Code White (6 page)

When she came out of the bathroom, she had decided to take a chance on making love to him. She didn’t want to humiliate him by forcing him to ask. She took the initiative herself, tearing his shirt from him so smartly that one of his buttons went flying. She kissed his lips, his jawline, his nipples, and pulled him down with her onto the bed. Kevin was astonished but answered with a blaze of ardor, not suspecting that it was all a gesture on her part—a hollow caricature of the passion she had once felt for him. He was exquisitely attentive, clinging to her body the way a drowning man clings to a lifeline. Something in his neediness brought her back to life.
He wants me. How can I not want to be wanted like this?
She began to feel a warm glow within her, the first wavelets of a tide of joy and surrender.

And then, with a single word, he drove a stake through her heart.

“Ramsey!” he huffed. “We’ll make another Ramsey, babe. We’ll put that business behind us for good.”

Ramsey!
She dried up instantly, and her hands and feet turned cold.
Ramsey!
Before her mind’s eye flashed a pool of blood. She saw a glass-walled bassinet, and a pink, doll-like form, writhing under a bright, inhuman light. A silent scream arose within her.…

For over a year, she had fought to expunge this memory. At times, death itself had seemed better to her than to go on seeing that tortured face, those tiny, hopelessly grasping hands, that blood … that sudden, shocking, tragic blood. Kevin knew this, and still he had stuck his finger in the sore. How long had he planned that ill-timed remark? Since Division Street? Since the restaurant? Weeks ago? Here was the old Kevin—the Kevin she had walked out on—obsessive, manipulative, and self-centered. He was pushing her beyond where he knew she could go.

It was all she could do not to throw him off her. She let him finish, but her thighs were stiff, and her hands held his upper body away from hers in a gesture of disgust. The minute he was done, she rolled away and sat on the edge of the bed, her heart pounding, her breath strained by an anvil-like pressure on her chest.

Kevin saw her anguish, but not with the eyes of pity. In fact, it infuriated him. Gone was the pleading little boy. Gone was the passionate lover.

“There you go again! Don’t turn your fucking back on me! Quit holding on to your grief, like it was some precious, private jewel that no one but you has a right to see! I have a right! I lost him, too!”

“Damn you, Kevin!” was all she could say.

“Yeah, I said the forbidden word.
Ramsey!
Go ahead, curse me for it! Scratch my eyes out! Turn around and let me have it! But you can’t, can you? What the fuck is wrong with you, anyway? You walk around with your head full of ghosts: your father, your sister, your … your …
our
son, that pathetic little tyke who squirmed in agony for a few days before his life was snuffed out altogether. If you believe in God, why can’t you curse Him, and scream at the top of your lungs how bastardly shit-fucking unfair that was? Any normal human being would do that. If you keep it locked up inside you, it will kill you. It will drive you insane.”

She stared at the floor, trying to shut him out. His words enraged her. She burned to shriek at him, to throw back his accusations, and in so doing to flush clean the sewers of pent-up rage and grief inside her. But she couldn’t. The very thought of confronting him made her ill, as every attempt to stand up for herself always had.
Why? Why?
she had asked herself a thousand times before. It was as though an unseen hand were poised to crush her if she dared to reveal the intensity of what she felt. It had always been so, as far back as she could remember. For all her training and degrees, she was helpless to do anything about it. She had the skill to cut into the brains of others, but could not heal this abscess within her own.

She knew that so much was at stake. It was the last chance to save her marriage, and yet she found her tongue paralyzed. She couldn’t even cry. All she could do was stare at the floor and breathe,
deep in, deep out
, trying to ward off that stomach-turning feeling of doom.

Meanwhile, Kevin made his jab for the jugular. “I suppose you think that son of a bitch Helvelius has got the answer.”

Ali rose to her feet. “Richard has nothing to do with it,” she said, jerking her panties and skirt back up around her waist. “It’s just like you to be suspicious of everyone. Nothing’s happened. We just … talk. He … he doesn’t try to force me.… He accepts … accepts me for who I am.”

“Do you think I believe that?”

“I don’t care what you believe.”

“You’re never going to change, are you, babe?”

“Who ever changes? Do you?” she said, without looking back. The next thing she was standing alone on the front porch of the brownstone, shivering in the warm night air. Only then did she notice that she had put on her blouse so hastily that the buttons didn’t line up.
I’m a damned fool,
she thought.
If I don’t end it, we’re both going to lose our minds.

The next day she filed for divorce. And two days later, she made love to Helvelius for the first time.

*   *   *

Clack! Clack!
The radiologist slapped the finished angio films against the clips at the top of the lightbox. While the rest of the staff returned to the room, Ali scooted from behind the lead screen to view the images. A dark blob, like an unraveling ball of yarn, could be seen in the back of the skull cavity, marking the location of the AVM.

“There’s the main feeder,” said Dr. Helvelius, looking over her shoulder. In his voice there was no trace of what had just passed between them—no baby, no Ramsey, no wedding bells.

“Looks like it comes directly off the posterior communicating artery,” said Ali, trying to match his composure, although nausea still wrung her stomach, and she felt weak and shaky inside.

“Do we have digital?” asked Helvelius. “Kevin, do you have it?”

Kevin was slouched far backward in his chair, punching the keyboard crisply with one outstretched hand. Despite his swagger, Ali could tell that he was far from at ease. Shorn of his characteristic smirk, he seemed deep in thought, even apprehensive. She was glad to see it, for he was always like that when he was immersed in work—and work, she knew, was his solace. It was the great unifier, too. Over the past few months, Kevin had increasingly isolated himself in his laboratory. But now, with SIPNI on the verge of realization, how could he help but feel a bond with those who were gathered in this room to bring the dream to life? In that might lie the germ of healing and forgiveness.

“Yes, yes, I have it,” he said. “I’m running it past Odin now.”

Kevin flicked the switch to the audio box, releasing Odin’s soporific voice.

“HELLO, DR. HELVELIUS.”

“Odin, do you have an analysis of the vascular pattern for us?”

“I DO, DR. HELVELIUS. THERE ARE SIX ARTERIAL FEEDERS, AND EIGHT MAJOR VENOUS EFFLUENTS. ONE OF THE SMALL VEINS HAS UNDERGONE SPONTANEOUS OCCLUSION SINCE THE LAST SURGERY. OTHERWISE, THE PATTERN IS THE SAME.”

“Thank you, Odin.”

“I RECOMMEND LEAVING THE LARGEST VEIN OPEN UNTIL LAST. IT CONNECTS DIRECTLY WITH THE SINUS RECTUS.”

“Afraid I’ll have to overrule you on that, Odin.”

“IT WILL PROVIDE THE HIGHEST POSSIBLE FLOW RATE, AND MAINTAIN THE LOWEST POSSIBLE PRESSURE WITHIN THE AVM. THIS MINIMIZES THE RISK OF A CATASTROPHIC BURST HEMORRHAGE.”

“Yes, but it’s too short. Tethered like that, I won’t be able to manipulate the AVM. I need a little room to work with, Odin.”

“YES, I SEE. MAY I SUGGEST AN ALTERNATIVE?”

Helvelius looked at Kevin’s monitor, where a longer but slightly narrower vein was highlighted in yellow.

“Yes, Odin, my thoughts exactly.”

Jamie was lying facedown, his head enclosed in the chrome-plated cage of the modified Budde halo ring retractor. The crown, where the AVM was, had been elevated a little above the rest of his body. Inside the metal ring was a small circle of freshly shaved, iodine-painted scalp, bordered by sterile blue paper drape.

“Let’s go in,” said Helvelius. Esther, his favorite scrub nurse, slapped a #10 scalpel into his hand, and with a single swerving motion, he cut through Jamie’s scalp, tracing the thin, U-shaped scar left from the last surgery. Ali held the incision open with a small retractor as Helvelius gently peeled the skin away from the glistening white skull underneath, working through the sticky patches with the blunt end of the scalpel. She watched as he used a bone chisel to pry away a coaster-sized disk of skull—the same skull flap he had cut out at Jamie’s first operation. Only a few judicious taps with the chisel were necessary now to free up the flap. Once loose, it swung open like a clamshell. Ali was satisfied to see that it was still connected to its blood supply through a flap of the parchmentlike dura mater that lined its inward face.

“Okay,” said Helvelius. “Start thiopental.”

“Giving two hundred milligrams now,” said the anesthetist.

“Titrate it until we get burst suppression on the electroencephalogram.”

Helvelius took a step back from the operating table and looked at the tiny red light of the TV camera. “Uh, thiopental is the notorious ‘truth serum,’” he explained. “We’re giving it to Jamie because it decreases the blood flow to the brain, and relaxes the pressure inside the AVM. It also slows down the activity of the brain itself, which will protect it in the event that there is any temporary cutoff of oxygen. We don’t expect that to happen, but it pays to be prepared.”

“We’re there,” said the anesthetist.

At a nod from Helvelius, Ali slipped a pair of retractors into the groove between the two halves of the brain and gently pulled them apart. Deep inside the brain, she now saw the wrinkled, purplish, softly pulsating mass of the AVM. She felt a little anxious. After two operations, more than half of the mass had been removed, and there had been no mishaps. But both she and Helvelius knew that the most difficult, knotty part of the tumor was what faced them now. If this phase of the operation went wrong, there would be no need for SIPNI.

But she was an experienced surgeon. There was no need for anxiety. The AVM was merely a delicate puzzle box, requiring a steady hand and the utmost of patience for its solution. It
had
a solution. It was nothing to fear. And with that insight, she returned to the calm, focused, Zen-like state of mind she always strove for—the sense of order she craved more than anything else in the world.

*   *   *

Harry Lewton strode quickly down the Pike. Over more than a century, Fletcher Memorial Medical Center had grown out of a jumble of buildings of different sizes and architectural styles. The outpatient clinic of the Department of Endocrinology was in the very center of this jumble, where it jutted from the central section of the quarter-mile-long corridor, or the Pike, that ran like Main Street through the long row of buildings. When Harry reached it, the big glass doors of the lobby had been propped open, and three or four patients were already spread out among the leatherette chairs, waiting for ultrasound exams or capsules of radioactive iodine. The ubiquitous drone of a TV set could be heard.

It was pretty quiet. On his morning rounds, he had noticed that this particular clinic was always dead on Mondays. It was no different today.

He went straight to the receiving desk, a long, high barrier of dark wood and sand-colored fabric panels that separated the patients from the suite of exam rooms in the back. He flashed his hospital ID and introduced himself to a young African-American woman in a white dress and flowered smock. “Did you open the clinic this morning, Tia?” he asked, reading her name from her ID badge.

“Yes, sir. Fifteen minutes ago.”

“See anything unusual? Anything that doesn’t belong here?”

“No.” She had that skittish look that people did whenever authority showed up without an invitation.

“Any unfamiliar people?”

“No. Just these.” She nodded toward the patients. “Is there a problem?”

Harry quelled an impulse to shrug. Although he didn’t want to alarm the girl, he didn’t want to appear too casual, either. “It could be nothing. Why don’t you go back to what you were doing while I have a look around?”

Tia nodded warily, then picked up a plastic watering jug and padded off through the door that led to the exam rooms. She looked back over her shoulder twice before she disappeared.

Harry scanned the room.
Okay, what have we got here?
There was a woman in her forties, short black hair—dye job—talking on a cell phone. She hadn’t looked at him since he came in, which meant she had nothing to hide. Two gray-haired gals sat together on the other side, one watching TV, the other just sort of staring at the wall. No, make that snoozing. There was one old geezer looking at a magazine. By the way his hand shook, Harry figured he’d have blown himself up directly if he had ever taken to building a bomb. That was it. No master criminals.
All right, what else?
Objects: women’s purses, all within arm’s reach. Old guy had a tripod cane. No backpacks anywhere. No parcels. Harry could see easily under all those spindly legged chairs. They were clean. Ditto for those little glass tables with the magazines on them. There weren’t any telltale carpet impressions to suggest that anything had been moved.…

Harry heard a shuffling noise behind him, and jerked his head around a trifle quicker than was normal for him. It was just Tia coming back to water the office plants.
Don’t get jumpy, Pilgrim.
Harry let her pass. As she did, his eye was drawn to the area behind the receiving desk. He saw a half-dozen computers with their cables tangled like jungle vines on the floor, some low-backed chairs on casters, and a taboret or rolling file with a sliding door with a lock on it. That looked like a possibility. The file had been pulled out, putting it in the way of the receptionist’s chair. It didn’t usually sit there.

Harry was about to approach the taboret for a closer look when, from the far window, Tia called out to him. “This what you’re lookin’ for?”