Chapter One
N
icolette Janssen's hands trembled as she struggled back into her clothes. She was getting out of here. To hell with the consequences. She'd had it with the lies and the false hopes. This time she was leaving for real.
But she had to hurry. They'd be coming for her soon, and she'd need every second of a head start she could get. She prayed for a ten-minute lead, but doubted she had a chance for that.
Seven, then. Whatever.
As she fumbled with the button on her shorts, she tried not to see the deep purple bruises on her arms.
Ooh, sorry. We're almost there. You sure have tiny veins.
Sure, blame her veins. Forget about the railroad spikes they called needles.
Now there was a favor she'd like to return one day. When they yelled and cussed at her to be careful, she'd be sure to smile and tell them in that soft voice that it was really for their own good. See how they liked it.
Let somebody else be their chemistry set for a while.
With her pants on and fastened, and her T-shirt in place, Nicki slung her purse over her shoulder and moved tentatively to the door, pausing a beat to thumb the TV remote that was part of the call button that was looped around the side rail of her bed. Oprah and the fears of pending Y2K crises disappeared. Nicki opened the door a crack, just to get a peek, and then stepped out into the wide hallway, standing tall and resisting the urge to run.
Just make like you belong,
she thought. And why not? With all the hours she'd logged, there ought to be a wing named after her. Her flip-flops squeaked on the tile floor as she turned right and started for the bank of elevators.
Jeez, what was she thinking? The elevators opened directly in front of the nurses' station. “Come on, Nicki, think, will you?” she mumbled. If a nurse or, God help her, her dad saw her out here, there'd be serious hell to pay. Patients weren't supposed to be up and around on their own. Hell, they weren't supposed to pee without telling someone. Prisons and hospitals had a lot in common, she imagined.
Oh, shit, there he is!
Her dadâthe famed prosecutor Carter Janssenâwas standing right
at
the nurses' station, ranting at the phlebotomist who last dredged her arm. How typical of dear old dad: Better to yell at a stranger than to comfort a daughter.
An exit sign to her right showed the way to the stair well. As Nicki pushed the door open, she prayed that there wouldn't be an alarm. There wasn't. Score one for the home team. It would have been a short chase. She smiled at the thought of what it might have looked like: sprint fifty yards, fall down unconscious, wake up, run another fifty yards . . .
It turned out that the stairwell was the primary vertical thoroughfare for everyone who wore a lab coat. All of them moved at three times the speed that she could muster, and they were far too busy to notice her.
She had eight flights to go. That meant sixteen half-flights to the bottom, probably more than the total number of stairs she'd navigated in the last three months combined.
See, Dad?
she thought.
I'm not as fragile as you thought.
If she made it, there'd be no turning back. Maybe now, finally, they would all understand that she meant what she said.
* * *
Carter Janssen knew that Priscilla, the phlebotomist, was the wrong target for his rage, but somebody had to answer for this atrocity, and she was the most available hospital employee. Nowhere near her thirtieth birthday, the technician looked close to tears.
“All I do is draw blood,” she whined.
“But you're part of the
team,
” Carter growled, leaning on the word he'd heard so often from the transplant crew. “We succeed or fail as a
team,
don't you remember?”
“You need to speak to the doctor,” Priscilla said. She moved to step around him. “I have nothing to do with the decisions that are made.”
“I'd love to speak to a doctor,” Carter said, making a broad sweeping motion with both arms. “Do you see one here? All I see are people telling me that the doctors are all too busy to speak with me.”
“Doctor Burkhammer is in surgery. I already told you that.”
“That's not possible,” Carter snapped. “He can't possibly be in surgery, because my
daughter
was next on his dance card, and she got stood up!” He yelled that last phrase, making Priscilla jump, and drawing uncomfortable glances from the nurses behind the glass. One nurse in particular, a broad-shouldered one in the back who carried herself with the posture of a boss, reached for a telephone. Carter had the distinct feeling that she was calling security.
“Can I help you?” a voice asked from behind.
Carter turned to see a chubby redheaded man who must have bought his clothes before going on a diet. He wore woefully out-of-date horn-rimmed glasses with lenses thick enough to start a fire if he looked the wrong way in sunlight. “Who are you?”
“I'm Dr. Cavanaugh,” the man said, extending his hand. “We met a few months ago. I'm from the Heart-Lung Consortium.”
Carter's jaw dropped. The last time he'd seen Dr. Cavanaugh, the guy had been the size of a boxcar. That he was now only thirty pounds overweight meant that he'd lost over a hundred. “I wouldn't have recognized you.”
The doctor beamed and patted his stomach. “I decided to start taking some of my own advice. I'm terribly sorry about Nicolette. I don't mean to sound flippant, but such are the ups and downs of the transplant business.”
“The ups and downs?” Carter repeated. The words tasted bitter on his tongue. “That's it? That's all you have to say to me?”
Dr. Cavanaugh gently grasped Carter's elbow with one hand and gestured to the collection of seats in the hallway. “Perhaps we should sit down and discuss this.”
“No,” Carter said. “I don't want to sit. I'm waiting for Nicki to get dressed, and I don't want her to step out and not see me.”
“Well, let's keep our voices down, then.”
“
Let's
keep
our
voices down? What are we, in fifth grade? What the hell happened?” Carter reached under his suit jacket and pulled a pager from his belt. “We got the word,” he said. “The message came through, we came down here just like we were supposed to, we went through all the pre-op bullshit, and then nothing.
Nothing.
A nurse told us it was just a false alarm, and that it was time for us to go home.”
Cavanaugh showed Carter his palms in an effort to soothe the situation. “I understand that you're upsetâ”
“What the hell is going on?” That time, Carter's voice rolled like artillery fire down the hallway.
Cavanaugh jumped, and seemed conflicted as to whether he should answer. Finally, he said, “They changed their minds.”
“Who?”
“The donor's family.”
Carter wasn't sure what answer he was expecting, but this wasn't it. “They get a vote?” His tone betrayed his utter disbelief.
Cavanaugh sighed, clearly resigned to the fact that Carter would never understand. “They lost a child to suicide, Mr. Janssen. I know you think you've had a blow of bad news, but please don't everânot for a momentâthink that those poor people owed you anything. They made a decision and then they changed their mind.”
The words rattled Carter. “I don't understand,” he said. “They'd prefer that their child's organs be buried in the ground?”
“It's a problem we face with patients like Nicki,” Cavanaugh explained. The rationality of his tone and his words belied the horror of his message. “There are a number of surgeons and patients alike who look at bilateral heart and lung transplants as the ultimate act of selfishness. A grieving parent has to decide, in the height of their grief, as they are being bombarded with one nightmare after another, whether their loved one's viscera should help only one person, or help many. The vast majority of transplant recipients need only a heart or one lungâ”
“And Nicki needs all three.” Carter closed his eyes against the pain of the revelation.
“Exactly.”
“My God.” Carter stared, searching for the next thing to say. He nodded toward that cluster of seats. “I think I'll sit down after all.”
Dr. Cavanaugh took the seat directly opposite. “I don't know if this is a detail you want or need to know, but the reason Dr. Burkhammer couldn't meet with you and explain this himself is because he had to perform the heart transplant that the family made possible.”
The enormity of it all was too much. So, this was how it was meant to be? At the whim of confused parents, one girl is condemned to death so that others might live? Carter had never allowed himself to understand that someone else would have to die to make that happen.
But those were concerns for another parent. Carter had a devastated child of his own to worry about. “Has this happened before?”
“Rarely, but it does happen. And before you ask why we don't make certain before we notify the recipient, the answer is, we try. We get a yes and a signature, and because time is of the essence, we make the phone calls.”
“So, they
signed
an agreement and reneged?” Suddenly, Carter the lawyer felt his feet on more solid ground.
“We're not selling commodities, Mr. Janssen. These are organs. Some might say that they're a part of the donor's soul. If grieving parents dig in their heels, we're not going to force a donation just because they spilled ink on a page. We're not ghouls.”
But we had a deal
, he didn't say. To give Nicki life and then to take it away seemed so horribly cruel. In Carter Janssen's world, everything was ordered and neat. Promises were met, and if they weren't then that was what courtrooms were for. This was all so . . .
unfair.
“What can you tell me about the recipient?” Carter asked. The question came partly out of a need to fill the silence, but also from a need to know in his gut that whoever it was, was worth the price of Nicki's life.
“I can't say anything about that,” Cavanaugh said. “I'm sure you understand.”
“Man, woman, boy, girl? You can't tell me any of that?”
The doctor shook his head. “I know how devastating this news must be to you, and I caution both you and your daughter not to lose hope. Not only is there a chance that another donor might appear, but there are some fairly encouraging mid-term therapies for Nicki's conditionâ”
“She wants nothing to do with them.”
Cavanaugh's head bobbed, but he clearly dismissed the relevance of that. “Of course she doesn't. She's a teenager. They frequently reject what is best for them. But as her fatherâ”
Carter cut him off with a raised hand. “No lectures, okay? Not now. I'll do what I have to do. But it's such an onerous procedure.”
Cavanaugh scowled. “Are we talking about the same procedure? We merely insert a pump into her chestâ”
“And administer prostacyclin. Yes, I know. But it means hospital time.”
“We have to monitor the condition carefully.”
“Of course you do. Doctor, you don't have to justify any of this to me. Nor do you have to explain it to Nicki, but I've got to tell you, after watching her mother wither away in here, she's scared to death of hospitals.”
“Well, then we have to set her mind at ease.”
Carter closed his eyes to stave off the frustration. “That's not possible,” he said. When he opened them again, they felt red. “Without the transplants she's got maybe nine months left, and of those only six are likely to be anything close to normal. The way she sees it, every hour she spends in a hospital is an hour she's not spending cramming life into every day.”
“But it's necessary,” Cavanaugh said.
“Of course it's necessary,” Carter snapped. “Everything is so goddamned necessary. But it sucks.”