A Heartbeat Away (2 page)

Brittney stepped forward. “Don't worry about it. I've heard her say the same thing.”

Tori shook her head. “That was before.”

The orderly cleared his throat. “It's time.” He transferred her oxygen supply to a portable tank and lifted her IV fluid to a pole attached to the bed. “Let's go.”

Brittney brushed back another tear.

“Don't cry,” Tori said.

“I'll be praying for you.”

Tori nodded. “Thanks.”

The distance to the OR must have been less than fifty feet, but it could as well have been fifty miles. Tori reviewed her life, her education, her career, and decided it would be okay to die.

The orderly pushed her past an elderly gentleman pushing a wide cotton floor duster. She reached for the orderly's sleeve. “Stop.”

He hesitated as she motioned the older man with the mop to come forward. When their eyes met, she said only two words. “I'm sorry.”

He nodded. They'd reached an understanding.

Six months before, Dr. Taylor was leading clinical rounds in the ICU, teaching, probing the residents' knowledge, lecturing on subjects as they came up in discussing the patients' conditions. There must have been a dozen or so following her. Her chief resident, two other surgery residents, two interns, four students, as well as a collection of the ICU nursing staff. Dr. Tori Taylor was in the spotlight. Bright. Smart. And to the resident staff, just short of divine.

They came upon a patient, an elderly man having a gastrointestinal bleed. He'd just had another black stool, the specimen deposited in a bedpan that he'd pushed aside. The specimen was still fresh and the characteristic sour odor unmistakable. Dr. Taylor wanted to continue rounds, but the smell was overpowering. She lifted the bedpan and called to a member of the environmental services staff, an elderly man passing by at just that moment. “Could you take care of this?”

The uniformed man shook his head and wrinkled his nose. “That's not in my job description.”

His attitude infuriated the surgeon. “And just what is your job description?”

The man shrugged. “I mop the floors.”

Tori Taylor didn't hesitate. She held the bedpan out at arm's length and turned it upside down, plopping the contents onto the floor. “Now it's in your job description.”

The incident caused quite a stir. Environmental services demanded an apology. Dr. Taylor refused. Apologies were for the weak. The story was circulated among the surgical house staff, ballooning Dr. Taylor's reputation. She wouldn't take anything from anybody.

Now, seeing that same member of the environmental staff, she had at last offered that apology, as a result of a twinge of a new emotion: guilt. She squinted to read his name. “Darryl.” She lifted her hand in a weak wave. She hadn't even known his name.

The orderly edged the stretcher forward toward a set of double swinging doors that led to the operating rooms. “This is as far as I go,” he said.

Quickly a team of masked men and women, their outfits complete with scrubs, hats, and shoe covers, surrounded her. She thought she recognized Dr. Parrish, the lead transplant surgeon. He pointed to the portable cardiac monitor. “When did she start that?”

Tori tried to concentrate on the blipping neon line on the monitor, but the rate was too fast. She started to feel faint. Breathing was more and more difficult.

She listened to the urgent voice of her surgeon. “She's in V tach! We need to get this patient on bypass. Now!”

She felt a fluttering in her chest. She knew exactly what her surgeon referred to. Ventricular tachycardia. She lifted her fingers to her neck, doing her own self-assessment. She touched Dr. Parrish's arm. “Don't rush,” she said. “I've still got a pulse.”

Her comment didn't erase the strain from his face. “I get that, Tori, but I don't need to tell you that this isn't a particularly good sign. Your heart doesn't seem to want to last another hour.”

“I'll hang on,” she whispered.

Her surgeon didn't respond. Her statement didn't appear to encourage him. The pace of activity around her accelerated.

The ceiling tiles blurred as she was wheeled quickly into an expansive operating suite. She studied the masked figures, guardians of the sterile fields of instruments lying ready for use. Someone pushed a mask over her mouth and nose.

A voice from somewhere else. “Take a deep breath. Pure oxygen.”

In the final minutes leading up to her surgery, a flight of images from her past pushed away the noise of preparation. She closed her eyes and tried not to think, but faces of the young men who had pursued her, wanted her, but whom she'd set aside in her professional quest, flitted past, floating on a sea of regret.

I haven't loved.

The thought assaulted her. She opened her eyes, hoping to erase her unwelcome guests.

I should think about all the people I've helped through their hours of need. Think about victories over cancer, parents who will live to see their children graduate, wives who have beaten breast cancers to celebrate anniversaries, and grandfathers who will attend another season of Little League baseball.

But her trophies felt hollow against her own failure to find love.

Someone lifted her blankets. She was cold. Exposed. A nurse began painting her chest with an antiseptic.

I'm still awake!

But nothing changed. Everyone continued as if she hadn't spoken.
Stop! I'm awake.

Can they even hear me?

She followed a scurry of excitement with her eyes, straining to see around the mask and the hand that squeezed it against her lips. A member of the donor team had entered the room. She caught a glimpse of a woman in scrubs, arms chest high, holding something in a stainless-steel basin.

“Delivery,” she said, as if someone had ordered pizza. She held the basin holding the mound of red-brown tissue toward a nurse still guarding the back table.

“Accepting delivery of donor heart.”

Another female voice announced the time. “9:05.”

Tori managed to twist her head to see. Everything around her seemed to slow. It was only a few seconds, but the weight of the moment focused the event with a clarity Tori had never experienced. In that surreal instant, she envisioned the intersection of two lives filled with emotions, love, pain, and relationships. Two paths converged into one. From birth to the present moment, she imagined her life and the life of her donor as two lines at warp speed, surging toward this one fixed point. With time compressed, the sounds of a lifetime of experience zipped along like an audio file played at fast-forward.
My new heart!
As the two lines intersected to become one, a bright light appeared.

Someone touched her eyelids, forcing them to stay open as a light flashed to check her pupils, and turned her face away from the back table. She felt something cool against her eyes as the anesthesiologist spread a protective ointment across their surface. She tried to blink. She understood what was happening.
Taping my eyes shut for protection.

She attempted to lift her hand. She wanted them to know.

She met a restraint.
I'm still—

Tori attempted to scream but made it only to the second word before a blissful coma descended.

2

There is a place of twilight between the coma of anesthesia and the first moments of awareness where the defenses are lowered. Memories bubble to the surface and are freed like carbonation seeking escape from the top of a cold soda. For Tori Taylor, it was a place of terror, a place where thoughts spurred by prior pain fought for recognition through a haze of sedatives and painkillers.

I'm burning. My arm is on fire.

Smoke chokes me. I spit and gasp, falling to my knees to crawl away from the yellow hell in the next room.

I listen as human screams fight to be heard above the roar of flames.

I cannot breathe.

The demon man is calling out for help, but I cannot save him, for I have sent him to the hell where he belongs.

“Don't fight, Tori, you're in the ICU. Your surgery is all over.”

A blurry image floated above her head. A face, a nurse with a soothing voice. Tori wanted to tell her about the fire, but she could not speak.

The face above hers was female. Young, maybe twenty-five, brown hair cut short, the wash-and-go practical cut of a professional. Green eyes sparkled, gems set in ivory sclera.

Why does she look familiar?

“Tori, don't try to speak. There is a tube in your windpipe.”

You can say trachea. I'm a surgeon.

Tori tried to reach for the tube. She needed to pull it out. It seemed to make breathing more difficult. Her hand wouldn't move. Restraints bound her wrists.
I must have tried this before.

“Don't fight the machine. Breathe with it.”

Tori shook her head. She looked over her left shoulder. A monitor revealed the regular blips, a neon-green stripe dancing to a rhythm across the screen.
My new heart.

“I'm giving you something to ease your mind, to help you breathe with the ventilator.”

No, I don't want to dream!

Tori watched the young woman adjusting an IV drip.

She began to float. The fire returned. Thick smoke blurred her vision.

Someone called to her. A man.

An evil man who was burning.

Darkness.

“Take this,” she cried. A female face appeared above her. Short hair. Beautiful green eyes. She shoved a paper into Tori's hand. Tori looked at it. In block letters was a number: 316. “Memorize it.” She paused. “It's the proof. I want to make that bastard pay.”

She heard a scream. Tori concentrated on the number. Of course she could remember. It was only one number.

Blackness. Pain.

A man's voice. He sounded strong.
Dr. Parrish?

“Is she off pressors?”

The second voice sounded young, a voice she recognized as a resident she helped train. “Only on enough dopamine to tickle her kidneys, not enough to squeeze her heart.” Tori watched as the young man pointed toward a pressure readout. 126/80. “She's doing that on her own.”

“Excellent.” A pause. “Can we get her off this ventilator?”

The resident surgeon, Dr. Joel Thomas, leaned over Tori's face. “Dr. Taylor, can you lift your head for me?”

Tori lifted her head from the pillow but not before she felt a stinging sensation spreading across her chest.

“Good, good. Call respiratory. Let's set up an oxygen mask.”

A few minutes later, the resident physician removed the tape securing Tori's endotracheal tube to her cheeks. “Cough,” he said. When she obeyed, he pulled out the tube with one swift motion.

As they positioned an oxygen mask over her face, the memory of the horrible dream lingered. Was it only a nightmare?

Dr. Parrish smiled at Tori. “Victoria, you really gave us a scare. It looks like you got a new heart just as your old one gave out.” He shook his head. “Timing is everything.”

She nodded without speaking. Someone had died so she could live. A few moments later, she managed a whisper. “What day is this?”

“Monday.”

“No.” She closed her eyes in disbelief. She'd lost three days.

She took inventory. In spite of having a new pump, minor things like shifting around on her hospital bed or lifting her head seemed to exhaust her. The past few months had wreaked havoc on her muscle tone and endurance. Six months ago, she would have enjoyed a six-mile run through the Richmond suburbs. Now, she found herself winded at the thought of taking one step.

With her restraints off, she started her own assessment. She lifted her left arm to see an arterial line exiting her wrist. She felt her upper chest. There she found another IV, something she'd placed many times herself, a central line that led directly into the large vein above her new heart.

She remembered the message and the paper that had been shoved into her hand. She lifted it.

The paper was gone.

Over the next few hours, she drifted in and out of sleep, each time returning to the same horrible dream of fire and pain. When she awoke again, a nurse was standing at the bedside recording something on a keyboard. She recognized the face but didn't know her name.

“Well, Dr. Taylor,” the young nurse said, “it's nice to see you awake.”

“Something burned my arm. Fire.”

The nurse leaned forward, frowning. She quickly looked over Tori's wrist, lifting it from the bed. “Your arm looks fine to me.” She ran her fingers over Tori's upper arm. “What's this? A skin graft?”

Tori nodded. “I burned myself on the muffler of a dirt bike when I was very young.” She paused, thinking. “I don't even remember it.”

The nurse nodded. “Well, you're not burning now.”

“I remember a fire. My arm was burning.”

The nurse's eyes widened. “Oh, you were on propofol for sedation. Many patients say it burns when it goes in. I'm sure that's all it was.”

Tori shook her head but wasn't ready to argue with the nurse. The experience, be it a dream or a memory or simply a distorted hallucination from all the drugs,
seemed
real.

Someone had died in a fire. Someone who meant to do Tori harm.

“Whose heart do I have?”

The nurse, a twentysomething with short hair and green eyes, smiled. “I have no idea. That information is strictly confidential.”

“Certainly you heard something.” Tori paused. “News of an auto accident perhaps?”

The nurse shook her head.

Tori squinted at the nurse. “You look familiar.”

“I've seen you in the ICU.”

“You have a tattoo on the back of your left shoulder.”

The nurse smiled. “Nope. Not me.”

“I seem to remember you having a tattoo. Two little hearts.”

“Sorry. Not me.”

“You gave me a number. Told me to remember. Three sixteen.”

The nurse smiled sweetly, the kind of smile you offer to someone who just spilled his or her lunch tray. “And just when did I do this?”

“You don't remember?”

“No.”

Tori took a deep breath. The memory was still fresh.

“What's your name?”

“Dr. Taylor, you've talked with me hundreds of times. Are you feeling okay?”

Tori sighed. “I just had a heart transplant. I'm exhausted.” She paused, staring at the nurse. “I'm sorry, I don't know your name.”

“Jennifer,” she said.

Tori nodded. “Thank you,” she whispered.

The nurse stepped back but halted as Tori whispered her name. “Yes?”

She wanted to ask if anyone had visited but knew better than to open herself up to the pain of reality. Instead, she said, “Nothing.”

Three days later, Tori Taylor had just completed a walk in the hall with a nurse when Dr. Samuel Evans entered. Dr. Evans chaired the surgery department and had his name on more book chapters than Tori could imagine. If there was ground that seemed hallowed to Tori, it was the area between the door to the chairman's office and his massive mahogany desk. “Well, look who's up,” he said.

“Just made my first lap around the nursing station.” Tori wiped her forehead with the back of her hand. “Might as well have been a marathon.”

“It will get better.”

“Give me a few weeks, a month max. I'll be back.”

“Take your time.” Dr. Evans looked away as the nurse helped Tori back into bed.

The nurse gently spread the sheet over Tori's legs. “Just press the call button if you need anything.”

“Honestly,” Tori said once her nurse disappeared, “this is driving me crazy. They act like I'm going to break. I need to get out of this place.” She sighed. “Seriously, I think I can start again on the first of the month.”

“That's only three weeks.” He shook his head. “No way.”

“I'll prove you wrong.” She glared at the chairman, but he turned away.

“I'm putting you on three months administrative leave.”

“But I'll go nuts. I—” She stopped when she saw his expression. Beneath his short white hair, his brow was furrowed, his eyes dead. “What aren't you telling me? The Board of Visitors …”

He nodded.

“They want me out?” She huffed, suddenly aware of her utter exhaustion. “You stuck up for me, right? They can't just—”

“Of course I stuck up for you. Getting them to agree to a three-month leave was the best I could negotiate.”

“But why now? I'm disabled. This has got to be illegal.”

“It's not illegal. They made their decision a few weeks ago. They didn't even know you were sick.”

“So you knew and didn't tell me?”

He nodded soberly. “I thought you were going to die. So telling you the board's decision was needless.”

She took a deep breath. This was so unfair. She was the best surgeon in the department.

“I'm sorry,” he whispered.

“So what's the deal? I get three months off and then what?” She looked at him, her eyes pleading. “Look, Sam, you know me. I need to work. My patients need me.”

“Come back after three months. Three months after that, as long as you've behaved, I get to keep you.” He traced a line across the floor with the toe of his shoe. “It's conditional.”

“On?”

“A few things,” he said, acting nonchalant. “I'll need a written apology.”

“I already apologized. I saw the janitor on my way to surgery and—”

Dr. Evans held up his hand. “Not to housekeeping. To the nursing supervisor.”

“Is this about Mr. Gates?”

“His nurse, yes.”

“She missed a dose of a critical medicine. She failed to give a patient with a known history of venous thrombosis a blood thinner. My patient threw a clot that nearly killed him.” Tori shook her head. “I spend seven hours doing a liver resection and he pulls through just fine, until he meets Nurse Tearful.”

“You called her down in front of the other nurses.”

“She almost killed my patient.”

“Tori, the nurse's father is on the Board of Visitors. That's the reason for the review. As it turns out, Nurse Stanfield isn't alone in her sentiment. Your file has six other letters of complaints from the nursing staff.”

“Half of them were from my resident days. I've mellowed.”

He lifted his eyebrows. “Really?”

“I'm harder on myself than I am on the nurses. I demand
and give
perfection.”

“You're too young to be a prima donna. Just write a nice letter. Promise to do better.”

“I don't do touchy-feely. The incompetent nurses get their feelings hurt and I'm to blame.”

“You can't come back to work unless you agree to write a letter.”

She folded her arms across her chest.

Dr. Evans walked to the door. “I'm sorry, Tori. That's the way it is.” He paused before adding, “There is one more requirement.”

She looked at him without speaking.

“You have to agree to counseling. Learn to express your emotions in a positive way.”

“I never once raised my voice to those nurses. My emotions weren't out of control.”

“It's not a matter of control. You called them idiots.” He shook his head. “One of the nurses claimed you said he had a stupidity virus.”

“Because he acted stupidly. He clamped off a chest tube to stop the bubbling. When we discovered it on rounds, my patient was in distress from a tension pneumothorax. He'd have died in another ten minutes.”

Tori watched as a smile fought with the edge of the chairman's lips. He cleared his throat, and the smile disappeared. “You've got some time to think about it.” With that, he turned and left, before she could fire back twenty excuses. He closed the door behind him, leaving Tori alone.

Then, for the first time since she was a little girl, Tori began to cry.