Change of Heart (10 page)

Mary MacDonald picked up the cold wrist for the third time in twenty minutes. Goddamn Diller, son of a bitch prima donna, she thought, as the taps beneath her fingers beat frantically—the panicked feet of millions of tiny lemmings scurrying to the cliffs by the sea.

Come on, MacDonald, come on, she chided herself, tucking the arm between the crisp sheets and smoothing her uniform. She stared down at the still, gray face.

“Sharlie, my sweet, you're in big trouble this time, aren't you? And where's that goddamn Diller?”

It had been two hours since the ambulance brought her in, and still the girl hadn't recovered consciousness. MacDonald hadn't even recognized her, the color was so bad. Features change as death approaches, and the subtle transformation had already begun by the time they hooked her up in ICU.

Another miracle for modern science, MacDonald thought grimly. We doing you a favor, girl? She stroked the lank hair, placing it gently behind Sharlie's ears.

“What's her CVP?” said a calm voice next to her shoulder, and MacDonald wheeled around, embarrassed at being caught in such an attitude of unprofessional tenderness. Diller was running his eyes down Sharlie's chart.

“Fifteen,” she replied, frowning at the young woman standing beside Diller. Different face, same body—immense breasts, slim hips, legs that began at the armpits. Diller caught the look.

“MacDonald, Miss Nobring,” he said with elaborate formality. “Mac's the best diagnostician in Cardiology. If there's any conflict between her and X ray, trust Mac over the pictures.”

Mary MacDonald ignored his frozen smile and nodded brusquely at Sharlie. “We're losing her,” she said.
You exhibitionistic, egocentric medical-matinee-idol asshole.

“Where're the parents?”

“Getting coffee.”

“I want to see them the minute they show up.”

“They're pretty eager to see you, too,” Mary said acidly.
Where have you been while my Sharlie lies dying?

Diller gave her a cool smile, taking Miss Nobring under the shapely arm. “I'll be in my office,” he said, and ushered Miss Nobring out.

Yes, and you'll keep your door locked for half an hour, too, won't you, doctor? Mary thought. Let's just hope nobody needs you before you're finished.

She looked down at her patient again, the slim body insubstantial, as if there were no one in the bed at all, just a crease in the sheet. Nothing to be done, Mary thought with an unfamiliar sense of panic. Usually she felt resigned when losing a cardiac patient. In fact, her recent lack of sorrow had begun to concern her, and she had spoken about it with the priest. After twenty-eight years of hospital work, had she become cold-hearted at last, another Carlton Diller? Herd ‘em off the ambulance, hook ‘em up to the machines, stick a dozen needles in their veins, and if they make it, shake their hands and ship ‘em out. If they don't, well, that's the breaks. I did what I could.

But when Charlotte Converse was born, Mary MacDonald was just beginning in Pediatrics. The young nurse had held the frail infant and prayed for her to survive. In those days she hadn't been cold-hearted. Too much the other way, in fact, so that sometimes her compassion got in the way of her judgment, so that one time …

She shook her head to clear it of ugly memories. No use crying over spilled milk, not when there were living people in her charge.

Sharlie stirred and opened her eyes just a slit, wincing at the glaring light of ICU. Mary leaned over her.

“Eyelashes about half-mast. Not bad, but you can do better.”

Sharlie tried to make a face at her, and Mary was nearly overcome by the urge to grab the girl's thin shoulders and hold her close to her own substantial breast. Instead, she said gruffly, “Cut the comedy, Converse. Save your strength for the second act.”

“I hope a comedy,” Sharlie whispered.

“Oh, for Christ's sake, girl, did we ever let you down?”

Sharlie shook her head and closed her eyes wearily. Mary picked up the thin wrist again, checking the monitor to confirm what her fingers told her. Then, as she started to place Sharlie's hand back under the sheet, she felt resistance, the fingers clinging. Mary bent down close to Sharlie's face.

“Let me go, Mary,” Sharlie whispered.

Mary stiffened and stared into the face that seemed old and twisted by suffering. “Bullshit,” she replied.

Sharlie moved her head weakly back and forth on the pillow. “No more.”

Mary couldn't find words, so she smoothed Sharlie's hair, letting her hands linger on the hollow curve of her cheek. She waited until sleep came, then stalked out of ICU with clenched jaw. The aides who saw her marching down the hall were quick to move out of the way.

Anderson Carlton Diller stood in his office, glaring at the X rays of Charlotte Converse's heart. They hadn't done the angiogram yet, but all preliminary tests indicated disaster. Goddammit, why couldn't she have some nice, neat little obstruction? He'd perform a triple bypass, impress the hell out of everybody, and get Walter Converse to finance his artificial-heart research unit. If he only had the facilities, he could perform every kind of operation right here instead of sending everybody off to Houston or California.

But
this,
he said to himself, snapping off the light-box in disgust. What a mess.

He sat down behind his desk and stretched his feet out on top of the cluttered surface. He contemplated the soft leather of his new Italian loafers sourly. Scuff mark already.

Converse would be in here any second, breathing condescension, outrage, and potential hundred-dollar bills. How much longer could Diller keep that kid of his alive? She'd outfoxed the statistics as it was. If he could just convince the guy he'd done a superhuman job on his little girl, then when she went, maybe he'd fork over. In her memory, of course. They'd call it the Charlotte Converse Memorial Heart Research Institute. Catchy.

The office door opened as the desk buzzer sounded. Diller reached for his intercom, but Walter was already halfway across the room. With some ceremony—just who the hell did Converse think he was anyway, there could have been a consultation going on in here—Diller elaborately replaced the receiver and rose. The mousy Converse wife trailed behind. Great body for a woman her age, and some class, but as far as personality was concerned, a mere puff of smoke from her husband's cigar.

“Diller …” Walter stuck out a hand, and the surgeon took it. Diller wondered how the huge square fingers got so rough, like a farmer's. His own were soft and smooth and pale. He lived in continual fear of damaging them and wore gloves as often as he thought he could get away with it. He'd read somewhere about a famous pianist who wore gloves all the time, indoors and out. Diller sympathized—anything to keep the artistry from leaking out—still the guy went a little too far, wrapping himself up in scarves like a madman.

Diller gestured for them to sit, and though Margaret plunked herself down immediately, Walter continued to stand. Diller decided the man had difficulty compressing all his energy into a chair and thought he'd better stay on his feet himself if he were to maintain a vestige of authority. He arranged his face into an expression of guarded concern.

“It's not good this time,” he said quietly.

Walter replied impatiently, “I know it's not good. Obviously it's not good. Question is, what do we do about it?”

Diller glanced briefly at Margaret, who sat stone-faced, not really focusing on anything. He wondered if perhaps she were in shock.

“We have to see the angiogram. Then we'll have a better idea what's going on.”

Walter strode to the lightbox, snapped it on, and said tersely, “That hers?” Diller nodded. Walter stared at the picture in silence. Then he said, “What's an angiogram going to show that we don't know already?”

Diller and Margaret were silent, and Walter sat down, almost slumped into the chair. Diller, taking advantage of towering over Walter Converse, put his hands on his hips and pushed back his white jacket to reveal a tailored pale-blue shirt monogrammed with the initials
A.C.D
. “It'll show us the exact position of the blockage.”

Walter snorted, and after a moment Diller said, “I can call in a couple of people, but I think they'll agree. I'm sorry.”

There was another long silence.

“I think it's time we discuss the possibility of a heart transplant,” Margaret said.

Both men gaped at her until finally Diller responded, “But your daughter won't give us permission.”

“Probably not,” said Margaret.

“She isn't a minor,” Diller protested, and at this Walter exploded.

“You should have done it when she
was
a minor. She'd be walking around with a halfway decent heart instead of that hunk of flab.”

Diller forced himself to remember the architect's cost estimates for the projected artificial-heart laboratory and controlled his voice. “If you remember, the last time we discussed transplantation, you decided against it yourselves.”

“With a lot of prodding from you and your chicken-shit buddies.”

They all sat quietly another moment. Ceasefire, thought Diller, waiting with clenched teeth for the next outburst. But there was none.

Margaret Converse looked him full in the face and said, “I'll see to it that you get your permission.” Then she turned to Walter. Her expression was polite and cold, and Diller found himself wondering what their sex life was like.

“Does that conform to your thinking, Walter?”

“What?” said Walter dully.

Margaret repeated, “The transplant. Do you agree we should do it?”

Walter nodded.

“Then you do whatever you have to do, Doctor Diller, and we'll do whatever we have to do.”

“It's not that simple, Mrs. Converse. There's a lot of arranging—”

“Whatever's necessary,” she interrupted crisply, then stood up and left the room without another word.

Well, I'll be damned, thought Diller.

Converse sauntered after his wife with an elaborately slow pace. Once he'd disappeared, the doctor went back to his X rays and stared at them balefully as if they were his mortal enemy.

Margaret and Walter sat downstairs in the hospital cafeteria. They were alone except for an oversized young woman in a print housedress with her two unruly children. Margaret watched her slap at their hands and wearily push her straggly blond hair behind her ears.

“How come you never listen to me, Buddy? How many times I gotta tell youse kids? Don't I speak English or what?”

“Close,” Margaret murmured under her breath. Walter looked up from his coffee cup to stare at her with a puzzled expression. She ignored him, and pretty soon he slipped back into his preoccupied munching. My God, she thought, he looks like a shaved buffalo.

Margaret flashed back again to the scene that still clung to her consciousness, attaching itself to her memory like a dark, exotic creature with fierce little claws. It was a slow-motion scene, with Walter blasting away at one end of the dining room table and Sharlie standing pale and quivering, defying him with huge glistening eyes. And suddenly she'd crumbled. Not a heavy-bodied crash to the floor, but almost as if someone had pulled a vital plug and all the essence of the girl hissed out, leaving a loose pile of clothes in a heap beside the chair.

At that precise moment Margaret had heard an audible snap inside her head. A tightrope would give way like that, with a sharp, metallic retort, and like the lady in the tutu, she began to tumble, her pink, frilly parasol useless against the powerful force of gravity. On her way down, she found that she had no curiosity about a net—whether or not it was there. She had lived with such intense fear for so long that now, in the midst of the disaster she'd always dreaded, she no longer cared what happened to her. Only the fall itself mattered, and she felt a thrilling exhilaration all the way down.

She glanced at Walter again now, and felt the same excited pounding in her head.
If he had tried to touch her then, I would have picked up a steak knife and stabbed him through the heart.

“What's the matter, Margaret? Your gut bothering you again?”

Margaret stared at him from far away, across the vast Formica surface of the cafeteria table. Goodness, she thought, how long has the man been losing his hair?

He saw her gaze fastened on the top of his head, and swiped at his hair curiously, wondering if there were a thread or speck of lint there. He shifted uncomfortably.

“Goddamn granite, these seats. Only fit for people with fat asses.” He looked pointedly at the woman with the two children, strewing food and paper napkins in an ever-widening orbit around their table.

What the hell's gotten into Margaret anyway? he thought, inspecting her surreptitiously as she tipped her teacup and drained off the last drop, her little finger extended just slightly in a manner that he enjoyed mimicking. He could almost always get a smile out of her with the performance, but something told him not to try it today.

“I'm going back to the waiting room,” she said. She got up abruptly, smoothed her soft gray skirt, and left him sitting there to stare after her. She stood very straight as she walked toward the cafeteria exit, and it seemed to him there was a more loose-limbed spring in her walk.

Just who the hell did she think she was, leaving him here without even a consultation about the next move? To hear her talk to Diller, you'd think she was the one who'd run the show all these years, who'd made all the agonizing decisions, who'd held his hand while
he
whimpered and whined and leaned on
her
for every little thing. Maybe the strain was finally too much—Sharlie's illness—and this time she'd had some kind of mental breakdown. Except that she looked so goddamn put together. Crazy people didn't function like that. Unless she'd turned into one of those nuts who thinks she's Queen Victoria.

The dreaded image flashed into his mind again—the two women, one unconscious on the rug, one crouched over the inert body like an animal protecting her wounded young, glaring at him in white-faced fury, ready to pounce at his slightest movement. He kept trying to force the memory away, but its impact became stronger as the hours passed. He found it impossible to sit still when the scenario recurred in his head. Bedeviling faces, one as white as death, the other a portrait of hatred.

He shook his head and looked up, hoping to distract himself with the sight of the slovenly family sitting nearby. But their table was empty—not one scrap of litter remained behind.

Suddenly he could no longer bear the idea that Margaret was upstairs, maybe learning some piece of news before he did. This time she hadn't consulted him about anything, much less the usual niggling details that used to drive him crazy—whether to raise or lower Sharlie's bed, and if so, how far; what magazines to bring her to read when she was up to it again; or maybe she'd like a newspaper, but wouldn't that be too upsetting?

Imagine Margaret just getting up like that and leaving him down here. He'd have to speak to her about their joint responsibility and the need for communication. He'd bring it up as soon as she wasn't acting quite so flaky.