Close Reach (26 page)

The cabin had been cleared entirely of furniture to make room for the operating theater. The men had hung plastic sheeting in a rectangle from the ceiling, sealing the seams with duct tape to make a clean room in the center of the cabin. The sheets were translucent. Through them, Kelly could see the shadowed forms of three people working above a gurney. The plastic nearest her was speckled with blood on the inside. A fine, undulating red mist of it. Sometimes an oscillating sternotomy saw would throw out blood like that if its blade was still running when it was lifted from a patient.

None of the figures inside the plastic room looked up at her.

They were murmuring softly in English. There were low, steady beeps. EKGs and ventilators, she thought. Kelly circled the perimeter of the plastic box, looking for the way in. The plastic sheets bulged out, tight with internal air pressure. She could see the outlines of the compressed air tanks they were using inside to maintain a pressure differential for sterility. There was an antechamber of draped plastic built off the theater’s side, a Velcro strip running down the middle of its entry point. It was their makeshift air lock.

She opened the Velcro with the gun’s barrel and stepped into the lock, closing it behind her. Then she opened the second sheet in front of her and entered the operating room. The yellow cords ran across the floor to power strips. Machines were plugged into them. Old equipment, the kind you could get on the cheap from medical clearing houses. Two heart-lung machines, a roller pump. A pair of FLOW-i anesthesia machines. There was another thing near the surgeons she didn’t recognize, but she guessed it was an antique cardiopulmonary bypass machine. Its cannulation tubes were coiled in waiting on a rolling Mayo table nearby.

Big halogen lights hung overhead and lit the space with a hot, white glare. The air smelled sharply of antiseptic and bleach.

The three men, dressed in blue scrubs and wearing masks and goggles, never looked up. Two of them were huddled over the gurney, looking down. The anesthesiologist was behind a drape of blue cloth at his machine, watching the LCD monitors. The surgeon and his assistant had lights clipped to their eyewear, magnifying loupes hanging from their plastic visors. There was a wheeled tray with instruments, a tissue table with its bloody bowls and used blades. She saw the electric sternotomy saw, its blade red with clotted blood. Scalpels, retractors.

Another piece of plastic divided the room down the middle, and she leaned to look into that half of the operating theater.

It was empty except for a gurney with an old man on it, surrounded by blinking equipment. The Colonel was naked and covered with a blue sheet from the waist down. They’d already drawn the incision marks on his chest with a purple marker. He was hooked to a saline drip and was on a ventilator. His eyes were closed.

She turned back to the men, who were still bent at their work.

“Get the fuck away from her,” Kelly said.

The surgeon looked up first.

“Who the hell are—”

“I said get the fuck away from her!”
Kelly shouted. She pointed the gun at them, and they all seemed to notice it for the first time.

The surgeon held up his hands. His blue latex gloves were stained red at the fingertips. He was holding a tiny-bladed scalpel and a disposable plastic hemostat.

“We’re right in the middle—”

“I don’t give a shit what you used to be doing. Step away from her. Now.”

She gestured with the gun as she stepped deeper into the operating theater. The surgeon and his assistant came out first. The anesthesiologist followed. They stood with their backs to the plastic and their hands in the air. Kelly kept the gun aimed at the surgeon but stole a quick look at Lena.

She was strapped to the gurney with thick tie-downs. Her face beneath the clear latex respirator mask was the color of trampled snow. They’d opened her chest with a saw and had used stainless steel retractors to spread her split sternum into a bloody opening five inches wide. She’d been a vessel for them, carrying in her chest the thing the Colonel needed most. And they’d cracked her open to take it.

“Goddamn you,” Kelly whispered.

She was looking the surgeon in the eye. He didn’t understand what was about to happen. He had Lena’s blood dripping off his fingers, untraceable millions in some Swiss account to pay for what he’d done. Some of it was probably Kelly’s money, taken by David after he’d tortured Dean aboard
La Araña.
But he still didn’t see this coming. Kelly stepped forward two paces and shot him twice in the face. She shot the assistant in the chest before the surgeon even hit the ground, and then she had the anesthesiologist in her sights. The pistol barrel wasn’t shaking at all.

The anesthesiologist was frozen, his hands in the air.

He looked from the dead men on the floor back up to Kelly. His lips were trembling and he was trying to say something, but his terror kept him mute.

“You’re part of this, too. You didn’t cut on her, but you put her under. You made it happen. And you can burn in fucking hell.”

She shot him in the throat, and he tore through the plastic sheeting and landed on the floor of the cabin. He turned on his stomach and crawled three feet toward the woodstove in the corner and then fell still. Kelly looked at the other two men on the floor. The surgeon’s face was a caved-in wreck, but he was still breathing. His fingers twitched against the floor planks. One of the bullets had split his chin so that his lower jaw hung in two toothless halves. The other bullet had turned his nose inside out and left it spattered on the plastic sheeting.

Either he’d bleed to death or he’d drown in his blood, but he wasn’t getting up again. She wasn’t going to give him a third bullet.

Kelly dropped the pistol and then fell to her knees.

She closed her eyes and listened to the ringing from the gun blasts. When that bled away, she could dimly hear the fire spit and crackle in the corner. The only other sounds were the slow, steady beep of the EKG and the hiss of sterile air from the tanks. The generators were a distant hum. She was dizzy, her head turning like a spindle, each chime of the EKG like the tone of an elevator car marking the floors as it shuttled her down a long shaft to a place of utter darkness.

But she snapped her eyes open and looked up when she realized something. The old man, the Colonel, was prepped for the transplant, but his chest was completely bare. There were no EKG leads on him yet. The beeping was coming from the machine hooked to Lena. The quiet, small tone was a register of her heart.

It was still beating.

There was a scrubbing station in the corner of the surgical room. Hot water in Igloo coolers, soap in plastic bottles. Three sets of spare scrubs hung from a stand. The men would have cleaned and changed into fresh surgical clothes after the bloody work of harvesting Lena’s heart. She’d taken a visor and eyewear from the floor, and she found latex gloves and a face mask. There was nothing she could do about the breach in the plastic sheeting. She’d just shot three men within a few paces of an open patient, and there was nothing she could do about that, either.

When she was clean and ready, she stepped to the side of Lena’s gurney and assessed the entry. They had split her sternum down the middle with the sternotomy saw, pulled her chest open with self-retaining surgical retractors, and exposed her heart. They’d been examining it when she came in. Now she leaned close and looked, lightly pulling back Lena’s ribs with her gloved finger to expose everything.

They hadn’t cut through the pericardial sac yet, hadn’t cut her heart from her body or poured ice into her chest cavity to keep their prize cold. They hadn’t performed a cannulation either, so Lena’s heart was still pumping her blood. It was beating once a second, each contraction a double pulse of atrial and ventricular systoles. Her heart was strong and red and healthy. Of course the Colonel had wanted it.

But there’d been no plan to put Lena back together after this theft. The tools for that repair had been on the other side of the operating theater, next to the Colonel. She’d wheeled that tray to Lena’s side before scrubbing in, knowing she would need everything they had prepped for the Colonel. The absorbing sutures, the surgical stapler, the thin titanium plates and six-millimeter screws for bolting Lena’s sternum back together.

The dead surgeon had at least been careful enough that Lena would stay alive through the examination and for however long it took him to ready the Colonel. He’d wanted her heart to beat until the second he was ready to steal it from her. It left Kelly with time and a chance.

She looked again at the instruments, some of them familiar, others less so.

She wished she had a nurse. An anesthesiologist who didn’t need to be shot. Without help, she wouldn’t be able to alter the inhalational anesthetics until she was done. The machine wasn’t sterile, and she wouldn’t be able to touch it in midsurgery. If Lena started to crash, she’d have to deal with the machine and the drugs, and then she wouldn’t be able to touch her patient again until she spent another ten minutes resterilizing herself. For the same reason, she wouldn’t be able to adjust the lights or change the magnification loupe on her visor. Maybe none of it
mattered, anyway. She’d already committed the greatest breach of operating room sterility she’d ever heard of.

There was an empty bullet casing on the blue sheet between Lena’s knees. She left it there.

“Okay, Lena, honey,” she whispered. “Let’s do this.”

The retractors were held apart with a thumbscrew. She twisted it to the left and then slid the steel hinge closed. She took the retractors off Lena’s chest and set them on the lower tray. Now the split sides of Lena’s sternum were loosely abutting each other. When she fit the sternal reduction forceps and locked them into place, the two sides of the saw-split bone came tightly together.

She was no expert in this kind of surgery. Her field was more precise and delicate. She operated on nerves. Tiny tumors or bleeding vessels deep in the brain. She went in through holes the diameter of a coffee straw and groped her way forward by remote control, watching her progress on a video monitor.

By contrast, this was like operating with a large-bore naval gun. The hole in Lena’s chest was big enough to pass her fists through. And in all her years of surgery, she had never used a Phillips head screwdriver on a patient. But she was about to.

She fit the first titanium plate and twisted the drill guide into place, bracing the rib from underneath with the fingers of her right hand. She used the surgical drill to bore a narrow pilot hole, then set the drill guide aside and twisted in the first screw. The plates had been custom fitted for the Colonel’s sternum and would be too big for Lena, whose bones were as delicate as a sparrow’s. But this would do until she got to a hospital. The other twenty-three screws were a little easier and took a minute apiece to drill and set. Without pausing, she ran a line of absorbing sutures through the lower layer of Lena’s skin, stitching flesh back over bone.

She leaned past the blue curtain and looked at the anesthesia machine’s monitors. Lena was still fine, running right down the middle. There was no way to guess how long that might last. For Lena, time was as precious as blood, and she was short of both.

She was closing the outermost layer of Lena’s skin with the surgical stapler when she saw a shadow pass the window. Kelly held her breath and froze. She was still half deaf from shooting the pistol in the tiny cabin. Her ears could have been stuffed with cotton. But she heard the footsteps all the same, the creak of dry boards out on the porch.

“Cuidado,”
a man said, his voice low.

She put down the stapler and picked up the pistol, pulling her mask down around her throat after she backed away from Lena. She stepped over the dead surgeon and through the hole the anesthesiologist had left in the plastic wall. Outside, there was more whispering. The generators cut out one at a time.

When the lights went out, there was just the orange glow of the fire in the stove, the purple glow of the sky outside behind the waving tree branches.

The EKG and some of the other equipment must have had a battery backup. The low beeping continued, and there were green and white lights from some of the control buttons on the other machines.

She stepped into the shadows behind the woodstove.

The flames wavered behind the stove’s greasy mica windows. By their light, she saw the front door swing open six inches. The man outside was pushing it open with the flensing knife. Firelight trickled across its blood-wet blade, and when he took one step more, she saw his face. Big Hands. If he’d armed himself with the knife, he didn’t have a gun. They’d thought that they were alone, that the only danger to their Coloel was the procedure itself, not anything from the outside.

Kelly crouched low and waited.

A knot popped in the fire, and Big Hands started, then appeared to relax. He stepped farther into the room, looking not at the stove but at the carnage on the other side of the room. Kelly waited until she saw the second man on the porch beyond the doorway. She shot him first, aiming for his chest but hitting him in the groin. He fell back screaming, and Kelly turned the gun on the first man, who was charging at her. She fired until the clip was empty, hitting him in the chest, in the face. The other shots went wide, smashing into the log wall and breaking through a window. Big Hands staggered and fell across the top of the woodstove, sizzling as he slid off it.