Eden's Eyes (3 page)

"You sick bastard," Ed accused over Ken's paroxysm of laughter. "You twisted sonofabitch!"

Ken's assistant, a taciturn G.P. by the name of David Wong, joined Ken's crowing, letting out a series of spastic, high-pitched chuckles. Nervously, the two, and finally Ed himself, took up the chorus.

For a moment the tension slackened.

Then: "The Ottawa team is here."

Ed turned to the sound of the voice and saw the nursing supervisor standing in the doorway, a hand cupped over her mouth in lieu of a mask.

"They're in the change-room now."

Ken nodded and the laughter abruptly subsided. "Let's get moving," he said to his assistant. "Get the perfusionist in here."

"Yes, Doctor," the circulating nurse said, then hurried out of the room to find him.

"Ed," Ken said. "Is this guy relaxed?”

Still red-faced, Ed touched the donor's cheek with the leads of a battery-powered nerve stimulator, a device designed to test the depth of surgical paralysis. At the start of the case Ed had infused a huge dose of muscle relaxant and expected no muscle-twitch now.

There was none.

"He's as relaxed as I can make him," Ed said.

Ken grunted and returned to his dissection, freeing up the kidneys for eventual removal.

The first of the Ottawa team entered the room, a husky resident dressed in tight-fitting greens. He greeted the Sudbury team warmly, and Ed guessed from his bright-eyed enthusiasm that his boss would be allowing him to remove the heart tonight. For a moment Ed recalled his own grueling residency without fondness. His gut still felt queasy from Ken's sick little prank.

Now four other members of the Ottawa team entered en masse, setting about their preordained tasks with practiced efficiency, and Ed felt a glow of admiration. These guys flew all over the nation, Ed knew, gentlemen farmers, late-night harvesters of man's most precious crop—human organs.

Maybe it was the fatigue, but Ed found himself recalling a Monty Python movie he'd see a few years back, a gruesome little flick entitled Meaning of Life. . .

Two guys in dirty-white lab coats appear at this rummy's front door and one of them says, "We've come for your liver."

And the rummy says, "But I'm not done with it yet. . ."

"Doctor, could you give the patient a gram of Solu?"

Ed whirled as if slapped. "Sure he said to the tall, imperious-looking fellow who had just stepped into the room. The head honcho, Ed guessed from the man's demeanor.

"Evening, Ken," the man said, peering over the drapes into the operative field.

"Hi, Ozzie!" Ken replied with genuine pleasure. "I didn't expect to see you up here."

"Oh, I like to make the trip every now and again."

"I'll be out of your way in just a few minutes," Ken said. The right kidney's shot—big subcapsular hematoma—but the left one looks fine." He chuckled." Oh, Ozzie. Have you met Dr. Skead?"

Turning toward Ed, the heart surgeon shook his head.

"Oswald Harrington," Ken said. "Meet Ed Skead, our weary gas man."

Ed shook the man's hand, surprised at its gentleness.

And all at once things sped up to triple-time, diverting Ed's attention from the dead man on the table and his own enveloping fatigue.

Ken stepped back from the table, dipping his bloody gloves into a water-filled basin but keeping them sterile. Once the heart was ready he would have to finish his job, extracting the one viable kidney as quickly as possible.

Now, under Harrington's supervision, the resident took over, extending Ken's incision up to just below the chin. Years removed from cardiac surgery, Ed stood at the head of the table and peeked over the drapes, his sleepy psyche easily entranced by the busy hands in front of him.

In a single slick stroke the incision was taken down to the breastbone. Next, a pressure-powered jigsaw rasped through the sternum with liquid ease. Again the odor of cooked tissue wafted up on gray-white smoke.

Noting an abrupt increase in the donor's heart rate, Ed glanced again at the oscilloscope. He's feeling that, he thought, even though he realized it was merely a brainstem reflex and not a conscious awareness. It spooked him just the same.

Now the pericardium, the lubricated bag in which the

heart tapped out its living beat, was incised and reflected away.

Bared to the world, the donor's heart thumped in earnest, rolling slightly to one side with each separate systole. Draped in a kind of apron of fat, it made a rather unimpressive sight in the white-hot glare of the overhead spots. No romantic associations here, Ed thought. Just a thick, muscular pump, jetting blood through myriad conduits in a frantic, suddenly pointless rhythm.

"You can take over now, Ken," Harrington said, stepping away from the table. "We're all set here."

While Tucker cut the kidney's final linkups, another Ottawan prepared a cold, potassium-rich solution which would later bathe the heart, paralyzing it in midbeat and facilitating its removal.

"Jesus, Ed," Ken said with annoyance. "Are you positive this guy is relaxed?"

Ed tested him again. "He's flat out, Ken. Really."

"Well then maybe he just doesn't want to part with this thing. I'm having a hell of a time here."

Tiring of Ken's complaints, Ed fired in another dose of relaxant. He failed to see, considering the size of the hole in the donor's belly, how Ken could be having any trouble—but he'd learned years ago that it was better to coddle than to clash, particularly with surgeons.

"Shit!" Ken said. "He's hemorrhaging!" An instrument clattered to the floor. "Clamp!" he snapped at the nurse.

Curious, the Ottawa surgeons stepped in for a closer look.

Ken’s hands moved with swift precision, delving into the wound and probing blindly. There was a sustained moment of tense silence, then a sound like a foot pulling free of a thick bed of mud.

"There," Ken breathed with obvious relief. "Got it."

He lifted out the small, purplish organ and carried it like a dripping newborn to the perfusionist, whose job it was to bathe the kidney in a preserving solution until the time of transplant. By now the recipient would be on the table in Ottawa, where this organ, along with the heart, would be going by helicopter very shortly.

Meanwhile, Harrington and his resident had already begun the final process. The removal of the heart.

At the head of the table, Ed Skead felt his own heartbeat quicken. This was it. Once the major vessels were cross-clamped, the guy was a goner.

It surprised Ed, the tension he was feeling. He supposed it was the presence of that old dark cousin, Mortality, that was doing it to him. That and his bone-deep fatigue. But this was a unique glimpse of death, he realized, glancing again at the donor's face.

A favorite expression of his father's, who before his death had been a Presbyterian minister, flitted unbidden through Ed's weary mind:

Death hath ten thousand doors for men to take their exits.

Ten thousand and one, Ed added morbidly. We just cooked up a new one.

The guy was brain-dead, he knew, and therefore legally dead. . . but what about the rest? Who could say with any real certainty, save for God Himself, what was going on inside him at this exact moment?

Suddenly Ed found himself stirring up questions he hadn't touched on since medical school. . . simply because they defied answering.

Was the guy really dead? Had his spirit, if such a mythical intangible actually existed, already fled his ruined body? Or was it still trapped in there somewhere, in some dark, untraceable cavern, festering into a gob of unsalvageable slime, unfit for eternity or reincarnation or whatever transcendence lay ahead? For Ed believed fervently in God, and therefore in some form of, if not life, then continuance after death. And all of that made this particular situation, this artificially suspended evolution from life to death, seem highly unique indeed.

"The aorta's clamped," Harrington said mildly. "Begin the infusion."

Ed looked up sharply from the donor's face, trying to switch his thoughts to another tack. He hoped he could get in a few hours sleep after this, because now his eyes were playing hallucinogenic tricks on him. He thought he'd seen the void, nerveless expression on the donor's face change subtly. Tighten somehow, as if. . . grimacing.

No way.

There was an empty stool in the far corner, and Ed found himself imagining the Reaper seated there. Not the faceless, hooded skeleton of lore, but a grinning goblin with a cobra's green eyes and a hint of impatience in the set of its curving jaw. The Reaper waited right in this room, Ed fancied, annoyed but resigned. . . because tonight, Oswald Harrington would determine the instant of death, not the creature with the scythe.

Ed looked up at the oscilloscope, at the electrical pattern of life gone suddenly awry. The blood pressure had dropped from one-ten over seventy to forty over nothing.

Any moment now, Ed thought, glancing compulsively at the donor's face. Sweat oozed steadily from the man's skin, which had already adopted the dusky hue of death.

"Cutting the aorta now."

Quite unexpectedly, there followed a huge spike in the donor's pressure, way up over two hundred when by rights it should have slipped to zero. Ed looked on in breathless awe as blood spurted up in a great red fountain-spray, spattering both surgeons, drenching their gowns and speckling their stupefied faces. Some of the stuff even found its way over the drapes, spotting Ed's shoes in dime-size gouts.

"What in hell was that?" Harrington erupted, losing his air of unshakable cool.

"Freaky," Ed whispered to himself. "Fucking freaky."

Now, as it should be, the pressure was zero. Blood welled passively into the yawning chest cavity.

"Suction," Harrington said edgily.

Ed thought of vampires as the length of clear-plastic tubing flashed red, and the room filled with a low rude sucking sound.

The scrub nurse turned pale above her mask.

Ed reached out and flicked off the ventilator, feeling like the impish demon that trips up from the Gulf at night to steal the breath, from sleeping children.

Scissors snipped, clamps clicked. Instruments changed hands, first gleaming silver, then streaked with blood.

Systematically, the donor's heart was taken.

Ed's gaze drifted helplessly, downward, bleak curiosity impelling him to study the man's face for hints of his passing.

But there were none, save for the physical.

The skin hue deepened from bluish pink to pinkish blue to the dusky shade of a new bruise. The lips grew pale, almost ivory. The cheeks sank. The sweating stopped. The runner of blood at the corner of the left eye-socket had already begun to dry into a flaky red brush stroke.

"Okay," Harrington said. "Got it. Mark the time."

"Four a.m.," Ed said. "Exactly." He marked it on his chart as the official time of termination. Then he peered back into the operative field.

The heart was out, lying on the donor's sheet-draped chest, now little more than a deflated balloon full of carefully cut holes. The surgeon inspected it a moment, then handed it over to a technician, who packed it in a bed of ice.

Three minutes later the Ottawa team was gone.

"Let's close 'er up," Tucker said wearily. He looked at Ed. "You should scram, man. You look like hell."

Ed nodded. Reflexes again, he thought, finding it difficult to leave ahead of the surgeon. Hesitating, he glanced around him. There was a single flat line on the oscilloscope; he reached up and switched it off. Then, bidding his colleagues good night, he left the OR

When he got to the change-room Ed found it abandoned, the only evidence of the Ottawa team's presence a litter of bloodstained greenery on the floor.

"Fast," he said aloud, a hint of admiration in his voice.

He went to the coffee machine and poured out a brimming cupful. It would keep him up, he knew, but somehow he'd lost his taste for sleep. Something about crossing into that void, itself so much like death, struck him as. . . unappealing just now.

He sat and sipped and felt like a superstitious idiot. But it sure felt good to be out of there. And he didn't care if he ever got involved in this kind of thing again. Who needed it? Christ, he'd had himself half-convinced that the guy had been aware, feeling the whole thing. It was a crock, of course. He'd examined the poor sot himself preoperatively. Not that he'd needed to. One glance into the dead pools of those eyes had been enough.

But. . .

But nothing.

He grabbed a magazine and flipped noisily through it.

Ten minutes later Ken Tucker and his assistant filed wearily into the change-room. The assistant changed quickly and left. Ken poured himself a coffee and joined Ed on the threadbare couch.

"That was quick," Ed commented.

"Aesthetics are not a major concern in a case like this," Ken replied bluntly.

Ed nodded bleakly. Then something occurred to him.

"Oh, shit," he grumbled, turning visibly pale. "I forgot my beeper in there." He remembered taking it out of his pocket at the start of the case and setting it atop the heart monitor. He stood. "The nurses still in there?"

"I think they broke for coffee," Ken said. "I don't envy them having to clean up that mess." He gulped his coffee and stood. "Let's hope that's it for tonight, eh, Ed?"

"Yeah," Ed replied, watching Ken leave. "You bet." He looked down at his blood-spattered shoes.

Then he turned and walked back to the OR.

The nurses were indeed at coffee; Ed could hear their nervous chatter from where he stood in the central corridor. Reluctantly, he trudged back to Room 5, pausing outside the open doors.

Jesus, what a scene, he thought with disgust. It looked like a slaughterhouse in there, an abattoir for the nearly dead. Stained instruments scattered everywhere, a gallon suction bottle brimming with clotted crimson, blood tracked over the floor in bootie-shaped footprints.

Ed avoided looking at the still-draped corpse as he crossed the room to the anesthetic machine. He grabbed the pager, pocketed it, and started away.

Then he heard a noise, so slight he might have imagined it.