Informed Consent (16 page)

E
vents began to blur
. As soon as Doug Wynn called the oncologist’s office to say that his son had agreed to donate his liver, some unseen, dormant machinery sprang to life.

Less than two hours after the call, a medical helicopter was landing in his backyard. He was bundled on to a stretcher and loaded into the aircraft—a private medical escort service that he was more than happy to pay for. By the time the sun was setting, he was being whisked through a private underground corridor normally reserved for Middle Eastern sheiks and royalty and then settled into his bed on the transplant ward in the University of Pittsburgh Medical Center hospital in Oakland. Blood was drawn, his temperature taken, his abdomen scanned.

A collage of cheerful female faces whirred by. Becky, his aide; Charlene, his nurse; Valerie, the resident. Every one of them asking the same litany of questions as she rubbed hand sanitizer between her palms. Do you have any concerns? Do you understand what’s happening? Are you in pain?

He answered everyone in halting English. Which was odd because he’d adopted the language wholeheartedly. He even dreamed in English.

He was watching ‘The Big Bang Theory’ on the ceiling-mounted television with the sound off, when Lester Baker, the surgeon who would be performing the surgery—if it happened—strolled into the room.

“Mr. Wynn,” he said cheerfully. “How are we tonight?”

“I’m fine. And you, doctor?”

“We’re getting up to speed on your charts. You’re a very sick man, Mr. Wynn.”

“Please, call me Doug.”

“Doug, your tumors are just barely within the acceptable parameter of a Milan score. If we’re going to do this, we need to jam.”

“To jam?” he repeated uncertainly.

“To move quickly. Forge ahead. We’re calling your son in for his evaluation tomorrow. We’ll be putting a rush on the whole thing. Seems you’re on the Arabian King Plan, eh?”

“I beg your pardon?”

“Foreign dignitaries. Rich men from other countries. They show up, no insurance, pay cash for everything. It certainly expedites the process, not having to go round and round with medical insurance bean counters, eh?”

“Heh.” Doug laughed weakly. He didn’t want to invite any questions about his finances. He had gobs of money, to be sure. The means by which he’d acquired those sums would not withstand close scrutiny, as his accountant used to say.

“That’s a good thing, Mr. Wynn. That means that if your son’s a match, you could have your surgery as early as this week.”

“Really?” Doug coughed and raised himself onto his elbows. That was sooner than he had allowed himself to hope.

Dr. Baker reached out and patted him on the shoulder. “Let’s not get ahead of ourselves. Leo is coming in tomorrow. We’ll know by the end of the day.”

“
T
hanks
, Mom,” Sasha kissed Valentina on the cheek and waved goodbye to her dad.

“Honey, truly, any time,” her dad assured her as he hefted the groaning bag stuffed full of baby supplies on to the kitchen counter.

“We really appreciate it,” Connelly said soberly.

“Leo, please. It’s such an amazing thing you’re doing. Just amazing. Saving a life—your father’s life!” Her mom teared up at the thought.

Sasha planted a kiss on Fiona’s forehead and then one on Finn’s before grabbing Connelly’s hand and hurrying him through her parent’s kitchen door and out to the waiting car.

She buckled her seatbelt, adjusted her side mirrors, started the engine, and then glanced over at her passenger. “You okay?”

“Fine.”

“Are you sure? You’re quiet.”

He stared straight ahead as he answered. “I really didn’t expect things to happen this quickly.”

Quickly was, in her view, a bit of an understatement. Less than eighteen hours ago, he’d decided to move forward with the possibility—the
possibility
—of donating part of his liver to his father. And somehow, now, his father was already checked in at the hospital in Oakland and had been cleared for a living donor donation. The only missing piece of this puzzle? Connelly.

But as she watched that muscle twitch in his jaw, she felt only sympathy. No snark. No blame. Just the sinking feeling of knowing how it felt to carry the weight of someone else’s existence on your shoulders.

She dug back through her memory to the night she’d gone into labor to find an approximation of the words Connelly had used. “This is it. Are you ready?”

They must have resonated, because he squeezed her hand then raised it to his lips for a kiss. “I’m ready,” he said pinning his clear gray eyes on hers.

“Let’s do this, then,” she said as she hit the gas pedal and the car lurched forward out of the alley.

She spent the short drive down the hill into town reminding herself that her role here was to be supportive. She wondered how Connelly had managed to stay so calm when she’d been about to give birth with the twins. Here she was, just driving him to an intake appointment, and her hands were so shaky she nearly hit the guardrail as she merged onto Bigelow Boulevard.

She passed a billboard advertising Golden Village’s superior, aging population solutions and made a mental note to call Dr. Kayser’s office to see whether anyone there knew a Dr. Craybill. By the time she pulled into the parking garage behind Montefiore Hospital, she’d forgotten all about Dr. Kayser’s cryptic message.

“
T
omorrow
?” Leo repeated, certain that he’d misheard the woman. The walls seemed to close in on him. The air was heavy and hot. His throat felt as if it were closing. He focused on taking the next breath.

“That’s right,” Angeline chirped. “Isn’t that amazing? You just
flew
through the health and mental screenings. And it’s clear you have family support.” She paused here to smile at Sasha, who squeezed his hand so tightly he was sure she crushed a few of his fingers.

“What about scheduling an operating room and a surgical team? People are just sitting around waiting for a surgery?” Sasha asked.

“That’s another stroke of good luck. Dr. Bryant, who will be performing Leo’s surgery, does all of his surgeries on Wednesdays. This Wednesday, as it happens, he didn’t have a surgery scheduled. Dr. Baker, who will be operating on Mr. Wynn is also free in the morning. And because Mr. Wynn is a cash patient we didn’t need to go through the process of submitting anything to his insurance—”

“He’s paying cash for a liver transplant?” Leo asked.

“Yep. And he’s picking up the cost of your surgery, too.”

“Excuse me?”

“Typically, the recipient’s insurance covers the donor’s surgery and follow-up, too. Because your father doesn’t have insurance we ordinarily would have checked with your insurer to see if they’d cover you, but he told us not to. He’s going to go out of pocket for the entire amount.” Angeline smiled broadly.

“Where would your dad get that kind of money?” Sasha asked out of the side of her mouth.

Blood money,
he thought. “No idea,” he said.

“So, Leo, the question for you is whether you’d like us to find you a room or if you want to spend the night at home and come back early tomorrow morning?”

He turned to Sasha. She gripped her fistful of glossy full-color brochures and looked at him wide eyed. He knew exactly what she was feeling. He also knew he wanted to sleep in his bed next to his wife tonight with her narrow back curved against his chest, his arm tight around her waist, and her wild waves of hair tickling his nose every time she shifted in her sleep.

“I’ll come back tomorrow,” he said.

“Great. Let me walk you through the pre-op information,” Angeline said.

“Excuse me. I’ll be back in a bit.” Sasha stood and walked out of the room stiffly, as if she were in a trance.

“She’s probably a little bit stunned,” Angeline suggested, as they watched her go. “It’s understandable. It can be a shock to the family when the idea of the transplant suddenly shifts from abstract to imminent. Just give her some time.”

S
asha hesitated
outside the door to Doug Wynn’s private room. Visiting the father-in-law she’d never met had seemed like a good idea when she’d bolted from the transplant coordinator’s office. But now that she’d made her way to the eleventh floor and located his room, it seemed like a strange, potentially awkward thing to do. She was backing away, headed toward the stairwell, when a tall, friendly nurse’s aide bustled out of the room, pushing a meal cart, and nearly bumped into her.

“Oh, I’m sorry, honey. I didn’t see you there.”

“It’s okay.”

“You can go ahead in. Mr. Wynn’s awake,” the woman assured her before she disappeared around the corner.

Just do it, already.

She cleared her throat, raised her hand, and gave the door a quick rap with her fist.

“Come in,” a male voice called.

She pushed open the door and walked into the room.

Doug Wynn was propped up in his bed with two pillows wedged behind his back. An untouched bowl of cherry Jell-O and a Styrofoam cup filled with water rested on the tray in front of him.

He glanced down from the ceiling-mounted TV screen and met her gaze.

“Do you need something?” He eyed her from head to toe, taking in her tailored dress and jacket, and apparently decided she was there in some sort of official capacity.

For her part, she blocked out the too-loud volume of his sitcom and its canned laugh track; the chill of the stale institutional air that circulated around her; and the faint scent of bleach and disinfectant that hung like a cloud over the sparse room. She focused on the man in the bed. Searched his angular, lined face for a hint of her husband. But there was no trace of Connelly’s warmth and wit in this man’s hard, dull eyes. No glimmer of the good humor that curved Connelly’s full lips into a perpetual bow in Wynn’s firm, unyielding frown. She saw nothing that tied the two men together. Yet, Wynn’s blood coursed through Connelly’s veins. And, by this time tomorrow, Connelly’s liver would be nestled in Wynn’s abdomen, already beginning its work, clearing toxins from the sick man’s body, pumping health and life back into his dying husk.

He stared back at her in a cold silence that rebuffed her. Then he repeated his question in a flat tone, “Do you need something?”

She stepped closer to his bed. “I’m Sasha McCandless-Connelly,” she finally answered in a voice that cracked just a bit. “I wanted to meet you before tomorrow.”

His face was a blank mask. “No visitors.”

“I’m sorry, maybe you don’t recognize my name? I’m Leo’s wife. I’m married to your son.”

He closed his eyes for a moment. She waited. When he reopened them and saw her still standing there, he raised his eyebrows slightly as though he were surprised to see that she hadn’t taken the hint and vanished. She smiled in an attempt to bridge the awkward distance between them—strangers who at once shared nothing and absolutely everything.

He turned his head and faced the wall.

She took out her phone. “Would you like to see a picture of your grandchildren?” she asked as she swiped through the most recent shots of the twins, looking for one that captured their nascent personalities.

“No.”

She drew back as if he’d slapped her.
No?
The hair on the back of her neck prickled. Her tentative efforts to reach out to the man were forgotten, and anger flared in her belly.

“Well, you need to. Their father—
their
father who’s raising them—is risking his life tomorrow to save yours. The least you can do is acknowledge his family.”

He turned back and locked eyes with her. His expression was icy. “I told Leonard, and I’m telling you. I want nothing to do with his family. Now, go. Or I’ll call the nurse and have you removed.”

He dismissed her and shifted away from her in the bed. She stared at his profile for a moment longer—and, in that final instant, she saw it. The barest shadow of Connelly. The muscle in the old man’s left cheek was pulsing in silent anger.

She turned and walked out of the room.

G
reta paced
around her living room in a futile effort to work through her anxiety. Everything was wrong. It was wrong for her to be at home in the middle of the day. It was wrong for her to risk falling further behind in her work. Her pulse raced at the thought of what would happen if she failed to deliver the results the Alpha Fund had paid for.

But she couldn’t sit in her office, fielding Virgil’s well-intentioned, worried calls and scrolling through the innumerable last-minute instructions that George Martinello was emailing her in periodic bursts as he prepared for the upcoming hearing.

She tried to convince herself that these distractions were upsetting her. But her excuse rang hollow even to her. She was upset by something much worse.

She was hiding in her apartment in an effort to forestall reality. Any minute now, a technician from the phlebotomy lab would upload the results from the ‘John Doe’ blood analysis. And then she’d be out of time. Dr. Kayser would be out of time.

Her stomach churned. Derrick was going to kill him unless she came up with a way to stop it. On Monday, she’d still had hope that Athena would move a new resident into the empty cottage and discover Dr. Kayser. That hadn’t happened.

Then this morning, when Coretta Gardner starting seizing, Greta had allowed herself to hope that the woman would die. Then she’d
have
her healthy brain and would only need George Martinello to convince the court to let her use it. But Coretta’s seizures had turned out to be the result of a new medication, and the staff had quickly stabilized her.

Now it was Tuesday afternoon, and as the hours passed, Greta was forcing herself to face the truth: By Thursday, Dr. Kayser would be dead. Unless she did something.

A sob escaped her lips and she began to cry again. She reached for another tissue and wiped her puffy, swollen eyes.

How could she save Dr. Kayser without getting herself killed in the process? Going to the police wasn’t option. It would be the equivalent of pulling on a loose thread and unraveling an entire sweater. The specifics of the Alpha Fund investment would come to light. She’d lose her professorship. Her work would be shut down. She’d be arrested. And if, somehow, she didn’t end up in prison, she’d spend the rest of her life hiding from the Alpha Fund.

But could she really let Derrick kill Dr. Kayser? The blood would be on her hands, too.

She shredded the tissue into fine pieces that fluttered to the floor as she walked and thought.

Her work was so important, though. If the nano-robotic supplement delivery could prevent age-related cognitive deterioration, she would be improving the quality of life for literally millions of people. She’d be viewed as a hero. Was it even morally right to weigh the life of one man against all the potential good she could do?

The room was spinning. She lowered herself into a chair and breathed through her rising nausea. She had no good options. For that matter, she had precious few
bad
options. And time was slipping away, minute by minute.