Noble Vision (59 page)

Chapter 33

Necessary Treatment

An orderly wheeled an unoccupied stretcher through the double swinging doors of the Department of Surgery. A janitor cleaned a vacant lavatory. The operating suites were dark that evening, save for OR 3. In the hallway outside the lighted room, two people in surgical scrubs stood over the sole patient in the area, a young woman lying on a gurney.

“I was an OR nurse once, so I’ll be assisting with your surgery,” Mrs. Trimbell said to the patient. “I told Dr. Lang from the beginning that he could count on me. I’m here because I want to be, child, because it’s right.”

Nicole nodded, her silence underscoring the depth of her appreciation.

“I’m here because I want to do what a hospital president is supposed to do—support the best medicine,” Randy Lang said to the patient. “Without CareFree, your surgery would be damn good for our business
because
it’s good for you. Only CareFree could make what’s good for you bad for the hospital. I don’t want to look into that carnival mirror anymore.” He fondly squeezed her shoulder. “I’m here to watch and to help if I can. But mainly, I’m here to handle anyone who might question your surgery.”

Nicole smiled at the two, understanding for the first time what it meant to have a family. “Thank you both, more than I can say.”

The two moved away when David approached. The surgeon was smiling, his eyes as fresh as morning, the strain and exhaustion of the past few days vanishing from his appearance. He turned to Nicole, taking her hands in his.

“We’ll be wheeling you in as soon as we finish setting up.”

“I’m ready,” she said, smiling radiantly.

“I have to explain something. I don’t have access to any of the general anesthetics that I used successfully in my lab experiments, but I do have a local anesthetic that worked with this surgery on animals.”

“Did you say a
local
anesthetic? Will I be awake?”

“Yes. It seems odd, but there’s no sensation of pain inside the brain, even though it’s the root of all sensations. Only the scalp and the outside of the brain can feel pain. So once I numb those areas with a local anesthetic, I can perform the brain surgery while you’re conscious, and you won’t feel anything. I’ve done many craniotomies with local agents for one reason or another. It’s the best way for us because it allows me to use drugs I have complete confidence in. And it’ll be easier for Mrs. Trimbell and me to monitor you with a local, because we won’t have an anesthesiologist. With the surgery being unauthorized, I couldn’t involve any of them.”

“Okay, David.”

“I’ll of course be with you, talking to you.”

“I’m not afraid to be awake. I’m so thrilled to have this surgery that nothing can scare me.”

He squeezed her hands, which she knew meant
Listen—this is important
.

“Nicole, you will have to stay perfectly still. No coughing, no sneezing, no moving. This is
very
important.”

“I understand.”

“I can’t have
any
sudden movements.”

She squeezed his hands reassuringly. “I have experience with that kind of role. I’ll be as still as I was when I played the princess who slept for a hundred years.”

“Good!”

Soon Nicole was wheeled in and slid onto a table. An overhead light warmed her body, then cool linens covered it. The muffled voices of Mrs. Trimbell and David spoke to her through masked faces. David placed patches over her eyes to prevent the optic nerves from firing impulses during the surgery, he explained. An IV line pricked her hand. A liquid dripped into her veins to calm her. An electric razor shaved her scalp. A pungent solution painted her bare head. She felt the intense but brief pain of needles injecting the local anesthetic into her scalp. Holding pins gripped her head in a vise. She heard the sonorous beep of her heart on a monitor. At one point, David left to scrub. When he returned, she heard the whoosh of a gown placed around him and the crisp stretch of rubber gloves sliding over his hands. Soon she heard the piercing whine of a drill and smelled the stench of scorched tissue as a superbly calm, matter-of-fact voice announced the cutting of her skull.
You just lie still like the sleeping princess
, Nicole ordered herself, while the roar of the drill and its furious vibrations resonated through her head.
We can’t confine our dreams to the world we see on the stage
.

Her head shook as David pried a block of bone from her skull like a brick from a wall. Nicole knew that the top of her head had become an open window. More clatter of instruments followed until the voice of science announced that her brain looked beautiful, palpating with her every heartbeat. As the clock on the wall pointed to nine, the narrator of the drama declared with ruthless self-confidence: “I’m going in now. Remember, Nicole, you’re to stay perfectly still.”

*
  
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Outside the building, a man walked into the hospital parking lot. He was someone who arrived for work with the surgeons, used the surgeons’ lounge, parked his car with the surgeons’ vehicles, and received the same deferential treatment as the surgeons. He even commented frequently to friends about having a hard day in the OR. But he was not a surgeon. He was CareFree’s Inspector Norwood.

After working earlier in Riverview Hospital’s Department of Surgery, Inspector Norwood had left his car in the doctors’ parking lot while he met friends for dinner nearby. One of his companions, a fellow inspector, told him the late-breaking news at the agency: David Lang had been caught performing illegal animal experiments and arrested. Inspector Norwood was elated at the misfortune of the brazen surgeon who had pulled a knife on him in the OR. His joy was marred only by his feet, which throbbed in a new pair of shoes. As he returned to the hospital to retrieve his car after an evening with his friends, he was limping.

He recognized an ER doctor having a smoke in the parking lot. “How’s it going?” the inspector asked casually, as one colleague to another.

“Oh, hello, Inspector,” replied the doctor, surprised to see the official at that hour. “It’s slow tonight.”

“Oh?”

“All we’ve seen are a few guys needing to sleep off a drunk,” the doctor added, as if justifying his cigarette break to a supervisor. “But it’s not yet midnight, so anything can happen.”

The inspector smiled courteously, and then continued limping to his car. He wondered how many blocks he would have to walk when he reached his home in Brooklyn. He did not have a garage, and finding a parking space on the street at that hour would be difficult. He suddenly had an idea. He could change into his work shoes, which were inside his locker in the surgeons’ lounge. This would make his trip home more comfortable.

He entered the hospital and took the elevator to the third floor, avoiding the looks of people who might ask him for information. His aloofness, combined with his business suit and speckled gray hair, gave him the air of a doctor with weighty concerns. He exited on the third floor and passed the swinging doors leading to the surgeons’ lounge and the operating suites. He noticed a light from OR 3 beaming across the otherwise dim hallway. He knew that no operations were scheduled that evening, and the ER doctor apparently had sent up no patients.
Curious.

*
  
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*

OR 3 resembled an overexposed picture with glaring white walls and pale blue linens. The only dark streaks in the whitewashed room were the trays of instruments by the operating table. David and Mrs. Trimbell attended the patient, and Randy stood farther away.

Nicole listened to the whispered monologue that David was having for her benefit. After hearing his voice remain steady for the entire time, she thought she detected the first subtle rise in his tone to punctuate something of particular importance.

“An aneurysm has formed on an artery near the trauma site, Nicole. This can happen sometimes in an injury like yours, where a fragment of broken bone can come loose and nick an artery. This weakens the wall of the artery, so it balloons out from the pressure of the blood. The danger is that the aneurysm could burst and cause a bleed. I have to put a clip around the neck of the aneurysm, so that it will be cut off from your bloodstream and never cause trouble. I suspected that this might occur, so I prepared instruments to clip the thing. It’s nothing to worry about.”

Nicole answered his soliloquy with the only response he wanted: a completely silent, motionless, accepting body.

The aneurysm was nothing to worry about—provided he could clip it before it burst, a condition he did not verbalize to Nicole. David paused to consider the best way to reach the aneurysm and the most suitable clip to use. From an instrument tray with an array of clips, David selected one. With a suction device in one hand and the clip at the end of a holder in the other, he approached the aneurysm.

Mrs. Trimbell and Randy quietly listened to David’s whispers. Then the surgeon, too, fell silent. Everyone sensed that this was the tensest moment in the surgery. There was no movement in the room, except for the subtle maneuvering of David’s hands, finding the best way to perform a critical task in Nicole’s brain. There was no sound except for the beep of Nicole’s heart monitor.

*
  
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*

Inspector Norwood walked down the corridor to find the reason for the lit surgical suite on a night when there should be no activity. He quietly peered through the window on the door of OR 3. To his astonishment he saw a figure resembling the man whom he most despised . . . performing surgery! This was the man who had humiliated him at knifepoint, the man who had just been arrested and had no right—

*
  
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Inside OR 3, David was about to clip the aneurysm. He approached it cautiously. It was difficult to reach, but he had it. . . . He thought he had it. But no, he did not have it at all! Before he could clip it, the aneurysm burst.

David quickly covered the tear in the artery with a suction device. Everything was under control. Provided that the sucker held the opening, there would be no hemorrhage, no flood of blood to wipe out his field of vision and leave him with no control at all. He had the sucker on the aneurysm and the clip in his other hand. He needed to get the clip around the aneurysm.

“Nicole,” he whispered almost inaudibly. She loved the way his baritone voice pronounced her name. Even then, she felt pleasure in hearing it. Even then, he pronounced it with softness. “This is the most important time . . . to . . . stay . . . still.”

Suddenly the swinging doors to the room flung open with a thump and a shrill cry pierced the calm. “Just what do you think you’re doing, Dr. Lang?”

Chapter 34

The Wake-Up Call

Mrs. Trimbell gasped. Randy jumped, startled, then leaped in front of the intruder.

“I’m Inspector Norwood of CareFree, and I’m calling my supervisor. He’ll be interested in learning how a surgeon who was just busted got back in the OR!” yelled the inspector, his cell phone out and ready.

“I’m the administrator of this hospital, and I say you’d better not make that call.” Randy stood before the inspector, blocking him from advancing further.

“It appears that you’re the accomplice to a crime, and I’m going to report it,” said the inspector proudly, like a man earning a medal.

“Turn around and leave. We’ll discuss this outside,” Randy ordered.

Ignoring the remark, the inspector began dialing a number on his phone.

In a violent twist of his body, Randy grabbed a knife from David’s instrument tray and lunged at the intruder, warning, “Don’t move a muscle.”

It was déjà vu for the mortified inspector.

Mrs. Trimbell seized the phone from his hand.

“You can’t do this to me! I’ll have all of you thrown out of medicine!” The inspector’s voice was still threatening but less steady than before, the knife’s presence rattling him.

“Shut up!” ordered Randy, forcing the intruder into a corner of the room, away from the patient.

“But Dr. Lang was arrested today. He can’t operate. He has no right—”

“Say one more word and you’ll have no throat!” The knife danced like a serpent’s tongue around the man’s vocal cords.

Mrs. Trimbell surveyed the anesthesia cart, and Randy, glancing her way, guessed her thoughts. She filled a hypodermic needle with a potion.

“Lie down on your belly, nice and easy,” Randy directed the inspector.

“But . . . but—”

“Shut up and do what I say!” Randy’s menacing knife silenced the inspector, who kneeled, then lay facedown on the floor.

Mrs. Trimbell pulled off a sleeve of his jacket, rolled up his shirt, and injected the liquid into his arm. “Have a nice nap. You’ll wake up later,” she told him, but his eyes had closed before she finished speaking.

She and Randy dragged the limp body into a small connecting room. Then the two took a step back into the OR—and back in time, it seemed, for David and Nicole were in the same positions as before.