Purple Heart
Jun 17 '02 (Updated Jul 17 '02)
The Bottom Line Heart surgeons weren't cut out for this.
I am good at breaking chests open. Human chests; the type with ribs and sternums.
But I slammed the phone down anyway. It was all I could do to avoid falling off the bed. Damn! Why couldn't these problems be scheduled?
Four o'clock and pitch black outside. Just great.
I went to the bathroom, stuck my head under the tub faucet, gritted my teeth and turned on the cold water. While brushing my hair back, I got whatever I threw on the floor last night and put it on while running to my truck. My socks were soaked by wet grass, covered with sticks. I put my sneakers on over the sticks, hopped in the truck, slammed the door and shot backwards out of the driveway. Scared the living crap out of my dog. Calling in on the cell, I got vital signs and told them what I wanted ready when I arrived.
". . . and tell security I'm coming this time, or I'm turning around and going home."
"Yeah, sure. You'll be in O.R. three."
"O.R. three. Who's on tonight?"
"Carrie."
"Yeah, Carrie! She's always good; she's on top of everything. Who else?"
"Bill's doing anesthesia, and . . . uh . . . well . . . "
"Not Jenny."
"Mike, we've got to work with her, and it's her shift toni -- "
"Dammit, Jim! Look, get Arlene. Last time Jenny did this she heaved on the table. We can't have that kind of crap."
"Look. She came with the building, you know that. Besides, there's no other scrub nurse on tonight. She's yours; make the best of it."
Damn it.
I arrived at the compound, and managed to get inside this time without a full security screen. Maybe they were getting to know me, or maybe they didn't like what they found in my bag last time.
That's another story, and perhaps I'll tell you about it if I have time.
I scrubbed up and walked into the OR without any preliminaries, as I was told that time was short. This procedure, of course, was entirely routine.
Well, for me.
That there were no other practitioners in the country (hell, the world, as far as I knew) that performed this procedure had turned out to be quite lucrative. They told me, and still maintained, that no one did this sort of operation at all, anywhere. I had no reason to disbelieve them so far.
I started the incision, beginning at the base of the neck and proceeding to the navel, my people swabbing the blood and getting the clamps ready. I ran into the usual obstructions in the center of the chest. Not many lay people know that several cuts must be done in the same place before you get through. Layers, layers, layers. We peeled back one layer after another, and I made the lateral cuts across the top and bottom. After the cuts were done, we suctioned, clamped the whole mess and got the saw. This was the messy part, even though the saws were much more advanced these days and didn't kick up the big mess like they used to.
A fine powder rose, along with a mist of other unmentionables, and Jenny turned her face away. Haven't changed a bit, have you, girl. She noticed my glance askance and resumed her job, but the sheen on her forehead glistened in the harsh light. She trembled for a moment.
The patient's face was covered, as usual, but that didn't hide the snuffling sounds he made through the anesthesia tube and the snorts he blew through that giant protuberance they called a nose. Par for the course, I knew; but gods, couldn't these people be quiet when they went under?
I looked at the anesthesia doc, but he just shrugged.
One by one, the ribs popped, and we clamped those back too, making a miniature, round stadium of the guy's chest: The ribs bleachers spreading wide, the clinging tissue wine-shirted fans. Not a level playing field, though, ha ha. The pericardium roiled and pulsed. I began the final incision . . .
* * *
. . . it was three years ago, after I finished my residency, that these guys from the Air Force made a call. At my house. I couldn't believe it. There had been run-ins with the military drones all during my residency . . . folding tables just inside the entrance to the lecture hall, always, with the flag behind them and slicks on the table. They all had big smiles, and they made big promises about how wonderful life could be as a military doctor. Exotic stations, great hours, low liability, the works. I had made my intentions clear to them on each visit, so there was no excuse for it now and I was pissed that they were at my door. Hadn't I told those guys to recruit the docs ranked below the top percentages in my class? Like I wanted some pock-marked desert for my back yard.
Unless those lower-ranking docs knew someone -- and granted, some of them did -- the military would be a better deal than anything they could find elsewhere. Outside, they'd be lucky to get a rural clinic, what with the competition for the top hospital posts and rare surgical group openings. Those morsels went only to the cream in each class. The cream made big money, bought a huge house they never saw, got an ulcer and a divorce, and died of myocardial infarction before they retired. That class of docs needed legal planning to protect their assets, and paid big fees to specialist attorneys to make them suit-proof. I'd learned all this from a cardio doc in Denver; it was the same everywhere. Sure, docs worried about suits too, as well as child support, alimony, and nitro pills.
Everyone wanted those jobs, but they went only to the cream.
Here I sat, in my packed-up apartment, ready to head out to a western state for my hotshot job in an exclusive cardio surgical group. Hell, I was already planning my divorce, and I wasn't even married. While I pondered what to do with these grunts, I made a mental note to see that asset protection attorney before I left to rough out a prenup agreement. Not that there was someone on the horizon, mind you. Romance was not one of my gifts. Still, it paid to plan ahead. My junk was all packed; all my furniture was in the living room. Everything was a mess. I was going to throw most of it away after my second paycheck anyway.
And there stood Abbott and Costello, waiting to come in. The tall one was all spit and polish; an expensive suit, perfect knot and dimple in the tie, no sweat sheen even though it was hot outside. That one looked as if he took himself very seriously. He never took his eyes off mine. His face said he suspected me of stashing dope, but he probably looked at everyone that way. He pissed me off immediately.
There were no introductions, other than the Air Force I.D.s, flashed so quickly I could not read the names. I glared at him long enough to let him know I didn't give a damn what he thought, and then turned my attention to the other guy.
He was short; shorter than me, though he outweighed me by at least forty pounds. His arms were like tree trunks, and he had a barrel chest. I liked his face, though. It was a friendly face, though he wasn't smiling right then. He stood there, wiping the sweat from his forehead with a wrinkled handkerchief, and looked casually around the room before nodding at me. I felt like I could make this guy see reason quickly, if and when I was ready for them to leave. Later, I learned his expressions were one of his occupational assets, but that's another story, too.
Hell! I didn't feel inclined to show much hospitality, as there was a meeting of some of the people from my cardio study group over at Bundy's bar in an hour and I still wasn't ready. The Cardiac Kids. That's what they called us. We loved it. It was our last time together before we went our separate ways, and I didn't want to be late.
But these guys persisted. And they didn't smile. That seemed strange; how did they expect to woo a top surgical resident, with his hotshot job and ulcer already in the bag, and not smile? My grades got me smiles from recruiters. These guys were annoying, so I wanted to get away.
I spoke to them while packing, my back turned to the door: "Come in, but I have to tell you that you came at a bad time. I'm leaving in twenty minutes. Maybe we can talk some other time, you think?"
"We won't be long, Mr. Sattler. We just want to make a quick proposition to you and get your answer."
Guys. I've gotten propositions from thirty of the best surgical groups in the country. They came to me; I didn't go to them. Why are you wasting my time?
And, by the way, and for your information, I'd worked too damn hard for my title to be "mistered" by this chump. I sighed. "I can't offer you anything to drink, I'm packed up. And if this proposition requires any extended discussion, we need to postpone this conversation."
"Sir, as an American citizen, you ought to be interested in what we're going to say."
I thought that things were bad enough with them in my house. But now they were talking about duty to country. What the hell? "Gentlemen, think of the taxes I'll be paying for the privilege of extending people's lives. You can hire three guys from State Medical for that kind of money."
"There are hostiles grouping against us. Your particular talents are needed."
The tall one gave me a Meaningful Stare for a moment. I said, "Hostiles? Hostiles? What the hell do you mean, 'hostiles?' And how the hell is scraping glop off of fat guys' arteries gonna put these 'hostiles' off our trail? Are your generals and admirals just real nervous types? Are they having heart attacks?"
That made the short one smile, a little. He glanced at Brooks Brothers and recovered quickly, though. And said: "Ahm. This work, doctor, will be the most challenging and scientifically stimulating work you could ever hope to do."
"You don't know what I hope to do. I never hope to do anything except what I've already planned to do."
O.K. I guess you want to know what I hoped to do. What I hoped was to make a lot of money and retire before I died. I had that part worked out, see. Damn surgeons can be stupid sometimes - they work themselves to death. But I think I had that problem whipped. Retire first. Drop out before dropping dead. That was the ticket. I made sure these guys knew that, and told them it was time to go.
So, with a look in their eyes that indicated they were playing their Big Trump Card, Brooks Brothers nodded to the other, who bent down behind him. The tall one sighed meaningfully, perchance to let me know how much trouble I was causing them by my resistance and that his exasperation, though tempered by patience, was nearing a critical point. The short guy looked confident. The tall one finally took his eyes off me, and motioned to the briefcase they had set on the floor.
They told me this stuff was highly classified. They asked me to shut the door. That bothered me, because all of a sudden they looked like those guys in the movies that shot you if you didn't go along with their plan right away. But they saw that I locked the door before they picked up the briefcase and set it on my counter. It was one of those gunmetal gray Halliburton briefcases; the kind they use for German cameras and rocket engine plans, you know?
They dialed the combination on the briefcase, and opened it up. Out came three long brown envelopes, the seals of which were torn with great ceremony, and photographs were laid out. About thirty pictures total. And that's when everything changed.
But not right at first, of course. "See anything unusual about this person?" said Shorty, smiling hugely now. His smile was like the guy on TV that sold home insurance during prime time. Like a good neighbor. It was a good smile, and I could see why he was here now.
There was a grainy picture of a woman wearing sunglasses, carrying a large satchel, with a three-quarters frontal view of her, head to toe. Blue top, gray dress pants. Yes, she had kind of a broad nose and short legs. Not cover girl material, not by a long shot. But what the hell, most people weren't. She looked ordinary. "She gets classified and put in a briefcase for walking down the street?" I asked, affecting great indignation. I was now sure my time was being wasted, and it was now my turn to appear Put Upon.
I hadn't noticed until then that Shorty was sticking almost hair-thin black wires up with some kind of clear adhesive, running them the length of my walls. After he hung them, he plugged one end into his cell phone. Or at least I thought it was his cell phone. After squinting at it a moment, he smiled again, and looked happily at Brooks Brothers. "We're fine," he said, and looking at me, "Oh, it won't mess up the walls, don't worry." Your brains will mess up the walls if you keep playing with us, one corner of his grin said. Brooks Brothers did not change his grim expression.
I thought the best posture was to show no fear, though god knows I was scared now. I walked over to the window, sat down and lit a cigarette. And I should tell you now that I was attempting to cultivate some bad habits before I started my new job. If I put these guys off in the process, so much the better. I looked at them askance, and then out the window. "Doesn't look like a candidate for the knife," I said as I tried covertly to blow smoke in their direction. I wanted them out, because I wanted out myself. The tall one said, "Ben, get out the close-up."
So the short one was Ben. "Ben, don't," I sighed, still looking out the window.
Ben did anyway. "Here's another picture of her," said Ben, and pulled it out and held it up. I sighed, stubbed out the cigarette, walked over to the counter and looked. The sunglasses were off, she was in a phone booth trying to scope a number out of the directory. Still the same woman, no big deal. . . well, OK. The eyes looked strange. A trick of the light . . . I didn't see iris or pupils, but this photograph was not the work of Ansel Adams, if you know what I mean, and I think you do. The image had clearly been enlarged and was grainy as hell. But the eyes . . . no, it was definitely a fluke of the light or something. Nobody had white marbles for eyes. At least, no one had white marbles for eyes and went about acting normal and reading the small print out of a phone book.
"Those are her eyes," said the tall guy, who had not smiled until now. He was making a Big Concession, and wasn't I Lucky to be part of the Inner Circle? His benevolent grace runneth over. I swore and handed him the picture.
"All right. Fine. I think we're done." I walked to the door and opened it. "You want ophthalmology. That's Dr. Gold on the fourth floor of the Medford building. He does white marble eyes. I do hearts. There's a difference, you know. Or maybe you guys should aim these ladies at the makeup counter." The tall guy looked like he was getting mad - I'd rejected membership to the club, after all - but that was too damn bad. I didn't care. I told them it was time to go now and held the door open. Ben was fumbling through the pictures, obviously looking for a particular shot. What next? A second head? Opposing thumbs on her feet?
I didn't want to see it. "It's really time to go, guys; I have an appointment."
Ben pulled out two pictures, but the tall one said to forget it, they had come to the wrong place, and to pack up the photographs. He was pissed and didn't try to hide it. Ben stared at him, dismayed, but slowly began arranging things in a pile on the desk and putting them in the briefcase. He closed the case, and they filed out. Ben handed me his card, smiled again, and said, "Here's my number, Dr. Sattler; you may want it later." I doubted it, but I was so glad they were leaving that I took his card and smiled back. And at least Ben called me "doctor," by God. "Thanks," I said and closed the door.
I tossed the card on the floor and began looking for the clothes I was going to wear that evening. Like I said, the place was a mess. I came to the desk, which naturally had some clothes on it, and started to fumble through them. Then I saw Ben's two pictures. He'd deliberately left them, and something told me Brooks Brothers would have reamed Ben, but good, if he knew those pictures were still here.
They were full color, sharp, and they made me forget about the Cardiac Kids. There was the woman, but this time on an operating table. She was naked except for a cloth draped over her pelvis. Her eyes were clearly white marbles - pure white, no hint of iris or pupils as there would be with cataracts. Her skin was yellow, but she was alive; her head was bent forward and she was looking at (or toward, I couldn't tell with those eyes) the camera.
Yeah, Ben was taking a big chance here.
One breast, sort of, was in the center of her chest. An odd opening under her chin, and parallel longitudinal ridges down the front center of her torso. Her feet were rounded bumps, flat on the bottom, no toes. Her hands - I hadn't noticed this in the first two photos, but probably would next time - her hands were more like anemones; eight or nine fingers extending like wormy petals from a central core. And something in the center of the core. I couldn't make it out.
The second picture showed this person with a large incision through the center of the breast, following the ridges on the torso. The chest was opened, the cavity was empty, and the unidentified doctor in a mask and scrubs was holding up . . .
Holy Mother of God.
Under the second picture, a caption:
ARL-00897-ZT
No. five of seventeen in Alberta Colony.
Male, Age Unknown.
Male?
I got the business card and called Ben. He wasn't there. I left a message on his voice mail and skipped my meeting with the group. My packing went on hold while I waited for his answer. I smoked a pack of cigarettes and paced. At ten that night he came by, knocking furtively, and gave me the scoop. Classified, of course. He acted jovial and friendly, but he made sure I saw the bulge in his jacket and sounded like he wasn't going to let me go anywhere knowing what I knew. It may have been a bluff, but I was hooked and he knew it. Like I said: Ben had an occupational asset.
They aren't the hostile force, these people in the photos, said Ben as he reclined in my chair, feet up - but there apparently is a hostile force. It's another race, or species, or something - something different altogether from these people. They've been tracked through this sector of space for centuries. The hostile race wants us, too, if they find these people here. These . . . "people" hold the key, in their own biology, to defeating the hostiles. Suffice it to say they are natural predators, but their prey is restricted to the hostile lifeform (and certain vegetable life here they have adapted for their consumption). But the diet here isn't enough. Their numbers have depleted to a point that their prey has turned the tables and begun hunting them.
So, says Ben of the great smile, Our friendly predators have a problem. The earth's biosphere affected their systems; allergies and infections closed some orifices, opened others, and altered their metabolism. They were dying off. The effect they have on their prey is sort of cumulative, and there's not enough of them to handle the enemy. In fact, they're almost extinct - except that we aren't hunting them down and killing them; at least not yet. Anyway, they needed a particular type of help. Because of the way our planet's biology affects them, they were no longer capable of certain . . . functions . . .
* * *
. . . incision through the tough, football-like "pericardium" sac around the wiggling center. And there it was. Squirming rhythmically, spewing liquid spastically, it jumped before settling back into its rhythm. I picked it up, bright violet--a good sign, and five cords trailed back into the chest cavity. Jenny passed out, I heard the thump of her head on the floor as I suctioned, but I didn't look; I was feeling too good.
It gave out a little squeal, I finished suction and we all smiled.
I never thought of myself as a baby doctor, you know?
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Member: Dwight
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About Me:
If I smell flowers, I start looking around for a coffin.
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