Excerpt
Dr. Hal Jessup squeezed the paddles against the heart and fired the defibrillator. Ernies chest bucked, and his quivering heart stoppedstill as a stone. The heart contracted only once. Hal held his breath. He always talked to hearts during surgical crises, and now he spoke to Ernies: a silent dialogue, commanding it to survive.
Sweat burned his eyes, fixed on the silver dollar sized bruise on the front of the heart: this brick-red muscle mass mystically endowed with courage. Ernie was courageous, but the heart attack had destroyed a lot of heart musclemaybe too much. The knot in Hals gut tightened, an anxiety that gnawed at his very core every time one of his patients faced death. Ernie must not die.
The heart suddenly burst into a run of uncoordinated contractions. Hals eyes flashed to the monitor. Jagged saw-tooth waves flashed across the screen. He wrapped his hand around Ernies heart, quivering like the heart of a captive bird.
Paddles, Hal said, holding out his hands. Scrub nurse Ingrid Hoffmann slapped the defibrillator paddles into his palms, and in one motion Hal pinched Ernies heart between the stainless steel blades. He shocked the heart again, and again it stopped.
Cardiac arrest." Lets get the pacemaker wires intry to control his rhythm. He sutured the pacing electrodes into the heart muscle and passed them off the table for connection to an external pacemaker.
Pacer on at 80, Hal said.
Red pacer spikes, followed by regular beats, marched across the EKG monitor screen. Hal sighed and his eyes danced from the monitor to Ernies heart.
Ernie Sanchez, a surgical orderly, came early to shave patients before surgery, stayed late in the research lab to baby-sit calves with artificial hearts, and in doing so taught Hal to respectin Ernies wordsthe little guys on his team. To Hal, there were no little guys on his team.
The whir of the heart lung machine echoed in the coffin-quiet room. Hal braced his hands on Ernies chest and looked out the window. Lightning splintered over the White Tank Mountains. How many times had he stood here watching a patient die because his damaged heart was too weak to pump blood?
Any ideas, Dr. Fargo? Hal always involved his residents in critical decisions.
Implant the artificial heart, Fargo said, it works in the calves. If hes going to die anyway, at least it gives him a chance.
I wish it was that simple.
****
Bent like a comma against the wind, Dieter limped across the graveled driveway fronting the orphanage. He carried his mothers worn leather traveling case in his left hand, and, with his right, leaned on a walking stick with a mocha-colored hickory shaft, silver bullet tip, and pewter handle in the form of a birds head. His green Lederhosen, too big for the rickety toothpicks inside, flapped in the breeze, and his brown high-tops scuffed the rocks as he made his way toward the circular reflecting pool. The wind skipped red leaves across the gravel and pressed black, rattling boughs against a leaden sky.
He walked to the far side of the pool and set his satchel and cane on the encircling stone bench. Looking back at the ocher-colored, stucco edifice, smoke curling from the chimney like a crayon apostrophe, he read the words carved in stone above the entrance: Waisenhaus Steiner. Orphanage, a word he loathed, a word symbolic of his life unwanted
Suddenly there was a great fluttering and a sky-darkening flock of Siberian crows descended onto the reflecting pool. Dieter ducked away and saw their intended prey: a tiny sparrow, gray wings and brown striped chest feathers. The tiny bird tried to fly from its perch, but one of the black predators slammed into the sparrow, knocked it onto the gravel, and with a saber-like beak speared the sparrows wing.
Dieter brandished his cane, and the black carrion crowsall with hideous small heads flew away as quickly as they had come. He laid the sparrow on the bench. It tried to hop, but fell sideways on a shattered leg. It attempted to fly, but, with a splintered wing, plummeted into the pool.
Dieter plucked the wounded bird from the water and cupped it in his hands. The sparrow shivered and its heart fluttered against his palm. Small black eyes pleaded and the yellow beak opened, but made no sound. With a feral smile, Dieter lowered the sparrow just below the waters surface. One wing momentarily flapped and splashed. He felt its heart flutter faster and fasterand then go still.
Dieter yawned, placed the bird on the bottom of the pool, and weighted the feathered corpse with a gray pebble headstone. He dried his hands, picked up his pad and coins, and limped into the orphanage.
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