Dead Certain

turned to the nurse standing at her side. “Thoracotomy tray, please,” she said. “I’m going to open his chest, perform internal cardiac massage, compress his aorta, and see if we can’t get some blood going to his head until cardiac surgery gets here.”
    “Sounds good to me,” replied the nurse calmly.
    “I’m afraid you’re going to have to leave now,” announced the intern, taking me by the arm as Claudia; picked up the scalpel.
    “She can stay,” said my roommate, never taking her eyes off Delius. “Just make sure you stay out of the way.” She turned to the intern. “Come here and give me a hand. I’m going to crack his chest. I’ll intubate, seven-point-five tube. Call respiratory therapy. Six units, type and cross match. Convert that eighteen-gauge to an eight French. Fluid wide open. Begin with O-negative blood as soon as it arrives.”
    Claudia bent over my client’s lifeless face and opened his mouth with her gloved hand. She began snaking the bright light of the laryngoscope down his throat. Once she had the breathing tube in place, she stepped back and listened with her stethoscope for a moment.
    “Two minutes,” announced the nurse who’d been with Delius from the minute we arrived at the emergency entrance. It felt as if I’d already been there a year. I wondered how long it had been since the heart attack first hit. How long had I stood on the sidewalk debating with myself what to do? How long had the drive to the hospital taken? Two minutes? Ten?
    I reminded myself that the heart is a resilient muscle, but I thought of Mrs. Lapinsky and how that in itself is a double-edged sword. Even if Claudia managed to get it restarted, how much time was left before brain damage turned Bill Delius into a lump of flesh, stripped of the feelings, insights, and ambitions that made him who he is?
    “Two minutes, fifteen seconds,” exhorted the CPR nurse.
    Claudia reached for the scalpel, and I turned my head away, worried that Delius would feel the incision and Pondering what kind of person could just cut through sonieone’s flesh like that. Any moment I expected Bill Delius to buck from the table, to scream, to protest. But some part of me knew that Claudia wouldn’t even be trying this if he weren’t for all intents and purposes dead already. By the time I got up the nerve to look, Claudia had already cut through the skin.
    “Spreader, please,” she said. Despite the stakes her manner was not just calm, but unfailingly polite. I watched fascinated, like a secret onlooker at a satanic tea party. The spreader resembled a reverse vise, which she turned and pushed until she’d managed to open a small space in the wall of Bill Delius’s chest, just wide enough for her to slip her hand through.
    I stared, transfixed, as she eased her gloved hand into the opening.
    “What was he doing when he collapsed?” my roommate asked. It took several seconds to register that she was talking to me.
    “He was walking to my car. He’d just come from some kind of business banquet,” I added idiotically. My voice sounded artificial from the strain.
    “Three minutes, thirty seconds,” the CPR nurse bleated.
    “Pupils?” asked my roommate, her eyes closed in concentration.
    “Still fixed and dilated,” responded the respiratory therapist.
    For a moment the whole room seemed to hold its breath, all eyes fixed on Claudia. Then, on my roommate’s face, through the armor of her concentration, I saw the faintest glimmer of a smile.
    “We have a rhythm,” the nurse declared without emotion as the heart monitor began to chirp.
    “Pupils?” inquired Claudia again.
    “Responsive,” the respiratory therapist reported. “Equal and responsive to light.”
    “Cardiac surgery is ready and waiting, Dr. Stein,” some-one called.
    Suddenly Claudia looked down, as if surprised to find that her hand was still inside the patient’s chest. She pulled it out and quickly arranged moist towels over the wound. Then she stood back and watched as the nurses wheeled Bill Delius down the corridor to the operating room.
    It wasn’t until after they were already gone that I found myself worrying that Gavin McDermott might be the surgeon standing by, ready to receive him.
     

CHAPTER 6
     
    “Thank you,” Claudia called to no one in particular as the room emptied out. In a matter of seconds we were alone, but everywhere we looked, there was the detritus of calamity. The floor was littered with blood-soaked gauze