Storm Prey

kinds—anesthesiologists, radiologists, neurosurgeons, cardiologists, plastic and orthopedic surgeons, and a medical professor who specialized in anatomical structures of the skull, as it pertained to craniofacial reconstruction. They had twenty nurses and surgical assistants.
    Weather said to Dansk, the neurosurgeon, “If you want to cut those wedges, you better get it done: they’ve got to start cleaning the place up.”
    Dansk said, “I’m on it,” and, “I need a scalpel or something. Anybody got an X-Acto knife?”
     
     
    ABOVE THE TABLE, in an observation room behind a canted glass wall, people were beginning to filter into the stadium seating.
    A nurse came into the OR—one of the sterile nurses—and said, “I wanted to see if we could make the move one more time.”
    She wanted to practice breaking the tables apart, so that when the final cut was made, and the twins were separated, they could be moved to separate operating areas for the fitting of the new composite skull shells.
    “Why don’t we visually check the linkage ...” Maret began.
    It was starting; Weather didn’t think it, but she felt it, felt the excitement and the tension starting to build. She worked almost every day, cutting, sewing, cauterizing, diagnosing. This was different.
    She thought, Remember to pee.
     
     
    THE RAYNES TWINS were a rare and complicated medical phenomenon. Craniopagus twins comprise only about one percent of conjoined twins. Because of the rarity of the condition, experience with separation surgery was limited. One of the twins, Sara, suffered from defects in the septum of the heart—the wall that divides the right side of the heart from the left side—and the defects were already causing congestion in the circulatory system.
    The type of surgery usually favored for craniopagus separation might take place over several months. The most critical part of most operations was doing a staged separation of the brain’s blood-drainage system. Each operation would isolate the drainage systems a bit more, and would allow the bodies to create new bypass channels.
    In the Rayneses’ case, surgeons feared that a protracted series of operations would weaken and possibly kill Sara, which would also threaten the stronger Ellen, especially if Sara were to go into a rapid decline.
    The additional factor in the Rayneses’ case was that the conjoined area was relatively small—the hole left behind in the babies’ skulls after the separation would be no bigger than the diameter of an orange. That meant that a single operation was possible—even with some shared venous drainage, it was thought that one continuous operation would be the best chance for saving both twins.
    The surgical team would do the separation, and once separated, the team would break in two, each working on an individual twin. The joint surgery was expected to last up to twenty hours.
    The team was committed to saving both twins.
     
     
    WEATHER DID AESTHETIC, reconstructive, and microsurgery. Her availability in Minnesota, and a paper she’d done on a thumb reconstruction, had caught Maret’s eye when he began to consider the Raynes twins.
    In Weather’s case, a young boy had caught his thumb in a hydraulic log-splitter: the thumb had been pulped. After the wound healed, Weather had removed one of the boy’s second toes, and used the toe to replace the thumb. Since a thumb represents a full fifty percent of the function of the hand, the reconstruction gave back the kid the use of his hand. As he used the new thumb, it would strengthen and grow, and eventually come to resemble a normal thumb, except for the extra knuckle.
    As part of the eleven-hour operation, Weather had hooked up two nerves, two tiny arteries, and two even smaller veins—veins the size of broom straws. The photomicrographs of the sutured veins had particularly attracted Maret’s attention. The more veins that could be hooked up, the better off the twins would be—and Weather could do that work, even on the smallest vessels.
    He’d also been attracted to her sheer stamina: eleven hours of microsurgery was a super-marathon. He sold her on the idea of joining the team, which also made her available to study the twins, to get to know the parents, and to place the skin expanders under their scalps.
     
     
    WEATHER HAD TURNED away from Maret and the argument— Remember to pee —when they heard a commotion outside the operating room.
    “What is that?” Maret asked. Dansk