girl.
Dr Melanie Schaff was cool and efficient and a good two inches taller than Cardinal. She had the kind of wary brusqueness one often gets in women who have struggled to make their way in a predominantly male world; Cardinal’s colleague Lise Delorme had it.
‘Your Jane Doe has sustained a partial lobotomy and the bullet has lodged near the hippocampus,’ Dr Schaff said. ‘Sometimes it can be safer to leave a bullet in than take it out, but this one is close to one of the cerebral arteries. With the seizure activity we’re seeing on her EEG there’s no way we can leave it in. One or two good seizures and Jane Doe could end up Jane Dead.’
‘What are the risks?’
‘Minor, compared to leaving it in. I’ve explained that to her and she seems quite prepared for the surgery.’
‘Is she in a state to make that decision?’
‘Oh, yes. It’s her memory and affect that’s impaired, not her reasoning ability.’
‘What are the chances of a total recovery?’
‘There’s only a partial severing of the frontal lobe, and it’s only on one side, so there’s a good chance she’ll exhibit the full range of emotions eventually. No guarantees, however. There’s no direct damage to areas of the brain that control memory, so I expect she’s just in a traumatic fog which should pass. I’ll be recommending therapy with a neuropsychologist for that. Now, what exactly do you need from me, Detective, other than the bullet?’
‘Is there any chance she’ll remember anything while you’re operating?’
‘We’ll be nudging along the hippocampus. It’s certainly possible she’ll get random flashes. Whether they’ll be dreams or memories, I can’t say. But you’ve seen the state she’s in. There won’t be any context for them.’
‘If you could just keep in mind that it might be useful for us and it could save her life. We don’t know who’s trying to kill her.’
‘That it?’
‘I need to actually see you take the bullet out.’
‘All right. Let’s get you gloved and gowned. We’ll be working with something called a Stealth Station. It’s a 3-D CAT scan hooked up to the microscope I’ll be using. Should give you a ringside seat.’
Like most cops, Cardinal had witnessed his share of gore – the torn wreckage of accidents or the blood-spattered kitchens, bedrooms, basements, and living rooms where men commit violence on each other, or, more often, on women. A policeman’s heart gets calloused, like a carpenter’s thumb. What Cardinal had never gotten used to, however, was the operating room. For some reason he could not fathom – he hoped it was not cowardice – the gleam of surgical blades made his stomach turn in a way that burns, dismemberments, or impalings did not.
Two doctors assisted Dr Schaff and two nurses. ‘Red’, as Cardinal had begun to think of her, was drowsy from sedatives and anti-seizure medication but conscious. A bigger patch had been shaved around the entrance wound, and she had been given injections of local anaesthetic from a huge hypodermic. General anaesthetic was not required, the brain being insensitive to pain.
Masked and gowned, Cardinal stood to one side near Red’s feet where he could see an overhead monitor and observe the surgeon at the same time.
‘Okay, Red,’ Dr Schaff said. ‘How you feeling?’
‘My goodness. You all have such beautiful eyes.’
Cardinal glanced around the OR. What the girl said was true: between the mouth coverings and the surgical caps, the eyes were emphasized; everyone appeared gentle and wise.
‘Flattery will get you everywhere,’ Dr Schaff said. She strapped on a pair of goggles that made her look like a benign alien. ‘Are you ready for us? It won’t hurt, I promise.’
‘I’m ready.’
Cardinal had thought he was ready too, until Dr Schaff took a scalpel and cut a flap in Red’s scalp. For a moment it formed a fine scarlet geometry, but then the red lines thickened and flowed, and Cardinal wished he were somewhere else.
Dr Schaff asked for the bone saw. Cardinal spent a lot of his off-hours doing woodwork, and it was amazing to him that the instrument in her gloved hand might have been something in his basement. It gave off a high-pitched whine, like a dentist’s drill, but once it touched the bone the sound was not all that different from ripping plywood. Red didn’t even blink as Dr Schaff extracted the piece of bone and set it aside. It would be preserved and put back in place in a day or two, when any brain swelling had gone down.
First do no damage. Of all medical endeavours, brain surgery is probably the one where physicians are most cognizant of Hippocrates’ proscription. Dr Schaff began to probe her way through layer after layer of tissue with unbearable gentleness. Except for the beep of the monitors and the occasional clank of metal on metal, utter silence. Every so often, Dr Schaff would call for a different instrument, now a ‘McGill’, now a ‘Foster’, now a ‘Bircher’.
Seeing a length of stainless steel moving millimetre by millimetre deeper into the girl’s brain, Cardinal felt a distinct softness in his knees. Looking up didn’t help. The monitor showed the same thing in lateral close-up. He felt as if he were slowly tumbling down an elevator shaft. Sweat gathered under his surgical cap.
Two hours went by. Three. The doctors made occasional remarks back and forth, commenting on pulse, blood pressure. There were calls for haemostats and spreaders and cautery. Dr Schaff spoke now and again to Red as she inched further into her brain.
‘Are you all right, Red? You doing okay?’
‘I’m fine, Doctor. I’m just fine.’
To calm his stomach, Cardinal concentrated on the background sounds, the beeping monitors, the whirr of ventilation, the buzz of lights. On the monitor, the instrument was a bar of bright metal several inches inside the girl’s skull.
‘Coming up on the hippocampus…’
Red began singing. ‘A hunting we will go, a hunting we will go…’
‘Yes, we’re on a hunt here, Red. And I think it’s just about over.’
‘Hi-ho, the merry-o…’
‘Okay, looks like we’re there,’ Dr Schaff said. ‘I’m going to try and grab it.’
On the screen the dark blot of the bullet was now in the angle of flat jaws. The instrument began pulling back. Cardinal had a daughter about the same age as Red, perhaps a little older. He had a strong paternal urge to reach out and protect the young woman in some way – absurd, really, since she wasn’t in the slightest pain.
Red spoke up as if in mid-conversation. ‘The clouds were amazing.’
‘Really?’ Dr Schaff said. ‘Clouds, huh?’
The bullet was steadily rising through the tunnel on the screen. Cardinal looked from the screen to Dr Schaff. Her gloves were slick with blood.
Then Red spoke in a different tone. ‘The flies,’ she said, hushed, even awed. ‘My God, the flies.’
Dr Schaff leaned over her patient. ‘Are you talking to us, Red?’
‘Her eyes are closed,’ someone else said. ‘It’s a memory. Or maybe a dream.’
Cardinal tensed, waiting for the girl to say more, but her eyes opened again and she stared blandly into space.
A moment later Dr Schaff extracted the bullet. A nurse held out a baggie to receive it, then handed it to Cardinal. He went out to the prep room and took off his scrubs. He slipped the baggie into his breast pocket. A moment later, he felt a tiny spot of heat there, the bullet still warm from the girl’s brain.