Tess Gerritsen

Under The Knife


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      “That’s it,” Guy said softly. He gave the signal to stop cardiac massage. The intern, his face dripping with sweat, backed away from the table.

      “No,” Kate insisted, planting her hands on Ellen’s chest. “It’s not over.” She began to pump—fiercely, desperately. “It’s not over.” She threw herself against Ellen, pitting her weight against the stubborn shield of rib and muscles. The heart had to be massaged, the brain nourished. She had to keep Ellen alive. Again and again she pumped, until her arms were weak and trembling. Live, Ellen, she commanded silently. You have to live….

      “Kate.” Guy touched her arm.

      “We’re not giving up. Not yet….”

      “Kate.” Gently, Guy tugged her away from the table. “It’s over,” he whispered.

      Someone turned off the sound on the heart monitor. The whine of the alarm gave way to an eerie silence. Slowly, Kate turned and saw that everyone was watching her. She looked up at the oscilloscope.

      The line was flat.

      * * *

      KATE FLINCHED AS an orderly zipped the shroud over Ellen O’Brien’s body. There was a cruel finality to that sound; it struck her as obscene, this convenient packaging of what had once been a living, breathing woman. As the body was wheeled off to the morgue, Kate turned away. Long after the squeak of the gurney wheels had faded down the hall, she was still standing there, alone in the O.R.

      Fighting tears, she gazed around at the bloodied gauze and empty vials littering the floor. It was the same sad debris that lingered after every hospital death. Soon it would be swept up and incinerated and there’d be no clue to the tragedy that had just been played out. Nothing except a body in the morgue.

      And questions. Oh, yes, there’d be questions. From Ellen’s parents. From the hospital. Questions Kate didn’t know how to answer.

      Wearily she tugged off her surgical cap and felt a vague sense of relief as her brown hair tumbled free to her shoulders. She needed time alone—to think, to understand. She turned to leave.

      Guy was standing in the doorway. The instant she saw his face, Kate knew something was wrong.

      Silently he handed her Ellen O’Brien’s chart.

      “The electrocardiogram,” he said. “You told me it was normal.”

      “It was.”

      “You’d better take another look.”

      Puzzled, she opened the chart to the EKG, the electrical tracing of Ellen’s heart. The first detail she noted was her own initials, written at the top, signifying that she’d seen the page. Next she scanned the tracing. For a solid minute she stared at the series of twelve black squiggles, unable to believe what she was seeing. The pattern was unmistakable. Even a third-year medical student could have made the diagnosis.

      “That’s why she died, Kate,” Guy said.

      “But— This is impossible!” she blurted. “I couldn’t have made a mistake like this!”

      Guy didn’t answer. He simply looked away—an act more telling than anything he could have said.

      “Guy, you know me,” she protested. “You know I wouldn’t miss something like—”

      “It’s right there in black and white. For God’s sake, your initials are on the damn thing!”

      They stared at each other, both of them shocked by the harshness of his voice.

      “I’m sorry,” he apologized at last. Suddenly agitated, he turned and clawed his fingers through his hair. “Dear God. She’d had a heart attack. A heart attack. And we took her to surgery.” He gave Kate a look of utter misery. “I guess that means we killed her.”

      * * *

      “IT’S AN OBVIOUS case of malpractice.”

      Attorney David Ransom closed the file labeled O’Brien, Ellen, and looked across the broad teak desk at his clients. If he had to choose one word to describe Patrick and Mary O’Brien, it would be gray. Gray hair, gray faces, gray clothes. Patrick was wearing a dull tweed jacket that had long ago sagged into shapelessness. Mary wore a dress in a black-and-white print that seemed to blend together into a drab monochrome.

      Patrick kept shaking his head. “She was our only girl, Mr. Ransom. Our only child. She was always so good, you know? Never complained. Even when she was a baby. She’d just lie there in her crib and smile. Like a little angel. Just like a darling little—” He suddenly stopped, his face crumpling.

      “Mr. O’Brien,” David said gently, “I know it’s not much of a comfort to you now, but I promise you, I’ll do everything I can.”

      Patrick shook his head. “It’s not the money we’re after. Sure, I can’t work. My back, you know. But Ellie, she had a life insurance policy, and—”

      “How much was the policy?”

      “Fifty thousand,” answered Mary. “That’s the kind of girl she was. Always thinking of us.” Her profile, caught in the window’s light, had an edge of steel. Unlike her husband, Mary O’Brien was done with her crying. She sat very straight, her whole body a rigid testament to grief. David knew exactly what she was feeling. The pain. The anger. Especially the anger. It was there, burning coldly in her eyes.

      Patrick was sniffling.

      David took a box of tissues from his drawer and quietly placed it in front of his client. “Perhaps we should discuss the case some other time,” he suggested. “When you both feel ready….”

      Mary’s chin lifted sharply. “We’re ready, Mr. Ransom. Ask your questions.”

      David glanced at Patrick, who managed a feeble nod. “I’m afraid this may strike you as…cold-blooded, the things I have to ask. I’m sorry.”

      “Go on,” prompted Mary.

      “I’ll proceed immediately to filing suit. But I’ll need more information before we can make an estimate of damages. Part of that is lost wages—what your daughter would have earned had she lived. You say she was a nurse?”

      “In obstetrics. Labor and delivery.”

      “Do you know her salary?”

      “I’ll have to check her pay stubs.”

      “What about dependants? Did she have any?”

      “None.”

      “She was never married?”

      Mary shook her head and sighed. “She was the perfect daughter, Mr. Ransom, in almost every way. Beautiful. And brilliant. But when it came to men, she made… mistakes.”

      He frowned. “Mistakes?”

      Mary shrugged. “Oh, I suppose it’s just the way things are these days. And when a woman gets to be a—a certain age, she feels, well, lucky to have any man at all….” She looked down at her tightly knotted hands and fell silent.

      David sensed they’d strayed into hazardous waters. He wasn’t interested in Ellen O’Brien’s love life, anyway. It was irrelevant to the case.

      “Let’s turn to your daughter’s medical history,” he said smoothly, opening the medical chart. “The record states she was forty-one years old and in excellent health. To your knowledge, did she ever have any problems with her heart?”

      “Never.”

      “She never complained of chest pain? Shortness of breath?”

      “Ellie was a long-distance swimmer, Mr. Ransom. She could go all day and never get out of breath. That’s why I don’t believe this story about a—a heart attack.”

      “But the EKG was