their expressions sad but accepting.
Five presses, one breath.
His mother looked on with hopeless eyes.
Five presses, one breath.
Outside, the howling wind stopped as if the very desert itself was holding its breath as it sensed him slipping away.
Five presses, one breath.
But she couldn’t let him go. His eyes had implored her when he first came into the clinic so many hours ago. She couldn’t just let him die of the ache in his belly. Not when everything inside her raged at the unfairness of allowing a six-year-old child to slip away, when all of her training taught her to fight harder and longer. After all, malnutrition could be countered, as could starvation and most of the diseases found here.
But it was too late for Mabulu. Too late for high- protein drinks from the States, too late for peanut-butter sandwiches or fresh bananas. Too late for the vitamins and shots that could so easily have saved him a few weeks before.
Sometimes it felt as if everything she did in this godforsaken country was too little, too late.
Five presses, one breath.
It was time to stop. Her intellect knew it, but her heart was already so cracked that she feared one more loss might shatter it forever. So she continued pressing down on his small chest, long past the time her medical experience told her to stop.
Sweat ran down her face, and her arms trembled from the strain.
Five presses, one breath.
Tears blurred her eyes—an appalling lack of professionalism she could do nothing about.
Hundreds of thousands of deaths she could do nothing about.
She railed at the unfairness of it, at the complete and utter hopelessness of this battle she had been fighting for eleven years now. What good was a medical degree if she couldn’t save anyone?
Five presses, one breath.
“Time of death—11:42 a.m.” The deep voice boomed across the impromptu operating room, and Amanda Jacobs glanced up, startled, into the face of Jack Alexander—head doctor of this particular clinic and a close personal friend since they’d done their first year of medical school together fifteen years before.
“He’s my patient,” she said, continuing CPR. “I say when he’s dead.”
“How long has he been down?”
She bit her lip, knowing that the answer would damn Mabulu—and herself. “Twenty-seven minutes.”
Jack’s eyes cut to hers, narrowed in disbelief. “Stop the CPR—now,” he roared when she ignored him.
Her hands trembled and her shoulders slumped as she slowly let her arms drop away from her patient. He had been a beautiful little boy, even with his belly bloated and his bones all but sticking through his skin. His eyes had been bright, inquisitive, and his ongoing stoicism made her own sudden emotional instability even more humiliating.
Sobs choked her and she could barely stop the scalding tears from falling.
“Call it,” Jack ordered.
Her gaze met his. “You already—”
“Call it.” His voice was implacable, his look compassionate as he stared her down. “As you said, he was your patient.”
She glanced at the clock, then cleared away the lump in her throat. “Time of death—11:44.” Her breath hitched and she felt—actually felt—her heart break wide open. She’d been right. Mabulu’s death had been one too many, Somalia one country too many in a list so long she’d learned years ago to stop counting.
“I want to speak with you in my office,” Jack said, his voice uncompromising.
“My patient—” Their eyes locked in a battle of wills she didn’t have the strength to win—at least not today.
“Nola will take care of him.” He nodded toward the head nurse, then turned, without waiting to see if Amanda would follow, confident of his power and leadership even here, in this hospital composed of a series of olive-green tents and overstressed generators in the middle of the desert.
Amanda followed slowly, trying to steady herself for the confrontation she knew was coming. Her behavior was growing more and more erratic, her inability to let Mabulu go just the latest in a series of bad judgment calls. She was exhausted, overemotional, burned out. She knew the symptoms well, had witnessed them in others time and again in the past decade.
She’d simply never expected it to happen to her. Then again, she could say that about so many of the things in her life lately.
“What exactly was that?” Jack asked, closing the curtain on his makeshift office.
Her spine stiffened at his strident tone. “That was me trying to save my patient’s life.”
“That was you completely out of control, Amanda, and we both know it.”
“That’s not true,” she protested, but her voice wasn’t as solid as she would have liked.
“Yes, it is. I’ve worked with you off and on for fifteen years and I’ve never seen anything like that from you.”
“It was a rough one.” She tried—and failed—to shrug off the incident. “I’ll be okay.”
He studied her, and she knew his blue eyes were taking in the strain around her mouth and the cloudiness of her usually clear gray eyes. Telltale signs she’d noticed herself. “I’m not so sure about that.”
She stiffened. “What’s that supposed to mean?”
Sighing, he gestured to one of the two chairs in the room. “Sit down, Mandy.”
“Are you firing me, Jack?” If so, she would prefer to stand.
“Of course not,” he snorted. “You know more about practicing medicine in these conditions than most of my staff put together. But I do want to examine you.” He put his stethoscope in his ears and motioned her to sit.
“Absolutely not!”
“I’m not arguing with you about this. Before you go back on duty, I’m going to make damn sure you’re all right.”
She started to protest more vehemently, to tell him her health was none of his business. But she had enough self-preservation to realize that doing so would only reinforce his beliefs about her fitness for the job.
Plus, for the first time in her life, she just couldn’t summon up the effort to fight.
“I told you I’m fine,” she said as she sank into the chair reluctantly, but she could hear the shakiness in her voice.
“Which is obviously a falsehood.” He put the stethoscope to her chest. “Take a deep breath.”
“Jack—”
“Do it.”
Amanda sucked in air as loudly as possible, before letting it out slowly. “I’m just tired. We all are.”
“But we’re not all in tears when one of our patients dies.”
“Sometimes it gets to me. You know what it’s like.”
He reached for her wrist to check her pulse. “Sometimes it does,” he agreed. “But this isn’t you, Mandy. Tired or not.”
“Well, who is it, then?” She laughed bitterly. “Please, tell me. If this isn’t my life, whose hellish existence is it? Believe me, I’d love to give it back to her.”
Jack didn’t respond and she regretted the words as soon as they were spoken. “I didn’t mean that the way it sounded.”
“I think you did.” He