FELT HIS pain more acutely than her own. Yet Anna stood poised to cut into the delicate heart of her two-month-old son. Her hand trembled slightly as she touched the precision steel blade to pale pink skin. Right before it pierced, she retracted the scalpel. Closing her eyes, she took a deep breath. Even a minuscule tremble could end Lucas’s life. She wasn’t a cardiac surgeon, but if she didn’t correct the big hole in his heart, he would die. If she made the tiniest of mistakes, he would die. If any one of a thousand things went wrong during the surgery, like the electricity going out again, he would die. She was six thousand miles away from California and they were out of time. There were no other options.
She opened her eyes and looked up to see Nico’s tall frame fill the viewing gallery window. His hair was disheveled, his eyes bloodshot, the normally smiling face creased. He put a hand on his heart, then onto the window that separated them. The gallery was meant for medical students and other physicians to watch surgeries. No father should witness his wife cutting into their son, but Nico had insisted on being there. Even across the room, she could see the wetness in his eyes. He mouthed, “I love you,” then kissed his fist, relaying confidence she didn’t feel.
She lowered her eyes from the viewing gallery to see the entire operating room staring at her. The panic in her chest was clearly visible in their eyes. The cold, sterile air reeked of desperation. They weren’t going to stop her, tell her how foolhardy this whole thing was. Not today. They were used to letting their babies die.
“Dr. Atao, you need to begin.”
The gentle but firm voice of the nurse anesthetist reminded her that the longer she waited, the more her son’s life would be at risk. The hospital didn’t even have a physician anesthesiologist. No one in their right mind would do this surgery. She looked at Nico one last time. His brown eyes reached into her soul, filling her with love. I have to do this. Lucas couldn’t die.
She took a deep breath, willing her heart to slow its frantic beating. She looked down at the small square of exposed skin, the rest draped with a blue sheet, as if the sheet could hide the fact that her little baby, the one she had nursed only an hour ago, was lying underneath. He was totally still, his normally wiggly, giggly, crying body as still as the air in the room. Ice seeped through her bones.
She pressed the scalpel into the skin above her son’s heart.
* * *
ANNA SAT UP with a sharp pain in her chest.
“Dr. Atao?” Her brain registered someone calling her name.
“Dr. Atao!”
She rubbed her eyes. A hazy face slowly came into focus. “Sorry, Doctor, you asked me to wake you. It’s eight o clock.” Anna thanked the clerk and checked her watch. Three hours had gone by fast, but at least she’d slept. The dream! She hadn’t had it for 392 days. But then she shouldn’t be surprised it had returned. It wasn’t so much a dream as a replay of the worst day of her life. The day she had performed surgery on her two-month-old son, hastening his death. It was technically a routine surgery; had she been in California, it would have been performed by a team of pediatric surgeons and Lucas would be a happy child today, five years, three months and four days old. But she’d been here on Guam, basking in the glory of being a new mother, ignoring the early warning signs.
She swung her leg off the cot, went to the latrine and splashed water on her face using the jug she’d brought. Time of death, 10:56. She’d done CPR for more than an hour, until finally the staff had pulled her away from Lucas and another physician had been called in to pronounce the death of her little baby.
For days after, his cries still woke her up at night.
She wiped her face with a paper towel. It was time to get back to work. There were still only two physicians, and patients were coming in by the truckloads as roads were getting cleared. Linda and Anna were taking turns sleeping. Anna had to keep moving; it was the only way to get through the remaining 319 hours on Guam.
A canteen hadn’t been set up yet, but the medical command tent had a corner stocked with a box of MREs—military grade “meals ready-to-eat”—instant coffee and hot water. She made her way there and was surprised to find hard-boiled eggs and basic bread. Compared to the MREs, any real food was a treat.
The PHS personnel and several of the local firefighters who had been helping were huddled around the cardboard box that served as a table. There was even fresh coffee, courtesy of a French press. Anna helped herself to a cup.
“Dr. Atao, thank you for the treats,” one of the firefighters said.
“What?”
“Your husband brought them in.”
Anna choked on the lukewarm coffee she had just sipped.
“Excuse me?”
“The man with the same last name as you.”
“Hi, Anna.” She turned to see Nico, all six feet three inches of him, looking strong in a fresh T-shirt and jeans.
“Um...thank you. You didn’t have to do that.”
“Actually, it’s a bribe.”
Anna grabbed his arm and pulled him outside the tent. She didn’t want her colleagues overhearing their conversation.
“I have no problems signing the divorce papers, but you might have some trouble getting them drawn up and adjudicated today given what’s going on,” she said. Last night after she’d asked for a divorce, he had sighed with relief, telling her that’s what he wanted to talk to her about.
“Oh, I already have them drawn up, but you’re right, it’ll be weeks before the courthouse is open for us to file them. That’s not what I was going to ask.”
He already has the papers drawn up? How long has he been thinking about this? While she had considered divorce many times, the thought of calling a lawyer and actually having papers drawn up had never crossed her mind.
“What is it, then?” She shifted on her feet, eager for him to leave. She had work to do and the last thing she needed was Nico hanging around distracting her.
“I have a hospital building in Talofofo. People who can’t make it to the camps on this side of the island have been coming there. Dr. Balachandra—you remember him, don’t you?”
How could I forget the doctor who pronounced Lucas’s death?
She must have nodded because he continued on. “He’s been treating those patients, but he went to Cocos Island late last night to see a woman in labor with a breech birth and the currents are too strong this morning. He can’t make his way back on the little boat he took out there.”
Anna took a sip of the now cold coffee she was still holding and studied him. The only sign that he’d aged were the stray gray hairs around his temple. Nico was four years older than her, which meant his fortieth birthday was just around the corner. Yet aside from those wisps of gray, nothing else had changed. His face remained smooth, his milky-brown skin, inherited from his mother, unmarred. His high cheekbones gave him the kind of exotic handsomeness that made women swoon, and he hadn’t lost any of his legendary charm.
“You built a hospital?”
“It’s the private hospital I told you I would build in Lucas’s memory. It’s three months from opening.” He looked around. “Maybe a little longer now.”
Don’t leave, Anna, I’ll build a hospital in Lucas’s memory. We’ll make sure no one ever has to sacrifice like we did. I need you to do this with me.
He gave her a small smile. “It took a few years, but I built it to the best hurricane standards so it fared pretty well. It’s damaged but still standing.”
The pride in his voice cut through her. Before she left, he had tried to show her the land he’d bought in Talofofo, vowing to make enough money to build a private hospital where specialists from around the world would be invited to care for the locals so they would never have to rely on the substandard