pulmonary artery. On the screen overhead, Abby could read the right atrial pressure. It was high. The boy's heart was too weak to pump effectively, and blood had backed up in his venous system. Even without the monitor, she could have reached that conclusion by a glance at his neck veins. They were bulging.
'You're looking at Redding High School's baseball star from two years ago,' said Vivian. 'I'm not into the game so I don't really know how to judge his batting average. But his dad seems pretty proud of it.'
'Oh, his dad/s proud,' said Hannah. 'He was in here the other day with a ball and mitt. I had to kick him out when they started a game of catch.' Hannah laughed. 'The dad's as crazy as the kid!'
'How long has he been sick?' asked Abby.
'He hasn't been to school in a year,' said Vivian. 'The virus hit him about two years ago. CoxsackieVirus B. Within six months, he was in congestive heart failure. He's been in the ICU for a month now, just waiting for a heart.' Vivian paused. And smiled. 'Right, Josh?'
The boy's eyes were open. He seemed to be looking at them as though through layers of gauze. He blinked a few times, then smiled at Vivian. 'Hey, Dr. Chao.'
'I see some new ribbons on display,' said Vivian.
'Oh. Those.' Josh rolled his eyes. 'I don't know where my Mom digs those up. She keeps everything, you know. She even has this plastic bag with all my baby teeth. I think it's pretty gross.'
'Josh, I brought someone along to meet you. This is Dr. DiMatteo, one of our surgical residents.'
'Hello, Josh,' said Abby.
It seemed to take the boy a moment to fully refocus his gaze. He didn't say anything.
'Is it OK for Dr. DiMatteo to examine you?' asked Vivian. 'Why?'
'When you get your new heart, you'll be like that crazy Road Runner on TV. We won't be able to tie you down long enough for an exam.'
Josh smiled. 'You're so full of it.'
Abby moved to the bedside. Already, Josh had pulled up his gown and bared his chest. It was white and haitiess, not a teenager's chest but a boy's. She lay her hand over his heart and felt it fluttering like bird's wings against the cage of ribs. She lay her stethoscope against it and listened to the heartbeat, the whole time aware of the boy's gaze, wary and untrusting. She had seen such looks from children who have been too long in paediatric wards, children who've learned that every new pair of hands brings a new variety of pain. When she finally straightened and slipped her stethoscope back in her pocket, she saw the look of relief in the boy's face. 'Is that all?' he said.
'That's all.' Abby smoothed down his hospital gown. 'So. Who's your favourite team, Josh?'
'Who else?'
'Ah. Red Sox.'
'My dad taped all their games for me. We used to go to the park together, my dad and me. When I get home, I'm going to watch 'era all. All those tapes. Three straight days of baseball…' He took a deep breath of oxygen-infused air and looked up at the ceiling.
Softly he said, 'I want to go home, Dr. Chao.'
'I know,' said Vivian.
'I want to see my room again. I miss my room.' He swallowed, but he couldn't hold back the sob. 'I want to see my room. That's all. I just want to see my room.'
At once Hannah moved to his side. She gathered the boy into her arms and held him, rocked him. He was fighting not to cry, his fists clenched, his face buried in her hair. 'It's OK,' murmured Hannah. 'Baby, you just go ahead and cry. I'm right here with you. I'm going to stay right here, Josh. As long as you need me. It's OK.' Hannah's gaze met Abby's over the boy's shoulder. The tears on the nurse's face weren't Josh's, but her own.
In silence, Abby and Vivian left the room.
At the MICU nurses' station, Abby watched as Vivian signed in duplicate the order for the lymphocyte crossmatch between Josh O' Day's and Karen Terrio's blood.
'How soon can he go to surgery?' asked Abby.
'We could be scrubbed and ready to cut by tomorrow morning. The sooner the better. The kid's had three episodes of V. tach in just the last day. With a heart rhythm that unstable, he doesn't have much time.' Vivian swivelled around to face Abby. 'I'd really like that boy to see another Red Sox game. Wouldn't you?'
Vivian's expression was as calm and unreadable as ever. She might be soft as slush inside, thought Abby, but Vivian would never show it.
'Dr. Chao?' said the ward clerk.
'Yes?'
'I just called SICU about that lymphocyte crossmatch. They said they're already running a match against Karen Terrio.'
'Great. For once my intern's on the ball.'
'But Dr. Chao, the crossmatch isn't with Josh O' Day.'
Vivian turned and looked at the clerk. 'What?'
'SICU says they're running it on someone else. Some private patient named Nina Voss.'
'But Josh is critical! He's at the top of the list.'
'All they said was the heart's going to that other patient.' Vivian shot to her feet. In three quick steps she was at the telephone, punching in a number. A moment later, Abby heard her say:
'This is Dr. Chao. I want to know who ordered that lymphocyte crossmatch on Karen Terrio.' She listened. Then, frowning, she hung up.
'Did you get the name?' asked Abby.
'Yes.'
'Who ordered it?'
'Mark Hodell.'
CHAPTER FOUR
Abby and Mark had made reservations that night for Casablanca's, a restaurant just down the road from their Cambridge house. Though it was meant to be a celebration, to mark the six month anniversary of their moving in together, the mood at their table was anything but cheerful.
'All I want to know,' said Abby, 'is who the hell is Nina Voss?'
'! told you, I don't know,' said Mark. 'Now can we drop the subject?'
'The boy's critical. He's coding practically twice a day. He's been on the recipient list for a year. Now an AB positive heart finally becomes available, and you're bypassing the registry system? Giving the heart to some private patient who's still living at home?'
'We're not giving it away, OK? It was a clinical decision.'
'Whose decision was it?'
'Aaron Levi's. He called me this afternoon. Told me that Nina Voss was being admitted tomorrow. He asked me to order the screening labs on the donor.'
'That's all he told you?'
'Essentially.' Mark reached for the bottle of wine and refilled his glass, sloshing burgundy onto the tablecloth. 'Now can we change the subject?'
She watched him sip the wine. He wasn't looking at her, wasn't meeting her gaze.
'Who is this patient?' she asked. 'How old is she?'
'! don't want to talk about it.'
'You're the one taking her to surgery. You must know how old she is.'
'Forty-six.'
'From out of state?'
'Boston.'
