Diane finished scissoring through the intercostal muscles, then wedged a rib spreader into the bloody gap. The pronged tool was silver and ratcheted, and she flipped out the handle and cranked it like a winch. The man's ribs stretched, then snapped, sending a splattering of blood across her surgical gown and Jill's face.
'How's the left lung?' David asked.
Diane peered into the hole in the man's body. 'Looks fine.'
'Now feel your way in there. Check to make sure the aorta isn't lacerated.'
She paused for an instant, her gloved hand hovering near the gap. David had walked her through this move on a cadaver, but she'd never had a live run. She looked up, her brilliant green eyes catching David's, and he nodded once, reassuringly.
Lowering her shoulder, she slid her hand into the man's living body.
'You feel the lung along the back of your hand?' David asked. 'Bumpy and soft?'
She nodded. 'I have my bearings.'
Her arm disappeared midway to her elbow as she slid her hand down along the inside of the man's back.
David's hand twitched at his side as he mentally undertook the maneuver with her. 'Did you check the aorta?'
She shook her head.
'How can you restrain yourself?'
Her eyes widened. 'I've got it!' A smile bloomed on her face, a child's smile at sighting something wondrous. 'Under my fingertips. It's firm and full of blood.'
'Good,' David said. 'Now let's check for a pericardial tamponade.' If the heart had sustained a trauma, which David guessed it had from the angle of the rebar, it was probably bleeding into the pericardium. And if the sac around the heart filled with blood, it would interfere with the heart's mechanism, preventing it from pumping effectively.
Someone banged into a rapid infuser and it nearly capsized.
'Where the hell is surgery?' Diane said. She readjusted her hand, and a soft sucking noise emerged from the wound.
'It's all right,' David said. 'Focus on the task.'
Diane twisted her body so she could better maneuver her hand. 'Got it! The pericardial sac is full and tense. The heart must've bled into it.'
She removed her right hand to grab a tiny pair of scissors, picked up a pair of tongs with her left, and went back in with both.
'Okay,' David said. 'Grab the edge of the sac with the tongs and make a small vertical incision.' He strained to look around her and saw blood spill into the chest. 'Good. Now deliver the heart.'
Her arm moving with exquisite care, she gripped the heart and pulled it out through the small incision, holding it in her hand. 'It's beating,' she said, ducking her head to see through the mess. 'It's got a small hole.'
'It's trying to push blood but can't. Put your thumb over the hole.'
She adjusted her thumb, then turned and looked to David again. He held her gaze as they waited. Now that she'd plugged the heart's hole, blood should begin pumping more effectively. A nurse near the man's head looked up triumphantly. 'I got a pulse!' A carotid pulse meant the blood pressure had just hit sixty.
'Me too!' another nurse exclaimed. 'Femoral pulse!' The blood pressure had risen to seventy.
A wisp of hair fell across Diane's eyes, and she flicked it aside with a quick jerk of her head. Her lips were trembling ever so slightly-David was sure he was the only one who noticed. Her face had taken on the fervent, confounded cast of one in extreme grief or ecstasy. She held a man's beating heart in her hand, and her thumb plugging its hole was the only thing keeping him alive.
The junior surgeon jogged into the room. 'Call OR,' Diane said. 'Tell 'em we're on our way.'
The gurney took off with a lurch as Jill shoved it toward the door, several others grabbing for the connecting gear and making sure it moved with the body.
Keeping her thumb firmly pressed over the hole in the heart, Diane threw one leg over the man's body as she hopped on the gurney. David stepped back as the gurney and its attendant mob swung out into the hall and rattled along at an impromptu sprint, the junior surgeon barking orders, nurses dragging rapid infusers on IV poles, and Diane straddling the patient's unconscious body, her arm inside him, seeming to ride the entire mob like a cowboy.
Looking up across the bobbing heads and waving poles, she caught David's eye. She winked just as the gurney turned the corner, and he realized he was in love with her.
Chapter 34
After checking that Clyde's composite was indeed being circulated through internal mail, David rode up to the fifth floor and entered the ICU ward. It was busier than the last time he'd visited Nancy, two days ago. A frail woman called out to him from a bed, wanting more morphine, and he smiled at her as he passed. 'I'm sorry, ma'am, I don't work in this department, but I'll get the nurse for you.'
The curtains were drawn in a tight oval around Nancy's bed, like a coffin pall. The rattle of the rings woke her. She turned her face, and he did his best not to let his horror show despite the fact that she couldn't see him. If shock found its way into his face, it would find its way into his voice.
If anything, she looked worse, her burns resolving into wounds even more horrifying for their permanence. In the six days since the attack, her hair had fallen out along the front of her crown, leaving her with a coarse fringe of ringlets around the sides and back of her head. The large bolster on her right cheek had dried and turned gray, and the skin around the edges had yellowed. David didn't have a plastic surgeon's eye, but he doubted that the graft would take. Between her other bolsters, her patchwork flesh shone red, slick with residual Silvadene. In the midst of it all, her two eyeballs perched inside their sockets, shrunken and sightless.
'Who is it?' she said weakly, her voice a tiny rasp. 'Who's there?'
'It's David Spier.'
'Oh. I don't want to see you. I heard what you did… that you helped him… and now he got away.' Her head drifted slightly on the pillow, a dying motion. 'How could you?'
'I didn't help him,' David said. 'I treated him.'
She drew breath raggedly. 'I don't want to see you.'
'Okay,' David said.
'Ever again.'
'Okay.'
David backed up quietly and pulled the curtain shut.
Diane was back from surgery by the time David got downstairs. She'd already changed into fresh scrubs when David entered the doctors' lounge.
'This morning's incident with Jenkins gave me an idea,' he said.
She gathered her bloody scrubs from the floor. 'If it's the handcuffs you're interested in, you'll have to buy me dinner first.'
'Sadly, nothing so titillating. That patient we helped out who the cops wanted-?'
'Hell's Angel guy?'
'No. The guy Jenkins was yelling about. The bullet in the ass. What was ostensibly his name again?'
'Ed Pinkerton.'
'Right.' David went to his locker and withdrew the odd bookmark that Ed had left behind in the ER. It read: AMOK BOOKSTORE. THE EXTREMES OF INFORMATION.
David stopped at a bad taqueria and wolfed down a burrito he was certain would give him acute GI distress. Driving toward the Amok Bookstore, he glanced down at the bookmark, double-checking the address. Located in a downscale-trendy area of Los Feliz, the storefront was small and unassuming, and David drove right past it and had to backtrack when he hit Hollywood Boulevard.
The book Ed had been reading, Wiretapping and Electronic Surveillance, implied that he'd be an asset in an
