It was hard to get any romantic traction with code blues going off all
over the place, while crash carts whizzed by and cardiovascular post-ops rolled
through on bloodstained sheets.
"If you want, we could explore some options," Shiller said.
"Tell you what, I'm off in twenty minutes and I haven't eaten since this
morning." He looked at his gold watch. "Holy Moley, that's almost
eight-and-a-half hours ago. No wonder I'm starved. How 'bout we jump downstairs
now and get a bite? I think we need to discuss getting your father a more
permanent result. The drug therapy doesn't seem to be doing it."
"Okay," she said nervously. "Okay . . . sure . . .
whatever you think is best, Dr. Shiller."
"Right. Well, that's what I think is best. . . and I prefer
Lance."
The windowless cafeteria was overlit and bustling with medical people of
all shapes and specialties, as well as a few civilians from the four o'clock
visitors crowd. Most
were carrying trays or hunched over processed meals at
institutional tables, looking uncomfortable in straight-back metal chairs.
Susan and Lance were in one of the few leather booths along the wall. Susan
only ordered coffee and Lance was poking at something called "The
California Plate" that was just an avocado and chicken salad with
honey-mustard dressing. He really wasn't hungry because, truth be told, he had
eaten only an hour ago.
"What other kinds of things are you suggesting?" Susan asked,
leaning forward, her beautiful, delicate features porcelain and perfect even
under the harsh neon glare. But her pale blue eyes, the color of reef water,
were clouded with concern.
God. . . I am falling in love,
Lance thought, as he nibbled and
considered. "To begin with, you have to understand how the heart
works." He took a gold pen out of his hospital white coat, clicked it
open, and started to draw on the paper place mat. "Your heart is shaped
like this." He drew a rough oval and divided it into four quadrants.
"The atria and the ventricles work together, alternately contracting and
relaxing to pump blood. The neuro-electrical system of our body is the power
source that makes this pumping action possible." He looked up and smiled.
He thought he had a killer smile—and he did. Susan smiled back. "This
electrical pulse is triggered in the sinus node, up here in your nasal
passage." He drew a small circle somewhere above the
heart, then
traced a line down to the oval as he talked. "The impulse travels a
special pathway like this, down and through your heart, where it then triggers
the heartbeat. In your father's case, something—age, maybe diet or alcohol, or
even stress—has interfered with this delicate process, and when that happens
the heart fails to respond to the impulse and goes out of rhythm. It can then
start to beat erratically. It speeds up or goes way too slow, even sometimes
threatening to shut down, and this is the general condition we call
arrhythmia." He clicked his ballpoint closed for emphasis. "Lecture
over." He returned the pen to his pocket and smiled again.
"Doctor,
I don't mean to be rude, but I know all of this. He's had four arrhythmias now.
I've had the condition explained to me three times. I'm not looking for a
description of his problem. I'm looking for a cure. Would you mind if we get to
the bottom line? I want facts. I want an actuarial prognosis. I want survival
percentages." A legal mind used to finding solutions jumped out from
behind that angelic mask and surprised him.
Okay,
Lance thought.
Go for it. Give her what she wants.
"Your
father has severe ventricular tachycardia fibrillation, which is one of the
life-threatening arrhythmias. It requires urgent treatment or death can occur.
Generally, we start with drug therapy and, often, as you know, this can correct
the problem for long periods of time. In your father's case we have seen that
option come and go. Failing that, we still have a range of other options
available to us. One is electrical shock cardioversion. It's basically paddles
and juice to the chest walls. The idea is to shock the heart back into a normal
rhythm."
"Will that last, if you do it?"
"It might. It's a case-by-case situation. Sometimes, yes.
Sometimes, no."
"What else?"
"We can install a pacemaker under the skin on the chest. It's a
battery unit that monitors the heart rhythm, and when it senses an arrhythmia
it gives the heart a little electric boost that gets it back in rhythm."
"How long does that take?"
"About two days. It's normally an outpatient procedure, but
speaking quite bluntly, your father is in pretty bad physical shape. I would
want him here for at least two days."
"He's got a trial that begins tomorrow morning. He'll never go for
that."
"Convince him."
"Yeah, right," she said. "You don't know him. What
else?"
"Surgery. We induce an arrhythmia, get his heart in fibrillation,
and then, using cameras and probes, we go in
through the groin, snake our way up a vein to the heart,
and look for the offending spot—usually, it's a fatty growth of some kind. We
probe for it, watching his heart rate on the monitors and on the TV. When we
hit the problem spot his heart will stop fibrillating, and then we give that
place a little zap of radio frequency and burn it off. In ninety-five percent
of the patients it fixes the problem forever."
"What are the risks?" Susan asked, prompting Lance to lean
back and lay down his fork.
"With yours truly on the drums, almost none. I've done forty or
fifty of these radio frequency ablations—never one mishap."
"How long will he be in here?"
"One day of pre-op, a day of post-op, and a week of bed rest."
"Too long," she said.
"He won't go for it."
"Make him."
"Listen—you think I haven't tried? He's a warrior. He fights for
causes he views as more important than himself. He won't do it, and he's in
charge of his life, not me. If it's going to take that long he's not going to
sign a consent for surgery."
"Then we should try and convert him with the paddles. That's the
next best option. If it works, he should be able to leave first thing in the
morning. But he's nuts if he tries a case in his condition. He's very sick. The
man needs rest. Christ, he must feel like hell."
She sat absolutely still, and for a moment Lance Shiller didn't think
she was going to respond. Then she looked up at him and in her eyes he now saw
something else. It was resolve. No, not quite resolve—it was more like fierce
pride.
"He told me once that most of the important work being done in the
world is being done by people who don't feel very well," she said.
"How much of it is being done by dead people?" Dr. Shiller
said angrily. He saw her eyes go cold and knew instantly he had blown it with
her, but, damn it, even
though he wanted to connect with Susan Strockmire he was still a
doctor, a brilliant chest-cutter, and a fine fucking surgeon. He hated it when
his patients chose the wrong option.
Susan left Dr. Lance Shiller in the cafeteria still picking at his
California plate. She wandered out onto the patio where the sun was just going
down. She couldn't believe that L.A. was this hot in April. She thought of her
apartment in Washington, D.C., and of her father's cramped little house where
she grew up after her mother split, leaving them to take care of each other.
Now that little bungalow located two blocks off the beltway housed Herman and
the Institute for Planetary Justice.
It was still cold in D.C. at this time of year—blustery. L.A. had it
all: beaches, mountains, deserts, and bright sunshine twelve months a year. And
yet there seemed something prefab and superficial about it. A town designed for
tourists. The fringe celebrity commerce of Tinseltown seemed absurd to her:
maps to the stars' homes, a tour of famous actors' gravesites in a
twenty-year-old black Cadillac hearse, plus the tacky Hollywood sign. In L.A.
fame towered over accomplishment. That was a concept that didn't fit the heroic
proportions of Herman Strockmire Jr., a man she fought daily to protect and
whom she adored.
Susan had grown up watching her beloved father run headlong into legal
and political brick walls, often badly damaging himself. "No, Daddy,
don't!" she would yell, feeling helpless to stop him, even as an adult.
Then she'd watch in awe as her battered father would pick himself up, shake it
off, back up, and do it all over again. Always in pursuit of an idea, a
principle, an underdog. He became her hero early in life and had never once
disappointed her. She never saw him do one thing she couldn't respect.
Not that he didn't have his shortcomings. Hell, he wore them like plates
of tarnished armor—and he had plenty. He didn't seem to know that sometimes
discretion
was
the better part of valor. He couldn't distinguish between
causes, taking on an important lawsuit against the Pentagon for
illegally developing bio-weapons at Fort
Detrick with the same fervor that he chased after the silly Area 51 alien
thing. But, to Herman they were equally important, because to him it was always
about morality, honor, and integrity.
Herman was the last defender of justice in a world that no longer cared,
because life in America now seemed to be only about celebrity, money, and
success. The core values her father stood for had been left in the vapor trail
of a seesawing Dow Jones Average.
Sometimes she cried for her father as she watched him standing alone
against huge corporate bullies and government tyrants, sick and bloodied, but
unbowed. A squat little warrior with a runaway heart who wouldn't back down no
matter what; not when he was protecting the weak, not when the cause was just.
And yet somehow, despite all of his courage, she knew that to most people who
bothered to look, he came off as old-fashioned, silly, and more than a little
bit corny.
Susan sat on the stone bench in the courtyard and watched the windows of
Cedars-Sinai Hospital turn orange with the reflected sunset. She couldn't let
her father die. She couldn't let him risk his life, but she didn't know how to
stop him. When he was committed there was no turning him back. She had tried
everything in the past: tears, begging, prayers, but he would just hold her
hand and smile sadly, because he wanted her, above all others, to understand.
He wanted her to get it.
"Honey," he would say. "Some people are unlucky, and you
know why?"
"Why, Daddy?" But she knew.
"Because they have second sight. Or maybe it's just that they have
a better view. They can really see what's going on, while the rest of society
is out buying a new, hip wardrobe. But if you've been given this gift of sight
you must use it. It's bigger than any one life, certainly bigger than
mine." That was what he would tell her. If she went up there now and
pleaded with him to ask the court for a continuance so he could get the radio
frequency ablation,
he would just smile sadly—mildly disappointed that she didn't
understand. Then he would tell her all over again.
Herman Strockmire Jr. is the last great knight,
she thought
proudly.
She turned and trudged to the elevator for the ride back up to the
cardio unit, thinking that if she lost her father she would just as soon die
herself.
R
oland Minton had taken a room in the new
Fairview Hotel, on the thirty-second floor, with a spectacular vista of the San
Francisco Bay. He always stayed at the new Fairview, because he thought the
place looked like a huge rectal thermometer jutting up into the San Francisco
sky, round and silver-tipped, its lone, mirrored spire flipping off the whole
town.
He was
planning to hit the bricks later in search of some prime female tatta, but
first he decided to pursue the downloads he had cracked from Gen-A-Tec. Trouble
was, the more he studied the stuff, the lamer it looked to him. The bio-corn
file seemed like it was just low-grade PR, not the kind of sophisticated
technical material you'd put in a secure computer.
So what gives?
he wondered. He had just clicked over to the
e-mails and was fast-scanning the messages when something got his hackles up.
He couldn't pin it down at first, but something was definitely skeevy here.