“It’s not like that, Colonel. I don’t concern myself with—”
“You do what you have to so Japan loses the war too!” Tanaka tightened the grip until Franz’s whole arm ached. “Is it so?”
“No, Colonel, not at all,” Franz spluttered. “All I want is for my family to be safe.”
Tanaka glared ferociously at him for a moment before his lips curved into a malevolent smile.
“No one
—not you, not the girl child, not the woman—is safe if the general dies.”
The implication hung between them like a grenade with its pin pulled.
“I will do all I can.” Franz held his hands out in front of him. “I do not know how ill the general is. Sometimes people with perforated ulcers die no matter what we do.”
Tanaka released Franz’s arm. “If he dies, you
and
your family …” He shook his head slowly before he wheeled and marched out of the room.
Franz rode with Kubota in the back of his staff car. As they drove, the colonel seemed intent on justifying the Japanese attacks on Pearl Harbor, the Philippines and elsewhere. “We are an island nation with few natural resources,” he explained. “The Americans cut off our oil supply. Starved us of our sources of steel and bauxite. It would be little different had they cut off our food and water too.”
Franz nodded, too preoccupied with what awaited him at the hospital to absorb the colonel’s stream of rationalizations. Franz realized he would again be forced to drag politics into the operating room. But this time would be much worse—the well-being of his whole family hinged on the fate of a patient he had never even met.
The ride to the Shanghai General Hospital, on North Soochow Road, was mercifully short. At the hospital’s entrance, four soldiers stood at attention. Colonel Tanaka and two of his Kempeitai men were waiting inside. Franz spotted only a few doctors and nurses, all of whom scurried about in silent trepidation. Franz wondered how many of them were facing a similar ultimatum to his.
Kubota and Tanaka led Franz down a hallway and past two guards, who snapped rigid salutes as they stepped into the private room. A Japanese doctor hovered by the patient’s bed, fiddling with the intravenous tubing that ran into the man’s arm. An apple-cheeked nurse stood at the head of the bed, dabbing at the patient’s brow with a damp cloth, her hand steady. She shot the Japanese officers a look of cold defiance but said nothing.
Franz had expected the worst, but the sight of General Nogomi still shocked him. Covered up to his neck with a sheet, the balding man stared glassy-eyed at the ceiling. His colour matched the storming grey skies outside. For a moment, Franz thought the general might already be dead, but then one of his eyelids fluttered.
Franz almost whipped the sheet off in his hurry to examine Nogomi, but he glanced at Kubota for permission. The colonel nodded. “Please proceed, Dr. Adler.”
Nogomi showed no sign of awareness as Franz peeled back the sheet and grasped for the general’s wrist. The man’s skin was afire, and his pulse ominously faint. Franz turned to the two senior Japanese officers. “This man is septic! Blood poisoning has already set in.”
Kubota nodded gravely, but Tanaka stared hard at Franz, unwilling to accept any excuses.
Nogomi’s abdomen bulged outward from his thin frame. Franz lightly touched the skin and met board-like rigidity. He laid his left middle finger flat on the belly and tapped it with the other. The hollow sound was unmistakable. Only air that had leaked out of a perforated intestine could turn a human abdomen into a snare drum.
Franz turned to Kubota. “I agree with your doctors. The general must have perforated his intestine. Probably a stomach ulcer. But someone should have operated hours ago!”
“You will do it now!” Tanaka commanded.
“The general is already overwhelmed by infection. The odds of this man even surviving surgery are—”
“Now!”
Tanaka cried.
Franz’s own pulse fluttered wildly. Tanaka’s threat resonated stronger than ever. He thought of Hannah and Esther. Ernst’s gut-wrenching depiction of the woman impaled on the Japanese standard flashed to mind.
“I am going to scrub for surgery.” Franz lowered his head and strode for the door.
“Very well,” Kubota said. “I will see that General Nogomi is transferred to the operating room immediately.”
If it’s not already too late for him. And for my family.
Franz’s hands had never shaken so violently in the operating room—not even that day he raced to excise Sunny’s hemorrhaging spleen. He willed his fingers still, but the tremble persisted.
Franz scanned the room. The Japanese doctor sat perched on a stool at the head of the operating table, timidly assuming the role of anaesthetist. Two English scrub nurses stood gowned and masked across the table, waiting to assist Franz. Both were wide-eyed with fear. A Kempeitai officer stood at the door as an observer. His overly long gown produced a comical effect that was grimly misleading.
Abdomen exposed but covered from the waist down with a sheet, General Nogomi lay on the operating table, his breathing shallow and halting.
Franz glanced at the Kempeitai officer, who stared back intently. Technically, the soldier was there to ensure that no one sabotaged the surgery, but Franz suspected that Colonel Tanaka had stationed him to remind everyone of the consequences of failure.
The Japanese anaesthetist tentatively dripped ether onto the mask over Nogomi’s face.
“Only another drop or two,” Franz instructed. “The general is far too unstable for anything but the lightest dose.”
The young doctor jerked the bottle upright. “Of course, Dr. Adler,” he said in clear English. “Dr. Reuben felt the same way.”
Franz gaped at the anaesthetist. “Are you saying Dr. Reuben has already seen the patient?
When?
”
The anaesthetist shrugged. “Perhaps two hours ago.”
So what in God’s name am I doing here?
As though reading his thoughts, the anaesthetist added, “Dr. Reuben told us you were the best surgeon in Shanghai for such emergencies.”
The rat-bastard!
“Scalpel!” Franz said to one of the nurses.
He grabbed the knife from her hand, jabbed the blade into the central indentation just below Nogomi’s rib cage and sliced downward in one continuous cut. The second nurse sponged at the incision’s bleeding vessels but could not stem the blood flow. Franz stuck the blade back into the wound and slit the layers of muscles and tendons that formed the abdominal wall.
Air hissed out of the abdomen like a tire rupturing. The patient’s belly visibly deflated. Franz snatched the retractors and tucked them into the edges of the incision, stretching its edges wide apart. One of the nurses silently freed the retractors from his grip. Franz dipped his gloved hand inside the general’s belly. Warm fluid enveloped his fingers.
Sweat beaded on his forehead as Franz tried not to think about the damage the corrosive stomach acid had already inflicted. He ran his hand over the rubbery deflated loops of intestine until his fingers touched the pylorus, the base of the stomach. He had to palpate the area twice before his finger slid through a button-sized hole.
“Dr. Adler, the general’s pulse …” the anaesthetist croaked.
“What about it?” Franz said.
“It is so weak I can barely sense it.”
Colonel Tanaka’s threat rang in Franz’s ears like gunfire.
What will they do to my Hannah?
“Increase the fluids!” Franz snapped as he turned his attention back to the wound. The only hope was to patch Nogomi’s leaking stomach as fast as humanly possible. “Needle driver and stitch!” he called out.
Franz pushed the omentum, the ligamentous layer of tissue that hung off the outside of the stomach like a thick curtain, out of the way. He craned his neck until he glimpsed the small defect in the front of the stomach. Franz poked the tip of the needle through the full thickness of the stomach wall beside the hole and ran a ring of stitches around it. He dropped the needle driver and pulled taut on both ends of the thread, closing the hole as though tightening a purse string. He poked at the stomach wall with a finger. Satisfied, he grabbed at a piece of the omentum and sewed it on top of the defect site to reinforce his repair.
Franz dropped his equipment on the tray and glanced over to the anaesthetist. “Well?”
Without removing his hand from the patient’s neck, the pale young man nodded. “I feel it still. Very delicate.”
Franz grabbed for the syringe loaded with saline. He pointed its nose into the abdomen and sprayed the fluid. He showered the abdomen with multiple sprays, washing out as much stomach acid and bacteria as possible.
Franz turned to the anaesthetist. “Please remove the ether.” The man dutifully pulled the mask from the patient’s face. Franz rushed to suture Nogomi’s abdominal wall back together. As he threaded the final loop through the skin, the general flinched in pain. “He is waking,” the anaesthetist announced joyously. “And his pulse?” “Still not good.”
Even though Nogomi had survived the operation, Franz knew that the odds were still stacked against the general, and as Franz watched the nurses bandage the general’s abdomen, the sting of Reuben’s betrayal burned deeper. Any competent surgeon could have performed the operation. Fate, not surgical prowess, would determine Nogomi’s outcome. Reuben would have known it too.
Franz found the two Japanese colonels waiting in the hallway. Tanaka appeared as hostile as ever, with shoulders squared and eyes glaring. Kubota viewed Franz expectantly. “How did the surgery proceed, Dr. Adler?” he asked.
“The general survived but …” Franz held out his hands. “His condition is grave.”
“Now the general gets well!” Tanaka stated. Franz shrugged. “Only time will tell, Colonel.”
Tanaka grunted, but his icy stare indicated that he intended to hold Franz, not time, responsible for any unfavourable outcomes.
Franz eyed Kubota intently. “I am certain Dr. Reuben must have given you the same prognosis,” he said evenly.
Embarrassment darted across Kubota’s face, but he quickly regained his composure. He bowed his head. “Thank you, Dr. Adler. You have done all we could ask of you.”
“May I go home to my family now?” Franz asked.
“Of course.” Kubota smiled. “I will have my driver take you.”
Tanaka shook a finger at Franz. “You will come back later to see the general.” He scoffed. “I will have
my
men carry you here.”
Outside, flecks much larger than snowflakes fell steadily from the sky. Franz let a few drift onto his palm. After a moment, he recognized them as ash from burnt paper.
As Franz rode home in the back seat of Kubota’s staff car, he did not see a single pedestrian on the streets of the International Settlement. Even the beggars had disappeared. Shanghai struck Franz as surreal, as though he was experiencing it in a post-apocalyptic nightmare.
Kubota’s driver pulled up to Franz’s building and barely slowed long enough for Franz to hop out. As soon as the car sped away, Heng Zhou materialized at the front door. His watery eyes darted around vigilantly. “Franz! What did they want from you?”
“My help.”
“Help?”
Heng grimaced. “How can you help the Japanese?” “I had to perform surgery on one of them.”
“Is that so?” Heng asked shakily. “Are you all right, Heng?”
“I am a defeated old man,” Heng sighed. “Shan is … Shan. He is so angry with the Japanese. I worry that he might do something rash.” “You cannot allow that, Heng!”
“I might have to solicit Mr. Muhler’s assistance.” Heng’s shoulder slumped. “I believe he has more influence on Shan than anyone.”
Franz had long suspected that Heng understood the nature of the two men’s relationship, but they had never discussed the subject. “We will all keep an eye on Shan,” he said. “Meantime, I must check on my family.”
“Yes, please do.” Heng waved distractedly. “Wish them well for me, please.”
Franz opened the door to his flat to find the four most important people in his life collected in the same room. Lotte and Sunny must have come to sit vigil with Esther and Hannah after his detainment.
“Franz!” Esther cried as she leapt off her chair in surprise. “Oh, thank God.”
“Yes, welcome back,” Lotte added with a shy grin.
Sunny beamed with a relieved smile that meant more to him than words.
Hannah sat on the couch between Sunny and Lotte, appearing confused by the women’s exuberant greeting. “Why are you back so soon, Papa? Tante Essie said you went away on special business.”
“I might still have to go away,
liebchen.”
Franz glanced purposefully at Esther. “But I am home for now.”
“I hope you stay, Papa.”
Franz’s heart melted at the sight of his eleven-year-old daughter flanked by his fiancée on one side and the woman he loved on the other. “I hope so too.”
“Tea?” Esther offered as she headed to the stove.
“Yes, please.” He turned to Lotte and Sunny. “Is there any news?”
Lotte pointed to the radio. “We still can pick up the BBC, but there is hardly any news of Shanghai. The Japanese have blocked all transmissions from the local stations.”
“Of course.” Franz understood that the Japanese were obsessed with controlling communication. “And the ash falling from the sky? Do you know where that comes from?”
Lotte motioned to the ceiling. “From the tops of office buildings. People are burning all types of documents before the Japanese seize them.”
Sunny turned to Franz, her expression a blend of affection and apprehension. “Do you think it likely that you will have to leave again on business?”
He held her gaze for a long moment. “I wish I knew, Sunny. The next few days will tell, but yes, I think there is every chance I will have to go.”
Franz had trouble breaking off the eye contact, until he sensed Lotte’s gaze upon them. He forced a smile for his fiancée. Conflicted as he felt, he realized that his focus had to be on protecting his family. An idea occurred to him. “Sunny, I wonder if I could impose on you for an enormous favour?”
“Of course,” she said.
“I need to host a meeting tonight. A very private and discreet one.” He lowered his voice. “Even Esther and Hannah cannot attend. I wonder if you might find space in your home for them to spend the night?”