Jane ushered everyone out of the room. When Donnelly finished scrubbing his arms and hands, he glanced at Marie. “You won’t need that notebook,” he said. “I want you to scrub in.” She hadn’t realized she was going to take part in the surgery. He must be joking! She had no training. But the look on his face told her he was stone-cold serious.
While she concentrated on fastidiously cleaning her hands, Donnelly sterilized his instruments, including a pair of bone nippers, and the nurses administered anesthesia. Once he was out, but still breathing, Donnelly examined the patient’s chest.
“Don’t worry, Miss Chevreau. Nothing to it,” he quipped. Was he trying to put her at ease? Her heart was pounding out of her chest as a nurse fitted her with an oversized operating gown and cap. She took a deep breath to steady her nerves—and her hands.
“This is the second time I’ve operated on a patient’s beating heart, Miss Chevreau. The first was six months ago—a patient with a gunshot wound at the hospital. Bullet went straight through his heart and out his back. There wasn’t much to be done in that case. But this here . . .” His voice trailed off as he squatted down, placing himself at eye level with the man’s chest. “This might actually work.”
Marie stared at the bright red trickle pulsing from the wound just to the right of Adler’s left nipple. Donnelly must have read her mind. “With every beat, his pulse grows weaker and his skin grows colder. Knife, Jane.”
He made two sideways incisions next to the sternum—one along the third rib, the other along the sixth. He joined the parallel incisions with a vertical cut, creating a three-sided rectangle. Marie couldn’t believe it. Donnelly was either a genius or a madman—she hadn’t decided which. She held her breath as he lifted the flap of skin, tissue and muscle to expose the three ribs located directly over the heart.
Jane handed Donnelly the bone nippers, and Marie cringed at the snap-snap-snap of the three ribs being severed. Once the portions of bone were removed, he startled Marie again. “What do you see?” he asked.
She blinked, trying to regain her focus. “The pericardium.”
“Yes, and why is it bulging out?”
Marie hesitated, but then understood what he was asking. “It’s filling with blood from the damaged heart?”
Donnelly persisted. “And?”
“And . . .” Marie racked her brain for the answer, but it didn’t come. Her face felt hot and prickly.
Donnelly explained, without a hint of irritation, “The heart is trying to pump, but it’s battling against the pressure of the pericardium. We must relieve that pressure to allow the heart to pump and circulate blood more effectively.” With that, he pierced the pericardium wall with his knife and blood began to pour out. “Jane, sponge. Miss Chevreau, feel his pulse now.”
“Miss Chevreau?” When he called her name again, she felt for Adler’s carotid artery, but didn’t need to press hard. The pulse was strong, beautiful. “His heartbeat is improving every second.”
“Now for the tricky part. I need you to slowly and gently cup your hand around his heart,” he said, pronouncing each of his words distinctly. Marie was disturbed by the blood that continued to squirt with every beat of Tom Adler’s heart.
“Like this,” he demonstrated, cupping his palm around hers, shaping it into the form of a bird’s nest. “Do it now,” he commanded, his turquoise eyes trained on hers. Marie moved her hand under Adler’s heart, which was the size of a fist and surprisingly warm. She knew that if she truly thought about what she was doing, she would lose her nerve. She decided to pretend that it was a hatchling fallen from a tree, in need of her care.
This bird was more slippery than she’d ever imagined. She was afraid to ask what was next.
“Hold it firmly, but don’t squeeze too hard.” To do what he asked was nearly impossible—with each beat, the heart jumped in her hand. “Now”—Donnelly inhaled—“pull it up toward the chest opening, so I can examine it.”
She lifted the organ slowly, prepared to stop if she felt any resistance. She didn’t want to risk tearing any of the connective tissues. A sheen of moisture had formed on her forehead. She could only hope she didn’t look as terrified as she felt.
Donnelly pointed a finger at the laceration on the heart’s left ventricle wall. “From this chamber, the oxygen-rich blood exits the heart to move through the body.”
Marie understood. “So the blood was pouring out into the pericardium instead?”
“Exactly. Keep holding the heart steady, just like that,” he instructed. Before he even asked, Jane handed him the catgut thread and a curved needle. Stitch by delicate stitch, Donnelly repaired the sliced ventricle wall.
The entire time, Marie held Tom Adler’s heart in her hand. She expected it to suddenly seize or slow its pulsating, but it never did. On the contrary, his heartbeat grew stronger, and his feet changed color from a mottled purple to a healthier pink. After the last stitch, Donnelly instructed Marie to lower the heart back into its sac. When her hand was finally free, he shot her a knowing glance. “How’d that feel, Miss Chevreau?”
Marie released a sigh, finding it hard to believe what she’d just done. “Like the rush and tumble of a fifty-foot ocean wave.” Jane guided her over to the basin, where she washed the blood off her hands, watching it swirl and sink into the drain below.
“Indeed, but the difference is you’ll survive this—we all will.” Donnelly stitched up the incisions he’d made. “Isn’t that right, Mr. Adler?”
Though Adler was still unconscious, Marie believed Donnelly was right—that he would actually survive. When she returned to the table, she saw his fingers and lips were no longer blue, and his breathing was stronger. She placed a sympathetic hand on his shoulder, willing him to heal.
The operating room door opened, and Virginia, another nurse, appeared. “Dr. Donnelly, Miss O’Shea is on the telephone. Should I tell her you’ll ring her back?” she asked, frowning.
Donnelly didn’t look up. “No, thank you, Virginia. I’ll speak with her in a moment.” He carefully completed the stitches, placed the needle and thread back on the tray, and began to untie his operating gown. “All yours, Jane,” he said pleasantly.
Marie’s curiosity was piqued. Who was this Miss O’Shea, and why would Virginia tell Dr. Donnelly about her call in the middle of surgery?
Before he left the room, Donnelly turned and said, “Miss Chevreau, have your notes prepared by tomorrow morning. Tell the others you’ll be presenting at seven sharp.” Without another word, she was dismissed.
Notes? A comprehensive set of surgical notes would take a week, not an evening. Marie walked toward the front parlor, a bit dazed. Her peers rose hastily from their chairs.
“Well?” The Beaver craned his neck to catch Marie’s eye.
The Frog chimed in. “Is your hand cramping from all that writing?” he teased, and they all chuckled.
Marie smiled, unwilling to share her secret. She had held a man’s beating heart in her hand and helped save his life. Even their jeering couldn’t stop the rush of adrenaline. As they left for the day, she called out, “Seven in the morning sharp, gentlemen. Donnelly’s orders.”
A few hours later, after she’d written up some preliminary notes, Marie picked up her bag of books and headed up the lapis-carpeted stairs, now covered with specks of lint and dirt from the day’s traffic, into the first bedroom on the left. In the second of five beds, Marie came face to face with Tom Adler, just waking from his ordeal.
Jane and another nurse had bandaged the incisions, dressed him in warm woolen socks and covered him with blankets. They took care not to move him, instructing him to lie still and sleep. “You’ll need all your strength, Mr. Adler, to make a full recovery. Only water and laudanum—no food until tomorrow.”
Jane looked quizzically at Marie, who stood at the foot of the bed. “Oh,” Marie said self-consciously, “I’ve no wish to intrude, Jane. It’s just that I have to write up my notes, and I thought it would be easier to col
lect my thoughts if I sat with him until closing.”
Jane winked approvingly. “I told Donnelly you were the best of the lot. You did well today. Others would have fainted dead away if they’d had to hold a man’s heart in their hands.” With that remark, Adler’s eyes flew open and he looked to Jane for an explanation. “Oops,” she said. “You’re a sly one, Mr. Adler. I thought you were sleeping.” Jane hugged an extra blanket to her chest and grinned. “She’ll explain the whole procedure to you, won’t you, Marie?”
Left alone with the patient, Marie pulled a chair up to his bedside and rested a hand on his arm. “Mr. Adler, the knife penetrated a portion of your heart, and Dr. Donnelly had to repair it. I lifted your heart up, very gently, so he could evaluate the damage and stitch it up right fine.”
Adler’s eyes flitted down to his chest, back to Marie, then to the open door. He looked like a frightened child. Perhaps he wasn’t ready to hear all the details. She added cheerfully, “You were very lucky, Mr. Adler. Most doctors would have turned you away, thinking it was too risky to operate.”
“And let me die?” he asked hoarsely.
“Most don’t possess Dr. Donnelly’s knowledge or skill.” Marie poured water into a spoon, lifted Adler’s head with her hand, and brought it to his lips. “This will wet your throat a bit.”
He swallowed the cool water. “You’re a nurse?” He glanced at her—she was wearing her gray walking suit and ivory shirtwaist today.
“No, I’m a medical student, training to be a surgeon.”
“Naw, you’re far too pretty,” he flirted feebly. His dark eyelids closed in fatigue.
Marie placed a hand on his wrist to check his pulse: one hundred beats per minute—too high. “Thank you, Mr. Adler, but I think it’s best if you save your compliments for the ladies of your acquaintance who will undoubtedly be thrilled to hear you’re back on your feet. Now get some rest—you don’t want to disappoint them.”
Adler smiled weakly and drifted off to sleep.
Marie blinked at the blank sheet of paper, wondering how to describe the most incredible medical procedure she’d ever witnessed. She must keep her emotions in check, and detail only the diagnosis, treatment and the patient’s progress. Yet as her memories of the surgery flooded back and her pencil glided across the page, Marie felt positively euphoric. She was in the right place, doing exactly what she loved. Even though it was late, she decided to stay and keep working. When the night nurse came in, she nudged Marie, who’d fallen asleep in her chair. Marie tucked back a strand of hair that had fallen in her face, thinking she must look ghastly. “I’m so sorry. What time is it?”
“Three in the morning,” the nurse whispered, placing a finger to her lips and glancing at the other four patients in the room. “How is he?”
“Pulse was normal an hour ago, down from one hundred earlier.”
“Don’t pester him with questions when he wakes,” the nurse ordered. Marie still had to organize her notes into a report that she could present to Donnelly and her peers in four hours. As she shoved her papers into her bag, her stomach gurgled violently. Marie was ravenous. She would have sold her soul for a croissant and a cup of strong tea.
As she descended the stairs, Marie gazed up at the treads rising to the third floor. Was Donnelly sleeping soundly or reviewing the surgery in his mind, restless from yesterday’s excitement like her? Probably sleeping, Marie decided. He’d be used to this kind of thrill by now.
She walked toward the kitchen, which was located next to the operating room, hoping to find something hot to drink or a scrap of leftover food in the icebox. She didn’t dare leave the building in the middle of the night. In the larder, Marie found a paper bag containing remnants of day-old bread. She bit in, nearly breaking a tooth on the stale crust. She heated some water and rummaged around until she found a tea bag. Finally, Marie fanned out her notes on the small, square table where the nurses ate their lunches.
Marie hadn’t been this tired since Adeline had been awake nights teething. She tried to rub the blurriness from her eyes and focus on what she was going to emphasize when she presented her report in the morning.
“Ahem.” Marie lifted her head off her forearm and peeled her eyes open. “Good morning, Miss Chevreau,” Donnelly said, standing over her with an amused expression on his face.
Marie started when she saw him and then looked down at her notebook, the cold cup of tea and the sprinkling of breadcrumbs on her napkin. “I thought a mouse had stowed away in the kitchen,” he mused. “Imagine my relief to find it’s only one of my overworked students.” He was dressed in a fresh shirt and suit, and appeared clean-shaven and energetic. In fact, Marie had never seen any man look better.
“I’m so sorry,” she muttered as she ran her hands over her matted hair, then down her warm cheeks before folding them in her lap. She must look haggard, she thought, with a wave of embarrassment. Determined to keep the conversation brief, she inquired about the time.
“Six-thirty. Do you like coffee, Miss Chevreau?” he asked as he filled the kettle with water and set it on the stove.
He made coffee? “Ah, yes, thank you,” she replied self-consciously.
Donnelly scooped grounds from a tin and emptied them into the filter of an elegant French drip pot. She had noticed the house was filled with many nice things: oriental rugs, top-of-the-line surgical equipment, electric lighting and sparkling faucets with porcelain sinks and running water. His family must be wealthy, she guessed, because surgeons didn’t earn much. They were more likely to receive a turkey or a year’s worth of free laundry for a surgery than actual payment for their work. Maybe that was another benefit to running your own medical boarding house: you could pick and choose your patients.
Waiting for the kettle to boil, Donnelly leaned against the counter. “How’s your report coming along?”
Marie sat up and cleared her throat. What she really needed right now was a toothbrush and some powder. “It’s done.”
His brow scrunched. “You were here through the night?”
She stacked her papers and books neatly to make room for Donnelly at the table. “I thought it would be easier to determine the patient’s progress if I were actually witnessing the patient’s progress.”
“Good idea. When’s the last time you saw him?”
“Three and a half hours ago. How is he now?” She knew Donnelly wouldn’t have been able to pass the second floor this morning without checking in on his prize patient.
“Excellent. He’s alert, vitals are good and pulse is back to normal. Today we’ll start him on some broth and lime-water.” Donnelly paused, his sea-green eyes searching hers. “Are you tired?”
Marie shrugged. “I suppose, but I’m used to staying up.” She almost slipped and said when my daughter was a baby, but caught herself. “As a midwife, my services were often required during the night.”
Before he could respond, the kettle began to squeal. Donnelly removed it from the stove and poured water into the drip pot. “I subscribe to the Creoles’ assertion that coffee promotes longevity, Miss Chevreau. I simply can’t do without.” He smiled brightly. Marie found herself admiring his white teeth.
She wondered whether he had a kitchen in his third-floor apartment. She’d rummaged through the cabinets last night and was certain there was nothing to eat here. “Do you eat breakfast?” she asked.
“Of course,” Donnelly said, checking his pocket watch. “As a matter of fact, Virginia just ran out to fetch some. Free, fresh beignets are just one of the perks of having relieved the baker of his colitis last month.”
Marie narrowed her eyes and tipped her head. “I never thought I’d hear the words ‘beignet’ and ‘colitis’ in the same sentence, but thank you for that.”
Donnelly’s laugh was unexpectedly loud and infectious. Marie found herself trying to puzzle out this enigma of a man, who sliced people open for a living, yet made his own coffee and was always beautifully turned-out, even beneath his linen surgical go
wn. His wavy brown hair was neatly trimmed, and this morning he wore a navy blue worsted wool suit with a high-collared shirt and gray tie. Not a thread was out of place. On a regular day, Marie knew she was fairly attractive, but this morning her hair was disheveled, her dress creased and her eyes probably lined with dark circles. She couldn’t wait to escape to find a looking glass. However, when Donnelly placed a piping hot mug of coffee before her, she couldn’t resist. She would stay a few more minutes before excusing herself to freshen up.
Virginia arrived, announcing, “Hot beignets!” When she spied Marie, she seemed surprised. “Miss Chevreau, whatever are you doing here?”
“Oh, well . . .” Marie blushed, but Donnelly interrupted.
“I came upon Miss Chevreau here in the kitchen, hard at work outlining the particulars of yesterday’s heart surgery. I’m a bit of a taskmaster, but I’m sure that if Miss Chevreau has any questions, you’d be happy to advise her, wouldn’t you, Virginia?”
“Of course,” Virginia said as she handed the bag to Donnelly.
The scent of sugared pastry filled the room, and Marie cleared her throat to mask the sound of her stomach rumbling. “Thanks, Virginia,” Donnelly said as he sprang up to retrieve two plates from the cabinet. “We’ll see you later tonight.” The nurse nodded and ducked out.
“I’d like to ask you a favor today,” he ventured. “When you’re relaying the details of the heart surgery to your classmates, I’d prefer if you didn’t mention your role.” He threw her a sideways glance. “I doubt the faculty at the college would approve.” He bit into a beignet.
Marie was bewildered. “Wouldn’t approve because I’m a woman?”
He looked at her strangely while he finished chewing. He dabbed a napkin to his mouth. “No. Wouldn’t approve because you’re a first-year medical student. It’s unorthodox.”
Another sip of coffee chased away the mossy sensation in her mouth. “Then why did you ask me to assist?”
The California Wife Page 24
