and would seem foolish and laughable in hindsight. Perhaps.
Nevertheless, entering the operating theater at George's side, she
wondered if her hands would shake. A surgeon's hands must never shake.
The operating room was all white and aqua tile, filled with gleaming
chrome-plated and stainless-steel equipment. Nurses and an
anesthesiologist were preparing the patient.
Johnny O'Day lay on the cruciform operating table, arms extended, palms
up and wrists exposed for the intravenous spikes.
Agatha Tandy, a private surgical technician who was employed by George
rather than by the hospital, stretched thin latex gloves over her boss's
freshly scrubbed hands, then over Ginger's hands as well.
The patient had been anesthetized. He was orange with iodine from the
neck to the wrist, swathed in neatly tucked and folded layers of green
cloth from the hips down. His eyes were taped shut to keep them from
drying out. His breathing was slow but regular.
A portable tape deck with stereo speakers was on a stool in one corner.
George preferred to cut to the accompaniment of Bach, and that calming
music now filled the room.
It may have calmed the others, but today it did not calm Ginger. A
secret scurrying something spun a web of ice in her stomach.
Hannaby positioned himself at the table. Agatha stood at his right side
with an elaborately ordered tray of instruments. The circulating nurse
waited to fetch whatever might be required from the cabinets along one
wall. An assisting nurse with large gray eyes noticed an errant flap of
green sheeting and quickly tucked it into place around the patient's
body. The anesthesiologist and his nurse were at the head of the table,
monitoring the IV and the EKG. Ginger moved into position. The team
was ready.
Ginger looked at her hands. They were not shaking.
Inside, though, she was all aquiver.
In spite of her sense of impending disaster, the surgery went smoothly.
George Hannaby operated with quickness, sureness, dexterity, and skill
that were even more impressive than usual. Twice, he stepped aside and
requested that Ginger complete a part of the procedure.
Ginger surprised herself by functioning with her customary sureness and
speed, her fear and tension revealed only by a tendency to perspire more
than usual. However, the nurse was always there to blot her brow.
Afterward, at the scrub sink, George said, "Like clockwork."
Soaping her hands under the hot water, she said, "You always seem so
relaxed, as if . . . as if you weren't a surgeon at all . . . as
if you were just a tailor altering a suit of clothes."
"I may seem that way," he said, "but I'm always tense.
That's why I play Bach." He finished washing up. "You were very tense
today."
"Yes," she admitted.
"Exceptionally tense. It happens." Big as he was, he sometimes seemed
to have the eyes of a sweet, gentle child. "The important thing is that
it didn't affect your skill. You were as smooth as ever. First ' rate.
That's the key. You've got to use tension to your advantage."
"I guess I'm learning."
He grinned. "As usual, you're being too hard on yourself. I'm proud of
you, kid. For a while there, I thought maybe you'd have to give up
medicine and earn your living as a meat cutter in a supermarket, but now
I know you'll make it."
She grinned back at him, but the grin was counterfeit. She had been
more than tense. She had been seized by a cold, black fear that might
easily have overwhelmed her, and that was much different from a healthy
tension. That fear was something she had never felt before, something
that she knew George Hannaby had never felt in his life, not in an
operating room. If it continued, if the fear became a constant
companion during surgery and would not be dispelled ... what then?
At ten-thirty that evening, when she was reading in bed, the phone rang.
It was George Hannaby. If the call had come earlier, she'd have
panicked and assumed that Johnny O'Day had taken a serious turn for the
worse, but now she had regained her perspective. "So sorry. Missy
Weiss not home. I no speak the English. Call back next April, please."
"If that's supposed to be a Spanish accent," George said, "it's
atrocious. If it's supposed to be Oriental, it's merely terrible. Be
thankful you chose medicine as a career instead of acting."
"You, on the other hand, would've done well as a drama critic."
"I do have the refined and sensitive perspective, the cool judgment and
unerring insight of a first-rate critic, don't I?
Now shut up and listen: I've got good news. I think you're ready,
smart-ass."
"Ready? For what?"
"The big time. An aortal graft," he said.
"You mean . . . I wouldn't just assist you? Do it entirely myself?"
"Chief surgeon for the entire procedure."
"Aortal graft?"
"Sure. You didn't specialize in cardiovascular surgery just to perform
appendectomies for the rest of your life."
She was sitting straight up in bed now. Her heart was beating faster,
and she was flushed with excitement. "When?"
"Next week. There's a patient checking in this Thursday or Friday.
Name's Fletcher. We'll go over her file together on Wednesday. If
things proceed according to schedule, I would think we'd be ready to
cut'on Monday morning. Of course, you'll be responsible for scheduling
all the final tests and making the decision to go ahead."
"Oh, God."
"You'll do fine."
:'You'll be with me."
'I'll assist you . . . if you feel you need me for anything."
"And you'll take over if I start to screw up." "Don't be silly. You
won't screw up- "
She thought about it a moment, then said, "No. I won't screw up."
"That's my Ginger. You can do whatever you set your mind to."
"Even ride a giraffe to the moon."
"What?"
"Private joke."
"Listen, I know you came close to panic this afternoon, but don't worry.
All residents experience that. Most have to deal with it early, when
they begin to assist in the surgery. They call it The Clutch. But
you've been cool and collected from the start, and I'd finally decided
you'd never clutch up like the rest of them. Today, at last you did.
The Clutch just came later for you than for most. And though I imagine
you're still worried about it, I think you should be glad it happened.
The Clutch is a seasoning experience. The important thing is that you
dealt with it superbly."
"Thanks, George. Even better than a drama critic, you'd have made a
good baseball coach."
Minutes later, when they concluded their conversation and hung up, she
fell back against the pillows again and hugged herself and felt so fine
that she actually giggled. After a while she went to the closet and dug
around in there until she located the Weiss family photograph album. She
brought it back to bed and sat for a time, paging through the pictures
of Jacob and Anna, for although she could not share her triumphs with
&n
bsp; them any more, she needed to feel that they were close.
Later still, in the dark bedroom, as she lay balanced on the thin edge
of wakefulness, she finally understood why she had been frightened this
afternoon. She had not been seized by The Clutch. Although she had not
been able to admit it until now, she had been afraid that, in the midst
of surgery, she would black out, plummet into a state of fugue, as she
had done that Tuesday, two weeks ago. If an attack came while she held
a scalpel, while she was doing delicate cutting, or while stitching in a
vascular graft ...
That thought brought her eyes wide open. The creeping form of sleep
retreated like a thief caught in the middle of a burglary. For a long
time she lay there, stiff, staring at the dark and newly ominous shapes
of the bedroom furniture and at the window, where incompletely drawn
draperies revealed a band of glass silvered by a fall of moonlight and
by the rising beams of streetlamps below.
Could she accept the responsibility of chief surgeon on an aortal graft?
Her seizure had surely been a one-time occurrence. It would never
happen again. Surely not. But did she dare test that theory?
Sleep crept back again and claimed her, though not for hours.
Tuesday, after a successful trip to Bernstein's Delicatessen, much food,
and several lazy hours in an easy chair with a good book, her
self-confidence was knit up again, and she began to look forward to the
challenge ahead, with only an ordinary degree and kind of apprehension.
On Wednesday, Johnny O'Day continued to recover from his triple bypass
and was in high spirits. This was what made the years of study and hard
work worthwhile: preserving life, relieving suffering, bringing hope and
happiness to those who had known despair.
She assisted in a pacemaker implantation that went without a hitch, and
she performed an aortagram, a dye test on a patient's circulation. She
also sat in with George while he examined seven people who had been
referred to him by other physicians.
When all the new patients had been seen, George and Ginger huddled for
half an hour over the file of the candidate for the aortal graft-a
fifty-eight-year-old woman, Viola Fletcher. After studying the file,
Ginger decided she wanted Mrs. Fletcher admitted to Memorial on
Thursday for testing and preparation. If there were no
counterindications, surgery could take place first thing Monday morning.
George agreed, and all the necessary arrangements were made.
Thus Wednesday progressed, always busy, never dull. By six-thirty she
had put in a twelve-hour day, but she was not tired. In fact, although
she had nothing to keep her at the hospital, she was reluctant to leave.
George Hannaby was home already. But Ginger hung around, chatting with
patients, double-checking charts, until at last she went to George's
office, where she intended to look again at Viola Fletcher's file.
The professional offices were in the back wing of the building, separate
from the hospital itself. At that hour the corridors were virtually
deserted. Ginger's rubber-soled shoes squeaked on the highly polished
tile floors. The air smelled of pine-scented disinfectant.
George Hannaby's waiting room, examining rooms, and private office were
dark and quiet, and Ginger did not switch on all the lights as she moved
through the outer rooms into the inner sanctum. There, she snapped on
only the desk lamp as she passed it on her way to the file-room door,
which was locked. George had given her keys to everything, and in a
minute she had withdrawn Viola Fletcher's records from the cabinet and
returned with them to George's desk.
She sat down in the big leather chair, opened the folder in the pool of
light from the desk lamp-and only then noticed an object that riveted
her attention and caused her breath to catch in her throat. It lay on
the green blotter, along the curvature of light: a hand-held
ophthalmoscope, an instrument used to examine the interior of the eye.
There was nothing unusual-certainly nothing ominous-about the
ophthalmoscope. Every doctor used such an instrument during a routine
physical examination. Yet the sight of this one not only inhibited her
breathing but filled her with a sudden sense of terrible danger.
She had broken out in a cold sweat.
Her heart was hammering so hard, so loud, that the sound of it seemed to
come not from within but without, as if a parade drum was thumping in
the street beyond the window.
She could not take her eyes off the ophthalmoscope. As with the black
gloves in Bernstein's Delicatessen more than two weeks ago, all other
objects in George's office began to fade, until the shining instrument
was the only thing that she could see in any detail. She was aware of
every tiny scratch and minute nick on its handle. Every humble feature
of its design seemed abruptly and enormously important, as if this Were
not a doctor's ordinary tool but the linchpin of the universe, an arcane
instrument with the potential for catastrophic destruction.
Disoriented, suddenly made claustrophobic by a heavy, insistent,
pressing mantle of irrational fear that had descended over her like a
great sodden cloak, she pushed the chair away from the desk and stood
up. Gasping, whimpering, she felt suffocated yet chilled to the bone at
the same time.
The shank of the ophthalmoscope glistened as if made of ice.
The lens shone like an iridescent and chillingly alien eye. Her resolve
to stand fast now swiftly melted, even as her heart seemed to freeze
under the cold breath of terror. Run or die, a voice said Within her.
Run or die. A cry escaped her, and it sounded like the tortured appeal
of a lost and frightened child.
She turned from the desk, stumbled around it, almost fell over a chair.
She crossed the room, burst into the outer office, fled into the
deserted corridor, keening shrilly, seeking safety, finding none. She
wanted help, a friendly face, but she was the only person on the floor,
and the danger was closing in. The unknown threat that was somehow
embodied in the harmless ophthalmoscope was drawing nearer, so she ran
as fast as she could, her footsteps booming along the hallway.
Run or die.
The mist descended.
Minutes later, when the mist cleared, when she was again aware of her
surroundings, she found herself in the emergency stairwell at the end of
the office wing, on a concrete landing between floors. She could not
remember leaving the office corridor and taking to the stairs. She was
sitting on the landing. squeezed into the corner, her back pressed to
the cinderblock wall, staring out at the railing along the far side of
the steps. A single bare bulb burned behind a wire basket overhead. To
her left and right, flights of stairs led up and down into shadow before
coming to other lighted landings. The air was musty and cool. If not
for her ragged breathing, silence would have ruled.
It was a lonely place, especially when your life was coming apart at the
seams and you ne
eded the reassurance of bright lights and people. The
gray walls, stark light, looming shadows, the metal railing . The place
seemed like a reflection of her own despair.
Her wild flight and whatever other bizarre behavior she exhibited in her
inexplicable fugue had evidently not been seen, or she would not now be
alone. At least that was a blessing. At least no one knew.
She knew, however, and that was bad enough.
She shivered, not entirely from fear, for the mindless terror that had
gripped her was gone. She shivered because she was cold, and she was
cold because her clothes clung to her, damp, soaked with sweat.
She raised one hand, wiped her face.
She rose, looked up the stairwell, then down. She did not know whether
she was above or below the floor on which George Hannaby had his office.
After a moment she decided to go up.
Her footsteps echoed eerily.
For some reason, she thought of tombs.
"Meshuggene, " she said shakily.
It was November 27.
6.
Chicago, Illinois
The first Sunday morning in December was cold, under a low gray sky that
promised snow. By afternoon the first scattered flakes would begin to
fall, and by early evening the city's grimy face and soiled skirts would
be temporarily concealed
Koontz, Dean R. - Strangers Page 6
