What was in the room with him?
The noise grew louder: shouting, hammering, a crash followed by a
clatter-rattle of wood, more shouting, and another crash.
Still groggy from sleep, his senses distorted by hysteria and excess
adrenaline, Dom was convinced that the thing from which he had been
hiding had at last come for him. He had tried to fool it by sleeping in
closets and behind the furnace. But tonight it would not be deceived: it
meant to have him; he could hide no longer; the end had come.
From the darkness, someone or something shouted his name-"Dom!"-and he
realized that someone had been calling to him for the last minute or
two, maybe longer.
"Dominick, answer me!"
Another'shuddering crash. The brittle crack of splintering wood.
Huddling in the corner, Dom finally woke completely. The clammy
creature had not been real. A figment of a dream. He recognized the
voice calling to him as that of Parker Faine. Even as the residual
hysteria of his nightmare subsided, another crash, the loudest of all,
generated a chain-reaction of destruction, a
crackling-sliding-scraping-toppling-crashingbooming-clattering-rattling
that culminated with the opening of a door and the intrusion of light
into the darkness.
Dom squinted against the glare and saw Parker silhouetted like some
hulking troll in the bedroom door, the hall light behind him. The door
had been locked, and Parker had forced it, had thrown himself against it
until the lock disintegrated.
"Dominick, buddy, are you okay?"
The door had been barricaded as well, which had made entrance even more
difficult. Dom saw that, in his sleep, he had evidently moved the
dresser in front of the door, had stacked the two nightstands atop the
dresser, and had put the bedroom armchair in front of it. Those
overturned pieces of furniture now lay on the floor in a jumbled heap.
Parker stepped into the room. "Buddy? Are you all right?
You were screaming. I could hear you clear out in the driveway."
"A dream."
"Must've been a lulu."
"I can't remember what it was," Dom said, remaining on the floor, in the
corner, too exhausted and weak-kneed to get up. "You're a sight for
sore eyes, Parker. But ... what on earth are you doing here?"
Parker blinked. "Don't you know? You phoned me. Not more than ten
minutes ago. You were shouting for help. You said they were here and
were going to get you. Then you hung up."
Dom felt humiliation settle over him as if it were a painful burn.
"Ah, so you did make the call in your sleep," the painter said. "Thought
as much. You sounded ... not yourself. Maybe I should've called the
police, but I suspected this sleepwalking thing. Knew you wouldn't want
it brought into the open in front of strangers, a bunch of cops."
"I'm out of control, Parker. Something's . . . snapping inside me."
"That's enough of that crap. I won't listen to any more of it."
Dom felt like a helpless child. He was afraid he was going to cry. He
bit his tongue, squeezed back the tears, cleared his throat, and said,
"What time is it?"
"A few minutes after four. Middle of the night." Parker looked toward
the window and frowned.
Following the other man's gaze, Dom saw that the draperies were drawn
tight shut and that the highboy had been moved in front of the window,
barring entrance by that route. He had been busy in his sleep.
"Oh, Christ," Parker said, moving to the bed, where he stopped, a vivid
expression of shock on his broad face. "This is no good, my friend.
This is no good at all."
Holding on to the wall, Dom rose shakily to his feet to see what Parker
was talking about, but when he saw it, he wished he had remained on the
floor. An arsenal was laid out on the bed: the .22 automatic that he
usually kept in his nightstand; a butcher's knife; two other meat
knives; a cleaver; a hammer; the ax he used for splitting firewood and
which, the last he remembered, had been in the garage.
Parker said, "What were you expecting-a Soviet invasion? What frightens
you so?"
"I don't know. Something in my nightmares."
"So what do you dream about?"
"I don't know."
"You can't remember any of it?"
"No." He shivered again, violently.
Parker came to him, put a hand on his shoulder. "You better take a
shower, get dressed. I'll start rustling up some breakfast. Okay? Then
I . . . I think we'd better pay a visit to that doctor of yours as
soon as his office opens. I think he's got to take a second look at
you."
Dominick nodded.
It was December 2.
December 2-December 16
Boston, Massachusetts
Viola Fletcher, a fifty-eight-year-old elementary-school teacher, mother
of two daughters, wife of a devoted husband, a wry and witty woman with
an infectious laugh, was silent now and still, lying on the operating
table, unconscious, her life in Dr. Ginger Weiss's hands.
Ginger's entire life had been a funnel, focusing on this moment: for the
first time, she was assuming the senior surgeon's role in a major and
complicated procedure . Years of arduous education, an immeasurable
weight of hopes and dreams, lay behind her ascension to this moment. She
had a prideful yet humbling sense of just how great a distance her
journey had covered.
And she was half sick with dread.
Mrs. Fletcher had been anesthetized and draped in cool green sheets.
None of the patient's body was visible except that portion of her torso
on which surgery would be performed, a neat square of flesh painted with
iodine and framed by lime-colored cloth. Even her face was out of sight
beneath tented sheeting, as an added precaution against airborne
contamination of the wound that would shortly be made in her abdomen.
The effect was to depersonalize the patient, and perhaps that was in
part the intent of the draping, as well, thereby sparing the surgeon the
need to look upon the human face of agony and death if, God forbid,-his
skill and education should fail him.
On Ginger's right, Agatha Tandy, the surgical technician, stood ready
with spreaders, rakes, hemostats, scalpels, and other instruments. On
her left, a scrub nurse was prepared to assist. Another scrub nurse,
the circulating nurse, the anesthesiologist, and his nurse also waited
for the procedure to begin.
George Hannaby stood on the other side of the table, looking less like a
doctor than like the former star fullback on a pro football team. His
wife, Rita, had once talked him into playing Paul Bunyan in a comedy
sketch for a hospital charity show, and he had appeared at home in
woodsman's boots, jeans, and a red plaid shirt. He brought with him an
aura of strength, calmness, and competency that was most reassuring.
Ginger held out her right hand.
Agatha put a scalpel in it.
A keen, thin, bright curve of light outlined the razor-sharp edge of the
instrument.
Hand poised over the score lines on the patient's to
rso, Ginger
hesitated and took a deep breath.
George's stereo tape deck stood on a small table in the corner, and
familiar strains of Bach issued from the speakers.
She was remembering the ophthalmoscope, the shiny black gloves. . . .
However, as frightening as those incidents had been, they had not
utterly destroyed her self-confidence. She had felt fine ever since the
most recent attack: strong, alert, energetic. If she had noticed the
slightest weariness or fuzzy-mindedness, she would have canceled this
procedure. On the other hand, she had not acquired her education, had
not worked seven days a week all these years, only to throw away her
future because of two aberrant moments of stress-related hysteria.
Everything was going to be fine, just fine.
The wall clock said seven-forty-two. Time to get on with it.
She made the-first cut. With hemostats and clamps and a faultless skill
that always surprised her, she moved deeper, constructing a shaft
through skin, fat, and muscle, into the center of the patient's belly.
Soon the incision was large enough to accommodate both her hands and
those of her assisting physician, George Hannaby, if his help should be
required. The scrub nurses moved close to the table, one on each side,
grasped the sculpted handles of the retractors, and pulled back gently
on them, drawing apart the walls of the wound.
Agatha Tandy picked up a fluffy, absorbent cloth and quickly blotted
Ginger's forehead, careful to avoid the jeweler's lenses that protruded
from her operating glasses.
Above his mask, George's eyes squinted in a smile. He was not sweating.
He seldom did.
Ginger swiftly tied off bleeders and removed clamps, and Agatha ordered
new supplies from the circulating nurse.
In the brief blank spaces between Bach's concertos and in the silence at
the end of the tape before it was turned over, the loudest sounds in the
tile-walled room were the sibilant exhalations and groaning inhalations
of the artificial lung machine that breathed for Viola Fletcher. The
patient could not breathe for herself because she was paralyzed by a
curarederived muscle relaxant. Though entirely mechanical, those sounds
possessed a haunting quality that made it impossible for Ginger to
overcome her apprehension.
On other days, when George cut, there was more talk. He traded quips
with the nurses and the assisting resident, using light banter to reduce
the tension without also reducing concentration on the vital task at
hand. Ginger was simply not up to that sort of dazzling performance,
which seemed akin to playing basketball, chewing gum, and solving
difficult mathematical problems at the same time.
Having completed the excursion into the belly, she ran the colon with
both hands and determined that it was healthy. With damp gauze pads
provided by Agatha, Ginger cradled the intestines, placed the hoe-like
blades of the retractors against them, and turned them over to the scrub
nurses, who held them out of the way, thus exposing the aorta, the main
trunkline of the body's arterial system.
From the chest, the aorta entered the belly through the diaphragm,
running parallel to the spine. Immediately above the groin, it split
into two iliac arteries leading to the femoral arteries in the legs.
"There it is," Ginger said. "An aneurysm. Just like in the X rays." As
if to confirm it, she glanced at the patient's X ray that was fixed on
the light screen,'on the wall at the foot of the operating table. "A
dissecting aneurysm, just above the aortic saddle."
Agatha blotted Ginger's forehead.
The aneurysm, a weakness in the wall of the aorta, had permitted the
artery to bulge outward on both sides, forming a dumbbell-shaped
extrusion full of blood, which beat like a second heart. This condition
caused difficulty in swallowing, extreme shortness of breath, severe
coughing, and chest pains; and if the bulging vessel burst, death
followed swiftly.
As Ginger stared at the pulsing aneurysm, an almost religious sense of
mystery overcame her, a profound awe, as if she had stepped out of the
real world into a mystic sphere, where the very meaning of life was soon
to be revealed to her. Her feeling of power, of transcendence, rose
from the realization that she could do battle with death-and win. Death
was lurking there in the body of her patient right now, in the form of
the throbbing aneurysm, a dark bud waiting to flower, but she had the
skill and training to banish it.
From a sterile package, Agatha Tandy had taken a section of artificial
aorta-a thick, ribbed tube that split into two smaller tubes, the iliac
arteries. It was woven entirely of Dacrol. Ginger positioned it over
the wound, trimmed it to fit with a pair of small sharp scissors, and
returned it to the technician. Agatha put the white graft in a shallow
stainlesssteel tray that already contained some of the patient's blood,
and swished it back and forth to wet it thoroughly.
The graft would be allowed to soak until it had clotted a bit. Once it
was installed in the patient, Ginger would run some blood through it,
clamp it, allow that blood to clot a bit more, then flush it out before
actually sewing it in place. The thin layer of clotted blood would help
prevent seepage, and in time the steady flow of blood would form a
neointima, a leak-proof new lining virtually indistinguishable from that
in a real artery. The amazing thing was that the Dacron vessel was not
merely an adequate substitute for the damaged section of aorta but was,
in fact, actually superior to what nature had provided; five hundred
years from now, when nothing remained of Viola Fletcher but dust and
time-worn bones, the Dacron graft would still be intact, still flexible
and strong.
Agatha blotted Ginger's forehead.
"How do you feel?" George asked.
"Fine," Ginger said.
"Tense?"
"Not really," she lied.
He said, "It's a genuine pleasure watching you work, Doctor."
"I'll second that," said one of the scrub nurses.
"Me, too," the other said.
"Thanks," Ginger said, surprised and pleased.
George said, "You have a certain grace in surgery, a lightness of touch,
a splendid sensitivity of hand and eye that is, I'm sorry to say, not at
all common in the profession."
Ginger knew that he never gave voice to an insincere compliment, but
coming from such a stern taskmaster, this bordered on excessive
flattery. By God, George Hannaby was proud of her! That realization
flooded her with warm emotion. If she had been anywhere but in an
operating room, tears would have come to her eyes, but here she kept a
tighter rein on her feelings. However, the intensity of her reaction to
his words made her aware of how completely he had filled the role of
father-figure in her life; she took nearly as much satisfaction from his
praise as she would have taken if it had come from Jacob Weiss himself.
Ginger proceeded with the operation in better spirits. The disturbing
&
nbsp; possibility of a seizure slowly receded from her thoughts, and greater
confidence allowed her to work with even more grace than before. Nothing
could go wrong now.
She set about methodically controlling the flow of blood through the
aorta, carefully exposing and temporarily clamping all branching
vessels, using thin elastic loops of extremely pliable plastic tubing to
valve off the smaller vessels, placing mosquito clamps and bulldog
clamps on the larger arteries, including the iliacs and the aorta
itself. In little less than an hour, she had stopped all blood flow
through the aorta to the patient's legs, and the throbbing aneurysm had
ceased its mocking imitation of the heart.
With a small scalpel, she punctured the aneurysm, releasing a pool of
blood; the aorta deflated. She sliced it open along its anterior wall.
At that moment, the patient was without an aorta, more helpless and more
dependent upon the surgeon than at any other time. There was no going
back now. From this point on, the operation must be conducted not only
with the greatest care but with the most prudent speed.
A hush had fallen on the surgical team. What little conversation there
had been now ceased. The Bach tape had reached the end again, and no
one moved to turn it over. Time was measured by the wheezing and sucking
Koontz, Dean R. - Strangers Page 9
