Under the Knife

by Tess Gerritsen

  The sound of his crying floated on the wind, over the crowded dock, to the distant spot where Kate was standing. Alone and ignored, she lingered by the row of tethered fishing boats and wondered why she was here. Was it some cruel and self-imposed form of penance? A feeble attempt to tell the world she was sorry? She only knew that some inner voice, begging for forgiveness, had compelled her to come.

  There were others here from the hospital: a group of nurses, huddled in a quiet sisterhood of mourning; a pair of obstetricians, looking stiffly uneasy in their street clothes; Clarence Avery, his white hair blowing like dandelion fuzz in the wind. Even George Bettencourt had made an appearance. He stood apart, his face arranged in an impenetrable mask. For these people, a hospital was more than just a place of work; it was another home, another family. Doctors and nurses delivered each other’s babies, presided over each other’s deaths. Ellen O’Brien had helped bring many of their children into the world; now they were here to usher her out of it.

  The far-off glint of sunlight on fair hair made Kate focus on the end of the pier where David Ransom stood, towering above the others. Carelessly he pushed a lock of windblown hair into place. He was dressed in appropriately mournful attire—a charcoal suit, a somber tie—but in the midst of all this grief, he displayed the emotions of a stone wall. She wondered if there was anything human about him. Do you ever laugh or cry? Do you ever hurt? Do you ever make love?

  That last thought had careened into her mind without warning. Love? Yes, she could imagine how it would be to make love with David Ransom: not a sharing but a claiming. He’d demand total surrender, the way he demanded surrender in the courtroom. The fading sunlight seemed to knight him with a mantle of unconquerability. What chance did she stand against such a man?

  Wind gusted in from the sea, whipping sailboat halyards against masts, drowning out the minister’s final words. When at last it was over, Kate found she didn’t have the strength to move. She watched the other mourners pass by. Clarence Avery stopped, started to say something, then awkwardly moved on. Mary and Patrick O’Brien didn’t even look at her. As David approached, his eyes registered a flicker of recognition, which was just as quickly suppressed. Without breaking stride, he continued past her. She might have been invisible.

  By the time she finally found the energy to move, the pier was empty. Sailboat masts stood out like a row of dead trees against the sunset. Her footsteps sounded hollow against the wooden planks. When she finally reached her car, she felt utterly weary, as though her legs had carried her for miles. She fumbled for her keys and felt a strange sense of inevitability as her purse slipped out of her grasp, scattering its contents across the pavement. She could only stand there, paralyzed by defeat, as the wind blew her tissues across the ground. She had the absurd image of herself standing here all night, all week, frozen to this spot. She wondered if anyone would notice.

  David noticed. Even as he waved goodbye and watched his clients drive away, he was intensely aware that Kate Chesne was somewhere on the pier behind him. He’d been startled to see her here. He’d thought it a rather clever move on her part, this public display of penitence, obviously designed to impress the O’Briens. But as he turned and watched her solitary walk along the pier, he noticed the droop of her shoulders, the downcast face, and he realized how much courage it had taken for her to show up today.

  Then he reminded himself that some doctors would do anything to head off a lawsuit.

  Suddenly disinterested, he started toward his car. Halfway across the parking lot, he heard something clatter against the pavement and he saw that Kate had dropped her purse. For what seemed like forever, she just stood there, the car keys dangling from her hand, looking for all the world like a bewildered child. Then, slowly, wearily, she bent down and began to gather her belongings.

  Almost against his will, he was drawn toward her. She didn’t notice his approach. He crouched beside her, scooped a few errant pennies from the ground, and held them out to her. Suddenly she focused on his face and then froze.

  “Looks like you need some help,” he said.

  “Oh.”

  “I think you’ve got everything now.”

  They both rose to their feet. He was still holding out the loose change, of which she seemed oblivious. Only after he’d deposited the money in her hand did she finally manage a weak “Thank you.”

  For a moment they stared at each other.

  “I didn’t expect to see you here,” he remarked. “Why did you come?”

  “It was—” she shrugged “—a mistake, I think.”

  “Did your lawyer suggest it?”

  She looked puzzled. “Why would he?”

  “To show the O’Briens you care.”

  Her cheeks suddenly flushed with anger. “Is that what you think? That this is some sort of—of strategy?”

  “It’s not unheard of.”

  “Why are you here, Mr. Ransom? Is this part of your strategy? To prove to your clients you care?”

  “I do care.”

  “And you think I don’t.”

  “I didn’t say that.”

  “You implied it.”

  “Don’t take everything I say personally.”

  “I take everything you say personally.”

  “You shouldn’t. It’s just a job to me.”

  Angrily, she shoved back a tangled lock of hair. “And what is your job? Hatchet man?”

  “I don’t attack people. I attack their mistakes. And even the best doctors make mistakes.”

  “You don’t need to tell me that!” Turning, she looked off to sea, where Ellen O’Brien’s ashes were newly drifting. “I live with it, Mr. Ransom. Every day in that O.R. I know that if I reach for the wrong vial or flip the wrong lever, it’s someone’s life. Oh, we find ways to deal with it. We have our black jokes, our gallows humor. It’s terrible, the things we laugh about, and all in the name of survival. Emotional survival. You have no idea, you lawyers. You and your whole damned profession. You don’t know what it’s like when everything goes wrong. When we lose someone.”

  “I know what it’s like for the family. Every time you make a mistake, someone suffers.”

  “I suppose you never make mistakes.”

  “Everyone does. The difference is, you bury yours.”

  “You’ll never let me forget it, will you?”

  She turned to him. Sunset had painted the sky orange, and the glow seemed to burn in her hair and in her cheeks. Suddenly he wondered how it would feel to run his fingers through those wind-tumbled strands, wondered what that face would feel like against his lips. The thought had popped out of nowhere and now that it was out, he couldn’t get rid of it. Certainly it was the last thing he ought to be thinking. But she was standing so dangerously close that he’d either have to back away or kiss her.

  He managed to hold his ground. Barely. “As I said, Dr. Chesne, I’m only doing my job.”

  She shook her head and her hair, that sun-streaked, mahogany hair, flew violently in the wind. “No, it’s more than that. I think you have some sort of vendetta. You’re out to hang the whole medical profession. Aren’t you?”

  David was taken aback by her accusation. Even as he started to deny it, he knew she’d hit too close to home. Somehow she’d found his old wound, had reopened it with the verbal equivalent of a surgeon’s scalpel. “Out to hang the whole profession, am I?” he managed to say. “Well, let me tell you something, Doctor. It’s incompetents like you that make my job so easy.”

  Rage flared in her eyes, as sudden and brilliant as two coals igniting. For an instant he thought she was going to slap him. Instead she whirled around, slid into her car and slammed the door. The Audi screeched out of the stall so sharply he had to flinch aside.

  As he watched her car roar away, he couldn’t help regretting those unnecessarily brutal words. But he’d said them in self-defense. That perverse attraction he’d felt to her had grown too compelling; he knew it had to be severed, right there and then.<
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  As he turned to leave, something caught his eye, a thin shaft of reflected light. Glittering on the pavement was a silver pen; it had rolled under her car when she’d dropped her purse. He picked it up and studied the engraved name: Katharine Chesne, M.D.

  For a moment he stood there, weighing the pen, thinking about its owner. Wondering if she, too, had no one to go home to. And it suddenly struck him, as he stood alone on the windy pier, just how empty he felt.

  Once, he’d been grateful for the emptiness. It had meant the blessed absence of pain. Now he longed to feel something—anything—if only to reassure himself that he was alive. He knew the emotions were still there, locked up somewhere inside him. He’d felt them stirring faintly when he’d looked into Kate Chesne’s burning eyes. Not a full-blown emotion, perhaps, but a flicker. A blip on the tracing of a terminally ill heart.

  The patient wasn’t dead. Not yet.

  He felt himself smiling. He tossed the pen up in the air and caught it smartly. Then he slipped it into his breast pocket and walked to his car.

  * * *

  THE DOG WAS deeply anesthetized, its legs spread-eagled, its belly shaved and prepped with iodine. It was a German shepherd, obviously well-bred and just as obviously unloved.

  Guy Santini hated to see such a handsome creature end up on his research table, but lab animals were scarce these days and he had to use whatever the supplier sent him. He consoled himself with the knowledge that the animals suffered no pain. They slept blissfully through the entire surgical procedure and when it was over, the ventilator was turned off and they were injected with a lethal dose of Pentothal. Death came peacefully; it was a far better end than the animals would have faced on the streets. And each sacrifice yielded data for his research, a few more dots on a graph, a few more clues to the mysteries of hepatic physiology.

  He glanced at the instruments neatly laid out on the tray: the scalpel, the clamps, the catheters. Above the table, a pressure monitor awaited final hookup. Everything was ready. He reached for the scalpel.

  The whine of the door swinging closed made him pause. Footsteps clipped toward him across the polished lab floor. Glancing across the table, he saw Ann Richter standing there. They looked at each other in silence.

  “I see you didn’t go to Ellen’s services, either,” he said.

  “I wanted to. But I was afraid.”

  “Afraid?” He frowned. “Of what?”

  “I’m sorry, Guy. I no longer have a choice.” Silently, she held out a letter. “It’s from Charlie Decker’s lawyer. They’re asking questions about Jenny Brook.”

  “What?” Guy stripped off his gloves and snatched the paper from her hand. What he read there made him look up at her in alarm. “You’re not going to tell them, are you? Ann, you can’t—”

  “It’s a subpoena, Guy.”

  “Lie to them, for God’s sake!”

  “Decker’s out, Guy. You didn’t know that, did you? He was released from the state hospital a month ago. He’s been calling me. Leaving little notes at my apartment. Sometimes I even think he’s following me….”

  “He can’t hurt you.”

  “Can’t he?” She nodded at the paper he was holding. “Henry got one, just like it. So did Ellen. Just before she…” Ann stopped, as if voicing her worst fears somehow would turn them to reality. Only now did Guy notice how haggard she was. Dark circles shadowed her eyes, and the ash-blond hair, of which she’d always been so proud, looked as if it hadn’t been combed in days. “It has to end, Guy,” she said softly. “I can’t spend the rest of my life looking over my shoulder for Charlie Decker.”

  He crumpled the paper in his fist. He began to pace back and forth, his agitation escalating to panic. “You could leave the islands—you could go away for a while—”

  “How long, Guy? A month? A year?”

  “As long as it takes for this to settle down. Look, I’ll give you the money—” He fumbled for his wallet and took out fifty dollars, all the cash he had. “Here. I promise I’ll send you more—”

  “I’m not asking for your money.”

  “Go on, take it.”

  “I told you, I—”

  “For God’s sake, take it!” His voice, harsh with desperation, echoed off the stark white walls. “Please, Ann,” he urged quietly. “I’m asking you, as a friend. Please.”

  She looked down at the money he was holding. Slowly, she reached out and took it. As her fingers closed around the bills she announced, “I’m leaving tonight. For San Francisco. I have a brother—”

  “Call me when you get there. I’ll send you all the money you need.” She didn’t seem to hear him. “Ann? You’ll do this for me. Won’t you?”

  She looked off blankly at the far wall. He longed to reassure her, to tell her that nothing could possibly go wrong; but they’d both know it was a lie. He watched as she walked slowly to the door. Just before she left, he said, “Thank you, Ann.”

  She didn’t turn around. She simply paused in the doorway. Then she gave a little shrug, just before she vanished out the door.

  * * *

  AS ANN HEADED for the bus stop, she was still clutching the money Guy had given her. Fifty dollars! As if that was enough! A thousand, a million dollars wouldn’t be enough.

  She boarded the bus for Waikiki. From her window seat she stared out at a numbing succession of city blocks. At Kalakaua, she got off and began to walk quickly toward her apartment building. Buses roared past, choking her with fumes. Her hands turned clammy in the heat. Concrete buildings seemed to press in on all sides and tourists clotted the sidewalks. As she wove her way through them, she felt a growing sense of uneasiness.

  She began to walk faster.

  Two blocks north of Kalakaua, the crowd thinned out and she found herself at a corner, waiting for a stoplight to change. In that instant, as she stood alone and exposed in the fading sunlight, the feeling suddenly seized her: someone is following me.

  She swung around and scanned the street behind her. An old man was shuffling down the sidewalk. A couple was pushing a baby in a stroller. Gaudy shirts fluttered on an outdoor clothing rack. Nothing out of the ordinary. Or so it seemed….

  The light changed to green. She dashed across the street and didn’t stop running until she’d reached her apartment.

  She began to pack. As she threw her belongings into a suitcase, she was still debating her next move. The plane to San Francisco would take off at midnight; her brother would put her up for a while, no questions asked. He was good that way. He understood that everyone had a secret, everyone was running away from something.

  It doesn’t have to be this way, a stray voice whispered in her head. You could go to the police….

  And tell them what? The truth about Jenny Brook? Do I tear apart an innocent life?

  She began to pace the apartment, thinking, fretting. As she walked past the living-room mirror, she caught sight of her own reflection, her blond hair in disarray, her eyes smudged with mascara. She hardly recognized herself; fear had transformed her face into a stranger’s.

  It only takes a single phone call, a confession. A secret, once revealed, is no longer dangerous….

  She reached for the telephone. With unsteady hands she dialed Kate Chesne’s home phone number. Her heart sank when, after four rings, a recording answered, followed by the message beep.

  She cleared the fear from her throat. “This is Ann Richter,” she said. “Please, I have to talk to you. It’s about Ellen. I know why she died.”

  Then she hung up and waited for the phone to ring.

  * * *

  IT WAS HOURS before Kate heard the message.

  After she left the pier that afternoon, she drove aimlessly for a while, avoiding the inevitable return to her empty house. It was Friday night. T.G.I.F. She decided to treat herself to an evening out. So she had supper alone at a trendy little seaside grill where everyone but her seemed to be having a grand old time. The steak she ordered was utterly tasteless and the ch
ocolate mousse so cloying she could barely force it down her throat. She left an extravagant tip, almost as an apology for her lack of appetite.

  Next she tried a movie. She found herself wedged between a fidgety eight-year-old boy on one side and a young couple passionately making out on the other.

  She walked out halfway through the film. She never did remember the title—only that it was a comedy, and she hadn’t laughed once.

  By the time she got home, it was ten o’clock. She was half undressed and sitting listlessly on her bed when she noticed that the telephone message light was blinking. She let the messages play back as she wandered over to the closet.

  “Hello, Dr. Chesne, this is Four East calling to tell you Mr. Berg’s blood sugar is ninety-eight…. Hello, this is June from Dr. Avery’s office. Don’t forget the Quality Assurance meeting on Tuesday at four…. Hi, this is Windward Realty. Give us a call back. We have a listing we think you’d like to see….”

  She was hanging up her skirt when the last message played back.

  “This is Ann Richter. Please, I have to talk to you. It’s about Ellen. I know why she died….”

  There was the click of the phone hanging up, and then a soft whir as the tape automatically rewound. Kate scrambled back to the recorder and pressed the replay button. Her heart was racing as she listened again to the agonizingly slow sequence of messages.

  “It’s about Ellen. I know why she died….”

  Kate grabbed the phone book from her nightstand. Ann’s address and phone number were listed; her line was busy. Again and again Kate dialed but she heard only the drone of the busy signal.

  She slammed down the receiver and knew immediately what she had to do next.

  She hurried back to the closet and yanked the skirt from its hanger. Quickly, feverishly, she began to dress.