Harry Gardner felt the air in the room congealing on him. He had to keep cool, calm down … get his drugs ready. Across from him two Filipino nurses laughed cheerfully and Gardner envied them. He wished to hell it was one of them instead of himself going in here. But that was no way to feel. He should be happy that he drew Lauren Shaw’s case. She was certainly one of the most famous persons the hospital had ever had. Ordinarily, he would see it as a great chance to make an impression on the staff. Hell, if he played his cards right, he might even get to know her after the operation. But still his hand shook a little as he lined up the drugs in his armamentarium—the Innovar, sodium pentothal, the Fentanyl, and the Arfonad, which would lower her blood pressure. Still, there was nothing particularly terrifying about the operation. She would come through it okay. An aneurysm wasn’t any joke, but Dr. Taylor was the best around. There shouldn’t be any real problem. Relax, he told himself, and stop thinking of June, or of Beauregard. Still, it was tough, for he knew that Beauregard would be watching him from the TV room on the second floor. Keeping a close watch. He knew damned well that Beauregard would have preferred to have Cross on the case, but Cross had been out with the flu for two days, so he had drawn the assignment. So relax. He picked up his bag, snapped it shut, and left the Prep Room to go to the OR.
“Hey, Harry,” Spencer Taylor said as Harry came through the door, “you’re a star.”
“Yeah,” Harry said. He went over and checked the pop-off valve in the anesthesia machine, then quickly went over the other equipment. Everything was in order. He laid a tray down and set out his drugs on it. Then behind him Lauren Shaw was wheeled into the room. She was already nearly under.
“Hello, Dr. Gardner,” she said, dazed.
“Hello, Miss Shaw. You feel all right?”
“Never better. You know they gave me some very nice drugs to help me sleep.”
“Relax, Miss Shaw. We’re going to have you back on the stage in no time.”
Dr. Taylor smiled at her and held her hand.
“It’s going to be fine,” he said.
“Okay,” Harry said. “Let’s get her up on the table.”
The two scrub nurses helped Lauren Shaw off the portable and onto the table.
“Time to relax,” Harry said.
He opened the airways for her and then turned on the anesthesia machine. Meanwhile, he got the Innovar ready—1 cc. of it, and quickly injected it into the IV. In a matter of seconds, Lauren Shaw was under, and they began to place her face in the Mayfield head rest, which allowed her head to be held tightly by two pins in the occipital area, and another in the frontal area. They tilted her head slightly to the right, the left side facing up, and then the nurse began to shave her. Harry looked down and let out a long sigh.
“Jesus, I hate to see that,” Beauregard said.
He sat in the darkened room along with the other doctors watching the TV monitor. In front of him a cigarette burned, and he realized how nervous he was. He wished Cross were handling this. Then he realized that Cross had been out for a couple of days. He should have called him, but the boy had been strangely cold during the dinner. He had meant to say something to Peter about it, but things had happened too fast. Dr. Dios sat on the other side of him, drinking some apple juice.
“Harry will do a good job,” Dios said to one of the others. “And Taylor … She’s going to be fine.”
Beauregard’s sentiments exactly. So why was he sweating so much?
“We’ll leave her some hair,” Dr. Taylor said. “As much as we can. Then she can get a wig for a while.”
The nurse, Peggy Schmidt, smiled.
“We cannot let the Post get hold of this. It would ruin her career.”
Harry watched as they finished prepping her head, then he injected some Innovar.
“Just a kiss,” he said. “Make her relaxed.”
He watched as she relaxed, checked her blood pressure. Everything was normal. Then Taylor and his assistant, Moss, slid their headlights over their eyes. Harry stared at them. He never quite got used to those big spotlights. It always seemed as if they were a couple of miners going after the mother lode.
“Towels, please.”
The nurses and Taylor draped the patient’s head with green towels, and then the nurse stitched the towels to her scalp. And Harry injected a touch of xylocaine locally, just to stop the bleeding. Then the doctors and the nurses hooked up the suction devices and the electric coagulation instruments.
Finally, Taylor looked over at Harry.
“Is everything ready?”
“Steady,” Harry said.
“Okay, then we’re going in.”
Beauregard sighed again. Harry had done a very competent job. In fact, better than competent. Perhaps he had been too tough on Harry, just as they all seemed to be too tough on Peter. The important thing was the quality of a man’s work. It was going to be fine. Behind him the door opened, and when Beauregard turned, he saw Cross come into the room. He motioned to him, and Peter made his way through the chairs and found a seat.
“Peter, how are you?” Beauregard said.
“Okay now. I had a couple of shots … got some rest. I’m going to work tonight for a few hours. Get crazy hanging around the apartment. I wish I could have been in on this one.”
“Frankly, so do I. But Harry seems to be doing a fine job.”
“He’s a good man,” Peter said. “A very good man.”
Dr. Taylor started the horseshoe-shaped incision on Lauren Shaw’s scalp. A neat, curving arc, which cut away the flesh. Then behind him Moss brought up the drill, and they started in working on the four burr holes. The first one was just above the zygomatic process. Harry watched as the tissue opened, the blood spilling a little. The sound of the drill always got to him. He watched as they started the second one in the frontal area, and then the third in the parietal bone, and finally number four in the temporal bone, a few inches above the ear. Harry heard the bone being chipped away and thought of termites … the Roto-Rooter Boys, they sometimes called it, though not today, for everyone was well aware that Beauregard was watching every move and listening to every comment. There was going to be no black humor today, for certain. Harry checked the blood pressure, his drip, the heart machine. Quickly they were inside her skull, looping the holes together from hole to hole. Then they lifted the scalp off and the dura was exposed.
“Okay,” Taylor said, “which way do you think we should go in?”
“I would think this way,” Moss said, indicating a semicircular direction. “That way the brain will be right in front of us.”
“Okay,” Taylor said. “That makes sense.”
They began to work their way in, and Harry watched as the skull was lifted completely away. In front of him was Lauren Shaw’s brain—the Sylvian fissure, that dividing line between the frontal and the temporal lobes.
“Well,” Taylor said, “we know it’s in the depth of the Sylvian fissure at the origin of the middle cerebral artery.”
“We’ve got to go very slowly here. Bring me the microscope.”
“Here they go,” Beauregard said. He was aware of Peter’s breath next to him.
“You all right?” he said.
“Yes,” Peter said. “I’m fine. Just fine.”
He stuck his hand in his pocket, fidgeted around, and stared at the TV as though he were watching a priest in some ancient ritual. Beauregard bit his lip and watched and smoked.
Harry watched as Taylor draped the microscope and looked down into Lauren Shaw’s brain. Taylor took the knife and slowly, millimeter by millimeter, began to dissect the Sylvian fissure. He could feel the tension in the room, and yet, he could tell the way things were going that it wasn’t as tough as they had thought.
“It’s okay,” Taylor said. “I’ve reached the aneurysm. It’s not that bad. We can clip it. But I need that hypotensive drug now, Harry. I want her blood pressure as low as possible.”
Harry smiled at the nurse. He was going to come out of this smelling like a rose.
He reached for the Arfonad bottle and hung it up on the IV pole. He then took a 20-gauge needle and introduced it into the main IV line, after which he slowly opened the stopcock of the Arfonad bottle and let it begin to drip in. He looked up and saw it working, then checked the blood pressure. Everything was okay.
“It’s all right,” Harry said. “Pressure should drop in a second.”
He turned and looked at the pressure gauge. Impossible … it was impossible. Her pressure was actually rising.
“Hey,” he said, “I don’t get it. Her pressure is going up.”
“What the hell did you put in there?” Taylor said.
“Arfonad,” Harry said. He looked at the label on the bottle. “It’s weird.”
Her blood pressure was rising … rising …
“Get that out of there,” Taylor said.
Harry stood stunned. He stared at the blood pressure.
“It’s up to two-ten,” he said meekly. “Christ.”
Taylor pushed him out of the way and pulled the bottle off the line.
“Jesus,” he said. “Jesus! She can’t take this. Get a new bottle of Arfonad quick. I don’t think she can take it. The vessel is getting huge. Oh, shit!”
There was suddenly a tremendous popping noise, almost like a balloon, and a bright clot of blood showered Dr. Taylor and Harry Gardner.
“Jesus!”
The two men watched helplessly as Lauren Shaw’s brain began to bulge out of the open skull, like toothpaste oozing out of a tube.
“Fentanyl,” Harry shouted, trying desperately to inject it in the IV.
But it was too late. The aneurysm had burst, and the brain splattered all over the floor. One of the nurses screamed, and the other grabbed her and held her. Harry stood back, staring at Lauren Shaw’s bald and broken head. He felt as though he were in a movie. That someone would yell, “Cut”; say, “Great job.” It was all just a play … it had to be. But then Dr. Taylor and Moss were grabbing him, and suddenly, he saw Beauregard racing into the room, and there were the horrified shouts of people in the hall, and he was being led, forcibly, his arms pinned behind him, out of the operating room.