I need to operate on Mrs. Sanchez.
Yes, but why? The urge was irresistible and incomprehensible. Her heart pounded in her ears; sweat broke out across her body. She was panicking, spiraling again toward madness.
Darcy. No matter what else happens, think about Darcy.
She had no choice. She had to keep going. Because of Darcy.
And because I need to operate on Mrs. Sanchez.
Nikhil was still lecturing the students. Rita took deep breaths and focused on what he was saying, trying to keep her mind occupied with something, anything, other than those damn table straps.
“This is isoflurane,” he said, patting a large metal canister located next to the respirator that, like the oxygen tanks, was fastened to it with hoses. “Isoflurane, and gases like it, produce the profound unconsciousness—a kind of reversible coma—needed for surgery. Paralysis drugs, like rocuronium, don’t induce unconsciousness. You need the gas to knock a patient out.”
“Can isoflurane, or any of these other tanks of gas, explode?” Leah asked.
“No. Isoflurane is completely inert.” He waved toward the oxygen cylinders. “But oxygen can burn.”
He twisted a valve on the top of the isoflurane canister and chuckled. “I mean, surgery’s weird, if you think about it. You know? For most of human history, you couldn’t operate on a person without pretty much killing them. Then along come these inventions that change everything. Sterilization. Antibiotics. Anesthesia. These days, we take them for granted. Like it’s no big deal. Especially anesthesia. Have you guys ever seen one of those old Western movies? Or Gone with the Wind, maybe? No? When a guy—a soldier, or cowboy—has his gangrenous leg cut off with only a hacksaw, a shot of whiskey, and piece of leather to bite down on? In the movie, it’s dramatic, but, like, no big deal. Well … consider the fact that amputation means sawing through bone. The pain would be inconceivable if you were awake.”
“I like him,” Finney pronounced loudly in her ear.
Shit!
She jumped so high she felt like she almost hit the ceiling, then looked around to see if anyone had noticed. Thomas and Lisa were preoccupied with sorting surgical instruments in the back of the room, and Dr. Chow and the students were absorbed with Nikhil’s informal lecture.
“Your anesthesia colleague there,” Finney added. “I like him quite a bit and what he has to say about things.”
She wondered what it was about Nikhil—and what he had to say about things—that Finney found so appealing. She waited for Finney to elaborate. He didn’t. As suddenly as he’d spoken, he fell back into silence. Which heightened her unease.
“Does anybody ever wake up accidentally? In the middle of surgery?” Nathaniel asked.
“Theoretically, yes. It’s called intraoperative awareness.” This was Dr. Chow. “Very rare. One in every twenty thousand surgeries performed, supposedly. But I’ve been doing this for over twenty-five years, and I’ve never seen it, or heard of it. Or run across another anesthesiologist who has.”
Lisa tapped Rita on the shoulder and flashed her a meaningful look. Rita followed her to a far corner of the room. Lisa glanced at Thomas sitting in front of the computer, mumbling to himself as he scratched at a hairy forearm sporting more ink than bare skin; and then at Nikhil and Dr. Chow, who had launched into an animated discussion of drug dosages and blood oxygen levels with the students. Chase and the visitors hadn’t arrived yet.
The quiet before the storm.
“You look … much better than you did earlier, Dr. Wu,” Lisa said in a low tone. A diplomatic observation. Lisa was nothing if not diplomatic.
“Thanks, Lisa. I’m okay.” She leaned in. “Does anyone, uh, know? About … you know.”
Lisa’s sharp eyes swiveled to Thomas, the anesthesiologists, the students, then back to Rita. “Dr. Montgomery told me not to tell anyone. He was angry. Calm. But angry. He implied I might get in trouble if I talked to anyone.”
She cocked a hip to one side and folded her arms. “Frankly,” she said coldly, “I could have done without the lecture. He should know me better than that, after all the years I’ve worked here.”
Rita nodded. Lisa was smart and tough. In the realm of life experience, a stern lecture from Chase wouldn’t even be a blip on her radar. Or, probably, discovering a naked surgeon on an OR table at the start of an otherwise normal working day.
Lisa added in a whisper, “Wendy, well … you just can’t tell about her. You know what I mean?”
“Yeah. I do. It’s okay. I’ll—deal with that later.” Rita placed a hand on Lisa’s arm. “Can you do me a favor, Lisa?”
“Of course.”
“Can you … keep an eye on me, this morning? Just to make sure that I don’t do anything … stupid?”
Lisa’s eyes were somber above her mask. “Sure. I’ll do that.”
“I’ll have my eye on you as well, Dr. Wu,” Finney said.
The sound of his voice was as abrupt as a slap to her face.
“Dr. Wu?” Lisa said, studying her expression. “Are you okay?”