Let Fall Thy Blade

By Glenn Vanstrum

Only in the heart of Africa can the heart of a surgeon change.

Dr. Malcolm Hartford promises to join his family on a grand vacation in East Africa before his daughter leaves for college. He cannot escape the hospital, though, until he finishes the most challenging case of his career. Sleep-deprived, burnt-out, mentally and physically exhausted, he finds rejuvenation among the wild plains and peoples of the Masai Mara.

Guided by a wilderness-savvy Maasai guide, the Hartfords (Malcolm, his wife, son, and daughter), unlock the secrets of the tooth-and-claw African plains, witnessing rituals and events that make their California world seem distant and unreal. As a pride of lions slaughters a Cape buffalo, a hippo defends its baby from a hungry croc, and a bull elephant dies mysteriously, the family strengthens its bonds through shared adventures and revelations.

In the land of the Maasai, the Hartfords become an integral part of the intersection of man and nature at its most raw. They steal honey from African bees, perform surgery in crude conditions, and participate in a circumcision ceremony with hundreds of warriors. The experience transforms them, calling forth ancestral memories buried deep within their DNA.

When the travelers encounter a gang of poachers, though, the vacation descends into catastrophe. Malcolm must use every bit of training a lifetime of running and operating have lent him. Even on returning to the United States, Kenya leaves its mark, both for good and evil. A fathomless love powers him to save his family in Africa. Only their faith and trust can help him choose between life and oblivion at home.

"An ambitious story, full of action and realistic dialogue, featuring a dynamic central character. Some of Vanstrum's finest writing to date."

--John A. Murray; author of more than 40 books, including Cinema Southwest and The Sierra Club Nature Writing Handbook

• Language: English
• Publisher: Glenn Vanstrum
• Release date: Oct 4, 2011
• ISBN: 9781465980496

Glenn Vanstrum

Glenn Vanstrum’s fiction has been published in LITnIMAGE, the Bellevue Literary Review, and THEMA. His book of nature writing, The Saltwater Wilderness (Oxford), won a San Diego Book Award. Essays of his have appeared in Sierra, California Wild, and the Los Angeles Times.Vanstrum has written five novels and two story collections. Setting plays a major role in his character-driven fiction, work that often uses nature, music, or medical themes. His novels range from drama (Let Fall Thy Blade; Certain Stars Shot Madly) to historical fiction (Northern Liberties) to satire (S.I.C. Memorial). His latest work, Humboldt, a story set among the Northern California redwoods, is part roman noir, part satire, and part thriller.A Minnesotan by birth, Vanstrum majored in music at Grinnell College in Iowa and attended U.C.S.D. medical school. He has spent most of his life in California, where he practices anesthesiology.A professional nature photographer, he publishes images in numerous venues worldwide. Magazine credits include Audubon, Sierra, Terre Sauvage, National Geographic Traveler, National Wildlife, and Discover. The photographic stock agencies Animals Animals/Earth Scenes and Custom Medical Stock Photography represent his photographs.Vanstrum, a pianist from age five, still practices daily and performs works from the classical, romantic, and modern repertoire on a regular basis. A student of Cecil Lytle and the late Nathan Schwartz, he plays both solo and chamber pieces.The author, a lifelong surfer, has ridden waves in Hawaii, Mexico, Costa Rica, and Bali. Still riding a shortboard, he wipes out with great regularity.Further information on Vanstrum’s writing, including book reviews; music, including concert schedules; and surfing, including a surf blog; appears at http://www.gvanstrum.com"Glenn Vanstrum is a force of nature. In addition to being a published author (The Saltwater Wilderness, Oxford University Press, 2003), he is a concert pianist (and regularly performs complex pieces by Beethoven and Mozart in public venues near his home in San Diego), a highly regarded medical doctor, an accomplished surfer, an underwater photographer who has worked around the world, and a dedicated husband and father. Somehow, in this incredibly busy life, he continually produces exemplary works of fiction and non-fiction."I've known Glenn for fifteen years. In that time, I have read every single one of his books, and they are uniformly excellent. His fiction is distinguished by fast-paced plots, fascinating characters, amazingly realistic dialogue, and passages of great strength and beauty. His innovative treatment (in Northern Liberties) of Thomas Eakins' painting 'The Gross Clinic' was absolutely brilliant, and his collection of animal stories is par excellence--certainly in the league with such notables as Roger Caras and Ernest Thompson Seton."His non-fiction, best exemplified in the essays of The Saltwater Wilderness, reflects his love for the sea and dedication to the conservation of oceanic resources. In summary, any book by Glenn Vanstrum is worth reading and owning, and I enthusiastically encourage all those who value contemporary literature to explore the corpus--now available as e-books or print-on-demand--of this gifted American author. "--John A. Murray, senior editor, The Bloomsbury Review (1987-present); founding editor, the Sierra Club American Nature Writing annual (1994-2005); former director, graduate program in professional writing, University of Alaska; author of 42 books; recipient of Southwest Book Award and Colorado Book Award.

Book preview

Chapter 1

Malcolm Hartford banged through the double doors of the operating room. He wheeled to face the cardiac team and froze, his dripping hands thrust forward, a demonic look on his face.

Bring forth my gown and latex hand coverings! he said.

The entrance and command, as he hoped, caught the attention of the room’s occupants. Three nurses, an anesthesiologist, a monitoring tech, and a perfusionist all erupted in laughter. 


And your obsidian ax, oh mighty Aztec priest? said Delores, the lead nurse. 


Yes, there will be need of it, but after I have donned these vestments.

More laughter. Hip-hop blared from four overhead speakers. Black Eyed Peas, Hartford decided. Elephunk. Let’s Get it Started. A hint of isopropyl alcohol hung in the air. In the center of the room lay a prostrate form draped in blue. The surgeon dipped his gloved hands in a pan of saline and stepped onto a lift next to the patient.

Knife.

He probed the spaces between the ribs with his fingers, outlining the underlying breastbone, and pressed the belly of the scalpel onto the skin. With a practiced movement he slid the blade down the center of the man’s chest, the skin giving way, the yellow fat bulging, the capillary bleeders leaking crimson.

A chance to cut--is a chance to cure.

Never let the skin get in the way of the physical exam--

The patient is a time bomb. Might get better any minute.

Hartford ignored the gallows humor, the stale jokes.

Bovie.

He cauterized each bleeder with a pop and hiss. Tendrils of smoke rose as the odor of burned fat filled the room. There was no window in the OR, no way to know if it were morning or evening, no trace of bone-dry, mid-January San Diego. Nor did any hint reveal today was the day when Hartford would learn of the journey that would jolt him from this puny kingdom where he ruled as lord and master, to a place so strange and alien it might as well be on another planet.

The patient’s name: Edwin Spooner. The surgeon remembered him well from his pre-op visit two days before. African-American. Fifty-nine years old. Handsome with a fine head of close-cropped gray hair and matching beard. Non-smoker. Thin. No diabetes. A global cardiomyopathy. The entire heart, for unknown reasons--most likely a viral infection--had turned swollen and flabby. Shaking the man’s hand earlier, Hartford noticed the effort he put into getting his arm off the bed, sensed the hidden fear in his soul.

Metzenbaum scissors. Pick-up.

He dissected through the tissue overlying the six-inch length of the sternum. Pale white bone appeared, reflecting light from four oversized spots that hung over the patient like silver moons. A wiry man, Hartford possessed quick, delicate fingers, fingers that might have belonged to a violinist or a Dutch master, a Paganini or a Vermeer. From his mask and paper hat a few strands of gray-streaked black hair protruded. His dramatic entrance belied the age and weariness that lined his eyes.

As he worked, he tried to keep mental blinders on. He did his best not to dwell on his wife, his kids, or his running. He could almost succeed in shutting his thoughts to his latest lawsuit, his lost investments, his lackluster sex life. He was doing the thing he loved. His hands became one with the tissue, one with the instruments--hours could go by and he would never notice. The more difficult and complex the operation, the better.

The twin doors swung open again. His partner, James Blalock, backed in with scrubbed hands. Blalock, in his mid-sixties, looked to be twenty pounds overweight. He had a calm, imperturbable manner that matched his Mississippi drawl.

How old’s this guy, Mal?

Fifty-nine, going on a hundred.

A young pup.

"Devouring time, blunt thou the lion’s paw..."

That the Bard?

"Let the earth devour its own sweet brood..."

This a destination pump?

Nope. Bridge to transplant.

Heard you had to talk him into it.

"Pluck the keen teeth from the fierce tiger’s jaw."

What’s that, a sonnet?

"And burn the long-lived phoenix in its blood."

Henry V?

Hacksaw. Lungs down. Hartford loved dropping bits of Shakespeare into the OR, anything to add culture to a doggerel world.

He fit the rails of the jigsaw under the sternum at the neck, turned it on, and, like a carpenter ripping a pine board, zipped down with a whining roar to where the chest ended just above the stomach. Prying the twin edges of blood-soaked breastbone apart, he cauterized more bleeders, slipped in a retractor, and started cranking open the thorax.

As he worked, he could almost hear Spooner’s rich baritone.

A transplant? Putting someone else’s innards inside me?


That’s right. But if we can’t get a donor right away, we’ll pop in a mechanical pump, an LVAD.


Ain’t that unnatural, taking someone else’s heart? Sounds kinda creepy. When he spoke the black man rolled his eyes so the whites shone, twin beacons surrounded by ebony skin.

Although Spooner came from a different world, Hartford found himself drawn to the man’s down-to-earth attitude.

Nothing makes me sadder than when a healthy guy like you, who doesn’t smoke, doesn’t overeat--a guy who takes care of himself--gets a cardiomyopathy. For no good reason. It’s not fair. I’m offering a way to get better.

The patient rolled his eyes a second time. Keeps you surgeons busy, don’t it?

Hartford slit the pericardium, the thick membrane surrounding the heart, and gazed at the surface of the swollen, beating organ. Spooner needed a new pump, and, yes, the surgeon needed money. His daughter, Samantha, was headed to Stanford for a summer session before her freshman year there. His son, Zachary, a photography nut, stood in constant need of new equipment. His lovely English wife, Edith, had a fondness for driving--and crashing--fine German automobiles. Although he was a smart man, Hartford proved a bad investor: His financial advisor in Los Angeles talked him into putting too much of his hard-earned cash into financial stocks--he lost a fortune when the market cracked and broke.

In response, he did the only thing he knew how to do. Work. He began removing pulmonary lobes from cancer patients and learned to operate on infected chests using plastic tubes through skin cuts one-half inch long. Like building a ship in a bottle. He and Blalock expanded the transplant program at Summit Memorial to include lungs, and he traveled to France to study with the great Carpentier to learn how to repair mitral valves.

Hartford dissected free the pulsating aorta.

Quiet, now, everyone, he said, only half-joking. I’m working on the largest blood vessel in the human body.

He told Jane Snow, the hawk-eyed, white-haired anesthetist, to inject heparin, a blood-thinner that prevented clots from jamming the heart-lung machine. Snow, also in her late fifties, kept oxygen and sevoflurane blowing into the lungs in a steady rhythm. She’d been working with the two surgeons for the past twenty years. Hartford suspected from the spider-like capillaries and violet blotches on her face that she drank her share of martinis off the job, but she remained steady and unfazed when things went wrong.

The heart don’t look so good on echo, she said. Fumes from a daily pack of cigarettes added gravel to Snow’s voice.

Guess that’s why we’re here.

As Hartford worked in the chest, in the back of his mind lurked the thought that at this stage of his career he should be throttling back, should be spending time with his kids before they disappeared off to college, should be paying more attention to his wife. But he was driven to operate. That, and run. Today, maybe, if things went well, he could squeeze in a jaunt on the beach. Ten miles. If things went well. He wanted to hang out with his son and daughter, but he needed to unwind first. He felt awkward with them anyhow, more like a favorite uncle than a dad.

Months ago he’d told Edith he would be happy to travel with the family on one last grand vacation before Samantha graduated from high school. He told her to pick any place in the world she fancied, France or Italy or maybe even Thailand, and they would pull the kids from school for some extra days around spring break to spend a few weeks of quality time together. He wondered if she would follow through with it.

After sewing a purse-string circle of suture in the aorta, he took a scalpel and cut a stab-wound in its center. He popped in a sharp-edged plastic tube, spilled only a few drops of blood, and tied it down. Then he pushed the heart to the left to expose the vena cava.

He doesn’t like that, Snow said.

What’s the pressure?

Fifty.

Hold the lungs. I’ll only be a second.

Moving with alacrity, he placed another purse string in one of the plump veins draining blood from the body to the heart.

Pressure’s forty.

Give two hundred, Hartford said to the perfusionist, who pumped saline into the aorta.

He’s not coming back.


He lifted the heart to wiggle a cannula into the superior vena cava. The tube hung up on an obstruction inside the vein. Dark blood filled the chest cavity.

Pump suckers up. Give back whatever you’ve got.

V-fib.

Paddles.

He jammed in the cannula, squeezed its other end into the tubing from the heart-lung machine, and removed the clamp.

Go on.

As the rotors on the bypass pump began spinning, he slipped twin steel electrodes around the heart and fired fifteen joules of current into the mass of fibrillating muscle. The jolt stunned each randomly contracting cell, and in seconds the heart returned to its usual coordinated squeezing.

Turn off that damn hip hop. Put on some classical.

Dolores, a brunette in her forties who had spent, like the others, most of her waking adult life with the cardiac team, shut down the blaring radio. She put on a disc, the fifth Bach Brandenburg Concerto.

How’s that, doctor? Johann Sebastian’s latest.

Better. Didn’t know he had anything new, though. Thought he was...de-composing.

He let the heart recover on the pump, dissected through thick strands of scar tissue, inserted a big needle, and clamped the aorta. He sliced a hole in the tip of the left ventricle and sewed a Dacron-coated metal ring to the raw and bleeding edges; after that he sutured a woven graft into the aorta.

Can somebody call Ferijani and Summers?

We’ve paged ‘em. Three times. No answer.

Pump please.

Hartford wondered where Edith would haul them to on the vacation, or if she would plan anything at all. He hadn’t left town in over a year. Two years ago he’d flown to New York--but for a meeting. Three years ago, the sabbatical in Paris to operate with Carpentier. It was insane to work like this, day in, day out, handling emergencies on weekends and nights, struggling like an intern to get enough sleep. Escape, though, seemed impossible, what with post-op patients to follow, new patients that needed consultation, a stuffed operating schedule...

Delores ripped the cover from a plastic container. Inside lay the latest in internal assist devices, a pump that could take blood from a tired, stretched, baggy ventricle and inject it with vigor into the aorta. A pump that could keep a body alive until a heart transplant became available. Made to fit into the upper abdomen, the gadget had the rough size and shape of a CD-player. Metallic, it gleamed under the spotlights. A hose protruded from each end, one for intake of blood, the other for egress.

Careful. Thing’s worth fifty thousand.

Delores popped it out of the packet. Knowing what she mustn’t do, trying to heed his warning, she did it anyway. The heavy pump slipped through her wet, gloved fingers and made a thud as it landed on the operating room floor.

Fuck!

Nice one.

Sorry, Doctor.

Guess it’s not sterile anymore, is it? Nothing like putting a filthy foreign body into a patient.

Here. We’ll dip it in Betadine.

Jesus fucking Christ.

I’m really, really, sorry.

Delores broke into tears. Hartford let the LVAD soak for ten minutes, dried it off, and began to attach each cannula to the sites he had prepped. What a cluster. Nothing to do but sew it in, dirty or not. There was no way to get a second pump without sending to Houston--Hartford hoped and prayed this one was neither contaminated nor damaged by the fall. His fingers a blur, he placed the stitches in neat, machine-perfect rows. As he worked his anger dissipated and gave way to a cynical resignation.

He hoped Edith would pick Tahiti, but perhaps it was too much of a honeymoon spot--the kids might not like it. Or they could ride a houseboat down a river in France, sip wine along the way. Again, not the greatest trip for children. She would pick something perfect, though, and arrange everything. He didn’t care where they went, really, just so they got away.

Head down.

Snow tilted the table so the patient’s feet rose into the air and the head sunk low. Hartford squeezed the ventricle with his right hand, forcing air through a vent in the aorta. Snow bagged the lungs to release the rest of the intracardiac air. He tied the aortic suture tight.

Tighter than a frog’s butt.

How tight?

Water-tight.

Clamp off. Time?

Fifty-seven minutes.

Not bad for an LVAD.

The heart, essentially dead for close to an hour, lay fibrillating in the chest. He picked it up again and felt its mass, felt the chaotic motion of the myocardial cells, felt a handful of quivering worms.

Paddles. Shock.

The cold organ began to beat, but slowly.

Pace at seventy. Give it fifteen for the RV to recover, he said. On bypass, with the anesthesiologist in the room, he could safely take a much needed break. He nodded at Snow and the perfusionist, ducked out to take a leak and gulp a stale sandwich in the surgeon’s lounge, and returned to don a fresh gown and gloves.

Pace at a hundred. Bring him off bypass.

Hartford watched the heart struggle. He grimaced as the systemic blood pressure hit fifty and faded.

Damn.

Look at that right ventricle. Swollen like a tick.

Start nitric oxide at 20 ppm.

Go back on pump.

They came off bypass a second time. For thirty minutes all went well. The surgeons pulled the tubes that drained blood from the heart and fed it back to the aorta. They reversed the blood thinner and cauterized bleeders, filling the room with another cloud of Texas barbecue. Delores turned off the endlessly recycling Brandenburg concertos to put on the Rolling Stones--closing music.

Uh-oh, Snow said.

The right ventricle once again turned swollen and lethargic, as if it was too much, this insult, this abusive reward of surgery. The blood pressure plummeted. Sixty, fifty, forty. The pulmonary artery pressures rose.

We’re going back on. Give heparin, Jane. Gimme a knife.

In his haste to jam a cannula back into the aorta, Hartford spilled a liter of blood. The OR now smelled more like a Chicago abattoir than a Dallas grill. Two minutes later the cardio-pulmonary bypass machine resumed pumping and put to rest Edwin Spooner’s tired heart for a third time.

Shit.

He looked at the clock. One p.m. Somehow five hours had passed. Where were Ferijani and Summers, anyway? He’d seen them in quiet conversation for the past two weeks, muttering, plotting. He knew they should promote the two, make them full partners, or they would be gone. Every time he broached the idea with Blalock, though, the surgeon refused to consider sharing the wealth.


Senior guys reamed us for ten years, he would say. Why shouldn’t we take advantage now?

Hartford argued that they ought not perpetuate an abuse, that they lived in a city with a high cost of living, that they couldn’t afford to lose their junior surgeons. But Blalock was adamant.

Now, when they could use some help, there was no one. While they waited for Snow to juice the heart with milrinone, dobutamine, norepi, and dopamine, they lavaged the chest cavity with three liters of antibiotic-laced saline.

Snow--rocket fuel ready?

Yes, doctor.

Off bypass.

Loaded with nitric oxide and cardioactive drugs, the patient responded slowly, ponderously, a B-52 lumbering down a runway. Spooner’s blood pressure began to climb as the new LVAD, tucked inside the plumber’s torso, pumped red cells to the body.

Ninety. Ninety-five. One hundred.

Be sure and give extra antibiotics, Snow.

Yes, doctor. Hartford was aware the anesthesiologist hated it when he told her things she already knew. Hence the ‘Yes, doctor.’ Sarcastic hospital lingo for ‘fuck you.’ But the surgeon couldn’t help it. He was too compulsive, he had to check everything--it all fell on him in the end. He was the one who had to talk to the family if the patient died.

Meanwhile Blalock cauterized and sewed and sucked blood.

He’s bleeding like stink. Every needle hole is oozing.

The slaughterhouse odor grew. Hartford closed his eyes. For a moment he smelled a dying zebra, a pride of lions gorging on its entrails, vital fluids spilling onto parched grass.

Six hours and a dozen units of blood later, they moved the patient to the surgical intensive care unit. They couldn’t close Spooner’s sternum, though--he arrested each time they tried--so they propped it open with a metal bar, covering the skin with a plastic sticky drape. Snow organized the journey, a complex train of rolling instruments, i.v. poles, pumps, and nurses. She was a master at keeping transfusion tubing, drips, and nitric oxide lines from getting tangled.

In the unit Hartford slumped at the monitor desk as the anesthesiologist gave report to Ingrid Johanssen, the ICU nurse. As she took command of the disaster that was once Edwin Spooner, he leaned back, exhausted, and drank in Ingrid’s creamy skin and slender, filly-like legs. She should model or be in the movies.

Ingrid had wide, sensuous lips and a broad smile. Too tired to control himself, Hartford imagined kissing her, imagined those long legs wrapping around him. Cool it. With an effort he rose from the desk with its row of EKG screens and made his way to the bedside.

How we doing?

Hi, Malcolm. She always called him Malcolm, never Dr. Hartford. Not good. Pressure’s sixty.

Give more blood. Give a gram of calcium. Give another amp of bi-carb.

Sure, Malcolm.

Cheeky.

In spite of himself, he let his arm slip around her waist and gave her a squeeze. She ran her hand up and down his back.

You drained?

Yeah.

He stood there a while as she massaged his aching neck and back muscles. A dozen hours of surgery took its toll. Her hand moved with the touch of an angel.

He glanced at the monitors. The blood pressure was fifty.

Better get that blood and those drugs going.

Yes, doctor.

He met the wife in the conference suite. A lamp flooded the room with a golden light. On one wall hung an Ansel Adams photograph, a black and white image of a Yosemite waterfall; on another was a print by the same artist of the moon rising over a New Mexican village, the tombstones in the town graveyard ablaze with a luminescent glow.

A handsome woman with gray-black hair who clutched a Bible and wore gold hoop earrings, Mrs. Spooner, elegant in her royal blue jacket and skirt, couldn’t hide the dark circles under her eyes. Hartford, trying to be positive and yet hang as much crêpe as he could, filled her in. She said nothing at first, then cleared her throat and spoke in a near whisper.

It’s been a long day for both of us.

We’ll see if he turns around in the unit.

You did everything you could, Doctor.

Hartford went back upstairs. Summers, the heretofore missing junior partner, a tall, tan surfer dude, stood at the bedside flirting with Ingrid.

How’s he doing?

The patient, or Dr. Summers?

Very funny.

Pressure’s one hundred. We got him tuned. Tali’s on tonight.


Good. I’ll be at home.

§

As Hartford whipped his silver Porsche up the steep driveway, Edith stood waiting for him outside the garage.

Hi, Mal, his wife said, giving him a kiss on the mouth. He gave her a hug, felt her thin figure rise to greet him, felt his own body respond.

You taste like peanut oil. Thai tonight?

Aren’t you clever.

Their black lab, Homer, jumped up and licked his chin.

Down, boy, good boy.

Hi, Dad, shouted his son, Zach. A wild grin plastered itself across his face.

What’s up? You look like the tabby that swallowed the tanager.


Nothing. Just glad to see you.

The three of them sat down to a table groaning with platters of curried chicken, Thai noodles, and mint salad. The smell of ginger, lemon, and cashews filled the dining room.

Can I have some wine, Mom? said Zach, who had just turned fourteen, and whose voice had barely started to deepen. A single red pimple sprouted from the tip of his nose.

If you drink your milk first.

Where’s Samantha? Hartford asked.

Before Edith could answer he heard soft footsteps coming down the stairs.

Hi, Dad, his daughter said. Waves of shining brown hair crowned her stunning figure, a figure he had not quite gotten able to accept.

How was the audition?

"Awesome. I, like, got the part. Lady Macbeth. ‘Out, damned spot, out, I say...’ I’m in there. I get to be one of the witches, too. ‘For a charm of powerful trouble, like a hell-broth boil and bubble...’"

Samantha, a senior in high school, got straight A’s but spent most of her free time on her love, the theater. Unlike many pretty girls in California, she did not dream of becoming a movie star. She loved the theater, wanted to stay with plays, wanted to retrace her mother’s footsteps and live in London.

Hartford poured himself a glass of pinot grigio and piled curry and rice onto his plate.

Ages have passed since we ate together. Edith took bird-like portions, barely sampling her own creation.

Sorry, Hartford said. It’s been busy at the hospital.

Like always, she said.

Mom, you gonna tell ‘em? Zach twitched as he spoke.

Tell us what? asked Samantha, her mouth full of bamboo shoots and watercress.

Mom decided on our March vacation.

Really?

Edith spun the food on her plate with her fork without taking a bite. She gardened daily, and winter or summer her cheeks and nose sprouted a spray of freckles. The source of her daughter’s brown hair, she kept her own locks cut short, a style that made her look much younger than her years. Hartford took another sip of pinot and gazed at her fondly. His girl. His woman.

I’ve been rather busy researching locations, actually. On the Internet. I wanted to find a trip that would have something for each of us.

Great, Samantha said. But what if one of us wants to stay home?

Hush, dear. You’re off to college. This’ll be our last chance to spend time together as a family.

Tell ‘em, Mom. Zach’s energy made Hartford feel uneasy. He had never seen his son so agitated, so bursting with nerves.

Right. I thought about going to Europe. But it’s really not that different from the States. And the dollar-euro exchange is bloody awful.

You ruled out France or Italy? he said. He’d hoped for Italy. He loved the food, loved the idea of touring Tuscany. He could relax, sip cappuccino, eat pasta and pesto, maybe take up oil painting. Landscapes with vineyards and stone farmhouses...

I looked into Tahiti or Fiji. But if you don’t dive or snorkel, there’s really not much in those sorts of places to do.


Long ago Hartford had certified as a scuba diver, but Edith got seasick just sitting on the beach. She could not bear sleeping overnight on a saltwater boat. He’d taken a few dive trips to the Caribbean, but since his wife hated them, he quit.

I started to look further afield. South America, Machu Picchu, the Amazon. I checked into Thailand. Then, out of nowhere, an old chum from Oxford sent me an e-mail.

Hartford became even more uneasy. Old college chum? He stirred a bite of chicken in the curry sauce, popped it in his mouth, washed it down with some more wine. His mouth dry, he tasted nothing.

Duncan Connery. The captain of the cricket team. A splendid athlete. His father founded Connery Pharmaceuticals, a major drug firm in Scotland.

Your old boyfriend?

Just a friend, Malcolm, dearest. Please. It’s been thirty years. He got my address from the alumni registry. I’d written in, told my class about life in California. Anyhow, Duncan--the black sheep of his family--moved to Kenya, became a big game guide. When hunting gave way to the reserves, he started a photo safari company. His father died, surprised everyone by willing him the drug company. But what he truly loves is the African bush.

We’re going to Africa? Samantha, incredulous, brushed back a strand of hair from her forehead.

Why not? Duncan promised us a smashing trip, half-price, just enough to meet his expenses, really.

Africa? Hartford coughed and spilled wine down his chin. He dabbed it with a napkin. A lot of disease and wars there. Is it safe?

Dad, it’s Kenya! Zach jumped in, his excitement contagious. Think of what we’ll see. Lions. Giraffe. Elephants. Lions eating elephants. Pythons. Black mambas. Wildebeest--


Pythons eating wildebeest? Samantha said.

Zach slugged down half a glass of pinot grigio.

Easy on the vino, there, dude, Hartford said.

Duncan insists it’s absolutely safe.

Of course, Hartford said.

How long’ll we be gone? asked Samantha, her eyes burning, her tone low and menacing.

You kids get nine days off for spring break, Edith said. "We’re going to pop you out of school for some extra time. It’s a long trip.

How long, Mother? said Samantha, brimming with anger.

Sixteen days.

The trip’ll take sixteen days? Tears dribbled down Samantha’s cheeks.

Sixteen plus the nine, Zach said. Three and one-half weeks. Cool, huh?

You’ve gotta be kidding, Hartford said, in spite of himself. As soon as he spoke, he regretted it. After all, the trip had been his idea.

I’m not going. I’ll miss too many rehearsals. Samantha sprang from her half-eaten meal and ran upstairs.

Hartford rose to pursue the subject with his daughter, but his work phone rang in the hallway. He stopped.

Damn.

He wiped his face again with the napkin, threw it on the table, stumped to the phone. He knew the call would slam closed this charming family interlude.

Malcolm?

Hello.

It’s Tali. Dr. Ferijani, Hartford’s other junior partner, an independent and outspoken Pakistani from Chicago, sounded stressed. Spooner’s dying. The nurses’re keeping up with the bleeding, but his right heart’s crapping out. He’s on mega doses of epi. His kidneys are dead.

Start dialysis. Keep transfusing if his filling pressures aren’t too high. I’ll be right in.

His wife’s in a state.

I’ll be there in twelve minutes.

Chapter 2

It took another trip to the OR, a wash-out of accumulated blood, a round of bedside hemodialysis, and an hour tinkering drug drips with Snow, but Hartford managed to get Spooner stabilized by three a.m. As the surgeon sped home on a deserted freeway, his mind remained in the