Hold Back the Wind

By J. K. Winn

     What's a doctor to do when the only way to save her patient is to take life-threatening paragliding lessons from an embittered ex-doc? And will the risk to life and limb be worth the effort?

     Pediatrician Vickie Marsh is determined to do everything in her power to save five-year-old Orlando Asala's life before he is released from the hospital and sent back to the migrant camp where his parents are living in squalor. With kidney cancer, his fate will be sealed before he's wheeled out the hospital door. Orlando's only hope is an experimental treatment developed by Doctor Zachary Scott. 

     One problem, Zack no longer works at the hospital, having quit his practice under bitter circumstances, and now teaches paragliding lessons. The only way Vickie can reach him is to sign up for a series of classes. While Vickie can certainly use a hobby to enliven her work-filled life, she has been warned that Zack has an axe to grind with the hospital and might not be willing to cooperate with her. Since Zack is her only hope, she forges ahead with a plan to convince the reluctant doctor to share his formula with her.

     In the meantime, there have been an increasing number of unexplained deaths on the pediatric unit. Is this only a temporary fluke, or is something malicious afoot at the hospital? 

      Under pressure to spare one child's life, and perhaps save others, Vickie soldiers on in the face of growing resistance from the hospital administration...and from Zack. Can Vickie convince Zack to work with her? Will she be able to save Orlando's life?  And, in the process, will she discover the cause of the mysterious hospital deaths? 

     To find out, read this spellbinding story of intrigue, romance and Big Wind.

• Language: English
• Publisher: J. K. Winn
• Release date: Jun 10, 2019
• ISBN: 9781393306856

J. K. Winn

J K Winn has many stories to share. After years of working in the "real" world, she decided to reinvent herself in mid-life and pursue her love of story. Out of the Shadow is her first published novel, but she has one prior novel published in genre, and one play produced by the Actor's Alliance Festival in San Diego. Her poetry has been anthologized in, For the Love of Writing, by the San Diego Writer's Workshop in 2011. Her play, Gotcha!, was selected for a reading at the Village Arts Theater in Carlsbad, California, May 2012. Look for her latest romantic action adventure, RIVER OF DESIRE. She presently lives by the beach in San Diego County, California. Visit her at her blog authorjswinn.wordpress.com or on facebook.com/authorjswinn

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Dedication

In deepest gratitude to Dr. Allan Lenetsky (1946-2006), who was my medical consultant for this book and a man of great intellect and character. Without you, this novel would never have been possible. You were ahead of your time.

You were taken from us too early, and we will always miss you.

Topic of Cancer

You spread your alien seed

Parasitic sprawl

Cellular congestion

Into membrane, soft tissue, muscularis

Gnarled tendrils stretch toward lymph nodes

Hitchhike a ride for far-flung organs

To populate new territory

Gorge on liver and spleen

With the stealth of a determined insurgent

You steal upon unsuspecting systems

Consume skin, connective tissue, blood vessels, bone.

Until little is left to feast upon

But I refuse to let you feed on flesh without a fight

I zap you with current

Douse with poison

Excise with sharpened instruments

Repel with optimism

And plan for a future without you.

Grasp daylight between frightened fingers

Insulate myself with tender dreams and renegade visions

Even as you send paralyzing probes deep within

I defend with well-prepared potions

Change biology through chemistry

Antioxidants, fiber, meditation, spirituality

Believe that magic and miracles mixed with the

correct measure of aminos

Can reverse the continental drift

Away from tantalizing tissue, succulent cells

All the while aware

I may have invited you in the first place

I’m being a terrible host

But you, like most guests, have overstayed your welcome

And must be taken by the tentacle and shown the specimen bag

Table of Contents

Chapter One

La Jolla, California 1998

Without a medical miracle, Orlando Asala would die. 

Dr. Vickie Marsh palpated the five-year-old’s stomach, distended to the size of a watermelon and hard as a rock. Sure signs of end stage kidney disease.

At her touch, Orlando winced and a single tear trickled from his large dark brown eyes and travelled down his cheek. Vickie reached up to pat his straight black hair. Sorry Sweetie. Since he didn’t understand a word of English, her reassurance was more for her own sake then for his. 

Even in pain, Orlando didn’t utter a sound.

Not normally a risk taker, Vickie had rarely stepped outside the dotted line, or questioned authority. But, every once in a while, life requires more of you than you're prepared to give. It asks you to stretch and grow in ways you never thought possible. And at those moments you can either bow under in defeat, or take a leap into the unknown.

Vickie knew what she had to do. She gently draped the cover over Orlando. I’ll be back. With a CT Scan extracted from his chart, she took the stairs two at a time to the first floor administrator’s office. Vickie had lost two patients unexpectedly in the last couple of months and she wasn’t about to lose one who could be saved without putting up a fight.

Heart pounding, palms sweating, she stationed herself by Bart Standly’s desk and placed the CT Scan under his nose. I'm wondering if you could help me understand your policy concerning the Asala kid. Since he's in kidney failure, why can't I dialyze him?

Bart frowned. You know as well as I do we’re only supposed to offer emergency treatment to illegals.

I know you won't treat his cancer, which is probably Wilm's tumor in both kidneys, she pointed at the scan, but after what happened in the Ramirez case, I'm having difficulty making sense of why you won't let us at least dialyze him. If we had only kept the Ramirez child here, he might be alive today. I hope you won't do the same thing with Orlando.

Bart brushed off her argument with a hand. This is a private hospital, Vickie. We don’t have the resources to treat everyone who waltzes through our doors. He can go to a public facility for further treatment­—

That’s what you said about Jose Ramirez. How can you transfer out anyone in Orlando’s condition? It’s... it’s unconscionable.

There’s no proof we could save him even if we intervened.

"But there is evidence if we don’t he’ll die."

Look, I have enough to deal with right now without anything else on my plate. You know as well as I do the state is sending someone over to look into the number of unexplained deaths on our pediatric floor. I’m under enormous pressure. Bart looked strained. He fingered a metal paperweight, nervously tapping it against the polished wooden desktop. Beside the legalities of treating this child, how do you think we’d be paid? We aren’t a county hospital. We can’t afford to treat patients for free. Be rational.

Still shaky, she had to think fast or her position wouldn't stand a chance. How would it look with all these pediatric deaths if we abandon a sick kid? I don’t care if he’s from Guatemala or Timbuktu. It won’t help the hospital’s image.

Although Bart raised a hand in protest, his voice became pious. Reasonable. I’m just as concerned a doctor as you. I’d like to treat this child, but it’s futile. Any drastic measures would be questionable...and irrationally expensive.

To calm her smoldering frustration, Vickie stared past him through the picture window at the brilliant blue San Diego sky. An ancient queen palm swayed in the ocean breeze. Bright scarlet bougainvillea encircled its trunk and clung to it with the same desperate determination driving her.

She pointed to the picture of a beaming tow-headed boy on the wall by the window. Orlando Asala is only five, about the same age as little Bart. How would you feel if this happened to him? I know you’d have the hospital cranked into high gear to handle the problem.

He looked away and gave a shrug of indifference.

You’re head of this hospital, you make the final decision. If Children’s or Scripps caught wind of this, what do you think they’d do?

At the mention of his competition, he squirmed. But I’d have to justify it to the Board and you know where they stand on these matters.

She saw fear of bad local PR was more likely to change his mind than humanitarian, or even personal, considerations. She pressed her advantage. You can tell the Board what you want; this kid needs treatment now. I’ve looked at his levels and he probably has nephroblastoma tumors. There's no time to delay.

But time did stop while he considered. Bart stared at the scan with flat black eyes surrounded by puffy bags. He ran a hand through his combed-over gray hair and then pinched his sagging jowls.

Finally, he sighed. All right. You win this round.

You're wrong, Bart, I haven’t won anything until I find a way to save Orlando’s life. The dialysis is only a stop-gap measure. It isn't a cure.

A buzz filled the room and Bart silenced it by pressing a button on his phone. Yes?

The voice of his secretary bellowed back, Steve Maple’s here from Med Machines.

Tell him I’ll be right out. Bart glanced up as though surprised to find her still there. I have to go. This is an important meeting.

She had squeezed out all the concessions he would deliver for now. After a terse goodbye, she left the office. Halfway down the hall she ran smack into oncologist Cynthia Reynolds. Cynthia looked as harried as Vickie felt.

Sorry, Cynthia mumbled, then stared at Vickie. Are you okay. You don’t look well...

I just had a meeting with Bart about one of my patients, Orlando Asala—you know, the five-year-old from Colombia.

Cynthia flexed her brow. And what was the gist of this meeting?

Money, of course. Bart doesn’t want to keep treating Orlando indefinitely without the hope of being paid. I can understand his position as Hospital Director, but I can’t understand tossing this child away like yesterday's breakfast. I don’t know what to do.

She started to move past Cynthia, when she heard her mumble under her breath, There’s one possibility—­

Vickie spun around. What's that?

I recall a similar case a couple of years back. There was someone who could help... She shook her head of wavy dark brown hair. Deep lines etched grooves around her bloodshot, sleep deprived eyes. Silly of me to even mention anything. He’s long gone... she muttered. It’s such a long shot, you might as well not bother."

Not bother. Any hope was no bother at all. She blocked Cynthia’s path. Who is it?

A tech walked past and gave Cynthia a nod. She smiled at the tech before glancing back at Vickie. And?

Cynthia looked confused. What were we talking about?

You mentioned someone who might be able to help Orlando.

That’s right. I probably shouldn’t have mentioned him because he left the hospital under less than the best of circumstances a few years back. I hear he’s working for a private research lab and teaching paraglider classes—

Who are you talking about?

Cynthia shrugged. I don’t believe he wants anything to do with this hospital anymore. So forget I mentioned him.

Him who?

I wish I hadn’t said anything. We're friends—I'd hate to piss him off. I warn you, if you approach him, don’t expect any assistance from me, and do expect a lot of resistance from him.

Just tell me his name and I'll take it from there.

Cynthia sighed. I know you, Vickie. You’ll never rest until I give you an answer, even if it’s a big mistake. Please don’t tell him I sent you. I'm not sure how he'll react.

Her reluctance piqued Vickie's curiosity all the more. Why?

To say he's not fond of Bart or Seaside Hospital is a serious understatement. I’ll leave it at that. Cynthia offered her a shallow smile.

His name is Zackery Scott.

A big wind buffeted the paraglider and sent it sailing cockeyed to the south. The turbulence would make a lesser man quake, but Zack prided himself on his fearlessness. The stronger the wind, the greater the challenge. He had already faced his worst fears; what did he have to lose that he hadn’t already lost?

Over the roar of the air current, he could barely make out the shouts from below. Two fellow flyers flailed their arms, pointing toward the hill. From his angle, he couldn’t tell what they were pointing at.

By maneuvering the wing around, he spotted Doug heading straight into an outcropping of rock on the side of the hill. Since Doug was not far below him, with the right current, Zack might get to him in time. Zack moistened his finger to test the wind current that had shifted slightly from the east to the north. Aware of the chance he was taking, he dog-eared his wing and dipped toward the out-of-control flyer. The wing trembled, but he didn’t let up on the lines. Coming in as close as he could, he let go of one line, grabbed Doug by the arm and thrust him away from the rock outcropping.

A gust pushed Zack toward the outcropping. He pulled on his own lines, trying to turn away. The rock was coming up fast. At the last possible second, the paraglider caught the north current, barely missing the outcropping. He let out a huge groan of relief.

When his feet touched ground, everyone rushed him.

Sporting a new buzz haircut and shiny gold earring, Larry slapped Zack on the back. You nut, you. That was a close one. What were you thinking up there pulling dog-ears? You could have collapsed the damn thing.

With a tug at his helmet, Zack pulled it over his head and passed a hand through his thick, matted hair. What choice did I have? It was either dog-ears or death.

You’re my hero. Teresa laughed, displaying small orthodonically aligned teeth. She playfully poked him in the ribs and stared longingly into his eyes. Lately she had been trying hard to let him know she’d be interested in more than an occasional tandem flight at Little Black.

Zack kicked aside a rock to make room for the paraglider. He didn’t want to hurt Teresa’s feelings, but since Patricia’s death, he wasn’t relationship ready and flings weren’t his thing.

Doug came over to thank Zack and shake his hand. Hey, man, what can I say? You’re one damn good flyer. If you ever need anything, don’t hesitate. Call on me.

Just be there if you ever spot me being overly intimate with a pile of rocks.

I’ll do my best, Doug promised.

Didn’t you say you have a tandem scheduled today? Larry asked.

Zack glanced at his watch, then down the empty road. "I guess had is a more accurate description."

Larry tested the wind with a finger. Since they’re not here yet, let’s take another flight.

Zack shouldered his pack and trailed Larry up the hill.

At the apex, he waited for Larry to launch before he took his turn. In the air, he scanned the land below for an unfamiliar vehicle. None apparent, he rotated the wing to the east and back again facing west. His new student had probably chickened out. With this risky business, he didn’t blame her.

In the distance a slice of the Pacific Ocean’s turquoise waters touched the horizon. When he turned the paraglider, he could see the late afternoon sun illuminating low—lying clouds an iridescent pearl. The breathtaking beauty of the landscape reminded him why he had chosen San Diego as his home. Funny, he had forgotten of late.

Sun slanted into his eyes. He pivoted to avoid the rays causing the glider’s wing to tremble violently then fold under on one side, leaving him breathless. Back in command, he rotated just enough to straighten the side while picking up a steady flow. The paraglider careened to the east. Wind rushed at him. How he loved flight—the only thing left in life he had any real control over.

A dust devil rose off the dirt road. A white car sped toward the hill, kicking up sand and soil. Since none of the other flyers had a white sedan, the one heading toward the parking area just might contain the student he had assumed was a no-show.

The yellow and red stripped wing soared gracefully above Vickie’s head. With one hand, she shielded her eyes in order to see the pilot dangling from what looked like thin threads pass overhead. He executed a one hundred and eighty-degree turn and sailed back the other way. The canopy rose unexpectedly and just as abruptly dipped, thrown to one side. Just watching him sent shivers down Vickie’s spine, but she swallowed deep breaths to calm the rising tide of fear.

How many afternoon breaks had she spent while at UCSD medical school watching the flyers spread their wings and swoop down over Torrey Pines gliderport to a graceful landing on the beach. Since the gliderport was on her route back to her condo, she would often stop by to take a break from her stressful routine. She knew paragliding probably looked easier than it was, but there was something alluring about the sport. If it hadn’t been for a sick child, she might have never taken the chance, but now she was about to take the leap. 

She had been lucky enough to use Bart’s fear of bad publicity to her advantage, which gave Orlando Asala a reprieve of a few days—max. The hard part was behind her. Now all she had to do was persuade an ex-staff doctor at Seaside Hospital to use his expertise to give the boy a chance at life. If it meant she had to fly without the advantage of a Boeing 747, so be it. 

The man pulled on a cord and the wing straightened. He made it look easy. He obviously didn’t mind the risk of leaving mother earth without a motor to power his flight.

A series of rotations brought him within a few feet of the ground. With one last tug at the cord, he collapsed the canopy and landed on his feet, running toward her. He came to a halt mere inches from where she stood.

Magnificent landing, she said in all sincerity.

Not my best. The pilot released the strap from the harness holding the paraglider to him and it tumbled behind him. Little bumpy today. Southwest winds.

His broad smile relaxed her a smidgin. I’m looking for Zackery Scott? Do you know where I can find him?

His smile widened. Call me Zack.

I’m Vickie Marsh, the one who called earlier about a tandem flight. Sorry I’m late. She extended her hand.

He shook the hand she offered. No problem, but we better get started right away. He bent over to lay the paraglider out on the ground, and as he did, he asked, What makes you want to take paragliding lessons?

This was not the right time to reveal the full extent of her purpose. My life is all work and no play. I need a hobby to lift it off the ground, so to speak. 

Scott chuckled. Okay, lesson number one. To begin with you have to unfurl the paraglider before you fold it, first one end and then the other.

How effortlessly he segued into a lecture. A friend told me you’re the best teacher around.

That’s because I’m the only one around Little Black. Now watch me carefully straighten the lines and fold the nylon canopy into a ball.

As she watched she noticed the sun sat not far above the horizon. I know it’s a little late today, but I’d still like to go up.

He glanced up at the sky. With these winds and you a beginner, I’m not certain it’s a good idea this late in the day.

Vickie wasn’t certain either, but she had urgency of purpose and a busy schedule pressing her on. She thought of the calendar on her desk at Seaside hospital, every hour closely accounted for. I’ll be glad to pay extra for it.

Humor played across Zack Scott’s face. For your information, I charge the same price no matter the wind currents or time of day. He wet his index finger with his tongue between straight, white teeth and held it high. Wind seems to be dying down a little. Come on. We’ll give it a try. He finished folding the paraglider into its pack.

He checked her out from nose to toes, making her a little self-conscious. Any problem?

It’ll be tough making it to the top of the hill in those heels.

She had changed out of scrubs into khakis and polo shirt at the hospital earlier, but had left her running shoes in the trunk of her BMW. Oh, She laughed. Don’t worry I’ll change before we start.

From where Scott stood slanting sunlight reflected off his dark golden hair and into his sea blue eyes. With his long, lanky frame fitted comfortably in a beige and brown flight suit, he was the epitome of a California surfer-type, making it difficult for her to believe he was capable of developing a cutting-edge cancer cure, but under the circumstances she hoped she could count on what she'd been told.

Vickie retrieved her aerobic shoes from the Beemer while Scott made his way to a black Ford Explorer with gold trim. The vanity license plate read ‘Hi Flyin.’ From the Explorer he extracted a clipboard with a white form attached and held it out to her. I need you to read and sign this disclaimer. Anything happens to you, I can’t be held responsible. You have medical insurance. Yada, yada, yada.

After she signed, he placed the form in a folder marked with her name, then tossed the clipboard and folder onto the passenger seat. We need a special glider for a tandem flight. He pulled a larger backpack out of the rear of the Explorer, hoisted it and carried it to where she stood, waiting for her to finish her preparations. Then he turned toward the base of Little Black hill. Follow me.

Trailing slightly behind, she trailed Scott up a steep slope over loose rock, past large boulders. Although the footing became difficult at times, she stumbled behind him, grasping onto branches for leverage. My friends have been on my case for working too hard. They say I need a diversion.

This is the best high around, he said over his shoulder.

Winded, she stopped for a breath and watched him spring up the hill like an adolescent, not the thirty-something she knew he must be. She was having more and more trouble keeping up.

You’re in amazing shape, she called after him, panting. But she couldn’t say the same for herself. She was a doctor, for Pete’s sake. This hike made it clear; it was time to make her health a priority. 

That’s what paragliding does for you. After you carry a pack up this hill a few times, it will be a breeze.

More like a gale, she thought and pushed herself to keep pace with him, stopping repeatedly to catch her breath.

Scott glanced over his shoulder at her. Maybe we’re taking on a bit too much the first time out. Want to take a rain check?

She interpreted this as a challenge, not a defeat, and sprinted the rest of the way to where he stood. Although she could