An Open Heart (23 page)

“Dr. Rawlings.” The voice was deep, male, and belonged to the MP.

He cleared his throat. “Minister Okombo.”

“I’m calling to thank you. I hear that your first open-heart case has been successful.”

He didn’t call her his daughter. Perhaps he was in a public place.

“I want to invite your team to my office. Dinner with the minister of health. I will be sending a car on Friday.”

Jace rubbed his eyes.
Friday?
He sighed and collected his thoughts. “I am honored, sir, but I have another urgent case to attend to. Perhaps we can reschedule.”

“It has to be Friday.” Minister Okombo raised his voice.

Jace was tired. And he didn’t feel like being manipulated by the politician. Again.

“Do I need remind you that your equipment is in Kijabe only because I arranged it?” Okombo said.

Jace reacted, speaking without restraint. “Do I need remind you that your daughter is alive because we were able to help her?”

Jace listened to the sound of breath blowing into the phone. “Look,” Jace said. “Could we come this weekend? I really do have an urgent case to attend to.”

“Fine.”

Silence followed his cryptic response. Jace worried that he had offended the powerful man. He wasn’t sure how to respond.

“I’ll send a car. Ten a.m. Saturday morning.”

Before Jace could thank him, he heard the noisy clunk of the phone slamming into its cradle.

In Richmond, Heather Rawlings sat across from Detective Steve Brady as he looked at the report lying on the coffee table between them. Steve’s wife, Carol, balancing a toddler on her hip, set a mug of coffee in front of her husband. He touched her hand gently as she lifted it from the mug. Their eyes met.

Jace used to look at me that way
, Heather thought.

Heather had called Steve and Carol, who attended her church, to ask if she could stop by their home and ask a few questions.

Her detective friend loosened his tie. “Where’d you say you got this?”

“Got it in the mail. Is it legit?”

“It might be.”

“There was ketamine in her blood.”

The detective sighed.

“I don’t need to tell you what that implies,” Heather said.

“You want me investigating this? Heather, you’re putting me in a funny—”

“No,” she said, shaking her head. “I don’t want to cause Jace trouble.” She hesitated. “I just need to know the truth. Can’t you just ask some questions for me?”

He shook his head slowly. “Look, this may not even be legit. I can check with the medical examiner’s office and see if I can find the original. I’ll keep it off the books for now, but the presence of ketamine complicates things a bit.”

“I’m not sure why your department wasn’t aware of this report.”

“Mrs. Franks’s death was not being investigated as a homicide. She was struck by a passing motorist. It was a pedestrian accident.”

“But if the governor’s wife had been raped, wouldn’t you want to know that?”

“Heather, you can’t believe Jace could—“

“I don’t know what to believe anymore. Jace has no memory of that night. He doesn’t remember being in a car with Anita Franks at all.” She hesitated. “But I want to know the truth. I want to know why someone thought this information was important enough to send to me.”

“We don’t even know if this is a real document. Someone could have easily forged it. Sent it to you to make you doubt your husband.” He tapped a pencil against his desk. “Who would want you to think Jace was unfaithful?”

She cleared her throat. “No one. I mean, the media went crazy with speculation about his relationship with the governor’s wife, but Jace assured me it was all talk.”

Steve shrugged and straightened a small picture frame containing a shot of himself and Carol standing in front of an ocean. “So you believe your husband?”

“I want to believe him.” Heather took a deep breath and touched the corners of her eyes with a Kleenex. She looked at Carol, who had positioned herself on the flowered couch beside her husband. “There are moments when I know I should throw my doubts away and believe that Jace is the man I love. But then, other times …” Her voice weakened.

Carol reached over and squeezed Heather’s hand.

“I’ll find the true ME’s report, see if this is valid,” Steve said.

“If it is?”

“I’m not sure it means anything. Ketamine in the blood doesn’t necessarily mean foul play. It may only mean that Anita Franks had a penchant for illegal drug experimentation. I hear ketamine and LSD share similar qualities.”

“Ketamine is a date-rape drug.”

“I know that. But the presence of the drug itself means nothing. Anita Franks was not known to be raped.”

Heather pointed to the report. “There was evidence of recent intercourse.”

“Exactly. Intercourse isn’t sexual assault.”

Heather sighed. “I’m not sure that news is any comfort to me now.”

“What exactly do you want me to do?”

“I’m not sure. I’m just looking for advice. I’m trying to find out the truth.”

23

Two days later, Jace’s team gathered in the theater for an aortic valve replacement. The room had been fumigated for mosquitoes; the blood bank was ten units ahead; monitoring lines were in.

Game on.

Jace sutured in the atrial and aortic canulas. “Let’s go on bypass,” he said to Gabby. “I’m opening venous line to you.”

“Venous line open. We’re on bypass,” she echoed.

Two minutes later, the electricity failed. Gabby scrambled to operate the pump by hand.

Jace looked around the room. The overhead lights were off, the operative field dim. A moment ago, with his attention only on his operative field, he could have believed he was anywhere in the developed world. With the electricity off, he was brought back to reality.
TIA. This is Africa.

In thirty seconds, the generator kicked on and the lights returned. Jace breathed a sigh of relief. “Let’s cool.”

After a few minutes, Jace used the cardioplegia, stopping the heart during diastole. “Knife.”

“Wow,” Jace mumbled as he looked at the patient’s valve. “No wonder he was in heart failure.”

For the next two hours, they worked with orchestrated precision. When the patient’s temperature was three degrees below normal, Jace put the paddles against the heart muscle. “Charge to twenty.”

“Twenty, charged,” Gabby said.

“Clear.”

At the head of the bed, Evan compressed both carotid arteries on the side of the patient’s neck. This was a protective measure to prevent the first blood pumped out of the heart from going to the brain, just in case all of the air hadn’t been removed from the heart before restarting it. Air left in the heart, even in small amounts, could cause a stroke if allowed to reach the brain.

The heart began a fine quiver. “We’ve got fibrillation. Charge again to twenty.”

“Twenty, charged.”

Crisis.

Jace depressed the buttons on the end of the defibrillator. This time the heart began to pump. Once, twice, then jumping into a regular rhythm.

Evan counted five beats, then opened flow to the brain by lifting his fingers from the carotid arteries. He studied the echo and then looked across the drapes into the open chest. “Looks like he could use a little volume.”

“Agreed,” Jace echoed. “Give me a hundred.”

Gabby nodded and turned a dial. “One hundred, in.”

“Better,” Jace said. “Dial back the bypass to fifty. Let’s get out of here.”

Jace spent the first eight hours post-op at Joseph’s bedside, doing what he could to keep his anxieties at bay. Give a bolus of fluid. Titrate in a little morphine. Wean down the oxygen. He relished the predictability of physiology at work.

But that night, he lay on his bed and sighed, unable to escape the oppression of Beatrice’s revelation.
I did not see light in you.

Her words didn’t really surprise him. He would have predicted he would be dark. But his patient’s words unroofed old hurt, a bellyful of pain that he knew he needed to face but didn’t know how.

If I am dark,
he thought,
my sister was light.

He remembered how intense she was in the weeks leading up to their graduation.

A youth minister from New York had given an emotional plea for students to make a commitment to Christ on the final day of spiritual emphasis week at Rift Valley Academy. Day after day, Janice had responded, weeping for herself and her friends at the altar. Jace had sat in his chair, dry-eyed and unmoved.

Afterward, they walked together down the rocky path toward their house.

“I’ve decided to stay an extra year in Africa,” she said. “I’ll work as a surgical tech for Dad in the theater and volunteer at the children’s hospital. It will give me a chance to beef up my résumé for medical school application.”

Jace said nothing. He couldn’t wait to get to America and start a life of his own.

“Jace, why don’t you stay? You could work in the physical therapy department or—”

“What’s this about? I’m going to college, Janice. I need to find a life outside this bubble.”

“Don’t you see? This bubble has been protecting us, Jace.”

“Restricting us, more like.”

She shifted her backpack to the other shoulder and sighed. “Why didn’t you respond to the message? All your friends were at the altar, yet you stayed in your seat.”

He shook his head. “It’s not my thing.”

“Your thing? Is that what you think this is? My thing?”

“I don’t know. We’ve always been different that way. We hear the same message. You believe. I doubt.” He shrugged.

“You could believe.”

“You could doubt.”

She shook her head. “No, Jace, I can’t. Look around. The world is amazing. Everything speaks of a creator. I feel Him. He loves us, Jace.”

“Jacob have I loved,” he mumbled.

“What?”

“Nothing.”

“Say it, Jace. You’re quoting the Bible.”

“Yeah. Spiritual me.”

They walked along in silence, but Jace knew his twin was boiling. Finally, when they reached the turnoff leading to their house, she spoke. “Do you think that’s us? Jacob and Esau?”

“Maybe,” he said. “I hate that story.”

“You’re not Esau.”

“How do you know? Why do you cry when you hear about the cross and I don’t?” He paused and shrugged. “Jacob have I loved. Esau have I hated.” He touched her shoulder. “Janice have I loved.”

“No, Jace. Listen to what He says to you. Jace have I loved.”

“I wish I believed it. It sounds nice.”

“It doesn’t just sound nice, Jace. It’s truth.”

“Is that why you don’t want me going off to America?”

“I’m afraid for you. You need to make a decision before you leave this place. Decide to live your life for something bigger than yourself.”

“God.”

“Yes, God.”

“You’re afraid I’ll get away from the bubble and never come back.”

“Jace, I just want you to respond to God’s call.”

“What is it with you? Why the God-talk all the time?”

She shook her head. “This isn’t something to joke about. You know what happened to Timmy. You never know what will happen. You heard the chapel speaker. We could have an accident and be standing before the throne of judgment tonight. Or tomorrow.”

“That’s just it. Timmy dies. And it makes you think we should make a decision to follow God. But for me, it just makes me want to doubt that God loved us in the first place. How could God let that happen to him?”

“We can’t know why. We just know He loves us.”

“Well, maybe He loves
you.” Jacob!

Jace walked into the house and up to his room. He wished he believed.

But faith just didn’t seem like something he could psych himself into, as if he were preparing for a rugby match.

God, if You’re really there, show me.

24

Jace fell into a fitful sleep after midnight, rousing at six when the ibis squawked a proclamation of the dawn.

He drank Kenya AA coffee prepared in a press and wondered how he’d survived in America without it. He showered, dressed, and hurried to the ICU. It was Saturday, and the team was supposed to join the minister of health for lunch in Nairobi, but Jace wanted to check on his post-op valve patient and be sure everything was stable before he left.