Last Surgeon (2 page)

“Nick, Nick, throw it here! Come on, let it go!”

Nick Garrity cocked his right arm and lofted a perfect spiral to the gangly youth waiting across the yard. The boy, who would have been happy to keep playing until midnight, gathered in the pass effortlessly and immediately threw it back.

“Okay, that’s it, Reggie. I gotta take Chance for a run and then get ready for work.”

“One more pass. Just one more. After dinner I’ll go over to your place and take Chance out. Promise.”

Through the gloom of what was going to be a stormy evening, Nick could feel the boy’s energy and see his enthusiasm. A drug-addicted mother, a long-gone father, time in juvenile detention for a crime no one seemed willing to talk about, seven years in a sequence of foster homes, and the kid was still upbeat and great to be around.

How in the hell do you do it?
Nick wondered.

For most of the week, Nick’s mood had been as somber as the prestorm sky. And as usual, there was no reason-at least not on the surface-to explain it. A night in the Helping Hands RV would improve his flagging morale. It usually did.

He made a final throw, handled as easily as most of the others, and then motioned for Reggie to come in.

“Come on, big guy. I’ve got to leave soon.”

“So, where’re you goin’ tonight, Nick? D.C.?”

“I think so. Junie keeps track of that.”

“Can I come?”

“It’s a school night, and you promised to deal with Second Chance. Remember, don’t let him off the leash or he’ll see a squirrel and chase it to the moon. Greyhounds are bred to chase little furry animals. Use the long leash if you’re going to throw him his Frisbee.”

“How about I go with you tomorrow?”

“We’ll see.”

“I never get to do anything exciting.”

“Yes, you do. Staying out of trouble is exciting.”

Reggie punched Nick playfully in the side.

Nick put his arm around the youth’s shoulders and walked with him to the back door. The modest one-family, with three bedrooms and a finished basement, was located in the Carroll Park section of Baltimore. Nick had lived there with June Wright and her husband, Sam, for a few months before renting the first floor of a refurbished two-family down the street, close to the park. Not long after the move, Reggie Smith, now fourteen, had taken over the basement bedroom.

A sequence of kids were constantly coming and going through the Wright household, including the six-year-old Levishefsky twins, Celeste and Bethany, who had been there for almost a year now. If one looked up “saint” in any encyclopedia, pictures of Junie, a sixty-year-old nurse, and Sam, a DPW worker, might well be there.

Since Junie would be working the RV tonight with Nick, her husband would be doing the cooking. The couple had children of their own, and grandchildren as well, but at every stage of their lives together, they had added foster children to the mix.

The Helping Hands RV was parked on the street by the Wrights’ house. It was an aging thirty-four-foot mobile home converted into a general medical clinic. Nick loped past it on the way to his apartment. At six-foot-one, with broad shoulders and a solid chest, he still moved like the running back he had been in college before an illegal block had taken out most of his anterior cruciate ligament. Now the repaired knee was serviceable, but hardly ready to absorb a major hit.

Nick’s father, once a football player himself, was a retired GP. The option of moving to the family home in Oregon was always available to Nick, but had never been one he had considered seriously. In general, his parents were decent, understanding people, though not about their only son. There was no reason to expect they would be. In that same encyclopedia, at least in their library, his picture might have been inserted next to the word “disappointment.”

“This is our son, trauma surgeon Dr. Nick Garrity,” they had introduced him on more than one occasion during the years when he was their golden child, “and this is his sister.”

Nearing his apartment, Nick heard the low rumble of thunder in the distance, sounding like a truck engine slowly coming to life.

He tensed at the sound.

He always would.

Nick’s duplex would never be featured in
Architectural Digest
, but that was fine by him. Oak floors, a variety of posters from the local art store, plus curtains and a few plants gave the place an airy, comfortable feel. He was bent over beside the mail slot, scooping up circulars and bills from the floor, when he was hit from behind hard enough to drive his forehead into the door. He turned, knowing what to expect. Second Chance sat, head cocked, panting around the red Frisbee in his mouth.

“I’m running behind,” Nick said, rubbing at his forehead, half expecting blood. “Reggie’s going to take you out.”

The dog pointed his snout toward the door and shifted his behind.

“No go, pal. Gotta shower.”

They had been a team for almost two years, dating back to the first and only time Nick had ever been to a dog track. Lost in thoughts about Sarah, he had been on an aimless drive that ended at a casino in West Virginia. After an hour losing at the slots, he wandered over to the adjacent Tri-State track. He was in the midst of a particularly difficult time, when self-destructive thoughts had once again been seeping into his mind.

Damn PTSD.

Second Chance, a long shot in the fifth race and a natural bet for Nick, had been well in the lead when he suddenly slowed dramatically. Twenty yards from the finish, he was trampled by seven dogs as they passed over and around him, and was left nearly motionless in the dust.

An hour later, Nick and the greyhound had claimed one another at the adoption tent, where the dog’s sleazy trainer tried to convince the Army trauma surgeon that Chance’s uneven, lurching gait was due to nothing more than a minor concussion. Back home, the “concussion” responded dramatically when Nick, assisted by Reggie, Sam, and two Army buddies, cleaned densely packed dirt from each of the greyhound’s ear canals.

Of all the therapies Nick had tried in his battle against post-traumatic stress disorder, Second Chance’s presence in his life was the most consistently effective.

There were days when Nick was able to fit in some calisthenics and weights before going out on the road, but tonight, after playing catch with Reggie, there was just no time. He showered and was dressing in his usual work uniform, jeans and a faded work shirt, when he glanced over at a printout he had taped to the wall beside his bed listing the ten levels of SUDS-the Subjective Units of Disturbance Scale he used to estimate his mood at any given time. This evening seemed like a five:
Moderately upset, uncomfortable. Unpleasant feelings are still manageable with some effort.

Progress, that’s all he and Dr. Deems had decreed he should shoot for-just a little progress each day. Days like today, even after all these years, it was difficult to tell whether or not he was succeeding. He spent a minute patting and scratching Chance, and then pulled on a Windbreaker and headed out the door.

The thunder was louder now.

As usual, Junie Wright looked like royalty perched on the massive passenger seat, her iPod earphones in place.

“Let me guess,” Nick said as he eased the RV down the street and toward the interstate south to D.C., “the Temptations.”

“Nope.”

“Sam Cooke?”

“Way off.”

“Not more rap.”

“Yup, it’s my main man, Jay-Z. Pure sex through and through. Ummm-hmm.” She punctuated the statement with a seductive shoulder shake and flashed him the smile that had raised so much money for various charities that it could have eliminated a chunk of the national debt.

An ample African-American woman with wide bright eyes and what seemed a perpetual smile, Junie was raised in the projects of Baltimore. After battling a thousand dragons on her way to a high school diploma, making it through nursing school was a relative breeze. She had been working for the Helping Hands Medical Foundation for some time when Nick returned to medicine and began volunteering first one night a week, then, after a half a year, two.

When the foundation went under due to mismanagement of their funds, Junie did what she often did in so many crises-she took control. First she formed a tax-exempt corporation with Nick as CEO and herself as chairman of the board. Then she mediated the sale of the RV to the corporation for one dollar. She proclaimed Nick the full-time, salaried medical director, and used his rugged good looks and history as a decorated combat surgeon to raise money and recruit volunteers. But by far her biggest challenge over the years-especially since the disappearance of Nick’s best friend, Umberto Vasquez-had been keeping the medical director afloat.

“We’re gonna get wet tonight,” she said, setting her iPod aside.

Nick nodded, keeping his focus on the road. Junie was good at many things, but making small talk was not one of them. The seemingly innocuous statement was her way of asking if he was okay and ready for their customary long night. One of the many symptoms that had gotten in his way since the horror of Forward Operating Base Savannah had been insomnia-fitful, perspiring, leg-cramping, nasty insomnia, coupled with more than one person’s share of lurid nightmares.

“I can handle it,” he replied. “I’m tough.”

He turned the massive wipers on against the drops that were serving as reconnaissance for the storm that was predicted to hit full force by about eight. Junie, deciding that matters with him weren’t dire enough to push, repositioned her earpieces and settled back into her seat. From the other side of the highway, lights flashed past hypnotically, summoning up, as they frequently did, the vision of another set of headlights…

“That was some job you did in there, Dr. Fury, sir.”

Nick grins at the name, taken from one of Vasquez’s favorite comic book heroes-Sgt. Nick Fury of S.H.I.E.L.D. Now, after five months, most of the hospital staff and many of the other soldiers have picked up on it.

Dr. Nick Fury.

“You’re the one who plugged that sucking chest wound in that kid, Umberto,” Nick says.

“Well, you’re the one who taught us how to do it
.”

“
So, congratulations to us both. Listen, my friend, I have something I’ve been meaning to give you for some time. But before I do, I want your promise not to refuse it.”

“But
-”

“
Promise
.”

“
Okay, okay. I promise.”

Nick reaches into the pocket of his scrubs and hands over his Combat Medical Badge, presented for medical service during active combat. It is a handsome award-oval, an inch and a half across, with a caduceus beneath a Greek cross at the center, overlaid on a field stretcher.

“I take this into the OR with me for luck,” Nick says. “I want you to have it not only for what you do around here, but for the way you do it.”

“I can’t-”

“
Uh-uh. You promised.”

Umberto sighs.

“I’m honored, sir. I’ll take real good care of it. Promise. In exchange, have a see-gar.”

The stocky Marine staff sergeant, nearly half a head shorter than Nick but probably the same weight, produces two long cheroots, and the friends move to the front of the massive field hospital to light up. Nick is gritty with fatigue from what is now an eighteen-hour day. Vasquez never seems to tire.

FOB Savannah, one hundred kilometers southeast of Khost, isn’t usually the busiest field hospital in Afghanistan, but today it probably has been. A convoy heading to the base along main supply road “Tiger” had been ambushed. Two deaths, twenty casualties. Four OR bays in continuous action all day. Bellies, limbs, heads, and the sucking chest wound in an eighteen-year-old named Anderson. Nice work by Umberto, who never failed to take one of Nick’s combat emergency lectures. Nice work by the whole team, including Nick’s fiancée of six months, Sarah Berman, also a surgeon.

She was career Army when they met. Nick, fairly new to a private practice in Philadelphia on September 11, 2001, had been hit hard emotionally by the tragedy, and had opted out of the reserves and into active duty. The two of them were as made for each other as they were fated to connect.

Nick and Vasquez lean against a Humvee parked in the dirt lot to the left of the main door and savor their cigars.

“You going to re-up when your tour is over?” Vasquez asks, his Dominican accent barely detectable.

“Maybe. I really love the work and the guys. So does Sarah.”

“
You’ve really hit the jackpot with that one, Doc.
”

“
Tell me about it.
”

“
The guys are crazy about her, and even more important, they respect her. She’s still at it in there.”

“Almost done. No need to save her a cigar, though.”

Nick, a self-proclaimed “adrenaline junkie,” has had three or four cigars in his life. This one, given his exhaustion, exhilaration, and the night air, is the very best. He warns himself against getting too fond of them. Sarah hates the way they make his kisses taste. It is nearly 3
A.M.
A firm breeze sweeps across the desert, but provides little cooling. Far away, near the camp perimeter, a pair of headlights appears-twin stars jouncing toward them through the blackness.

“Who do you suppose that is?” Vasquez asks, inhaling deeply and exhaling through his nose. He flips on his radio and calls the guardhouse. “This is Vasquez at the hospital. Who’s bouncing across the desert at us?”

“That’d be Zmarai from the clinic down the road, Sergeant. He’s coming to check on his people from the firestorm this morning. Also, wants to mooch some supplies off you guys.”

“Vasquez out,” Vasquez says, turning to Nick. “Zmarai-now there’s a scary dude. Beady eyes. Bad teeth.”

“I’ll bet he thinks the same of you,” Nick counters. “He does a good job running that place and the little store. At least we have positive news for him this time. The two civilian casualties are both gonna make it.”

The lights from Zmarai’s truck move closer. The Afghani is a local leader who has his fingers in most of the area’s pies, and often passes through security on his way to pick up supplies for the tiny clinic he runs. They know him well.

The battered, ancient Chevy pulls into the floodlit perimeter and stops fifteen feet from the massive wooden door to the hospital.

“Hey, Zmarai,” Nick calls out as he approaches, “what’s in the truck? I sure hope it’s pizza.”

Through the side window, the man looks off-kilter. His face is tilted skyward. His eyes are closed. All at once he opens his mouth and begins a chilling, screeching chant.

“Allah Akbar!… Allah Akbar!”

“Umberto, down!” Nick yells, now sprinting toward the driver’s side. “Oh, my God! Get down! Get down!”

He leaps onto the running board and grabs the side-view mirror with one arm, pounding on the window with his other hand just as the engine roars to life and the truck surges forward, spewing sand.

Nick sees Vasquez appear at the tightly closed passenger window at the moment the truck shatters the main door with a fearsome jolt. It hurtles ahead toward the heart of the enormous tent-the operating and recovery rooms. Suddenly, Sarah appears, locked between the headlights. Nick barely has time to register that she is there, to see the terror in her eyes, before the grille of the truck hits her at the base of her ribs, tearing her nearly in half. Nick sees blood gush from her mouth as she flies backward toward the ORs.

Vasquez is slammed against a support pole and driven off the running board. The truck bursts into the brightly lit space, scattering victims and hammering into patients. Zmarai hits the brakes, hurling Nick to the ground like a rag doll. Paralyzed by Sarah’s gruesome death, Nick stares unseeingly at the floor. He knows the truck is going to explode and that he’s about to die. The image filling his mind is Sarah. Suddenly, there is a blur of movement from his right side. Heavy arms wrap around his shoulders and drive him backward into the base of a massive refrigeration unit filled with blood and blood products.

Umberto!

Glass shattering, the refrigerator topples onto Nick and his friend, covering them both. Nick is semiconscious, facedown under the glass-and-steel appliance. Units of blood are torn open and their contents pour onto his head and torso. Then, amidst the chaos and screaming, Zmarai’s ancient truck explodes. The roar is deafening. Blast-furnace heat floods Nick’s face and arms.

Then there is nothing.

It is more than twenty-four hours before Nick begins to regain consciousness. His skin is badly scorched, his ears are ringing, and his hearing is muffled, but he can still hear the surgeon telling him that rather than leave the tent, Umberto had rushed back to Nick’s side and saved his life. He is told that Umberto is still in a coma and there is only one other survivor, an orderly, who is still touch and go. There are twenty-eight fatalities. Some of the bodies, including Sarah Berman’s, have not been pieced together yet.
…

“Jeez Marie, Nick,” Junie cried. “I just looked over at you and you weren’t there. It’s like the RV is on automatic pilot.”

“I was here,” Nick lied, flexing his shoulders and back against the chilly perspiration that was soaking into his clothes.

The rain had become a downpour, and the RV was blasting through it into the darkening night.

“You want to go home?”

“I said I was okay,” Nick snapped.

Junie knew better than to react. Whatever had been going on was leaving him, and no one had gotten hurt. The episodes had been coming fewer and farther between. He’d be okay.

“On the highway, this here bus is like a battleship against a bunch of rowboats,” she said.

“I… know. I’m sorry.”

He slowed the RV to forty.

“You’re going to be okay, Nick,” the nurse said in what was half statement and half query. “You’re going to be fine.”

Nick’s reply was a grim smile.