'Shit… Shiiit!' He stood transfixed, staring at the empty space. Around him, pandemonium was building. He was the only person on the second floor not in motion. A steady stream was now heading for the stairs, and a medic with a fire extinguisher was spraying the inside of the store room while a porter rushed for another extinguisher.
It took a moment for Chapeau to break himself out of his trance and ask someone passing where the boy had gone. He'd stopped three nurses before finding someone who knew. 'He was taken into the operating theatre over an hour ago.'
'Thanks.' Chapeau merged with the throng heading down the stairs. The porter had joined the medic with a second fire extinguisher. They would probably have the fire out within a few minutes.
In the first floor operating theatre, the alarm bell rang ominously in the background. The Chief Surgeon, Dr Trichot, asked one of the nurses to find out what was wrong.
She came back in after a moment. 'Fire on the second floor, apparently.'
'Is it confined to there?'
'I don't know, I didn't ask.'
Trichot nodded for his assisting nurse to dab his forehead, and silently cursed. 'Let's assume that there's no immediate danger, or at least someone will come running in when there is, and continue. Please!'
The assisting nurse took the scalpel from him as he held it out tersely. She thrust a self-retaining retractor into the same hand.
The boy, Christian Rosselot, had been on the operating table over thirty minutes now, but they'd lost vital time getting X-rays and angiograms and preparing for anaesthetic. In that time, the temporal skull section by the boy's ear had bulged alarmingly with an active clot.
But two nights ago he'd operated on the boy for a similar clot in the parietal lobe, snatched him within minutes from the jaws of death — and he was determined not to be defeated now. Fire or no fire. The clanging bell was enfuriating, grating at his nerves. It couldn't have come at a worse time. He needed all his concentration at this point. Implements were placed in his hand and taken back without him looking up, the last an electric burr drill. Its high pitched drone lowered as Trichot cut into the bone of the skull.
The extradural cortex was exposed. There was no sign of haematoma, and Trichot began to worry. He would have to go deeper. 'We must go into the subdural.'
Partly gelateneous, Trichot sliced through the dura easily with the scalpel, pulled back with a hook and prompted his assistant to shine a penlight into the aperture.
Grey and white tissue and vessels reflected brightly under the light; the dark matter of the blood clot only showed up as Trichot widened the arc of the penlight. It was in the upper portion of the temporal. He wouldn't be able to judge its size or remove all of it without a larger incision.
A nod, a dab. Trichot passed back the penlight. 'I'll have to go higher.'
The attending anaesthetist announced, 'Pulse rate sixty to sixty-five,' as the sound of the drill cut in again.
From seventy, seventy-five just a few minutes ago, thought Trichot. He looked across briefly at the blood pressure gauge. It had dropped 20 points to 116 over 67 in the same period. The burr hole made, he started sawing across, joining the two. The bleep rate dropped still further.
‘Fifty-four, fifty-one.' Now with a note of urgency.
Trichot was sweating profusely. Another dab. It was going to be a race against time. Another ten seconds of sawing, fifteen or twenty seconds to cut through the dura and widen the aperture. Then the time needed to suck away the clot itself would depend on how large it was. How much more would the pulse have dropped by then?
Trichot finished sawing, and pulled back with the hook. All but a small portion of the clot was now visible. The air pressure sucker was passed across.
'Forty-five….three... dropping fast! Forty!'
Trichot felt a twinge of panic. Once the pulse rate fell to thirty, thirty-two, it was effectively all over. He'd fought too hard for the boy to let him go now.
The air sucker ate into the congealed dark red mass of the clot. Within twenty seconds, Trichot had removed almost a third of it.
'…. Thirty-eight… seven.'
The rate of pulse drop had slowed, but part of the clot was still out of sight. Trichot glanced at the blood pressure gauge: 104 over 61. It was going to be a close call. If the rupture was behind the last portion of the clot; if it was difficult to reach to cauterize; if the pulse rate dropped more rapidly; if there was more than one rupture. Any one factor meant that he wouldn't make it in time. Beads of sweat massed on his forehead, and his own pulse drummed a double beat to the bleep from the monitor. Trichot moved his way upward with the sucker, praying that the ruptured vessel would soon come into view.
'Thirty-six… thirty-five!'
Outside, the alarm bell suddenly stopped ringing. Only the sound of the bleep remained, slowly counting down the seconds Trichot had left to save his patient's life.
Chapeau found a bar three blocks from the hospital and sat over a Pernod while he pondered what to do. How long would the boy be in the operating theatre: two hours, three? Probably he would be returned to the same intensive care room, but then what? He couldn't use the same fire distraction again, he would have to think of something else.
Nothing came to mind quickly, and Chapeau sharply knocked back another slug of Pernod. He should have made the hit the night before rather than wait till the morning. His best shot had probably now gone; he was going to be hard pushed to come up with an alternative plan that would be so effective and carry such low risk. Worse still, if the boy died on the operating table, there would be no more chances. He finished his drink, paid, and headed out. He needed a walk to clear his mind.
Early morning, nine-forty, the streets of Aix were coming to life. But Chapeau was in his own world, oblivious to passers-by: planning, scheming, weighing options. He'd walked for almost twenty minutes, blindly window shopping between his thoughts, when a smile slowly crossed his face. It was cheeky and audacious, but why not? He'd always liked a gamble, and the prospect of shafting that little paedophile prick, Alain, somehow appealed to him. He thought it through once more for possible pitfalls, but it was perfect: the timing matched almost exactly.
But he would have to wait over two hours to deliver the news: two pre-arranged phone kiosks and times. One in Le Luc for the midday call, one in Brignoles for the ten o’clock call. Chapeau decided to drive back to Marseille to make the call. At one point on the drive, the audacity of what he was about to do tickled him again, and he burst out laughing.
By the time he made the call, he'd managed to control his mirth. It rang only twice before Alain answered. 'It's done,' said Chapeau.
'When was this?'
'Just this morning. I created a diversion, pumped the boy with a syringe, and last thing I knew they were in the operating theatre trying to save him.'
'Are you sure he's finished?'
'Don't worry, he won't make it. Also, they won't suspect anything: it will look like he died from complications arising from his coma and the initial injuries.'
They made arrangements to meet and settle payment at six o’clock the next day at Parc du Pharo. Chapeau was sure Alain would probably phone the hospital that afternoon to check, but it was a reasonable set of odds. If the boy made it, he would just have to come up with another plan. If not, for once he'd get paid without having any blood on his hands.