“Blood pressure’s falling a bit,” said Hwa.
“Crystalloid fluid, please,” said Mamikonian, glancing at the readouts. “And let’s add a little dopamine back in.”
Mamikonian stood on Enzo’s right, next to his chest. Across from him was the scrub nurse. A surgical assistant stood next to her, holding the abdominal-wall retractor. Five one-liter containers of ice-cold Ringer’s lactate were lined up in a neat row on a table so they could be emptied quickly into the chest cavity. A nurse also had six units of packed red blood cells ready to go. Peter tried to stay out of the way near the head of the bed.
Next to Peter, the perfusionist, a Sikh wearing a large green cap over his turban, scanned a series of readouts labeled remote temperatures, arterial vent, and cardiac sucker. Nearby, another technician carefully watched the rising and falling of the ventilator’s black bellows to make sure Enzo was still breathing properly.
“Let’s go,” said Mamikonian.
A nurse moved in and injected something into Enzo’s body. She spoke into a microphone dangled on a thin wire from the ceiling. “Myolock administered at 10:02 A.M.”
Dr. Mamikonian requested a scalpel and made an incision starting just below the Adam’s apple and continuing down the center of the chest. The scalpel split the skin easily, sliding through the muscle and fat until it banged against the breastbone.
The EKG shuddered slightly. Peter glanced at one of Hwa’s monitors: blood pressure was rising, too.
“Sir,” said Peter. “The heart rate is acting up.”
Mamikonian squinted at Peter’s oscilloscope. “That’s normal,” he said, sounding irritated at being interrupted.
Mamikonian handed the scalpel, now slick and crimson, back to the nurse. She passed him the sternal saw, and he turned it on. Its buzzing drowned out the blipping from Peter’s EKG. The saw’s rotating blade sliced through the sternum. An acrid smell rose from the body cavity: powdered bone. Once the sternum was cut apart, two technicians moved in with the chest spreader. They cranked it around until the heart, beating once per second, was visible.
Mamikonian looked up. On the wall was the digital ischemic counter; it would be started the moment he excised the organ, measuring the time during which there would be no blood flowing to the heart. Next to Mamikonian was a plastic bowl filled with saline. The heart would be rinsed in there to get old blood off it. It would then be transferred into an Igloo container filled with ice for the flight to Sudbury.
Mamikonian requested another scalpel and bent down to cut through the pericardium. And, just as his blade sliced through the membrane surrounding the heart—
The chest of Enzo Bandello, legally dead organ donor, heaved massively.
A gasp escaped from around his ventilator breathing tube.
A moment later, a second gasp was heard.
“Christ — ” said Peter, softly.
Mamikonian looked irritated. He snapped his gloved fingers at one of the nurses. “More Myolock!”
She moved in and administered a second shot.
Mamikonian’s voice was sarcastic. “Let’s see if we can finish this damned thing without the donor walking away, shall we, folks?”
Peter was dazed. Mamikonian departed with the excised heart. Since that meant there was no more need for an EKG operator, Peter went up to the observation level and watched the rest of the harvesting from there. When it was done — when Enzo Bandello’s hollow corpse was sewn shut and rolled off to the morgue — Peter staggered down to the scrub room. He found Hwa, who was pulling off her gloves.
“What happened in there?” Peter asked.
Hwa exhaled noisily; she was exhausted. “You mean the gasping?” She shrugged. “Happens every once in a while.”
“But Enz — but the donor was dead.”
“Of course. But he was also on full life support. Sometimes there’s a reaction.”
“And — and what was that business with Myolock? What’s that?”
Hwa was untying her surgical gown. “It’s a muscular paralyzer. They have to administer that. If they don’t, sometimes the donor’s knees tuck up toward the chest as you carve into it.”
Peter was appalled. “Really?”
“Uh-huh.” Hwa dropped her gown into the hamper. “It’s just a muscular reaction. Nowadays, it’s routine procedure to anesthetize the corpse.”
“Anesthetize the corpse…?” said Peter slowly.
“Yeah,” she said. “’Course, Dianne obviously didn’t do a good enough job today.” Hwa paused. “It gives me the willies when they start moving like that, but, hey, that’s transplant surgery for you.”
Peter kept a little copy of the timetable for his girlfriend, Cathy Churchill, in his wallet. He was in the first year of his master’s; she was in her last year of her bachelor’s in chemistry. She would be finishing her final class of the day — polymers — in about twenty minutes. He hurried back to the campus and waited in the hall outside the classroom for her.
The class ended and Cathy came out, chatting animatedly with her friend Jasmine, who caught sight of Peter first. “Well,” she said, grinning, and tugging Cathy’s sleeve, “look who’s here. It’s Mr. Right.”
Peter smiled at Jasmine briefly, but really only had eyes for Cathy. Cathy had a heart-shaped face, long black hair, and enormous blue eyes. As always, she smiled radiantly when she saw Peter. Despite what he’d seen earlier in the day, Peter felt himself grinning, too. It happened every time. There was an electricity between them — Jasmine and their other friends often commented on it.
“I’ll leave you two lovebirds alone,” said Jasmine, still grinning. Peter and Cathy said good-bye to her, and the two of them came together in a kiss. In that brief moment of contact, Peter felt himself revitalized. They’d been dating for three years now, and still there was wonder in each embrace.
When they separated, Peter asked, “What are you doing for the rest of the day?”
“I’d been planning to drop by the arts department to see if I could get some kiln time, but that can wait,” Cathy said, her voice mischievous. Overhead, every other fluorescent tube had been removed to cut costs, but Cathy’s smile lit up the whole corridor for Peter. “Got any ideas?”
“Yes. I want you to come to the library with me.”
Again the wondrous smile. “Neither of us is that quiet,” said Cathy. “Even if we did it somewhere that’d likely be deserted — the Canadian Literature section, maybe — I suspect the noise would still disturb people.”
He couldn’t help grinning, and he leaned in to kiss her again. “Maybe afterward,” he said, “but first, I need help with some research, please.”
They joined hands and began walking.
“Into what?”
“Into death,” Peter said.
Cathy’s eyes were wide. “Why?”
“I was doing some more of my practicum today — running an EKG during an operation to remove a heart for transplant.”
Her eyes danced. “That sounds fascinating.”
“It was, but…”
“But what?”
“But I don’t think the donor was dead before they started removing his organs.”
“Oh, come on!” said Cathy, letting go of his hand long enough to whap him lightly on the arm.
“I’m serious. His blood pressure went up when the surgery started, and his heart rate increased. Those are classic signs of stress — or even pain. And they anesthetized the body. Think about that: they anesthetized a supposedly dead person.”
“Really?”
“Yes. And when the surgeon sliced into the pericardium, the patient gasped.”
“My God. What did the surgeon do?”
“Called for more muscular paralyzers to be injected into the patient, then just went on with the operation. Everyone else seemed to think this was all perfectly reasonable. Of course by the time the operation was finished, the donor really was dead.”