Lara snapped herself out of that reverie too and lifted a journal on “Exciting News in Alloys and Metallurgy.”
Down in Virginia, at an Emergency Room in Charlottesville, Dr. Andrew Jones was finishing stitching a four-inch gash in a truck driver’s head. “Next time you hug your wife after five days on the road,” Jones said, clipping the last suture, “make sure you don’t smell like a waitress’s perfume, okay?”
“Thanks, Doc,” the teamster said, surprisingly sheepish for a man whose back was hairier than his head. “I’ll remember that.”
“I bet you will,” Jones said, and both men laughed.
At that moment, at the main entrance of the University Hospital, Frank Willig was shaking hands with Lara Blair. Willig was the hospital’s chief administrator, and in his efforts to keep UV at the leading edge of teaching hospitals, he had made many purchases from Blair Bio-Med. When he heard its owner was on her way, he was determined to be the first to greet her. “We’re so pleased you’d visit us in person!” he said in a voice he considered quite musical—Willig loved to sing karaoke, though no one loved to hear him do it—as he led Lara down the polished main corridor. The sun had come out after several days of rain, and light was pouring through the skylights. “We use your company’s equipment, of course,” Willig intoned, “and the grants from your Foundation are—”
“You’re sure Dr. Jones is around this morning?” she interrupted, more harsh than she had meant to sound. She was determined to stay focused on her goals, but instead of feeling ruthless and businesslike she felt herself strangely nervous and unbalanced.
Just then they heard a call over the hospital’s sound system: “Dr. Jones, Code 6!”
As Lara’s eyes flicked to Willig he told her, “That’s our emergency code for the operating theater.”
“Do you have an observation balcony?”
The surgical nurses were waiting for him in the sterile room, and they held up a blue gown to cover the hospital scrubs Jones was already wearing when he banged through the door. He washed his hands quickly, popped them through the sleeves, and stretched his fingers so they could glove him; as they slid on the cap and mask he snapped to them, “Who’s cutting?”
“Stafford,” the head nurse shot back.
Jones had been running, but when he backed through the second door into an operating room full of tense young surgeons around a patient whose head was curtained off, he exuded an almost casual calm. He turned and seemed not to notice the panicked looks in the eyes of the surgical team, the only part of their faces visible between their caps and masks.
Twenty-seven feet above and behind the patient’s curtained head, Lara Blair stood next to Willig, and from the moment she saw Jones enter she understood the leadership and the confidence he was spreading; she felt it even at this distance, separated by a double layer of soundproofing glass. The students around Jones had recognized the master.
The lead cutter, standing at the head of the patient whose brain was the object of the drama, shifted so that Jones could move in beside him. Jones’s voice was smooth and even; Lara could hear it on the speaker at the base of the observation window: “Pulse and blood pressure?”
The anesthesiologist, whom Lara noticed was the most veteran of the surgical team below her, monitored the array of sensors attached to the patient’s body. “Rising, 180 over 150,” he reported, and Lara understood his unspoken warning: Not yet critical, but it soon will be.
Beside her, Willig dropped his voice into a smooth baritone that he hoped would sound not only professional but seductive, for he found Lara Blair intensely appealing; he rumbled to her, “They often call Dr. Jones in, if the patient presents unpredictably.”
Lara kept her eyes on the operating theater below her and thought about that phrase: the patient presents unpredictably, as if the person strapped to the operating table—the son or daughter of someone, husband or wife of someone, father or mother of someone—had somehow just up and decided to surprise the surgeons with a little extra challenge, what doctors called a “complication.” And for them it was a complication, because they had to scratch their heads and ponder and do paperwork afterwards; the patient simply died. Lara was used to hospital administrators talking to her as if she didn’t understand the nuances of what went on in the practical life of hospitals; she was used to it but still it rankled.
She heard through the monitor speakers the voices from the operating theater below her as the surgeon told Jones, “It seemed straightforward. Then we found a second aneurism, hemorrhaging behind the first…” The young surgeon’s voice was tense, fragile.
“One thing at a time,” Jones said, as easily as he might describe a play in rugby or pickup basketball. “You can do this, Ben. Retractor!”
The nurse extended an instrument to Jones.
“Not to me, to Dr. Stafford,” he said. “Put it in your left hand, Ben.… Your other left hand.” As the surgeon shifted the instruments that had suddenly become so unfamiliar to his fingers, Jones peered through the surgical magnifiers trained at the brain open below them. Lara could not see Jones’s eyes, but she noticed the sudden stillness of his body, as if he’d put himself into a trance. Stepping back from the magnifiers he said, gently and firmly, “Now look at the brain. See what is. And see what has to be.”
Stafford, the surgeon, pressed his face to the eye ports. “The first artery…”
“Right, it has to be clamped. So do it. Right now.”
Lara could tell Stafford’s fingers were trembling, though it may not have been her eyes but her gut that told her so—just as she could tell that Jones’s hand was perfectly steady as he gripped Stafford’s wrist and moved it into position. Then Jones drew his own hand away. “Shift the artery clear, then clamp it,” he ordered.
Stafford had frozen. He just could not get his hand to move.
Then Jones surprised everyone in the operating room and on the observation balcony, including Lara. He looked away from the patient, directly into the eyes of the frozen surgeon, and said, “Hey, Ben, you hear about those two drunks staggering home one night, when one of ’em says…” Jones leaned closer to the young surgeon and dropped his voice, so that no one outside the operating team could hear his voice again until he said, casually yet firmly, “Clamp it, Ben.”
Stafford made a move and inserted a clamp.
“Good. Now the second artery!” Jones said clearly, and his voice dropped again and picked up the quiet narrative he had begun. Lara, Willig, and the others on the observation balcony strained to hear, but all they could catch were occasional words. Lara thought she heard him say, “… stinking drunks…” and “… the lady wouldn’t open the door…” And Lara began to smile.
“What’s he doing?” Willig wondered aloud beside her.
“He’s telling a joke,” Lara whispered. “Probably a bawdy one.”
Down below her, Jones lifted his voice again, enough so that Stafford heard the next instruction without tensing. “Scalpel,” Jones said, then dropped back into his easy narrative as Stafford began what Lara knew was an even more delicate maneuver inside the patient’s brain. Jones’s eyes flicked to catch every move the rookie surgeon made, yet Jones never broke stride in his narration.