Tess Gerritsen - Harvest

At the MICU nurses' station, Abby watched as Vivian signed in duplicate the order for the lymphocyte crossmatch between Josh O" Day's and Karen Terrio's blood.

"How soon can he go to surgery?" asked Abby.

"We could be scrubbed and ready to cut by tomorrow morning. The sooner the better. The kid's had three episodes of V. tach in just the last day. With a heart rhythm that unstable, he doesn't have much time." Vivian swivelled around to face Abby. "I'd really like that boy to see another Red Sox game. Wouldn't you?"

Vivian's expression was as calm and unreadable as ever. She might be soft as slush inside, thought Abby, but Vivian would never show it.

"Dr. Chao?" said the ward clerk.

"Yes?"

"I just called SICU about that lymphocyte crossmatch. They said they're already running a match against Karen Terrio."

"Great. For once my intern's on the ball."

"But Dr. Chao, the crossmatch isn't with Josh O" Day."

Vivian turned and looked at the clerk. "What?"

"SICU says they're running it on someone else. Some private patient named Nina Voss."

"But Josh is critical! He's at the top of the list."

"All they said was the heart's going to that other patient." Vivian shot to her feet. In three quick steps she was at the telephone, punching in a number. A moment later, Abby heard her say:

"This is Dr. Chao. I want to know who ordered that lymphocyte crossmatch on Karen Terrio." She listened. Then, frowning, she hung up.

"Did you get the name?" asked Abby.

"Yes."

"Who ordered it?"

"Mark Hodell."

Abby and Mark had made reservations that night for Casablanca's, a restaurant just down the road from their Cambridge house. Though it was meant to be a celebration, to mark the six month anniversary of their moving in together, the mood at their table was anything but cheerful.

"All I want to know," said Abby, 'is who the hell is Nina Voss?"

'! told you, I don't know," said Mark. "Now can we drop the subject?"

"The boy's critical. He's coding practically twice a day. He's been on the recipient list for a year. Now an AB positive heart finally becomes available, and you're bypassing the registry system? Giving the heart to some private patient who's still living at home?"

"We're not giving it away, OK? It was a clinical decision."

"Whose decision was it?"

"Aaron Levi's. He called me this afternoon. Told me that Nina Voss was being admitted tomorrow. He asked me to order the screening labs on the donor."

"That's all he told you?"

"Essentially." Mark reached for the bottle of wine and refilled his glass, sloshing burgundy onto the tablecloth. "Now can we change the subject?"

She watched him sip the wine. He wasn't looking at her, wasn't meeting her gaze.

"Who is this patient?" she asked. "How old is she?"

'! don't want to talk about it."

"You're the one taking her to surgery. You must know how old she is."

"Forty-six."

"From out of state?"

"Boston."

"I heard she was flying in from Rhode Island. That's what the nurses told me."

"She and her husband live in Newport during the summer."

"Who's her husband?"

"Some guy named Victor Voss. That's all I know about him, his name."

She paused. "How did Voss get his money?"

"Did I say anything about money?"

"A summer home in Newport? Give me a break, Mark."

He still wouldn't look at her, still wouldn't lift his gaze from that glass of wine. So many times before, she'd look across a table at him and see all the things that had first attracted her. The direct gaze. The forty-one years of laugh lines. The quick smile. But tonight, he wasn't even looking at her.

She said, "I didn't realize it was so easy to buy a heart."

"You're jumping to conclusions."

"Two patients need a heart. One is a poor, uninsured kid on the teaching service. The other has a summer home in Newport. So which one gets the prize? It's pretty obvious."

He reached again for the wine bottle and poured himself another glass — his third. For a man who prided himself on his temperate lifestyle, he was drinking like a lush. "Look," he said. "I spend all day in the hospital. The last thing I feel like doing is talking about it. So let's just drop the subject."

They both fell silent. The subject of Karen Terrio's heart was like a blanket snuffing out the sparks of any other conversation. Maybe we've already said everything there is to say to each other, she thought. Maybe they'd reached that dismal phase of a relationship when their life stories had been told and the time had come to dredge up new material. We've been together only six months, and already the silences have started.

She said: "That boy makes me think of Pete. Pete was a Red Sox fan."

"Who?"

"My brother."

Mark said nothing. He sat with shoulders hunched in obvious discomfort. He'd never been at ease with the subject of Pete. But then, death was not a comfortable subject for doctors. Every day we play a game of tag with that word, she thought. We say 'expired' or 'could not resuscitate' or 'terminal event'. But we seldom use that word: died.

"He was crazy about the Red Sox," she said. "He had all these baseball cards. He'd save his lunch money to buy them. And then he'd spend a fortune on little plastic covers to keep them safe. A five-cent cover for a one-cent piece of cardboard. I guess that's the logic of a ten-year-old for you."

Mark took a sip of wine. He sat wrapped in his discomfort, insulated against her attempts at conversation.

The celebration dinner was a bust. They ate with scarcely another word between them.

Back in the house they shared in Cambridge, Mark retreated behind his stack of surgical journals. That was the way he always reacted to their disagreements — withdrawal. Damn it, she didn't mind a good, healthy fight. The DiMatteo family, with its three headstrong daughters and little Pete, had weathered more than its share of adolescent conflicts and sibling rivalries, but their love for each other had never been in doubt.

It was silence she couldn't stand.

In frustration she went into the kitchen and scrubbed the sink. I'm turning into my mother, she thought in disgust. I get angry and what do I do? I clean the kitchen. She wiped the stove top, then dismantled the burners and scrubbed those as well. She had the whole damn kitchen sparkling by the time she heard Mark finally head upstairs to the bedroom.

She followed him.

In darkness they lay side by side, not touching. His silence had rubbed off on her and she could think of no way to break through it without seeming like the needy one, the weak one. But she couldn't stand it any longer.

"I hate it when you do this," she said.

"Please, Abby. I'm tired."

"So am I.We're both tired. It seems like we're always tired. But I can't go to sleep this way. And neither can you."

"All right. What do you want me to say?"

"Anything! I just want you to keep talking to me."

"I don't see the point of talking things to death."

"There are things I need to talk about."

"Fine. I'm listening."

"But you're doing it through a wall. I feel like I'm in confession. Talking through a grate to some guy I can't see." She sighed and stared up at the darkness. She had the sudden, dizzying sensation that she was floating free, unattached. Unconnected. "The boy's in MICU," she said. "He's only seventeen."

Mark said nothing.

"He reminds me so much of my brother. Pete was a lot younger. But there's this sort of fake courage that all boys have. That Pete had."

"It's not my decision alone," he said. "There are others involved. The whole transplant team. Aaron Levi, Bill Archer. Even Jeremiah Parr."

"Why the hospital president?"