Robin Cook - Seizure

“We called them too,” Sal said. “They’re never overly cooperative, as you know, but they said they’d check it out. So there are feelers out there. Obviously, we want to know where the moron is holed up and why.”

“Is any of your money missing?” Tony asked.

“Nothing Gaetano could have taken,” Sal said enigmatically.

“Weird,” Tony remarked, for a lack of anything else to say. He didn’t know what Sal meant, but he wasn’t about to ask. “I’m sorry you’re having this problem.” He moved forward on the couch as if he were about to get to his feet.

“It’s more than weird.” Lou sneered. “And sorry ain’t good enough. We’ve been talking about all this over the last few days, and I think you should know how we feel. Ultimately, we hold you responsible for this foul-up with Gaetano, however it plays out, and also for our one hundred K, which we’re going to want back with interest. The interest will be at our usual rate from the day we handed it over and is nonnegotiable. And one last thing: We now consider the loan overdue.”

Tony abruptly stood up. His rising anxiety had reached a critical point after hearing Lou’s comments and thinly veiled threat. “Let me know if you hear anything,” he said, heading for the door. “Meanwhile, I’ll make a few inquiries myself.”

“You better start making inquiries about how you are going to raise the hundred grand,” Sal said, “because we’re not going to be all that patient.”

Tony hurried out of the store, oblivious to the rain. He was perspiring, despite the chill. It was only after he’d leaped into his car that he remembered his umbrella. “Screw it!” he said out loud. He got the Caddy going, and with his arm hooked over the back of the front seat, he looked out the rear window and gunned the engine. With a shower of pebbles, the car lurched out into the street. A moment later, he had the Cadillac up to almost fifty miles per hour, heading back into the city.

Tony relaxed to a degree and dried each palm off in turn on his pant legs. The immediate threat was over, but he knew intuitively that a much larger long-term threat was looming on the horizon, especially if the Sprianos became involved, no matter how tangentially. It was all very discouraging, if not frightening. Just when he was mobilizing his resources to fight his indictment, he was now facing a possible turf war.

“John! Can you hear me?” Dr. Nawaz called. He had leaned over while holding up the edge of the sterile drapes hanging down over Ashley’s face. Most of the stereotaxic frame anchored to Ashley’s skull as well as Ashley himself was covered by drapes, exposing only a portion of the right side of the senator’s forehead. There, Dr. Nawaz had made a small skin incision, now held open with a clamped skin retractor.

After exposing the bare bone, Dr. Nawaz had used a special power drill to make a small, eleven-sixteenth-inch-diameter craniotomy hole to expose the grayish-white fascial coverings of the brain. Directly aligned with the hole and firmly attached to one of the arches of the stereotaxic frame was the implantation needle. With the help of the X rays, the correct angles had been determined, and already the needle had been inserted through the brain’s coverings, into the outer part of the brain itself. At this point, it was only necessary to advance the needle to the exact, predetermined depth to reach the targeted substantia nigra.

“Dr. Newhouse, perhaps you could nudge the patient for me,” Dr. Nawaz said in his melodious, Pakistani-English accent. “At this point, I would prefer the patient to be awake.”

“Of course,” Dr. Newhouse said, getting to his feet and putting aside a magazine he was reading. He reached under the drapes and gave Ashley’s shoulder a shake.

Ashley’s heavily lidded eyes struggled open.

“Can you hear me now, John?” Dr. Nawaz asked again. “We need your help.”

“Of course I can hear you,” Ashley said, his voice thick with sleep.

“I want you to tell me if you have any sensations whatsoever over the next few minutes. Can you do that?”

“What do you mean ‘sensations’?”

“Like images, thoughts, sounds, odors, or sense of movement: anything at all you notice.”

“I’m very sleepy.”

“I appreciate that, but try to stay awake for just these few minutes. As I said, we need your help.”

“I’ll try.”

“That’s all we can ask,” Dr. Nawaz said. He lowered the drape, obscuring Ashley’s face. He turned and gave a thumbs-up to the group standing outside the window in the hall. Then, after flexing his latex-gloved fingers, he used the micromanipulator wheel on the guide holding the implantation needle. Slowly, millimeter by millimeter, he advanced the blunt implantation needle into the depths of Ashley’s brain. When the needle was halfway in, he again lifted the edge of the drape. He was pleased to see Ashley’s eyes still open, although barely. “Are you doing okay?” he asked the senator.

“Lovely,” Ashley said, with a trace of Southern accent. “As happy as a pig in a poke.”

“You are doing fine,” Dr. Nawaz said. “It won’t be much longer.”

“Take your time. The important thing is that it is done right.”

“There’s never a question about that,” Dr. Nawaz responded. He smiled beneath his surgical mask as he lowered the drape and returned to advancing the needle. He was impressed with Ashley’s courage and good humor. A few minutes later and with a final twist of the micromanipulator, he stopped at the exact measured depth. After a final check of Ashley’s status, he told Marjorie to ask Dr. Lowell to come into the room. Meanwhile, he readied the syringe that was to deliver the treatment cells.

“Everything going okay?” Daniel asked. He had donned a facemask as he entered. With his hands clasped behind his back, he bent over to look into the craniotomy hole with its imbedded needle.

“Very well,” Dr. Nawaz said. “But there is a problem I admit slipped my mind in the earlier fracas. At this stage, it is customary to take another corroborating X ray to be one hundred percent certain of the needle tip’s location. However, without X ray here in the OR, that is not possible. With the craniotomy open and the needle inserted, the patient cannot be safely moved.”

“Are you asking for my opinion whether to proceed?”

“Precisely. Ultimately, he is your patient. In this rather unique situation, I am, as you Americans say, only a hired gun.”

“How confident are you of your needle’s position?”

“Very confident. In all my experience with the stereotaxic frame, I have never not been where I targeted. There is also another reassuring factor in this case. We are adding cells, not doing ablative surgery, which is what I am usually doing with this procedure and which would cause far more problems if the needle were to be slightly off.”

“It is hard to argue with a one hundred percent record. I’m confident we’re in good hands. Let’s do it!”

“Right you are!” Dr. Nawaz said. He picked up the syringe, now loaded with the predetermined aliquot of treatment cells. After removing the trocar from the lumen of the imbedded implantation needle, he attached the syringe. “Dr. Newhouse, I’m ready to begin the implantation.”

“Thank you,” Dr. Newhouse said. He liked to be informed at critical stages of a procedure, and he quickly rechecked the vital signs. When he was done and had taken the stethoscope from his ears, he motioned for Dr. Nawaz to go ahead.

After raising the drape and having Dr. Newhouse give Ashley another nudge to wake him, Dr. Nawaz repeated the same instructions he’d given Ashley before inserting the needle. Only then did he start the implantation, utilizing another manual mechanical-assist device to depress the syringe’s plunger in a slow, even fashion.