Under The Knife

The sound of his crying floated on the wind, over the crowded dock, to the distant spot where Kate was standing. Alone and ignored, she lingered by the row of tethered fishing boats and wondered why she was here. Was it some cruel and self-imposed form of penance? A feeble attempt to tell the world she was sorry? She only knew that some inner voice, begging for forgiveness, had compelled her to come.

There were others here from the hospital: a group of nurses, huddled in a quiet sisterhood of mourning; a pair of obstetricians, looking stiffly uneasy in their street clothes; Clarence Avery, his white hair blowing like dandelion fuzz in the wind. Even George Bettencourt had made an appearance. He stood apart, his face arranged in an impenetrable mask. For these people, a hospital was more than just a place of work; it was another home, another family. Doctors and nurses delivered each other’s babies, presided over each other’s deaths. Ellen O’Brien had helped bring many of their children into the world; now they were here to usher her out of it.

The far-off glint of sunlight on fair hair made Kate focus on the end of the pier where David Ransom stood, towering above the others. Carelessly he pushed a lock of windblown hair into place. He was dressed in appropriately mournful attire—a charcoal suit, a somber tie—but in the midst of all this grief, he displayed the emotions of a stone wall. She wondered if there was anything human about him. Do you ever laugh or cry? Do you ever hurt? Do you ever make love?

That last thought had careened into her mind without warning. Love? Yes, she could imagine how it would be to make love with David Ransom: not a sharing but a claiming. He’d demand total surrender, the way he demanded surrender in the courtroom. The fading sunlight seemed to knight him with a mantle of unconquerability. What chance did she stand against such a man?

Wind gusted in from the sea, whipping sailboat halyards against masts, drowning out the minister’s final words. When at last it was over, Kate found she didn’t have the strength to move. She watched the other mourners pass by. Clarence Avery stopped, started to say something, then awkwardly moved on. Mary and Patrick O’Brien didn’t even look at her. As David approached, his eyes registered a flicker of recognition, which was just as quickly suppressed. Without breaking stride, he continued past her. She might have been invisible.

By the time she finally found the energy to move, the pier was empty. Sailboat masts stood out like a row of dead trees against the sunset. Her footsteps sounded hollow against the wooden planks. When she finally reached her car, she felt utterly weary, as though her legs had carried her for miles. She fumbled for her keys and felt a strange sense of inevitability as her purse slipped out of her grasp, scattering its contents across the pavement. She could only stand there, paralyzed by defeat, as the wind blew her tissues across the ground. She had the absurd image of herself standing here all night, all week, frozen to this spot. She wondered if anyone would notice.

David noticed. Even as he waved goodbye and watched his clients drive away, he was intensely aware that Kate Chesne was somewhere on the pier behind him. He’d been startled to see her here. He’d thought it a rather clever move on her part, this public display of penitence, obviously designed to impress the O’Briens. But as he turned and watched her solitary walk along the pier, he noticed the droop of her shoulders, the downcast face, and he realized how much courage it had taken for her to show up today.

Then he reminded himself that some doctors would do anything to head off a lawsuit.

Suddenly disinterested, he started toward his car. Halfway across the parking lot, he heard something clatter against the pavement and he saw that Kate had dropped her purse. For what seemed like forever, she just stood there, the car keys dangling from her hand, looking for all the world like a bewildered child. Then, slowly, wearily, she bent down and began to gather her belongings.

Almost against his will, he was drawn toward her. She didn’t notice his approach. He crouched beside her, scooped a few errant pennies from the ground, and held them out to her. Suddenly she focused on his face and then froze.

“Looks like you need some help,” he said.

“Oh.”

“I think you’ve got everything now.”

They both rose to their feet. He was still holding out the loose change, of which she seemed oblivious. Only after he’d deposited the money in her hand did she finally manage a weak “Thank you.”

For a moment they stared at each other.

“I didn’t expect to see you here,” he remarked. “Why did you come?”

“It was—” she shrugged “—a mistake, I think.”

“Did your lawyer suggest it?”

She looked puzzled. “Why would he?”

“To show the O’Briens you care.”

Her cheeks suddenly flushed with anger. “Is that what you think? That this is some sort of—of strategy?”

“It’s not unheard of.”

“Why are you here, Mr. Ransom? Is this part of your strategy? To prove to your clients you care?”

“I do care.”

“And you think I don’t.”

“I didn’t say that.”

“You implied it.”

“Don’t take everything I say personally.”

“I take everything you say personally.”

“You shouldn’t. It’s just a job to me.”

Angrily, she shoved back a tangled lock of hair. “And what is your job? Hatchet man?”

“I don’t attack people. I attack their mistakes. And even the best doctors make mistakes.”

“You don’t need to tell me that!” Turning, she looked off to sea, where Ellen O’Brien’s ashes were newly drifting. “I live with it, Mr. Ransom. Every day in that O.R. I know that if I reach for the wrong vial or flip the wrong lever, it’s someone’s life. Oh, we find ways to deal with it. We have our black jokes, our gallows humor. It’s terrible, the things we laugh about, and all in the name of survival. Emotional survival. You have no idea, you lawyers. You and your whole damned profession. You don’t know what it’s like when everything goes wrong. When we lose someone.”

“I know what it’s like for the family. Every time you make a mistake, someone suffers.”

“I suppose you never make mistakes.”

“Everyone does. The difference is, you bury yours.”

“You’ll never let me forget it, will you?”

She turned to him. Sunset had painted the sky orange, and the glow seemed to burn in her hair and in her cheeks. Suddenly he wondered how it would feel to run his fingers through those wind-tumbled strands, wondered what that face would feel like against his lips. The thought had popped out of nowhere and now that it was out, he couldn’t get rid of it. Certainly it was the last thing he ought to be thinking. But she was standing so dangerously close that he’d either have to back away or kiss her.

He managed to hold his ground. Barely. “As I said, Dr. Chesne, I’m only doing my job.”

She shook her head and her hair, that sun-streaked, mahogany hair, flew violently in the wind. “No, it’s more than that. I think you have some sort of vendetta. You’re out to hang the whole medical profession. Aren’t you?”

David was taken aback by her accusation. Even as he started to deny it, he knew she’d hit too close to home. Somehow she’d found his old wound, had reopened it with the verbal equivalent of a surgeon’s scalpel. “Out to hang the whole profession, am I?” he managed to say. “Well, let me tell you something, Doctor. It’s incompetents like you that make my job so easy.”

Rage flared in her eyes, as sudden and brilliant as two coals igniting. For an instant he thought she was going to slap him. Instead she whirled around, slid into her car and slammed the door. The Audi screeched out of the stall so sharply he had to flinch aside.

As he watched her car roar away, he couldn’t help regretting those unnecessarily brutal words. But he’d said them in self-defense. That perverse attraction he’d felt to her had grown too compelling; he knew it had to be severed, right there and then.

As he turned to leave, something caught his eye, a thin shaft of reflected light. Glittering on the pavement was a silver pen; it had rolled under her car when she’d dropped her purse. He picked it up and studied the engraved name: Katharine Chesne, M.D.

For a moment he stood there, weighing the pen, thinking about its owner. Wondering if she, too, had no one to go home to. And it suddenly struck him, as he stood alone on the windy pier, just how empty he felt.

Once, he’d been grateful for the emptiness. It had meant the blessed absence of pain. Now he longed to feel something—anything—if only to reassure himself that he was alive. He knew the emotions were still there, locked up somewhere inside him. He’d felt them stirring faintly when he’d looked into Kate Chesne’s burning eyes. Not a full-blown emotion, perhaps, but a flicker. A blip on the tracing of a terminally ill heart.

The patient wasn’t dead. Not yet.

He felt himself smiling. He tossed the pen up in the air and caught it smartly. Then he slipped it into his breast pocket and walked to his car.

* * *

THE DOG WAS deeply anesthetized, its legs spread-eagled, its belly shaved and prepped with iodine. It was a German shepherd, obviously well-bred and just as obviously unloved.