At twenty minutes after five o'clock, a black Audi convertible rolled up the ramp, headlights bouncing when its tires bumped over expansion joints. The car swooped into a reserved parking place in the physicians' area. Five seconds later, a short blond woman got out and started toward the exit door opposite Barakat.
Had to be her-the same woman he'd seen in the elevator. He let the door close: he couldn't allow her to see him again. Even being in the same part of the building, where she might see him by accident, could trip off a memory.
He waited, nervous, stressed, sweating in the freezing cold, and when she'd gone through the door, went after her. And as he went, the thought crossed his mind: fix it now. Take her. She was a small woman in a deserted building, he could break her neck, who'd know what happened?
Just a thought, but it stayed with him. He might catch her at the elevators… but when he got there, she was gone. A little feather of disappointment trickled across his heart, his gut. He could have done it.
So now, the question remained. Who was she, and where was she going?
She was early for most docs. They wouldn't normally arrive until sometime after six. On the other hand, the Frenchman's surgical team was supposed to start separating the twins…
He went that way. THIRTY PEOPLE milled in the hallway outside the special operating theater. Like most of the other docs, he'd found an excuse to look the place over-the special double operating table, the intricate anesthesia setup, the newly painted, sign-posted floor, an attempt to better choreograph the movements of the massive operating team, to keep the sterile and the non-steriles separate, even as they walked among each other.
He saw the blond woman, still in her long winter coat, talking to Gabriel Maret, the Frenchman. Maret was listening closely. She had to be somebody important.
Barakat was an emergency room doc, not on the team, or anything close to it, and all the team members knew each other, so he couldn't risk joining the crowd. What he could do, though, was climb into the small observation theater above the OR. If you wanted a seat, all you had to do was get there early. One of the team members would be narrating the surgical procedures for the observers. The woman, if she were central to the work, would be introduced. LUCY AND LARRY RAYNES were with the children, who were still awake, but about to be moved to the operating theater. Sara saw Weather and her eyes misted up. She was still a baby, but she recognized the woman who'd caused her pain in the past. She began to cry, softly, and then Ellen started, not yet knowing why.
Lucy Raines bent over them, comforting them. Larry flapped his hands around, helplessly, and said to Weather, "They're about to give them something."
Weather nodded: "We're not the only ones who feel the stress. They're babies, but they know something is happening."
Ellen pushed against the sides of the hospital bed, and that torqued Sara, who stopped crying and thrashed with her hands. The babies could hear each other talking, but had never seen each other.
Larry said, "We just talked to Gabriel, he said everything was going smoothly."
"Yesterday was like a freak accident," Weather said. "Everything now is just like it was yesterday-maybe better. Maybe some of the nervousness got burned off."
"I felt terrible about that guy," Lucy said.
"So do I." Weather bent forward and kissed Sara on the forehead. "It's hard, baby," she said. AN HOUR LATER, the twins were rolled into the OR, sedated, but not yet fully anesthetized. As the two anesthesiologists worked to position them, to rig them with the drip lines and to take a final look at the blood chemistry, to check their monitors, Maret wandered over to Weather and said, "It's time. No problems with the pharmacy this morning."
Weather nodded and followed him into the scrub room. A few seconds later, Hanson, the bone-cutter, followed them in, with his resident; the surgical assistant stood waiting behind Weather. They scrubbed silently, until Maret said, "That first day of practice, we started with Vivaldi. If no one objects…"
"Perfect," Weather said. She'd always had music in her ORs. "Start with 'Primavera.' "
"Your choice," Maret said, smiling at her. "You're okay?"
"Anxious to get going," she said. Her part, her first part, would be routine, nothing more than she did every day: cutting down to bone, cauterizing the bleeders, rolling back the scalp. Then, she'd get out of the way until the bone-cutter was done.
An anesthesiologist stuck his head in: "We're set. You want to say go?"
Maret looked at the team members in the scrub room, pursed his lips, smiled, nodded and said, "Go." THE OBSERVATION THEATER was packed: team members had the first choice of seats, but after that, it was first-come first-seated, as long as you had the right ID. Barakat looked around: the watchers weren't just residents, but included a lot of senior docs on their own time. He was at the back, in the highest row of seats.
Down below, three nurses and two anesthesiologists clustered around the two small bodies joined at the skull; so close to perfection, and yet so far. Each was an attractive child-if there'd been another inch of separation, they'd have been just fine. Now they lay on the special table, brilliantly lit, cradled in plastic, asleep, their eyes covered and taped, the bottoms of their faces isolated in breathing masks.
The scrub room doors opened in, and a small woman led a first group into the OR. A man sitting in the first row of the observation theater said into a microphone, "Doctors Gabriel Maret, Weather Karkinnen, Richard Hanson. Dr. Karkinnen will begin…"
She was masked, hatted, robed, gloved and slippered, wearing an operating shield over her eyes; but she was the woman from the elevator and the Audi, Barakat thought. Right size, right shape. Now that he knew her name, he could Google her, just to be sure.
The narrator said, "For those who just got here, the first procedure will be to open the scalp at the point of conjoin, to remove the first expander, and to prepare the bed for the initial craniotomy."
The surgical lights were miked. Barakat could hear Karkinnen talking with her surgical tech as they prepared the tools on a tray at her left hand. Karkinnen bent over the babies, with a surgical pen, her head blocking Barakat's view of what she was doing. Then Karkinnen straightened and asked an anesthesiologist, "Where are we?" and the anesthesiologist took a few seconds and then said, "We're good. Sara's heart looks good."
Karkinnen: "Dr. Maret?"
Maret looked around and said, "Everybody… may God bless us all, especially the little children. Weather, go ahead."
With Vivaldi playing quietly in the background, Weather took the scalpel from the surgical tech, leaned over the skulls of the two babies. She'd used a surgical pen to indicate the path of the incision, and now drew the scalpel along it, the black line turning scarlet behind the blade. ALL SKIN has its own toughness and flexibility, and from post-puberty to old age, there was so much variation that you never knew quite what you'd get when you made the first cut. Sometimes it was saddle leather, sometimes tissue paper. Older people often had papery skin, and so did the young, though it was different.
Cutting into the twins was like cutting into a piece of Brie; Weather had noted that in earlier operations and no longer really paid attention to it. There was almost no separation between scalp and bone. She cut the first jigsaw pattern, got one little arterial bleeder, burned it, then slowly peeled the skin away from the incision. The room was suffused with the scent of burning blood, not unlike the smell of burning hair.
Her first part had taken twenty minutes.
She hadn't done much, but at the same time, she thought, everything: they were under way. They could still turn back, but the bone-cutter was right there, with his custom surgical jigs. Once they were in, turning back would be more complicated.