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PART ONE

New Orleans 2003

Mike Boudreaux’s gloved hands worked quickly and decisively to finish a gallbladder in operating room five.   Paul Smythe, the anesthesiologist, entered from the corridor through swinging double doors.  “Trouble in seven,” he said, his usually calm voice edged with urgency.

Boudreaux’s hands didn’t hesitate in the measured motions of the instrument tie.  The toothed forceps gripped the tissue, and with a twist of the needle holder, the needle passed cleanly through with little resistance.  “Who is it?” he asked Paul without taking his eyes off the field.

“Clayton.”

“He ask for me?” Boudreaux asked.

Paul didn’t answer but stared directly until Boudreaux met his gaze, and then he glanced in the direction of room seven.

Boudreaux finished one more tie and handed the instruments to the resident assistant.  In seconds, he was in room seven.  Except for the respirator and monitors, the room was silent.  Clayton was bent over the OR table, his usual ruddy complexion now pale below the line of the blue surgical cap; the circulator stared at the floor avoiding eye contact.

“Suction,” Clayton said with a tenuous voice.  The scrub nurse passed the instrument with a hesitant, uncertain motion, sweat beading on his forehead.  Clayton pressed a sponge up into the wound, pulled it away, then activated the suction.  The resident gripped the retractors with a fine tremor that faintly rippled the tissue held by the blade, his anxious eyes diverted from field.

Boudreaux moved to the table and the assistant shifted toward the foot of the table to give him room to see without breaking sterility.  He couldn’t see any anatomy with the blood.  He knew somewhere a vessel had been cut.  They needed better exposure.