Toxic Transplant

9781483538334

CHAPTER 1

Lily Carr made a spectacle of herself as she sped past slower drivers. The top was down in her classic red Bel Air convertible. Wind whipped her bleached blond hair, stinging her face. She didn’t care. She waved to the drivers as she passed them. The wild week in Vegas was just what the doctor ordered. So what if she drank too much, screwed complete strangers, and lost a couple thousand bucks? Lily couldn’t be happier. She was a rich new widow. Best of all, though, she was free!

On a drunken whim, Lily marked the occasion and got a tattoo. The red tiger lily on her shoulder still hurt but she loved the way it looked. If people were put off by it, she could always cover it up. Or, she smiled, they could just go to hell.

Glancing in her rearview mirror, Lily saw a slinky black Corvette racing up behind her. He had to be doing almost 100 miles an hour. She stomped on the gas and swerved left into the passing lane to block him. He wasn’t going to show her up. The driver, challenged by her gutsy maneuver, didn’t slow down until his car almost kissed the Bel Air’s bumper. He braked only enough to avoid a rear-end collision. The two cars performed their dangerous dance for several minutes, speeding up and slowing down together, shocking drivers in the right lane. Lily pushed the vintage convertible and its souped-up engine to its limit. She didn’t know how long the older car could hang on but she’d be damned if she’d be the one to chicken out. Two miles ahead of them, a huge Winnebago, driven with great caution by an older tourist in a Hawaiian shirt, pulled into the passing lane. It lumbered past two slower cars. Looking casually in his rear view mirror, the man saw the speeding cars coming up fast behind him. He was blocked from going back into the right lane by the ancient pickup truck beside him. He had nowhere to go, so he gunned the accelerator to pass the old truck. It was like pushing an elephant. Lily reacted to his maneuver by swerving back into the right lane, still far enough behind the old truck that she was able to brake without causing an accident. The Corvette’s driver, realizing there was not enough time or room to squeeze in ahead of her or behind her, jammed on his brakes. He veered onto the shoulder of the gravelly medium, spewing small rocks into the air like buckshot. Righting the car after a few teetering seconds, his tires skidded, leaving black marks to decorate the highway. Lily laughed, letting out a whoop. She raised a straight arm into the air, middle finger pointed heavenward, as she waved goodbye to the Corvette.

She slowed down to the speed limit and savored the adrenalin as it diffused through her body. What a rush! Once her breathing returned to normal, she turned her face toward the sun for a few seconds, savoring the warmth of Arizona springtime. The blazing sun and dry air would bake out her aches, especially that roaring hangover she earned on her one-week mourning period in Vegas.

Lily eased into a gas station at the edge of Kingman, Arizona. She went through the convenience store into a fast food restaurant attached to it. Taking her tostada and burrito to a table by a window, she ate the meal slowly. The pain from her hangover began to abate but she could only finish half the food. She tossed a five-dollar tip on the table and returned to her car.

Heading down the main street toward the highway, Lily fiddled with the radio buttons. She stopped at a classic rock station, just as Born to be Wild came on. Cranking up the volume, she belted out the lyrics to the song. When the song ended, a sappy love song followed. Lily turned off the radio and went back to thinking about her next move. Back on the highway, the whine of the tires droned on, numbing her thoughts. She gazed mindlessly at the desert scenery. A full stomach and a letdown from the earlier adrenalin rush made her groggy. Flicking ashes outside her convertible, Lily took a deep drag off her Turkish cigarette, savoring the sensation as it made its way into her lungs. Slowly she blew the smoke out, holding on to it as long as possible.

A green highway sign told her that Wickenburg, Arizona, was only five miles away. She stretched her neck and straightened her tired back. Glancing to the side, she viewed the unspoiled panorama with appreciation. Dazzling wildflowers hid the usually brown floor of the desert. The colorful flowers provided welcome relief from a typically dull-beige scene that was usually broken only by the occasional hostile cactus or ugly creosote bush. A small tornado-like whirlwind of dust swirled up and raced across the median towards her car. She had no choice but to continue driving through it.

Dust blew in the side of her favorite Gucci sunglasses and lodged in her eye. Maneuvering the steering wheel with her left hand, she used her right to remove the glasses. Her eye stung from tiny particles of dust trapped behind her contact lens. Her vision started to blur. Lily unbuckled her seat belt and leaned over to open the glove compartment. She took out a package of wet-wipes to clean her hands. Concentrating on removing her contact lens, she failed to notice the warning sign about a bridge repair over a dry creek bed. When she looked up, she saw the construction equipment ahead of her, jutting into her lane. She slammed on the brakes but not fast enough to avoid hitting the backhoe. Metal crunched and glass shattered as debris flew through the air after impact. With no airbag in the vintage convertible, Lily became airborne. Her body and head made a crash landing on the asphalt. A single bright-pink Manolo Blahnik sandal skidded along the road and came to rest on the shoulder twenty feet away from the car. Lily’s designer sunglasses dangled from a yellow-blooming mesquite tree.

CHAPTER 2

Jordan Bradshaw walked up to the small group of Operating Room staff gathered around the nurses’ station. They were describing the morning’s surgeries, each trying to outdo the others with graphic tales of blood and gore. Jordan grabbed a chocolate chip cookie and listened in. One new resident complained loudly, Mornings are brutal around here. With all the new admits and early surgeries, when are we ever going to get a break?

How do you think I feel? a nurse’s aide interrupted. I don’t know how I’m ever going to get through my nursing degree program at this pace. I’m busting my butt with all the midterm exams and papers due. I haven’t slept a full eight hours any night since the semester began. I don’t have a social life, I eat crap food on the run and the bags under my eyes feel like steamer trunks.

"You think you’re tired, JaNeen? the resident sneered, not to be undone by an aide. I haven’t slept eight hours total this month and I’m operating on live patients. How can I possibly learn everything about organ transplants when I’m so seriously sleep-deprived?"

This is all fascinating, Jordan broke in, pouring a cup of coffee. Your complaints are truly unique. In fact, I don’t think I’ve heard anything like them ever before, he said with obvious sarcasm. I have a serious announcement, though--unlike your petty gripes. The Surgical Intensive Care team will have to function for several days without visits from the charming, witty, and soon-to-be world famous, Dr. Jordan Bradshaw. I’ve been invited to appear on a panel at a national medical conference in Tucson. You will probably want to postpone all social interaction until my return on Monday.

So, when are you going, Jordan? Head Nurse Chandra Mehta inquired in her lilting British-Indian accent. And, more importantly, what kind of present will you bring back for me?

Jordan took her hand in an exaggerated theatrical fashion and kissed it. Chandra, my sweet, my return will be the best present I could possibly bring you.

The groans from his friends gathered around the desk were loud enough to turn the heads of passing hospital staff. Seconds later, Dr. Aaron Berk, Chief of the Organ Transplant Unit, rounded the corner. He slowed down and frowned. Stopping in front of the group, he turned deliberately to Jordan. Berk’s gray curly hair was disheveled as usual. He folded his arms, resting them on the top of his ample stomach.

"Well, Bradshaw, I was surprised to hear we’re on the same organ transplant panel at the Tucson conference. I look forward to our little debate but expect it will be quite short. My job debunking your cellular memory presentation will be too easy. Maybe you ought to prepare an extra report on something scientific to fill in the gaps in your comic-book theory." He turned abruptly and continued down the corridor.

When she was sure he was out of earshot, Chandra complained, Why do I always feel like I’m a little girl the principal has caught doing something naughty every time he comes around--even when I haven’t done a bloody thing!

He’s such an arrogant asshole, JaNeen chimed in. "He’s made several rude comments to me, putting me down for going to school and studying hard. He acts like I’m cheating this job of my primary focus. I have the feeling that what he really thinks is that I’m trying to rise above my allotted station in life--the little shit."

Well, have pity on me, Jordan said. I have to face him before dozens of doubting, maybe downright hostile, transplant surgeons just like him. While Berk will never win any popularity contests, he still represents the mainstream medical opinion that cellular memory is an unproven concept. He’ll be doing his best to make a fool out of me, and he’s quite an expert at that. It’s a no-win situation for me. I’m never going to win an argument with him. But I’m hoping I can just educate the doctors enough to open their minds about this theory. With luck, I might even be able to get out of the session without being flayed alive. And now, at the risk of being thought a coward, I’d suggest we all go before he comes back this way or Berk might start the skinning process early.

Jordan and the resident left, being sure to go in the opposite direction from Berk, even though it was a longer way to the Operating Room lockers. Chandra and JaNeen stayed at their desks in the nurses’ station, lingering over another cookie.

Jordan is quite a catch, isn’t he? JaNeen asked. I notice he’s not wearing a ring. Is he available? And, more importantly, how do you think he feels about inter-racial dating? Think he might be interested in a little brown sugar?

Well, I know for a fact, that he’s open to that idea. I’ve seen many of his dates over the course of five years. If you have any romantic interest in Jordan, though, you’ll be disappointed. He’s gay. I told you he was too good to be true--for women at least.

Damn, JaNeen blurted, why are all the great guys married or gay? Well, I guess it doesn’t matter anyway. I won’t have any time for romance for at least two more years. Maybe he’ll change his orientation by then.

One can always hope, Chandra sighed, as she went back to filling out requests for meds. Even so, I think he is already in a relationship with a friend from his college days. He told me they’ve re-connected now that his grant is in Arizona.

The doctors’ dressing room at the hospital was deluxe. After all, it was the Bayer Hospital. Renowned as one of the most prestigious hospitals in the United States, competition to practice medicine there was fierce. Once hired, those doctors were treated to the best working conditions and equipment that money could buy.

Jordan opened his locker and stared at the contents inside. Should he have brought along his one and only interview suit for the presentation? What would Berk be wearing? Of course, Berk would be hanging out with the big shot executives of the drug and hospital industry so he’d be all decked out. They always worked at impressing each other with their imported, six thousand dollar Brioni suits. Berk thrived on intimidating people with his appearance. He was the only doctor on the entire staff who wore black surgical scrubs. He probably thought it made him appear powerful and menacing. Well, he was certainly right about that. After he started wearing them, no one dared copy him.

The Surgical Transplant Conference of the American Medical Association was being held at the Ventana Canyon Inn in Tucson. On the northern edge of town, the resort nestled up against the Santa Catalina Mountains. Jordan knew the place. It overlooked the city and was a great conference venue. He lived in Tucson as a college student, but he never had the disposable income to go to places like that. Once, though, he did go to hear a jazz quartet in the lounge area. The drinks cost more than his weekly food bill. This time he could actually afford to enjoy the resort without having to worry about eating next week.

When his favorite professor asked him to face off against Berk on a panel discussing his grant on cellular memory, Jordan only thought about the social aspects of the national conference. He looked forward to seeing several of his former classmates from the medical school at the University of Arizona. They were now scattered all over the country but he’d have a few days to renew old friendships. Philip Montague and his wife would be there from Chicago. They were always so good to him, inviting him over for dinners because they knew money was tight. Philip opened Jordan’s eyes to new therapeutic and medical approaches being pioneered at the Center for Alternative Medicine. Professionally, it changed Jordan’s life. Philip encouraged him to apply for a prestigious federal grant to test new developments in the field of organ transplantation. Much to everyone’s surprise, including his own, Jordan won the award. Some of his older, more experienced colleagues resented the hell out of it.

As soon as he agreed to participate and hung up the phone, Jordan knew what a mistake he had made. He regretted his decision instantly. He already felt the heat from challenging mainstream medical opinion and his grant was only getting started. He realized, too late, that his participation in this panel might not help matters. If he blew it, his career could be seriously jeopardized. If only he hadn’t said yes.

CHAPTER 3

The twin-engine BK 117 helicopter hovered above the Bayer Hospital heli-pad, positioning itself for touchdown. It landed on the rooftop with a bump. Emergency medical technicians leaped out of the chopper. They handed a stretcher with a body strapped on it to the hospital’s waiting Trauma Unit staff. Like a relay race’s tag team, Lily Carr went from a nurse at the accident scene, to the helicopter paramedics, to the hospital’s trauma unit. Each member of the tag team breathed a sigh of relief as she left their care alive. Her life or death at each transfer point then became someone else’s job. They, at least, had passed her on to the next point without losing her.

The hospital team hurled the gurney through Bayer’s spacious aisles to a dedicated elevator. It took them down to the first floor. The entourage screeched to a stop at the Trauma Unit. Several beds were empty so Lily was gently lifted onto one closest to the door. Doctors and nurses scurried around, intent on a single purpose to save her. They checked her vital signs: heart rate, blood pressure, pulse. She stopped breathing on her own. A nurse quickly connected her to the hospital’s ventilating machine. The three sticky patches slapped on her chest linked her to a cardiac monitor. Another nurse checked carefully for signs of trauma that might have occurred elsewhere on her body. After a thorough exam, she was wheeled to the lab, where x-rays and scans would be taken to assess the extent of internal injuries.

The Level One Trauma Center was the best in Arizona, if not the whole Southwest. It was a noisy room, cool and dark. Machines beeped, hummed and burped their surveillance of Lily. Each different sound was a language familiar to trained medical staff. Those sounds told the doctors that Lily might not make it.

Outside of looking like she had been badly beaten, there was little internal damage to her body. A broken shoulder, three broken ribs, and some awful-looking bruises and cuts appeared frightening, but none were life-threatening. The condition of her brain told a different story. Looking at the CT scans, a neurosurgeon confirmed the presence of an epidural hematoma. The hemorrhaging and swelling needed to be relieved immediately or blood would continue to build up inside her cranium. She could be brain-dead within the hour. He ordered her into surgery immediately.

An Intra-Cranial Pressure valve was inserted into her skull, and the ICP’s small plastic tube started to drain the excess blood into a plastic bag. It might already be too late, but they had no choice but to try and save her. Back in the Surgical ICU, the nurses quickly hooked up a monitor by her bedside. Another monitor was situated outside the room at the nurses’ station. The screen would continuously display the pressure in Lily’s brain.

The neurosurgeon wasn’t optimistic about her recovery. He ordered heparin, a blood thinner, to be dripped intravenously, just in case she didn’t make it. The drug would keep her organs suffused with blood. If she had signed up as an organ donor and she did die, it would help keep the organs viable until they could be harvested. As long as the ICP valve continued to drain blood from her head, though, the pressure in her brain might go down. It was her only chance.

Through it all, Lily remained in a coma.

While Chandra was attending to Lily Carr, Nurse Catherine Griffin searched her belongings for more information. She found a California driver’s license, showing her name, birthday and a pink dot, signifying she had signed up to be an organ donor. There was no insurance card or indication of any family or responsible party. The brown leather Louis Vuitton purse contained only a cell phone, a pack of foreign cigarettes, a silver cigarette lighter and a wallet with $1,200 in it. Catherine tried to contact the home listed on her driver’s license but she had moved and left no forwarding address. Attempts to find family or friends’ numbers on her phone failed.

There are no saved numbers, she told Chandra, when she returned to the station. I’ve checked Redial and Caller ID but there’s nothing there either. It must be a brand-new phone. There is some good news, though. We have permission on her driver’s license for organ donation if she doesn’t make it.

Both nurses knew the staff at the Organ Donor Network would review their waiting lists. Should brain death occur, they would decide who was most eligible to receive the organs, The criteria would take into account comparisons of blood type, size, age and gender. Geography also had to be factored into this particular decision. Due to severe thunderstorms in the Midwest and East Coast, air traffic was at a standstill in many cities. Organs destined for transplantation only had viability for a limited time. While there was no urgency yet, the Network could at least start sifting through their records to find potential matches. Time was always crucial when harvesting organs.

CHAPTER 4

Registration for the Tucson medical conference was at the end of a wide hallway lined on both sides by meeting rooms. Only a few people were milling around. Jordan thought this looked like a good time to get in and get out quickly. The conference officially opened at 7:00 pm with introductions and welcoming speeches. Generous happy hours followed in the hospitality suites of the pharmaceutical, medical devices, and managed health care companies. It was in those happy hour suites that most of the lucrative business deals were made. Jordan knew that Berk would be puffed up and strutting, in his glory in this group of phony glad-handers. Jordan and his friends would also hang out in the suites, but they were there for the free booze and appetizers. They would both ignore and be ignored by the power brokers.

Hey, you, someone in back of him said, tapping him on the shoulder. Turning around, he broke into a wide grin when he saw Miranda Daley. Miranda was the moderator for his debate with Aaron Berk. She was also a Transplant Team surgeon working with Berk. Jordan became acquainted with her shortly after he moved to Phoenix and began his study at the hospital. He sensed an instant friend and thought the feeling was mutual.

I was sure you’d chicken out as the conference got closer. Can’t say as I’d blame you, either. I’ve got some notes in my briefcase that I’ll give you about the procedures for the meeting. I have to register first but could we meet in a few minutes?

Absolutely. I’d appreciate any advance preparation I can get. Maybe I’d even have a shot at not peeing my pants in terror. You might help me come up with some strategy to keep Berk from destroying me. When you finish registering, meet me over there, he said, pointing to a large, open-air lounge.

Jordan sat on the periphery of the lounge waiting for her when Philip Montague came by. They shook hands and slapped each other on the back affectionately. Miranda came through the door shortly and Jordan introduced them. While she was looking through her briefcase for her notes, Philip turned to Jordan and raised his eyebrows suggestively. His question was clear. Jordan decided he’d have to straighten him out soon or he’d never hear the end of it.

Miranda handed Jordan the agenda. This is pretty self-explanatory, just pay attention to the timing of each presentation and the Q&A afterwards. I’ve got to see if I can track down Aaron and give him the time limits too or he’ll go on bragging forever. I’ll do what I can to set a civil tone for the presentations, but I can’t guarantee he’ll pay any attention.

Wow. Sounds like fun, Jordan said. "I can hardly wait. In the meantime, Miranda, would you like to join us for a happy hour at the expense of the world’s largest pharmaceutical companies? While we may deplore some of their practices and obscene profits, we have nothing against drinking their booze and