Dr. Leah Wright cradled the boy’s heart in her hand.
She glanced at his unconscious face. So young, so peaceful. Some might have said that he was dead already, but Leah wasn’t one to give up so easily. What the hell had he been doing out on the street, getting stabbed in the heart, on Valentine’s of all nights?
“Give it up, doc,” the cop told her. He’d transported the teen to Cambria City’s Good Samaritan Medical Center’s ER in his squad car. Despite his racing from the scene, the kid had no vital signs when they’d arrived at Good Sam. “Just heard from my partner.” He shook his head as he peeled bloody nitrile gloves from his hands. “Some people aren’t even worth trying to save.”
The anesthesia resident had one hand on the boy’s carotid pulse, the other forcing oxygen into his lungs. His frown mirrored Leah’s own fears—the kid’s heart had stopped for too long; there might be nothing left to revive. “Still no pulse.”
“Hang on. Wait. There. Found it.” Leah used her gloved finger to plug the hole in the boy’s right ventricle. Hidden by the mask she wore, her mouth twisted in determination. She ignored the sounds around her: monitor alarms, people talking, the huff and puff of the bag-valve-mask the anesthesiologist squeezed, and focused on listening through her fingertips, stretching every sense to find the life left in the boy’s damaged heart. “Foley catheter. Get ready to push the O-neg as soon as I have the balloon inflated.”
She guided the thin catheter through the puncture wound by touch alone. It was a strange sensation, her hands inside the chest cavity, working blind. An out of body experience—really tough traumas were all like that in a way. Time slowed, senses expanded, the entire world collapsed into a surreal tunnel vision of absolute focus.
“Now. Inflate the balloon. Slowly.” She gently tugged the catheter against the heart muscle, the balloon plugging the wound from inside the ventricle. “Push the O-neg.” This was the hard part: waiting for the damaged organ to start to beat. Everyone in the trauma bay hushed.
C’mon, she urged the motionless organ. Leah wasn’t superstitious or particularly religious, but she felt something cold pass through her own body—someone walking on her grave, her great aunt Nellie would have said.
“Internal paddles,” she ordered, ready to shock the heart back to life. As the nurse offered them to her, Leah felt a contraction ripple beneath her fingers. First one, then another. She held her breath, hoping, praying. “Wait. I’ve got something.”
All eyes turned to the monitor. A bleep of activity. Then a flurry of more. Slow and irregular but definitely there. Was it enough?
“Anything?” she asked the anesthesia resident.
At first, he shook his head, but then jerked his chin up, meeting her gaze. “Got a pulse!”
The trauma team arrived. Leah brought the surgical resident up to date on everything they’d done to revive the kid—she still didn’t know the boy’s name.
“We’ll take it from here,” the resident said as he left. “Hope he still has some brain left after being down so long.”
It wasn’t Leah’s fault that he’d arrived without vitals. Her team’s hit-the-door to return-of-circulation time was near record-breaking.
“Good work,” she told them as they filed out, leaving her alone in the suddenly silent room.
As she scrubbed clean the blood that had seeped over the rims of her gloves, she glanced at the overhead clock. Almost eight, she could still make it. Phoning home before Emily went to bed was a ritual she tried never to miss. Leah grinned. Tonight, if Emily asked her if she’d saved any lives, she could honestly say yes.
The door slammed open.
“When you gonna learn playing God isn’t your job?” came the rough bark of a Bronx accent mixed with a Haitian lilt. Andre Toussaint, the chief of trauma and emergency services and Leah’s boss’s boss, was a short man, not much taller than Leah, with wiry gray hair. Even when he was in a good mood, he was brusque and domineering—and with thirty-seven years on the job and his position at the apex of the hospital professional hierarchy cemented, he could get away with it.
She frowned at him. “Did the kid crash on the way to the OR?”
“This isn’t about one kid. It’s about you treating every patient as if you’re personally arm wrestling with God. It’s about a flagrant disregard for the needs of the hospital and all of our patients, not to mention the community we serve. Because of your would-be