Nick of Time Read online

  “Well, let’s keep our voices down, then.”

  “Let’s keep our voices down? What are we, in fifth grade? What the hell happened?” Carter reached under his suit jacket and pulled a pager from his belt. “We got the word,” he said. “The message came through, we came down here just like we were supposed to, we went through all the pre-op bullshit, and then nothing. Nothing. A nurse told us it was just a false alarm, and that it was time for us to go home.”

  Cavanaugh showed Carter his palms in an effort to soothe the situation. “I understand that you’re upset—”

  “What the hell is going on?” That time, Carter’s voice rolled like artillery fire down the hallway.

  Cavanaugh jumped, and seemed conflicted as to whether he should answer. Finally, he said, “They changed their minds.”

  “Who?”

  “The donor’s family.”

  Carter wasn’t sure what answer he was expecting, but this wasn’t it. “They get a vote?” His tone betrayed his utter disbelief.

  Cavanaugh sighed, clearly resigned to the fact that Carter would never understand. “They lost a child to suicide, Mr. Janssen. I know you think you’ve had a blow of bad news, but please don’t ever—not for a moment—think that those poor people owed you anything. They made a decision and then they changed their mind.”

  The words rattled Carter. “I don’t understand,” he said. “They’d prefer that their child’s organs be buried in the ground?”

  “It’s a problem we face with patients like Nicki,” Cavanaugh explained. The rationality of his tone and his words belied the horror of his message. “There are a number of surgeons and patients alike who look at bilateral heart and lung transplants as the ultimate act of selfishness. A grieving parent has to decide, in the height of their grief, as they are being bombarded with one nightmare after another, whether their loved one’s viscera should help only one person, or help many. The vast majority of transplant recipients need only a heart or one lung—”

  “And Nicki needs all three.” Carter closed his eyes against the pain of the revelation.

  “Exactly.”

  “My God.” Carter stared, searching for the next thing to say. He nodded toward that cluster of seats. “I think I’ll sit down after all.”

  Dr. Cavanaugh took the seat directly opposite. “I don’t know if this is a detail you want or need to know, but the reason Dr. Burkhammer couldn’t meet with you and explain this himself is because he had to perform the heart transplant that the family made possible.”

  The enormity of it all was too much. So, this was how it was meant to be? At the whim of confused parents, one girl is condemned to death so that others might live? Carter had never allowed himself to understand that someone else would have to die to make that happen.

  But those were concerns for another parent. Carter had a devastated child of his own to worry about. “Has this happened before?”

  “Rarely, but it does happen. And before you ask why we don’t make certain before we notify the recipient, the answer is, we try. We get a yes and a signature, and because time is of the essence, we make the phone calls.”

  “So, they signed an agreement and reneged?” Suddenly, Carter the lawyer felt his feet on more solid ground.

  “We’re not selling commodities, Mr. Janssen. These are organs. Some might say that they’re a part of the donor’s soul. If grieving parents dig in their heels, we’re not going to force a donation just because they spilled ink on a page. We’re not ghouls.”

  But we had a deal, he didn’t say. To give Nicki life and then to take it away seemed so horribly cruel. In Carter Janssen’s world, everything was ordered and neat. Promises were met, and if they weren’t then that was what courtrooms were for. This was all so . . . unfair.

  “What can you tell me about the recipient?” Carter asked. The question came partly out of a need to fill the silence, but also from a need to know in his gut that whoever it was, was worth the price of Nicki’s life.

  “I can’t say anything about that,” Cavanaugh said. “I’m sure you understand.”

  “Man, woman, boy, girl? You can’t tell me any of that?”

  The doctor shook his head. “I know how devastating this news must be to you, and I caution both you and your daughter not to lose hope. Not only is there a chance that another donor might appear, but there are some fairly encouraging mid-term therapies for Nicki’s condition—”

  “She wants nothing to do with them.”

  Cavanaugh’s head bobbed, but he clearly dismissed the relevance of that. “Of course she doesn’t. She’s a teenager. They frequently reject what is best for them. But as her father—”

  Carter cut him off with a raised hand. “No lectures, okay? Not now. I’ll do what I have to do. But it’s such an onerous procedure.”

  Cavanaugh scowled. “Are we talking about the same procedure? We merely insert a pump into her chest—”

  “And administer prostacyclin. Yes, I know. But it means hospital time.”

  “We have to monitor the condition carefully.”

  “Of course you do. Doctor, you don’t have to justify any of this to me. Nor do you have to explain it to Nicki, but I’ve got to tell you, after watching her mother wither away in here, she’s scared to death of hospitals.”

  “Well, then we have to set her mind at ease.”

  Carter closed his eyes to stave off the frustration. “That’s not possible,” he said. When he opened them again, they felt red. “Without the transplants she’s got maybe nine months left, and of those only six are likely to be anything close to normal. The way she sees it, every hour she spends in a hospital is an hour she’s not spending cramming life into every day.”

  “But it’s necessary,” Cavanaugh said.

  “Of course it’s necessary,” Carter snapped. “Everything is so goddamned necessary. But it sucks.”

  Chapter Two

  “Hi, this is Nicki. I’m either on the phone or I’m ignoring you. Leave a message, please.”

  “Nicolette, it’s Dad. I don’t know what’s going on, but please give me a call. Like, yesterday.”

  She was gone. Poof. Without a trace. Carter could feel his face getting hot as his hands started to tremble. The hospital staff was falling all over themselves apologizing, but he was tired of hearing it. “Okay,” he said, silencing the three nurses. “There are only so many ways out of here. Let’s get security looking for her.”

  Okay. Absolutely. Brilliant idea. Clearly thrilled to have something productive to do, the nurses scurried off to put the plan into action. And the less face time they had with a lawyer, the better. There wasn’t a hospital in the country that didn’t look at lawyers as organisms only slightly less terrifying than Ebola.

  Carter seethed. Nicki never would have dreamed of pulling a stunt like this if her mother were still alive. Jenny wouldn’t have tolerated it. It had been her special gift to communicate with their daughter. In the quiet moments, he still wondered why God made the choices He had. Life would have been so much better for Nicki if He’d chosen Carter for His cancer games and left Jenny alone.

  Carter kicked himself for not seeing the escape in the offing. It was exactly what she’d promised to do if he didn’t agree to her terms. He just never thought she’d follow through. Her terms were the equivalent to suicide, for God’s sake. He’d given her credit for being smarter than that.

  He had to find her, and he had to get her therapy started as soon as possible. With the prostacyclin and a minor turn in their luck, she might be able to buy the time she needed to wait out the next donor.

  So, where would she have gone? He spent a minute running through her options, but only came up with one: home. How sad was that? Ever since her grim prognosis was announced, Nicki’s depression had manifested as an ugly rejection of all her friends and her hobbies, driving her instead to the impersonal interaction of the Internet and its endless chat rooms. God only knew what she talked about.

  Carter call
ed the house three times during his drive home, but to no avail. That meant one of two things: either she wasn’t there, or she was dodging his calls.

  Okay, there was one more possibility, but he refused to consider it. Suicide.

  He pressed a little harder on the gas.

  I don’t care what happens to me anymore, she had told him a dozen times. It’s my life and I’m tired of it. Just let nature take its course. Those damnable adolescent platitudes on fatalism drove him up the friggin’ wall.

  What the hell did a seventeen-year-old know about life or living? For her, life was exclusively about the comforts—junk food, freedom, and the right friends. There was no world outside of suburbia for her. It would be years before she could realize how thoroughly her limited horizon blocked any view of the future. What seemed so bleak to her now might well be the gateway to great things. Momentary discomfort was the price of long-term good health, period. Why couldn’t he make her understand that? Why was she so much more impenetrable than a dozen juries?

  God, he missed Jenny.

  Carter slid the turn onto the parkway, past the landmark diner that told him he was exactly six point seven miles from home.

  For some awful reason, his mind had seized on the image of Nicki slitting her wrists. If that was how she chose to do herself in, there’d be no stopping the bleeding. Not with the Coumadin on board.

  “Stop it,” he said aloud.

  Nicki needed a mother, a confidante. He tried to fill those shoes, but every attempt at a father-daughter chat somehow turned into a cross-examination. His was a world of facts and logic, Nicki’s was one of emotions and feelings. How was he supposed to deal with that? A couple of decades ago, when he’d signed on for this parenthood gig, he’d never in a million years thought that he might have to go it alone. With a daughter.

  He sped past the Alabaster Dam on his right. Four point four miles to go.

  It had been twenty months, almost to the day, since Jenny had been diagnosed with pancreatic cancer, thus beginning the longest, most relentlessly awful period of Carter’s life. Two months later, just after Thanksgiving, she was dead. It felt like no time at all, the cancer equivalent of being hit by a truck, and whatever genius had devised the platitudes about grief diminishing with time had no clue what he was talking about.

  Back in the happy days, Carter and Jenny used to chat glibly about what each of them would do in the event of the other’s death. Jenny made him promise to let her go first, because she said she’d never be able to find another man, and he’d find a new wife in a heartbeat.

  In a heartbeat. The irony brought a lump to his throat. There was only one heartbeat that he cared to hear again, and Carter prayed every night that she could somehow return to him. It was silly, he knew, but it was all he had.

  He navigated the hairpin curve at Waples Mill. Three point eight miles to go.

  In Nicolette’s mind, she became an orphan when Jenny died. Those two were different sides of the same brain. They could think each other’s thoughts, complete each other’s sentences. Now, she found herself facing her own mortality without an ear she was willing to talk to. No wonder she was so depressed.

  Nothing about Carter’s relationship with Nicki had ever been easy, but it tore him apart to be shut out of her pain. The only person she was willing to open her heart to was the psychologist who charged a hundred twenty bucks an hour for the privilege.

  He slowed for the stop sign at Clatterbuck Road, then gunned the engine. Three miles. He called her cell phone again, left another message.

  In the clarity of 20/20 hindsight, Carter should have seen Nicki’s impending illness long before he did. She’d had no stamina, no energy for anything but sleep. She’d allowed her grades to slip. Because it had started at the height of Jenny’s illness, Carter had written it off to normal, ordinary depression. Besides, teenagers were always tired, right?

  Working on the assumption that it was all about the depression, he didn’t even take her to the doctor till February, almost three months after they’d buried Jenny. A diagnosis took four months: primary pulmonary hypertension, a gift from a pharmaceutical company that preyed on young women’s desires to look like supermodels with physiques more suitable to the gulag than the runway. A death sentence.

  Jenny had picked up on Nicki’s binge-and-purge cycle four years ago and saved her life by whisking her off to a shrink. Carter had never had much tolerance for psychology or its practitioners—he’d always seen it as equal parts voodoo and bullshit—but God bless him, the doctor’s counseling had turned her around. To Nicki’s horror, she’d even put on a few pounds.

  Then came Jenny’s Cancer. The Big C. Within a month, between the chemo and the radiation, there was barely enough life left in Jenny to power a smile. A few weeks later, she was dead.

  Suddenly, with the speed of half a finger-snap, Carter and Nicki were all alone together. Father-stranger, meet daughter-stranger. It was like trying to turn on a light when no one had connected the wires. All they shared between them was the desperate need for Jenny to somehow reenter their lives.

  Carter took the bridge at Wilson’s Creek way too fast. If there’d been a car coming the other way, there’d have been no survivors. As it was, he was only a mile from the house and accelerating even faster.

  Nicki’s relapse, it turned out, had been inevitable. In Nicki’s mind, the doctor explained, recovery had been all about pleasing her mother. In the tangled non-logic that defined so much of psychology, Jenny’s death had relieved Nicki’s obligations to the get-well contract. “Surely you must have seen the warning signs,” the doctor had observed. “Some kind of abnormal behavior.”

  Right. Nicki’s behavior hadn’t resembled normalcy since she was twelve. Besides, Carter would have been looking for all the wrong signs.

  This time, instead of bingeing and purging, Nicki turned to diet drugs obtained from friends. Carter knew nothing about them, of course, but if he had, he might actually have approved. They’d have seemed like a good compromise: Nicki would eat something and keep it down for the whole day, even as the drugs reduced the size of her appetite. The diet drug was two drugs, actually, and taken together, according to the popular media—hell, according to the evening news—the results were truly amazing. People shed unwanted pounds, seemingly without side effects. Why wouldn’t that have been a good thing to try? If it would have improved her consistently sour attitude, he’d have tried anything.

  But there were side effects. Deadly ones. Primary pulmonary hypertension, PPH for short, thickened the tiny vessels in the lungs. This thickening, or “hardening,” in turn caused the pressure in those vessels to increase, causing blood to back up in the rest of the body as the cells awaited their turn to pass through the narrowed passages. The biological chain reaction that resulted took a half hour for the doctor to explain, but the time would come when Nicki’s lungs would no longer be able to sustain life.

  The average life expectancy from diagnosis to death was eighteen months. The average waiting time for transplants was twenty-four to thirty months. Do the math.

  At first, Carter had refused to believe it. Doctors were a dime a dozen, for heaven’s sake. He’d figured he could keep shopping till he found a physician who told him what he wanted to hear.

  But the decision was unanimous: a bilateral heart-lung transplant was her only hope for long-term recovery. In the end, Carter decided on a multipronged approach. He’d wear the damn pager for the transplants, but he’d also keep pressure on the doctors to try something new.

  No matter what the literature said, come hell or high water, he was not going to let Nicki die.

  God forbid that Nicki might make it easier. She was so pissed off that her regularly scheduled teen years had been interrupted by illness that she’d turned downright recalcitrant. She just wanted it all to end, she’d said. Life wasn’t worth living if it couldn’t be lived on her terms, and long hospital stays for experimental procedures were not on her agenda. She wanted
movies and pizza, not EKGs and intravenous drugs.

  With five hundred yards to go before his street, Carter eased the Volvo down from eighty and hoped that he wouldn’t spin out in the turn.

  Carter’s house on Berwick Place in the Westgate subdivision was identical to fifty percent of the homes in his neighborhood. The builder had designed exactly two interiors for his houses—both center-hall colonials, but one about $75,000 more expensive than the other—with half a dozen exterior elevations for each. The effect to the casual passerby was a wide variety of charming, 2,200-square-foot brick-and-siding homes. The homeowners’ association saw to it that the lawns stayed trimmed and green, and that nobody dared to install chain-link fences.

  Carter jerked the Volvo to a halt in the driveway, nearly forgetting to turn off the ignition as he dashed to the front door. His heart sank when he found it locked. Nicki never locked the door when she was home, despite his repeated demands that she do so. Nobody would try to do harm to a prosecutor’s daughter, she’d say with a smirk.

  His key found the slot and he threw open the heavy door. “Nicki?” he called. “Nicki, where are you!”

  No answer.

  “Nicki! Are you here?”

  Still, no answer.

  Wheeling from the kitchen, he charged back through the foyer and up the stairs to her bedroom. “Please God,” he prayed, “let her be okay.”

  * * *

  Nicki made the one phone call she needed to make, then turned her phone off. She’d silenced the ringer while in the hospital room, so as she looked at the Nokia’s display, she was surprised to see that she’d already missed five calls from her dad. So he knew. The clock was ticking.

  She swung around in the backseat of the cab for the thousandth time to check out the back window to make sure no one was following her. As stupid as it sounded, this was the first time she’d ever been in a taxicab. It all felt so daring and adventurous. Now all she had to do was keep her cool. It wasn’t the time to get jittery.

  And no one was following. Duh. She hadn’t broken any laws; why should anyone be following? She settled back into her seat in time to catch the taxi driver watching her in the rearview mirror. She smiled.