SAMPLE CHAPTERS

CHAPTER 1

LOOK INTO MY EYES

Trauma-Surgical Intensive Care Unit, Tillman Medical Center, Los Angeles

3:43 a.m.

As she prepped the patient, Alicia Saldana realized that people were terrible at stabbing each other to death.

She’d worked on dozens of stab victims on the long journey to her trauma surgery fellowship. Many, like the sedated gang member on the operating table with a chest wound, were stabbed only once. But when some people survived thirty or more, one thrust seemed like a half-hearted effort.

With an expensive surgery, the thug would live to deal more drugs, knock over more liquor stores, and do a terrible job of trying to kill other thugs.

Some people should do the world a favor and just die.

Alicia pushed aside her uncharitable thoughts. A few bad decisions as a teenager and she could be the one lying on the table instead of the surgeon standing beside it.

Never forget how blessed you are to be here, she thought while yawning into her mask.

“You aren’t nocturnal yet?” Charles Wong, a surgical resident, asked.

“I should be by now. Why can’t people stab each other during the day?”

Charles shrugged. “That’s when I stab people.”

Roger Duncan, the anesthesiologist, looked up from his iPad. “I like to stab people in the morning. Starts the day off right.”

Before the conversation completely derailed, the suite’s double doors opened and Gerald Alvey, the Director of the Trauma Division, stepped inside.

Dr. Alvey’s presence electrified the air in the operating room. The nurses stopped chatting and focused on pre-op paperwork. Dr. Duncan set down his iPad and monitored the anesthesia equipment. Charles double-checked the surgical tools with the circulating nurse.

Alicia reacted to Dr. Alvey’s appearance like the rest of the surgical team. She stood straighter. A rush of adrenaline swept away the fog of exhaustion.

She’d applied for one of the two Surgical Critical Care fellowships at Tillman Medical Center that opened each year in hopes of working with Dr. Alvey. She was proud to be one of the few Hispanic women in history to have been accepted.

Dr. Alvey walked to the center of the operating room. “You guys got it all wrong.”

The adrenaline in Alicia’s veins boiled. Charles and I triple checked everything.

Dr. Alvey looked between Alicia and Charles. “You should stab people when you get home from work. Very therapeutic.”

An involuntary laugh burst from Alicia’s lips as her panic evaporated. The rest of the team chuckled.

Despite opening with humor, Dr. Alvey wouldn’t allow a patient to go unattended for long. He called for the surgical time out.

One by one, the team stated their names and roles. Dr. Duncan confirmed the patient’s name and Dr. Alvey stated that the team would be repairing a traumatic pneumothorax.

Finished with the time out, Dr. Alvey stepped up to the operating table and looked at Alicia. “Have you repaired one of these before?”

“Many.”

“Did your patients survive?”

“Of course.”

“I want you to take lead.”

It was the first time Dr. Alvey had asked her to lead a major operation. Tension surged through her, but she was thoroughly prepared. “Thank you, Dr. Alvey.”

“Good. I’ve worked 23 days straight and I’m exhausted.”

Alicia agreed with Dr. Alvey’s self-assessment. Dark circles framed his red, inflamed eyes. He screwed them shut every few seconds as if they itched. His previously tan skin was pallid, bordering on anemic.

“Take it away,” Dr. Alvey said.

Alicia looked at the patient. He lay on his side, most of his body covered by blue drapes. Amateur tattoos decorated the exposed parts of his back and clashed with the blue anatomical landmarks that Charles had drawn with a marker. Betadine stained his skin orange and a chest tube drained air and blood.

Here we go. “Scalpel.”

A nurse handed it to her. Alicia inserted its blade just below the patient’s nipple and cut a ten-inch, semi-circular incision that ended near the shoulder blade. Blood oozed out and slithered along the skin. A few more slices deepened the cut through layers of tissue and fat. She switched to a Bovie pen and burned through the intercostal muscles. The buzz of electricity and the aroma of cauterizing flesh filled the OR. It smelled like barbecue.

Charles placed a Finochietto between the ribs and ratcheted it open. The bones spread apart with a series of wet, muffled pops and the cartilage groaned as it stretched. Blood dribbled down the patient’s back and added its scent to the already pungent mix of betadine, burned muscle, and the new-car smell of the surgical drapes.

Alicia glanced up at Dr. Alvey. Despite his exhaustion, she could tell his red-rimmed eyes assessed every move she made. She wondered if Dr. Alvey’s exhaustion stemmed from his weight loss. When she’d interviewed with him several months ago, he looked like a different person. He’d been at least forty pounds heavier.

At first, she was concerned for his health. But the rumor around the unit was that Dr. Alvey was a client of StriveNow—a secretive health program popular with celebrities and the wealthy. He refused to answer questions about StriveNow and claimed to have signed a strict non-disclosure agreement that forbade him from sharing details.

So far, the program seemed to have helped. Even in the two weeks since starting her fellowship, Alicia noticed that he’d lost more weight, and four days ago he’d announced to the surgical team that his type 2 diabetes had resolved.

But such rapid weight loss couldn’t be healthy.

Alicia cut through the pleura lining into the chest cavity. Blood spurted onto her gown. She kept cutting and blood gushed onto the operating table. It ran down her legs and pooled in her tennis shoes.

“Suction,” Alicia said.

Charles yawned as he suctioned the blood, revealing the lung. It quivered with every beat of the neighboring heart.

“Let me assess the wound.” Dr. Alvey rounded the table and squinted hard, as if trying to force the exhaustion from his eyes. He slid his gloved hand into the patient’s chest cavity and circled the lung.

Then Dr. Alvey screamed.

Alicia jerked backward and nearly fell. It took a moment to process what had happened.

Yes, Dr. Alvey had screamed. Now he rubbed at his eyes in frantic, erratic thrusts, smearing the patient’s blood over his face.

Alicia grabbed his arms and tried to keep him from rubbing more blood into his eyes. “Stop that! What’s wrong?”

Dr. Duncan jumped to his feet, a dumbfounded expression on his face.

“We need to get him out of here,” Charles said.

Dr. Alvey went quiet. He stopped fighting Alicia for control of his arms.

“Wait, wait.” Dr. Alvey doubled over, his eyes clamped shut. His fingers gripped the side of the operating table. He hissed breaths between clenched teeth. “It’s getting better.”

The surgical team froze, all eyes watching Dr. Alvey as his breathing normalized.

“What’s happening?” Alicia asked. “Talk to me.”

“I started to lose vision. Severe pain in both eyes. I think it’s going away.” Dr. Alvey stood up to his full height and turned toward Alicia, his eyes still held shut. “Alicia, look at my eyes.”

Alicia moved closer. “Open them.”

With some effort, Dr. Alvey managed to pry them open.

Alicia struggled to comprehend what she saw. The green iris and white sclera were replaced by an inky, shimmering blackness, as if the pupils had swelled to consume everything else. Oddly reflective, the blackness caught the glare of the surgical lights.

The blood that Dr. Alvey had smeared around his eyes contrasted with the dark pools. He looked devilish.

“Dios mío.” Alicia involuntarily crossed herself, a childhood of superstition overriding a decade of science education.

“What?” Dr. Alvey asked.

Before she could answer, he collapsed.

He fell forward, made no effort to catch himself, and his face slammed into the patient’s incision. He bounced off the table and flopped to the floor.

“Call a code blue STAT!” Alicia fell to her knees beside Dr. Alvey and checked his neck for a pulse.

Nothing.

She looked into his blacked-out eyes and found no spark there. It was as if he’d passed from vibrant life to death in an instant.

“Out of the way.” Dr. Duncan knelt and also checked the neck for a carotid pulse, then held his ear over Dr. Alvey’s nose. “No pulse, no airway.”

Dr. Duncan leaned over Dr. Alvey and started chest compressions. The crunch of Dr. Alvey’s fracturing ribs reverberated through the operating room. The circulating nurse held back sobs.

The code team burst through the doors and loaded Dr. Alvey on a gurney. Dr. Duncan jumped on top, straddled Dr. Alvey, and continued chest compressions as the team rushed to the Emergency Department.

Alicia turned back to the patient and resumed operating, a difficult task with trembling hands and tear-filled eyes.

An hour later, word made it back to the OR that Dr. Alvey was dead.

CHAPTER 2

POLO

I’m Michael Emerson, and I consider myself an involuntary connoisseur of human folly.

War and nineteen years of law practice gave me a thorough introduction to the topic, but nowhere was folly more prominently displayed than at the Imperial Polo Club in Indio, California.

Exhibit A: Seth Reyes. He was the guy you hated in high school. Perfect hair, perfect teeth, impossibly fit, brimming with easy-going confidence, billionaire parents, champion rider. All that at 17.

Seth sat on the white leather couch under the white canvas cabana at the edge of the field. He held a Coke and was dressed in a white polo outfit. He looked as if he were posing for a Lacoste catalog. What made him look even better was that my youngest daughter Carolyn sat next to him.

She also wore a riding outfit and radiated the kind of natural brunette beauty any magazine would love to exploit.

Seth was telling Carolyn about how he and his brothers used to feed their dog crayons and then wait around all day for it to crap rainbows. My daughter laughed at the story, briefly forgetting she had standards, manners, and a brain.

“That’s why kids should be in school,” I said, “so they don’t do stupid stuff like that.”

“This was summer, Mr. Emerson,” Seth said.

“Summer school.”

Seth laughed off my comment. Carolyn shot me a look to thank me for condemning Seth’s vulgar behavior. Or perhaps it meant something else.

To protect my remaining IQ points, I stood, winced at the soreness from my bypass incision, and walked to the edge of the cabana. I stopped beside Seth’s father, Howard Reyes, and looked out over the empty polo field.

Howard was everything his son was not. Short, balding, crooked teeth, and brilliant. Before joining the board of StriveNow—a fancy health program that he and my wife Jennifer had talked me into joining—he’d also been fat. Now he looked shriveled, but he exuded more energy than he’d generated in years. Whatever hippy dippy wheat grass shots or hot yoga nonsense he was into must be working.

Across the field were the cheap seats, and they bustled with spectators waiting for something to happen.

Polo was called the “Sport of Kings” because only kings could afford to play. But the peasants enjoyed watching, so for $10, they could drive their vehicles to the edge of the field and set up camping chairs and beach umbrellas.

Over this crowd of tailgate enthusiasts, Howard’s eldest son, Peter, flew his red and white Eurocopter EC135. He planned to fly low over the field in order to dry it with the helicopter’s downdraft. A dense and unseasonably damp fog had settled on the field during the night and rendered it too wet for the horses to play on.

I yelled over the chopper, “When you have a hammer, every problem looks like a nail.”

“The most expensive hammer of all time,” Howard said.

“We do what we can for our children. My daughter will ride half her inheritance onto the field.”

Howard laughed, then cringed as Hurricane Peter swept across the peasants and sent them scurrying after flying beach umbrellas and empty soda cans.

Peter lowered the chopper until it hovered four feet off the grass, then slowly circled the field. The thumping whir of the helicopter made me nervous. I looked around to make sure everyone was safe. Thinking ahead to when the storm would make landfall on the ritzy side of the field, I said, “Let’s get ready to hold things down.”

We turned to the table that was heavy with catered food and a large sheet cake on which was written, “Happy Birthday Michael.” Howard weighed down the napkins and I set a casserole dish on the paper plates.

I was stretching plastic wrap over the cake when the chopper’s downdraft peppered it with slivers of grass. At least nothing flew off the table. I glanced over at the couch. Much to my disappointment, the fierce wind hadn’t blown Seth into another dimension.

I should mention that it was my 49th birthday, a significant accomplishment considering that I died four weeks ago. But thanks to the grace of modern medicine, I was among the living, at least for a while longer.

Given the choice to be waterboarded or to throw a birthday party, I’d choose the more aquatic and pleasant experience. I’d said as much, but my wife insisted that all who cared about me wanted to celebrate that I still exist. My birthday happened to coincide with our daughter’s polo game in the Coachella Valley, so my wife decided to make one big day of it.

After the chopper passed, Howard busied himself restoring order to the table. I picked at the grass blades decorating my cake.

“When I was young, we played polo on horseback, not in helicopters.”

I looked up at the sound of the familiar voice and saw Miriam Haddad walking toward me.

“Off with the old.” I gave her a brief side hug. “This is a pleasant surprise.”

“Jennifer invited me. How are you feeling?”

“Never better. I wish I could have another heart attack.” I pointed at Howard. “This is Howard Reyes, owner of this fine establishment and also a client. Howard, this is Miriam Haddad, a law-school classmate of mine.”

As a rule, I didn’t mention Miriam’s profession because people invariably got weird and disgraced themselves by asking stupid questions or making lame jokes. Miriam was the Special Agent in Charge of the Criminal Investigative Division of the Los Angeles FBI Field Office. In government speak, the SAC of the CID of the LA FBI FO.

Unlike yours truly, Miriam hadn’t changed much since law school. She exuded simple elegance and quiet confidence. Her thick, curly black hair was cropped just above her shoulders. Triathlon training kept her in shape. She wore a gray dress and carried a leather handbag that probably contained a pistol, flex cuffs, and her badge.

Howard shook Miriam’s hand, said something about having to talk with the grounds manager, and walked off toward the clubhouse.

Miriam looked around. “Where’s Jennifer?”

“Some of our relatives are late. She’s in the clubhouse calling them.”

Miriam pointed toward the couch where Seth and Carolyn chatted and laughed. The sustained thunder of the helicopter drowned out their voices. “Who’s that?”

“He’s a terrorist. The FBI should send him to Guantanamo until Carolyn is twenty-nine.”

Miriam smirked. “If he causes any trouble, the FBI is just a call away.”

While looking at the couch, I noticed my wife Jennifer walking up the side of the polo field. She wore brown leather riding boots, stylish jeans, and a light sweater that fit with the unspoken dress code of the polo elite. Her long, wavy blonde hair fell from beneath a sun hat, its wide brim flapping in the helicopter’s downdraft.

She walked with self-assurance and the ease of an athlete. She ran several miles per day and did Pilates or something. I wasn’t an expert in such matters, as my rotting arteries and ample girth would attest. Perhaps, after I recovered from surgery and got into the StriveNow program, she could help me get in shape.

I needed to do something. During my recent follow-up, my cardiologist told me that I had a 75% chance of dying in the next ten to fifteen years. Those words had rattled around in my mind ever since, keeping me in the grip of a low-grade panic.

As I watched Jennifer, I realized that something wasn’t right. Tension pulled at her lips and her pace was stiff and brisk. She stepped under the cabana and approached Miriam and me.

“I’m so glad you could make it,” Jennifer said as she hugged Miriam.

“Thanks for the invitation. I’m excited to see Carolyn play.”

“You should be. What she does is amazing and terrifying. I have to close my eyes a dozen times per match.”

Jennifer turned to me. “Babe, could you help me get something out of the car?”

“Of course.”

We walked toward the parking lot behind the club house. Once away from the cabanas, I asked, “What’s going on?”

Jennifer glanced around to make sure no one was watching. When she looked back at me, tears glistened in her eyes. “Teresa just called me back. Gerald died this morning.”