Mending The Doctor's Heart

Anna nodded. She’d been waiting for almost two days. A few more hours wouldn’t make a difference. Not to Nico.

She parted ways with Linda and went to the medical command to ask the clerk for the roster of patients.

“I’m still transferring the paper logs to the computer. Check in later.”

“Can you see if there was anyone by the last name Atao?” she said softly. The clerk looked up, eyeing the nameplate on her right breast pocket. He nodded, then tapped on the keyboard and shook his head.

“No one so far. I’ll come find you if I see that name appear in the paper logs or the new arrivals.”

Anna thanked him.

“We’re not the only medical camp around the island. I’ll ask the others when I make my status calls.”

Tears stung her eyes at the pity in his voice. She stood straight, thanked him, then turned. Despite her best efforts, she hadn’t been able to sleep on the plane. Couldn’t stop herself from imagining all the scenarios she would face on Guam. Still, she was alert and eager to get to work.

The tents were filled to capacity. A standard issue tent could comfortably take twenty patients, but there were easily more than forty per tent. Each person shared his or her narrow cot with one or two others, taking as little space as they could so there was room for everyone. Anna introduced herself to the local paramedic, Jared, who was assigned to watch over the tent, and got right to work. Most people had broken bones and wounds of various sorts, which the paramedic had bandaged. A dialysis patient was worried about how he would manage. Anna figured the patient could comfortably make it another day or two before he would get toxic; hopefully resources would arrive by then. The first days after a disaster were always the hardest.

The young paramedic with curly black hair and dark eyes followed her from patient to patient, chatting away.

“My cousins are helping get the airport fixed,” Jared told her. “There’s so much junk on the runway, Lando—that’s my uncle—had to go get a garbage truck to haul it all out.”

Anna knew that one of the reasons so few resources had made it to the island was that helicopters were very inefficient. They could only carry so much weight to conserve fuel for the long journey back to Japan or the Philippines. The neighboring Marshall Islands and the Commonwealth of the Northern Marianas Islands—CNMI—had also been badly damaged in the tsunami.

“What about the military base?” Anna inquired as she drained the infected wound of an older woman.

“They were also damaged. They’re repairing the base and sent an engineer to direct the efforts to fix up the airport, but there aren’t a lot of people on base.”

Anna nodded. Five years ago she had pleaded with the garrison officer on the air force base and each of the two navy bases, but they hadn’t been able to help her. They’d been stretched thin with troop surges in Iraq and Afghanistan and there were no helicopters to transport Lucas off the island, no cardiac surgeons at the military hospital to perform the operation that could have saved his life.

“Have there been a lot of casualties?” Anna asked out of earshot of the patients as they went to get more supplies.

Jared shrugged. “It’s hard to say right now. We had a brief warning from Hawaii saying they detected an earthquake off their coast, so we told everyone to take shelter inland, but not everyone made it. We’re seeing a lot of rescuer injuries.”

Her stomach roiled. Knowing Nico, he’d be out there putting himself at risk.

Once she was done gathering supplies, she moved on to the next tent, scanning every face for the one she knew so well. Yet another paramedic assisted her as she checked each patient in the overflowing tent. The hours sped by as more tents were put up, additional workers arrived and patients who’d been waiting in a triage area outdoors were moved to shelter.

Anna was surprised to see it was already dark when she came out of the last tent. People were still coming in, but she’d visited every patient at least once and discharged several after bandaging their wounds. She rolled her shoulders, trying to ease out the tension. She’d been on the island for five hours and forty minutes. She wondered whether she should try to find Linda or just inform the medical command clerk that she was heading to Tumon Bay to check on Nico. He’s probably okay. Still, she couldn’t shake the uneasy feeling in her stomach.

A shout grabbed her attention. “We have incoming, they need a doctor. Now!”

Anna ran to the triage area, where a group of new arrivals were gathered. A man yelled, “Ayuda, ayuda.”

Anna stepped up and placed a hand on the man’s shoulders. “I will help you. Tell me what’s wrong,” she said in Chamorro.

The man blinked rapidly. “A car fell on this man.” He pointed across the field. Anna turned and asked the clerk to go find Linda and anyone else who was available. The damage from the tsunami was astounding; she’d seen a boat perched on top of a tree. In such cases, secondary accidents after the disaster injured more people than the event itself. She followed the shouting man away from the camp. They got to the main road, which was blocked by a big tree. On the other side of the trunk was a farm tractor with a wagon attached.

“Anna?”

She turned toward the familiar voice, momentarily blinded by the lights of the tractor. Is that really her? She shielded her eyes from the glare. Her chest squeezed painfully.

“Nana?” she said. Nana was what Nico called his mother. What Anna had once called the small woman standing before her. Nana stepped forward, blocking the light from the tractor. She looked exactly as she had five years ago, her curly gray hair pinned in a bun, standing tall in her five-foot frame.

“Anna!” She closed the distance between them, then reached out and clasped Anna’s hands, her eyes wild. “Please, you must help Nico.”

CHAPTER TWO

ANNA RAN TOWARD the tractor. The giant tree that blocked the roadway lay there, dark and ominous. Branches and limbs tore at her bare arms as she scrambled over the trunk. The thin cloth of her scrub pants tore as she made her way over the top. She barely felt the sting of the scrapes on her knees. Still blinded from the glare of the headlights, all she could see were shapes of people milling about. She scooted her way down a branch; it was too high to jump down. A shadowy figure approached at a run.

She used her hands to propel her body downward a little faster, ignoring the protests of her damaged skin. Just as she got close enough to jump the rest of the way, a pair of powerful hands grabbed her around the waist and pulled her down, slamming her into a hard chest. The smell of Irish Spring soap and sweat filled her nose, a scent as familiar to her as her own perfume. He held on to her even after she had a firm footing on the concrete.

“Anna!” Her heart thudded against her chest. She collapsed against him, relief flooding through her like someone had hit the release valve on a pressure cooker about to blow. He was alive. His strong arms held up her boneless body. Drawing her close, he rubbed his cheek against her head and her heart flooded with warmth.

“Oh God, Anna, it’s really you.” His voice was husky, and he pulled her even closer. The feel of his body against hers, so familiar and yet so distant, tugged her back into reality.

She pushed away, the words out of her mouth before she raised her face to look at him. “Nico!”

He stared down at her. His height had always been the talk of the island, a trait no doubt inherited from his white father.

Their eyes locked, her blue-gray ones pinned to his soft brown.

“You came back?” His voice was low, the words a little broken.

Something burned through her. Her legs weakened, threatening to buckle underneath her.

She stepped back, out of his reach. “I had to come for my job.” There was a slight tremor in her voice.

His eyes shifted. She stared pointedly behind him, eager to look away. “You need to come with me, Tito is hurt.”

She followed him to the wagon behind the tractor and climbed up to the platform. Nico’s cousin Tito was on the back of the wagon. He had an obvious open femur fracture, the bone protruding from his leg at an odd angle. Someone held a cloth to the wound, pressing on it to stop the bleeding.

“Anna, is that you?” Tito groaned in pain.

Anna smiled reassuringly at him. She’d been fond of Tito. He was slightly shorter than her but what he lacked in height, he made up for in width. “Yes, it’s me, Tito. Looks like I’m gonna have to save you again.”

“You came back for Nico?”

Anna shook her head, wishing she’d had the forethought to bring her medical bag. Her stethoscope was still miraculously around her neck. She took it off and began listening to his chest.

“Good! ’Cause he ain’t available no more.”

Anna took the stethoscope out of her ears. Did I hear him correctly? Tito groaned again and Anna cast around for something she could use to reduce the fracture. She spied a blanket in the corner of the wagon and pieces of rope, used to secure animals, hanging from the side rails. She picked up the blanket and wrapped Tito’s fractured leg. He howled in pain, but Anna knew there was no other way. They wouldn’t be able to safely transport him to the camp if she didn’t reduce the fracture first.

As she untied a rope, she spoke to the group of men who had come with Tito, avoiding eye contact with Nico.

“Okay, we need to make a manual hare traction splint.” She took the rope and tied it to the ends of the blanket. This wasn’t the first time she’d had to reduce a femur fracture in the field. The last one had been in a rice paddy in Thailand. At least she was on dry ground this time. She finished constructing the makeshift splint. “I’m going to pull on this rope. I need you men to hold Tito down.”

“What? No! This woman is gonna kill me!” The men ignored Tito and two of them kneeled on the floor, bracing themselves on either side of the injured man.

Anna grabbed the rope and balanced her footing. She pulled as hard as she could, keeping an eye on the bone, watching for the shift in the bulge telling her she’d snapped it back into place. She grunted, increasing the pressure on the rope. Tito screamed.

Nico wrapped his arms around her from behind, pressing his body close to her with the familiarity of a husband. Heat spread through her but she ignored how well she fit against him. He put his hands on top of hers and yanked with her. The bone fell into place and she held the rope taut. She could feel the warmth of Nico’s body against her back. The hair on his arms pricked her skin.

“Okay, Nico, take this blanket and hold traction while I go arrange for a stretcher.” She was glad her voice was businesslike. Ducking, she crawled underneath his arms and over Tito’s legs. He had ceased howling and was now moaning and mumbling incoherently. Anna checked his breathing and pulse. Tito was in pain but would be okay until they got him to camp and gave him something to dull it.

Anna stepped down from the wagon to see a few of the men had run ahead to the camp and requested a stretcher already. She instructed the men to find two pieces of wood and nail a makeshift cross to the board.

They rolled Tito onto the stretcher and with Nico’s help, she tied her traction splint ropes to the cross to hold the fracture in place.

Someone lifted one end of the stretcher and nearly dropped it. Nico teasingly reminded Tito to lose weight and picked up the front end. That’s when she noticed the blood on his T-shirt, right around his waist.

“Nico, you’re hurt!”

He shrugged and adjusted his grip on the stretcher but she heard the unmistakable groan and saw the shift of his body. He was injured.

Two other men lifted the back of the stretcher, and a couple others held the sides as they maneuvered it down from the wagon and made the long walk around the tree trunk, since there was no safe way across. Anna followed, watching Nico shift his weight every few seconds. He was in pain.

They found Nana on the other side of the tree and she fell in step with Anna, reaching out to squeeze her hand. Anna let the woman take it for a moment, but pulled it back on the pretense of needing to check on Tito.

When they arrived at camp, Linda was waiting. She inspected the hare traction splint. “Not bad for fieldwork.”

Linda took over Tito’s care, instructing Anna to manage the rest of the arrivals. Anna opened her mouth to protest but Linda was long gone.

* * *

NICO WOULD HAVE gone with Tito but they wouldn’t allow him. It was just as well. He had a lot to do, and that was without knowing Anna was back. What is she doing here, anyway?

She turned to Nico. “Let me look at your injury.”

He began shaking his head; the pain would subside eventually. He needed to get back to Talofofo, but one look at her face and he stopped. Maybe fate had intervened to give him the courage to do what he’d been putting off for more than a year. A jab in the arm caught his attention and he looked down to see Nana, her eyebrows raised at him. He didn’t need her to speak to know what she wanted him to do. She’d been bugging him for months to get in touch with Anna.

After nodding to his mother to let her know he understood her silent message, he followed Anna silently to a tent that had just been erected. A man was delivering boxes.

She opened a zippered bag and one-handedly pulled out a folded cot. Anna had always been self-sufficient, preferring to do the hard work herself rather than ask someone else for help. It was her strength that he’d been drawn to when they’d first met, and also what he had counted on to get them through their son’s death.

“Sit,” she said sternly.

He was lower than her on the cot, so he tipped his head back to take her in. She looked the same, yet different. The luscious brown and golden locks that had hung all the way to her waist were cropped short now, close to her earlobes. Once vibrant blue-gray eyes were tired and had crinkles around them that hadn’t existed five years ago. Her face held more definition, less of the fullness that used to be there. She was far more beautiful, but hauntingly so. Sadness shrouded her.

“You’ve lost a lot of weight.” He winced as the words left his mouth. Didn’t mean to say it out loud.

She pressed her lips together. “Yeah, well, I haven’t had your relatives stuffing food down my throat.”

His gut twisted at the bitterness in her voice. One of his favorite memories was right after she’d given birth to Lucas. Her face had a plumpness to it, her skin shone brightly, her normally slim figure had a wonderful feminine roundness. His relatives had showered her with attention and food, and she’d welcomed the nurturing for herself and baby Lucas. It was the only time in their marriage she’d embraced the presence of his extended family.

“Remove your shirt.”

He wasn’t going to make this any easier on her than it was on him. She had left him. Nico had done everything he could to get her to stay. When he finally let her go, it was with the hope that distance would heal her. He’d emailed her. Once a week for the first year, then monthly until he’d given up two years ago when she still hadn’t answered. Not a single text, email or call. Not even to tell him she was okay. She’d even shut down her Facebook page, so he had no idea where she was or what she was doing. He’d finally resorted to emailing her sister Caroline, who at least had the decency to give him regular updates on what was happening with Anna, and let him know that she wasn’t lying dead in a ditch somewhere.

He grabbed the bottom of his shirt and lifted it, wincing at the stab of pain across his belly. She inhaled sharply as he slid the shirt across his head and balled it up.

“How did you get that cut?”

“Tito got himself trapped under a car. The door had a jagged edge I didn’t see when I was pulling him out.”

“It’s dirty and likely to get infected.”

“It’ll be fine.”

“Some things never change,” she muttered.

“Anna.”

When she was upset at him, her eyes would normally turn an icy blue, a color he loved so much he would sometimes needle her just to see it. But now there was nothing but darkness. The same one that had been there when she left the island. He had hoped time would heal her. That leaving him would somehow bring her comfort. It hadn’t.

“I’m going to stitch it up, then give you antibiotics.”

She went to leave, but he grabbed her hand. Her skin felt soft, her hand small and fragile in his. “Why aren’t you at peace with what happened to us?”

Her eyes flashed. “Because it didn’t happen to us, it happened to me.” His chest burned. No matter how hard he tried, she had never let him share her pain. Looking at her now, a familiar tightness choked his chest. He had grieved for Lucas, but he had moved on with his life. Taking a breath, he tried to shake off the suffocating feeling. What was wrong with him? He was at peace with what had happened. It was Anna who obviously still needed closure.

“Anna, you have to stop blaming yourself. You’re not the reason Lucas died.”

“I’m not the only reason. This island is the other reason. If we had been in California, he never would have died.”

He let go of her hand and she stepped away. After Lucas’s death, she had begged him to leave Guam, to come with her to California where they could start a new life. When they married, he’d thought she understood the man he was, a family man, one who wouldn’t leave his home, his land. Not like his father. But ultimately she hadn’t understood. She’d left without him and he’d let her go, thinking she would come back after time healed her wounds. But she hadn’t come back. Nor had she healed.

Anna rummaged through some boxes and returned to him. He started to say something but stopped when a man entered the tent and began unpacking medical supplies.

Anna held up a needle in one hand and an upside-down bottle in another.

“Lie back,” she ordered.

Nico lay on his back and felt her pouring liquid over his belly. It stung. He closed his eyes; there was no point in repeating the same conversation they’d had for months after Lucas’s death.

A needle pierced his stomach, sending a sharp pain through his body, but then everything went blissfully numb. He opened his eyes and craned his neck. Anna was bent over him, stitching away. He remembered the last time he’d seen her like this and a different pain speared his chest.

“Anna...”

“Not now, Nico.”

He waited patiently until she was done and saw her place a dressing over his wound. When she turned away, he sat up.

The man who’d been unpacking boxes left with an armful of empty containers.

“Anna...”

She turned to him, her eyes wet. “I can’t do this, Nico. Not here.”

He stood, then reached out and took her hand, pulling her close to him. She rested her face on his chest. Wrapping his arms around her, he placed his hand on her head, feeling her soft cheek on his bare skin, weaving his fingers into her silky hair. The years melted away as he felt her body against his. She belonged to him, always had. But her wounds were still as raw as the day she left. This island had never been her home because she hadn’t let it be. And never would.

“I’ve missed you, Anna.”

She nodded against his chest and he knew she still loved him, had felt the agony of their distance just as he had. Lifting her head, she stepped back, eyes shining, cheeks wet. He felt what she wanted to say. The very words that were on his lips. “Anna...we...” They were simple words, yet they stuck in his throat, threatening to choke him.

Her big, wet eyes stabbed at his soul. “Nico, I can’t do this. I can never come back here for good. We...we...we need to divorce.”

CHAPTER THREE

SHE FELT HIS pain more acutely than her own. Yet Anna stood poised to cut into the delicate heart of her two-month-old son. Her hand trembled slightly as she touched the precision steel blade to pale pink skin. Right before it pierced, she retracted the scalpel. Closing her eyes, she took a deep breath. Even a minuscule tremble could end Lucas’s life. She wasn’t a cardiac surgeon, but if she didn’t correct the big hole in his heart, he would die. If she made the tiniest of mistakes, he would die. If any one of a thousand things went wrong during the surgery, like the electricity going out again, he would die. She was six thousand miles away from California and they were out of time. There were no other options.

She opened her eyes and looked up to see Nico’s tall frame fill the viewing gallery window. His hair was disheveled, his eyes bloodshot, the normally smiling face creased. He put a hand on his heart, then onto the window that separated them. The gallery was meant for medical students and other physicians to watch surgeries. No father should witness his wife cutting into their son, but Nico had insisted on being there. Even across the room, she could see the wetness in his eyes. He mouthed, “I love you,” then kissed his fist, relaying confidence she didn’t feel.

She lowered her eyes from the viewing gallery to see the entire operating room staring at her. The panic in her chest was clearly visible in their eyes. The cold, sterile air reeked of desperation. They weren’t going to stop her, tell her how foolhardy this whole thing was. Not today. They were used to letting their babies die.

“Dr. Atao, you need to begin.”

The gentle but firm voice of the nurse anesthetist reminded her that the longer she waited, the more her son’s life would be at risk. The hospital didn’t even have a physician anesthesiologist. No one in their right mind would do this surgery. She looked at Nico one last time. His brown eyes reached into her soul, filling her with love. I have to do this. Lucas couldn’t die.

She took a deep breath, willing her heart to slow its frantic beating. She looked down at the small square of exposed skin, the rest draped with a blue sheet, as if the sheet could hide the fact that her little baby, the one she had nursed only an hour ago, was lying underneath. He was totally still, his normally wiggly, giggly, crying body as still as the air in the room. Ice seeped through her bones.

She pressed the scalpel into the skin above her son’s heart.

* * *

ANNA SAT UP with a sharp pain in her chest.

“Dr. Atao?” Her brain registered someone calling her name.

“Dr. Atao!”

She rubbed her eyes. A hazy face slowly came into focus. “Sorry, Doctor, you asked me to wake you. It’s eight o clock.” Anna thanked the clerk and checked her watch. Three hours had gone by fast, but at least she’d slept. The dream! She hadn’t had it for 392 days. But then she shouldn’t be surprised it had returned. It wasn’t so much a dream as a replay of the worst day of her life. The day she had performed surgery on her two-month-old son, hastening his death. It was technically a routine surgery; had she been in California, it would have been performed by a team of pediatric surgeons and Lucas would be a happy child today, five years, three months and four days old. But she’d been here on Guam, basking in the glory of being a new mother, ignoring the early warning signs.

She swung her leg off the cot, went to the latrine and splashed water on her face using the jug she’d brought. Time of death, 10:56. She’d done CPR for more than an hour, until finally the staff had pulled her away from Lucas and another physician had been called in to pronounce the death of her little baby.

For days after, his cries still woke her up at night.

She wiped her face with a paper towel. It was time to get back to work. There were still only two physicians, and patients were coming in by the truckloads as roads were getting cleared. Linda and Anna were taking turns sleeping. Anna had to keep moving; it was the only way to get through the remaining 319 hours on Guam.

A canteen hadn’t been set up yet, but the medical command tent had a corner stocked with a box of MREs—military grade “meals ready-to-eat”—instant coffee and hot water. She made her way there and was surprised to find hard-boiled eggs and basic bread. Compared to the MREs, any real food was a treat.