After driving for six hours, Tom, Elias and Mariah pulled up to the University of Pittsburgh Medical Center, where they rushed Mariah inside to start getting her prepped for surgery. Elias, brandishing his shiny new ID's that Tom created for him as Dr. Elijah Balfour, went into the staff washroom and took a hot shower and shaved.
After he looked himself in the mirror and splashed cold water in his face to try to wash away the fatigue and the wrinkles that he had acquired over the past few weeks. He was not feeling extremely confident. This was a complicated surgery he was about to undertake and had been literally fighting for his life over the course of the events in Mexico and in the South Pacific. He needed a good long vacation. Well, maybe after completing his deal with Tom, he could take one, now that he was back and anonymous in the United States.
He looked at himself again in the mirror. “I have a feeling that if I don't kill this young lady on the operating table, I'm going to kill myself through sheer exhaustion,” he thought. He looked down to see his hand trembling. He sighed, and took a couple of swallows from his flask, just to calm his nerves.
Tom had taken a side trip to some of his old hangouts at the University of Pittsburgh Engineering campus, to put the finishing touches on the paperwork to slot in Mariah's surgery. He sure hoped that Elias had his game face on, because his first meeting with the crack medical team that Tom had assembled began in just under an hour.
Dr. Dan Jacobson drummed his fingers against his chair. He was greatly curious to meet this highly esteemed Dr. Balfour from 'The Brigham' that up until now, he had strangely never heard of. He had been planning to blow off his shift today to do some sailing down at the Moraine Club. He had just bought a forty-six foot Oceanic pilothouse cruiser, and was anxious to get some sailing time in with her. He hadn't had the opportunity to take her out very far, and was scared to death of neglecting his new pocket cruiser. Rather, he wanted to get to know just how fast and well he could make her point. But alas, duty called and here he was at work. He didn't mind that much anyway. Surgery was easy money.
Jacobson leaned back in his chair to whisper a question into Dr. Sophia Acosta's ear, the anaesthesiologist. "So what have you heard about this guy?"
Sophia was occupied reading through a stack of folders, and could barely be bothered to acknowledge Jacobson's juvenile interest in the personal details of every colleague they worked with. This obviously was not her only patient that she was treating. Also, Jacobson was an olympic-class flirt.
"I haven't heard anything, Dr. Jacobson. I'm too busy to follow our hospital's gossip, let alone that of another state."
"It's just weird, is all," Jacobson continued, despite Acosta's clear display of disinterest. "I couldn't even find his Facebook page."
"I don't have a Facebook account," Acosta said, not looking up.
"Shut your face," Jacobson spouted. "I don't believe that for a second."
"How do you expect your patients that are alive and breathing in this century to have any trust and confidence in you as a doctor who is up to date with what's current in modern medical procedures if you don't even have a social networking account? Don't you want your grateful patients whose lives you've saved to be able to keep in touch with you?"
"I barely want my obnoxious colleagues to be able to keep in touch with me. Why would I want everyone I've ever met to be able to track me down?"
Jacobson sat back in his chair. "Well that doesn't say much for your bedside manner, Doctor," he said shaking his head.
"I like Instagram," Dave Lee, the perfusionist, suddenly spoke up. Jacobson blinked dully at this comment and it's narrator, but he promptly lost interest in dignifying him with a response. He turned his attention to Dr. David Portugal, the Interventional Cardiologist, who was also sitting in the row in front of him and slapped him on the shoulder, causing him to spill a bit of his coffee.
"And what are you doing here, Porch? The file says that this patient is barely thirty years old. We're not going to be performing a TAVR. We're going to be cutting her open like a Thanksgiving turkey."
Shaking her head, Dr. Acosta was in the midst of saying "God, you're an ass," when the highly regarded Dr. 'Elijah Balfour' walked into the room for the briefing.
After introducing himself under his pseudonym, Elias proceeded to explain to his team the condition of their patient and how they would proceed for the surgery, delicately yet firmly explaining some of the rather different tactics that they were planning.
Dr. Acosta raised her hand. "If we're going to be replacing both the patient's mitral and aortic valves with human replacements, why isn't the patient on a heavy dose of strong immunosuppressants?"
Elias cleared his throat. "The patient has signed off on an experimental procedure that involves specially produced valves that were custom created just for her, thus eliminating the need for immunosuppression drugs. Next?" Acosta frowned.
Next Dr. Jacobson spoke up. "This patient is relatively young, and if everything goes well she should be able to live a long and happy life. Why aren't we replacing them with mechanical valves if tissue valves wear out in ten to fifteen years?"
"If you turn to your information packet, page ten," Elias responded as the team turned to the appropriate page in their folders, "you'll find that for this particular patient we have, ready to transplant, stentless tissue valves that have been specifically bioengineered to endure the life of the patient. At least, that is what we are aiming for.
"You've all been specially selected to contribute your skills to this operation, that will be as groundbreaking as it is full of thrilling possibilities for the future of medicine. Are there any other questions?"
Dr. Portugal raised his hand. "Just one. Which medical facility did you say that it was that is providing an unbelievably advanced and sophisticated organ such as this?"
"I didn't. That will be all," Elias snapped, dismissing the team.
Tom was sitting with Mariah, as she waited to be wheeled into the OR. Tom was trying to be consoling, but she was obviously scared. As tears rolled down the sides of her face onto her pillow, she whispered, "I've decided that I don't want to die, Tom."
Tom smiled. "Courage, Mariah. Courage is what we need more than anything. I know you're not going to die. Not today. Sometimes even to live is an act of courage. And if we have the courage to open our eyes and to live another day, then we can count ourselves among those who squeeze the most satisfaction out of this mortal coil, and are truly happy."
Tom was seething with quiet rage that Elias had kicked him off of the surgical team. He stood in the scrub room and watched as one of the OR nurses sterilized herself before going into the operating theatre. "You shouldn't be in here, you," she gently scolded. Her name was Jessica Kasraie and Tom thought that she seemed rather pleasant and kind. "You seriously look like you could use some rest. Why don't you go and try and relax in the waiting room. Trust me that your friend is in very good hands. And if you take care of yourself you'll be able to give her the support she needs during recovery."
"I should be in there assisting. It's going to kill me to be outside and not know what's going on."
Another doctor who was scrubbing up for a surgery in one of the adjoining theatres overheard their conversation and as he walked past Tom he gave him a big, jovial smile. He was a big man, who spoke with a thick Tennessee accent. "Well you positively look like hayle, son. I believe you've already done all you cayan for your lady friend. Now it's time fer you to let go and t'let God."
Tom smiled and nodded. Nurse Jessica's words and this strange southern folk wisdom were finally getting through to him.
Upon stumbling out to the waiting room, he was utterly shocked to find Gwen sitting there. She immediately jumped to her feet upon seeing him and as they went to greet one another, Tom suddenly felt like he didn't know how to react, and the two ended up sharing a very awkward hug.
Once they had sat down again, Gwen asked Tom how Mariah was doing. Tom shrugged and lay back into the seat with his hand over his eyes.
"When was the last time that you got some sleep?" she asked with some concern.
Tom waved his hand dismissively. "I catch a nap here and there. It's true that I haven't been able to really get a good rest for maybe at least, going on a week now. And I guess that could be a bit worrisome, I'll admit. But the truth is, that I'm so tired, I can't sleep." He looked up at her.
"Well that makes about as much sense as a Bedouin with a boating license," she spouted. "Well hopefully this will be over soon and you can take some time off. You seem," Gwen paused, "different. Not just tired, but like there's something more serious bothering you. Are you okay? Do you want to talk about anything?"
Tom thought about it for a few moments. "Well I'd be lying if I said that I hadn't been through some pretty stressful experiences lately. But I'm sure I'll be back to normal once I have the chance to unwind."
"What's going on with Osborne, now that the Liberator's faction has been dealt with? Do you think he will support your research?"
"Osborne and I have had some very strong differences of opinion but as we've left it, we're prepared to respect each other's positions for now."
"How long do you think that will last?"
"Who knows? But one thing's for sure. Harold does not tolerate dissension in the ranks."
Gwen studied her hands and then looked at Tom intently. "What does that mean for Mariah?"
"What do you mean?"
"I mean, if Osborne is trying to keep a lid on the tech we've created, and she's a living, breathing example of that, will he be threatened by her existence?"
"He'd better not," Tom growled, tightening his hands into fists. "I've already had to protect her from him once."
"But listen to me, Tom. And please, please don't misinterpret what I'm trying to tell you. I only have your best interests at heart. And Mariah's. You won't be able to always be there to protect her. It's impossible."
Tom looked at her. "What are you saying?"
Gwen heaved a huge sigh. "What I'm saying is that maybe it would be best for you, but especially for her, if you put some distance between the two of you. To protect her. To save her."
Tom's world was rocked from under him. He didn't know what to say. "I don't know if that makes any sense. I did all of this so that we could be together."
"No, Tom. You did all of this because you love her, don't you?"
"Yes, I risked everything because her love is better than life," he said, struggling to sort out his feelings.
"But, I don't know. I'm not sure if I can make sense of this."
"It all comes down to one quotable phrase: If you love something, give it away."
Tom looked at her. "But why?" he pleaded. "Is this what love is?"
"When you love someone, you are willing to do whatever is best for them. Whatever the cost. You know who taught me that?"
Tom slowly shook his head. "Who?"
"You did. You showed me that genuine compassion is what drives us to help others."
Tom's eyes gazed in wonder. "I can't remember…" He stared blankly at Gwen. "I can't remember what compassion is. Is it a concept that I used to be able to understand? Now it seems like something so abstract, so ephemeral that I can't get a grasp on it."
Gwen swallowed slowly. "Do you think that Mariah has noticed a change in you?" Tom slowly nodded. "What did you see when you looked into her eyes?"
Tom hung his head. "I saw fear."
"So then what do you think you need to do?"
He threw his head back on the chair and stared at the ceiling. "I know. But this is not how things were supposed to go. I mean, I don't know if I'll ever to be able love again. I guess that's the price I must pay for all my sins. It's true, things have changed for me and I think I've lost my heart. It must be gone, never to be found."
Gwen put her hand on his shoulder. "No. Don't be so negative. You just need to get some rest that's all. And maybe some therapy."
The two of them sat quietly next to each other, contemplating where life had taken them.