Dr. Dawson, Chelsea’s physician at the medical center, swept into the room, and instantly, everyone rose. He clasped Chelsea’s parents’ hands. “She’s stable,” he told them. “And she’s holding her own.”
“Thank God,” Mrs. James sobbed.
Katie felt her knees go weak. While Chelsea wasn’t out of the woods yet, she was better off than Katie had thought. Stability meant that her heart was pumping, and as long as it continued to pump, Chelsea was alive.
“I have other news,” Dr. Dawson said. “We received a call about an hour ago that there’s a possibility”—he emphasized the word—“a fair possibility that we have a donor heart available.”
With his words, Katie’s gaze flew upward. She heard Chelsea’s parents ask, “Who? When will you know for sure? Is Chelsea strong enough to withstand the surgery?”
Dr. Dawson patted Chelsea’s mother’s hand. “The victim is a seventeen-year-old girl in Columbus, Ohio. Her snowmobile hit a tree, and she sustained a massive head injury. She’s on life support now, but she’s about to be declared brain dead. The blood type is compatible, and so are her weight and size. Her family has agreed to her being a donor.”
Katie felt a mix of jumbled emotions. She recoiled at hearing the girl was being kept alive by machines, yet she experienced wild hope for Chelsea’s sake.
The doctor continued. “Our transplant team has been notified, and they’re coming in. A surgeon has been dispatched by helicopter and jet to the hospital in Columbus, and if the heart looks good, he’ll remove it, pack it in a container of dry ice, and bring it back here. It can hold up for approximately four hours this way.”
Katie saw Mrs. James shiver. She felt a wave of nausea herself. Someone’s heart—a stranger’s—would be cut out and whisked away to save someone else’s life. The process seemed both miraculous and macabre. Involuntarily, her hand slipped to her chest, where she felt the steady beat of her own transplanted heart. Aaron’s heart.
Dr. Dawson said, “This girl’s parents are donating all their daughter’s organs, so many lives will be affected by their gift.”
“Will Chelsea get her heart?” Mr. James wanted to know.
“That’s not positive,” Dr. Dawson said, making Katie’s hopes plummet.
“But you said her blood type and body size were compatible,” Mrs. James replied. Her voice sounded desperate, and Katie’s mother put her arm around the woman’s shoulders.
“That’s true. But our philosophy is, ‘Do all that can be done medically for each patient.’ Chelsea’s not our only patient in need. Medications are helping her now, and that may move her away from the immediate need for a transplant.”
“But that’s terrible!” Mrs. James cried. “She needs the transplant, and it’s taken so long to find a donor. She may not survive the next heart attack. You may not be able to pull her back, and then she’ll die. She’ll die!” She buried her face in her hands.
Chelsea’s father attempted to console her. “Everything possible is being done for Chelsea,” Dr. Dawson assured them sympathetically. “These aren’t easy calls for us. There’re so many patients awaiting donors and so few donors to go around. Hard decisions have to be made.”
Katie heard what had been left unsaid. He was trying to tell them that it wasn’t easy playing God. That doctors were faced with impossible choices, life-and-death decisions where someone always lost out. It struck her then how very lucky she’d been to have gotten her heart when she did. And it dawned on her that because she’d received it when she did, someone, somewhere else had not gotten it—and, more than likely, had died waiting for a heart that never came.
Once the doctor had gone, Mrs. James collapsed, weeping, in her husband’s arms. Katie’s parents were attempting to comfort her. Katie glanced back up at the clock and was surprised to see that only forty-five minutes had passed. It had seemed like an eternity.
Suddenly, she knew she had to have someone with her who understood. Who cared. Quickly, Katie went to the phone booth on the other side of the room. There was only one person to call. There was only Josh.
“Are you okay?” These were the first words out of Josh’s mouth when he swept into the waiting room less than twenty minutes later.
“I’m all right.” Katie wrapped her arms around him and buried her face against his chest. “You must have set a land speed record getting here.”
“I did run two red lights, but when you called, I couldn’t think about anything except getting here. How’s Chelsea?”
Katie told Josh all that the doctor had said. “I can’t believe this is happening,” she added at the conclusion of her story. “Josh, Christmas is ten days away. Chelsea can’t die before Christmas.” She started crying.
Josh held her and rocked her gently. “You can’t let yourself think that way. They’ve got her stable, and maybe the donor situation will work out.”
“But what if she dies during the surgery? No one can predict how that sort of thing will go.”
“They couldn’t predict it with you either, but you pulled through.”
“But I was stronger than Chelsea in lots of ways.”
“She’ll be all right.”
Katie sniffed and pulled away. “First Amanda. Now Chelsea. How can I lose another friend, Josh? It’s not fair.”
He took her hand. “Come on down to the cafeteria. I’ll buy you some breakfast.”
“I can’t leave.”
“There’s nothing you can do here. And nothing’s going to happen until the donor organs arrive. Come on. Some breakfast will make you feel better. And it’ll give you strength for the rest of the morning.”
Her parents agreed, so she allowed Josh to lead her to the elevator. Her knees felt wobbly, and she had to lean on Josh while they waited. “I’m glad you called,” he said, stroking her hair. “I … um … wasn’t sure if you were still speaking to me.”
“I guess what happened at Garrison’s is something we need to work out.”
“I’m really sorry about the way I acted at that party, Katie. And going off and leaving you was totally stupid. I was a real butthead.”
Garrison’s party seemed like a million years ago to Katie. As if it had happened in another lifetime. Yet, she could still recall Garrison’s mouth on hers and the way her heart had pounded when he’d kissed her. Guiltily, Katie dipped her head. “I don’t want to talk about that now.”
“How did you get home?”
“Garrison drove me.” She braced herself for Josh’s jealous reaction, but it never came.
“Do you forgive me?” he asked.
His plea touched her. She knew that really, she should be the one asking forgiveness. “I wasn’t very nice to you either. I knew you didn’t want to go to the party, but I made you.”
“I’d do anything for you, Katie. I love you.”
His words stabbed at her conscience. “I love you too.”
For the first time, Josh smiled. “I’m glad you called me this morning. So glad you wanted me to be here with you.”
“There isn’t anyone else I’d rather be with right now.” At least that much is true, Katie told herself. She’d have to sort out the rest of her feelings later.
The elevator doors opened into the lobby area. Because it was still so early, the usually busy lobby was almost empty. The lights were still dimmed, and some of the night crew were clëaning. She noticed a wheelchair being pushed across the polished lobby floor. Katie sucked in her breath. “Jillian?” she called, hurrying over. “Is that you?”
Jillian looked up. She was holding a portable oxygen tank in her lap, and the mask was clasped to her face. An orderly pushed the wheelchair, and Mrs. Longado walked briskly beside her daughter, an anxious expression on her face. “Katie?” Jillian asked. “What are you doing here?”
“I’m here because of Chelsea,” Katie replied. Josh edged alongside her.
“Is something wrong with Chelsea?” Jillian’s breath came in small gasps.
“You sh
ouldn’t exert yourself,” Mrs. Longado warned.
“Haven’t you come to see Chelsea?” Katie asked.
“No,” Jillian said, her voice a hoarse whisper. “I was beeped this morning. The doctors may have a donor for me.”
Fifteen
“A DONOR?” KATIE ASKED. She suddenly noticed the plastic banded bracelet from the admitting office on Jillian’s thin wrist.
“That’s what the page told Mom when we were called. We called Daddy in Texas right away, and he and DJ are on their way here.”
Jillian’s mother intervened. “We’re taking Jillian upstairs. They must run some tests at once.”
“Mama, it’s all right,” Jillian interrupted. “We can take a minute to talk to Katie.” She looked up at Katie. “What’s wrong with Chelsea?”
“She had a heart attack in the middle of the night. They’ve got her upstairs in Cardiac Intensive Care, and she’s doing better now.” Katie added the last quickly when she saw the look of alarm spread over Jillian’s face.
“Will she be all right?”
“Josh and I are betting she will,” Katie said with a bravado she didn’t feel.
“Mom, will you go see her as soon as I get settled?”
“I should be with you. Katie can keep us informed.” Mrs. Longado looked hopefully at Katie.
“Of course I will.”
“But she’s my best friend in the whole wide world.”
“I’ll handle it,” Katie insisted.
The orderly cleared his throat impatiently. Jillian reached out with her free hand and grasped Katie’s arm. “Come see me soon as you can. And if Chelsea’s awake, tell her this may be the big day I get a new heart and lungs. Tell her that she’d better get well so she can visit me while I’m recovering.”
Katie nodded and watched as Jillian and her mother disappeared into the elevator.
“Katie? Honey?” Josh’s voice penetrated the fog in her brain. “What’s wrong? You’re white as a sheet.”
Katie turned to him, so sick to her stomach, she could barely form words. “Josh, Jillian’s been beeped for a transplant.”
“I heard. Aren’t you happy for her?”
“But Josh, Chelsea needs one too.”
“I know.” He wore a puzzled expression as he waited for Katie to make her point.
“Don’t you see? There’s one donor coming in. Only one. Who will the doctors save? Who will get the transplant?”
For a moment, Josh stared blankly as her question sank in. “Katie, you don’t know for sure there’s only one donor.”
“Yes, I do. There’s only one. One heart. Two lungs. The doctor said that the donor’s family had given permission for all her organs to be donated.” Katie’s voice had risen with the tide of panic rising in her. “There’re two people in need and only one heart.”
As the truth of what Katie was saying spread over Josh, emotion crossed his face. “Do you think that’s really the case? Do you think they’d have two recipients stand by when they know only one can get the organ?”
Katie felt anger rising in her. “That’s exactly what it sounds like they’re doing. They can’t do it! It’s wrong to get someone’s hopes up, then dash them to bits. I want to go back upstairs and talk to the doctor,” Katie insisted. “I want to know—really know—how they decide who lives and who dies.”
“But—” Josh called after her.
“I can’t think about anything but talking to the doctor.” Katie punched the elevator button impatiently and bounded inside the instant the doors opened. Josh rode with her up to the cardiac care floor. When the doors opened, she shot out into the hall. Dr. Dawson was standing at one of the nurses’ stations, writing on a chart. Katie jogged up to him and touched his shoulder. “I want to talk to you,” she said.
Looking surprised. Dr. Dawson folded the chart and put it atop the desk. “What is it, Katie?” He knew her, not only because of her involvement with Chelsea, but because she was one of the transplant center’s success stories.
“This donor heart that’s coming—who’s going to get it?”
He blinked at her, as if he didn’t quite understand her question. “You heard what I told Chelsea’s family. We’re not sure if it will be Chelsea or not. Why are you asking?”
“Because I saw Jillian Longado in the lobby, and she said she’d been beeped. That must mean that she’s a candidate for the heart too. How can you do such a thing? How can you make two people compete for the same heart?” Katie was mad; her blood was racing, and her adrenaline pumped as if she’d just run a five-minute mile.
“Katie, I don’t know who’s been notified about the possibility of transplantation. It’s all done by computer, and when the compatibility factors coincide, patients are notified.”
“But they can’t all get transplants,” she cried.
“That’s right. But the organs can’t go to waste either. Lots of factors go into choosing the recipient. I shouldn’t have to tell you this. We have to cross-match for maximum compatibility; therefore, more than one person might be prepped for surgery. Don’t you remember when you were brought in for your transplant? All the tests we ran?”
“I had to wait a while,” she said, but she knew she had very little recall from that frenetic time before her surgery.
“The transplant team had to make sure you were a good candidate medically. We wanted to be as sure as humanly possible before the surgery that the transplant would match. Because once you got the heart, there was no going back.”
That stopped Katie cold and dampened her anger. He was right. Once Chelsea’s heart was removed, it couldn’t be put back if the new one didn’t work out. “But Chelsea needs a new heart so much. And Jillian needs—” Her voice cracked. Josh took her hand.
Dr. Dawson nodded. “That’s what I was trying to say earlier in the waiting room. We doctors have to weigh all the factors.” He held out both his hands. “Do we save the one person who needs heart and lungs?” He elevated his palm as if he were holding a weight. “Or do we save three people—one who needs a heart and two who each need a lung?” He raised his other palm level with the first. “It’s a tough call, Katie, especially when patients’ needs are equal.”
Numbly, Katie nodded. All the fight had gone out of her. She saw the medical dilemma with absolute clarity; a choice had to be made, and someone would lose. With the incoming organs, three people could be helped. Or all three organs could go to save only one. “What a terrible choice,” she whispered.
“Actually, although the patients’ needs may be equal, medically speaking, all factors aren’t equal.”
“What do you mean?”
“That’s why we run so many tests. Medically, someone always has an edge. It’s never equal medically. Tests help us separate and fine-tune our choices. Nothing’s worse than giving a patient a transplant and then losing him. It’s like we’ve lost two people at once—the recipient and the donor.”
His gaze said, “You’re a survivor, Katie.” She was alive, and so was Aaron Martel. But then. Josh had told her that all along. Through her, he still had part of his brother living.
Dr. Dawson’s beeper sounded. He switched it off. “I need to answer this.”
She watched him swiftly disappear down the hall. “Maybe the donor organs are here,” Katie told Josh without emotion.
“It’s a little soon all the way from Columbus,” Josh said.
She turned to Josh, tears welling in her eyes. “So, what do I wish for, Josh? Chelsea and Jillian are both my friends. I love both of them. Who do I want the doctors to save? How do I accept one friend’s life over the other?”
The tears spilled down her cheeks. Josh took her in his arms, where she wept bitterly.
* * *
Ten minutes later, her mother came out of the ICU area. “Katie! I’ve been looking for you. Did you eat?”
Katie hurriedly brushed her damp cheeks. “I couldn’t face the thought of food.”
“Chelsea’s regained conscious
ness. She’s asking to see you.”
Katie felt a rush. “Let’s go.”
Inside the glass cubicle, Katie took Chelsea’s hand and squeezed. Her friend’s eyes fluttered open and focused on Katie’s face. “It feels like a truck ran over me,” Chelsea mumbled. Her words sounded slurred, and Katie knew it was from pain medications.
“I got the license number. It won’t get far.”
Chelsea attempted a smile and groaned. “I didn’t know I could hurt so bad.” She turned her head so that she could see the heart monitor. “Funny how they put your heartbeat in a box. It’s pooping out on me, isn’t it? I’m afraid, Katie.”
“Don’t talk like that.”
“Dr. Dawson told me there’s a chance I may get a transplant today. Bye, bye, old heart. Hello, new.”
“It’s for the best. You’ll see. You’ll feel like a brand-new person.”
“Dr. Dawson says there are others being considered. He didn’t want me to get my hopes up … you know … just in case it doesn’t work out.”
“It could happen.” Katie purposely avoided eye contact as she spoke.
“What aren’t you telling me?” Chelsea asked suddenly.
Katie started. “I—I don’t know what you mean.”
Chelsea rolled her head on her pillow and made the line on the monitor screen jump. “Your face tells me you’ve got a secret.”
“Not true! I don’t know a thing.”
“You know my hobby is observing people. And I know you’re keeping something from me, Katie O’Roark.” Chelsea tried to seize Katie’s arm, but she was so weak, her hand dropped back to the bed helplessly. “Don’t keep anything from me.”
Shaken by the urgency in Chelsea’s voice, Katie said, “I know others have been beeped.”
“Others?”
“Others who need the organs.” Katie squirmed. If Chelsea got the heart and Jillian died, Chelsea might never forgive Katie for keeping such a secret. Her voice shook as she managed the courage to mumble, “Jillian.”
Chelsea squeezed her eyes shut. “I knew it. Deep down, I knew it. We have the same blood type. We’re too much alike.”