Page 149 of Gone Before Goodbye

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Time to move fast and disconnect the blood vessels.

Maggie uses scissors to part the aorta and pulmonary artery, their ends tattered by disease. She trims the right ventricle along the atrioventricular groove, preserving the tricuspid annulus. She does the same on the left side.

“Prepare the donor heart and THUMPR7,” Maggie says.

The Vineyard has the latest cardiac retraction glove and sling, which are designed to lift the heart out of the chest without damaging surrounding tissue. Maggie does that now, carefully yet quickly. The native heart is seriously diseased—thinned and stretched, weak and so fragile that Maggie worries the heart muscle might rip or crumble or even disintegrate upon extraction.

“Need another set of hands?” the assistant surgeon asks.

Her voice is high-pitched, with an exaggerated Southern twang, and Maggie wonders whether the voice is a put-on for further disguise.

Maggie is a photo of focus. “I got it.”

When the heart is clear of the chest, Maggie turns and drops it into a basin on the surgical back table. Normally a heart like this is sent to pathology for examination or disposal. What will they do with it down here in The Vineyard? Study it maybe. Use it for experimentation. Eat it. Who the hell knows?

Maggie lets herself smile at the thought.

In fact, she realizes, under her mask, she’s been smiling the whole time.

Because even though she’s scared out of her mind, even though she can almost feel the gun being readied if something goes wrong, Maggie loves this.

She loves being a surgeon. She loves operating.

“TAH,” she says.

One of the surgical nurses hands her the THUMPR7 artificial heart.

“Donor heart ready?” Maggie asks.

“Coming in the moment you need it.”

“Now,” she says.

Maggie takes hold of the THUMPR7. She looks down at Oleg’s vacant chest cavity. Where there should be a heart, there is nothing but a yawning, bloodless void. It is a sight to behold, this threshold between death and life, between an ending and a beginning, between emptiness and hope. This chest is the emptiest of vessels and a promise waiting to be fulfilled.

For the briefest of moments, Maggie considers ending that hope.

Her patient is a man with no heart, figuratively and, for the moment, literally. He is also, perhaps figuratively and literally, dead.

Only she can bring him back to life.

What would happen if she didn’t? What would happen if she just let Oleg die on the table?

She glances to her right, toward Ivan Brovski. He may be goggled and masked up too so that she cannot read his expression, but his little headshake says it all:

Don’t even think it. He dies, you die.

The door opens. The other assisting surgeon, his gloved hands covered in blood—it’s a man—wheels an Organ Care System carrying the donor heart into the room. The OCS pumps an oxygenated blood base solution through the organ, keeping the heart viable.

The new surgeon stands on the other side of the table.

Maggie looks at him. He looks at her. But she can’t really see him, of course. She can’t see his eyes or his face. The shape of his body, too, looks pretty vague in the loose surgical gown. His hands are gloved.

He nods at her. For a moment, Maggie doesn’t move.

Ivan Brovski says, “Doctor?”

Maggie snaps out of it. With her gloved hand, she steadily lowers the THUMPR7 artificial heart—the one created by WorldCures but mostly by Marc, Marc’s brainchild, Marc’s work, Marc’s attemptto save lives on a massive scale—into the seemingly bottomless hole where Oleg Ragoravich’s heart once resided.