Balance of Power

    This intake, though heavy, was lighter than in winter—with the chilly rains, the homeless would seek refuge in the waiting room or, in desperation, attempt to hide in the tunnels beneath the hospital. This was no place, Callie thought once more, for those who would close their eyes to pathology and poverty, hopelessness passed down from one generation to the next.

    The ambulance bay burst open.

    On the gurney lay a small dark-haired girl with tubes in her nose

and throat. She was conscious: her eyes were wide with shock—not simply to her body, Callie thought, but to her spirit, her sense of what the world was.

    Callie rushed with her to the trauma room.

* * *

Mary Costello could not think or feel. Her only focus was Marie.

    Two cops in a squad car sped her to the hospital. At the door of the emergency ward one of them punched numbered buttons on a panel; the door swung open, and a plump black woman took her to a sterile room with a telephone and pastoral pictures on otherwise bare walls. Mary felt claustrophobic.

    "I need to see her," Mary said.

    The social worker took her hand. "She's already in the trauma room. The prognosis isn't good. They'll have to operate as soon as possible . . ."

    "I know that. That's why I have to be there."

    The woman appraised her. "Will you be okay?" she asked.

    "Not if I stay here."

    The woman nodded. "All right," she said, and led Mary to the trauma room.

* * *

    Marie lay on a gurney. She was surrounded by men and women in purple scrubs or white jackets, all wearing masks and leaded aprons; two cylindrical lamps and an X-ray machine extended toward her from the ceiling; a screen monitored her heartbeat. A blonde woman doctor directed the activity; to the side, a handsome, somewhat imperious black woman watched with folded arms.

    Marie's bloody clothes were in a paper bag beside the gurney. An anesthesiologist stood at her head, administering oxygen. Marie moaned softly. "I'll get the morphine," someone said.

    Stunned, Mary tried to absorb this. A young doctor in glasses turned to her. "You the aunt?" he asked.

    "Yes."

    "Do you know who her doctor is, or whether she's taking any medication?"

    Helpless, Mary shook her head.

    "What about allergies?"

    "I don't know."

    He turned away. Beneath the calm, Mary felt the pulse of urgency. "How much blood out?" the blonde doctor asked.

    "About two in the tube, and two on the sheets. Maybe four hundred cc's—half the blood in her body."

    A beeper went off. "Her pressure's dropping," someone said.

    Marie's moaning ceased. An X ray appeared on the screen; to Mary, the white stain at its center looked like a starburst. The black woman studied it, eyes narrowing.

    Turning, she ordered, "Get her to the OR—now."

* * *

Marie's eyes closed.

    They hurried her to an elevator, the black doctor at her side. Mary and the social worker followed.

    "She's crashing," someone said.

    In the silence of the elevator, Mary looked into her niece's face, pale and still.

    "Can I hold her hand?" Mary asked. When no one answered, she took the child's hand, cool to the touch.

    The elevator rose two floors, then opened into a room with a long desk and steel doors marked "Room One." Slowly, Mary let Marie's fingers slip from hers.

    The social worker took her arm. "I'm afraid this is as far as we can go."

    Three nurses rushed the gurney inside the room, the black doctor following. Tears blurred Mary's vision. Blinking, she focused on the dark crown of Marie's head, and then the doors closed behind her.

* * *

    In the dim-lit great room, Kerry gripped the telephone, watching Lara through the open door of the bedroom as she listened on another phone. Her face was pale, intent. To Kerry, the telephone was Lara's lifeline, Marie's struggle all that kept the grief and horror from crashing down on her.

    "They're about to operate," the hospital director said. "All that I can tell you, Mr. President, is that Callie Hines is as good as they get."

    In the bedroom, Lara's eyes closed, as if in a prayer. "As soon as you know," Kerry responded, "call us."

* * *

    Struggling into her operating gown, Callie recalled the shooting of Kerry Kilcannon—cops surrounding the hospital; press jammed in the media room; the mayor of San Francisco hovering near Room One. It would happen again now. But Room One was empty and clean, a haven from chaos.

    Marie lay on the table with her arms outflung. At her head three anesthesiologists administered a paralytic agent, a sedative, and a narcotic. A team of nurses ran blood to the OR. Another kept Marie's legs covered to fight the loss of body heat. The chief surgical resident, another resident and an intern watched Callie open an incision beneath the child's nipples. Perspiration began beading on her forehead—at Callie's orders, the temperature was cranked up to eighty, another measure against hypothermia. Their speech was clipped; their movements controlled. Soon they would sweat like athletes.