Balance of Power

    Callie's second cut went from the first incision to the pubis. As the head nurse inserted a retractor, dark blue blood of a hematoma erupted from Marie's abdomen.

    "Clamp the aorta," Callie ordered.

    The resident inserted a rib spreader, then cross-clamped the aorta to stop the flow of blood. Two others tried to staunch the bleeding with surgical packs so that Callie could do her work; a third began massaging the child's heart. Wearing double gloves, Callie searched for the bullet with a rubber tip extractor; the X ray had told her that to extract this bullet with her fingers might slash her tendons.

    Callie found the bullet. Carefully, she removed it from amidst the roiling blood. Its tip had exploded into six metal shards, the pattern of a flower. Callie was tight-lipped with anger.

    "Eagle's Claw," she said.

    "What's that?" the intern asked.

    "Quadruple the mortality rate." She had no time to explain that the shards ripped through vital organs like a buzz saw; that their jagged edges had ended surgical careers; that a shredded vena cava could be inoperable; that her chances of saving this child had slipped from probable to long; that the Eagle's Claw, in the words of her first mentor, was "God-awful," absolutely demoralizing to a surgeon; that the quiet which had descended at the name "Eagle's Claw" meant that only the young intern did not know this. "She's at 95 degrees," the head nurse said.

    Racing against time, Callie searched for the wound.

* * *

    On the telephone, Mary was sobbing. "I know," Lara said brokenly. "I know. But maybe they can save Marie."

    She heard her sister struggle for control. "I'll adopt her . . ."

    "I know you will. You'd be so good with her."

    A ragged cry escaped. Grasping for hope, Lara said, "It's where they saved Kerry."

    She felt his hand on her shoulder. Abruptly, her sister burst out. "You two made him so angry . . ."

* * *

    The vena cava was shredded. Instead of a single clean rupture, there were three. Blood spurted from their ratty strands. The child's face was pale and still.

    "No clotting," the chief resident said. "Temperature's at 94.5."

    There was no time left to operate—Marie would die from hemorrhagic shock before Callie could suture the shredded vein. Sweat rolled down her face.

    "Damage control," Callie snapped. Her last hope was to stop the bleeding, prop up the child's body temperature and hope the veins would begin to clot, so that tomorrow she could try to repair the wound. The head nurse pressed a plunger against the vena cava; two more nurses packed the shredded area with surgical pads; another placed a defibrillator on the child's heart, to shock it into action. Callie closed the flap of Marie's abdomen with towel clips. The child's lips fluttered.

    "Ninety three degrees," the chief resident said urgently. "Her blood pressure's in free fall . . ."

    Callie began to massage the child's heart. The only sound was the whirl of the ventilator.

* * *

    Ten minutes later, leaving Room One, Callie Hines noticed the drops of blood on her shoes.

    Cops ringed the OR. The hospital administrator and the mayor stood by the door. Callie stared at the mayor. "Get him out of here," she told her boss. "Then get me a telephone."

* * *

    At eleven-oh-five, the telephone rang in Martha's Vineyard. In the living room, Kerry picked up first.

    "Mr. President?" The voice was measured. "This is Callie Hines."

    From the couch, Lara watched Kerry's face. "How is she?" Kerry asked.

    "I'm very sorry," Hines answered softly. "But the wound simply wasn't survivable. All that I can offer you is that she felt no pain."

    A numbness passed through Kerry. Gazing at Lara, he slowly shook his head. She doubled over, hands covering her face, emitting a cry of agony which made him shudder.

    "The bullet was an Eagle's Claw," Hines told him. "In a child that small . . ."

PART TWO

THE

REFUSAL

LABOR DAY–MID-SEPTEMBER

ONE

At five the next morning, Clayton was at the White House, preparing to move the Presidency to San Francisco. The C-130 had landed in Martha's Vineyard; Air Force One awaited at Logan Airport in Boston. The President and First Lady would stay at a private home in Pacific Heights, joined by the Secret Service, the White House physician, the military aide in charge of the codes for responding to a nuclear attack, and a small support staff headed by Clayton himself. Closer to the time of the funerals, Kit would arrive. The President's schedule would be limited to his daily national security briefing; to protect the First Family's private time, all other communications would go through Clayton.

    Shortly after eight o'clock, Clayton stopped to watch CNN.