Two Weeks Earlier,
Wednesday, June 13, 6:45 A.M.

She felt the sound more than heard it.

It came from deep within her brain, and in the first few seconds seemed to have no more significance than the tiny popping noise a congested sinus makes when it clears, or the slight creak that even a healthy neck can produce after the muscles and tendons have stiffened from being too long in one position.

So Kathleen Sullivan ignored it, automatically relegating the minute sensation to the background trivia of everyday life, deeming it part of approaching forty, unimportant, therefore not to be heeded, and resumed making love to Richard Steele, whom she sat astride watching his eyes glitter in the gray traces of morning light that had begun to creep into her still-darkened bedroom.

God, she loved him. Their sex seemed always such a celebration of how they matched each other in life.

Then the pain hit her at the base of her skull with the force of a two-by-four. "Oh, my God!" she screamed, clasping the back of her head and freezing.

She felt him initially increase his movements, then slow when she failed to respond, his flushed, smiling features growing puzzled.

A swirl of dizziness sent her reeling to the right as if she'd been slapped. She toppled off him. Nausea overwhelmed her, and vomit arched out of her mouth as if shot from a hose. She flopped down, half on and half off his chest. Blackness came quickly, but it took longer before she lost sensation enough to stop feeling the pain entirely.

And she could still hear.

"Kathleen! Kathleen, what's the matter?" he cried from somewhere far off.

Someone's prying open my skull from the inside, she tried to tell him just before the pressure squeezed all consciousness out of her.

The pain, like roots, ate deep into her sleep, and tendrils of harsh light ripped her out of the merciful dark. She tried to scream, but no sound came. She could see racks of bottles, bags of fluid, and coils of plastic tubing lining the walls of whatever little room they were in, yet everything looked wrong, as if outlined in double. She blinked to clear her vision; it made no difference. She couldn't shift her eyes from side to side, but she could look up and down. She tried to move her hands, but not even her fingers would budge. Had they tied her to the bed?

Someone loomed over her and placed a black mask on her face, then pumped air into her mouth and down her throat.

"Her breathing's labored," she heard Richard say from a place beyond her line of sight. "Step on it!"

"We're a minute from the door, Doc!"

She felt the room sway hard to the left, and realized they were in an ambulance. Probably on the way to Richard's ER. But why couldn't she look at him? Move anything? God, what had happened to her?

"It's okay, Kathleen," she heard him say. "We've got you. Just relax and let us help you breathe."

Volleys of air forced their way past the base of her tongue and down into her larynx. Each one felt big as a tennis ball and filled her with the urge to gag, but her pharynx stayed flaccid, refusing to respond. She wanted to shake off the mask and gasp for breath, yet couldn't.

"If you can hear me, Kathleen, we've called ahead to the hospital, and the chief of neurosurgery is waiting for us. You've suffered some kind of stroke, probably hemorrhagic from the way it's affected your eyes, but you'll make it okay, Kathleen. Count on it!" His voice trembled and broke, leaving her wondering if he'd sobbed. Squeeze after squeeze of air went down her throat. "Hyperventilating you like this blows off carbon dioxide and constricts arteries in the brain," Richard continued, his words coming in fragments as if they were catching on something sharp. "That'll slow the bleeding."

With a squeal of brakes the vehicle lurched to a stop. Instantly she heard the doors at her feet snap open and felt the cool morning air flow into the vehicle. Only then did she realize she was nude under a blanket.

The attendant went on ventilating her and a half dozen men and women in white clustered around to help lift out the stretcher. "Where's Tony Hamlin?" she heard Richard ask.

"In resus, ready and waiting with his neurosurgical team," someone answered as they raced into the ER and down a corridor, the sweep of the ceiling past her vertical stare adding to her dizziness. She could feel Richard's hands against her face as he took over holding the mask tightly in place around her mouth and nose. By straining her eyes upward she could see him. His expression grim, he snapped off orders to his staff as he ran. Even when he glanced down at her and tried to smile it was a miserable attempt to reassure her.

My God, she thought, the poor man. He thinks I'm going to die, just like his wife.

They wheeled her into a vacuous cool chamber filled with a dozen people in green gowns, masks, and surgical gloves. Everyone grabbed a part of her and worked on it as if she was a race car at a pit stop. While IVs went in her arms, a tube was shoved down her throat, and what looked liked tiny spigots were stuck into her wrists. Once more she felt she had to gag, but not even a cough or sound of any kind emerged. She lay as motionless as a corpse, yet aware.

"We've got her stable, Richard. Why don't you let us take it now?" said a man with long white hair standing by her head.

"Right, of course, Tony," she heard her lover reply, his voice more strained and uncertain than ever.

No, don't leave me alone, she wanted to cry out.

His face once more came into view, his handsome features as tense and pale as latex stretched over a skull. "Kathleen, our chief of neurosurgery, Tony Hamlin, is right here to take care of you."

"Hi, Kathleen," Hamlin said. "Sorry to meet you in such circumstances."

"These people are the best," Richard continued. "They'll get you through this." He leaned closer and whispered, "I love you."

Please stay!

He turned, and out of the corner of her fixed field of vision she watched him disappear.

Then a nurse whipped off her blanket and proceeded to insert a catheter up her urethra. "Did the event happen during intercourse?" she asked coldly, examining the secretions she'd picked up between her gloved fingers.

"Isn't that one of the classic presentations of an arterial rupture?" asked a curly-haired man in a short clinical jacket as he adjusted her IV. He didn't look much older than her daughter Lisa, who'd just turned nineteen. Christ, Richard had left her in the hands of a kid.

"When you've finished what you're doing, Doctor, why not step outside and get a proper history from Dr. Steele?" said the white-haired man behind her head as he proceeded to shine a penlight into her eyes. Despite the glare, she couldn't avert her gaze, only blink. His face looked to be in pieces, like a Picasso.

Richard stood in the corridor slumped against the wall. His taking charge in the ambulance had been both critically necessary and a retreat into action, his concentration on technique keeping his terror at bay. Now he had nothing to divert him from facing what had happened, not as a doctor, but as her lover. At the center of the domain where he'd spent his professional life resuscitating others from the dead, he began to tremble with helplessness.

A nurse with closely cropped gray hair and rectangular, gold-rimmed glasses came steaming out of the room he'd just left. "Dr. Steele, let's sit together in your office. I'll get you a coffee." Her name tag read Josephine O'Brien, but she'd been around the department longer than he, and everyone with whom she was friendly called her Jo. "Dr. Sullivan's completely lined, we've wired her to every monitor we have, and her vitals are holding. A CT's next, so there'll be nothing new to report until then."

A much younger colleague followed on her heels. "She's in good hands with Dr. Hamlin," she added. "You're doing her and yourself no good hanging around the doorway."

They spoke with exactly the mix of firmness and compassion that he expected everyone in his department to use when dealing with frightened family and friends of patients. He mumbled his thanks for their support, and had he not been a physician, might even have felt reassured. The trouble was, like most good ER doctors, he knew the odds. No niceties on the part of his staff could stop the percentages from pummeling his brain.

Mortality for this type of intracranial bleed -- eighty percent.

Morbidity or permanent brain damage in those that survived -- almost certain.

Chances of a fatal rebleed -- high.

A cold empty feeling settled into the pit of his stomach. As the two women led him down the hallway, he had to watch his step the way a drunk man does. The numbers literally staggered him. At his door he fumbled his keys until Jo took them and unlocked it for him.

Don't die on me, Kathleen, he kept saying to himself. Please, don't die on me.

As soon as he stepped into his own small sanctuary -- a carpeted shoe box with an oversized metal desk, two chairs, and a potted tree -- he quickly raised a hand to his eyes, not wanting the nurses to see the tears brimming over his lower lids. But the streams were halfway down his cheeks before he could wipe them aside. "Please, just leave me be," he said quickly, straining to keep his voice steady while looking up to avoid their gaze. The tiny perforations in the ceiling tiles shimmered like black stars in a white universe.

"Not on your life, Richard," said Jo, one of the few who would dare use his first name. Keeping her hold on his arm, she added, "Now sit down and let us take care of you for a change, starting with the mug of hot caffeine we promised you." A jerk of the head toward the door sent her junior running down the hallway to fetch it. "And don't worry about letting down in front of me," she continued when they were alone. "As for Kathleen, let me be telling you, us Irish women have a stubborn strength that adds up to an edge for seein' us through any ordeal. It probably comes from dealing with all the ornery men in our lives. From what I've heard she's as good a fighter as any, and that's sure to help her survive."

Richard looked up at her lined face and kind brown eyes. His wife had had fight in her, too. What good did it do her?

At that moment there was a knock, and a young resident stuck his head in the door. "Dr. Hamlin sent me to ask you a few questions, Dr. Steele," he said.

"Not now!" Jo snapped.

He disappeared back out again.

"These kids they make into doctors nowadays," she muttered after he'd fled. "Know all the facts, and nothing about people."

Because the people part's too painful, Richard thought.

Copyright © 2002 by Peter Clement Duffy