Too Late (A Morgan Stark FBI Suspense Thriller—Book 1)

CHAPTER TWO

CHAPTER TWO

Ayres whirled around. “What the hell are you doing in my OR, Stark?”

Morgan skidded to a stop. Ayres wasn’t a big man, but he carried himself like he was. Plus, he held a very sharp scalpel in his hand. “Trying to save your patient, Jason.” Maybe a personal plea would help his case.

Ayres’s eyes narrowed at him over his mask. “Explain yourself.”

His tone was imperious. It made Morgan grind his teeth. He got it. Really, he did. Surgeons have to be cocky. They have to have courage of their convictions. They make a lot of tough calls and everything they do carries a certain amount of risk.

He didn’t have to like them, though, and he often didn’t. He took a deep breath and blew it out, willing himself to remain calm. For a few seconds, the only sound in the room was the beeping of the monitors tracking Vincenzo’s heart and respiration.

The scrub nurse had made it around Lexa. “I’m sorry, Dr. Ayres. He got past me.”

Ayres held up the hand that wasn’t holding the scalpel. “It’s okay, Malik. Let’s hear what Dr. Stark has to say for himself.” He turned back toward Morgan. “Well?”

“Vincenzo Rohr has a relatively rare genetic disorder. Fibromuscular dysplasia. It’s likely what caused the aneurysm and the ones before it.” Morgan finished tying the surgical mask around his face with practiced fingers and walked a few more steps toward the table where Vincenzo lay motionless.

Shaking his head before Morgan could get any closer, Ayres said, “No. That doesn’t make any sense. He’s had two prior successful aneurysm clippings. If he had fibromuscular dysplasia he would have bled out during one of those.”

“Not necessarily,” Morgan took another step in. He’d pull the damn scalpel out of Ayres’s hand if he had to. “With each subsequent insult to those arterial walls, his chances of a good outcome go down. He’s been lucky so far, but there’s no guarantee he’ll be lucky a third time. Look at the numbers. The time between his second and third aneurysms is about half the time between the first and the second. His condition is getting worse. The arterial walls are getting weaker.”

Ayres lowered the hand that held the scalpel with an irritating slowness. “How sure are you about this? Because I’m pretty sure that aneurysm is going to blow soon.”

“I’m very sure.” Morgan glanced over his shoulder to check on Lexa. Her ponytail was a little askew, but she seemed otherwise unharmed by her skirmish with Malik even if he was easily four inches taller and forty pounds heavier. “Sure enough that I was going to let my resident tackle your scrub nurse so I could get in here to stop you from doing this procedure.”

The anesthesiologist snorted. Ayres threw her a look and the woman turned her attention to her instruments. Ayres never had much of a sense of humor. He put the scalpel back on the tray, though. That was all Morgan really wanted, to get that knife away from Vincenzo’s head so there was a chance he could watch his two-year-old daughter grow up.

Ayres gestured at his team. “Get Rohr into recovery.” Then he turned back to Morgan. “Let’s go figure out how to save this man’s life, then.”

“I’ve got some ideas about that,” Morgan said, tensing as he waited to see how cooperative Ayres was going to be.

Ayres snorted and waved for Morgan to follow him out of the room. “Why am I not surprised to hear that? Let’s hear it.”

“We put him on beta blockers to lessen the pressure on those arterial walls and then we do an angiogram. We’ll be able to keep an eye on any place a leak is even threatening and pull back if necessary. If we work together on it, we can be in and out before we do any more harm. Then we can get Vincenzo over to vascular services and let them take over long term treatment of his condition.” It took Morgan a second to realize they were heading into the waiting room.

The second they walked in, a young woman sitting on the couch stood up. She was a sweet-faced woman in her late twenties who had nearly been enveloped by the threadbare sprung sofa in the waiting room. “The surgery is done already?” She looked up at the clock on the waiting room wall and then back at Ayres.

“No. We’re going to postpone the surgery for at least another day or two. Dr. Stark here will explain why.” Ayres gestured at Morgan.

Morgan dragged a straight back chair from the corner closer to where Rohr’s wife stood. He sat and motioned for her to sit back down as well. “Ms. Rohr,” he began.

“Sofia, please.” she interrupted.

“Sofia, then. Your husband has a rare condition called fibromuscular dysplasia. It causes a weakening of the arterial walls.”

Sofia frowned.

He cast about in his mind for a way to simplify the explanation. “It’s why Vincenzo is developing these aneurysms. We need to be extra careful in how we fix this aneurysm and then we can treat Vincenzo for the underlying condition so he doesn’t get another one.”

Sofia looked up at Morgan, big brown eyes both hopeful and worried. “So Vincenzo will be all right?” The couple’s daughter sat at her feet, stacking blocks on the coffee table.

Ayres cut in before Morgan could answer. He’d been standing near the doorway, checking his phone while Morgan explained Vincenzo’s diagnosis and how they planned to go forward. “We think so. Vincenzo is stable for the moment. We’ll start him on beta blockers. We should be able to go in with an angiogram to fix the aneurysm once all the dust settles. Meanwhile, we've sent him for a CTA to confirm the diagnosis.”

Typical surgeon. Obviously he was going to try to take credit for the save. Let him. Morgan couldn’t care less about who got the credit for it. All he cared about was that the save actually happened. Then Ayres surprised Morgan by saying, “We wouldn’t have known without Dr. Stark here. It’s possible that Vincenzo would have been okay through this surgery as he was with the previous two, but there’s no guarantee he would have had a good outcome.”

Morgan might have to rethink his opinion of surgeons. At least, of this one.

Sofia silently mouthed the words good outcome. Morgan saw the moment when Ayres’s meaning dawned on her. He wasn’t a huge fan of euphemisms, preferring straight talk. Sometimes a softer touch was a good idea, though. Sofia’s lower lip trembled a little, then she said, “Thank you, Dr. Stark. Thank you so much. You, too, Dr. Ayres. And –” Looking a little confused she glanced at Lexa.

Lexa smiled. She really was the spitting image of Fiona. Even that little tic she had of straightening her ponytail when she was working up her courage was something Morgan remembered Fiona doing. “I’m Dr. Windham. I’m a resident working with Dr. Stark.”

Morgan's cell phone buzzed. He pulled it out of his pocket and glanced at the Caller ID, swiped the button to send it to voicemail, and turned back to Sofia. Now was not the time to take a call from his soon-to-be ex-wife.

He stood up, getting ready to leave, but Lexa gave a little head nod toward the little girl. Oh, right. The other part of the news to deliver. He sat back down. “Sofia, there’s one more thing that’s important to mention. Fibromuscular dysplasia is a genetic disorder. Do you understand what that means?”

Sofia nodded. “Yes. It means it’s passed down through the family.”

“It would probably be a good idea to get your daughter tested as well.” Morgan glanced over at Lexa. “Dr. Windham can help you get that set up.”

By the look on Sofia’s face, she hadn’t put that together yet. He felt like a heel, but better they should know what they were dealing with. Maybe they could avoid the little girl having some of the issues her father had.

They said their good-byes and Ayres and Morgan walked to the doctors’ lounge. Outside the door, Ayres stopped. “I’ve got to get to my next procedure. I wanted to thank you, though. It’s a pleasure working with you.” He stuck out his hand.

Morgan took it, but didn’t comment.

His lack of enthusiasm was not wasted on Ayres. “I mean it, Morgan. Yes. I was pissed as hell when you disrupted my OR, but you saved my patient. Our patient. Sure. Maybe it would have been okay. Maybe Vincenzo would have come through one more procedure. But maybe he wouldn’t have. Then that little girl back there would be growing up without her Daddy.” Ayres’s eyes clouded up for a second and he coughed. “You and I both know that there are some patients who can’t be saved, but Vincenzo isn’t one of them. I would not have wanted that on my conscience for the rest of my life.”

He turned and walked down the hall, back toward the Neurology Department.

Morgan watched him go, trying to get a handle on all the feelings surging through him. That had definitely taken a turn he hadn’t expected. Maybe Ayres wasn’t quite the scalpel jockey Morgan had thought he was. He went into the lounge to wait for Lexa. His cell phone buzzed again, this time with an incoming text. He sighed. Ashley asking him to call when he had a minute to talk. So civil. So polite. So utterly depressing.

Sometimes he wished she'd scream at him, throw stuff against the wall. It would be easier to handle than the sadness he saw in those big blue eyes of hers.

He did everything he could think of to make the doctors’ lounge coffee drinkable, adding enough cream and sugar so that the damn thing might as well be a milkshake. Still, it tasted nothing but bitter.

Maybe it wasn't the coffee's fault. Maybe that bad taste was permanently in his own mouth.

He sat down at the long table, scarred with water marks, and leaned back looking at the ceiling, long legs extended in front of him. Fatigue dragged at him. There was a time that the coffee wouldn’t have mattered. It could have been made from actual horse dung and still would have tasted sweet.

He’d loved his job and a save like this one would have made him feel like he was flying. That family would stay intact. He could see the tangible results of his hard work and study.

Why wasn’t it enough anymore?

He looked down at his phone again. Did it have to do with Ashley?

Maybe.

While he’d poured his attention and focus on other people’s lives and families, he’d neglected his own and now he was losing that. Ash wanted a divorce.

If he didn’t have his marriage and his job no longer kept him going, what was the point? He didn’t know.

The room was like so much else in the hospital. Generic. Unremarkable. Two couches and a coffee table with nearly every major medical journal in the country strewn across it, clogged with the stench of old coffee and the lingering scent of burned coffee grounds.

Yet, some of the finest doctors in the United States regularly sat in this room, humbled as Morgan was now, by the mysteries of the human bodies they tried so hard to save. Humbled by the hubris it took to think that they could change people's fates.

Morgan sat up at the sound of the door creaking open. His green scrubs pulled at his broad shoulders and he shrugged against them. “How'd it go?” His voice came out in a croak.

“Good. Or as good as it could be.” Lexa went to the counter to get herself a cup of coffee. “No one wants to hear that their child might have a genetic disorder that will follow her for the rest of her life. Still, if the daughter has the condition, you probably just saved her life as well as her father's.”

She sat down across from Morgan, turning the coffee cup around in slow circles in front of her. “How did you know to look for fibromuscular dysplasia? What clued you in?”

Morgan rubbed the back of his neck. “It was the combination of symptoms. The aneurysms for sure. Add in the tinnitus, the occasional blood pressure spikes, and the migraines, and it all came together.”

“For you.” She took a sip of her coffee and made a face. Maybe the bitterness wasn’t all in Morgan’s head, after all. “It didn't come together for anyone else. I was thinking maybe Ehlers-Danlos or even Loeys-Dietz.”

“That’s great, Lexa. You were on the right track. You’d have figured out that it was something genetic. You were only one step away.” Every time Morgan looked at Lexa, he saw Fiona. Lexa was about the same age as Fiona was when she'd disappeared. The coloring was there with the dark hair and blue eyes. There was more to it, though. There was an inquisitiveness, a curiosity coupled with a first-class mind.

As much as Morgan enjoyed having his resident acknowledge his expertise, he would have much rather had his little sister there next to him. Man, the team they would have made.

“A step that would have been too late if Ayres had cracked his skull. Me almost diagnosing Rohr correctly after he died on the table wouldn’t have given Sofia back her husband or given Catalina back her father.” She bowed her head. Her dark hair glinted in the harsh fluorescent light.

Poor kid. She was way too hard on herself. She was right, though. People’s lives were in their hands. “So what kept you from making that one last step?” he asked.

Lexa looked up at him. “I thought I should look at environmental factors, too. Maybe he’d been exposed to something at work or at home that could have triggered the aneurysms.”

“But your first instinct was that it was genetic?” Morgan leaned forward, elbows on the table supporting him. She’d been so close. What had stopped her? What had she let get in her way? “Why not pursue that fully before switching to a different avenue of thought?”

Lexa sighed. “I was worried I was wasting my time looking at genetic possibilities and thought I should hedge my bets.”

Ah. Morgan got the picture. “There is no bet hedging in this business. It’s literally life and death every day. You have to have the courage of your convictions. You have to learn to trust yourself.”

“I . . . I’m just not sure how to do that. There’s so much I still don’t know,” Lexa said.

“And that’s why you’re a resident working under an attending physician. Most residents wouldn’t have made it anywhere near as far as you did. I know. I’ve trained more than a few.” He knew he had a knack for figuring out the tricky diagnoses, the ones with multiple factors. He suspected that Lexa would, too. She had that kind of brain. She just needed a bit more time, a little more experience under her belt. She’d get there and it would be a pleasure watching her grow and develop. Working with her had brought back some of the delight he’d always taken in his work that he’d found hard to reach lately. “You should go home. Get some sleep. After, of course, you schedule me in for that angiogram on Vincenzo.”

Lexa frowned at him. “You're going to do it yourself?”

“Best way I know of to make sure it's done right.” The only way to make sure it was done right. His opinion of Ayres might have risen some, but not that far yet.

Lexa pushed back her chair. “You'll be going home soon, then, too?”

He nodded. “Of course.”

He smiled at Lexa, not wanting her to know that the thought of returning to his apartment, and what he had to do when he got there tonight, filled him with a sense of dread.