"Why is that?" Kelly asked.

"That level of competition extracts a high price from anyone, much less a prepubescent child. It's not always mentally healthy. It's a lot of risk without a lot of payoff."

"Hmmm," Kelly said. "I'll have to give that some thought. But, meanwhile, I've got a more pressing problem. I'm trying to do a piece for tonight's eleven o'clock news since today's the sixth-month anniversary of AmeriCare's merger of the Samaritan with the University Med Center. What I wanted was the community's reaction, but I've run into a lot of apathy. So I'd love to get your husband's feelings on the issue since I know he'd have an opinion. By any chance is he coming here to the rink this afternoon?"

"No," Tracy said with a giggle, as if Kelly had suggested an absurdity. "He never leaves the hospital until six or seven on weekdays. Never!"

"Too bad," Kelly commented, while her mind rapidly processed various contingencies. "Tell me, do you think your husband would be willing to talk with me?"

"I really have no idea," Tracy said. "You see, we've been divorced for a number of months, so I couldn't guess how he feels about you at the moment."

"I'm sorry," Kelly said with sincerity. "I didn't have any idea."

"No need to be sorry. It was best for everyone, I'm afraid. A casualty of the times and a clash of personalities."

"Well, I can imagine being married to a surgeon, particularly a cardiac surgeon, is no picnic. I mean, they think that everything pales in importance compared to what they do."

"Hmmm," Tracy responded noncommittally.

"I know I couldn't stand it," Kelly said. "Egotistical, self-centered personalities like your former husband and I don't mix."

"Maybe that's saying something about you," Tracy suggested.

"You think so?" Kelly said. She paused for a moment, recognizing she was dealing with a gentle but quick wit. "Maybe you're right. Anyway, let me ask you this: Would you have any idea where I might find your former husband right now? I'd really like to talk with him."

"I can guess where he is," Tracy said. "He's probably in surgery. With all the fighting for OR time at the med center, he's had to do all three of his weekly cases on Friday."

"Thank you. I think I'll head right over there and see if I can catch him."

"You're welcome," Tracy said. She returned Kelly's wave and then watched the woman walk swiftly back around the rink. "Good luck," Tracy murmured to herself.

Friday, January 16th

All twenty-five of the University Medical Center 's operating rooms were identical. Having been recently renovated and re-equipped, they were up-to-the-minute in every way. The floors were a white composite that gave the impression of granite. The walls were gray tile. The lights and fittings were either stainless steel or gleaming nickel.

OR twenty was one of two rooms used for open-heart surgery and at four-fifteen it was still in full operation. Between the perfusionists, anesthesiologists, circulating and scrub nurses, the surgeons and all the necessary high-tech equipment, the room was quite crowded. At that moment the patient's still heart was in full view, surrounded by a profusion of bloodstained tapes, trailing sutures, metal retractors, and pale green drapes.

"Okay, that's it," Dr. Kim Reggis said, as he handed his needle holder to the scrub nurse and straightened up to relieve the stiffness in his back. He'd been operating since seven-thirty that morning. This was his third and final case. "Let's stop the cardioplegia solution and get this ticker going."

Kim's command resulted in a minor flurry of activity at the console of the bypass machine. Switches were flipped. "Warming up," the profusionist announced to no one in particular.

The anesthesiologist stood and looked over the ether screen. "How much longer do you estimate?" she asked.

"We'll be closing here in five minutes," Kim said. "Provided the heart cooperates, which looks promising."

After a few erratic beats, the heart picked up its normal rhythm.

"Okay," Kim said. "Let's go off bypass."

For the next twenty minutes there was no talk, everyone on the team knew his job, so communication wasn't necessary. After the split sternum had been wired together, Kim and Dr. Tom Bridges stepped back from the heavily draped patient and began removing their sterile gowns, gloves, and plastic face shields. At the same time the thoracic residents moved into the vacated positions.

"I want a plastic repair on that incision," Kim called to the residents. "Is that understood?"

"You got it. Dr. Reggis," Tom Harkly said. Tom was the Chief Thoracic resident.

"But don't make it your life's work," Kim teased. "The patient has been under long enough."

Kim and Torn emerged from the OR into the operating-room corridor. Both used the scrub sink to wash the talc off their hands. Dr. Tom Bridges was a cardiac surgeon like Kim. They had been assisting each other for years and had become friends although their relationship remained essentially professional. They frequently covered for each other, especially on weekends.

"That was a slick job," Tom commented. "I don't know how you manage to get those valves in so perfectly and make it look so easy."

Kim's practice over the years had evolved into mostly valve replacement. Tom had gravitated more toward bypass procedures.

"Just like I don't know how you can sew those tiny coronary arteries the way you do," Kim answered.

Leaving the sink, Kim interlocked his fingers and stretched them high over his six-foot-three-inch frame. Then he bent down and put his palms on the floor, keeping his legs straight to stretch out his lower back. Kim was an athletic, trim, sinewy type who'd played football, basketball, and baseball for Dartmouth as an undergraduate. Because of the demands of time his current exercise had been reduced to infrequent tennis and lots of hours on a home exercise bike.

Tom, on the other hand, had given up. He, too, had played football in college, but after years of no exercise, the muscle bulk that he'd not lost had turned mostly to fat. In contrast to Kim, he had a beer belly despite the fact that he rarely drank beer.

The two men started down the tiled corridor, which at that time of day was relatively peaceful. Only nine of the OR's were in use, with two more available for emergencies. It was about standard for the three-to-eleven shift.

Kim rubbed his stubbled, angular face. Following his normal routine, he'd shaved that morning at five-thirty, and now, twelve hours later, he had the proverbial five-o'clock shadow. He ran a hand through his long, dark brown hair. As a teenager in the early seventies he'd let his hair grow beyond shoulder length. Now, at forty-three, it was still on the long side for someone in his position, though it was nowhere near as long as it had been.

Kim looked at his watch pinned to his scrub pants. "Damn, it's five-thirty already, and I haven't even made rounds. I wish I didn't have to operate on Friday. Invariably it cuts into any weekend plans."

"At least you get to have your cases run consecutively," Tom said. "It's sure not like it used to be when you ran the department over at the Samaritan."

"Tell me about it," Kim said. "With AmeriCare calling the shots and with the current status of the profession, I wonder if I'd even go into medicine if I had it all to do over again."

"You and me both," Tom said. "Especially with these new Medicare rates. Last night I stayed up and did some figuring. I'm afraid I'm not going to have any money left after I pay my office overhead. I mean, what kind of a situation is that? It's gotten so bad Nancy and I are thinking of putting our house on the market."