The Universal Donorby Craig Nova
Bitten by one of the snakes she is studying, Virginia Lee, an accomplished herpetologist, drives herself to the hospital, carrying a
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"In the hands of this accomplished novelist, a love story becomes a thriller as a Los Angeles doctor tries to save a woman by tracking down the criminal psychopath who shares her rare blood type."New York Times Book Review
Bitten by one of the snakes she is studying, Virginia Lee, an accomplished herpetologist, drives herself to the hospital, carrying a decaying antidote and using her pantyhose as a tourniquet to slow the poison's path in her bloodstream. Through the hideous traffic of L.A., she must reach her lover Terry McKechnie, who works as an emergency-room physician. Her hope and faith is in him, even as it has been withdrawn from her husband, Terry's college friend. After her arrival, Virginia desperately needs transfusions of her rare blood type-and only an explosive criminal-at-large with whom Terry has already clashed can save her life. In this "absolutely bewitching" (Jonathan Harr) novel, Craig Nova brings us into the moral morass of contemporary America, gripping us with the beauty of his exacting prose and the suspense of his riveting emotional drama. "I wouldn't delay reading a novel of Nova's, not even to complete one of my own."John Irving "Craig Nova is a fine writer, one of our best, and if you haven't read him, the loss is yours."Jonathan Yardley, Washington Post Book World (1997 Critic's Choice) "As skilled a piece of storytelling as Mr. Nova has yet pulled off."Christopher Lehmann-Haupt, New York Times
Dr. Terry McKechnie is working the emergency room during the 1992 riots in Los Angeles, treating victims of substance abuse and gunshot wounds, when Virginia Lee, the woman he's having an affair with, checks in. She's a herpetologist and has been bitten by a rare and extremely poisonous viper, a Taipan from New Guinea. Virginia brings along the appropriate anti-venom, but one of her allergies fights against its effects, and her recovery is problematical. Worse, it becomes clear that she will need blood, but she has a rare type, so rare, in fact, that even Terry's status as a universal donor is useless. After this suspenseful and affecting opener, the novel moves backward in time, to portray the origins of Terry and Virginia's love affair. Virginia is the new wife of Terry's old friend Rick, but the two are helplessly, hopelessly drawn to each other, which they first realize soon after the wedding. Both are moral people, deeply troubled by how they're hurting Rick in a situation that's made even more complicated by Rick's agony at his wife's bedside. He suspects the affair, and he strikes out at Terry even as Terry tries doggedly to save Virginia. In a subplot, Terry's expensive foreign car has recently been stolen. From a police line-up, he identifies "Number 2" as the thief, and the suspect, out on bail, tracks Terry, threatens him, and yet also challenges him philosophically during a wild ride around Los Angeles. Turns out Number 2's blood type is the same as Virginia's, a neat though rather too convenient development. Marred by the use of coincidence and Nova's slight tendency toward melodrama. But, even so, the author's spare lyricism and philosophical manner are absorbing, original, and moving.
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Dr. Terry McKechnie stood at the sink in his kitchen and looked out the window. It was seven-thirty in the evening. From his window he saw Los Angeles, or he saw those parts south of Sunset that stretched away toward the ocean. After dark, the lights made a yellow clutter that was beautiful, yet oddly alarming, as though it concealed a threat. Terry got a glass of water and thought about the hospital. More patients had drug-resistant tuberculosis than before. New diseases from the tropics were appearing in the city, and many of these were particularly vicious. Vicious diseases, of course, were nothing new. After all, plague had even broken out in Los Angeles, in the twenties. A couple of hundred people had died. What really left Terry staring at the lights with dread was the number of gunshot wounds he was seeing. The high-velocity rounds were particularly destructive, and he was seeing more of those cases. The gunshots were bad, but there were some other cases, too, that left him standing here and looking out the window. He'd seen one the night before.
As Terry stood there he realized that his state of mind was something new. He had gone through the same process as most physicians, a kind of hardening that was necessary to go on being a doctor, but recently this toughness had become insufficient. In its absence, he had moments like this, which left him wondering just where he was headed. Terry touched the Xanax in his pocket, a sample that had been left at the hospital by a drug salesman.
The water tasted of chlorine, which, from Terry's point of view, wasn't such a bad thing. A friend of his, an epidemiologist, liked to remind Terry that bacteria of different species were able to exchange genetic material. As a physician, Terry liked to think that he was able to keep one jump ahead of the mutants with new antibiotics, although at times he wasn't sure about this.
Terry came from a long line of physicians and surgeons. In his grandfather's house, which was on Hollywood Boulevard not far from where Terry lived now, the talk had always been of medicine, of sutures and instruments, of incisions (Rocky-Davis, McBurney, and Battle), of one's percentage in correct diagnosis. Terry's grandfather maintained that if you were always a hundred percent correct in operating for appendicitis and never found an appendix that wasn't inflamed, someone was going to die. It was better to find some appendixes that weren't inflamed than to miss one that was. Eighty percent correct was the figure he thought was right.
On the day Terry received his acceptance to the UCLA Medical School, he drove from Westwood (where, as an undergraduate, he had an apartment) to his father's house out in the Valley. His father had been a radiologist. Terry's father looked at the letter, and said, "Well, we better get over to your grandfather's," and then they got into his car, a good, serviceable station wagon (unlike the primer-gray Porsche that Terry drove). They went over the hill and pulled up in front of Terry's grandfather's house, which was built against the hillside, a series of enormous white blocks topped with terra-cotta tile. Terry's grandfather's name was Jack McKechnie, but everyone called him Iron Jack.
Iron Jack had quit his practice, although he still treated a few of his old patients, and when Terry and Terry's father had entered the study, which now served as an examination room, Iron Jack was checking Ben Halloway's prostate. This was the Ben of Ben's Supermarkets. Ben was curled up on his side, knees pulled up to his chest, pants around his ankles. Iron Jack wore a plastic glove and his eyes had the faraway look of any physician who is checking a prostate. Terry's father held up the letter for his father to read. Ben grunted. Iron Jack said, "Yes. That's all right. Everything's fine," being as economical with words, now, as he was in his surgical technique, summing up both the medical school acceptance and Ben's prostate at the same time. They had champagne in the kitchen, where Terry's father (who was now in a nursing home) and Iron Jack (who was now dead) and Ben (who, when Terry saw him now said he wished he was dead, the way his joints were killing him) stood next to one another as they drank. Between sips Terry's grandfather discussed surgical technique. A Battle incision gave the best exposure. A Rocky-Davis was made in the skin line, and left the smallest scar. He said that he had treated some gunshot wounds, bad wounds, by clamping the arteries from the heart in such a way as to divert blood to just the head and the heart. "It buys a little time," he said.
Terry wondered why it is that medicine seems to run through families, like a streak of white that some people have in their hair. And when he was preparing for medical school he often wondered where the ability to endure medicine existed, or just where on the genetic material a physician was marked, the strands of DNA twisting around each other like a banister going around a spiral staircase.
In medical school, Terry attended a lecture where he had learned that one of the best questions to ask a patient, when trying to diagnose alcoholism, is "Can you remember your first drink?" A real drunk will answer this with an uncanny clarity, recalling the clothes he wore, the time of day, the people he was with, the odors that had been in the air (especially the scent of perfume), the way in which the light around him had been enhanced by warmth and brightness. Terry understood this perfectly, not in the context of alcoholism, but of the moment when he had discovered he was a universal donor. He could still remember precisely what he had been doing when he had found out. He had been standing in a biology laboratory, the light of the fall afternoon coming through the windows. The panes of glass were dusty, and this made the light into a whitish haze. Terry stood next to a young woman whose cotton blouse had been dried on a clothesline, and the fabric had the scent of the open air. She had been leaning over the counter, where she was working, the fragrance of her hair mixing with that misty light. It made him feel that much more attracted to medicine because it really was in his blood after all. And in a way that he found difficult to describe, the knowledge gave him hope.
Now Terry was in his middle thirties. He stood at the sink drinking water and thought about the case he had seen the night before. He turned and looked at the refrigerator, where a magnet held a wedding invitation to the door. It was from a classmate of Terry's from medical school. Rick Bartlett. Rick once had a landlady who used to get up in the middle of the night and turn off the electricity for an hour to save money, and to beat her at her game Rick used to set his electric clock an hour ahead. And, of course, sometimes the landlady slept all the way through the night, and Rick got up an hour early for nothing. In medical school, losing an hour's sleep was a serious matter. Terry and Rick started to become friends when Terry said, "Get a windup clock." Rick had talked about becoming a surgeon, even a neurosurgeon, but in the end he had become a dermatologist. Regular hours and good pay is how Rick had explained it, blushing as he did so. Easy practice. All you need, said Rick, are Valium and cortisone and to remember the basics: if it's wet, make it dry, and if it's dry, make it wet. Terry hadn't seen him in years. He looked at the invitation: the printing was good, engraved, textured when you touched it.
Terry hadn't been getting out enough. He knew it was a bad sign when he went out and couldn't talk to people who weren't physicians, but he took comfort in the fact that it was a fairly new phenomenon. When he was alone, the weight of a bad case, which previously he had been able to ignore, now seemed to combine with a general longing for an antidote to those moments when he stood at the window and drank that chlorine-tainted water. He stood there, looking at the lights from the city, the coolness and gaudy intensity of them seeming like malice itself. In the silence of the house, in which regret so perfectly mingled with desire, he reached into his pocket for the Xanax. He took half of it, estimating the rate of absorption, and then he thought, Screw it, and took the other half. Sometimes he stood at the kitchen sink until the lights seemed warmer and more appealing and even romantic. Anyway, he guessed he'd go to the wedding.
Terry practiced internal medicine, but recently he had been spending two nights a week at the hospital. One of the emergency medicine physicians had died and while the hospital looked for a replacement, the medical staff was dividing up the work. Everything took more time now than it used to: there were federal regulations to follow, hiring practices to observe, and, of course, a number of committees to consult. The hiring process had dragged on for months. Terry didn't think much was going to change.
The hospital was situated south of Westwood, and it took cases from neighborhoods that were well-off and those that weren't. Usually, the gunshot cases started coming in at around eleven o'clock. Terry supposed that this was because it took a couple of hours of hard drinking in the evening to bring people to the point of using a gun. On weekends the gunshot wounds started coming earlier, although Terry usually had a little warning because the ambulance called ahead. The worst cases were those that just came in the door. No warning. There had been one of those the night before.
In California, in the spring, the storms build steadily: at first there is nothing more than a mist in the sky, but each morning is a little more gray than the one before. It continues like this, day by day, the soft hues of the sky slowly becoming darker and filled, too, with a hint of foreboding that can be relieved only by rain. It was in the building stage right now. Terry had driven to work glancing at the sky.
A young man had arrived at about nine o'clock. Everything about him, the T-shirt he wore, the jeans, the running shoes, his jacket, suggested someone who could tell, down to a minute, what was cool and what wasn't. He probably wanted to get a tattoo, but hadn't been able to decide about the right one. A flower? A nude woman? A diamond in the small of his back? ... (Terry was seeing a lot of geometrical tattoos these days.) His friends had simply brought him in, through the doors that opened with a swish, all of them running up to the triage desk. There were three friends. The young man they carried was having convulsions.
He had long red hair and freckles. His name, Terry learned later, was Sam Peterson. He had been riding around in a friend's car. They hadn't been able to find anything to drink or smoke, and so the young man had gone into a convenience store and bought a can of butane.
His heart had already stopped. Terry looked around for the cardiac equipment, but it was down the hall. While he went to get it, a nurse stayed with the young man. A woman was in the next cubicle, by the defibrillator: she had come to the hospital after taking a handful of Tylenol. She looked at Terry with a mixture of shame and defiance as he came in and grabbed the machine and pushed it out into the hall and from there into the room where Sam Peterson was, the nurse hammering on his chest, and saying, "Oh, shit. Oh, shit." They put the paddles on his chest, which was pale and thin and looked as though it had never seen the sun. The young man jumped when the electricity hit him: the suddenness of it reminded Terry of Frankenstein's monster coming to life. There was a brutality in it, too, as if the mechanism of life had become spiteful.
The heart started again, and Terry and the nurse and an anesthesiologist stood there. Terry still held the paddles. He listened for the heart. It was going all right. The anesthesiologist intubated the young man. They could control the oxygen better that way. The throat was swollen and it wasn't easy to get the tube in. Terry realized that he had been clenching his jaw, and thinking, Don't die. Don't die.
At that moment Terry heard a noise, a reassertion of ordinary sound, footsteps in the hall, the squeak of a curtain on an overhead runner, the odd rattles of a stainless steel IV stand, the distant sound of the television in the waiting room, the clicking of computer keys, all coming back as though whatever had been happening wasn't a matter of terror but something that simply filtered the sound.
Terry noticed some pink froth coming out of the tube that had been down the young man's throat. The lining of the lung, where gases are actually exchanged, is only two cells wide, and Terry realized, as he saw that froth, that the butane was breaking it down. He first thought about the possibility of the boy drowning in his own blood, but that was before he thought about acidosis--the buildup of acid in the blood. The heart stopped. They had a monitor attached to him, and Terry watched it. He could do nothing about the heart because the shocks only worked if there was enough oxygen in the blood. The anesthesiologist and Terry stood there and watched while the young man died.
Anyway, in the morning, after Terry had finished his shift, he stood in front of the hospital for a while, and just at dawn he had seen the sky filled with a diffused and yet aureate glow. A few stars were still visible, too, in the west. It hadn't rained and the clouds had disappeared. Then he got into his car and drove home, touching the sample of Xanax in his pocket. He didn't take it right away. He was tired enough to sleep on his own for now.
In the evening, he woke and went into the kitchen, where, through the window, he saw the clutter of the city. His face was a little numb, as though he were wearing a plastic mask. Along with this, he had another sensation, which was the presence of something that seemed to suffuse the landscape with ... an impulse toward ... he didn't know precisely what, a loving inevitability, he supposed, between himself and another human being. He swallowed the bitter water. Just how was he connected to the young man, anyway? Terry had wanted to keep him alive. This desire was something he could depend upon. It was the purest thing he had ever experienced. And what, if anything, had been torn, or ruptured, when the patient died? It was the summation of such moments, the continual addition of that sense of separation, that left Terry with the impulse toward some particular human being: he didn't know who she was exactly, but he was sure, if only by the effect of her absence, that she existed.
Terry stood in the kitchen. The thing that he saw on the icebox was the invitation to the wedding.
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Craig Nova's previous novels include Tornado Alley, Trombone, and The Book of Dreams. He lives in Vermont.
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