Double Jeopardy

  1

  DOUBLE JEOPARDY

  BOBBY HUTCHINSON

  CHAPTER ONE

  “Okay, Charles, let’s take these dressings off and you’ll feel a whole lot better.”

  Reconstructive surgeon Ben Halsey gently began to unwind the yards of gauze he’d used to protect his handiwork. Two days before, he’d performed aesthetic surgery on sixty-two-year-old Charles Bedford, both blepharoplasty to remove the pouches under his eyes, and rhytidectomy, a full face-lift to eliminate the wrinkles and sagging skin on his face and neck. The procedures had taken just over five hours in the OR, and Ben knew the results would be all that Charles had hoped for, but at the moment his patient’s bruised and swollen face looked anything but handsome.

  The last piece of gauze fell away, and Charles’s flattened and blood-matted cap of silver hair appeared. Ben liked his patient’s attitude. When he’d asked Charles during the preliminary visits why he wanted the surgery, the man had grinned wryly and said that obviously it wasn’t just because he wanted to look younger; if that was the case, he’d have dyed his hair long ago. No, he wanted to feel more youthful, he’d explained; there was a difference. But appearance was important, too. He was a businessman, an executive at a large insurance company. Looking his best might help him make vice president before he retired.

  Until a few years ago, Ben had done this type of surgery predominantly on women. In the past several years, he’d had an increasing number of men requesting cosmetic procedures, so now the numbers of men and women were almost equal. It was an interesting comment on society’s changing attitudes.

  “You’re gonna look at least ten years younger when this swelling goes down,” he assured Charles.

  “That’ll be about ten years older than you, then,” his patient joked. “Why is it you doctors look so young?”

  “Because we are young.” Ben laughed, not bothering to tell his patient he was actually even younger than Charles had guessed. He knew that certain mornings he appeared much older than his thirty-six years; Charles must have based his assessment of Ben’s age on one of those bad days, guessing him at forty-two. Yet the nights preceding those mornings were delectable. Sex might not make him look younger, Ben mused, but it certainly contributed to a youthful attitude.

  “Aaaggghhh.” Charles grimaced and his hands clenched.

  “Sorry, sorry, just one more and we’re done here.” Ben was now deftly extricating the last of the small, thin tubes he’d placed behind each ear to allow the blood collecting under the skin to drain.

  “These sutures are looking good.” He’d closed the incisions along the natural skin lines and creases so they’d be all but invisible. He tipped his patient’s chin up gently to check the two-inch incision that had facilitated the liposuction device to remove the accumulation of fat from the neck. Ben had also tightened the muscles and connective tissue in the area, pulling the loose skin up and back, tailoring it to the face, suturing it in front of and behind the ears and snipping off the excess.

  “I want you to wear this supportive bandage at night and as much as possible during the day for the next ten days. The swelling and skin discoloration will subside within a week or two. You may have some numbness in your face for a while, but that’ll disappear. Healings a gradual process, with final results not fully realized for three to six weeks.”

  Charles nodded. Ben had covered all this before the surgery. “I’m so damned itchy. I can’t wait to have a shower and shampoo.”

  “I don’t know, I sort of like the punk look,'” Ben joked. He enjoyed making his patients smile. “For a few months I want you to stay out of the sun, and after that use a sunscreen with a high protective factor when you go sailing.”

  Charles had confided that he had a forty-two-foot sailboat.

  “Sunscreen won't be an issue unless Vancouver’s weather changes drastically,” Charles re- marked. It had been raining steadily all through the first half of June.

  There was a discreet tap at the door, and Ben’s office nurse, Dana Dolgoff, stuck her head in. “Emergency over at St. Joe’s, Doctor. They want you there stat.”

  “Okay, Dana. We’re done here. Come back in two days and we’ll see about those sutures, Charles. Dana, I’ll call and tell you whether we need to cancel this afternoon’s appointments.”

  “Right, Doctor.” Dana nodded with a dubious expression on her friendly face. She didn’t believe him. She knew he’d get so involved he’d forget. She’d been with him since he’d opened his private practice three years before, and she understood him as well as any female.

  “I will call this time. Honest. I’m working on responsibility this week,” he teased her as he grabbed his pager and his navy raincoat and loped out the door, down the stairs of the professional building and out into the heavy rain.

  Having an office situated right across the street from St. Joseph’s Medical Center was well worth the exorbitant rent the space cost him. It meant that he could be in Emerg within six minutes of a call. Face-lifts and nose jobs were great because they paid the bills, but the unexpected challenges, the high drama in St. Joe’s Emerg, were what Ben lived for.

  Those, and his dream of heading the burn unit that would be housed in the new wing presently under construction at the back of St. Joe’s. He was hoping for a sessional appointment, which would mean he’d spend a fixed portion of his workweek at the bum unit, with adequate time left over to devote to his private practice. He strode to the crosswalk and held up a peremptory hand to a bus. When it groaned to a halt, he stepped out into the bumper-to-bumper traffic on Burrard Street, adrenaline coursing through his veins. Three minutes later, the wide automatic doors to the ER parted to allow him through. The triage nurse, Leslie Yates, hurried toward him.

  “Hi, Dr. Halsey. You got here fast.”

  “Like a speeding bullet. What’ve you got for me, Les?” He shucked off his raincoat and tossed it behind the nurses’ desk. The nurses knew him. One of them would hang it up for him. He used a comer of his shirt to wipe the rain from his wire-rimmed glasses before plunking them back on his nose.

  “Bad one, Doctor. Young female construction worker on the hospital project, hit in the face with a two-by-four being moved by a forklift.” As she spoke, she quickly led the way to trauma room three. “The good news is, she was working just outside the hospital, so we got her in here right away. Her name’s Gemma Cardano.”

  A large burly man with steel-gray hair was standing at the bank of phones, anguish on his strongly drawn features as he spoke urgently into the mouth- piece, punctuating his words with dramatic hand gestures.

  “That’s her father, Aldo Cardano,” Leslie explained in a quiet tone. “He’s the contractor on the construction project. And that tall man sitting over there is the one who was operating the forklift. He’s pretty shaken up. I should speak to him. Excuse me, Ben.” She moved away.

  Ben paused outside the door to the trauma room only long enough to scrub and put on a gown and mask. Inside, senior ER physician Joanne Duncan greeted him and rapidly gave him a summary of her findings.

  “Twenty-nine-year-old female with multiple facial fractures, unstable zygomatic process, fractured nose, fractured mandible. Pupillary response sluggish. Airways clear. We did a C-spine precaution. That was fine. Patient is conscious.”

  Ben listened intently, his attention centered on the slender figure on the gurney. What Joanne was describing was an injury so severe it could be fatal, the dreaded Lafort three, which meant that the en-tire bone structure of the face—nose, cheekbones and jaw—was unsteady. Breathing was often jeopardized; loss of vision was a very real possibility if the bones that surrounded the eyes, called the floor of the orbit, were involved. There was a danger of total loss of the olfac
tory sense and a compromised ability to chew, swallow and talk.

  His adrenaline surged anew and anticipation filled him. This was exactly the sort of case he found most fulfilling. Ben leaned over the figure on the gurney.

  “Gemma, I’m Dr. Ben Halsey, a reconstructive surgeon. I’m just having a look at you.” He spoke calmly, doing his own fast but thorough assessment of the injuries, moving aside gauze to reveal a nasty gash on the right side of the face where the edge of the board had struck.

  She was making an agonizing sound that emanated from somewhere deep in her chest. Her curly golden brown hair was long and wild; the nurses had secured it away from her face with a length of gauze. Her eyes were already swollen shut, ringed by the distinctive “raccoon eye” blackening, a result of her fractured nose, and the rest of her face was also beginning to swell. Such extensive facial injuries were profoundly shocking to relatives because the patient was virtually unrecognizable.

  Ben did his best to reassure her. “I realize you can’t see, Gemma, and not being able to talk, either, is rough. This is painful and really scary, but I want you to know that you’re gonna be just fine. We’re taking you straight up to surgery. You’ll feel better real soon.” He gave quick instructions to the staff, arranging for a surgical team and an operating room, and then he studied the X rays that had been taken.

  He’d stabilize the fractured jaw immediately, and order CT scans. These would help him do a three-dimensional reconstruction of her bone structure before the accident, which he would use as a template for the major operation he’d perform to repair her face.

  He’d schedule the operation within the next ten to fourteen days, before the fractures began to set. The delay would give the patient’s system a chance to recover from the severe trauma of the accident and allow Ben to do the intricate computer imaging that was necessary.

  That operation would be long and exacting; Gemma’s facial bones were now like a huge broken apart puzzle. But sophisticated technology and Ben’s skill meant she’d almost certainly look the way she always had once healing was complete. That could take six months or longer.

  There might be minor operations to remove sears after that, or some small adjustments to the original work, but nothing significant as long as the universe granted the two of them good luck and no nasty surprises in the next few hours, such as an infection that would result in a brain abscess.

  Ben had no illusions or false modesty about his abilities; he was one of the best reconstructive surgeons in Vancouver. If Gemma was beautiful before her accident, she’d be beautiful again; it was just going to take time and painstaking effort. Already plotting strategy, he headed upstairs to the OR.

  Sera Cardano had finally bought a cell phone a week ago, but the sound of it ringing inside her handbag still caught her off guard. It was ringing now, and several moments passed before she realized what the sound was. Her mind was totally on the heated argument she and Maisie Jones, her boss and best friend, were having over the set for the next episode of the television sitcom Dinah.

  Still determined that her choice of sofa over chaise longue for the love scene was the right one, she fumbled among the clutter in her bag and at last extracted the phone.

  “Papa?” Just the way her father had said her name warned her that something wasn’t right. “Papa, what’s wrong?” Her heart gave a thump and then threatened to hammer its way through her chest wall, as her father’s shocking words reverberated in her head.

  Around her, the members of the design team gradually stopped talking. Everyone became ominously still, all eyes on Sera’s horrified features.

  “Honey, what is it?” Maisie hurried over to her and looped a plump arm around her shoulders. “I’ve gotta go to the hospital. Right now.” Hands shaking, Sera shoved the phone back in her purse, hardly able to speak. “It’s my sister, Gem- ma. She’s...she’s had an accident. She was...” She gulped as the full impact of her father’s words sank in. “Oh, my God, how could such a thing happen?”

  How could it happen and she not know? The room whirled around her and she worried that she was going to be sick or would pass out. “Gemma was hit in the face, a piece of lumber a forklift was moving. Her face is...she’s badly hurt.” Her voice seemed to come from a long distance away, and she barely heard the shocked gasps and exclamations of alarm that greeted her words.

  “I’ll drive. Which hospital?” Maisie grabbed her own purse and raincoat, then Sera’s.

  “St. Joe’s, but I have my car. I can, I’m--”

  “Not in this lifetime. You’re in no shape to drive, you’re in shock. And parking’s a nightmare down there. I’ll drop you. Don’t argue.”

  Moments later, they were in Maisie’s battered old Volvo, and as her friend skillfully negotiated the busy streets, Sera knew that Maisie was right. She wouldn’t have been capable of driving. Her entire body was trembling uncontrollably, as over and over again her brain replayed the nightmarish image of her sister’s face being smashed with a heavy piece of lumber.

  “Now, don’t get crazy until you know what the score is,” Maisie admonished. “Things aren’t usually as bad as we imagine. If she needs plastic surgery there’ll be someone excellent to do it. Plastic surgery these days is a cinch. You remember I told you my sister’s boy in Idaho was born with a cleft palate. They did such a good job you can’t even tell....”

  Sera barely heard Maisie’s reassuring patter, but the sound of her voice was at least a distraction. When they reached the street in front of St. Joe’s, Maisie nonchalantly stopped, blocking a lane of traffic. Horns blared and hands gave her the finger. Maisie ignored everything except Sera.

  “I’ll send good thoughts. You let me know if you need a ride home or anything at all. I’ll leave my cell on. You do the same, okay?” Maisie leaned across and enveloped her in a bear hug, oblivious to the noise from the trapped cars behind them. “Good luck. I’m out of practice, but I’ll pray.”

  “Thanks, Maise.” Sera was out of the car and running for the entrance to the ER before Maisie pulled away.

  Ben rotated his arms and tipped his head back to ease the knot between his shoulder blades. For two hours and forty minutes, his mind had been entirely consumed with the delicate surgery necessary to stabilize his patient, and now that it was done he was suddenly stiff and weary. Yet knowing that everything had gone as well as it possibly could have was exhilarating.

  Without stopping to remove his operating room garb, Ben headed out to the waiting room, where a nurse had told him Gemma’s relatives had gathered. The small room smelled of stale coffee, sweat and fear and was crammed full of people, standing, sitting, crouched in corners. If these were all Cardano relatives, Gemma had a big family. The ear- splitting clamor of voices subsided immediately when Ben entered.

  Gemma’s father hurried over, his arm around a plump, pretty middle-aged woman with a mass of graying curls. The strained expression on their faces told Ben how frightened they both were. He gave them a reassuring smile and reached out to shake their hands.

  “I’m Dr. Ben Halsey.”

  “Aldo Cardano, and this is my wife, Maria. How is she? How’s our Gemma?”

  “She’s doing well. She’s in Recovery. You can see her in a few minutes. I’ve stabilized her fractured jaw and inserted a tracheal tube. I should warn you she looks pretty battered. It’ll be ten days to two weeks before we can fully repair the facial structure. I’m confident we can expect a good result at that time. There shouldn’t be any loss of vision. The fractures didn’t involve what we call the floor of the orbit, the bones that support the eyeballs. However, she might lose her sense of smell. We’ll just have to wait and hope that doesn’t happen. We’ll be keeping a close eye on her, watching for any signs of infection or excess swelling. But your daughter’s young and strong. Chances are she’ll do just fine.”

  A buzz of relief and renewed concern circled the room, and it seemed as if everyone drew in a deep breath and exhaled it.

  Aldo Carda
no’s soulful eyes filled with tears. “Thank you, Dr. Halsey. Thank you very much.”

  “This tra— This tube.” Maria Cardano frowned at Ben. “Does that mean she can’t breathe properly on her own?”

  “No. The tube’s a precaution because she’s un-conscious and because she’s had extensive damage to her jaw. With the jaw wired, we don’t want her to choke.” Ben smiled at the woman reassuringly, thinking how attractive she was with her strong features and smooth, nearly unlined olive skin

  “Why do you have to wait so long before you operate on her face? Why not do it right away?” Maria wanted details.

  “It’ll be a long operation, and we want Gemma to recover from the trauma of the accident before we proceed. Also, I need to do some preliminary work first.” Ben explained how he planned to rely on CT scans and computer technology to prepare for the surgery. Aldo appeared confused, but Maria nodded.

  “Basically, I’ll do a three-dimensional reconstruction of her uninjured face and then use it as a template.”

  “Like a pattern for how she looked before?” Maria shook her head. “But, doctor, you don’t need a computer for that.” Maria motioned with a hand. “Seraphina, come over here, carissima.”

  Mystified, Ben watched as a young, slender woman who’d been standing nearby and listening intently to their conversation moved over to Maria. She was obviously Maria and Aldo’s daughter; she had her mother’s bone structure and her father’s long, straight nose and huge, deep-set brown eyes. Her golden-brown hair was long and loose. Untidy strands curled around her face; reflexively, she raised a hand and shoved them back.

  She wasn’t tall. Ben was five eleven, and he guessed her about five six, but her perfect posture gave the illusion of height.

  “This is Gemma’s sister, Sera.” Maria spoke as if that solved the matter.

  “Hello, Sera.” Ben studied her. She had arresting good looks. “Your sister and you resemble each other?”