Frank Huyler - White Hot Light

W HEN THEY BROUGHT HIM IN, HE WAS ALMOST ALIVE. H E was a handsome boy, in his early teens, and I saw this first because he was nearly unmarked. He was brown and slim, and we stripped him immediately, and he lay still under the lights.

The gunshot wound itself wasnt bleeding, and it stared at us from his chest. A little blue circle, an open eye.

I thought of my son. I thought of him immediately.

The young surgery attending was there early, thin and lean and hungry, well trained and arrogant and fast, and he has economy and grace and he looks through me as if he doesnt know who I am. I dont care. Im indifferent to him. But he is sharp and hard and quick and sometimes that is what you need.

He tried to save the boy.

When did you lose pulses? he said to the paramedic.

On the way in, she answered.

So he acted, right then, without waiting for anything or anyone. There was beauty in his ruthlessness.

* * *

He stepped forward, poured iodine on the skin, put on a pair of sterile gloves, took the blade in his right hand, and opened the boys left chest with a single astonishing stroke from his sternum to the bedsheet. Flesh parts to a scalpel effortlessly, like the wave of a hand.

Open the thoracotomy tray, he said, over his shoulder, as the others arrived.

I was standing behind him. I could see exactly what he was doing, because the light was bright, and lit up the tissues.

The wound was bloodless. It should have come alive with little points from the capillaries, but it was clean and dry, and so I knew.

He took the scissors and inserted one of the blades between the ribs down low, by the bedsheet. Then he lifted his hand up to the sternum again, and there was the lung, pale and gray, with a few yellow beads of fat clinging to it.

By then the tray was ready. He put in the rib spreader and turned the crank, and the boys rib cage opened like a flower.

Dark blood poured from his chest to the floor.

* * *

When I was young, and still a student, I once went to my advisors lab. He was doing basic research on cardiac arrest, trying to find ways to keep the brain alive for a few more minutes.

Ambition is so vulnerable to the passage of time. We remember it, we can even still feel it, but there was no solution that could be injected into the vessels that would preserve brain function, no technique that would revolutionize CPR or raise the dead with their memories intact. Instead, there were dozens of dogs.

The dogs were from shelters, and they were young, because older dogs could skew the data. He didnt know their ages exactly, but if you know about dogs, you can guess, and be close enough.

The dogs were brought out from their cages on a leash, and led to the room. They were afraid, and trembling, as if they were at the vets.

Starting an IV in a dog is no different than starting an IV in a human being. His graduate assistant would start an IV, and inject a sedative.

It took a few minutes. They held the dog on the table, as it grew unsteady and finally lay down, and then they gave it Pentothal that put it out forever. They intubated the dog, taping the long tube to the dogs nose, and attached the cardiac monitors, and then they flipped it on its back and shaved its chest and performed a thoracotomy.

When the dogs chest was open, they would cross-clamp the aorta, stopping blood flow to the brain. Then the measurements would begin.

My advisor was not changing their fates. They were from shelters, and would have been euthanized in any case. But I could see that it troubled him anyway, as he soothed them on the table, and spoke gently. He seemed human then, for a few moments, before they were asleep, and humbled by what he was about to do.

* * *

The surgeon worked on, scooping warm handfuls of clot out of the boys chest and onto the sheets.

The others were there, crowding around me, straining also to see, and the entire focus of the room settled on the beam from the surgical light overhead. The boy receded, as we looked into the field.

The hearts empty, he said, and stopped the massage, and pulled a few more fistfuls of blood out of the boys chest until the interior was empty and pink and still. The heart lay there before us, the lung, the pleural membrane, and it all looked clean and beautiful.

Then he surprised me.

Lets have a minute of silence, he said, and bowed his head.

Its new, that moment of silence. Its a modern ritual. The younger surgeons do it, even as the older surgeons walk away.

So everyone stopped. The nurses, the trauma team, the X-ray tech who stood waiting in the corner, her services unrequired.

For a moment everyone stood quietly under the lights, looking at the boys body, and no one knew the story then, no one knew anything, but suddenly it was reverent, and everyone could feel it.

A minute can pass slowly. A minute is more than enough.

OK, he said finally, lifting the flaccid heart and pointing with his finger. The bullet went in the ventricle here. And then it continued through the vena cava. Its an unsurvivable injury.

So the attention changed, and it became the wound again, and then he stepped aside and let the residents in.

One by one they took their turn, feeling the slack heart, and the hole, and the vena cava, because such chances are rare, to be so close, when everything is warm and the anatomy is so perfectly clear, young and new and as crisp as the morning. In that moment, the dogs came back to me.

When they were done, I did the same, reflexively, without thinking. I hadnt been a resident in more than twenty years. But I forgot all of that, forgot that I wasnt young anymore, forgot myself entirely. I just saw the wound, and felt the same cold curiosity, and was drawn in also.

I held his heart in my hand just like the others, and felt for the path the bullet had taken, just like the others. But it is an impossible intimacy, and you cant escape it entirely, and I didnt escape it at all. I saw his face beneath mehis face, that handsome boyand suddenly it came to me with a terrible vengeance. I did think of my son again, and of a stranger, a man my age, doing this to his body for no good reason on this earth.

He was a child, I thought later, driving home. Have I learned anything?