"Van Lustbader, Eric - Dark Homecoming(eng)" - читать интересную книгу автора (Van Lustbader Eric)

Jenny Marsh leaned forward. "The kidney needs to be replaced pronto."
A cold pool was forming in the pit of Croaker's stomach. "Why?"
"Normally, dialysis would work. But, in Rachel's case, there are complications."
Her face grew grim and determined and Croaker had the terrible suspicion that they'd entered the final phase of this nightmarish conversation. "Like what?"
"She's developed sepsis. An infection."
"From the catheter?"
"Not in this hospital and definitely not in my section," she said. "When she passed out she fell. I suspect the sepsis developed from the wound. The attending in Emergency was quite rightly concentrating on the renal failure. The wound was treated later."
She put the empty yogurt container aside. "This is why I wanted to get you away from your niece and your sister. Mrs. Duke is going to need your cool head in the days and weeks to come. You see, I've tried several times to fully explain Rachel's situation to her, but she just won't listen."
"Tell me, then," Croaker said with a certain sense of dread.
She took a quick breath. "The dialysis machine is washing her blood, doing the work of her kidney, that's true enough. If we can stabilize her. But the hard truth is she's far from stabilized now. In the meantime, we're having difficulty controlling the sepsis. It's sapping her last reserves of strength."
Croaker stared at her. "Bottom line."
Jenny Marsh was not one to flinch from hard truths. "Without an immediate kidney transplant, she'll die."
"Immediate." The cold pool spread up into his abdomen and chest. "How long?"
Dr. Marsh shrugged. "Now that becomes a matter of medical interpretation. This medical professional says two weeks, maybe three, no more." She said this in a clear, steady voice while looking him straight in the eye. He appreciated that.
"Doctor, tell me something. How good are you?"
"I'm the best." She said it flatly, as a statement of fact. There seemed no ego involved at all. "My advice to your sister was to get a second-even a third opinion-if she desired. She did and both doctors concurred with my prognosis. You can speak to them if you wish, but the bottom line is Rachel has got to have a new kidney."
"Would you be the one to put it in her?"
Dr. Marsh nodded. "Most assuredly."
"Okay. Then we get her one."
Jenny Marsh sighed ruefully. "Yes, the ideal scenario is for a sister-preferably a twin-to donate his or her kidney. There are no other siblings in this family. I've tested Mrs. Duke. She isn't compatible."
"You'll test me, of course."
Jenny Marsh nodded. "ASAP. But I have to be honest, the chances of a match aren't good. Your sister's already been screened and rejected."
"Okay. Say she can't use one of mine. Give me another alternative."
"Every kidney that becomes available for transplant in this coun- try is typed. The report is then put on-line at the National Computer Center of UNOS in Richmond, Virginia. The United Network of Organ Sharing registers each and every organ. There are no exceptions. Organs are harvested, but there are never enough for the growing list of recipients. If anyone's to blame it's our fellow man. People just don't want to donate. It's tragic. I'll give you one example close to home. Last year we had thirty-five thousand deaths in Palm Beach county alone. If all those people had been organ donors, Rachel and others in dire need like her all across the country wouldn't have a problem."
"But we do have a problem," Croaker said.
"Yes." Dr. Marsh nodded. "And it's an insoluble one, I'm afraid. There's a waiting list for a kidney of about thirty-six thousand people nationally. Also, there's a case for need. Rachel's young, which is in her favor, but she's a drug user, which is definitely not. In terms of time, we're looking at between sixteen and twenty-four months at the earliest."
Croaker rocked backward, as if he had been slapped across the face. "Christ, this can't be happening. It isn't possible."
"I'm afraid it is," Dr. Marsh said. "In one way, we've become lucky with kidneys. They're the only major organ we are able to keep alive outside the host body. With a perfusion machine you chill it to thirty-two degrees centigrade and pump Belzer solution through it. Believe it or not, it's a potato starch compound. It's a real medical breakthrough. You can even do it on a brain-dead body. Just pump the chilled solution into the abdominal cavity. That way, you've got seventy-two hours before the kidney becomes compromised."
"But in Rachel's case this breakthrough does us no good at all." Croaker tried not to sound bitter.
"Unless you can pull strings I don't know about and get her a kidney."
He leaned forward. "Doc, can't you, you know, pull strings?"
She looked at him for a minute, and he thought he saw a flicker of pity in her eyes. "This isn't city hall. You don't pull strings to get a new kidney; not unless you have a hundred million dollars to donate to renal research, and even then it's more a matter of luck than anything else. As I told you, each kidney is registered. If I-or any other doctor in this country-is caught putting an unregistered organ into a patient it's not only our license that's forfeit, it's our freedom. The act's illegal."
Croaker's biomechanical hand curled into a powerful fist. "But there's got to be a way," he said.
Jenny Marsh silently regarded that curious and singular weapon with the respect it merited. "Unless you can come up with a donor who's willing and whose blood type and HLA-human lymphocitic antigens-are compatible with Rachel's, I'm afraid there isn't."
"Did Matty tell you I was a detective in the NYPD?" Croaker said.
"Yes, she did."
"I'll find Rachie a donor." Then the look on her face registered. "What're my odds?"
"I can tell you from experience there aren't many people around willing to give up a kidney. At least, a kidney in decent shape. But even if you did find someone, their blood type and three of six of their HLAs would have to match Rachel's body chemistry."
Croaker was shaken all over again. "Christ, I'd have as much chance of winning the Florida lottery."
She shook her head sorrowfully. "Mr. Croaker, if it weren't for bad odds, you'd have no odds at all."
Speaking of which, Sonia .Villa-Lobos was having a very bad day indeed. When she got up that morning, she discovered that the power was off. It flickered on just long enough for her to take a shower before it died again. In the morning's light, she carefully made the bed, smoothing down corners and edges that were ruffled. She was forced to break out her emergency equipment: a battery-powered hair drier. She did her makeup sitting in her car with the door open. The sun streaming through the tinted windows would have otherwise destroyed her color sense.
Mrs. Leyes emerged from the house next door, and Sonia leaned out the car door to complain about the power outage. Estrella Leyes, a Paraguayan from the hill country, stopped to hand over a casserole covered with aluminum foil.
"For Nestor." She kissed Sonia warmly on both cheeks. With her only daughter long moved away she had come to look on Sonia as a surrogate. "He's better?" she asked hopefully,
"Unfortunately he's not." Sonia put away her hair drier.
"You should have him come see me," Mrs. Leyes said.
Sonia smiled and patted the older woman's arm. "I would, but he's gotten to the point where he can't get out of the house."
"ЎAy, pobre! Then I should come see him."
"That would be nice," Sonia said. "But I don't know what good it would do. Nestor's dying."
From where Sonia lived in El Portal it was not more than twelve minutes due south to work. However, three days a week she made a detour off NE Second Avenue to look in on her friend. Nestor had been a professional dancer, a young man with a beautiful, sinuous body. His work had been ethereal, so it was doubly a crime that he was dying of AIDS. She often brought him food she made or, when too busy, that she bought at the Thai restaurant down the road. Nestor loved Thai food. He didn't care much for Estrella's goat casseroles, but Sonia had the good sense never to tell the older woman that.
Today, she discovered Nestor lying in bed, facing the wall. The sheets were an unholy mess, and she spent forty minutes cleaning him up. He was in one of his unresponsive moods, so while she worked she recited poems by Rudyard Kipling. She'd read them to him so many times they were committed to memory. He loved the precise cadences of Kipling's nineteenth-century mind, and he responded to the profound sense of mystery Kipling must surely have felt for the exotic places to which he traveled.