United States- 09/12/2016- (http://www.linwilder.com/) He who learns must suffer. And even in our sleep pain that cannot forget falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom through the awful grace of God.
—Aeschylus


PROLOGUE
She lay listening to the unfamiliar night sounds: the pacing of other sleepless prisoners, the occasional echo of a heavy-footed guard making his rounds. Mostly though, she waited for the terror of the dream to subside, for the iron bands around her heart to loosen, and for the awful pressure on her chest to lighten so that she could breathe. And she waited for her heart to climb back down into her chest and out of her throat.

The dream was a familiar one. It had begun four years before following the sudden death of a fifty-two-year-old man whose heart she had catheterized. Dr. Lindsey McCall had surgical hands—a reference to the skill and dexterity that she brought to the Cardiac Catheterization Laboratory at Houston General Hospital. A colleague had made the comment during rounds one day during her cardiology fellowship at Houston General, and it had stuck.

There had been no reason for his death. Nate Morrison was a healthy senior executive with Southwest Oil, one of the largest oil conglomerates in the world. During his annual physical, Morrison had been referred to Houston General for a work up based on nonspecific changes in his cardiac diagnostic tests. Upon reviewing his tests, Lindsey had suspected that the man’s coronaries might be clean—free of coronary artery disease. She was well aware of the numbers. Of the sixty thousand cardiac catheterizations performed each year in the United States, over 30 percent revealed clean coronaries: absence of plaque in the vessels supplying the heart with oxygenated blood. And the procedure was not benign. Complications of cardiac catheterization were not uncommon and ranged from mild hematoma to death. In twelve years, Lindsey had done over five hundred cardiac catheterizations and more than three hundred angioplasties. She had never lost a patient.

But close to 75 percent of the revenue of her department came from referrals from doctors practicing in Texas and the Houston metropolitan area; the physicians at Southwest Oil referred hundreds of patients to Houston General per year, usually for an angioplasty or cardiac cath. Furthermore, McCall was well acquainted with the financial realities of her profession—turning down lucrative procedures such as cardiac catheterizations was not smart.


For some reason she could no longer recall, she, rather than one of the cath lab nurses, had gone to see this man the night before the procedure. While she had been reviewing the potential complications with her patient and obtaining his informed consent, Morrison had asked with a wink, “Just how many patients have you lost in your twelve-year career, Dr. McCall?”

His quick-grinned response to her answer had been, “Well then, let’s you and I make sure that I’m not the first, deal?”

Lindsey could picture that conversation as if it had happened a moment ago. Fourteen hours later, he was dead.



Lin Weeks-Wilder has published dozens of articles, wrote a textbook, and has written four self-help books. Lin has written three medical thrillers situated in Houston, Texas where Lin worked for over 23 years. For More Information Visit http://www.linwilder.com/