Dr. Leah Wright cradled the boy’s heart in her hand.
She glanced at his unconscious face. So young, so peaceful. Some might have said that he was dead already, but Leah wasn’t one to give up so easily. What the hell had he been doing out on the street, getting stabbed in the heart, on Valentine’s of all nights?
“Give it up, doc,” the cop told her. He’d transported the teen to Cambria City’s Good Samaritan Medical Center’s ER in his squad car. Despite his racing from the scene, the kid had no vital signs when they’d arrived at Good Sam. “Just heard from my partner.” He shook his head as he peeled bloody nitrile gloves from his hands. “Some people aren’t even worth trying to save.”
The anesthesia resident had one hand on the boy’s carotid pulse, the other forcing oxygen into his lungs. His frown mirrored Leah’s own fears—the kid’s heart had stopped for too long; there might be nothing left to revive. “Still no pulse.”
“Hang on. Wait. There. Found it.” Leah used her gloved finger to plug the hole in the boy’s right ventricle. Hidden by the mask she wore, her mouth twisted in determination. She ignored the sounds around her: monitor alarms, people talking, the huff and puff of the bag-valve-mask the anesthesiologist squeezed, and focused on listening through her fingertips, stretching every sense to find the life left in the boy’s damaged heart. “Foley catheter. Get ready to push the O-neg as soon as I have the balloon inflated.”
She guided the thin catheter through the puncture wound by touch alone. It was a strange sensation, her hands inside the chest cavity, working blind. An out of body experience—really tough traumas were all like that in a way. Time slowed, senses expanded, the entire world collapsed into a surreal tunnel vision of absolute focus.
“Now. Inflate the balloon. Slowly.” She gently tugged the catheter against the heart muscle, the balloon plugging the wound from inside the ventricle. “Push the O-neg.” This was the hard part: waiting for the damaged organ to start to beat. Everyone in the trauma bay hushed.
C’mon, she urged the motionless organ. Leah wasn’t superstitious or particularly religious, but she felt something cold pass through her own body—someone walking on her grave, her great aunt Nellie would have said.
“Internal paddles,” she ordered, ready to shock the heart back to life. As the nurse offered them to her, Leah felt a contraction ripple beneath her fingers. First one, then another. She held her breath, hoping, praying. “Wait. I’ve got something.”
All eyes turned to the monitor. A bleep of activity. Then a flurry of more. Slow and irregular but definitely there. Was it enough?
“Anything?” she asked the anesthesia resident.
At first, he shook his head, but then jerked his chin up, meeting her gaze. “Got a pulse!”
The trauma team arrived. Leah brought the surgical resident up to date on everything they’d done to revive the kid—she still didn’t know the boy’s name.
“We’ll take it from here,” the resident said as he left. “Hope he still has some brain left after being down so long.”
It wasn’t Leah’s fault that he’d arrived without vitals. Her team’s hit-the-door to return-of-circulation time was near record-breaking.
“Good work,” she told them as they filed out, leaving her alone in the suddenly silent room.
As she scrubbed clean the blood that had seeped over the rims of her gloves, she glanced at the overhead clock. Almost eight, she could still make it. Phoning home before Emily went to bed was a ritual she tried never to miss. Leah grinned. Tonight, if Emily asked her if she’d saved any lives, she could honestly say yes.
The door slammed open.
“When you gonna learn playing God isn’t your job?” came the rough bark of a Bronx accent mixed with a Haitian lilt. Andre Toussaint, the chief of trauma and emergency services and Leah’s boss’s boss, was a short man, not much taller than Leah, with wiry gray hair. Even when he was in a good mood, he was brusque and domineering—and with thirty-seven years on the job and his position at the apex of the hospital professional hierarchy cemented, he could get away with it.
She frowned at him. “Did the kid crash on the way to the OR?”
“This isn’t about one kid. It’s about you treating every patient as if you’re personally arm wrestling with God. It’s about a flagrant disregard for the needs of the hospital and all of our patients, not to mention the community we serve. Because of your would-be rapist, we’re now closed to trauma. He’ll deplete our blood bank, take up nursing hours, OR staff time, and—because my team is just that good, he’ll make it out of the OR to tie up our last ICU bed, probably for days. All for nothing. Because you know as well as I do, he was down too damn long.”
Leah barely heard the last half of his harangue; she was caught on one word. “Rapist?” Rapist? The police officer had said something during the trauma about letting the kid die, but Leah had been too focused on saving his life to listen. “I thought he was the victim—”
“Surprised you had time to think, so busy raising Lazarus. Cops tell you how he got stabbed? Attacking a girl in a parking lot—had the knife on her but a good Samaritan came along, jumped him.”
“I—I didn’t know.” Leah still couldn’t wrap her mind around the fact that the kid was a rapist. He was so damn young. She remembered when they’d cut off his clothes, he’d had rolls of baby fat, his pale skin marred by acne. God, what a waste. The elation of triumphing over death was replaced by a sinking feeling deep in her gut. She swallowed hard then faced Toussaint, chin up, refusing to be cowed. She’d done the right thing. “Doesn’t matter who he was or what he was doing when he got injured. My job is to care for each patient the best I—”
“Your problem?” He steamrolled over her words. “Is that you think small. Don’t see the bigger picture. You should’ve thought about what bringing him back from the dead would cost everyone. Should’ve declared him, then maybe we could have saved some lives with his organs. Least then the kid’s life would’ve been worth something.” Toussaint came from an older generation of surgeons and seemed to think that his own hardscrabble climb out of the South Bronx gave him the right to preside as judge and jury over his patients—along with the other medical professionals who treated them.
Leah’s posture grew rigid at his challenge. “You’d just let him die? Because of what he’s accused of doing?”
“No. Not because of his crimes.” He shook his head. “Because I have to think of everyone’s best interests. Including that kid and his family—the quality of life he’ll have. Or not have. You know as well as I do. Kid has zero chance of recovery. We don’t have the resources to waste.”
“I’m not a bean counter—”
“Little comfort to the next poor slob we have to turn away because we’re too busy keeping your miracle-boy alive.” His phone rang. “Yeah, I’m on my way.” He hung up. “Got to get to the OR, finish what you started. I’ll see you at next week’s Morbidity and Mortality conference where you’ll be justifying your actions.” He pulled the door open. “You really should think about taking that job at the Crisis Intervention Center. Plenty of lost causes to fight without endangering innocent lives.” Satisfied that he’d had the last word, he flapped his white coat around him as he whirled, strutting away like a bantam rooster.
Leah stared after him. The weekly Morbidity and Mortality conference gathered the medical staff to discuss cases where things went wrong in the hopes of preventing similar incidents. It was meant to be a peer-teaching event but occasionally deteriorated into a public shaming.
She left the trauma room, not making eye contact with anyone, certain her cheeks were blazing red after Toussaint’s accusations. She reached the nurses’ station, where she eyed the triage queue. Not bad for Valentine’s Day—whoever created a mandatory date night holiday in the middle of February had never spent a winter in the mountains of central Pennsylvania. Luckily the weather was clear tonight, no snow in the forecast for another day or two. She glanced at the clock: seven past eight. “Nancy, I’m taking five.”
“Tell Emily I say hi,” the charge nurse replied. The ER staff always tried to free Leah for her good-night call to Emily—her own prescription for self-care to get her through a twelve-hour shift. “What did Ian get you for V-day?”
“No idea. He said it’d be a surprise.”
Nancy and Jamil, the ward clerk, exchanged glances. “Oil change. Same as last year.”
“I hope so,” Leah said. “I hate having to deal with that stuff, especially in winter.”
She headed toward the ER’s back hallway and used her ID badge to key herself into the office she shared with three other attendings. She quickly dialed Ian’s cell. “Is she still awake?”
“It’s me, Mommy,” Emily shouted so loud, Leah pulled the receiver away from her ear. “Fooled you. Daddy let me answer.”
“You got me. How was your day?”
“I got Valentimes from every single person in class. Plus a special one from Daddy. And I made one for you. It’s hanging on the fridge.”
“Well, here’s a special Valentine’s kiss from me.” Leah blew a loud smacking kiss into the phone. “Did you catch it?”
“Yep. Oh, Daddy helped me make a new game—musical chairs. You stack them real high but sometimes you can only use two or one legs and you have to get them just right and you have to watch the ones at the bottom because they shift as the Earth spins, but if you’re real good you can make it all the way to the moon!”
“You know it was nice out today—you could have played outside instead of on your computer.” Leah reminded herself to reinforce that notion with Ian—his idea of “playing” often translated into teaching Emily new computer skills instead of doing what normal six-year-olds called fun. The two of them could happily escape for hours, heads bowed together over a screen, speaking their own language—unintelligible to Leah—creating their own virtual worlds, leaving Leah behind, stranded in reality.
“When will you be home?” Emily asked.
“Not until after you’re fast asleep. Which PJs are you wearing?”
“Purple polka dots! But what time?”
“Work ends at midnight. So, after that, I’m not sure. Why?”
Leah could practically hear Emily’s pout over the phone. “Midnight means tomorrow. So you’ll miss Valentime’s.”
“Tell you what. You be a good girl and go to bed without more than two stories—”
“One for me and one for Huggybear?”
“Exactly. And I’ll get up early, make you a special super-duper Valentine’s Day after breakfast, okay?”
“Yeah! Okay, here’s Dad. Night.”
There was a rattle as she handed the phone to Ian. “Good day?” he asked.
“Patient-wise, fine. Toussaint is on the warpath, though. Wants me to reconsider that job with the Crisis Center.” She took a breath, trying to cleanse her thoughts of Toussaint; last thing she wanted was to ruin her few minutes of family time with talk of her idiot boss.
“It’d mean less night shifts,” Ian reminded her. He taught cyber security at the college and had assumed the brunt of caring for Emily. Including mastering an assortment of skills that Leah could never dream of achieving: coiffing Emily’s hair, playing princess dress up, baking allergen-free cupcakes for school birthdays. Not a day went by without Leah wondering what she’d ever done to deserve him—or their beautiful, brilliant daughter.
“Yeah, but less money.” Despite her student loan debt, money wasn’t the real problem. The Crisis Intervention Center was the part of the ER that dealt with victims, performing forensic evaluations—sexual assault exams, specialized interviews for the police—and then presenting that evidence in court. Right now, all the ER physicians took turns overseeing the Sexual Assault Nurse Examiners and the social workers at the CIC, but Toussaint wanted one person to take over as medical director. Leah was the newest ER attending—she’d only been at Good Sam four years—and had all the requisite qualifications, which some of the older ER physicians hadn’t gotten during their training, so the pressure was on her to take the job. No one wanted it. There was no saving lives in the CIC.
“Wait up for me?” she asked Ian.
“Of course. I want to see your face when you see my surprise.” He hesitated. “Then we need to talk.”
“What’s wrong? Did the furnace break down again?” Their budget was already strained after the last time. Leah glanced up as Nancy rapped on the office door. “Gotta go. Can we talk later? Not tonight, though—you still need to open my present to you,” she said in a seductive tone, glad she’d found the time to order from Victoria’s Secret.
“Right. Yeah.” His tone was flat, distracted.
“What is it? Everything okay?” He was silent for a long moment. Leah rubbed her palm along her thigh, the smooth cotton of her scrubs soothing. She and Ian had been together for eight years, but sometimes—always for no good reason—a sudden wave of anxiety would ambush her, leaving her as nervous as she’d been on their first date. Fearful that with one small slip she could ruin everything, lose him forever. “Are we okay?”
“What? Of course. It’s just work stuff.” His tone brightened. “And you’re right—tonight is for us, you and me. We’ll deal with the rest of the world after. Love you.”
He hung up. Leah stared at the phone, taking a few deep breaths. She had no reason to doubt Ian—he was her rock, her touchstone, easing her past the myriad of stupid, imaginary fears and insecurities that had haunted her since she was a child. She couldn’t help it; her upbringing had hardwired her to always leap to the worst possible conclusion.
“Control freak,” she chided herself as she returned to the ER. Her pessimistic nature made her a better ER doctor, never taking anything for granted, but she knew it also made her at times not the best wife or mother. Instead of imagining every dire catastrophe Ian might have been alluding to, she forced herself to concentrate on the smile he’d greet her with when she got home.
The rest of the night went quickly until, finally, she’d finished with her last patient and her charting, and had given her sign-out to the next attending. It was twenty past midnight by the time she was walking through the ER on her way to her car, when the clerk called her name, gesturing with a phone handset from his seat at the nurses’ station. He nodded to a bouquet of red roses wrapped in cellophane and green florist tissue paper lying on the counter. “These came for you.”
“From Ian?” Ian never sent her flowers for Valentine’s.
“Sorry, didn’t see. They were just left here, not sure when.”
Leah ruffled through the roses until she found the card. The envelope had her name typed on the front. The card inside was also typed, reading:
I left a surprise for you at home.
No signature, but if Ian phoned the order into the hospital gift shop, there wouldn’t be. She inhaled the fragrant bouquet’s perfume. He must have heard her frustration when they’d talked earlier, ordered the flowers to make her smile.
She headed out to the parking garage, suddenly exhausted, wanting only Ian’s arms wrapped around her. She spotted her Subaru Forester parked in her reserved spot, but instead of being backed in like she’d left it, it was now parked head in. It was also gleaming clean, no trace of winter road salt.
Leah grinned. Ian had definitely been here. And gotten her exactly what she wanted. She climbed inside the SUV and set the roses on the passenger seat, where there was a receipt from the mechanic waiting for her. Oil changed, tires rotated, all the past-due maintenance performed, state inspection taken care of along with a wash. She leaned back and inhaled the almost-new car smell. Best Valentine’s present ever.
Ian always knew how to make her smile. Her good mood lasted her entire drive from Good Sam to their townhouse in a converted Victorian on Jefferson Street. She pulled into their narrow driveway paved with ancient cobblestones that refused any attempt to be covered with modern materials. The sidewalk leading from the old carriage house that was now their garage was freshly shoveled and salted.
Leah found herself humming as she carried the roses past the tiny garden mounded with remnants of the snow that had fallen over the past few days. Moonlight danced with clouds, giving the dormant plants a bluish glow as shadows tangled with the snow’s gleam.
She climbed the steps to the back stoop, tapped her shoes to shed any road salt, and reached to put her key in the kitchen door. It was unlocked. More than unlocked—it was slightly ajar, as if someone had pushed it shut but not hard enough for the latch to catch. Maybe when Ian had taken out the trash?
An unexpected shiver raced over her, a stray dagger of winter piercing her fleece jacket. She opened the door. The lights in the kitchen were off—also unusual. Ian always left a light for her. She flicked them on.
That’s when she saw the blood.
Leah scanned the tiny outdated kitchen. “Ian?”
There was a single streak of blood on the countertop. One kitchen chair lay on the ground below their vintage steel and red vinyl-topped table. Flecks of blood glared red against the white of a stack of napkins fluttering in the wind from the still-open door. Beside the stove, the knife block was toppled on its side, knives gleaming under the glare of the fluorescent light, half-naked where they’d slid free from their safe haven. None were missing.
Had Ian cut himself? But why put the knife back? Why not grab the first aid kit she kept in the drawer beside the sink? The thoughts rushed through Leah’s mind, pushing out other thoughts she could not—would not—allow herself to think. She took one step inside but kept the door open to the night chill, leaving her blanketed by the cold, barely able to feel her face or feet. Shouldn’t waste heat—the electric bill would be staggering. She should close the door… Why didn’t she?
“Ian?” she called louder this time. Leah touched the door behind her, as if to close it, and froze there, one hand on the knob, the other holding the roses, adrenaline spiking, everything in her gut telling her to get out. She forced the primal emotions aside, focusing on what had happened here. Emily? Could she have been the one who’d gotten hurt? No. Ian would have called Leah or brought Em into the ER. So… where was he? Was Emily all right?
Then she spotted more blood streaks marring the surface of the refrigerator, not quite forming a handprint that echoed Emily’s finger-painted Valentine’s Day artwork from school. Leah froze, listening to her home. It was drowning in silence. And yet there was an underlying disturbance, a faint vibration, a breath held too long before sighing. When Leah inhaled, the stench of something more primal than blood filled her nostrils. Fear. Beyond fear. Terror.
Why not close the door, Leah? She’d only been inside her house for less than four seconds but was fighting the urge to flee. An escape. That was why she left the door open.
“Ian!” His name scraped against her tight vocal cords, fighting for escape. No answer. She took another step into the kitchen even as she slid her phone from her pocket.
She had to force herself to glance into the dining room. Empty. And dark. Not even a glimmer of light from the stairway. They never turned that light off at night—in case Emily had to get up to use the bathroom.
Her hand trembled as she snapped on the dining room lights.
Blood stained the walls, all the way up to the ceiling. The chandelier crystals reflected scarlet onto the cream-colored walls, danced blood-red light onto the tablecloth. One of the chairs was smashed, its legs splintered among the crystal bowl and candlesticks.
Emily. She needed to get to Emily.
“911, what’s your emergency?”
Leah stared at the phone in her hand, not even remembering dialing. It was as if her brain was slashed in two: one part absorbing the details surrounding her, awareness blunted by shock and awe; the other half following well-trained instincts, taking control.
“I think someone broke into my house,” she told the operator after first giving her address and name in case they were disconnected. “I got home and the back door was open. There’s blood in the kitchen and my husband isn’t answering. I can’t find him.” Her voice up-ticked, tight with fear. She forced a breath. Focus, Leah. “There are signs of a struggle.”
“Ma’am.” The operator’s voice sliced through her panic. “Leave the house. Now. I have help on the way.”
“I can’t.” Leah’s voice was a strangled whisper. Even as she spoke she stumbled toward the staircase leading to the second floor, leading to their bedroom… and Emily’s. She wanted to scream Emily’s name, but couldn’t force enough air past the noose that had tightened her throat. “My daughter. I need to find—”
“No. Ma’am. Leah. Listen to me. You need to leave the house. Wait for the police. They’ll be there in just a few minutes.”
Leah pounded up the stairs, not caring how much noise she made or whom she woke, praying only that she woke someone, that this was all a mistake, a dream, some kind of sick joke. A surprise waiting for you, the message on the roses said. She glanced down at the bouquet in her free hand. She dropped it, numbly watched the roses tumble down to the bottom landing, blood-red petals littering the steps.
“Get out of the house, Leah,” the operator ordered.
“I can’t.” It was as much a plea for help as a statement of fact.
Leah gripped the phone to her ear as she reached the banister at the top of the stairs and used it to pivot around the landing into the hallway. All the doors were open. No lights except for the ghastly glow of her phone. The air stank of blood.
She turned on the hall light. Her foot squished in something, pulling her gaze down. Dark blood, sticky, enough of it to form a small puddle. More blood in ribbons and dribbles on the hardwood of the hall floor that suddenly appeared warped, extending into an unnatural distance. Tunnel vision. Adrenaline-induced, along with the roaring that had hijacked her brain. Knowing the reason for her pounding chest and shaking hands didn’t help, though. She raised her gaze. Smeared handprints, one so close she could see the old scar that formed a crescent moon across the base of Ian’s right thumb. She gagged, forcing herself not to scream.
“Leah?” the operator asked. “Stay with me. Are you out of the house?”
Leah barely registered the disembodied sounds coming from her phone. The plaster along the hallway was crushed in spots—too large to be fists, someone’s head? A few of the dents went all the way through the ancient wire lath plaster to its horsehair insulation. A sleepwalker in a trance, she followed the trail of destruction. Emily. She had to get to Emily.
She felt as if she was in slow motion while also aware that she was moving too fast down the hall to properly assess any danger lurking behind her. Every cell in her body was screaming at her to go faster, faster. Was the intruder still here? Was he waiting for her in Emily’s room? Was he behind her, ready to pounce? Where was Ian? Emily… please, God… Emily.
The blood trail led to Emily’s door at the far end of the hall. So much blood. The door was ajar, Emily’s Happy Hippo nightlight casting bright red and yellow dancing stars across the pink rug inside.
“Leah,” the operator said. “They’re almost there. Where are you? I need to know where you are so I can tell the officers.”
Leah didn’t answer, her attention focused on Emily’s bubblegum-pink rug and the darker red stains splashed against it. She pushed the door open wide, her hand on the knob catching some of the dancing stars, and gasped. Emily’s bed was piled high with her stuffed animals, the sheets in disarray. Empty. No Emily.
But that wasn’t what made her stumble back, hitting the doorjamb. She blinked, as if the simple reflex could erase what she was staring at and reset reality.
Ian sat on the floor, his back against Emily’s bed. He wore the silly Curious George PJs Emily had gotten him for Christmas, their bright yellow flannel slashed and stained with blood. His head rested against one shoulder, twisted to an unnatural angle, his face bruised and swollen into a grotesque mask. One palm pressed against his abdomen, his wedding band glistening in the gleam of the nightlight.
Leah fell to her knees, crawling toward him. Pulse, did he have a pulse? But she knew before she even touched his flesh that it would be cold and lifeless.
“Emily!” Her voice ricocheted from the walls, returning to her with a hollow thud that barely made it over the pounding of her pulse. She spun around, still on her knees. Other than Ian’s mutilated body, there was no sign of struggle, nothing out of place. Emily’s bookcase, her toy chest, dresser, all stood intact, mocking Leah.
Then a small sound, the rustle of an animal hiding from prey, came from under the bed. Leah flattened her body, ignoring the blood she had to lie in, and aimed her cell phone into the darkness. Emily had curled herself into a ball, the smallest target possible, backed into the far corner. Out of Leah’s reach.
“I’m here,” Leah whispered. “Emily, look at me. It’s okay.”
Emily had her eyes squeezed shut, her hands tightened in fists pressed against her mouth. She didn’t move.
“Emily,” Leah tried again. “It’s Mommy.” In the distance, Leah heard sirens. She ignored them. Right now, her daughter needed her, and she was too far away.
She did the only thing any mother would do. She crawled through her dead husband’s blood to get to her daughter.
The space beneath Emily’s bed was so crowded Leah could barely move. It didn’t help that she was hyperventilating, her chest ratcheted tight, each breath a ticking bomb threatening to explode.
Emily didn’t reach for her, didn’t respond when Leah grabbed her ankle. Leah tried again, stretching farther until she could touch one of Emily’s elbows. Emily kept her eyes shut, her hands pressed tight against her face, her entire body heaving with silent, swallowed, half-birthed sobs.
“I’m here, baby,” Leah crooned. The stench of blood contaminated what little air there was in the tiny space. She fought to control her breathing, to forget the body that lay beside them, to focus on her daughter. “Did he hurt you? The bad man?” God, if he did, if the animal who did that to Ian touched one hair on her baby girl’s head—fury cauterized her fear. She belly-crawled a few inches closer to Emily, shoving shoe boxes and discarded toys and books and sneakers aside.
Using her cell, Leah examined what little she could of Emily’s balled-up body. No blood. No obvious injuries. Finally, she’d edged far enough beneath the bed that she was able to wrap her arms around Emily. Leah was cramped and contorted, her head pushing against a bed slat, one shoulder nudging the mattress, and both legs sprawled behind her.
“Leah.” The 911 operator hadn’t given up on her. “The officers are there. They’ll be coming in the rear of the house. Stay where you are. Make sure your hands are empty and keep them where they can see them. Set the phone down, it’s okay, I’ll still be here until I know you’re with them.”
A wave of hysterical laughter burbled up, but Leah choked it back. “I can’t show them my hands,” she told the anonymous operator. “I’m under my daughter’s bed. She’s here, too. I’m not leaving her.”
“Which room?” The sound of computer keys drifted past the woman’s voice.
“End of the hall. Where Ian—” Leah gulped, lowered her voice. Emily knew about Ian—more than Leah did—but Leah couldn’t say the words, risk them penetrating Emily’s protective cocoon of denial. “Where my husband is. He’s on the floor.”
“They’re securing the house. You will probably hear them checking all the rooms. You’re safe now, Leah. You can come out. You and your daughter. Just show them your hands, leave the phone.”
Leah could barely hear the operator over the sounds of two men shouting downstairs and banging through the first floor. The noises did not make her feel safe—in fact, they were terrifying. Probably the point if she was a thief cowering, desperately hiding. “I’m not leaving Emily.”
“Okay, hang on. Let me tell them where you are. Is your daughter injured?”
“She’s in shock. But I can’t find any external injuries.”
Footsteps thundered up the stairs followed by the thud of doors being thrown open. Finally, the light clicked on inside Emily’s room. A man made a guttural sound and swore, stepping inside only far enough to swing the door and look behind it, and then to check Emily’s closet.
Leah gasped at what the light revealed. Thankfully Emily still had her eyes squeezed tight.
Ian’s back was shredded with deep gouges that exposed muscle and cut down to the bone. How the hell had he found the strength to keep fighting? For Emily. Of course. Leah blinked back tears and gripped her daughter tigh
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