The surgeon by Tess Gerritsen

Author:Tess Gerritsen [Gerritsen, Tess]
Language: eng
Format: epub
Tags: Mystery, Mystery & Detective - General, Police Procedural, Fiction - Psychological Suspense, Police, Serial murders, Mystery & Detective, Medical, Police - Massachusetts - Boston, General, Boston (Mass.), suspense, Mystery fiction, Fiction
ISBN: 9780345447845
Publisher: New York : Ballantine Books, 2001.
Published: 2002-07-30T07:00:00+00:00

Nourishment for the demons. How powerful is the meaning of blood. I think this as I watch a thread of it being sucked into a needle-thin pipette. All around me are racks of test tubes, and the air hums with the sound of machines. The ancients considered blood a sacred substance, sustainer of life, food for monsters, and I share their fascination with it, even though I understand it is merely a biological fluid, a suspension of cells in plasma. The stuff with which I work every day. The average seventy-kilogram human body possesses only Jive liters of blood. Of that, 45 percent is cells and the rest is plasma, a chemical soup made up of 95 percent water, the rest proteins and electrolytes and nutrients. Some would say that reducing it to its biological building blocks peels away its divine nature, but I do not agree. It is by looking at the building blocks themselves that you recognize its miraculous properties. The machine beeps, a signal that the analysis is complete, and a report rolls out of the printer. I tear off the sheet and study the results. With just a glance, I know many things about Mrs. Susan Cannichael, whom I have never met. Her hematocrit is low--only 28, when it should be 40. She is anemic, lacking a normal supply of red blood cells, which are the carriers of oxygen. It is the protein hemoglobin, packed within these disk-shaped cells, that makes our blood red, that pinkens the nail beds and brings a pretty flush to a young girl's cheeks. Mrs. Carmichael's nail beds are sallow, and if one peeled back her eyelid, the conjunctiva would appear only the palest shell-pink. Because she is anemic, her heart must work all the faster to pump diluted blood through her arteries, and so she pauses at every flight of stairs to catch her breath, to calm her racing pulse. I picture her stooping forward, her hand to her throat, her chest heaving like a bellows. Anyone passing her on the stairs can see she is not well. I can see it just by looking at this sheet of paper. There is more. On the roof of her mouth are flecks of red--petechiae, where blood has broken through capillaries and lodged in the mucous membrane. Perhaps she's unaware of these pinpoint bleeds. Perhaps she has noticed them elsewhere on her body, beneath her fingernails, or on her shins. Perhaps she finds bruises she cannot account for, startling islands of blue on her arms or her thighs, and she thinks hard about when she might have injured herself. Was it a bump against the car door? The child clinging to her leg with sturdy fists? She seeks external reasons, when the real cause lurks in her bloodstream. Her platelet count is twenty thousand; it should be ten times higher. Without platelets, the tiny cells that help form clots, the slightest bump may leave a bruise. There is yet more to be learned from this flimsy sheet of paper.

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