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PROLOGUE

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DENNIS ROBICHEAUX gave the propofol thirty seconds to work, then leaned over the patient. “Can you hear me, Mrs. Flanders?”

“Is she fully under?” Angela Dubuisson asked, not looking up from the instruments she was readying for the surgeon.

“Yeah. They can’t resist my French kiss.”

“Are we still talking about patients?”

“Now, boo, you know you can’t believe all that trash they talk by Suzette’s.”

“That’s not a problem since I don’t hang out in smoky bars that smell like crawfish and grease.”

“You don’t know what you’re missing.”

“Sure I do. A bunch of drunks looking for an easy lay.”

Dennis fit the endotracheal tube down the patient’s throat, slowly, easing it past the relaxed muscles, the task almost second nature to him now.

Angela pulled the blanket over the patient. “How’s she doing?”

“All that’s left is to hook her up to Big Blue,” he said, nodding toward the anesthetic machine. Dennis finished sealing the tube so that the patient wouldn’t choke on her own saliva. “Down for the count. Where’s our surgeon and his faithful nurse?”

As if on cue, the door to the operating room swung open and Dr. Norman Guilliot strode in, his hands still dripping from the sanitizing scrub. Angela became far more animated now that the self-proclaimed king of scalpel makeovers had appeared. She handed him a towel, then helped him into his gown and gloves. Susan Dalton was a step behind the doctor, her blue eyes dancing above her surgery mask.

“Got Ms. Ginny Lynn all ready for you, Doc,” Dennis announced.

Dr. Guilliot leaned over the patient and pinched the excess skin beneath her chin, pulling it tight. “In for the works, isn’t she?”

“Eyelid, face and forehead lift.”

“Must have a sentimental attachment to the nose,” Dennis said.

“She just wants to look her best for the glory of God,” Guilliot said, mimicking the patient as he ran a finger under the delicate eye area. Ginny Lynn was the wife of the Reverend Evan Flanders, a TV evangelist who’d become a household word in the New Orleans area.

Dr. Guilliot lifted the fatty tissue above the lid, pinching and pulling it away from the eye before beginning the delicate task of marking his incision lines in blue.

Dennis monitored his machine. “Want me to make the initial incision for you, Doc, since Fellowship Freddie’s off on his minivacation?”

“No, just stick to giving your Versed cocktails to the patient. The surgery has to be a work of perfection. We can’t have any scars showing when she goes back under the bright glare of fame.”

“I doubt Frankenstein’s scars would show beneath the makeup she wears,” Susan said.

“Careful,” Dennis said. “You’re talking about the Lord’s anointed.”

“What’s the deal with Fellowship Freddie?” Susan asked. “I never see him with a woman. Does he swing the other way?”

“He’s got a girlfriend,” Dennis said. “A real looker, way too hot for him.”

“I guess you checked her out,” Guilliot said.

“Me? Mess around with a friend’s woman? You know me better than that.”

Easy chatter, the kind you didn’t get in a big city hospital. That was one of the reasons Dennis had jumped at the offer to work with Dr. Guilliot at his private clinic. Not only that, but he and the surgeon got along great. If Guilliot treated him any better, Dennis would expect to be in the will.

But the deal clincher for accepting the position had been location. The restored plantation house was practically in his backyard, and good Cajun boys like himself didn’t like straying too far from home.

Angela moved in beside the doctor as he started the procedure. She’d been his tech nurse for twenty years, had come with him sixteen years ago when Dr. Guilliot had left his position as chief of reconstructive surgery at a New Orleans hospital and established the Magnolia Plantation Restorative and Therapeutic Center.

Like any good tech nurse, Angela worked like a seamless extension of the surgeon’s arm. He reached, she was ready with forceps, scalpel, surgery scissors, lighted retractor or lap sponge.

“How are her vitals?” Dr. Guilliot asked.

“Blood pressure’s down. Ninety systolic. I’ll drop off on the gasses.” Dennis turned the knobs, making small, precise adjustments. “How’s the new Porsche?” he asked. “Had it full throttle yet?”

“Close. She’s one sweet piece of dynamics.”

“How ’bout I take her for the weekend and break her in the rest of the way for you?”

“Touch that car, and you lose an arm.”

The chatter continued, from cars to fishing and back again. They were thirty minutes into the operation when Dennis felt the first pangs of apprehension. “Pulse rate is dropping,” he said. “I’m going to inject a vial of ephedrine.”

“What’s the reading?”

“Fifty-five.”

Dennis opened the vial, injected it through the IV line and watched the monitor, confident the ephedrine would kick in and do its job. The seconds ticked away.

“How we coming?” Guilliot asked without looking up from his work.

“Pulse and pressure not responding.” Dennis opened another vial of ephedrine and injected it through the IV. “This should take care of it.”

It didn’t. The numbers continued to slide. Dennis’s hands shook as he tore open the next vial and injected the drug. Still no change. Damn. There was no explanation for this. The woman was healthy. He’d read her chart.

Susan rounded the operating table, took one look at the monitor and gasped.

“What the devil’s going on?” Guilliot demanded.

“Not looking good.”

“Then do something, Dennis. I’ve got her wide open here, and I’m not losing a patient on the table.”

Dennis hadn’t prayed in quite a while. It came naturally now, under his breath, interspersed with curses as sweat pooled under his armpits and dripped from his brow.

Guilliot kept working. “Give me a reading.”

“She’s full code.”

“Sonofabitch!”

Susan moved to Dennis’s elbow. “Stay calm. You can do it. What else do you have?”

“Calcium gluconate.” He injected the drug. Fragments of his own life flashed in front of him as if he were the one slipping away. The sound of his Puh-paw’s voice singing along to his fiddle music on Saturday nights. The smell of venison frying in the big black skillet. The way Kippie Beaudreaux’s tongue had felt the first time he’d kissed her.

The past collided with the present, all bucking around inside Dennis while the monitor continued to glare at him, daring him to defy it.

No easy chatter now. No reassurance. Just deadly silence. He turned to Guilliot. The usually imperturbable surgeon had backed away from the table, jaw clenched, looking totally stunned.

None of the glory. All of the blame. The role of the anesthetist. Dennis grabbed a vial of bretyllium.

Too little, too late.

“Oh, shit!” Angela shoved the instrument cart out of the way, jumped on the black footstool and started pumping on the patient’s chest, hand over hand.

Finally Guilliot snapped out of his paralysis and took over for Angela, pressing the patient’s heart between the sternum and the spine with quick, steady motions.

Dennis was so scared, it was all he could do to hold the long needle as he filled it with epinephrine.

Susan grabbed his arm. “Not intracardiac, Dennis. Not yet.”

“Get the hell out of the way.” Holding the needle in one hand, he grabbed the edge of the sterile drape with his other and ripped the fabric from the runners.

Guilliot stopped pumping as Dennis slid the point of the needle under the breast bone. The room felt small. Icy cold. Quiet, as if they’d quit breathing so that the patient could have their breaths.

They all watched the abnormal rhythm play across the face of the monitor, but Angela said the words out loud. “The tack.”

Dennis snatched the paddles from the crash cart and stuck them to the patient’s chest. The shock lifted her off the table, but still the monitor screen went blank.

Asystole.

Dennis administered the shock again. And again.

Finally Susan took his arm. “She’s gone, Dennis.”

“No one loses a cosmetic surgery patient on the table.” Guilliot’s voice boomed across the operating room, as if he were God issuing an eleventh commandment.

It changed nothing. Ginny Lynn Flanders was dead.

Alligator Moon

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