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Guest post: The Story Behind ‘The Cavalier Spy,’ by S.W. O’Connell

TheCavalierSpy_medIn many ways, The Cavalier Spy should have been an easy book to write. After all, it is the sequel to the first book in the Yankee Doodle Spies series, The Patriot Spy, so many of the characters, themes and settings were in place when I began the book. But ironically, that made the book all the more difficult. Why? Because I wanted The Cavalier Spy to stand on its own. I wanted readers who had not read the first book in the series to enjoyThe Cavalier Spy as much as those who did read The Patriot Spy. I had no idea how hard that would be. And starting out, I had no idea how I would do it. But then I began to write and the story took over, as it often does.

The story has three general settings. I think that helped. In fact, the settings are essential to the building of the tale. This is, after all, a historical novel and I am trying to portray history through fiction. And history is about places, as well as people. The first setting is New York. The second is the area around the Hackensack Valley of New Jersey. The third setting is “western Jersey,” the area along the Delaware River. During the time of the American Revolution New Jersey was often referred to as “the Jerseys.” The Jerseys were east and west Jersey. East Jersey is that part of the state that borders New York and the North (Hudson) River. West Jersey is the portion that borders Philadelphia and the Delaware River.

Since the first setting was the same as that of The Patriot Spy, and as I began to draw out the plot, I used the setting to refer back to events that unfolded in it. I did not plan this. It just came to me as I wrote. An example is when the protagonist, Jeremiah Creed and his men are sent behind British lines he decides to go by the post house in Yorkville. There he “re-recruits” young Thomas Jefferies to the cause. I use those scenes to flash back to how they originally met, and the events that drew them together. As Creed drives deeper into British occupied New York, people he encounters and venues provide opportunities to briefly let the reader in on what happened in book one. Another challenge for the writer is to do this without making things tedious for those who read the first book. The trick is to keep the flashback short. Usually a couple of sentences. The trick is to do this without tying up the story too much and break the flow. As the story progresses to the other two settings, the need and opportunity to do this fades away. Soon the story is standing on its own legs and the reader is caught up on what happened.

Another interesting challenge I faced was telling the tale of how my protagonist arrived in America. In The Patriot Spy I hinted that he was an immigrant. InThe Cavalier Spy, I show it. But how to get there without distracting too much from the main plot, Washington’s desperate attempt to avoid defeat and his use of intelligence to aid those efforts. The idea came to me suddenly. I would have Washington and his fictional “Senior Intelligence Advisor” conduct what is essentially a “subject interview” of Creed. They confront him on his mysterious past and want to “vet” him. He decides to tell all in a “confession” to his commander in chief. Don’t worry. He doesn’t really tell all. Some things have to be saved for future books. But we do get a several chapter flashback out of it. And I had a lot of fun writing it.

By time I got to the Hackensack Valley setting, I was thoroughly enjoying myself. I was able to create a fictional village and spin some interesting characters in and out of it. But in doing it, I reveal an interesting and little noted fact about the American war for Independence. It was a complex struggle and a local one. New Jersey raised some impressive Loyalist troops for the King and one of those regiments plays a role. The Hackensack Valley had a significant Dutch populace. After all, East Jersey was part of the Dutch colony (along with New York) of New Amsterdam. This provided me some rich characters to develop. It is in this setting that I bring the strange case of “Mister X” into the story. Weaving a controversial historic figure into the plot was intriguing to me, the writer. I hope it is for the reader as well.

The last setting is West Jersey. This is the iconic “times that try men’s souls.” The new nation’s hopes are all but dashed. Washington escapes the British but is now ignominiously holed up on the far bank of the Delaware River and his army has evaporated. To have any hope of saving his army and the cause, Washington must send Jeremiah Creed back into the bosom of the enemy. A key ingredient, almost a character, in this setting is, believe it or not, Mother Nature. A cold winter is gripping the Delaware Valley and it has a role in everything. The characters (and their horses) are affected. The Continental Army is affected. And most importantly, the British Army is affected. The despair that unfolds in the first two settings culminates in desperation. And this desperation sets in on both the fictional and historical characters. Washington is desperate to save his Army and the Revolution. Creed is desperate to do his duty. And the British are desperate not to lose what they have achieved. But desperation breeds valor and resourcefulness. But it can also breed mistakes. And ultimately, the fortunes of men and of nations, can turn on mistakes.



S.W. O’Connell is the author of the Yankee Doodle Spies series of action and espionage novels set during the American Revolutionary War. The author is a retired Army officer with over twenty years of experience in a variety of intelligence-related assignments around the world. He is long time student of history and lover of the historical novel genre. So it was no surprise that he turned to that genre when he decided to write back in 2009. He lives in Virginia.


Title: The Cavalier Spy

Genre: Historical

Author: S. W. O’Connell


Publisher: Twilight Times Books

Purchase link:

Amazon / OmniLit 

About the Book:

1776: His army clinging to New York by a thread, a desperate General George Washington sends Lieutenant Jeremiah Creed behind British lines once more. But even the audacity of Creed and his band of spies cannot stop the British juggernaut from driving the Americans from New York, and chasing them across New Jersey in a blitzkrieg fashion. Realizing the imminent loss of one of the new nation’s most important states to the enemy, Washington sends Creed into the war-torn Hackensack Valley. His mission: recruit and train a gang of rogues to work behind British lines.

However, his mission takes a strange twist when the British high command plots to kidnap a senior American officer and a mysterious young woman comes between Creed and his plans. The British drive Washington’s army across the Delaware. The new nation faces its darkest moment. But Washington plans a surprise return led by young Creed, who must strike into hostile land so that Washington can rally his army for an audacious gamble that could win, or lose, the war.

“More than a great spy story… it is about leadership and courage in the face of adversity…The Cavalier Spy is the story of America’s first army and the few… those officers and soldiers who gave their all to a cause that was seemingly lost…”

~ Les Brownlee, former Acting Secretary of the Army and retired Army Colonel

“Secret meetings, skirmishes and scorching battles… The Cavalier Spy takes the reader through America’s darkest times and greatest triumphs thanks to its powerful array of fictional and historical characters… this book shows that courage, leadership and audacity are the key elements in war…”

~ F. William Smullen, Director of National Security Studies at Syracuse University’s Maxwell School and Author of Ways and Means for Managing UP

The Writing Life with Linda Lucretia Shuler, Author of ‘Hidden Shadows’

LindaShuler_authorPix72Linda Lucretia Shuler knew she wanted to “tell stories” ever since she was a toddler sitting in her father’s lap, listening as he read to her. She eventually published poems and short stories in literary journals, intending to write a novel when time allowed, but was so busy with her career as a university and high school theatre teacher time slipped past. At long last she retired early, “switched horses in mid-stream,” and turned to writing  – just a good while later than she had originally intended. Hidden Shadows is the result.

She enjoys acting in community theaters, participating in writer critique groups, and is an award-winning member of Toastmasters International. She’s also an enthusiastic fan of the San Antonio basketball team, the Spurs.

What’s inside the mind of a literary author? 

My mind is a jumble of things: images, sounds, feelings, tumbling together like a kaleidoscope:

Daydreams. Creating stories centered around the faces of strangers wandering past, dilapidated old houses, ancient trees, a landscape. Often a sound, an image, a particular scent will stir my imagination; characters whisper, rise like lovely phantoms behind my eyes, wanting their stories to be told. Sometimes I’m moved to tears by an old black-and-white photograph of people long vanished from this earth, and I long to know them. As I drive down a street, I wonder about those living within all the houses I pass, their fears and struggles and joys. Or I may see an old couple strolling along the sidewalk, holding hands, and I have to stop myself from running toward them, pleading to hear their story.

There’s more, but I need to stop somewhere!

What is so great about being an author? 

I love the creative aspect of it. Of helping characters introduce themselves, bloom and develop and become a living presence. Of the pages adding up one by one, of the story veering into new and wonderful places as if it had a mind and will of its own. I cherish the times I can forget time, when the muse takes over and words flow from my fingertips, when characters speak to me in thoughts and dreams, when the imagined becomes, for a moment, real.

When do you hate it?

The nitty-gritty of editing can drive me nuts. As can the times when inspiration takes a holiday, and I sit staring at the blank screen, waiting for something, anything to happen.

What is a regular writing day like for you? Be honest!

I try to write late morning and early afternoon. (Note the word try.) To keep myself on schedule, I use an old fashioned notebook to record the hours worked and the total number of words written. I learned this trick long ago from an accomplished writer, and it’s worked well for me, too.

Life being what it is, there will be times when I go off-schedule. When that happens – and it often does – I tell myself not to fret, but to pick up where I left off and keep going.

Do you think authors have big egos? Do you? 

I think any artist must have a strong ego to endure. Otherwise they’d shatter under the stress. Without self-esteem, a writer couldn’t survive negative reviews, or have the wherewithal to write write write, sometimes for years, on a single project.

Having a strong ego shouldn’t imply a “better than thou” outlook. Quite the contrary. If we are  strong and whole in spirit, we will be better able to be empathetic toward others, whether real or imagined.

HiddenShadows_medHow do you handle negative reviews?

I cry in private, smile in public, and remind myself that the review is the opinion of a single individual.

It’s difficult for any writer to face criticism; our work is a deeply personal part of ourselves, the result intense labor, often lasting years. The challenge is to consider the criticism objectively, determine what may be true, accept and learn from it, then ignore the rest.

What is the usual response when you tell a new acquaintance that you’re an author? 

A quizzical, “Oh?” with raised eyebrows, as if I had announced I was born on planet Pluto.

What do you do on those days you don’t feel like writing? Do you force it or take a break?

I trick myself by saying, “Only an hour, that’s all.” Then once I get into it, the hours somehow accumulate. Or sometimes I’ll go ahead and take a break. Writing should be a joy, something to anticipate with pleasure. Otherwise why do it? So I try to approach it in that fashion.

Any writing quirks?

I talk aloud to my characters. I’ll visualize them sitting in the chair opposite me  – green velvet, an armless antique I inherited  – and I’ll ask questions about their feelings or actions, their fears and dreams. Sometimes I’ll rail at them for being obtuse, or making bad decisions, or keeping their thoughts to themselves. Or I’ll just look at them, at how they’re sitting, or what they’re wearing, the expression on their faces. Occasionally I’ll change places. I’ll sit in that green chair and become the character for a short time, speaking as the character would, responding to the questions. I’ve often laughed at myself, thinking if anyone were to suddenly appear and witness what I was doing, they’d swear I was crazy.

What would you do if people around you didn’t take your writing seriously or see it as a hobby? 

I’m fortunate enough to have a slew of gifted and dedicated writer friends who are as passionate about writing as I am, if not more so. I also have a loving family that applauds every effort. I strongly feel that writers need other writers and at least one encouraging family member. If people around us don’t take our writing seriously, or consider it a mere hobby, we should have a support system of those who respect our work and honor it. Otherwise it could be a very lonely occupation.

Some authors seem to have a love-hate relationship to writing. Can you relate? 

Absolutely. But isn’t this true of almost any profession, especially in the arts?  We rejoice in the creativity; we howl at the work involved.

Do you think success as an author must be linked to money?

Some do, I’m sure. But if that were the criteria to publishing success, I and the majority of writers out there would consider ourselves failures. Success is, or should be, measured by other standards.

I didn’t always feel this way, I confess. I once thought success was being published by a major house offering a six-figure advance, and selling thousands upon thousands of books. But success can be achieved in less dramatic ways. A smaller kingdom, perhaps, but a rewarding one. A validation. If we are forever unsatisfied, constantly dreaming of “What if,” how are we to find joy in the present?

Leave us with some words of wisdom.

I leave it to Shakespeare’s Hamlet:

This above all: to thine own self be true,
And it must follow, as the night the day,
Thou canst not then be false to any man.

Write from your heart, from that unique part within you that belongs to you and no one else. No matter the genre, no matter the style. Be true to yourself, and you’ll be true to the reader.


Title: Hidden Shadows

Genre: Literary

Author: Linda Lucretia Shuler


Publisher: Twilight Times

Purchase link:  Purchase links will be available on the chapter excerpt page:

The ebook version of Hidden Shadows is available for purchase from Amazon Kindle, Apple iBookstore, BN Nook, Kobo Books, OmniLit, etc.

The print version of Hidden Shadows will be available from Amazon, Barnes and Noble Bookstores, Brodart, Coutts, Davis-Kidd Booksellers, Emery-Pratt, Follett, Ingram, The Book Despository, The Book House, etc.

About the Book:


Hidden Shadows is a story of healing, of connection: to the land, to our ancestors, to others, to ourselves – and to the redemptive power of love.

Cassie Brighton, devastated by the death of her husband, flees to a remote homestead in the rugged Texas Hill Country. Alone in a ramshackle farmhouse steeped in family secrets, Cassie wages a battle of mind and heart as she struggles to overcome the sorrows of her past, begin anew, and confront the possibility of finding love again.

What others are saying:

Hidden Shadows is a wonderful novel of a women’s journey of self-discovery and search for purpose. The characters will win your heart (and sometimes break it) in this beautifully written and satisfying story of loss and renewal.”

~ Sandra Worth, Award-winning author of The King’s Daughter: A Novel of the First Tudor Queen.

In Hidden Shadows, Linda Lucretia Shuler has written a poignant novel that explores the complex and ever-shifting definitions of art, community, and love. The result is a story that is as vivid and melodious as the paintings and music of Cassie’s new Hill Country home.”
~ Diana Lopez, Award-winning author of Confetti Girl


Chapter reveal: Adrenaline, by John Benedict

adrenalineTitle: ADRENALINE



Purchase on Amazon

About the Book: A sensational, skillful and highly suspenseful tale, Adrenaline introduces anesthesiologist protagonist Doug Landry. About Adrenaline: When patients start dying unexpectedly in the O.R. at Mercy Hospital, Doug Landry finds himself the focus of the blame. Is he really incompetent or is there something more sinister going on? As Doug struggles to clear his name and untangle the secrets surrounding these mysterious deaths, it becomes exceedingly clear that someone is serious—dead serious—about keeping the devastating truth from ever seeing the light of day. As he launches a pulse-quickening race against time to prevent more deaths, Doug soon finds that the lives of his patients aren’t the only lives at stake.  Seems that someone will stop at nothing to keep Doug from revealing the truth. Could it be that murder is the ultimate rush?


“Shit!  Don’t give me any bullshit!” said Dr. Mike Carlucci under his breath, as his gaze locked on the unusual rhythm displayed on the EKG monitor.  His warning was meant mostly for his patient, Mr. Rakovic, who was scheduled to undergo an arthroscopy of his right knee.  Mike’s plea was also directed at God, just in case he was listening, and at the monitor itself to cover all bases.  Mike didn’t expect a reply from any of them.  Mr. Rakovic was deeply unconscious with an endotracheal tube sprouting from his mouth.  Mike had just induced general anesthesia and was preparing to fill out his chart when the trouble began.

Mike stared grimly at the potentially lethal dysrhythmia known as ventricular tachycardia, or V-tach, and felt the first raw edge of fear scrape lightly across his nerves.  It occurred to him that he had never actually seen V-tach during a routine induction in his six years at Mercy Hospital, or during any induction for that matter.  It was something that happened in the case reports, not in real life.  He wondered if Doug Landry, his best friend and colleague, had ever seen it.

His first instinct was to doubt the EKG.  Frequently movement of the patient or electrical interference caused the EKG to register falsely.  He rapidly scanned his array of other monitors.  Modern anesthetic workstations had upwards of ten sophisticated computer-driven monitors.  Substantial redundancy of these instruments allowed him to check one machine’s errors against another.  The pulse oximeter, a small finger-clip sensor, beeped at a heart rate exactly the same as the EKG.  This unfortunately ruled out the possibility of EKG artifact; there was no false reading this time.

Mike absently fingered the gold crucifix dangling from his neck.  Grandma Carlucci had brought it back from Lourdes, and had given it to him when he had graduated from med school.  The medallion always comforted him.  He punched his Dinamap, the automatic blood pressure machine, for a stat reading.  The mass spectrometer system, which continually monitored the gasses going in and out of Mr. Rakovic’s lungs via the endotracheal tube, registered normal carbon dioxide levels.  Mike breathed a sigh of relief; it meant the breathing tube was properly positioned in his patient’s trachea and not in the esophagus.  He quickly checked breath sounds with his stethoscope to ensure both lungs were being ventilated normally.  They were.  The pulse oximeter showed a ninety-eight percent oxygen saturation level, confirming beyond doubt that his patient was being adequately oxygenated.  Again good.  However, nothing to explain the sudden appearance of V-tach.

The blood pressure reading would be key for a number of reasons.  First and foremost, Mike knew he must treat the offending rhythm; its cause was of secondary importance at the moment.  A normal blood pressure reading would mean Mr. Rakovic would still have adequate blood flow to his vital organs—brain most importantly—in spite of the rhythm disturbance.  Mike knew that as V-tach accelerates, the heart can beat so fast it doesn’t have time to fill and fails as a reliable pump.  The blood pressure can fall drastically or disappear altogether.

“C’mon you piece of shit!  Read, damn it!”  Mike hissed under his breath to his Dinamap.  Fifteen seconds never seemed so long.  While waiting for the blood pressure, he opened the top drawer of his anesthesia cart and pulled out two boxes of premixed Lidocaine, a first-line emergency antidysrhythmic drug.  He ripped open the boxes and assembled the syringes.  He glanced up at Diane, the circulating nurse.  She was busily filling out her paperwork, oblivious to any problem.

“Diane,” Mike called out, “I got trouble here.  Get the crash cart!”

“Jesus, Mike!  Are you kidding?” asked Diane, eyes bugging wide, pen frozen in mid-task.

“Serious badness,” Mike said, trying to keep the dread he felt out of his voice.  “Looks like V-tach.”  His voice sounded a little higher than he had intended.

“Oh shit!” she said as she hurried out of the room, almost tripping over the trash bucket.  Mike was thankful that Dr. Sanders, the orthopedic surgeon, was still out of the room scrubbing his hands.  No time to tell him just yet; he wouldn’t take it well.  If the blood pressure were unacceptably low, Mike would need to shock the patient back into a normal rhythm.  He injected one of the syringes of Lidocaine into the intravenous line and simultaneously felt Mr. Rakovic’s carotid pulse.  It was bounding, arguing against a low blood pressure.

250/120!  “Holy shit!  Where’d that come from?”  Mike asked the leering LED face of the Dinamap.  Accusatory alarms screeched from the Dinamap in response.  Mike truly had not expected such a high blood pressure and was momentarily confused.  The temperature in the OR seemed to have jumped twenty degrees, and he felt rivulets of sweat coursing down his arms.  The fear was back and not so easily dismissed this time.  Think, damn it, think!  What would Doug do?

He quickly reviewed what he knew of Mr. Rakovic’s medical history and his own induction sequence.  Mr. Rakovic was a sixty-two-year-old hypertensive with a history of coronary disease and a prior heart attack.  But, his hypertension was well controlled on his current regimen of beta and calcium-channel blockers.  Mike knew his patient had a bad heart, and had taken care to do a smooth induction along with all the usual precautions to avoid stressing the heart.  A blood pressure of 250/120 and V-tach at 160 beats-per-minute were about the worst stresses any heart could undergo.  Mike knew this, but was still baffled.  Be cool, Mike.  Be cool.

He had been stumped before; medicine was by no means an exact science, and anesthesia was one of the frontiers.  Mike also knew better than to waste precious time pondering this.  As long as he had reviewed it sufficiently to make sure he hadn’t overlooked something, it was time to move on to the immediate treatment.  He could replay the case to search for subtle clues when Mr. Rakovic was safely tucked in the recovery room.

What lurked in the back of Mike’s mind during these first few minutes, prodding him along, was the specter of ventricular fibrillation or V-fib.  V-tach was reversible with rapid proper treatment.  V-fib, on the other hand, was often refractory to treatment, leading to death.   The problem was that V-tach had a nasty habit of degenerating into the dreaded V-fib without warning.  The longer V-tach hung around, the more likely V-fib would appear.  So Mike knew time was of the essence.

“Gotta bring that pressure down,” Mike mumbled to himself.  He reached back into his drawer for Esmolol, a rapidly acting, short duration beta-blocker designed to lower blood pressure.  He drew up 30 mg and pumped it into the IV port.  He also punched in the second syringe of Lidocaine.  Mike tried hard not to take his eyes off the EKG monitor for long as he drew up and administered the drugs.  He wanted to see if the V-tach broke into a normal rhythm or converted into V-fib.  Irrationally, he felt that if he continued to watch the rhythm it wouldn’t convert to V-fib; if he took his eyes off it for too long, the demon might appear.

His Dinamap on STAT mode continued to pour forth BP readings every 45 seconds.  290/140.

“What the hell!”  Mike said.  Alarms were now singing wildly in the background, adding to the confusion.

Just then, Dr. Sanders charged into the room demanding answers.  “What’s going on here, Carlucci?” roared Sanders.

Mike didn’t have time to deal with the irate surgeon.  A wave of nausea swept over him as he felt events slipping out of control.  Things were moving so goddamned fast.  Fear threatened to engulf him.  “Hypertensive crisis!” he managed to blurt out while he grabbed for some Nipride, his strongest antihypertensive.  Unfortunately, it had to be mixed and given as an intravenous infusion rather than straight from the ampule.  This would take a minute Mike and his patient could ill-afford.  Diane returned with the crash cart and several other nurses.  She looked at Mike and said, “Do you need help?”  It certainly sounded like she thought he did.

“Get Landry in here stat!” Mike yelled in response.  He took his eyes off the monitor as he worked on the Nipride drip.  Just as he got the Nipride plugged into the IV port, he heard an ominous silence.

The pulse oximeter had become quiet.  Usually the pulse ox signaled trouble, such as a falling oxygen saturation, by a gradual lowering of the pitch, not an abrupt silence.  Mike could think of only three possible causes, and two of them were disasters—V-fib or cardiac standstill.  The third reason could be as simple as the probe slipping off the finger.  Although this third possibility was enormously more likely, Mike doubted it.  As he turned his head toward the EKG monitor, he knew with eerie prescience what awaited him.

V-fib greeted him from the monitor.  He had failed to get the blood pressure down fast enough.  The V-tach had degenerated into V-fib as the strain on the heart had become too much.  His Nipride was now useless; in fact, it was harmful.  He immediately shut it off.  Mike knew that in V-fib, the heart muscle doesn’t contract at all; it just sits there and quivers like a bowl full of jello.  No blood was being pumped.  High blood pressure had ceased to become a problem; now there was no blood pressure.  Brain damage would ensue in two minutes, death in four to five minutes.

Doug Landry, the anesthesiologist on call that day, burst through the OR door.  “What d’ya got Mike?” he asked, slightly out of breath.  Doug glanced at the EKG monitor and said, “Oh shit!  Fib!”

“Paddles!” shouted Mike, comforted by Doug’s presence.  “He went into V-tach, then shortly into fib,” said Mike, nodding at the monitor.

“Yeah, I see,” Doug said.  His large sinewy frame looked like it was coiled for action.  Diane handed Mike the defibrillator paddles.

“400 joules, asynchronous!”  Mike barked.

Diane stabbed some buttons on the defib unit and it emitted some hi-pitched electronic whines.  “Set,” Diane said shrilly.

“Clear!”  Mike shouted.

Mike fired the paddles, and a burst of high-energy electricity pulsed through Mr. Rakovic’s heart and body.  The EKG monitor first showed electrical interference from the high dose of electricity, then quickly coalesced into more V-fib.

“Shit!”  Mike said.  “No good.”  He had never appreciated how ugly those little spiky waves of V-fib were.

“Hit em again, Mike,” Doug said.

“OK.  Recharge paddles.”  The paddles took several seconds for the high amperage capacitors to charge between countershocks.  “Better start CPR,” Mike said as he began pumping on Mr. Rakovic’s chest.  His hands soon became slimed from the electrolyte gel left by the paddles on Mr. Rakovic’s chest.  God, he hated chest compressions.

“Paddles are ready, Doctor!” said Diane.  Her eyes were wider than before, and her mask ballooned in and out, as she gulped air.

‘Boom’ went the paddles again, and Mr. Rakovic’s body convulsed a second time.  Mike stared at Mr. Rakovic’s face as it contorted, reminding him of a medieval exorcism.  Mike held his breath and waited for the monitor to clear, pleading with it to show him some good news.

“Still fib!”  Mike growled.  He resumed chest compressions as he nodded to the circulator to recharge the paddles yet again.

“Epinephrine?  Bicarb?” asked Doug.

“Doug, I don’t think he needs epi,” Mike replied quickly.  Mike wondered if Doug was also feeling the pressure.  His voice was too damn even, though.  “His pressure went through the roof on induction.  I don’t know why, but I just can’t believe he needs epi.”

“Okay,” Doug said.  “The paddles are ready.”  Doug’s forehead creased momentarily, then he added, “V-fib in an elective case.  Unusual.  Any history, Mike?”

Mike stopped compressions long enough to fire the paddles a third time.  He smelled the ozone coming off the arcing paddles.  The V-fib continued.  Gimme a break, Mr. Rakovic!

“Shit!  Charge the paddles again,” Mike said to Diane.  He turned to Doug.  “Yeah, prior MI, stable angina, hypertension.  Doug, I think we better try Breytillium.  I already gave him two doses of Lidocaine.”  Sweat was now soaking through his scrub top, pants and surgical cap, and running down his face.

“Yeah, sounds like a good idea,” said Doug.  “I’ll take care of it.”

Mike glanced over at Doug and cursed his calm efficiency.  He knew ‘the Iceman’ was a veteran of the OR wars.  Doug had worked at Mercy for twelve years.  He had been on the front lines before and had always performed well.  Doug reminded Mike of his mentor in residency days, Dr. Hawkins.  Mike thought he could hear Dr. Hawkins now: “Retaining control and being cool are critical in these situations.  Split second decisions need to be made.  Panic is a luxury you can’t afford.”  The advice sounded hollow.

“Any allergies, Mike?” Doug asked.  “Malignant hyperthermia?  Breytillium’s ready.”

“No allergies.”  Mike was breathing hard now and had to space his words with short gasps.  “Doesn’t look like MH—no temp.  Hurry Doug.  Run that shit.  He’s been in fib for a while.  We’re running out of time.  He may never come out.”

“I’m bolusing now,” Doug said as he injected a large quantity, “and here goes the drip.”

Mike clung to Doug’s steady voice like a lifeline.  Mike realized that he was in danger of losing control.  He could see it in the trembling of his own hands and hear it in the huskiness of his own voice.  He wondered if Doug noticed.  Deal with it, Mike.  Deal with it. 

Hawkin’s words floated back to him again.  “It’s just like being in combat.  Soldiers can train and drill all they want, but they never really knew how they’ll react until the bullets are real and start to shriek by their heads.  Will they turn tail and run, or fight back?”  Leave me alone, Hawkins!

Mike looked around the room.  He felt they were all staring at him; he could read the expressions in their eyes:  “It’s your fault!  You screwed up!”

“Try it now, Mike,” Doug said, jolting him back to reality.

Mike grasped the paddles tightly to prevent them from slipping from his slick hands and applied them to Mr. Rakovic’s hairy chest for the fourth time.  He pushed the red trigger buttons on each paddle simultaneously to release the pent-up electricity.  All 280 pounds of Mr. Rakovic’s body heaved off the OR table again and crashed down, sending ripples through the fat of his protuberant abdomen.  Mike now smelled an acrid, ammoniacal odor and realized it was coming from the singed hairs on Mr. Rakovic’s chest.  He frantically wiped the burning sweat out of his eyes so he could see the monitor.  The V-fib continued stubbornly and had begun to degrade into fine fibrillations.  “Damn you!”  Mike yelled at the monitor.

“I’ll give you some bicarb,” Doug said.  Out of the corner of his eye, Mike thought he could see Doug shaking his head slightly.

The next fifteen minutes were a blur to Mike.  More chest compressions, more emergency last line drugs, many more countershocks were tried.  Nothing worked.  Mr. Rakovic continued to deteriorate, his pupils widening until at last they became fixed and dilated.  His skin was a gruesome, dusky purple-gray.  He was dead.  Doug finally called the code after fifty-three minutes and gently persuaded Mike to stop chest compressions.  Dr. Sanders walked out of the room without saying a word.

Mike was numb as he stared at the corpse in front of him.  One portion of his brain, however, continued to function all too well.  It kept replaying his initial encounter with Mr. Rakovic in the holding area.  He could see Mr. Rakovic in vivid color and hear him plainly, as the rest of the OR faded to silent gray.  They had joked about the Phillies’ pitching staff.  They wondered whether Barry Bonds would break Big Mac’s homerun record.  God, he wanted this to stop, to get his laughing, living face out of his mind.  But he couldn’t.  His mind was a demonic film projector playing it over and over.  He felt very sick to his stomach and had an overwhelming need to get out of the room and get out of the hospital with all its stinking smells.  Just go, anywhere but here.

God, this was what he hated about anesthesia.  One minute you’re having a casual conversation with a living, breathing, laughing, for God’s sakes, human being and the next you’re pumping on his chest.  He becomes subhuman before your eyes as his face turns all purple and mottled.  He cursed his decision to ever become an anesthesiologist.  What in God’s name was I thinking?  Frail human beings were not meant to hold someone’s life in their hands.  The responsibility was just too awesome.

“Mike.  Hey, Mike.  You OK?”  Doug put his hand on Mike’s slumped shoulders.  Mike came out of his trance enough to nod his head.  Several tears rolled down his cheeks.  “Mike, there’s nothing else you could’ve done,” Doug continued.  “We were all here too.  He must’ve had a massive MI on induction.  Not your fault.  Some of those guys just don’t turn around no matter what you do.  Don’t blame yourself.  We tried everything.”

“Yeah, I know Doug.  But I just can’t get his face out of my mind.  We were talking, joking just an hour ago.  Now he’s dead.”

“C’mon, let’s get out of here.”  Doug led Mike out of OR#2.  “I know you might not be up to this, but Mike, you’ve got to talk to the family.  Did he have any relatives here with him?”

Mike didn’t answer immediately.  As the adrenaline haze faded, he struggled to regain control.  He felt completely drained with an enormous sense of loss, but coaxed sanity back into place.  “Yeah, he came in with his wife.  Nice lady.”  Mike paused, feeling his vision blur again, this time with tears.  “What do you say, Doug?”

“Listen, I’ll go with you.  Just tell her what happened.  Everything was going fine.  He went to sleep and then bam, out of the blue, he had a massive heart attack.  Nothing in the world was going to save him.  We worked on him for almost an hour and tried everything.  Tell her we’re really sorry.”

“OK.  Help me, Doug.”  He would’ve rather stuck nails in his eyes than face Mrs. Rakovic at that moment.

The two men walked through the electronic entrance doors toward the OR waiting room.  Mike swallowed hard and entered the small windowless room.  Doug was right beside him.  Mike searched the faces until he found Mrs. Rakovic.  It wasn’t hard.  As soon as she saw him, she immediately leapt out of the chair with a quickness that belied her bulk.  Her frantic gestures revealed the depth of her hysteria.  Mike walked over and she collapsed into his arms.  “Tell me is not so!” she wailed in her thick, Slavic accent.  “Tell me Doctor Sanders made mistake.  Not my Joey!”  She cried convulsively.

“I’m so sorry, Mrs. Rakovic,” Mike said, blinking fast.  “He had a massive heart attack.  We tried everything.”  He felt her tears burn into his shoulder and then felt his own tears stream down his face.  “I’m sorry.”  Her wracking sobs shook them both.