Elysium Tide

James R. Hannibal

• Publisher: Revell
• Year: 2022
• eBook ISBN:
  9781493436279
• Print ISBN:
  9780800738518

Dr. Peter Chesterfield is one of the Royal London Hospital's top neurosurgeons. He is also a workaholic, ordered by his boss to take a week off to attend a medical symposium at the luxurious Elysium Grand on the island of Maui. While there, Peter pulls a woman with a skull fracture from the water. Though he is able to revive her in the ambulance, she eventually dies in his arms, leaving him with only one clue to what happened to her: the word "honu."

Increasingly obsessed with discovering the cause of his patient's death, Peter becomes entangled in an ongoing investigation of a brazen luxury auto theft. He also becomes a source of deep irritation to detective Lisa Kealoha, who has jurisdiction over the case.
But when the two join forces, they begin to uncover a destructive plot that runs far deeper than either of them could have imagined. And if they're not careful, they're both going to end up dead.

Award-winning author James R. Hannibal whisks you away to the deadly beauty of Hawaii for a story of greed, violence, and justice that will leave you breathless.

CHAPTER
ONE

PEDIATRIC SURGERY
THE ROYAL LONDON HOSPITAL
LONDON, UK

DR. PETER CHESTERFIELD WATCHED his chief resident cut a three-millimeter patch of flesh and muscle away from the boy’s forehead above the eyebrow. “Easy, Anna. No sense in leaving a scar that might scare off the ladies.”

“Michael’s seven, Dr. Chesterfield.” The resident passed control of her forceps to a waiting nurse, who held the patch in place, and then lifted a cranial drill from the instrument table. “He’s not old enough to worry about girls.”

“He will be someday, if we do our jobs right. Begin your burr hole.”

“Drilling now.”

Wisps of smoke rose toward the bright lights of the operating theater, carrying the smell of hot bone dust and cooked blood to Peter’s mask—not the most likable scent in the world, but one he’d grown used to. When Anna finished, she stepped aside, and the lead surgical nurse handed Peter a multi-instrument scope. He immediately began his incision, cutting through the final layers of tissue that protected the boy’s brain.

“Dr. Chesterfield.” Once she had Peter’s attention, the nurse, an older Black woman and a longtime friend, inclined her head toward the theater’s microphone. A red light already burned next to the word RECORD.

Peter glanced at her and then at the line of students standing a respectful distance from the table. He sighed. “Right. Thank you, Carol. We can’t forget our protocols, can we?” He raised his voice for the microphone. “This is Dr. Peter Chesterfield, senior attending neurosurgeon, Royal London Hospital. My accomplices today are doctors Anna Evans, chief resident, and Barbara Davies, a second-year neurosurgery fellow.”

While he spoke, Peter maneuvered his scope through the folds and valleys of his patient’s brain. “Today, we are conducting a four-hand, two-scope endoscopic procedure to remove a pesky adenoma growing from little Michael’s pituitary gland. I will approach through the third ventricle while my accomplices take the nasopharyngeal route.” He paused his work and lifted his gaze to the students. “Like Hamilton and Hickman fighting the Boers, we will attack this creature from both the north and south.”

The students answered him with blank stares.

Cretans.

Shadows fidgeted in the tinted windows surrounding the upper level of the operating theater. More students, Peter supposed. They were everywhere, one of the hazards of attending at the Royal London and St. Barts, both teaching hospitals. To escape these hordes and practice in peace, Peter would have to commute outside the city to someplace like Surrey. But he had no stomach for long drives—or Surrey.

He punched through the wall of the third ventricle, steering his scope through a cavern of cerebral spinal fluid like Verne’s Nautilus in the deep. “I’m almost there, Barbara. What’s your status?” Peter knew her status. He could see the progress of her scope on his dual display, but if she wanted to be an attending neurosurgeon someday, she’d have to learn to work and talk at the same time.

“I’m at the cavernous sinus, Dr. Chesterfield. I should have a visual in—”

A flood of red wiped out Barbara’s side of the display. An alarm blared from the monitor stack next to the table.

“Blood pressure rapidly dropping,” Carol said, the barest tension tightening her voice. “Dr. Davies, you might have cut the internal carotid.”

“Might?” Peter asked.

Barbara eased her controls up and down, staring at her screen. “I know. I know. I’m trying to get gauze on it. I can’t see anything.”

Peter would have taken over her scope, but in his current position, deep into the boy’s ventricular system, he had to maintain control with at least one hand. If his line drifted too far to the left, the kid would fail every math test for the rest of his life. Too far to the right, and Michael might lose the ability to understand the concept of love, pain, or Saturday. “You have red out, Barbara. You need to clear your visual field. Get a larger suction tube in there.”

“Already on it.”

“Are you?”

While the surgical fellow fumbled with her scope tubes, Peter wrapped his gloved fingers around the boy’s throat, signaling Carol with his eyes. “Pressure. Here. Like this. We have to slow the blood flow.” He let her take over, then looked to the chief resident who’d made the first incision for him. “Anna, are you comfortable with the nasopharyngeal path?”

“Yes, Dr. Chesterfield.”

“Good. Get another scope in there. Cut a one-millimeter square of tissue from the temporalis. We’ll graft it into the artery as a patch.”

Barbara worked her larger tube through the scope port and began clearing the cavity with suction and gauze. As the red curtain receded from her camera, the team got their first look at the damage.

Peter grimaced and shook his head. “Make that a two-millimeter square, Anna.”

The tear might be two millimeters, but in the altered perspective of his tiny scope, the pressurized stream of blood pouring through it looked like a meter-wide gusher pouring from a breaking dam. The monitor in the observation room above repeated his display in seventy inches of high-definition glory. Peter imagined the students up there were getting quite the horror show. “Make your grip tighter, Carol. We’ve got to slow this bleeding.”

“Doctor, the patient is exhibiting cyanosis.” Carol’s warning contravened his order, yet her hand tightened around Michael’s small throat in complete obedience. “He can’t take much more. Blood ox is tanking.”

Peter’s foot tapped the floor, loud enough for the rubber sole of his theater boot to be heard through the sterile overshoe. “I need that patch, Anna. In case you’re not up on current events, Carol is choking the life out of this child to stem the tide while your partner in crime, The Barbara of Seville, sucks the remaining blood out of his brain. I’d say moving with purpose is the order of the day, wouldn’t you?”

“I’ve got it. I’ve got it. Bringing the tissue up now.” The third scope’s display showed Anna following Barbara’s red-soaked line up the channel. She reached the cavity, and together, they pushed the muscle tissue into the gap.

“Anna, hold it in place. Barbara, use your blunt electrode to solder the patch. Muscle side only. Make no contact with the artery.”

Neither answered but followed his commands as if he were steering their fingers with his voice. The moment they’d soldered the full perimeter of the patch, Peter looked to Carol. “Release him. Slowly.”

On the display, a trickle of blood spilled from a corner of the patch. Barbara gave the area another pass with the electrode, and the flow stopped. Peter checked the numbers on the monitor. Michael’s blood oxygen and pressure slowed their plunge, leveled for a second, then rose.

Peter nodded. “Good.” With his patient stabilized and in no immediate danger, he looked hard at the second-year. “Do you often try to kill your patients on the table or was that just today?”

Barbara sucked in a breath. “Excuse me?”

“You heard me. We brought this boy in with an eminently operable benign tumor that should have left him with nothing but a sore throat and a week of headaches. But you up and lacerate his carotid artery. Either you’re a psychopath or neurosurgery isn’t your bag.” He pointed with his free hand. “Perhaps you should try the Royal Dentistry Academy next door.”

The students shifted in their line. One of them coughed. Peter hit him with a glare. “You. Out. No one coughs in my operating theater.” The young man lowered his gaze and headed for the door, and Peter returned his gaze to Barbara. “You, too. As soon as Anna has her scope clear, transfer control of yours and get out.”

“You can’t be serious. We’re in the middle of a procedure.”

“Which Anna can handle under my guidance. Out, Barbara. Now.”

CHAPTER
TWO

PETER TOOK A LONG BREATHER in the attendings’ changing room after the surgery. He had no desire to speak with the boy’s parents. He’d never enjoyed that part of the job.

After removing Barbara from his operating theater, he and the more-than-capable Anna had finished the operation, assisted by Carol. Working from above and below in what had become known in neurosurgery as the Chesterfield pincer, they had removed more than 99 percent of the tumor. With minimal radiation therapy, Michael stood a good chance of never seeing it grow back.

Victory over death. He’d done it, as he had a hundred times before, some in far more pressing and far less pristine circumstances. Peter sank onto the bench between the lockers and dropped his head into his hands. Tomorrow, he’d step onto the battlefield again. And again the next day, and the next, over and over, until death—relentless—finally won. But such was man’s plight.

The door slammed open.

Peter did not have to look up to know who’d entered. “This changing room is for attending surgeons only, Barbara.”

“Which I will be in three months.”

“Not if I have anything to say about it.”

Barbara, for all the fury and drama of her arrival, stayed close to the door, arms crossed. “That kid had a prominent internal carotid. It could have happened to anyone.” She thrust her chin toward Peter. “It could have happened to you.”

He let out a wry chuckle. From the catch in her voice, he could tell even she didn’t believe such a claim. “Stop making excuses and go. I was serious about the Dentistry Academy. I believe they’re accepting applications for next semester until the end of the day. You can make it if you hurry.”

“I’m reporting you to the executive board.”

This was enough to make Peter lift his head. “You’re reporting me? I’m not the one who almost killed that boy.”

“You called me The Barbara of Seville.”

“Oh. You caught that, did you?”

“If I had your lack of professionalism, I’d slap you.”

Peter left the bench and raised himself to his full height of six foot three, not as a threat, but to remind her who she was talking to—the top attending neurosurgeon in the Barts Health Trust. He didn’t have to say a word.

“You’ll be sorry,” she said, and walked out.

PETER FOUND MICHAEL’S PARENTS in the family room outside the children’s ward, waiting for their son, and waiting for answers. He gave them the latter. The nurses would bring them the former soon after. He explained the complication of the injured ICA and assured them it had been properly repaired with no threat whatsoever of future damage, then gave them the good news of the successful Chesterfield pincer.

Both listened with grave expressions. The mother, a short redhead with eyes puffy from crying, nodded with real understanding, almost like she’d been there for the whole thing.

When Peter finished, he paused and waited. He didn’t do the job for the praise, but accepting it with the right amount of practiced grace was a necessary function of his position. He’d even come to tolerate the overzealous hugs often offered by the Welsh.

But these two, as Welsh as they came, offered no hugs and no praise. The father glowered at him. The mother reached up and slapped him across the face.

Carol appeared out of nowhere to rescue him and ushered the two away, promising they would see Michael soon. She cast Peter an apologetic glance. He answered with a shrug that said, What was that for? I saved their child’s life.

“I guess Michael’s mother is not as professional as Barbara.” Nigel Avery, the group chief medical officer, pushed himself off the wall near the snack machines, where he’d been lurking.

“I saw you there,” Peter said, turning to face him. “Those machines don’t hide you, though they might if you used them less.” Peter had recognized Nigel’s reference to Barbara’s rant. “Though I failed to see you in the changing room. Were you spying on me there, as well?”

“Not spying. Then or now. I never spy. I observe the goings-on in my medical group. And lately too many of those goings-on have involved you. I was not in the changing room, but Barbara came to me and lodged a formal complaint. She told me what she said to you, and what you said to her.”

Things were coming together. Barbara had been busy. “I suppose she spoke to the parents after she spoke to you. That explains the slap.”

Nigel shook his head. “Wrong. I ordered her to keep well clear of the parents.”

“Then how did the boy’s mother seem to know everything that happened in there?”

Nigel pulled Peter to the side, closer to his snack machines. Carol had returned with Michael and his parents. As they passed, the mother shot Peter a glare so violent, he could feel the heat on his cheek ...

Table of contents

• Cover
• Endorsements
• Half Title Page
• Books by James R. Hannibal
• Title Page
• Copyright Page
• Contents
• Chapter 1
• Chapter 2
• Chapter 3
• Chapter 4
• Chapter 5
• Chapter 6
• Chapter 7
• Chapter 8
• Chapter 9
• Chapter 10
• Chapter 11
• Chapter 12
• Chapter 13
• Chapter 14
• Chapter 15
• Chapter 16
• Chapter 17
• Chapter 18
• Chapter 19
• Chapter 20
• Chapter 21
• Chapter 22
• Chapter 23
• Chapter 24
• Chapter 25
• Chapter 26
• Chapter 27
• Chapter 28
• Chapter 29
• Chapter 30
• Chapter 31
• Chapter 32
• Chapter 33
• Chapter 34
• Chapter 35
• Chapter 36
• Chapter 37
• Chapter 38
• Chapter 39
• Chapter 40
• Chapter 41
• Chapter 42
• Chapter 43
• Chapter 44
• Chapter 45
• Chapter 46
• Chapter 47
• Chapter 48
• Chapter 49
• Chapter 50
• Chapter 51
• Chapter 52
• Chapter 53
• Chapter 54
• Chapter 55
• Chapter 56
• Chapter 57
• Chapter 58
• Chapter 59
• Chapter 60
• Chapter 61
• Chapter 62
• Chapter 63
• Chapter 64
• Chapter 65
• Chapter 66
• Chapter 67
• Chapter 68
• Chapter 69
• Sneak Peek of The Gryphon Heist
• Acknowledgments
• About the Author
• Back Ads
• Back Cover