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through his curly hair, or the last silly knock-knock joke he had told. Ali had been taught that it was wrong or even dangerous to take pleasure like that from a patient. A surgeon cuts people. Life and death decisions had to be based on cold mathematical probabilities, and not on the promptings of the heart. But Jamie was not a typical patient. He was a helpless seven-year-old boy without a father or mother to love him. And Ali couldn’t resist wanting so much more for him than a doctor could give.
    Her feelings had already profoundly affected the course of the SIPNI project. SIPNI was supposed to be tested first on an elderly patient, someone who had little to lose if things went wrong. But Ali believed strongly that Jamie deserved a chance at a full life. When the IND—the government-sanctioned Investigational New Device approval—finally came through, allowing the SIPNI device to be tried on a human being, she had argued relentlessly that it should be Jamie who got the first trial. She won out, but she had taken an awful risk. For if Jamie wound up being hurt, the responsibility would be hers alone.
    *   *   *
    The operating room door swung again as Dr. Helvelius made his entrance. This was the signal for someone to hit play on a CD player. In a moment, the room was filled with the sound of Media vita in morte sumus , a responsory from the Gregorian chant.
    “Could we have a little anesthesia, please?” said Helvelius gaily, as though ordering a bottle of chablis.
    “He’s under,” came a voice from behind the blue screen that separated the brightly lit circle of scalp from the rest of Jamie Winslow. It was Dr. Godoy, the anesthesiologist, who spoke so softly that Ali could barely hear him above the whoosh of the bellows of the anesthesia machine.
    “Radiology ready?”
    A gowned figure nodded from beside the portable fluoroscope across the room.
    Helvelius looked into the Betacam in the corner. “We’re going to start with a pre-op angiogram to give us an idea of what the blood vessels look like inside Jamie’s brain. Get the lay of the land, so to speak. We can’t afford any surprises once we open him up. Dr. O’Day, would you be so kind as to start the catheter?”
    Ali looked at Helvelius with surprise. The catheter insertion was a routine but sometimes messy procedure, usually performed by a resident from Interventional Radiology. “You don’t want radiology to do it?”
    “Not today. I’d like a sure hand.”
    Sure hand? Ali still felt shaky from her agonies in front of the camera.
    But it was no time to demur. The camera was running, and Ali had to proceed. Turning from the scrub nurse who had just tied the back of her operating gown, she pulled back the edge of a blue paper drape over Jamie’s right groin, where the skin had been painted iodine yellow. She felt for a pulse, then cut a one-eighth-inch nick in the skin and used a fine hemostat clamp to tunnel into the opening.
    “Dr. O’Day will be passing an ultrathin catheter tube into an artery in Jamie’s leg. It will have to travel through the main artery, the aorta, almost to his heart, and from there through the neck until it reaches the circle of arteries at the base of the brain. We will use this catheter to inject a puff of dye, which we can photograph on X-ray.”
    Ali was amazed at Helvelius’s self-assurance. Here she was, nearly paralyzed by the unnatural scrutiny of these spotlights, and he seemed to frolic in their glow. Where did he get that kind of confidence?
    But before her lay the artery, pulsating, glistening white. Focus, now! This is all you have to worry about. Just this artery. Just this one little task. Deftly, Ali pushed a large twelve-gauge needle at a forty-five-degree angle through the opening, thrusting toward Jamie’s pulse. A couple of small spurts of blood showed that the needle was inside. Then Ali attached the introducer, shaped like a big metal Y, and through this passed a thin guide wire for the