Changes by Danielle Steel Page A

full of charts, two residents and a nurse were following respectfully behind. Peter Hallam's day had begun. He smiled once at Mel and pushed open the first door, which revealed an elderly man. He had had a quadruple bypass two weeks before and said that he felt like a boy again. He didn't look much like a boy, he still looked tired and pale and a little wan, but after they left his room, Peter assured her that he was going to be fine, and they moved on to the next room, where suddenly Melanie felt a tug at her heart. She found herself staring down into the face of a little boy. He had a congenital heart and lung disease, and nothing surgical had been done for him yet. He wheezed horribly and was the size of a five- or six-year-old child, but a glance at his chart told Mel that he was ten. They had been contemplating a heart-lung transplant on him, but thus far, there had been so few done that they felt it was too soon to attempt it on such a young child, and intermediary measures were being taken to keep him alive. Melanie watched as Peter sat down in a chair next to his bed and talked at great length to him. More than once, Melanie had to fight back tears, and she turned so the boy wouldn't see her damp eyes. Peter touched her shoulder again as they left the room, this time in comfort.
    They moved on to a man who had been given a plastic heart, which Melanie learned was powered by air. The patient was suffering from a massive infection, which apparently was sometimes a problem. Given the odds and the circumstances surrounding these desperately sick people, everything was a risk or a threat or a problem. Danger lurked everywhere, within their own defeated bodies, even in the air. And infection was greatly to be feared, and almost impossible to avoid, in their weakened condition. And then there was another patient, obviously comatose, and after speaking briefly to the nurse, Peter didn't linger long in the room. There were two moon-faced men who had undergone heart transplants within the year, and Melanie already knew from the material she'd read that often the steroids they took had that side effect, but eventually it would be controlled. Suddenly these people came alive to her. And what was even more real to her now was how poor the odds were. Peter answered some of her questions now, as they sat in his cubicle again. And as she looked at her watch, she was amazed to discover that it was almost noon. They had been doing rounds for four hours, had probably been to twenty rooms.
    “The odds?” He looked at her over his coffee cup. “Heart-transplant patients have a sixty-five percent chance of living for one year after the surgery is performed. That's roughly two chances in three that they'll make it for a year.”
    “And longer than that?”
    He sighed. He hated these statistics. They were what he fought every day. “Well, the longest we can give anyone is about a fifty-fifty chance for five years.”
    “And after that?” She was making notes now, appalled by the statistics, and sympathetic to the defiance in his voice.
    “That's about it right now. We just can't do better than that.” He said it with regret, and simultaneously they both thought of Pattie Lou, willing her better odds than that. She had a right to so much more. They all did. One almost wanted to ask what was the point except that if it were one's own life, or one's child, wouldn't one take any chance at all, for a day, or a week, or even a year?
    “Why do they die so soon?” Mel looked grim.
    “Rejection mostly, in whatever form. Either a straight across-the-board rejection, or they get hardening of the arteries, which will lead to a heart attack. A transplant will kind of step things up. And then the other big problem we face is infection, they're more prone to that.”
    “And there's nothing you can do?” As though it all depended on him. She was casting him in the role of God, just as some of his patients did. And they both knew it wasn't fair,