Forbidden Beginnings
Table of Contents
Title Page
Also By William Rubin
Copyright
Dedication
Preface
Prologue
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
Newsletter Sign Up
Acknowledgments
About the Author
Discussion Guide
Forbidden Birth
Forbidden Birth: Excerpt
Forbidden Beginnings:
Jacqueline’s Tragedy
By William Rubin
Also by William Rubin
Forbidden Birth
Forbidden Cure
Jacqueline’s Tragedy is a work of fiction. Names, characters, businesses, organizations, places, events, and incidents are either the product of the author's imagination or are used fictitiously. Any resemblance to actual persons, living or dead, events, or locales is entirely coincidental.
No part of this book may be used or reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission of the author. You can contact William Rubin at werubin.wordpress.com.
This book is also available in print.
ISBN: 978-0-9975949-3-5
All rights reserved.
Copyright 2017 William Rubin
Published by Crystal Vision Publishing
Cover by William, Eilene, and Diane Rubin
Formatted by Christine Keleny – CKBooks Publishing
Proofreading by Anne Pottinger and Diana Delfino
To All Those
Who Have Lost a Loved One
Much Too Soon
Preface
Dear Readers,
Welcome to FORBIDDEN BEGINNINGS: Jacqueline’s Tragedy. This book takes place prior to FORBIDDEN BIRTH, which has been on the Amazon Best Sellers lists for Medical Thrillers and Medical Fiction since January 2017.
Jacqueline’s Tragedy chronicles the exploits of trauma surgeon Chris Ravello and was written for new and established readers alike. New readers will find it an entertaining introduction to the Chris Ravello Medical Thriller Series and a perfect lead-in to FORBIDDEN BIRTH. Established readers will enjoy learning more about Chris’ backstory, including the life-altering events that occurred just prior to FORBIDDEN BIRTH.
Thank you for your support and happy reading!
Regards,
William Rubin
Prologue
The brutal images race through my mind. Blow after blow strikes her defenseless body. She tries in vain to fight back, to repel the attack. But the barrage is unrelenting. It pummels her face, head, and chest until finally, mercifully, she slips into unconsciousness. My hands clutch at my head. I’m ravaged with guilt and anguish. How could this have happened? Why wasn’t I there to help her, to save her?
Oh God – not now.
The searing pain comes from nowhere. It rips through my chest, doubling me over as it races up my neck, down my arms, throughout my body. Don’t think I can handle it much longer. My hands fly out in front of me, desperate to grab onto something, anything to brace my fall.
Chapter 1
August 2014
“Thank God! The bullet’s lodged in the cystic duct about a half inch from the gall bladder. A couple of inches in either direction and it would have torn through his liver, stomach, or intestines,” I say as I peer past my blood-soaked gloves at the glistening projectile. “Nurse, give Doctor Peters two hemostats, and I’ll take an Addison forceps.”
“Right away, Doctor Ravello.”
I look over at Peters, sizing him up. His blue eyes blaze with intensity, his brow is deeply furrowed. Good. Forty-four days into his surgical internship, this is the first of many bellwether moments for him. Five years earlier I stood where he is now. Two months ago, some forty-five hundred cases later, I finished up my chief residency in general surgery. Now I am the attending physician in charge - all the pressure falls on me. One false move on my part, one wrong step, and our patient will not see tomorrow. But wrong steps are for another day. Hardened by countless hours sewing together Harlem’s more antisocial inhabitants, trauma surgery is an old friend of mine, and today I am up for all of my friend’s challenges.
I reach in with my Addison forceps. “Clamp each side of the duct, Peters, and give me a clear field with that suction while I extract the bullet.”
“Yes sir, right away.”
Twenty-five minutes later we have the bullet out, the patient’s cystic duct repaired, and his abdominal wall re-approximated with a series of absorbable and non-absorbable sutures.
“Good job, Peters,” I say with a nod. “Your first of many traumas here at Washington General. You were well composed. Work on your suturing though, make it second nature. It will come in handy on the more challenging cases. Oh, and don’t forget the damn paperwork – always plenty of that. I’ll speak to the family.”
"Sure thing, Doctor Ravello. Thank you,” he says with a quick nod as if he’s ready to salute me.
A wave of my hand activates the door sensor for OR 4. I stride down the hall, through double doors that lead to the ambulatory surgery recovery rooms. I find my patient’s mother in bay four, just where I left her. Pulling down my mask I make steady eye contact with her.
“Mrs. Olivera, Derrick was very fortunate. The bullet missed his vital organs. The only thing that was hit was the duct leading to his gall bladder and we repaired that just fine. Things could have been much, much worse.”
“Oh, thank God, doctor,” Olivera says as she exhales in relief.
I place my hand on her shoulder. “I’ve seen Derrick before under similar circumstances, Mrs. Olivera. I know he’s a good kid and just needs some more help finding his way. Please talk with one of our social workers, okay? They’ll do what they can for both of you. Good luck.”
“Thank you so much, doctor,” she says through tearful eyes. “We will.”
I smile back at Mrs. Olivera and hold onto her shoulder a few moments before heading off to see who else will need my help today.
Chapter 2
“Honey, this is still like a dream,” Michelle says with an infectious smile. It consumes her face as she stares out of our living room at the Long Island Sound.
My wife of ten years, love of my life since we met in our sophomore year at Fordham University, can hardly contain herself.
Neither can I.
“I know, baby. All those years of sacrifice, long hours, little pay... We’ve finally made it!” I wrap my arm around Michelle’s shoulders, snuggling my chest against her back, our bodies perfectly melded together. I tilt my head down so it touches the top of hers. “The water seems like it goes on forever out there even though the North Shore of Long Island is just a short boat ride away.”
Michelle turns towards me, laughing. Even after all these years together, her beautiful face, the wonderful way she carries herself, still leave me breathless. “You’re starting to sound like our real estate a
gent, Doctor Ravello. What do you have to say about our in-ground pool or the beautiful bay windows we’re looking through?”
“Just that they pale in comparison to your beauty, Mrs. Ravello,” I say with sincerity.
“Awww, you always know just what to say to a girl.” She winks at me. “You just might get lucky tonight, tiger.”
Our lips meet and merge into one, just as our oldest, four-year-old Christine, ambles up. “Where’s James, Mommy?”
Michelle pulls back, startled. “Uh, he’s taking a nap, sweetheart.”
“Oh. He sure sleeps a lot,” Christine says with an innocent grin. Michelle smiles as she hoists her up, and we move through the living room, the dining room, and into the kitchen.
The kitchen, like everything else in our newly constructed house, is top of the line, no expense spared: white cabinets with beautifully etched glass faces reach to the ceiling; hand-painted backsplash tiles depicting playful scenes at the beach cover the area between the cabinets and our counter top.
“Are you getting hungry, kiddo? Maybe Mommy can work some of her magic and whip something up for you in our new kitchen.”
I slide onto one of the chairs surrounding the center island as Michelle places Christine on the brown speckled granite countertop in front of me.
“How come you never cook, Daddy?” Christine says with a tilt of her head. She is my little darling, a beautiful amalgam of my and Michelle’s best qualities and features. I melt every time I lay eyes on my daughter’s doubly dimpled face ‒ even when she is unwittingly putting me on the spot.
Michelle grabs eggs, bacon, and bread out of our Sub-Zero refrigerator and works her way over to the range, collecting a frying pan along the way.
“Christine, can you read this on the front of the oven?”
“Sure, Mommy. W-o-l-f. Wolf.”
“Very good, sweetie. Now Daddy is a big, strong man as you know. He isn’t afraid of anything in the whole wide world ‒ except this wolf, it seems.” Michelle’s eyes lock on mine, a mischievous smile on her face. “I guess we have Grandma to blame for that one, huh? She always protected your daddy from big bad monsters – like the oven.”
Christine’s face scrunches up, her left eyebrow rising above the right as she struggles to discern what her mother means.
I tear my eyes away from Michelle and home in on Christine. “Er, how’s preschool, kiddo?” I say with a sheepish grin.
“You’re a silly daddy,” she says with a chuckle. “There’s no preschool during the summer.”
“Of course.” I stick out my tongue and cross my eyes. “How could Daddy be so silly? One thing I do know, Grandma and Grandpa will be over for dinner this Sunday.”
“Yeaaahh!” she says with a little dance and wave of her hands. “I can show them our new house and ask Grandma how she kept you safe from the monsters. Maybe James will be up from his nap by then,” Christine says with an authoritative look on her face and a quick nod.
Chapter 3
Stab wounds litter our patient’s chest. Hank, a cabbie who normally works the Upper East Side, wandered too far north this morning in search of a fare and paid the price for his indiscretion. A lacerated right lung allows air to leak out into his chest cavity. Each breath he takes fills his right chest cavity but not his lung. Eventually, the air will compress his lung, pushing it across his body, where it will drive his heart into cardiac arrest.
Peters and I move quickly to open up Hank’s chest and repair his laceration.
“BP is 70 over 40 and his heart rate is becoming irregular. We’re losing him, Chris,” yells Dr. Craig Chang as he injects more meds into Hank’s IV.
“We’re moving as fast as we can. I think he’s bleeding into his pericardium. How much time do we have, Craig?”
“A minute tops…maybe less.”
“Shit! No time to crack his chest. Nurse, give Peters the ultrasound probe. I’ll take an inch and a half long 18 gauge spinal needle on a 60 ml syringe.”
“Peters, hold the probe at the bottom of the sternum, just below the xiphoid process. Show me the blood in the pericardial space.”
“Chris, he’s in arrest! I’m pushing meds, but we’re losing him!”
“Nurse, quickly, a number 11 blade. I’m going in just above the fifth rib.”
I puncture the skin with my scalpel, then slowly advance the needle, aiming towards our patient’s left shoulder while I pull back on the syringe’s plunger.
Peters, Chang, and the nurse look on, transfixed. The cabbie’s EKG continues to flat-line despite our best efforts. Beads of sweat dot my forehead and face.
Seconds seem like minutes, then I feel it. An almost imperceptible pop as red fluid rushes into my syringe. We’re in! One milliliter, then five, then ten races into the empty space. The EKG dances to life and assumes a regular rhythm. Peters, Chang, and the nurse collectively exhale.
Our patient is far from okay, but now we have a fighting chance to save him.
Over the next hour and a half, we continue our grueling work, methodically isolating and repairing each wound in our cabby’s heart, lung, and chest cavity. When it is all over, our patient’s chest and abdomen look like a battlefield – but at least he’s alive.
In the doctor’s lounge, slumping forward, head in my hand, I am drained but deeply satisfied. It took every bit of knowledge, training, dexterity, and skill I possess, but none of that matters. What’s important is I found my way through it and helped another patient cheat death in the process.
Chapter 4
Sunday afternoon at the Ravello residence in beautiful Rye, New York – it’s the best time of the week. Jacqueline and Bill Ravello, aka Mom and Dad/Grandma and Grandpa, are over for our weekly family dinner. My best friend, Kevin Kennedy, is here as well. He is like a brother to me. Michelle, Christine, James, and I round out the crew. Our magnificent seven use this time to catch up with each other and enjoy some great cooking courtesy of Mom and Michelle. Today is extra special, as it’s the first time Michelle and I are hosting the event at our new home, a four thousand square foot, five bedroom Victorian in one of Westchester County’s more exclusive neighborhoods.
Michelle gathers the children at the top of our sprawling staircase, putting the finishing touches on their hair, as the rest of us catch up with each other in the living room.
Dad, a retired NYPD detective, who worked many of those years in the Bronx, and Kevin, a detective first grade stationed at the 17th precinct in Midtown Manhattan, trade war stories. The two have known each other since Kev and I met in fourth grade. His family had just moved to Ossining from Queens, mine from the Arthur Avenue section of the Bronx, better known as Little Italy.
“So I’m investigating a robbery on 181st Street and Hughes Avenue. I’m still wet behind the ears, trying to make a name for myself as a detective third grade,” my dad says, leaning in. “I find this low-level mobster, Jimmy ‘No Nose’ Ciachi, in deep with the Godfather’s wife! He about has a heart attack when I bust in and see him plowing her on the couch, his sweaty red face all contorted like a pretzel. Next thing you know I cut a deal with Jimmy to keep the whole thing under wraps in exchange for him becoming an informant.” Dad slaps Kennedy on one of his massive shoulders. “Ended up making detective first grade off of all the busts from the intel Jimmy gave me!”
Kennedy bellows with laughter, his huge chest straining against the bright blue Polo shirt he is wearing.
“Ah, you’ve got the best stories, Bill! Most of my busts these days are drug related, low-level stuff. Turf war skirmishes, crimes committed to get money for drugs. You know, that kind of shit.” A wistful look takes over Kennedy’s face. “I’d love more interesting action.”
Kennedy stands well over six feet tall, broad-shouldered, ruggedly good looking. Most people know him superficially. To them, he is a living monument of muscle, determination, and grit, the physical embodiment of an immovable object and an irresistible force rolled into one. But we who know him best, know him as so much
more. He remains, in the best of ways, the same scrappy, vulnerable little boy I met in fourth grade. That pre-Goliath version of Kennedy still resonates in him today: big-hearted, idealistic, and selfless. He ambles over to me, the floor of our living room quaking under him. He drapes his left arm over my shoulder, his right arm tussling my hair as he addresses my mother.
“Ya done good with this one, Jackie. Summa cum laude at Fordham, Class of 2005, tops in his med school class at Stony Brook, one helluva surgeon at the busiest trauma center in the city. No wonder he’s got this frigging picture-perfect estate overlooking the water.” He looks me up and down and continues with a sarcastic smile, “Lord knows how you pulled it off with so little to work with, but you did.”
Ma’s eyes reach towards the heavens as a small smirk appears. She winks at Kennedy. “You didn’t turn out too badly yourself, Detective. Now, why don’t you give an old lady a hug and then gather everyone up for Chris’ magic show.”
Kennedy complies, capping the moment with a salute and an “Aye, aye, ma’am.” She waves her head in mock frustration and chuckles at the behemoth, then turns to me, her hands resting on the sides of my upper arms.
“I’m so proud of you, Christopher. This new house, your career, the two wonderful children you and Michelle are raising.... I always knew you could do it.” Mom beams with pride.
Blushing, I try to downplay it. “I’m as surprised as anyone, Ma, with how well it’s turned out. For a lot of years, I was a major screw up. You were the one who pulled me through all the fights, the turmoil, the feeling I didn’t fit in when we moved to Ossining from Arthur Avenue.” A smile fills my face. “I don’t know how you hung in there with me, Ma, how you believed in me when I didn’t even believe in myself. You made this all possible. Thank you so much.”