“I’ve been waiting and waiting for this day,” Timothy told him. “I thought I’d feel nothing but relief and excitement. And I do . . . feel that way. But I’m also frightened.”

“Me too.” Megan secured her grip on her husband’s elbow.

“That’s normal,” Sebastian said. “You became familiar with the holding pattern Isabella has been in. Today that changes.” Holmes had called him after removing the heart to say that the organ showed a little bruising from CPR, but overall looked to be in great condition.

“The next several hours are going to be long ones for us,” Timothy said.

“We’ll keep you updated throughout,” Sebastian said.

They stopped at the entrance of the lounge. A large number of Ackerman family members of all different ages had already gathered. Their faces communicated eagerness, worry.

“This is Isabella’s doctor,” Timothy announced to them. “Dr. Grant. He’ll be performing the surgery.”

A wave of comments washed over him. Mostly greetings, thanks, and assurances that they’d be praying.

He was praised more than he deserved when a patient’s outcome was good. He disappointed people more than he deserved when a patient’s outcome wasn’t good. Either way, in this line of work, there was never any place to hide.

He excused himself. Keeping a close eye on the clock, he stopped by the break room for a snack and a drink, then did some stretches in his office.

The timing of a heart transplant required more precision than the gears of a Swiss watch. After scrubbing in, he entered the OR when the senior fellow was opening Isabella’s chest. The perfusionist stood ready with the heart and lung bypass machine. An anesthesiologist, two nurses, and Markie rounded out the group.

“Good morning,” Sebastian said.

“Morning,” they responded.

“Let’s get to work, people.”

“Some of us are already working,” Markie replied.

Sebastian watched Isabella’s numbers and answered friendly questions about his vacation days in Misty River until the new heart arrived. It floated inside sterile solution within a plastic bag, surrounded by a Playmate cooler’s icy water.

Sebastian set about removing Isabella’s defective heart. It was swollen, dark red in color, too deformed to be functional. Once he’d freed it, he handed it to the scrub nurse, who placed it on a towel on the set-up table. Immediately, it became an inanimate lump of ruined muscle. Useless.

Meticulously, Sebastian worked to secure the new heart—light pink, shiny, smooth—inside Isabella’s small chest.

After thirty minutes of stitching, he asked the perfusionist to begin warming the blood. Soon he’d be able to remove the cross clamp and allow her blood to flow.

Sebastian found Megan and Timothy waiting for him in the hallway outside the restricted area of the operating wing. The staff had sent them frequent messages regarding the stages of the surgery and their daughter’s stability. Even so, they both looked wrung out.