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First Chapter Reveal: Tell on You by Freda Hansburg

Tell On YouTitle: TELL ON YOU
Author: Freda Hansburg
Publisher: Micro Publishing Media
Pages: 248
Genre: Thriller

Tell on You is a psychological suspense novel that best fits within the Gone Girl-inspired niche genre of “grip lit.” Jeremy Barrett’s obsessive love equals that of Jay Gatsby for Daisy Buchanan, as life imitates art in his private school English class. But his angst-driven infatuation brings dire consequences as he is drawn into the machinations of his disturbed 16-year-old student Nikki Jordan, whose bad intentions rival those of her teacher. A fast-paced, drama-filled tale, Tell on You reminds readers about the wildness and trauma of adolescence—and the self-defeating behaviors to which adults resort in times of stress. From gaslighting to vicious bullying, poisonous family privilege to the loss of a parent—Freda Hansburg draws on her experience as a clinical psychologist to explore the depths of each dark situation in Tell on You.

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First Chapter:

“ALL RIGHT, LADIES!”

Jeremy Barrett clapped to get the attention of his second period Advanced Placement English class. When they continued talking, he barked: “Hey!” Eleven pairs of adolescent eyes turned toward him and the buzz of their conversations died down. The Forrest School demanded academic excellence along with the steep tuition. These daughters of wealthy New Jersey bedroom communities mostly rose to the challenge. Jeremy found them a pleasure to teach.

He scanned the room, mentally taking attendance and ticking off today’s borderline violations of the school dress code. Here, a bit of exposed belly or cleavage, there, some serious piercing. He frowned, but not over the wardrobe issues. No one had called in absent today, but someone was missing.

“Anyone know where Heather is?” They were all enmeshed in a tapestry of tweets, texts and posts. If one fell off the cyber trail for more than fifteen minutes it drew the herd’s attention. Cellphones were supposed to be turned off, but there were always a few cheaters. Probably more than a few.

But nobody offered an explanation for Heather’s absence.

Jeremy shrugged off his unease about the missing girl and began his lecture. The Great Gatsby, one of his favorite novels. The latest movie remake, combining 3D and JayZ, had piqued his students’ interest when he’d shown it in class. Personally, Jeremy considered the film an over-the-top, gaudy spectacle that turned Nick Carraway into a derelict and mangled Fitzgerald’s gorgeous prose and dialogue. But his students ate it up.

“So, let’s come back to our discussion of how Fitzgerald used water imagery.” A loud rapping on the open classroom door interrupted. Jeremy looked over to see the principal’s administrative assistant, Mrs. Marvin, wearing a prim suit and a pinched expression.

He scowled at the interruption. “What is it?”

“Mr. Donnelly would like to see you.”

“Now?” Jeremy’s tone bore the outrage of a surgeon interrupted in mid-operation.

Mrs. Marvin looked back at him, stone-faced. “Right away, he said. I’m to stay and monitor your class.”

Her words provoked a chorus of murmurs among his students, which Jeremy put a stop to with a loud “Shhh! Start reading the last three chapters. I’ll be back in a few minutes.”

A prickle of anxiety clenched Jeremy’s stomach as he walked down the hall to the principal’s office. Nothing to do with any childhood memories of disgrace, for Jeremy had been a diligent, rule-abiding student. His peccadilloes –well, transgressions – a recent development. He’d promised himself he’d get his act together. But – Donnelly. What did he know?

The principal rose as Jeremy entered his office.

A room designed to elicit tranquility rather than fear, it boasted a pastoral view of the green athletic field through French doors that led out onto a small balcony. Set on an estate, the Forrest School resembled a plantation more than an institution. Still, as Mr. Donnelly pointed him toward the sofa, Jeremy’s hands felt clammy. He mentally prepared defenses, but kept coming up short.

“Thank you for coming so promptly, Jeremy.” The principal wore a gray pin-striped suit today, dressing the part of CEO. Probably to stay on a par with the parents, many of whom were CEO’s.

“Of course.” Jeremy nodded. “What did you want to see me about?” He winced inwardly. An English teacher, ending a sentence with a preposition.

Mr. Donnelly didn’t appear to notice. He drew up his hands to form a steeple, touching his lower lip. Sunlight from the French doors reflected off his glasses. He looked like a church. A folded piece of paper rested on his lap. “It’s about Heather Lloyd.”

Jeremy drew a breath. Bad, but not the worst. “She’s absent this morning,” he said. “Has something happened?”

“That’s what I’d like to understand.” The principal passed the paper to Jeremy. “I received this email from Heather’s mother this morning.”

Jeremy unfolded the paper and read the message, his mouth turning to dust. Finishing, he looked up at Mr. Donnelly in silence.

“Jeremy,” the principal demanded, “what is this all about?”

 

About the Author

Freda Hansburg

Freda Hansburg is a psychologist and Tell On You is her debut trade thriller. She self-published the suspense novel Shrink Rapt and co-authored two self-help books, PeopleSmart – a best-seller translated into ten languages – and Working PeopleSmart. Freda lives in the South Carolina Lowcountry, where she is working on her next novel and her Pickleball game.

Her latest book is the thriller, Tell On You.

WEBSITE & SOCIAL LINKS:

WEBSITE | TWITTER | FACEBOOK

Tell On You Banner

Book Blast: The Raid on Troy by Murray Lee Eiland, Jr.

Title: THE RAID ON TROY
Author: Murray Lee Eiland Jr.
Publisher: Independent
Pages: 300
Genre: Light Fantasy / Historical Fiction / YA

The Greek raid on Troy is chronicled in the Iliad and the Odyssey. These poems are pillars of ancient literature and continue to be carefully studied. Homer, who lived in the 8th or 7th century BC, is credited as the author. The actual conflict has been dated from 1260-1180 BC or even earlier. The question is, how close is Homer’s account to real history?

In the Orfeo Saga volume seven there are some familiar characters from Homer. Their motivations, as well as their history, can be radically different. Memnon is a self-made man and a petty king who craves the fabled gold of Troy. His brother Menas is king of Sparta. They assemble a coalition to sack the city. Telemon, not eager to join the expedition, is moved to act after his daughter Elena is taken. He seizes the city of Mycenae and goes to Troy. Odysees might not be as clever or brave as the man described in Homer, but he joins the expedition out of greed. He soon meets Orfeo’s son, who is in search of his first real adventure. Orfeo is on the Trojan side, and has to face the assembled military might of Greece as well as Odysees cunning plans. The Greeks have Ajax, who they count on to defeat any foe in single combat. Can Telemon – now an old man – defeat the greatest Greek warrior and recover his daughter?

The Raid on Troy might not be any closer to real history than the ancient poems, but it does offer insights into what might form the basis of the stories.

ORDER YOUR COPY:

Amazon

Excerpt:

Memnon knew the ship was hitting the beach. He heard the scraping of the hull against sand and

pebbles, and the angle of the deck changed as the prow rose higher. He had not seen the ship’s deck for days, nor had he been permitted to walk around on land for perhaps two years. Slaves on Theran ships were treated with about the same respect as sheep, only slaves could not even be eaten because of some Theran religious prohibition. Galley slaves were useful,but were neither expensive nor in short supply.

At age fourteen, Memnon had seen little else of the world, as he had been seized in a slaver raid as he and his brothers played on an unknown beach now well beyond remembering. He knew he was less than five years old at the time, and now he believed he was nearly fifteen, although no one had been interested in explaining the concept of birthdays to him. Memnon had learned virtually all of what he knew from other slaves in the orchards of Thera, where he had begun his working career by carrying buckets of water to the men who tended the trees and picked the fruit. He had been separated from the two older brothers seized at the same time, but recognized one of them as he was taken to his place at an oar on one of the warships the Therans used to exact tribute from various cities; Memnon had occasionally spoken with him when their different groups of oarsmen were allowed on deck

Memnon recognized that his brother burned with rage. Over time, Memnon found himself coming to understand its origin and nature. Although he could not recall much about his life before his abduction, he remembered a world with occasional comforts, and even times of celebration.

Dr Eiland is a psychiatrist by training, and has written about Near Eastern art and culture. His novels are set in the heroic past and feature fictional characters in a realistic matrix. He has a special interest in exploring how and why people lead. The books contain themes that are suitable for young adults who have an interest in history.

WEBSITE & SOCIAL LINKS:

WEBSITE | TWITTER | FACEBOOK

Interview with Diana Sims, author of Forever King: Surviving the Loss of My Unborn Child

As a self-publishing author, Diana Sims has felt compelled to share her journey regarding the loss of her son, and the miracle that took place after his passing. She simply wants to let other women, who have lost children, know that there is still light at the end of the tunnel.

Aimed primarily at all mothers ranging from teenagers to the older women, Forever King: Surviving the Loss of My Unborn Child particularly addresses those who have lost a child, no matter the circumstance.

Diana is committed to humanitarian services whether in her field or position. She worked for many years helping customers keep their homes from foreclosure during the economic fall in 2008. Currently, she is assisting physicians and patients as a Patient Liaison. Diana is a California native and resides in Southern California with her loving husband Cory Sims, and three handsome Kings in training: Isaiah, Solomon, and Anthony Sims.

WEBSITE & SOCIAL LINKS:

WEBSITE | TWITTER | FACEBOOK

About the Book:

Title: FOREVER KING: SURVIVING THE LOSS OF MY UNBORN CHILD
Author: Diana Sims
Publisher: Forever King Publishing
Pages: 78
Genre: Inspirational/Self-Help

Sims life has been one of a survivor… a survivor of grief and distraught after having lost a child. Today, she is using the journey, to help other women, who have had similar experience of losing a child, whether through early pregnancy, miscarriage or stillbirth, to have hope.

Watch the book trailer at YouTube.

FOR MORE INFORMATION:

Amazon | Barnes & Noble

Q: Welcome to Beyond the Books, Diana.  Can we start out by telling us whether you are published for the first time or are you multi-published?

This is my first manuscript being published. I am so excited and happy to share it with you and the world.

Q: When you were published for the first time, which route did you go – mainstream, small press, vanity published or self-published and why or how did you choose this route?

My manuscript is self-published. I chose this route because I wanted to have all creative control on the book about my unborn son, and the legacy he will leave behind through me spreading his story and helping the hurting world know there is hope.

Q: How long did it take you to get published once you signed the contract?

Self- Published author on my own publishing company: Forever King Publishing. It took me a month after I completed the book.

Q: How did it make you feel to become published for the first time and how did you celebrate?

I was so elated and anxious at the same time. Sharing such intimate details of my son’s passing was a big leap of faith and courage that I had to do in order to help other women see life continues and life does go on and great things are awaiting them. I celebrated by having a book signing. I had a great photographer who captured all the events gracefully.

Q: What was the first thing you did as for as promotion when you were published for the first time?

I ran Facebook and Instagram Ads to promote the book and get the word out. I also reached out to family and friends to share my book cover and particulars on their own timelines on all social media platforms available.

Q: Since you’ve been published, how have you grown as a writer and now a published author?

What I realized, the easiest part is writing the book, I had to realize what I did after the book was published as a self-publishing Author was vital and key to this book becoming a success. Put in the work and life will pay off!

Q: What has surprised or amazed you about the publishing industry as a whole?

I am a self-publishing author so this whole experience is new and amazing because I was able to complete this project on my own.

Q: What is the most rewarding thing about being a published author?

The most rewarding thing about being a published author is being able to convey my life on paper and others being able to read and live this piece of my life through me.

Q: Any final words for writers who dream of being published one day?

Just do it! Don’t think about it, don’t hesitate, there is someone’s healing depending on you and the word that God has placed in your mouth. Rise up and mark your mark in the world.

 

Publishing Tips with Kelley Pryor Amrein & Becki Stevens

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Kelley Pryor Amrein is a writer and EFT practitioner. Kelley first discovered Emotional Freedom Techniques (EFT) in 2007. She used EFT personally and with her family before becoming certified as an AAMET Level Two practitioner in 2014. As a coach, Kelley has witnessed the power of EFT to release negative emotions, relieve stress, and lessen physical pain. As the parent of college students, Kelley believes that Tapped Out is a much-needed resource on college campuses, where stress levels are on the rise. The book provides students with a life-long tool, allowing them to easily alleviate stress and enjoy a healthy and successful life.

You can find Kelley on Amazon at amazon.com/author/kelleyamrein and amazon.com/author/kdpryor.

You can connect with Kelley at http://www.EFTBooksForYou.com, http://www.KDPryor.com, and http://www.SpiritGuidedJourneys.com.

Becki Stevens is an AAMET certified Advanced EFT Practitioner. For the past two years she has owned a successful EFT practice in southern New Hampshire. She works with people of all ages, including college students, to ease their physical and emotional distress. Becki focuses on how a person’s emotions can sabotage their success. Becki believes that Tapped Out For College Students is an empowering introduction to EFT for college students, giving them a tool they can use throughout their lives to relieve stress and foster healthy relationships, creativity, and overall health.

You can find Becki at http://www.EFTBooksforYou.com and at www.RebeccaStevensCoaching.com.

WEBSITE & SOCIAL LINKS:

WEBSITE | TWITTER | FACEBOOK

About the Book:

Title: TAPPED OUT FOR COLLEGE STUDENTS: STRESS RELIEF USING EFT
Author: Kelley Pryor Amrein & Becki Stevens
Publisher: Creative Spirit Books
Pages: 236
Genre: Nonfiction/Self-Help/Stress-Relief

Book Blurb:

You’re in college and college is stressful. Your stress impacts every facet of life, from classes to grades to work commitments. Even your physical health can be affected. Studies show that college students like you now face more stress than ever, leaving you with less time for relaxation and self-care. When you’re already overburdened, the idea of finding a way to relieve stress sounds like one more way to add extra stress to your life. But, what if you can relieve the stress of college in minutes? What if homework didn’t have to be so hard, and you did have time for school and fun? Tapped Out For College Students: Stress Relief Using EFT, is a guidebook that empowers college students like you, allowing you to reduce your level of stress and opening the door to success in college and in life.

In Tapped Out, college students are introduced to our unique BESD (Because, Emotions, Sensations, and Distress) system, which easily guides them through the tapping process. Once you’ve defined your personal BESD related to a specific issue, you can easily translate this into a tapping session. The book is full of tapping scripts relating to the most common stress-inducing issues you face in college. Students can tap through the scripts as they are written, or they can personalize them, using the responses they develop using the BESD system.

The Table of Contents is the perfect starting place, allowing students to pinpoint their issue and flip to the appropriate section of the book. Some of the topics covered in the book include time management, homework, exams, relationships, money, health, and preparing for the real world following college.

Students no longer have to be stressed throughout their college career. With Tapped Out as a companion, college students can face the college landscape calmly. This unique book, intended to be used as and when needed, empowers students to control their reactions and respond to each situation successfully. College is stressful. Tapped Out for College Students can help.

ORDER YOUR COPY:

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Q: Welcome to Beyond the Books, Kelley and Becki.  Can we start out by telling us whether you are published for the first time or are you multi-published?

Hi. We’re very happy to be here at Beyond the Books and we’re excited to share about our book, Tapped Out For College Students: Stress Relief Using EFT (Tapped Out).

This is Becki’s first time publishing a book. Together, we’re working on two companion books to Tapped Out. We’ve really enjoyed the process of working together on our book. Kelley has published two Young Adult novels under her pen name, KD Pryor and is working on her third novel, a women’s fiction.

Q: When you were published for the first time, which route did you go – mainstream, small press, vanity published or self-published and why or how did you choose this route?

As a team, we decided early in our process to self-publish. We used the services of JetLaunch, LLC to get the book formatted and uploaded to Amazon. We decided to self-publish Tapped Out for College Students because we wanted to get the book into the world before students begin to head back to classes in the fall.

Kelley’s YA fiction books were published by a small press publisher who guided her through the process and handled the technical end of things. She enjoyed working with her publisher on a one-on-one basis and she was happy to have the books released quickly.

Q: How long did it take you to get published once you signed the contract?

Once we signed the contract with JetLaunch, LLC to get the book formatted and the print and digital versions uploaded, the process took off. We signed the contracts at the end of 2016 and the book came out in February of 2017. We’re pleased to say that everything, from writing to publication, went smoothly and quickly. We had the book completed and into the world in a year from the date we started the project.

Q: How did it make you feel to become published for the first time and how did you celebrate?

Publishing Tapped Out was a wonderful experience. Unfortunately, we weren’t together when the book came out. But we were together when we got the first proof copies of the book. It was like Christmas morning when we ripped open the box and held the book for the first time. Then, we started editing.

Releasing the book was one of the most exciting and satisfying experiences for both of us and it was especially wonderful because it was the first book for Becki. We are happy with our accomplishment and are looking forward to releasing the next book in 2017.

Q: What was the first thing you did as for as promotion when you were published for the first time?

A week prior to the release of Tapped Out, we contacted friends and contacts on our business lists to let them know that the book was being released soon. We offered them a chance to get the book free for two days. We combined this offer with promotional bookings to get the word out about the book.

We have continued to promote the book both online and in person. We’ve been lucky that Becki has had some great contacts which have led to both a radio and a television interview where we were able to discuss Emotional Freedom Techniques (EFT), or Tapping, and how we use EFT in our book. We’re thrilled to be here, at Beyond the Books, as part of our Pump Up Your Book tour, to let your readers know about our book.

Q: Since you’ve been published, how have you grown as a writer and now a published author?

As co-authors, we refined our writing process as we wrote Tapped Out For College Students.

For Kelley, writing is her passion, and any time spent writing is a fulfilling learning experience. She finds that she needs creative time alone to delve deeply into the characters that populate her fiction. Writing a non-fiction is very different and writing a book with another person presents different challenges and joys. You cannot be as solitary when co-authoring a book, and that takes getting used to. That being said, Kelley enjoyed the creative give-and-take she shared with Becki during the writing process. She loved seeing how the book changed and grew as they both added new thoughts to the manuscript. She is certain that the book would not be what it is without the input from both of them, and she appreciates Becki, her wisdom, and all the fun they had. Because they definitely did laugh a lot during the writing process and beyond.

Becki had never really considered writing before working with Kelley.  As they went through the book development and writing process, Becki learned so much about what goes into writing a nonfiction book.  If it weren’t for Kelley, Becki wouldn’t have known where to start, and probably wouldn’t have ever written a book!  As a team, they were able to brainstorm, bounce ideas off each other and edit for each other.  Becki has realized that she has helpful knowledge to share with people.  Now, she feels like she has book topic ideas popping into her head all the time!  She is looking forward to continuing to work with Kelley and write more books in the Tapped Out series.

Q: What has surprised or amazed you about the publishing industry as a whole?

Writing is the easy part of this industry. During the writing process, there may be days when the words feel stuck and they can’t flow, there can be resistance to the process, and there can be hold-ups while waiting for research to be completed or for input from one another, as in our case as a co-author team. But, in the end, the writing is the fun part, because you can see your accomplishment, hold it in your hands, share it with everyone you know.

Thanks to the advent of so many publishing options, it’s easier than ever to get a book into the world. One of the most important aspects of publishing that we both recognize is how vital a good editor is to the process. We each vowed to ensure that our book was clean and error free and, to that end, we hired an editor and enlisted the help of several readers, who pointed our mistakes, gave great feedback, and helped make our book very accessible and reader friendly.

Marketing is the difficult part of the publishing industry, for self-published and traditionally published authors alike. With so many possibilities and marketing options, it can be daunting to know which avenue to pursue and where to spend those marketing dollars. We both continue to study and learn as much as we can about marketing. We determined that a Virtual Book Tour was going to be a vital part of our efforts, and we’re glad to be on tour with Pump Up Your Book, appearing here, at Beyond the Books.

Q: What is the most rewarding thing about being a published author?

Being published authors of a non-fiction, self-help book aimed at helping college students alleviate stress is very rewarding. We really believe in the book we’ve written and in the process of EFT or Tapping. We’re committed to helping stressed students and stressed people everywhere learn about Tapping, an empowering method to release stress and negative emotions.

Q: Any final words for writers who dream of being published one day?

The most important thing for writers to remember is to write. It’s easy to dream about completing your book. It is much more difficult to actually do it. But, the reward is in the doing. Throw away any excuses and make writing a commitment and a good habit. And good luck in all of your efforts.

 

 

 

First Chapter Reveal: Chasing Hindy by Darin Gibby

Chasing Hindy

Title: Chasing Hindy
Author: Darin Gabby
Publisher: Koehler Books
Pages: 284
Genre: Thriller

ADDY’S DREAM AS a patent attorney is to help bring a ground breaking energy technology to the world. Addy’s hopes soar when she is wooed by Quinn, an entrepreneur, to join his company that has purportedly invented a car that can run on water using an innovative catalyst. After resigning her partnership to join Quinn, Addy discovers things aren’t as they seem. The patent office suppresses the company’s patent applications and her life is threatened by unknown assailants if she doesn’t resign.

When she is arrested for stealing US technology from the patent office she realizes Quinn has used her. Now, Addy must find a way to clear her name while salvaging her dream of propelling this technology to the world, all while powerful forces attempt to stop her.

FOR MORE INFORMATION:

Amazon | Barnes & Noble

 

First Chapter:

ADDY FELT LIKE jumping out of her car and doing a quick happy dance in the middle of stalled traffic. Her excitement at becoming the newest—and youngest—partner at the intellectual property law firm of Wyckoff & Schechter was nearly overwhelming.She grinned at the shadow on the hood of Hindy, her treasured retrofitted cherry red Shelby Mustang. The shadow was created by a barrel-sized, hydrogen-filled balloon that floated above the Mustang’s roof. Gawkers pointed and laughed as the Shelby eased down El Camino pulling the tethered balloon as if in a Macy’s Thanksgiving Day parade. The balloon—which on one side sported her law firm’s logo, and on the other Hindy in giant cursive script—was just an advertising gimmick to show her passion for alternative energies. It was only strapped to the roof on calm, sunny days when she was travelling at slow speeds using routes that avoided overpasses. The retrofitted Mustang was really powered by four electric motors using electricity produced by solar panels and a conventional fuel cell.

At first, the Wyckoff partners questioned Addy’s prudence in strapping a floating balloon to the roof of any vehicle, but they’d

come to admire the effectiveness of her marketing innovations. They even lifted their champagne glasses at the end of her mentor’s welcome speech acknowledging that her Shelby was responsible for bringing in increasing numbers of the “green” companies sprouting like weeds all over the Silicon Valley— inventive, entrepreneurial companies in need of legal advice and support for their patents.

While the traffic inched forward, Addy chuckled with excitement. “Hindy, ol’ pal,” she said, patting the dashboard, “you and I are going places now! Next time some overzealous cops accuse you of being a traffic hazard, I’ll stare them down and inform them they’re messing with the partner of a highly prestigious law firm.”

Traffic momentarily loosened and Addy eased Hindy forward, careful not to snap the lines tethering the egg-shaped balloon. Addy sang along with Zissy Spaeth, pop rock’s newest and most flashy star, as Zissy belted out her latest hit, Light in Your Eyes, over the radio. In the corner of her eye she noticed a blaze of neon orange.

Her heart stopped. In the car next to her someone was pointing a bazooka-sized gizmo at her balloon. She blinked, trying to clear her vision.

A flare shot out, aimed straight at her floating ball of

hydrogen.

Even in the late afternoon sunlight, it was impossible to miss the explosion. The dirigible burst into a giant fireball, then slowly deflated and floated down toward the Shelby’s crimson hood.

Addy stomped on her brakes, hoping the balloon’s momentum would shoot the flaming mass forward. The fireball, safely secured by its fluorescent yellow nylon tethers, crashed down onto the windshield, blocking Addy’s view. She screeched to a halt, slammed her shoulder into the door, flung it open, and darted out, catching the heel of her pump on the doorjamb, which sent her sprawling headlong onto the pavement.

She heard tires squeal and at least a half dozen blaring horns. Stinging pain shot up from her elbow and knees. Thank goodness traffic had been just inching along.

Ignoring the pain, she bolted forward, arms raised, ready

to yank the still-burning fabric off the windshield. Before she got close enough to grab it, the sweltering heat from the flames scorched her cheeks, and she shielded her eyes with her forearm. Just when she reached the hood, a breeze lifted the infernal blob and propelled it directly at her, the nylon cords now seared through.

She braced herself for the fireball when she felt arms wrap around her chest and yank her back, barely in time to avoid the searing molten mass of goo about to descend on her head, threatening to fry her face and melt her hair.

“Are you crazy? What are you thinking?” a deep voice

bellowed in her ear, still holding her tight.

Together they watched what was left of the blimp float like a falling leaf onto the grassy shoulder, just like the Hindenburg did almost eighty years ago.

“Someone clearly doesn’t like you, short stuff,” her rescuer said, now standing next to her stroking his goatee, his face hidden behind dark sunglasses and a low-riding Dodgers cap. “More like out to get you. That was some kind of flare the driver shot at your blimp. I tried to spot his license plate, but it was covered up. Snapped a picture with my phone, though,” the man said fishing it from his pocket. “You can kind of see a tattoo on his forearm. The police will love this.”

Before she could thank him, someone cried out, “Call a fire

truck! The grass!”

Brush fires in California were no joking matter. Addy could smell the smoldering grasses. A strong breeze fanned the flames, pushing the fire toward a row of redwood trees.

Then she heard a whiny voice coming from the milling crowd of stranded passengers who’d gathered to find out what was holding up their homeward commute. “I’ve seen that blimp before. I knew it was trouble,” the whiner complained.

“Yeah, but at least she’s part of the solution,” said someone else. “Her car doesn’t use gasoline. Look at what you’re driving,” he said, sneering at the whiny woman’s crossover SUV.

Addy’s knees buckled, her head spinning. She plopped down onto the pavement and hugged her bare legs. This couldn’t be happening.

Why would someone try to destroy her car? Hindy, her

 

beloved Mustang, was just a marketing ploy, no worse than a billboard. Hindy’s fuel cell and solar panels were just two modern technologies that Addy hoped someday would become mainstream to the automotive industry. And her purpose was noble. Her “green” car told the world of inventors that she was one of them, that she would secure their patents and protect their investments. Now her expensive marketing project was in jeopardy.

Soon, swarms of firefighters were scrambling around dousing the flames, while police officers attempted to reroute traffic. A well-built bald man flipped out a paper pad and scribbled a few notes. After removing his sunglasses, he swapped the pad for a pocket camera and snapped random shots of the avid crowd.

All four local networks had sent news crews, and Addy knew two of the reporters. They had already run stories about Hindy, praising Addy’s creative marketing, which one reporter said was a refreshing change from the barrage of personal injury commercials littering daytime television.

As Addy told the reporter during her interview, Silicon Valley was going to be known, not just for starting the computer revolution and launching the social networking scene, but now for making the world green. And Addy was their lawyer.

Reality burst her daydream bubble when she was whisked aside by a team of Sunnyvale police officers. She told them what had transpired, hoping it would help them find the sniper. And she pointed out her rescuer, who was showing another pair of police officers the photo on his phone.

At the end of the interview, one of the officers handed her a ticket. “You were carrying a flammable substance without a permit. You’ll need to make a court appearance.”

Addy gasped. “But they shot at me.”

“And we’re not taking it lightly. There’s been a serious crime committed here, but that doesn’t mean you can break the law. If you hadn’t been toting that blimp, none of this would have happened.”

Addy’s eyes narrowed. “Am I’m free to go?” she said,

snatching the paperwork and turning toward Hindy.

“Yes,” the officer said, “but we’re going to need to impound

your vehicle.”

Addy halted. “Hindy? You can’t.”

The other officer beckoned with both hands, big gestures, as if directing an airplane to the gate. A tow truck wedged its way through the onlookers and began backing up in front of Hindy. “But Hindy works perfectly fine,” Addy protested. “The balloon, that was all for show. The hydrogen for the fuel cell is

where the gas tank used to be.”

The officer shook her head. “We need your car for evidence. As I said, a serious crime has just been committed, and we need to take the vehicle to the station for a thorough evaluation.”

“But I need to get home, and get to work tomorrow.”

“There’s always Uber,” said the officer with a shrug.

 

About the Author

Darin Gibby

In addition to a thriving career as a novelist, author Darin Gibby is also one of the country’s premiere patent attorneys and a partner at the prestigious firm of Kilpatrick Townsend (www.kilpatricktownsend.com). With over twenty years of experience in obtaining patents on hundreds of inventions from the latest drug delivery systems to life-saving cardiac equipment, he has built IP portfolios for numerous Fortune 500 companies. In addition to securing patents, Gibby helps clients enforce and license their patents around the world, and he has monetized patents on a range of products.

Darin’s first book, Why Has America Stopped Inventing?, explored the critical issue of America’s broken patent system. His second book, The Vintage Club, tells the story of a group of the world’s wealthiest men who are chasing a legend about a wine that can make you live forever. His third book, Gil, is about a high school coach who discovers that he can pitch with deadly speed and is given an offer to play with the Rockies during a player’s strike. Gil soon discovers, however, that his unexpected gift is the result of a rare disease, and continuing to pitch may hasten his own death.

With a Bachelor of Science degree in mechanical engineering and a Master of Business Administration degree, he is highly regarded in Denver’s legal and business community as a patent strategist, business manager, and community leader. He is also a sought-after speaker on IP issues at businesses, colleges and technology forums, where he demonstrates the value of patents using simple lessons from working on products such as Crocs shoes, Izzo golf straps and Trek bicycles.

An avid traveler and accomplished triathlete, Darin also enjoys back country fly-fishing trips and skiing in the Rocky Mountains. He lives in Denver with his wife, Robin, and their four children.

His latest book is the thriller, Chasing Hindy.

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First Chapter Reveal: Surgeon’s Story by Mark Oristano

Surgeon's Story

Title: SURGEON’S STORY
Author: Mark Oristano
Publisher: Authority Publishing
Pages: 190
Genre: Nonfiction Medical

What is it like to hold the beating heart of a two-day old child in your hand? What is it like to counsel distraught parents as they make some of the most difficult decisions of their lives?

Noted pediatric heart surgeon Dr. Kristine Guleserian has opened up her OR, and her career, to author Mark Oristano to create Surgeon’s Story – Inside OR-6 With a top Pediatric Heart Surgeon.

Dr. Guleserian’s life, training and work are discussed in detail, framed around the incredibly dramatic story of a heart transplant operation for a two-year old girl whose own heart was rapidly dying. Author Mark Oristano takes readers inside the operating room to get a first-hand look at pediatric heart surgeries most doctors in America would never attempt.

That’s because Dr. Guleserian is recognized as one of the top pediatric heart surgeons in America, one of a very few who have performed a transplant on a one-week old baby. Dr. Guleserian (Goo-liss-AIR-ee-yan) provided her expertise, and Oristano furnished his writing skills, to produce A Surgeon’s Story.

As preparation to write this stirring book, Oristano spent hours inside the operating room at Children’s Medical Center in Dallas watching Guleserian perform actual surgeries that each day were life or death experiences. Readers will be with Dr. Guleserian on her rounds, meeting with parents, or in the Operating Room for a heart transplant.

Oristano is successful sportscaster and photographer and has made several appearances on stage as an actor. He wrote his first book A Sportscaster’s Guide to Watching Football: Decoding America’s Favorite Game, and continues to volunteer at Children’s Medical Center.

“We hear a lot about malpractice and failures in medical care,” says Oristanto, “but I want my readers to know that parts of the American health care system work brilliantly. And our health care system will work even better if more young women would enter science and medicine and experience the type of success Dr. Guleserian has attained.”

Readers will find all the drama, intensity, humor and compassion that they enjoy in their favorite fictionalized medical TV drama, but the actual accounts in Surgeon’s Story are even more compelling. One of the key characters in the book is 2-year-old Rylynn who was born with an often fatal disorder called Hypoplastic Left Heart Syndrome and was successfully treated by Dr. Guleserian.

Watch the Book Trailer at YouTube.

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CHAPTER ONE

A Day in the Life

“We eat stress like M&Ms in here.”

 

OR-5

Children’s Medical Center, Dallas

November 5, 2009

I’m staring at eleven month-old Claudia, lying sedated on the operating table in OR-5, as still as a doll with no moving parts. She looks smaller than her charted weight of nine kilos (20 pounds). Nurses cover her with sterile blue surgical drapes so all that’s visible is a 4-inch square patch of skin on her chest. Bright white lights bathe the center of the table. Doctors and nurses in gowns, caps, and masks crowd around. They look almost identical. Except for the earrings. The earrings are the “tell.” That’s how you know it’s her.

Kristine Guleserian, pediatric cardiothoracic surgeon, is scrubbed in. Known throughout the hospital as Dr. G, she is one of only nine women in the U.S. certified to do what she’s about to do — take a scalpel sharper than a dozen razors, cut through Claudia’s skin, saw open her breastbone, and spread her ribcage apart in order to repair two congenital defects threatening a malformed heart the size of a walnut. It’s just after 9:00 AM. Claudia will be in OR-5 until 2:00 PM, along with a team of talented surgeons, nurses, techs, anesthesiologists, and others. Dr. G is in charge.

 

October 27, 2009

Children’s Medical Center – Heart Center

Two weeks before Claudia’s surgery, I had a 1:30 PM meeting with Dr. G at her office. At 1:25, I sat in the waiting room. At 1:30, Dr. G came through at her favorite speed — full. She headed for the door while putting on her white, starched lab coat over surgical scrubs and said, “Come on.” We trotted down the hospital hallway.

“This is my world. You wanted to see it. Welcome to my life.”

“Where are we going?” I was struggling to keep up with her even though I’m a foot taller.

“We have to do a consult.”

“We?”

“I have to. You’ll watch.”

We whisked past the main desk of the echocardiography lab. Dr. G motioned to the charge nurse.

“He’s with me.”

We squeeze into the dark and cramped echo lab, where there’s barely enough space for the two women sitting at the monitors. Dr. G introduced me to cardiologists Dr. Catherine Ikemba and Dr. Reenu Eapen, then turned her focus to the echo monitors. An echocardiogram is a moving image produced by sound waves directed at the heart and reflected back again as the waves pass from one type of tissue to another. To me it looked like a blurry, moving x-ray. To the eyes of these three women it was an intimate cardiac road map. A nine-year old boy had a malformed aorta, and the cardiologists wanted Dr. G’s opinion. She was Socratic, asking questions she likely already knew the answers to, saying, “Well, I might do…” so-and-so, and then asking her colleagues for their opinions.

Two weeks later, I came back for the first of many long days as her shadow. I wasn’t quite Alice in Wonderland, but the feeling of falling down a hole did occur to me.

 

November 5, 2009

7:30 AM – Heart Center Research Meeting

There’s more to being a surgeon than surgery. This particular day begins in a windowless media room, the kind of video-meeting-training center you’d find in any school or business. Rows of desks and chairs give it a classroom feel. A/V equipment hangs from the ceiling and a large video screen dominates the front of the room. The dress code is strictly medical, no business attire here. Doctors and nurses in scrubs and lab coats shuffle into the room, many with the ubiquitous cup of Starbucks in hand. Today will feature a presentation of two ongoing cardiac studies being conducted at the Children’s Medical Center’s Heart Center. The room is very cold, and Dr. G wears a black turtleneck sweater under her white lab coat. She pulls the sweater neck up over her nose and mouth as the meeting goes on, seeking warmth. A presenter advances to the lectern, and the unmistakable look of the PowerPoint presentation flashes on the screen behind her. The title slide reads:

CHROMOSOMAL COPY NUMBERS IN

HYPOPLASTIC LEFT HEART SYNDROME

Before I ventured into Dr. G’s world, I had begun my own rudimentary study of congenital heart disease (heart defects present at birth), trying for a foothold in the maze of childhood cardiac problems. I had read that hypoplastic left heart syndrome (HLHS) is a life-threatening cardiac deformity where the left ventricle, which pumps blood to the aorta and then around the body, is so weak that without surgical intervention any infant suffering from it will likely die. The pediatric heart specialists in the meeting room critique what they’ve just heard. A senior cardiologist might question the validity of this or that portion of the research methodology. These are works in progress, not ready for publication. Ongoing study is a part of the surgeon’s job description.

In the meeting room, the media screen glows again.

ECHOCARDIOGRAPHIC PREDICTION OF SPONTANEOUS

CLOSURE OF DUCTUS ARTERIOSUS IN PREMATURE INFANTS

After only two weeks shadowing Dr. G, I was able to make some sense of this title. The Heart Center team is using echocardiography to predict whether the ductus arteriosus in the hearts of premature infants will close properly after birth, sparing the need for open-heart surgery. That was about all I knew. I had to dig deeper into the textbooks to learn more about what was beating beneath my own breastbone.

The human heart is a four-chambered pump, designed to send deoxygenated blood to the lungs to get a new supply of oxygen, and then sending that oxygen rich blood on its journey around the body to nourish organs and tissues. The left and right sides of the heart each have two chambers — an atrium on top, and a slightly larger ventricle on the bottom. Each side is like Dali’s version of an hourglass. The atria and the ventricles are each separated by a thin wall called a septum. The ventricular septum is slightly more muscular than the septum for the smaller atria.

In a normal heart deoxygenated (blue) blood enters the right atrium from large blood vessels called the vena cavae, which bring blood back from the rest of the body after distributing oxygen. The right atrium contracts, opening the tricuspid valve, and blood flows down into the larger right ventricle. The contraction of the right ventricle sends blood through the pulmonary valve to the pulmonary arteries, and into the lungs for oxygenation. The newly oxygenated blood enters the left atrium through the pulmonary veins. When the left atrium contracts, blood is sent through the mitral valve into the left ventricle. The left ventricle contracts, blood moves through the aortic valve into the aorta, and off to oxygenate the rest of the body — the brain, the coronary arteries of the heart itself, deep into the internal organs, and superficially to the skin. Over and over again, on average 100,000 times per day. That’s in an anatomically correct heart. (Anatomic trivia: The pulmonary arteries are the only arteries that handle deoxygenated blood, while the pulmonary veins are the only veins that handle oxygenated blood. Otherwise, oxygenated blood always flows through arteries, and deoxygenated blood through veins.)

The number of things that can go wrong with the human heart is staggering. Heart disease in adults is usually acquired. When we develop a heart condition in later life, it’s most often our own doing. Smoking, obesity, hypertension, poor diet, lack of exercise, diabetes, genetics and more, contribute to the clogged coronary arteries, heart attacks, strokes and other events that make heart disease the leading cause of death in most developed countries. Congenital heart disease is present in approximately 35,000 newborns in the U.S. each year, although many of these show no symptoms and don’t learn of any problems until years later, if ever. Since infants haven’t had a chance to do much damage to themselves, it’s fair to wonder how a newborn heart can have so many problems. Congenital heart defects occur because of interruptions in normal fetal heart development.

The developing fetal heart contains a series of shunts, like miniature bypasses, to keep blood away from the pulmonary arteries and lungs so that blood flow is kept low, and the tiny lungs won’t be overtaxed. Fetal lungs are non-functional, because the fetus gets oxygen from the mother through the umbilical cord. The shunts in the fetal heart are:

1) foramen ovale, which lets blood flow from the right to the left atrium,

2) ductus venosus, which draws umbilical blood away from the fetal lungs and into the vena cava, and;

3) ductus arteriosus, which connects the pulmonary artery to the descending aorta, thus allowing most blood from the right ventricle to bypass the non-functional fetal lungs.

All three of the shunts alter themselves after birth to create the normal heart design. When something interferes with the natural switch over from fetal to breathing infant heart, physicians call it “persistent fetal circulation.” It can manifest in hundreds of way. In certain situations, it’s never even noticed.

Anatomy of the Heart 101 is over. Bookmark these diagrams and return PRN (medical for “as needed”).

 

8:15 AM

3rd floor Cardiovascular Intensive Care Unit

The Cardiovascular Intensive Care Unit (CVICU) has twenty rooms arcing around a large central desk. The furnishings are modern, corporate-like, and austere. The pulse of the CVICU is the rhythm of the beeping sound common to every TV medical drama. Each patient is attached to a monitor measuring blood-oxygen saturation (sats), heart rate (HR), blood pressure (BP), respiratory rate, temperature, and more. Each monitor is a computer, producing different sounds for different reasons. The one constant is that audible beep, one for each heartbeat. An infant’s tiny heart beats significantly faster than an adult’s, so the pace of the beeping is rapid, and each baby here suffers from a potentially fatal malfunction of that rapidly beating heart.

Nurses move everywhere, monitoring every child. Intravenous (IV) fluid bags hang at each bed — six, eight, sometimes more. One patient has ten IV drips, each one delivering a different life-supporting medication — sedation, painkillers, antibiotics, anticoagulants, blood products, nutrition and others. The drips hang from poles, and flow directly into the tiny patient’s arm or leg, or more often, into a catheter inserted into the chest for easy access. The drips feed into a large control panel with the concentration and rate of flow of each drip handled by computer. All these babies are critically ill, critically tiny, many premature. Most of them are smaller than the stuffed animals that sit, unnoticed, next to them.

I’ve been volunteering at Children’s for 13 years, but this is my first time in the CVICU. I’m here for cardiac surgery rounds, following Dr. G as she checks on the progress of patients. Another familiar sight from medical TV shows is on display here — the long, white coat — the peacock feathers of physicians and surgeons. Children’s Medical Center is a teaching hospital, part of the University of Texas Southwestern Medical School in Dallas. Doctors and surgeons, long past their residencies now and specialists in their fields, wear the long, white lab coat. Medical students, residents and interns are in shorter coats. Dr. G is the shortest of the long coat-clad. Sure, she’s only five feet tall, but as they say in the sports world, she plays six-two. She’s not the only woman in the group, but she’s the only one wearing a long white coat. The young doctors listen to her.

Heart surgeons, ICU doctors, cardiologists, nurses, nurse practitioners, physician assistants, fellows, residents and students start at one end of the unit to move room by room around the floor. A cardiology fellow pushes the computer on wheels (COW), and presents each case. This young doctor has made several of the basic choices his career path requires. He’s just finished his residency where he worked in various specialties. He’s chosen medicine over surgery, pediatrics over adult, and cardiology over other disciplines, making pediatric cardiology his career choice. He’s taking his first steps down the six-year road it will take to earn “attending” status, when he’ll be in charge of cases. He’ll then be a pediatric cardiologist, a doctor who treats young people with heart disease. He’ll refer cases needing surgery to people like Dr. G, a pediatric cardiothoracic surgeon. Her career path was twice as long, requiring twelve years to attending status. Cardiologists diagnose — surgeons repair.

Even though he’s out of residency, this doctor is still learning. He stops in front of the door to the first patient room and runs down the important events from overnight — vital signs, patient status, complications, and planned treatment. The male attendings ask questions that are pointed and occasionally harsh. Dr. G draws the younger doctors out with her questions, gently nudging them back on the right track. “I didn’t hear anything about left atrial pressure there,” she tells the presenter, who immediately refers to the COW screen and spews a series of numbers out in a specific order. The young doctor’s voice is tense, rising a bit, as he makes up for his omission. It’s unlikely he’ll make this mistake again. Terms like “open-chest” and “life-threatening event” are heard on cardiac rounds, said calmly and with nonchalance. Hospital personnel in critical care settings are outwardly detached. It’s a key to staying focused.

The CVICU nurses rounding make notes while answering questions concerning how patients fared overnight. There is a pecking order among hospital personnel, and some doctors treat nurses as underlings; nevertheless, a tremendous level of trust exists between the doctors and nurses at Children’s. If the doctors are the officers of this army, the nurses are the sergeants, the ones who make sure everything gets done.

While the rest of the group moves along the hallway, Dr. G stops to look inside the room of the patient just presented. If she sees a family member inside, and they’re awake at this early hour, she goes in to say hello and ask how things are going. She feels a responsibility toward every family, even if the case isn’t hers. It’s not done for effect or because her medical training requires it. This is the way she treats everybody. It doesn’t matter if your child has a serious heart condition. It doesn’t even matter if you have a child. When Dr. G sees you, in the hallway, in the cafeteria, in the OR, she says hello.

Rounds end, leaving just enough time to dash up to the eighth floor cardiac unit and check on patients who are out of ICU, waiting to be discharged. One young heart transplant patient has turned up her oxygen level without the nurses knowing about it. Dr. G tells the 13-year old girl, in a firm, motherly way, that medical decisions are made by the pros and here’s how we’ll manage the oxygen for the remainder of your stay. The girl hangs her head and nods.

The moments after rounds, before the next issue presents itself, offer a chance to head down to the first floor food court for a snack. As Dr. G stands in the register line, her pager beeps. She checks the number and heads up to the third floor office suite she shares with her partners and staff. She phones the person who paged her and, in a flash, it’s out the door and back to the echo lab, a half-eaten banana left behind on her desk.

Two weeks after my first visit to the echo lab I stood to the side again, this time better able to make sense of some of what Dr. G and the cardiologists discussed as they looked at the screen. Eleven-month old Claudia’s diagnosis was Tetralogy of Fallot (TOF), a syndrome with four separate cardiac abnormalities:

1) Ventricular septal defect (VSD) — a hole in the wall between the two ventricles;

2) Overriding aorta — the aorta is not positioned properly on the heart;

3) Right ventricular outflow tract obstruction — for any of several possible reasons, the blood flow to the lungs is restricted, leading to:

4) Right ventricular hypertrophy, (which surgeons pronounce “hy-PER-tro-phy”) — a dangerous buildup of the right ventricle’s musculature.

Claudia has alarming episodes of cyanosis where her lips, fingers and toes turn blue because her oxygen saturation rate becomes dangerously low. She also has what are called “Tet spells,” when her oxygen level drops so low that she loses consciousness. The preoperative indications of most concern to Dr. G are an extremely small pulmonary valve, which leads from the right ventricle to the pulmonary arteries; the significantly thickened muscle bundle below the valve; and the somewhat larger than average VSD.

Thirty minutes later we were walking down a second floor hallway toward the operating rooms. Dr. G walked quickly, straight ahead, focused. She was getting her game-face on.

 

10:30 AM

OR 5

Claudia lay motionless on the table in the center of the OR, her head sticking through a hole in the draping around her neck. It’s visible to the anesthesiologists seated at the head of the table where they are concerned with the numerous gauges, medicines, inhalation gases and monitors at their fingertips. They’re also in charge of tilting the table at the surgeon’s request, to put the patient at a more favorable angle, because the motorized table can be raised, lowered and tilted to various angles at the touch of a button.

(Example of pediatric cardiothoracic humor —A flight attendant goes on the p.a. and asks if there’s a pediatric cardiac anesthesiologist on the plane. There is one, in the rear of coach. He signals the attendant and asks what the trouble is.

“There’s a pediatric heart surgeon in first class. He wants his tray table lowered.”)

The scrub tech stands at the opposite end of the table, facing a series of trays that hold an array of odd looking tools; forceps for picking up or grasping things; scalpels that slice through human flesh as if it were air; sutures (thread) finer than human hair, attached to small needles curved like fish hooks. The scrub tech is the right hand person to the surgeon, responsible for pulling instruments and supplies for the operation, knowing what the order of the operation is, and arranging everything in the most efficient format for this particular surgery and this particular surgeon. Dr. G knows that when she calls for an instrument, the proper one will be there in a flash. Often, it will be offered to her before she has to make the call.

A six-foot-by-six-foot metal frame sits to one side of the operating table, containing gauges, canisters, and clear plastic hoses. This is the cardiopulmonary bypass machine —“the Pump.” This technology will serve as Claudia’s circulatory system while her heart is stopped for repairs. Developed in the 1950’s, modern bypass machines still use hoses much like the beer keg tubing in the first experimental models. The two specialists in charge of operating the pump, the perfusionists, sit at the machine.

The small patch of Claudia’s chest that’s visible is covered with a material called Ioban, plastic coated with iodine in a further effort to reduce any risk of infection during surgery. Dr. G will make a tiny incision to get at this heart that was compromised in utero by Tetralogy of Fallot. To give you an idea of the progress of medical knowledge, TOF was first medically described, though primitively, in 1672. Two hundred years later Etienne Louis Fallot, a French physician, described the clinical pathology of the condition, but the first surgical treatment for TOF wasn’t available until the late 1940’s. Dr. G, ever the teacher, drew a diagram of the surgery for me before she scrubbed in.

After scrubbing, Dr. G re-enters the OR with hands and forearms still wet. She dries with sterile towels provided by a scrub tech who then helps her into a surgical gown and gloves. She wears loupes over her cap. They look like small telescopes growing from each eye, and they give her a magnified view of the tiny area in which she’s working. A fiber-optic cable runs up her back, over the top of her cap and onto a small, bright lighting instrument/video camera at her forehead, to light and televise what she sees to monitors hung around the OR. Dr. G is at the center of the sterile area, where only those who scrub in can go. The rest of us, wearing surgical masks and caps in addition to our scrubs, have to stay away from the table. She climbs up on a small step stool to get her five-foot frame high enough above the table to work easily, without making her taller assistants bend over.

She takes a scalpel and makes a four cm incision in Claudia’s chest. Next, she cuts the breastbone open with a small saw and puts retractors in place to hold the ribs apart. The first object Dr. G encounters inside Claudia’s chest is the thymus gland, a small, flesh-colored organ. It has some minor involvement with the lymphatic system, but it gets in the way of open-heart surgery, and you can live without it. So the gland is removed and discarded.

Dr. G takes an electronic scalpel called a “Bovie,” which cauterizes as it moves through tissue, keeping bleeding to a minimum. She cuts the pericardium, the sac-like membrane containing fluid that lubricates the heart. The pericardium has extra meaning for Claudia. Dr. G precisely excises a small portion of the sac and places it in a dish containing 0.6% glutaraldehyde, a preservative fluid. She’ll use this patch later to close the VSD, the hole between Claudia’s ventricles that failed to seal itself properly at birth. She works around the small space filled with tiny body parts, freeing up the aorta and the pulmonary arteries from the underlying tissue. Claudia has been given heparin, an anticoagulant, so that her blood is less likely to clot when it goes through the pump. Dr. G inserts cannulae, small tubes, into the aorta and the vena cavae. The other ends of these tubes are attached to the pump, connecting to Claudia’s circulatory system. Because Claudia has very small blood vessels, the work is delicate and precise, and the tubes they need for this bypass, like the vessels in Claudia’s chest, are extremely narrow. Her cannulae are smaller than the width of a ballpoint pen.

The mood in the OR shifts at various moments. Dr. G has been casually introducing me to the OR team while routine work is going on — as routine as heart surgery can be. But when the cutting starts, the room goes quiet. Dr. G hovers over the small body on the table, staring down into the chest she has cut open. The view from the camera attached to her loupes doesn’t shake on the OR monitors. She’s a human tripod.

The perfusionists are cooling Claudia’s body down to 28 degrees Celsius, 82.4 Fahrenheit, to slow her metabolism and protect her heart. Hypothermia lowers the amount of oxygen the brain requires, giving the surgeons time to perform the needed repairs. They aid this chilling process by turning the temperature in the OR down to 64 degrees, so cold that several people drape their shoulders with blankets from a nearby warmer.

Dr. G clamps the aorta, and blood stops flowing to Claudia’s heart. Dr. G tells the perfusionists to run the cardioplegia, a solution of chemicals inducing cardiac arrest. In order to operate on the heart they must intentionally cause something that usually kills when it happens on its own. The cardioplegia solution includes potassium chloride, one of the chemicals used in lethal injection executions. Claudia’s heart stops beating and the blood exits her vena cavae into the bypass machine for oxygen, returning to her body through the cannula inserted just above the clamp on the aorta. Her heart and lungs have been turned off. There’s no more beeping or EKG activity on her monitor. She has flat-lined. When the patient goes on pump the heart is like a water balloon with the water let out. It changes in shape from full and throbbing to flat and motionless. The only way to repair Claudia’s heart is to stop it and empty it.

The first task is to examine the heart to see if the preoperative diagnosis is correct. Dr. G uses delicate instruments to retract portions of the tricuspid valve and examine the extent of the defect of the ventricular septum, the wall between the two ventricles. She determines the exact size and shape of the VSD and trims the segment of pericardium she saved earlier in preservative. She cuts miniscule pieces of the pericardial tissue and sutures them along the walls of the VSD, creating anchor points for the actual covering. Each suturing is an intricate dance of fingers and forceps, needle and thread. Dr. G works with a small, hooked needle, grasping it with forceps, inserting the needle through the tissue, releasing and re-gripping with the forceps, pulling the hair-thin suture through, using a forceps in her other hand to re-grip the needle again and repeat. The pericardial tissue being sewn over the VSD has to be secure, and it has to stand up to the pressure of blood pumping through Claudia’s heart at the end of the operation. This isn’t like repairing knee ligaments, which can rest without use and heal slowly. Claudia’s heart is going to restart at the end of this operation, and whatever has been sewn into it has to hold, and work, the first time. The VSD repair involves cautious work around the tricuspid valve, and their proximity is a concern because the valve opens and closes along the ventricular septum with each beat. Dr. G and her team find that it’s preferable to actually divide the cords of the tricuspid valve to better expose the VSD. After the patch is fully secured, the tricuspid valve is repaired.

Things don’t go as smoothly during the attempt to repair the pulmonary valve. When Dr. G looks inside Claudia’s heart she discovers that the pulmonary valve is not nearly large enough, and it’s malformed. It only has two flaps where there should be three. She repairs it by what she later says is “just putting in a little transannular patch.”

Here’s what it’s like to “just” put a transannular patch on the pulmonary artery of a child as small as Claudia:

First, take a piece of well-cooked elbow macaroni. Tuck it away in a bowl of pasta that has a bit of residual marinara sauce still floating around in it. Take several different sized knitting needles. Slowly, without damaging the macaroni, insert one of the knitting needles into it to see if you can gauge the width of the macaroni on which you’re operating. Then using a delicate, incredibly sharp blade, cut a small hole in the piece of elbow macaroni, maybe a little larger than the height of one of the letters on the page in front of you. Now use pliers to pick up a small needle with thread as fine as human hair in it. Use another pliers to pick up a tiny piece of skin that looks like it was cut from an olive, so thin that light shines through it. Take the needle and sew the olive skin on to the hole you’ve cut in the piece of macaroni. When you’re finished sewing, hook up the piece of macaroni to a comparable size tube coming from the faucet on the kitchen sink, and see if you can run some water through the macaroni without the patch leaking.

That’s the food analogy. Those are the dimensions Dr. G worked with as she patched Claudia’s pulmonary artery. She made it a little wider to give it a chance to work more efficiently, to transport more blood with less blockage, requiring less work for the right ventricle so that the built-up heart muscle could return to a more normal size. It wasn’t the repair she’d planned to make, but it was the most suitable under the circumstances, and it gave Claudia her best chance.

Before restoring Claudia’s natural circulation, the team makes certain that no air is in the heart or the tubes from the pump, because it could be pumped up to the brain. Air in the brain is not a safe thing. When all the repairs are completed, Claudia is rewarmed and weaned from the bypass machine. She was on pump for 114 minutes and her aorta was clamped for 77 minutes, not an extraordinary length of time in either case.

Claudia’s heart starts up on its own, with a strong rhythm. With her heart beating again the beeps, and the peaks and valleys on her monitor return. All is well. An echo technician wheels a portable machine into the OR and puts a sensor down Claudia’s throat where it lodges behind her heart to perform a transesophageal echo —a more detailed view than the normal, external echo. Everything looks good. Chest drains are put in to handle post-operative drainage, and wires are placed for external pacemakers, should anything go wrong with Claudia’s heart rhythm during her recovery from surgery. Dr. G draws Claudia’s ribcage back together with stainless steel wires, perfectly fastened and tightly tucked down.

Claudia and the surgical team return to the CVICU, and Dr. G monitors her reentry to the unit, making sure the nurses understand Claudia’s condition and the proper procedures to be followed for the next 24 hours. From there, Dr. G enters a small room tucked away from the noise of the unit to meet with the family. Claudia’s mother, father, and aunt are waiting. Dr. G sees Mom wiping tears away.

“Are you crying? Oh, no, no need to be crying, everything is fine.” Her wide smile reassured Mom, who put away her tissues.

She tells the family what she did, and why she did it, using a serviceable mixture of medical and lay terms.

“I got in and saw the valve and it was really abnormal,” Dr. G tells the family, “really, really small. It only had two leaflets, and that’s not good, it’s supposed to have three. So I did a little transannular patch through a mini-sternotomy, which is really good for her — much smaller scar. Her echocardiogram was beautiful. There’s no hole where we closed her VSD. We know there’s another small, little hole in the muscle, but we all agreed that because it’s in the muscle it’s going to close on its own, so we won’t worry about it. My plan is, once she wakes up later today, to get the breathing tube out.”

There is a noticeable sense of relief evident on the family faces, even though one or two of the terms may have been unfamiliar. Then, comes the caveat.

“The arteries that go to each lung are a little bit small. She’ll need to have a pulmonary valve at some point. Some people need one not so long from now. Some people go a good portion of their lifetime without needing one. My brother had this same surgery when he was little, and he still hasn’t had a new valve put in yet. But he will some day.”

The simple fact that her brother had similar surgery seems to put the family a little more at ease. They know Dr. G has been on both sides of the equation, and she can relate to their anxiety.

 

From there it was off to a brainstorming session with the architects designing new cardiac surgery suites. They wanted staff input on what should go where, how far the doors should be from the operating tables, etc. In the OR, a matter of a few feet can mean the difference between life and death.

Lunch came at 3:30, which can actually be early in Dr. G’s world. She debriefed herself from the surgery as we ate, describing to me what had taken place. She would later dictate all this for the official surgery report in medical terms such as, “The right-sided pericardium was fenestrated to approximately 1 cm anterior to the right phrenic nerve.” It may be true that “the heart has reasons which reason knows not of.” It also has a language that’s pretty hard to understand as well.

I told Dr. G this was my first time in the OR and I couldn’t believe I’d just seen a kid’s heart beating inside her chest.

“You’ve never seen that before?” she asked me.

I reminded her that I’d spent the last 30 years as a sportscaster.

“It’s not exactly the kind of thing you see in the Dallas Cowboys locker room.”

She was genuinely surprised at my sense of wonder.

The rest of her day consisted of phone calls, emails, consults with other surgeons, afternoon rounds through the CVICU (which move more quickly than morning rounds, as these are just for checking up on each patient one more time), and the never-ending battle with paperwork.

On rounds at 7:30 tomorrow morning, Dr. G will check up on Claudia to see how she’s doing. That’s assuming she makes it through the night easily. If problems develop, it’s likely Dr. G could spend the night here with her.

“We eat stress like M&Ms in here,” said Dave Bartoo, her surgical tech this day.

This is where Dr. Kristine Guleserian repairs the tiny hearts of tiny children.

Come on in.

 

 

About the Author

Mark Oristano

Mark Oristano has been a professional writer/journalist since the age of 16.

After growing up in suburban New York, Oristano moved to Texas in 1970 to attend Texas Christian University. A major in Mass Communications, Mark was hired by WFAA-TV in 1973 as a sports reporter, the start of a 30-year career covering the NFL and professional sports.

Mark has worked with notable broadcasters including Verne Lundquist, Oprah Winfrey and as a sportscaster for the Dallas Cowboys Radio Network and Houston Oilers Radio Network. He has covered Super Bowls and other major sports events throughout his career. He was part of Ron Chapman’s legendary morning show on KVIL-FM in Dallas for nearly 20 years.

In 2002 Oristano left broadcasting to pursue his creative interests, starting a portrait photography business and becoming involved in theater including summer productions with Shakespeare Dallas. He follows his daughter Stacey’s film career who has appeared in such shows as Friday Night Lights and Bunheads.

A veteran stage actor in Dallas, Mark Oristano was writer and performer for the acclaimed one-man show “And Crown Thy Good: A True Story of 9/11.”

Oristano authored his first book, A Sportscaster’s Guide to Watching Football: Decoding America’s Favorite Game. A Sportcaster’s Guide offers inside tips about how to watch football, including stories from Oristano’s 30-year NFL career, a look at offense, defense and special teams, and cool things to say during the game to sound like a real fan.

In 2016 Oristano finished his second book, Surgeon’s Story, a true story about a surgeon that takes readers inside the operating room during open heart surgery. His second book is described as a story of dedication, talent, training, caring, resilience, guts and love.

In 1997, Mark began volunteering at Children’s Medical Center in Dallas, working in the day surgery recovery room. It was at Children’s that Mark got to know Kristine Guleserian, MD, first to discuss baseball, and later, to learn about the physiology, biology, and mystery of the human heart. That friendship led to a joint book project, Surgeon’s Story, about Kristine’s life and career.

Mark is married and has two adult children and two grandchildren.

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First Chapter Reveal: Alan 2 by Bruce Forciea #cyberthriller #firstchapters

Alan 2

Title: ALAN 2
Author: Bruce Forciea
Publisher: Open Books
Pages: 278
Genre: Cyber-Thriller

A brilliant artificial intelligence (AI) scientist, Dr. Alan Boyd, develops a new program that integrates part of his brain with a computer’s operating system. The program, Alan 2, can anticipate a user’s needs and automatically perform many tasks. A large software company, International Microsystems (IM) desperately wants the program and tempts Dr. Boyd with huge sums of money, but when Dr. Boyd refuses their offer, IM sabotages his job, leaving him in a difficult financial situation.

Dr. Boyd turns to Alan 2 for an answer to his financial problems, and Alan 2 develops plan Alpha, which is a cyber robin hood scheme to rob from rich corporations via a credit card scam.

Alan and his girlfriend Kaitlin travel to Mexico where they live the good life funded by plan Alpha, but the FBI cybercrime division has discovered part of Alan 2’s cyber escapades, and two agents, Rachel and Stu, trace the crime through the TOR network and Bitcoin.

Alan 2 discovers the FBI is on to them and advises Alan and Kaitlin to change locations. A dramatic chase ensues taking them to St. Thomas, a cruise ship bound for Spain, and finally to Morocco.

Will they escape detection? They will if Alan 2’s Plan Beta can be implemented in time. Or is ‘Plan B’ something altogether different than it appears to be, something wholly sinister that will affect the entire population of the world?

Watch the trailer at YouTube!

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First Chapter:

Bang! Bang! Bang! The flimsy apartment door rattled on its frame with every blow.

“Kaitlin, don’t even think of answering that!” Alan growled through his teeth.

Kaitlin shrugged her shoulders and moved away from the door toward the living room where Alan sat at a table full of electronics gear.

“Dr. Boyd, are you home?” shouted the voice on the other side of the door in an Indian accent. “I want to talk to you. I have a very good offer. Please, Dr. Boyd, it will only take a minute, and I think you will be quite pleased with what we have for you.”

“Go away; leave us alone,” Alan shouted. “I don’t want your offer.”

“But Dr. Boyd, we do pay very well. We are great admirers of your work.”

“I don’t care and I don’t want your money,” said Alan. “Now go away before I call the police.”

“Think about it, Dr. Boyd; I will be in touch.”

“Incessant bastards,” said Alan as his attention turned back to his work. “I’ll cherish the day they leave us alone. Kaitlin, come over here and help me with this injection.”

Alan rolled up the sleeve of his t-shirt while Kaitlin picked up the syringe containing the gadolinium contrast. She pinched an ample section of skin and plunged the syringe into his arm. The needle stung like an angry wasp, causing Alan to grimace.

“Can’t you be gentle? You’ve done enough of these by now to get the hang of it. You shouldn’t jam it in like that!”

Kaitlin rolled her eyes and shook her head. “I think I do pretty well considering I don’t have any medical training,” she said while jerking the syringe out of his arm.

“Okay, okay. Just take your position at the console.”

She sighed, plopped onto a small task chair and rolled over to a makeshift wooden table holding a desktop PC and a large high-definition monitor. She had been through this process countless times before.

Alan entered a large metallic structure in the center of the living room. The box-like structure, made of aluminum, dominated the rectangular room which was devoid of furniture. Its dull silver hue contrasted the blank walls. He closed the door and climbed into a chair that looked like it came from an early Gemini spacecraft. The stiff plastic chair, sandwiched between two large metal discs, afforded a good deal of postural support but little comfort. He sat down and slowly slid his head between the thick metal and plastic arms of a large U-shaped device. There was just enough clearance as he wriggled his head to achieve the perfect position. He pulled down on a large metallic tube suspended above him so that it surrounded his entire head. He positioned the tube so that the rectangular slit lined up with his visual axis, allowing for a line of sight to the monitor located outside of the tube. The small fMRI scanner had taken a good deal of time and money to cobble together, but it was the only way to capture the needed information from his brain.

Alan viewed Kaitlin through a small round Plexiglas window in the door and signaled with a thumbs-up to begin the scan. She waved and entered the start sequence into the keyboard, sat back, slid an unlit cigarette between her lips and picked up a copy of People Magazine. He pushed his head back against the headrest and adjusted the monitor suspended on a boom so he could see the screen. The machine first hummed as it powered up and then made periodic knocking sounds.

Alan focused his attention on the monitor while the scanner began its first sequence. The monitor displayed a series of images designed to evoke emotions. Each image popped onto the screen and persisted for ten seconds before another replaced it. There was a small child holding hands with his father, a mother holding a baby, a couple admiring their child in a crib, and many more. All the images had been chosen to trigger emotional responses, causing changes in blood flow to certain areas of Alan’s brain. An image would appear for a few seconds and then the machine would complete a scan. The process repeated until all one hundred twenty-seven images had been displayed. The entire cycle then repeated two more times with random sequences of the same set of images.

This would be the final scan involving diffusion tensor imaging of Alan’s frontal lobes. Previous scans had involved the study of responses to a variety of topics. In addition to emotions such as sadness, joy, anxiety, and fear, there were cognitive studies that examined Alan’s problem solving techniques as well as his reaction to global events. In all, there were over one hundred fifty scans taken over the past two years.

About the Author

Bruce Forciea

Bruce Forciea is known for taking complex scientific concepts and making them easy to understand through engaging stories and simple explanations. He is an Amazon Best Selling Author and author of several books on healing and biology, along with science fiction thriller novels. His fiction writing draws on a diverse and eclectic background that includes touring and performing with a professional show, designing digital circuits, treating thousands of patients, and teaching. His stories include complex plots with unexpected twists and turns, quirky characters, and a reality very similar to our own. Dr. Forciea lives in Wisconsin and loves writing during the solitude of the long Northern winters.

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