Under the Knife(35)

She squeezed her eyes shut, then opened them, as if for the first time that day. What the hell was she doing here, anyway, trying to talk Chase into doing something she didn’t want to do? Something that would put a patient at terrible risk? She knew she shouldn’t operate. So why were they even having this conversation?

Rita tugged at her left ear.

“No,” she said aloud to Finney.

The word was loud in the small alcove.





SPENCER


Spencer’s patient eyed him up and down.

“You a prayin’ man, Doc?” he rumbled. A rancher—third-generation, he often reminded Spencer—from the arid mountains east of San Diego, he had a big barrel chest and even bigger voice.

“As a matter of fact, I am, Mr. Bogart,” Spencer replied. He was standing over the man’s gurney in the pre-op area.

Bogart’s craggy face broke apart into a wide grin. “I knew it. You look like the prayin’ type. I can always tell. Episcopalian?”

“Presbyterian.”

“Close enough. Come on, then, son. We don’t got all day.” He reached up a rough, meaty paw, and Spencer took it. He had thick calluses, and the feel of it matched the look of Bogart’s face.

“Sheila?” Bogart offered his other hand to the woman standing next to the gurney.

She was his sister, as small and mousy as her brother was large and burly. She stepped forward wordlessly, and Mr. Bogart’s hand swallowed hers.

“Sheila’s a pastor in our church,” he explained.

Bogart’s wife had passed away last year. “Goddamn pancreas cancer ate her to the bone,” he’d growled during their first meeting. “Never smoked or drank a day in her life. Pesticides, Doc. It was those goddamn pesticides. Always knew those things caused cancer. Government knew, but wouldn’t tell us. Goddamn feds. Guess it’s my turn now, huh, Doc?”

“We don’t know that, Mr. Bogart,” Spencer had replied carefully. But Spencer was in fact pretty sure that yes, indeed, it was Bogart’s turn. Spencer could read a brain MRI as well as anyone, and based on Bogart’s, he was almost certain that he had a glioblastoma multiforme—about as bad as it got in the brain-cancer department. Chances were he’d be joining his wife within about eighteen months, no matter what Spencer did. In fact, Spencer wasn’t planning on cutting out his tumor: it was too deep and too close to too many important structures that, if damaged, might leave him a vegetable for his remaining days. Spencer’s goal today was simply to get a biopsy.

Sheila the sister grasped Spencer’s free hand. He could barely feel it. It was like holding hands with a two-year-old. The three of them bowed their heads, closed their eyes, and Sheila began to pray in a clear, strong voice: the usual stuff, invoking God and the Lord Jesus Christ to guide Spencer’s hands during the surgery. Spencer had heard variations on it many times.

He knew that an outside observer might not appreciate the importance of ritual in a surgeon’s mind. But as a surgeon, he’d learned not to underestimate the power of ritual. Habit and ritual were calming to surgeons: provided reassurance and confidence, reinforced a sense of control. Spencer had colleagues who would operate only in rooms corresponding to their lucky numbers, or only on certain days of the week; or always wear the same pair of shoes while operating; or insist on using the same type of suture, sewn in the exact same pattern, with the same number of knots, when other sutures and patterns and knot numbers would have done just fine.

Since Spencer ultimately placed his faith in God, his own ritual was to cross himself and mouth a short prayer before each operation. All his operations: big and small, straightforward and complex, because he knew that, from a patient’s perspective, there was no such thing as a little or simple operation.

Spencer never prayed openly in front of patients or the OR staff unless patients like Bogart invited him to join them. He otherwise hid in one of the OR supply rooms. This was in part because he didn’t want to offend folks of other faiths or of no faith at all.

But it was mostly because, as a surgeon, he knew that one of the surest and quickest ways to invoke a crisis of confidence among patients and staff was to demonstrate the need for the intervention of a higher being. After all, could he imagine wanting to board an airplane after watching its captain perform the sign of the cross at the gate? Or don a yarmulke and recite Hebrew prayers? Or kneel on a carpet in the direction of Mecca? No way.

Praying: that’s how he’d met Rita.

Not that Rita was religious. She wasn’t. Not in the least. She’d never given religion any real thought, ever, despite her having lost two parents at a young age. She didn’t even know if she was an agnostic or atheist. She didn’t care, and Spencer hadn’t minded. Lack of faith had never been a deal breaker for him when dating women. He’d come across more than his share of women who professed faith but actually had none, or who did but expressed it in ways he found weird, disturbing, or both.

She’d spotted him praying one morning before an operation, almost two years ago, crouched behind tall racks of equipment in the supply room.

“What are you doing?” she’d asked, as he’d stood up and crossed himself. She hadn’t been confrontational, just curious. That was Rita. She didn’t explain to him, then or later, what she’d been doing back there in the otherwise empty supply room, and for some reason he’d never asked.