The Queen of Hearts(32)
It worked. With the blood loss slowed and the anesthesiologist transfusing her, Eleanor’s vital signs began to rebound. Still, we didn’t know where the bleeding was coming from. I suspected the spleen, but it could also have been the liver. Or both.
Or maybe it was something else. I felt the first little flurries of panic trying to worm their way into my consciousness as I removed some of the packing; the lake of blood immediately repooled. I shut off my mind, silently chanting to myself. No bad thoughts, no bad thoughts, no bad thoughts. The panic receded. “It’s the spleen,” I said.
Sanjay and I worked quickly but carefully, first identifying and then clamping the blood supply to Eleanor’s macerated spleen. This improved matters, but the hemorrhaging didn’t fully stop. An hour went by, and then another one, as we painstakingly identified the little bleeders scattered around Eleanor’s belly. Thank goodness for the anesthesiologist, who was fighting as hard as we were to keep her alive.
“Send word to the Packards that we’re closing,” I said finally. “I think we got them all.”
For the first time, the atmosphere in the room relaxed. “Bless you, Dr. Colley,” said the circulator, clasping her hands prayerfully toward the heavens. “That was a hard one.” Behind his curtain, Bart Fisk, the anesthesiologist, started whistling as he clicked at his computer.
The medical student behind me shifted his weight from foot to foot, probably sick to death of just standing there. “Can I help close?” he asked.
“Absolutely not,” I said. “We are going to make this scar so pretty they’ll think plastics did it. But you can have the next drunk that comes in.”
Only Sanjay seemed unaffected by the good cheer suffusing the OR. He studied the little body in front of him. “Maybe we should leave her open,” he said.
I frowned, considering this. What Sanjay suggested—not closing the surgical incision, in favor of leaving the packing in place and the huge gaping wound covered only by skin or surgical dressings—had some considerable disadvantages. The risk of infection was higher, and we’d have to keep the child fully sedated, among other things. And it felt barbaric: the image of a tiny girl with her belly split open is not one anyone wants to contemplate, especially the child’s parents. But it offered the advantage of easy access if we’d missed anything, and we could even leave the packing in place temporarily to try to get the bleeding to stop on its own if it started again. It was a drastic effort, but it also offered protection after a catastrophic injury.
I made my decision. “We’re not going to do that,” I said. “We got this. And I don’t want to put this family through any more.”
Sanjay studied the area where we’d ligated—tied off—the biggest blood vessels. I knew what he was thinking.
“We didn’t hit the pancreas,” I said. “I’m sure.”
“Okay,” said Sanjay. I could not read his expression.
“Have a little faith in us,” I said, starting to close the first layer. “Her abdominal pressures will be fine.”
“Of course,” said Sanjay.
“You finish up,” I said. Sanjay’s closures were meticulous and beautiful, maybe even better than mine. I turned to the med student, reconsidering. “Come up here,” I offered. “You can cut sutures for Dr. Patil. You might as well get something out of standing there sterile all this time.”
“Thank you!” yelped the student.
“Don’t do anything stupid,” I told him. “Cut them exactly the length Dr. Patil tells you.”
“Yes, ma’am,” said the student, eyeing his hands warily. I made a mental note to look up his name as soon as I left the OR; for some reason, I kept forgetting it.
“Great job, everyone. Thank you,” I said to the room as I broke scrub. “Now I’m going to find the Packards to tell them their little one should be fine.”
Chapter Fourteen
NO SEX FOR SIX WEEKS
Late Summer, 1999: Louisville, Kentucky
Zadie
Some fourteen hours after my call room encounter with Dr. X, I let myself into the old house I shared with Emma, who was out. Both of us had a flair for design, and although we were impoverished medical students, we’d managed to cobble together a stylish abode, with metallic green and purple and yellow throw pillows, brightly hued quilts, framed posters of the obscure hippie sixties bands we loved, photographs of our friends scattered about, and many recently deceased plants.
It was the first time I’d been alone in almost forty hours. I wanted a moment to savor the astonishing events of the preceding long day. I’d done some actual surgery, I had survived a volley of questioning by Dr. Markham at TICU rounds—not just survived, even, but distinguished myself with coherent answers miraculously pulled out of the ether—and finally, I’d had the dizzying encounter with Dr. X.
Men in general were difficult to interpret, as every woman since the dawn of time will attest, but it was hard to know what to make of this. There was quite an unequal footing. Dr. X was a fifth-year resident, a chief; at the end of this year he would be in private practice or, more likely, in a fellowship somewhere, tacking on an extra year or more of subspecialty training. I actually knew very little about him. He was from somewhere in the Northeast, he drove a sports car of some sort, he lived in Louisville’s Highlands neighborhood, and he liked Rage Against the Machine. I had gleaned these things from casual conversation with the team, but now, with a mixture of dawning shame and curiosity, I realized he might as well have been Dr. Markham for all I knew about him.