Rescheduling the outdoor rounds for the evening, Caroline rushed to the scrubbing area and started washing her hands for an emergency operation. Her mind enumerated the steps in the back of her head because she was going to do 'Surgical Ventricular Restoration' without senior assistance.
Not that she hadn't done procedures, but Ventricular Restoration was one of the most complicated heart surgeries, and she had always performed it alongside Dr. Van. The surgery was initially scheduled for the day after, but it couldn't be delayed further as the patient suffered his second stroke.
Entering the OT, she checked for all the medicines beforehand, wanting not to leave any room for error like the last time. Ten minutes into the surgery, she had successfully opened up the patient's chest and was doing scar assessment when the OT emergency phone rang.
Erica picked up the phone immediately, and from her face, Caroline could read that the news wasn't ominous.
"What happened?" she asked while checking for the damages in the atrium.
"Emergency case, Caroline."
"Critical?"
"Yes - Code Blue. Needs immediate surgery."
"Heart condition?"
"Twelve-year-old girl with a rod lodged in her chest and stomach."
"You got to be kidding me." Caroline mentally calculated the amount of time needed for the current surgery. But speeding up anything here might lead to a mistake. She was in no mood to put two lives at stake.
"General Surgeon is tending to her, but they need your help as Dr. Van will take another two hours to reach here."
'Two hours. In two hours, that girl would go into cardiac arrest.'
She had to find a way.
"Can't the paramedics route her to City Hospital?"
Erica tried to enquire the same over the phone and then turned towards Caroline. "There is way too much blood loss. Going over there would take a minimum of 10-15 minutes more."
"OK, contact City Hospital and get their cardio-surgeon, Dr. Rothman, as fast as possible. Our GS can handle her in the meantime. You can put the request in my name. They will prioritize. Meanwhile, set another bed here and bring in the girl."
"You will handle both surgeries, Caroline?"
"Do I have a choice?"
Within five minutes, the doors of the OT opened, and that little girl was brought in. The general surgeons were working on stabilizing her to remove the rod from her stomach first. But there was an immediate risk of cardiac failure and infection as the CT scan showed a massive blood clot on the left side of her chest. The iron rod was lodged close to major blood vessels.
At that moment, the rod was actually helping control the bleeding as it was creating pressure. But once taken out, it could prove fatal. Caroline knew what was at stake, and it pained her to be that helpless in that situation.
After an ordeal of twenty minutes, when the General Surgeon slowly started removing the rod from her stomach, her vitals began tanking.
'Beep'
'Beep'
She was going into cardiac arrest.
A worried Caroline turned back. Things were not looking good for her heart, but she couldn't leave this man's chest open either. The second-year assisting residents couldn't do it on their own.
"Inject vasodilator - 1mg," she immediately instructed and started moving her hand as fast as she could to complete the surgery. But unfortunately, the vasodilator couldn't do much.
"Vasodilator not helping doctor. Rhythm is still unstable," a worried Erica replied, but just then, the OT door opened and coming inside, Elora announced, "Dr. Rothman is here."
Caroline breathed a sigh of relief. She could now focus on her surgery as Dr. Rothman was an equally skilled cardiac surgeon. Once inside, he took command of the situation.
"Amiodarone - 300 mg rapid bolus." He instructed as soon as he reached the vital monitor. That immediately helped and as soon as the beeping stopped Caroline could finally breathe in relief. She tilted her head a bit to share an acknowledgment glance at Dr. Rothman, but he had his back facing her.
"We will deal with the rod in her chest first. Her heart needs strength to survive the second operation," she heard him speak, but his voice sounded ... sounded different.
'Maybe it's the mask.'
Ignoring her thoughts she focused back. Quickly checking her condition Dr. Rothman requested four more bags of blood and started marking her chest for the procedure. From the corner of her eyes, she saw him lightly touching her chest and saying, "We are going to save you. Fight with us."
And Caroline paused, for that voice sounded familiar and those words… Those were the exact words that her father used to say before every surgery that he did.
But it was not the time to be nostalgic, so she refocused all her attention back.
As she was irrigating, she heard the general surgeon exclaim. "How is that possible? I had seen a blood clot and a vessel rupture in the image with my own eyes."
That caught her attention. She gently tilted her head and looked at the monitor. The chest of the girl was open, and only her left lung had been punctured and there was no impact on her heart.
Without saying anything, Dr. Rothman immediately placed a chest tube to make sure that blood or air did not collect in her chest, and following suit, the general surgeon helped to put her on nasal prongs with oxygen.
Something was definitely off about this.
Jerking her head, Caroline pushed all her speculatory thoughts away.
Caroline got busy closing the chest in layers with near perfection, but she could clearly hear that the operation next to her was going on smoothly.
'Mr. Rothman to the rescue!'
Soon they moved on to repairing her perforated stomach and Dr. Rothman assisted the general surgeon this time.
.
.
'Cut'
Caroline said as she finished suturing up her patient and turned around to check on the girl. Her stomach was being sutured up and a smile etched on her face seeing her vitals in the normal range.
"Thank you, Dr. Rothman. You have been God send." But he didn't turn. So Caroline checked the monitor. Dr. Rothman was focused on doing buried sutures. A smile crept on Caroline's face as that won't leave a large scar later. Time taking nonetheless.
She wasn't offended by his silence. Being a surgeon herself she knew how much focus one needs sometimes. So she walked out of the OT after giving out all the necessary instructions to the resident doctor.
Once she got cleaned up, she went to the ICU to discuss the case with the ICU in charge. While returning, as she was crossing the OT area, she saw Dr. Rothman coming out from the OT, and she wondered.
'Has he become taller?'
But then Erica called her, and she turned to sign a few documents and when she turned back Dr. Rothman was nowhere to be seen. She looked around but was interrupted by a phone call.
"Hello!"
"Is this Dr. Caroline, from Seattle High?"
"Yes, that's me. This is regarding?"
"Dr. Caroline. I am calling from City Hospital. We are sorry but Dr. Rothman won't be able to make it. While leaving for your hospital he had a minor car accident. He told me to inform you as soon as possible. His leg is…"
But Caroline couldn't hear a word after that. She was hating connecting the dots. That voice. his height, him not reciprocating, and the clot. She was not liking where her suspicion was drifting to.
Turning towards Erica she asked, "Where is Morpheous?"
Creation is hard, cheer me up!
Come on Guys! Pour in votes. Lets break under 200 rank barrier. We will celebrate with a mass release. I promise.