speeds up, jolted out of its earlier, complacent cadence by Mrs. Samuelson’s heart, which has started beating faster in response to the blood now squirting ferociously into her abdomen.
“Anesthesia? I’m having some trouble here.” I try to sound calm. I know I don’t.
In response to the increased tempo of the cardiac monitor, Susan has already tossed her textbook aside and is standing up, her body tensed, perfectly motionless except for her eyes, which dart between her cardiac monitors and the video screen.
“I’m having a little trouble. We’ve got some bleeding. Pretty brisk. Probably from the IVC, maybe something else, too. I can’t tell where for sure. I think we’re having some serious volume loss here.”
Serious volume loss is euphemistic surgeon talk for bleeding like a stuck pig.
“Please call your attending now!” I call, still focused on the unchanged red image on the video screen, all the while sweeping the camera around with my left hand and futilely moving the sucker back and forth with my right. “And make sure she’s got an active type and cross!”
Susan starts working furiously, simultaneously grabbing the telephone with one hand and one of the patient’s IV lines with the other.
I try one more feeble pass with the sucker, groping this way and that, hoping that I’ll get lucky, that I’ll find the source of the bleeding, that everything will turn out okay, willing with every neuron in my brain for the blood to go away but at the same time knowing that there’s not a chance on God’s green earth that it will.
Nothing happens, of course. The absolute redness of the screen doesn’t change one iota. Presumably, Mrs. Samuelson’s blood continues to gush from the big hole I’m sure I’ve made in the biggest vein in her body and there’s nothing I can do about it.
She’s bleeding to death right before my eyes.
Raw, primal panic slams over me with the force of a sledgehammer. I freeze, staring at the video monitor in disbelief, paralyzed by what’s happening, still holding the camera and sucker but doing nothing.
The blood, inscrutable and indifferent, stares back. I suddenly wish I were somewhere, anywhere but here. I feel as if I’ve plunged over my head into a frigid, roiling, black ocean, and I’m completely disoriented and don’t know which way to swim to get to the surface.
All I want to do at this moment is drop everything and run home and hide in a closet and hope all this crap just goes away and everything goes back to the way it was before the bleeding started.
Shit, shit, shit. It’s all my fault.
“Steve!” Luis is frantically tugging at the sleeve of my gown.
My fault.
“Holy shit, Steve!” Luis screams.
My fault, my fault, my fault.
“Do something! Let’s convert! Holy shit!” He’s practically yanking my arm off now in an attempt to get my attention.
Convert.
“Convert!”
Convert?
Right. Convert.
I’ve got to convert.
Right now.
Luis has managed to pull me back into reality, to jerk me to the surface of that dark ocean, by reminding me that the only option we have at this point is to pull out all of our laparoscopic instruments and make as big an incision as possible in Mrs. Samuelson’s side so we can stick our hands inside her body and control the bleeding the old-fashioned way. To convert as quickly as we can from a minimally invasive surgical procedure to a maximally invasive one.
It’s the only shot we have at saving her life.
“Call Dr. Lassiter. Now—911!” I yell to no one in particular over Zeppelin, which is still playing in the background. “Give me a scalpel. We’re going to convert. And turn off that goddamn music!”
I quickly open all the laparoscopic valves to let the carbon dioxide out of Mrs. Samuelson’s belly. It escapes with an angry hiss, and her abdomen deflates like a popped balloon.
Luis and I start ripping the sterile sheets off so we can make a bigger incision in the skin. But the adhesive strips
“Anesthesia? I’m having some trouble here.” I try to sound calm. I know I don’t.
In response to the increased tempo of the cardiac monitor, Susan has already tossed her textbook aside and is standing up, her body tensed, perfectly motionless except for her eyes, which dart between her cardiac monitors and the video screen.
“I’m having a little trouble. We’ve got some bleeding. Pretty brisk. Probably from the IVC, maybe something else, too. I can’t tell where for sure. I think we’re having some serious volume loss here.”
Serious volume loss is euphemistic surgeon talk for bleeding like a stuck pig.
“Please call your attending now!” I call, still focused on the unchanged red image on the video screen, all the while sweeping the camera around with my left hand and futilely moving the sucker back and forth with my right. “And make sure she’s got an active type and cross!”
Susan starts working furiously, simultaneously grabbing the telephone with one hand and one of the patient’s IV lines with the other.
I try one more feeble pass with the sucker, groping this way and that, hoping that I’ll get lucky, that I’ll find the source of the bleeding, that everything will turn out okay, willing with every neuron in my brain for the blood to go away but at the same time knowing that there’s not a chance on God’s green earth that it will.
Nothing happens, of course. The absolute redness of the screen doesn’t change one iota. Presumably, Mrs. Samuelson’s blood continues to gush from the big hole I’m sure I’ve made in the biggest vein in her body and there’s nothing I can do about it.
She’s bleeding to death right before my eyes.
Raw, primal panic slams over me with the force of a sledgehammer. I freeze, staring at the video monitor in disbelief, paralyzed by what’s happening, still holding the camera and sucker but doing nothing.
The blood, inscrutable and indifferent, stares back. I suddenly wish I were somewhere, anywhere but here. I feel as if I’ve plunged over my head into a frigid, roiling, black ocean, and I’m completely disoriented and don’t know which way to swim to get to the surface.
All I want to do at this moment is drop everything and run home and hide in a closet and hope all this crap just goes away and everything goes back to the way it was before the bleeding started.
Shit, shit, shit. It’s all my fault.
“Steve!” Luis is frantically tugging at the sleeve of my gown.
My fault.
“Holy shit, Steve!” Luis screams.
My fault, my fault, my fault.
“Do something! Let’s convert! Holy shit!” He’s practically yanking my arm off now in an attempt to get my attention.
Convert.
“Convert!”
Convert?
Right. Convert.
I’ve got to convert.
Right now.
Luis has managed to pull me back into reality, to jerk me to the surface of that dark ocean, by reminding me that the only option we have at this point is to pull out all of our laparoscopic instruments and make as big an incision as possible in Mrs. Samuelson’s side so we can stick our hands inside her body and control the bleeding the old-fashioned way. To convert as quickly as we can from a minimally invasive surgical procedure to a maximally invasive one.
It’s the only shot we have at saving her life.
“Call Dr. Lassiter. Now—911!” I yell to no one in particular over Zeppelin, which is still playing in the background. “Give me a scalpel. We’re going to convert. And turn off that goddamn music!”
I quickly open all the laparoscopic valves to let the carbon dioxide out of Mrs. Samuelson’s belly. It escapes with an angry hiss, and her abdomen deflates like a popped balloon.
Luis and I start ripping the sterile sheets off so we can make a bigger incision in the skin. But the adhesive strips
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