Raney & Levine by J. A. Schneider Page B

ruptured ectopic pregnancy - a serious emergency – had
     just been brought in. Added to the two women in labor, suddenly everyone available
     was needed.
    “Can I help with the ectopic?” Ortega asked. “I’ve never
     seen one.”
    David’s face was tight. “Wait. I need two of you for the
     first delivery, and two for the second. First one looks routine but is further
     along. Lemme see…” He was scrolling his schedule. “Trish and Ramu are where?”
    “Clinic,” Woody Greenberg said. “You sent them.”
    “Oh…yeah, I’m distracted.” David shot Jill a glance. “Okay,
     Gary? Help MacIntyre, he’s already with the first one. Jill, check the second
     one’s status in labor room three, and call George Mackey. He’s probably
     sleeping, and if he yells, ignore, stay sweet.” David flipped the second
     patient’s chart page, his brow creasing. “This is odd, re-check her urine for
     albumin.”
    Jim Holloway, second year resident like Sam, came running
     up. “You called about an ectopic?”
    “Ruptured,” Woody told him.
    “I’ve only seen it done once,” Jim said.
    “Learning time,” David said, looking at Woody and Holloway.
     “You two go scrub, fast. Phipps - change, you scrub for the ectopic too, Sam
     can manage the routine one, he’ll probably just need a catcher’s mitt.
    David fast-glanced at Phipps, Holloway, and Greenberg.
     “Okay, crew, see you in OR 4.”
    He touched Jill’s arm as the others moved off. “You okay?”
    “No.”
    He exhaled. “Listen,” he said low. “The second you get in
     there you’ll see a new life on its way and you’ll get right into it. It will
     take your mind off the other thing.”
    She smiled weakly. “That ectopic sounds bad.”
    “It’ll take longer. I’ll call you when we’re done.”
    Minutes later David, his two residents and an intern, were
     all in the OR, scrubbed and gowned. The patient was already anesthetized, the
     anesthesiologist busy adjusting her intubation and the right amount of
     anesthetic. The others took seconds to peer at the ultrasound of her lower
     abdomen and pelvis in the view box.
    “Refresh me on why ectopics happen?” Phipps asked.
    “You sleep through that lecture?” Woody groused.
    Holloway spoke fast. “Fertilization happens in one of the
     two fallopian tubes. If the tube is scarred from some infection, the fetus gets
     stuck there and grows…”
    “Fetus is just a few weeks old, nonviable.” David eyed the
     bulge in the pencil-diameter fallopian tube. “This must have been incredibly
     painful.”
    He turned back to the operating table.
    “Hemoglobin and hematocrit taken?” he asked the charge
     nurse. She answered yes, read the results from a lab sheet, and said two units
     of blood were coming.
    “Tell them to hurry, we may need to transfuse.”
    Beeping suddenly speeded from the patient’s monitor, and
     then a high, thin alarm lasting ten seconds.
    “BP down to 80 over 50, pulse up to 130,” Woody said,
     frowning at the monitor.
    “Oh shit, internal hemorrhage.” David took a scalpel from
     the scrub nurse. Phipps finished placing sterile towels around the incision
     area, and Holloway finished painting it with antiseptic.
    “BP 70 over 40, pulse 96!” Woody piped.
    “Get the blood here,
” David snapped.
    “It’s coming, it’s coming,” from someone.
    He barely heard. Made a quick incision in the left lower
     quadrant of the abdomen, and saw blood well up.
    The clock on the wall read 1:55.

18
    T he second delivery came faster than expected, no
     complications. It was a boy. And a thrilled mother. And two surprised interns,
     Jill and Tricia, who had finished clinic early and come up to help. Suddenly
     the two had free time on their hands. George Mackey just wanted to go back to
     sleep.
    “Bed, bed,
bed
,” Mackey groaned trudging into the
     scrub room, pulling off his cap and surgical gown, dumping them into the
     laundry bin.
    Tricia, entering behind him said,