When the Air Hits Your Brain: Tales from Neurosurgery by Jr. Frank Vertosick Page B

type O in case she crashes. What’s her pressure now?”
    “Ninety over sixty.”
    “Force in another liter of lactated Ringer’s as fast as you can and get the X-ray people in here.”
    I called the CT technician to let him know that we needed an urgent brain scan. A physician must wake up a lot of people in the middle of the night and attempt to engage them in meaningful conversation.
    “Hello,” a dreamy voice answered.
    “Are you the CT technician on call?”
    “Hello?”
    “IS THIS THE CT TECH ON CALL?”
    There was a pause and the rustling of bedsheets. Christ, I thought, he’s falling asleep. The previous month, a tech had dropped the phone on the floor while I was talking to her and gone back to sleep. I had to send the police to get her.
    “…Uh, is this the hospital?” The tech was barely conscious.
    “No,” I replied, “it’s Ed McMahon calling you from Publisher’s Clearinghouse. You have just won one million dollars. And, by the way, I’ve got a trauma here in the ER and I need a scan now.”
    “OK.”
    It wasn’t a convincing okay, more like the okay of someone who was slipping back into slumberland, to awake in four hours wondering if the hospital had really called or if he’d just had a nightmare. I called again ten minutes later and was informed by his irate wife that he indeed was on his way.
    Perhaps I was a little rude, but I didn’t care. I now knew how James Bond must feel when he thinks he’s saving the world from certain destruction. Politeness and civility are sacrificed without a trace of guilt. As the earth teeters on the brink of nuclear holocaust, Bond runs through a crowded airport knocking people flat, kicking over their luggage and spilling their drinks—all without so much as an “Excuse me.” He’s not rude; he’s a hero on a mission. He can grab people by the throat, hold a gun to their heads—anything to get the job done. I can say: “Get your ass out of bed and scan this lady BEFORE SHE DIES.” In the end, all is allowed, all is forgiven. We do what we have to do. Results, not effort.
    Shirley’s blood pressure began to rise and stabilize. The intern had finished closing her scalp and the X-ray technicians were setting up to take chest, neck, and abdominal films.
    “Shirley, are you still there?” I asked.
    “Yes, but my head hurts. Am I going to die?”
    “No. Too much paperwork if you die. We’re going to take some X-ray films.”
    “How’s Jack? I want to see him.”
    “Uhmmm…he’s not here right now. They took himsomeplace else.” A diplomatic response. She was in no condition to learn that her friend had been guillotined. Bill and I retreated to the small coffee lounge, where we feasted on a box of vanilla wafers stamped “For Institutional Use Only.” I had gained twenty pounds in three months on the boss’s service from eating vanilla wafers washed down with chocolate milk and was becoming an “institution” myself, at least in terms of body habitus. The coffee was a day old, but we drank it anyway for its medicinal properties.
    “This is just fucking great,” Bill complained. “I have a Whipple to do tomorrow and I’m going to be totally fried. We get a Whipple about twice a year.” An operation for pancreatic cancer, the complicated Whipple procedure was something that the general surgery residents slather over.
    “At least you may be able to go back to bed soon,” I countered, “but she’s got the gray matter coming out of her head. She’s going to need a craniotomy if she doesn’t croak first. And the boss has all four of our OR’s booked at seventhirty. If he gets bumped by this case he’ll blow a fuse.”
    I glanced at my watch. It was now three-thirty. My mind turned to those bureaucratic dilemmas which consume so much of a resident’s time and energy. There was no way I was going to get Shirley scanned and complete a craniotomy fast enough to avoid delaying the boss in one of his rooms. Tomorrow was his squash