problems than this one.”
When Tyler didn’t answer she added, “Like the Nike ads used to say … just do it.”
4
“S LICK … VERY SLICK. Where did you learn that one?”
Tyler glanced up. Michelle was peering over the drape at him. “Surgery 101. Apply pressure, wait, and try to strike a bargain with God.” He made no attempt to hide the huge relief from his voice. He used saline to irrigate the cavity where the tip of Larry Childs’s temporal lobe had been. He stopped irrigating and waited for the bubbles to clear. The water remained free of blood this time. “Time to play hockey.”
Michelle laughed. “Watch it, Tyler. You’ll ruin your image.”
Tyler held out his hand to the scrub nurse. “Load me up with dural silks and keep them coming as fast as you can.” Then to the anesthesiologist, “What image is that?”
“Doctor Dour. Surgeon Serious. The man who doesn’t joke around in the OR.”
Suture accepted, Tyler began the first stitch. I haven’t always been like that , he mused. It wasn’t like that when I was with Nancy.
T WENTY MINUTES LATER Tyler leaned over to inspect Larry Childs in the recovery room. The area was populated with only a few stragglers from end-of-the-schedule cases. “He’s not waking up. You given him anything since the OR?” After helping to load Larry Childs onto a recovery room stretcher, he’d ducked into the dressing room to dictate an op note. Now, standing over his patient, he tried again to evoke a response by pinching the skin over his chest. Nothing.
Michelle Lawrence, sitting at a stainless steel counter between two patient bays glanced up from the computer terminal she was typing on. “Give him anything? Heavens no. I ran him the last hour on just nitrous and oxygen.” She began playing with the mask still hanging around her neck.
“Good.” Tyler preferred his patients awake soon as possible after the end of the case so he could examine their brain function. Tyler continued to examine Larry in more detail.
The endotracheal tube was out and the kid was breathing on his own, so at least that much was okay. Tyler gently opened Larry’s eyelids. The left pupil remained dilated, the eye deviated to the left. No worse than pre-op but still a sign of damage to the third cranial nerve—probably from the shift of the temporal lobe before he decompressed it. The right eye also appeared to be the same as pre-op. Tyler rocked Larry’s head side to side. The left eye didn’t move, but the right did. Next, he pulled the cotton tip of a Q-tip into a wisp, which he used to gently brush each cornea. Both eye lids blinked a weak response. Larry’s respirations, however, were Cheyne Stokes. Abnormal, signifying a poor connection between the brainstem and cortex.
“Doctor Mathews?”
The RN assigned to Larry drifted over from her other patient. She wore a blue scrub suit with a gray hospital-issue stethoscope draped around her neck.
“Yes?”
“The family’s been increasingly inquiring about Larry’s condition for the last hour. They seem quite anxious. When can I tell them you’ll be down to talk to them?”
He’d become familiar with the various family members during discussions leading up to Larry’s enrollment in the radiation trial. He didn’t want to deal with Larry’s antagonistic sister right now.
“I’ll call down and talk to them. I don’t want to go face to face with his sister until I have a better idea how soon it’ll be before Larry wakes up.”
She seemed to accept this but wasn’t happy with his plan.
Tyler glanced at the anesthesiologist. “Hey Shellie, you interested in grabbing a bite before the cafeteria closes?”
The anesthesiologist checked her Swiss Army watch. “Sure. I have enough time. There’s a potential C-section cooking upstairs, but if we go now …” She slipped off the stool.
An idea hit. “Hold on a sec. Want to check something first.” He took the stool Michelle just vacated and logged onto
When Tyler didn’t answer she added, “Like the Nike ads used to say … just do it.”
4
“S LICK … VERY SLICK. Where did you learn that one?”
Tyler glanced up. Michelle was peering over the drape at him. “Surgery 101. Apply pressure, wait, and try to strike a bargain with God.” He made no attempt to hide the huge relief from his voice. He used saline to irrigate the cavity where the tip of Larry Childs’s temporal lobe had been. He stopped irrigating and waited for the bubbles to clear. The water remained free of blood this time. “Time to play hockey.”
Michelle laughed. “Watch it, Tyler. You’ll ruin your image.”
Tyler held out his hand to the scrub nurse. “Load me up with dural silks and keep them coming as fast as you can.” Then to the anesthesiologist, “What image is that?”
“Doctor Dour. Surgeon Serious. The man who doesn’t joke around in the OR.”
Suture accepted, Tyler began the first stitch. I haven’t always been like that , he mused. It wasn’t like that when I was with Nancy.
T WENTY MINUTES LATER Tyler leaned over to inspect Larry Childs in the recovery room. The area was populated with only a few stragglers from end-of-the-schedule cases. “He’s not waking up. You given him anything since the OR?” After helping to load Larry Childs onto a recovery room stretcher, he’d ducked into the dressing room to dictate an op note. Now, standing over his patient, he tried again to evoke a response by pinching the skin over his chest. Nothing.
Michelle Lawrence, sitting at a stainless steel counter between two patient bays glanced up from the computer terminal she was typing on. “Give him anything? Heavens no. I ran him the last hour on just nitrous and oxygen.” She began playing with the mask still hanging around her neck.
“Good.” Tyler preferred his patients awake soon as possible after the end of the case so he could examine their brain function. Tyler continued to examine Larry in more detail.
The endotracheal tube was out and the kid was breathing on his own, so at least that much was okay. Tyler gently opened Larry’s eyelids. The left pupil remained dilated, the eye deviated to the left. No worse than pre-op but still a sign of damage to the third cranial nerve—probably from the shift of the temporal lobe before he decompressed it. The right eye also appeared to be the same as pre-op. Tyler rocked Larry’s head side to side. The left eye didn’t move, but the right did. Next, he pulled the cotton tip of a Q-tip into a wisp, which he used to gently brush each cornea. Both eye lids blinked a weak response. Larry’s respirations, however, were Cheyne Stokes. Abnormal, signifying a poor connection between the brainstem and cortex.
“Doctor Mathews?”
The RN assigned to Larry drifted over from her other patient. She wore a blue scrub suit with a gray hospital-issue stethoscope draped around her neck.
“Yes?”
“The family’s been increasingly inquiring about Larry’s condition for the last hour. They seem quite anxious. When can I tell them you’ll be down to talk to them?”
He’d become familiar with the various family members during discussions leading up to Larry’s enrollment in the radiation trial. He didn’t want to deal with Larry’s antagonistic sister right now.
“I’ll call down and talk to them. I don’t want to go face to face with his sister until I have a better idea how soon it’ll be before Larry wakes up.”
She seemed to accept this but wasn’t happy with his plan.
Tyler glanced at the anesthesiologist. “Hey Shellie, you interested in grabbing a bite before the cafeteria closes?”
The anesthesiologist checked her Swiss Army watch. “Sure. I have enough time. There’s a potential C-section cooking upstairs, but if we go now …” She slipped off the stool.
An idea hit. “Hold on a sec. Want to check something first.” He took the stool Michelle just vacated and logged onto
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