Operation Neurosurgeon

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Operation Neurosurgeon Page 10

by Barbara Ebel


  Danny selected appetizers here and there, enough to pass for a light dinner, as Rachel slid slivers of cake onto two plates. She handed Danny one after he finished. On the far side of the room, Harold mingled, but looked for his colleagues.

  “Let’s switch,” Danny said. “I think the rose-adorned slice is yours. It’s the least I can do.” He trailed off with his gregarious laugh as Rachel’s eyes held.

  Harold weaved his way through hospital staff and acknowledged Danny. “I’ll see you over there at the meeting,” he said.

  Danny and Rachel both threw their plates in the trash. “See you in the OR,” he said.

  “I’m leaving too. I don’t like walking across that busy street to the employee parking lot, however. It seems like every month another pedestrian gets hit, especially after hours.”

  “My car is right out here and I’ll be re-parking in the doctor’s lot on the northeast corner. I’ll drop you off. After all, I wouldn’t want you on my operating room table tonight.”

  She jabbed his arm and kept up with his long stride. “Dr. Tilson, what a lovely thing to do. We couldn’t have me get hit anyway, because then, who would scrub for you?”

  Danny opened his Lexus door for her and threw a newspaper and empty coffee cup in the back seat.

  “Thank you, Dr. Tilson.”

  “Please call me Danny.” He went around the other side, slid behind the wheel, and sprang his engine to life. She looked like a trophy from a luxury car commercial. She had elegant long fingers, her hands resting on a petite shoulder bag perched on her crossed legs.

  “Will you be discussing OR block time at your meeting?” she asked.

  “Probably. We address it briefly every month.”

  “Dr. Tilson, I mean, Danny, it seems to me that you and your two colleagues could schedule block time more effectively.”

  “I’m listening,” he said. “Do you have a suggestion?”

  She uncrossed her legs and edged sideways. Never before in Danny’s car had a front seat passenger felt that close.

  “Right now, the three of you have three half days blocked for your cases. Two of those days include two rooms. But sometimes when your block time ends at one p.m., you can’t start a new case at say, twelve, because it would run into the next surgical specialty’s time.”

  Danny nodded, creeping through rows of parked cars.

  “Well, if you traded in at least two half days for a full day, you’d have less wasted time, or down time. Between the three of you, cases in that room would flow. And with the amount of business the three of you have, I don’t see how the hospital wouldn’t allow it. It would just mean rearranging the present schedule.”

  “No surgeons have been given a full day before,” Danny commented.

  “No one has tried since the new OR’s were finished last year. Plus, even for the neurosurgery equipment your group uses, it would be easier for the OR staff.”

  Danny rolled her idea around. It would mean rearranging the office schedule also, but that wouldn’t be a big deal. “Hmm. I’ll discuss that with my partners and toss it around at our meeting.”

  Danny went through the intersection then slowed into the employee’s parking lot. Rachel pointed to a back aisle and Danny stopped behind her vehicle.

  “Nice CRV.”

  “It’s configured for my Chessie.”

  “What do you mean?” Danny asked, not being able to see through the tinted back window.

  “The back seats are folded down and a large rubber mat covers the back. I’ve never been married and don’t have kids so I give the space to my big dog.”

  “Ahh. Yes. Your working therapy dog.” Danny searched for his name. “Dakota.”

  Rachel’s smile broadened. “You remembered,” she said softly, slowly. “Thank you, Danny, for your courtesy. For the lift, that is.” She leaned over the middle console to plant a momentary kiss on his cheek. Danny turned his head as the left side of her moist lips landed on the side of his mouth, startling him.

  She got out and flashed a smile.

  ________

  Danny tried not to make noise opening the conference room door. The meeting had started; he had no valid excuse for being late. He signed the attendance sheet and joined Bruce and Harold in the back of the room. Bruce scowled at his tardiness, so Danny waited to ask him in a whisper his opinion about an extra-long OR day. Bruce liked the idea and by the end of the meeting, a genitourinary surgery group considered trading slots. Later they would discuss it with the OR committee, which was as good as a done deal.

  ________

  “Wait for me, Mom,” Annabel said as she laced a new pair of Nike’s.

  “You’re serious,” Sara said.

  “I told you when school finished I would run with you.”

  “This is going to be fun. Your age will compensate for my experience. But I thought you canned the baseball cap so as to be less of a tomboy.”

  “But you’re wearing one, too, Mom. While I run or fish, it’s allowed.”

  “You’re right, sweetheart. We’ll keep the rays off our sun-sensitive skin but absorb the vitamin D.” Sara opened the back door, stepped to the porch rail and stretched. She was glad for the sunshine and weather getting warmer; if she had had to face a bleak winter after Melissa’s death, she didn’t know how she would’ve survived.

  Nancy sat rocking, holding her first summer book. “Have fun,” she said, looking at Annabel. “I bet Mom will beat you.”

  “I don’t know about that, but I know I could beat you.”

  “You wish. Like everything else.” She stuck her tongue out.

  Past the brush line, twigs crackled with the fleeing of a single deer as Sara stepped down the steps. The hummingbird and finch feeders whirred with activity; the flighty gluttons hovered in mid-air and the finches pinched seed between their beaks and stole away. She had overstuffed a feeder deep in the yard, hanging from a tree hook, which was attracting a variety of species. Tree-clinging red-bellied and redheaded woodpeckers ran up and down the tree busily grabbing black oil sunflower seeds. They were easy to see without binoculars from the house. She marveled at the detail of a full bellied male scurrying up the trunk, proudly holding a single seed in its beak.

  “Mom, if I like running and practice with you all summer, I could join a track team in college.”

  “Are you thinking about college already?”

  “A little. I haven’t told you or Dad, but I may want to be premed or prevet.”

  “That’s a big commitment,” Sara sighed. “You have plenty of time to think about it.”

  “Mom, so does Nancy.”

  Sara secretly would dislike it if either girl embarked on the difficult career choice of being a physician. She wanted Annabel and Nancy to have worthy professions, but not give their lives to them. Life was too short. Danny’s training had taken forever. However, she would support her daughters if that’s what they wanted. They rounded the street corner and jogged in the middle of the street to avoid parked cars and trucks. The construction workers building a nearby house had nowhere to park except on the side of the road.

  “How far we going to run?” Annabel asked.

  “Just a few miles.”

  Annabel caught the flirty glance from the foreman’s young son and hastened her pace to show off. She avoided further conversation with her mother; something about talking made it easier to lose her breath.

  ________

  Casey had to work Saturday night so he declined a Friday night poker game to take Mary out instead. Casey and Mary ordered Thai curry and rice and decided to skip a movie. They kept unveiling silly or surprising things about each other and those discoveries were better than any Hollywood story. Mary confessed she clued her parents into searching for Danny and Casey when they were fifteen years old and were sneaking cigarettes in the back yard. Casey had often slept over and Mary had woken her parents from sleep one night by pretending to be sick. Casey admitted to Mary that he and Danny had hidden her fishin
g pole when she was little, preventing her from tailing them to their fishing pond.

  At Mary’s, they slouched on porch lounge chairs after returning from the restaurant. Casey opened a bottle of wine. Sipping slowly, they appreciated the lush view over the hills. It had been a wetter spring than the last two; thick carpets of green grass blanketed the areas between Donna’s trees.

  “Do you still employ the same gardening crew your mom and dad used?” Casey asked.

  “For some things. They’re fantastic. It’s as if they remain loyal to Mom and Dad.”

  “There are two dead trees down there,” he said. “Your dad has a chain saw around here. I can cut them down for you one of these days.”

  “I’d appreciate that.” Mary slipped her sandals off. “I suppose it’s official. Barefoot with wine in Tennessee.”

  “Why is that official?” Casey tipped the bottle and poured into her stout glass.

  “I let my friend in Alaska rent with an option to buy. We confirmed her purchase this week. And she’s also buying my boat.”

  “Are you sure that’s what you want?”

  “I’m sure. It’s important that I continue to monitor Dad’s finances and affairs. And I can’t justify selling this place, either. It’s too big for me, but for the time being, it’s where I belong.”

  “Danny appreciates what you’re doing. But he’s not the only one who admires you.”

  “Really?” Mary edged forward, wondering what he would say.

  “You make a wonderful aunt to Annabel and Nancy.”

  “Is that all?”

  “You make a pretty good date.”

  She pouted, pretending to be hurt. “Like I said, is that all?”

  Casey left his chair and sat on the edge of hers. “I’m sorry.” He took her hand. “You are by far the easiest to talk to, and the loveliest woman that I have ever dated.”

  “And you are the most sure-of-yourself conceited male I’ve ever dated.” She met his glance, a big smile erupting. “Who is somehow unsure of himself with me.”

  Casey growled a masculine rumble, placed her wine on the aluminum patio table, and enveloped her in his arms. He kissed like a bottomless abyss, making them forget the day, the time, the place. When they surfaced, they eased off the chair. Mary left her sandals, tiptoed alongside him into the house, peeled off a vest, and dropped it on the counter. Casey unbuttoned his shirt on the way up the stairs, and Mary’s lavender skirt slipped to the carpet outside her bedroom. They locked into each other’s arms inside her room, against the wall, ridding each other of their half-buttoned shirts.

  Casey carried Mary’s featherweight to the bed where their remaining clothes ended on the floor. Mary’s hands searched his muscles and skin as they laid sideways and explored. They rolled over where Casey caught the gleam of Mary’s eyes as they melted into one.

  ________

  Mary pulled the sheet around them as a barrier to the cool room air settling on their moist skin. Casey’s arm embraced her, his head almost awash with her silky hair, as they lay wrapped alongside each other.

  “What made you so independent?” Casey whispered into her ear.

  “You mean minus a man?”

  “I suppose.”

  “It wasn’t my grand plan; it’s just how it worked out. I love my independence, but more than that, I like to make solo decisions. I’ve been happy with every single thing I’ve done, and I’ve kept out of trouble.” She paused. “Along the way, no one has surfaced who truly enamored me.”

  Mary rolled flat. “What about you?”

  “If you asked your brother, he’d say I’m too picky. It’s easy for him to say since he has the perfect marriage. Plus, the two of them should get medals for the way they raise those girls.”

  Mary raised her eyebrows. “You’re right about his marriage.”

  “I’ve had several special relationships, but I’m not on the prowl and I don’t force things. There have been reasons for relationship failures. Try women who are ready to get married. Period. Women who are ready to have a baby. Period. Meddling women who encourage me to work a nine to five day and dump the shift work. Women who don’t want to meet me halfway with dating schedules; women who are so beautiful, they flirt with other men when I go out with them; women who expect me to be their front man to their auto mechanic by the end of our second date. And as time marches on, the list grows like a swelling tsunami.”

  Mary thought about it his comments. “I can understand your disappointment. It’s difficult finding a partner who doesn’t have an agenda, let alone one you can admire and care about.”

  “Well, as for us, we had a magical evening. And to think I would’ve been winning at poker.”

  “Casey Hamilton.”

  He ran his fingers along her long, silky hair draped in front of her neck. “I’ve played many hands, but it’s not every day that I realize I’ve known someone special for a long time.”

  Chapter 13

  Harold and Danny chipped away at elective Saturday cases. They prodded at, and relieved, several patients’ cervical and lumbar degenerative disc disease problems. Harold went home in the early afternoon, leaving Danny to remain on call and to round on patients later in the day.

  Danny stacked a croissant with ham and cheese in the doctor’s lounge to bring to the call room in the rear-most hallway. It had been built with the new ORs and lounges a year ago, and looked like a high-end hotel suite with a large bathroom, a queen bed, and a flat screen TV. There was even a stash of fragrant soaps and musky after shaves. Going home before making rounds would be a waste of time, so he had placed his briefcase and small duffel bag next to the desk. He occasionally did paperwork there, but mostly passed the time watching sports channels not available at home.

  He ate his sandwich while flicking the remote, but stopped when he found a golf tournament live from the west coast. Crashing waves made more noise than the hushed crowd mesmerized by Tiger Woods on the green. Finally, Danny leaned back on the headboard of the queen bed and intermittently dozed. Later, he called Sara, then strolled in and out of patient’s rooms and amended orders at nurses’ stations.

  When Danny’s pager beeped, he wondered if the ambulance siren he had heard outside was for an inbound neurosurgery patient. However, things hadn’t changed much since residency. Most Saturday night ambulances brought in heart patients or general surgery/trauma patients.

  Danny called the busy ER. “It’s hectic in here,” said a physician. “EMS is wheeling in a sixty-five year old woman with a head injury. She’s an MVA with a Glasgow coma scale of six.”

  Since a total Glasgow coma scale of fifteen was normal, Danny knew the patient would land on his service. “I’m in house. I’ll be there.”

  When Danny got to the ER, he passed one of the MVA patients without significant injury. He looked around eighteen years old, maybe a new, now scared, driver. The young man fumbled through his wallet as a woman from ER admitting tried to procure his health insurance information.

  Danny found Casey and Mark buckling a strap to an ambulance stretcher. They had moved their patient to another gurney and an ER doctor was alongside the female patient.

  “She and her husband got rear ended,” Casey said. “They hit the car in front of them. Her husband was driving. He’s alert. He’s in a room around here somewhere, but he told us his wife is on anticoagulants for atrial fib.”

  “How long we out?”

  Casey nodded, knowing the importance of Danny’s question. “An hour.”

  The frail woman disappeared into the CT scanner after Danny finished his assessment. Danny found her husband, almost in tears, with his arm in a sling and his other forearm being drained for a few vials of blood.

  “I’m waiting for CT pictures of your wife’s head,” Danny said. “I may need to take her to surgery.”

  “It’s all my fault,” the man said. “It may not have happened if I hadn’t taken my eye off the road. I was pointing out a llama on a farm we were passing.”<
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  Down the corridor, Danny slipped into the small room to scout for coffee. Casey and Mark leaned against the counter while fresh brew trickled into the round pot. A female X-ray technician thumbed through a magazine on the table, glancing intermittently at Casey.

  “Are you two concocting the coffee?” Danny asked.

  “We’ll vouch for it,” Casey said. “We need it as much as you do.”

  “So? Do I dare ask?” Danny wore an extra-wide grin. “About my sister’s recent social life?”

  “Our dating is going along fine. Very fine.”

  The young woman at the table frowned, disappointed to hear that Casey was dating someone.

  Danny wasn’t offered any more information, so he didn’t press to hear more. They were apparently having a good time. For now, anyway. As long as Casey didn’t break her heart.

  “In the meantime,” Danny said, “Annabel and Nancy have surprised us. They’re considering premed.”

  Casey rolled his eyes. “Since when have they been type A personalities?”

  “I don’t know. We’ll have to hike and fish this summer to cloud their heads with great memories in case either of them go ahead and bury their future.”

  “You two just going to stand there?” Mark tilted the glass pot over a Styrofoam cup and dumped in one sugar packet.

  Casey poured three. He handed one to the technician and Danny, and kept one for himself.

  “Thank you,” the young woman said, investigating the color of Casey’s eyes.

  ________

  Pauline Macke’s CT showed an acute subdural hematoma, and what Danny feared – it was greater than one centimeter. He called the OR to book his emergent case. The critical wheels started turning; so far, Mrs. Macke abided by the ‘four hour rule.’ Getting to surgery within four hours of her injury would increase the chance of her survival. She did have a complicating factor, though - her anticoagulant treatment.

  Danny proceeded to the OR to talk personally with Dr. Lucas, the anesthesiologist on call. He decided to forego an exploratory burr hole. He had his diagnosis of an intracranial bleed and a burr hole would probably be too modest for a surgical evacuation. He found Dr. Lucas in the recovery room, told him the initial pertinent details about the case, then walked to the OR front desk. Rachel and another nurse both held a blue wrapped packet and checked off a list of supplies on a clipboard.

 

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