Fusion

by Diana Kane

  I know sleep has left me behind. I check the clock, 4:17 am. Good enough. Disentangling myself, I pull the sheets free from the bed and toss them in the washer. On an average day I would be pressed for time to make it to the hospital to round on my surgical patients before heading either to appointments at the office or down to the OR for the day’s cases. With clinic starting tomorrow I elect to enjoy my last truly free morning. I swim, shower, make breakfast and turn on the TV. I will be joining Dr. Hastings for his aneurysm clipping this morning, but have plenty of time before I need to arrive.

  By seven I can take it no more, the itch to be back in the OR driving me out the door. I have done all I can to delay any longer, the bed is made, the dishes I dirtied washed. I decide to head in early, maybe that will calm me down.

  I arrive at the hospital around 7:15 and make my way to the locker room to change. I still have at least half an hour before Dr. Hastings will make his way down to the OR. With no where else to be, I head down to the surgery desk to find out which OR we will be in. Greeted by the stares of people who I have yet to meet and a few good mornings from those I have, I discover we are in OR 4 today. The desk points me in the right direction and I head down to pull up the scans and and meet our staff for the day.

  In route to room 4 I bump into Alex’s friend from the elevator. She greets me with a smile and a hello. Even this early she is upbeat and full of life. I return her good morning and ask her how she is. We exchange a few more moments of small talk and go our separate ways, each of us having cases to attend to.

  A quick glance in the window shows me that the room is already open and the staff is working on setting up. The music is on and the staff is chatting and joking around with each other. I take it in for a moment. A staff that can work together like this is always a great thing.

  I grab a mask and head in, greeting everyone as I make it through the door. Their conversation stops briefly as they register who their unexpected guest is and return my greeting. I look around me, recognizing the faces of the nurses, my eyes finally landing on Alex. She is scrubbed in working on the craniotomy set up. I make my way towards her, careful to maintain an appropriate distance, watching her do what she has likely done countless times before. She seems focused and efficient, qualities that make a great assistant.

  “Good morning Alex, how are you today?” I inquire, breaking her focus.

  “Dr. Waters. Good morning. Will you be joining us today?”

  “Yes. Dr. Hastings has invited me to scrub with him.”

  “Large gown and seven and a half ortho?”

  “Yes, thank you.” She is all business, an interesting contrast to what I witnessed a few moments ago. I write it off to the staff not knowing what environment I prefer in the OR. I realize then that the music has been turned off. I tell them they are welcome to turn it back on. This seems to lend them all a little ease as they get back to their preparations. I make my way towards the doctor’s terminal to call up the films and review them, peeking at the nurse’s chart as I pass it to make a mental note of the rest of their names. I notice it has gotten quiet again. I look over my shoulder to see Alex and Erin whispering to each other, their set up forgotten momentarily.

  Alexis

  “What was that?” Erin has abandoned setting up the aneurysm clips to confront me. Her tone hushed, accusatory. She stops me from finishing my set up.

  “Nothing,” I answer looking over my shoulder at Catherine, who is watching us. I try to get back to work but Erin is having none of it.

  “Oh no, you are not getting off that easy. What. Was. That?”

  Erin and I have worked together for years. We know the other’s thoughts and body language like one would know a movie they have seen a dozen times. Catherine caught me off guard by showing up unexpectedly and I know Erin has picked up on something.

  “Nothing, really. I just wasn’t expecting her. Did you know she was joining us?”

  “No, I didn’t know. I’m not buying that caught you off guard shit either. You hesitated. You actually hesitated. I’ve never seen you do that. Plus you were cold, to the point of being rude. You didn’t even look at her. You always greet the doctor and ask how they are.” This is the result of someone knowing you too well, Erin has me cornered.

  “I’m just really focused is all. It’s early.” My set up complete, I break scrub, walking away from Erin. “We have a few minutes before the patient will be back. I’m going to use the bathroom and get a glass of water.”

  “Fine, but I’m not buying it.” Erin turns to finish setting up the clips and microscope as I leave the room.

  “Neither am I,” I mutter under my breath and head for the locker room. I have got to get it together and fast.

  *****

  Home. I’m relieved to be home. What a long day. The aneurysm was an anterior communicating artery, which can be difficult. Adding more difficulty was that it was the second one for the patient, which meant scar tissue and a tougher dissection. Taking three hours longer than anticipated pushed us severely behind for the second case. Fifteen hours after leaving this morning I’m happy to be home. I kick off my shoes and head to the kitchen for some water and any sustenance I can eat as I make my way to the shower. All I really want is to shower and go to bed. Elena surprises me. It was so quiet I didn’t think she was home.

  “You’re late. Everything ok?” There was a time when I would know if she was upset or concerned. Now I have no idea what she is feeling.

  “Yeah just a really tough case today that took longer then expected. Everything is fine though, thanks.”

  “I was really hoping we could talk tonight.” Upset for the win, I see.

  “Sorry, I didn’t know. We had two rooms running late so I volunteered to stay.”

  “You give too much of yourself to that place. You aren’t on call tonight.”

  “Maybe I do. It’s part of the job though. Not everyone is trained to do the cases I do. I can’t in good conscious leave my patient and surgeon with someone who isn’t efficient. Can we please not get into this right now? I really just want to grab a shower.”

  “Fine. You’re right. I do want to talk soon though. Are you on call the rest of the week?”

  “No. I’ll try to be home relatively on time.”

  “Good,” Elena answers before turning to head back into her office.

  *****

  Two days later I manage to get out on time. I had a pretty good idea early in the day that I would so I sent Elena a text letting her know I’d be home. Mixed feelings of apprehension and relief war with one another in my head and stomach. To think that five plus years could boil down to the upcoming conversation is unfathomable, yet the possibility of some resolution is appealing.

  “Elena I’m home. You here?”

  “In the kitchen.” Might as well get this over with. I head towards the kitchen where Elena is busy working on dinner. It looks like blackened chicken caesar salad, one of my favorites. “Hungry?”

  “A little maybe.” Honestly I am not, my stomach feels upset from the anxiety of our impending talk.

  “Ok. Want to go grab a shower first?”

  “Yeah, that would be nice.”

  “Go ahead. It will keep.”

  I head towards the bedroom wondering when we became so formal, so unfamiliar. I really don’t feel like eating. I just want to get this talk over with and figure out what has to happen from there. I barely feel like taking my required afterwork shower to cleanse the germs, body fluids, sweat, and stress from the day away.

  Showered and changed I head back towards the kitchen. Elena has dinner set up in the dining room. I take my seat and thank her for making dinner. I realize I have no idea when the last time we shared a meal was. I wait. I have no idea where I am supposed to start. Elena eventually breaks the silence that looms around us.

  “I don’t think we can continue on like this.”

  I sigh and put down my fork, my dinner untouched. “Neither do I. I don't like findi
ng reasons to avoid coming home, not connecting with you, and fighting all the time.”

  “Good. We agree on those points. What are we going to do?”

  “What can we do? I honestly thought we were fairly good. I know you want me to cut back at work a bit but the whole wanting a kid thing has really thrown me for a loop.”

  “I know and I’m sorry.” Elena looks down, studying her hands. “We were doing good. Yes it would have been great to have you around more, but I understand why you work so much, I know it is part of the job.”

  “And the kid thing. When did that start? I thought we were on the same page about not wanting them.”

  “It was about a year ago, when Rachel had Liam. Something just clicked. Until then I didn’t think I wanted any.”

  “A year? You sat on this for the better part of a year without mentioning it to me?” Shock, anger and hurt run through me. How could I not realize that my lover of five years had started to hide something of this magnitude from me? How could my lover of five years hide something like this from me for so long? I struggle to maintain my calm.

  “I did. I knew how you felt. I hoped it would pass, that spending time with Liam would be enough. I couldn’t send our world into chaos for something that might go away on its own.”

  I sit in silence. I don’t know what to say. I look at the woman I’ve been with for five years and feel like I’m sitting across from a stranger. In that moment I know for certain that we are over, we have been for months.

  “I don’t want to fight anymore, this endless argument we’ve been having, only taking a break when we avoid each other. We’ve stopped talking, touching, or even looking at each other.” Elena speaks these words to me and all I can wonder is how she cannot see that we are through.

  “I know. I don’t know what I’m supposed to say. My feelings on the matter haven’t changed. I don’t really feel like they ever will. I can cut back on the call shifts and volunteering to stay late, but I honestly know that I do not want a child. What do we do?” I feel sad about this. Not in the devastated way, part of me knows that this ship has been sinking since Elena first told me. Sad because something that had been so strong, so stable, so fulfilling for so many years is no longer any of those things. Sad because I know that all the positive things from our relationship are gone, eclipsed by the thing we will never agree on.

  “I’m not sure, but I don’t think either of us have been happy these last few months.”

  “No, not really. I’d be happy to get a puppy or a kitten, but it seems a ludicrous suggestion to make as a substitution for a kid.”

  “Yeah, I don’t think that will work. I think we need to take some time to really figure out what we can and cannot live without. Both of us.”

  “What are you asking for?”

  “Nothing. I just think we should stop fighting and both examine what it is we want in our lives and what we are willing to sacrifice.”

  “We’ve been together five years. I don’t think you have ever given me an ultimatum. This feels like one.”

  “It isn’t. I have some thinking to do as well. This is a major crossroads, one that could change things in drastic ways. This isn’t a decision we should make hastily.”

  “How long are we talking? What are you proposing? Do I need to find a place to stay?”

  “No. I’m not suggesting you move out. I’m suggesting we take some time, a month or two, work on us and each of us examine what we want for our lives and this relationship. Lets try to stop avoiding each other and arguing about this.”

  “Ok, but Elena, I don’t think I will change my mind. I don’t want either of us to get our hopes up. I love you and would give you almost anything, but not this. I’ve never wanted one and am pretty certain I never will.”

  “I know. Please, just a month and then we can reevaluate.”

  I acquiesce. I know it is a mistake but I’m just not ready to give up and let go of the past.

  That night I’m awakened by Elena pulling my hair. We are spooning. Everything about this situation has me confused.

  “Why’d you stop?” Elena’s breathing is heavy, her voice raspy.

  “Stop what?” I have no idea what she is talking about or how we even ended up entwined.

  “You woke me up. You were grinding your hips against my ass, pinching my nipple and murmuring. You were sleeping?” I hear the sound of her soft chuckle. “That must have been one hell of a dream.”

  It had been one hell of a dream. I just have no idea who I was having sex with. I realize she isn’t joking, her breast is still in my hand and I’m incredibly horny. The debate in my mind is quickly won. I resume teasing Elena’s nipple and grinding my hips against her. We have sex for the first time in months, only it doesn’t feel like it used to. It feels like goodbye.

  Catherine

  It has been just over a month since I started here. The transition has gone smoother than I expected it would. That doesn’t diminish the relief that I feel knowing that it is Friday and I just need to make it through the day to have a few days off.

  Alex and I are just finishing applying the Kerlix gauze around the craniotomy incision when Dr. Hasting’s nurse come in. “Dr. Waters! Dr. Hastings was just paged for an incoming trauma but he is still in the middle of his fusion. He wants to know if you can take a look for him.”

  “Sure. I’ll head right up. Are they here?”

  “ETA is 5 minutes.”

  “Ok. Alex, Erin you two good?” They assure me they are. I’ve ordered an immediate CT scan so no need for me to wait for the patient to be extubated. I break scrub and head for the ER.

  The trauma team is in place and waiting when I arrive. “What have we got?”

  “Eight year old boy struck by a car while getting off the bus. Loss of consciousness, pupils unreactive, GCS 2.” I feel my blood turn to ice.

  It is the nightmare all over again. I can feel it. I text Alex telling her to set up an OR immediately. They arrive with the boy less than a minute later. My gut feeling was right, there isn’t anything I will be able to do to save him. Still I have to try. I order that we immediately go to surgery. The ER staff looks at me like I am crazy, they know what I know. The charge nurse is waiting at the elevators when we get to the basement. She sends us to OR 6.

  Alex is setting up when we arrive. Several people float around the room, scurrying to get ready. She looks at the boy and then at me. She sees it too. Bleeding from they eyes, ears and nose. She knows this war is lost before the battle begins. The look only lasts a second or two before she gets back to work.

  He lives for nearly an hour. I still cannot save him. The nightmare is reality once again. I feel a weight on my forearm.

  “Dr. Waters. There is nothing more we can do. Anesthesia is calling it,” Alex says as she moves her hand to my wrist, moving to take the suction and bipolar from me. She is right. This fight is over.

  We close the incision in silence, the only sound is that of the two nurses trying their best not to cry. With the incision closed we clean him up as best we can. I leave to do the hardest thing I will ever do, tell a mother and father their son is gone. Only this time it isn’t just the mother and father. Grandparents, aunts and uncles wait with them. The family consult room is packed. I close the door and shatter all their worlds with one sentence: “I’m very sorry but your son did not make it.”

  *****

  Quiet. I just want quiet. I need to be alone for a few minutes. It isn’t that I don’t want the staff to see me as human, I would just prefer it if they did not see me upset like this. I only know of one quiet place in the hospital. I head there now. The platitudes given by the OR staff won’t do any good. I just need a few minutes to get it together before I head back to the OR to speak with the medical examiner.

  I take in the evening view, a stark contrast to the sunshine filled daytime. The lights over the city are beautiful. Much smaller in scale than they were in Chicago, but beautiful none the less. I’ve always loved the nig
ht time sky scape of a city. I have no idea how long I’ve been up here when my phone goes off. A text from Alex asking if I need anything and letting me know that the M.E. will be here in twenty minutes. I have twenty minutes to get it together. I set the alarm on my phone for fifteen so I will be back downstairs when the M.E. arrives.

  The floor is closed for the weekend, the only noise is the faint humming of the fluorescent lights. The ding of the elevator arriving pulls my attention away from the calming view. Alex steps off, stops when she spots me, then continues to where I am. Neither of us say anything, we just stare out the window. Minutes go by. Without turning to her I whisper, “Sorry for invading your secret space, I just needed quiet.”