How to Save a Surgeon

by C. M. Stone

  Halfway through his coffee, a page came through. He swallowed down as much as he could, then took Morales with him to the ambulance bay. The EMTs arrived moments after they walked through the doors and took a screaming little boy out on the gurney. He cast a look in Darla’s direction, hoping she wouldn’t start crying and make things worse.

  “Seven year old white male, fell off the back of a personal watercraft on Lake Mead and hit in the abdomen by the exhaust,” an EMT said as they wheeled him in.

  It wasn’t the first personal watercraft accident he’d dealt with, but it was also far from the worst and for that he was grateful. The force of water and air had left his entire abdomen bruised, but the skin was intact. That was certainly better than alternatives he’d seen, where skin was torn and organs were completely detached.

  Morales took the little boy’s hand, patting the back of it. “Shh. Stay calm. It’s going to hurt more if you cry. Just breathe with me, all right? We’re going to get you fixed up.”

  Whatever had happened to improve her bedside manner since the last time he’d worked with her, he approved. Soon the screaming boy settled as he focused on matching his breathing with Darla’s.

  Further examination found the boy’s stomach hard to the touch, sending a chill down Jackson’s spine. Not the worst he’d seen, but far from the best. “Page Dr. White and get me an OR stat. This internal bleeding can’t wait.”

  “What’s happening? What are you doing?” The little boy started to thrash in a panic, but barely managed to move before he screamed in pain again.

  Darla squeezed his hand and braced her other hand on his shoulder to push him back down. “Dr. DeMatteo’s going to help you. Just hold still. Breathe with me again.”

  As they wheeled him to the OR, Jackson kept waiting for the other shoe to drop with Darla. Focusing on his patient was priority, but that didn’t stop him from looking at her, watching for some trembling of her hands or catch in her voice. In contrast, her own attention never wavered from the little boy until she had to leave him to prep for surgery.

  Another doctor pushed her way in through the operating room doors and cast a quick, assessing glance over the little boy. Dr. Nancy White was a tall, slender woman with silver streaks through her blond hair, though that hair was currently covered. Her pale blue eyes narrowed over her face mask. “What do we have here?”

  Jackson nodded to Darla. “Morales, were you paying attention?”

  “Oh. Um.” She looked nonplussed by this and Jackson felt a spark of annoyance. Was this when she’d fall apart? “Seven year old male suffering blunt force trauma to the abdomen with internal bleeding.” Her description went on for a moment. The words were a little halting, and he could see the stiffness in her shoulders as she spoke, but all the details were there.

  Jackson gave her a nod of approval. “Good.”

  “Have you ever scrubbed into surgery before?” Nancy asked as they began.

  “Five times.”

  The answer was out almost before Nancy finished her question and Jackson had to grin at the promptness. She was still at the point when each individual surgery stood out in her mind. He remembered those days well. The fact that they were still prominent in his memory made their importance clear. What she learned now would have more of a lasting effect than all the lessons to follow.

  Despite the poor impression she’d given their first day together, her hands were steady as they worked on the patient. There was a rhythm to surgery when things went well. Like a dance, each movement was choreographed. The fewer complications, the fewer deviations from that plan and rhythm. It took time to learn the rhythm and be able to follow it without getting in anyone’s way, but Darla never faltered. Her lack of experience was more than made up for by her attentiveness and what seemed to be an ability to anticipate his next move. McGaffey had spotted a natural talent under all those nerves.

  “You ever thought about a specialty track in PEDS?” Nancy’s admiring tone sent a possessive shock through Jackson. Just getting her good enough for Singh’s approval and not driving her off had seemed difficult enough before. Other doctors trying to scalp her from the trauma department would make his Herculean task next to impossible.

  Darla shook her head. “Oh, no. I’m going into trauma. It’s what I’ve always wanted.”

  The tension drained from Jackson’s body, leaving him light and empty. Regardless of whatever talents Nancy saw, Darla’s sights were set on one thing and one thing only. That it perfectly coincided with what he needed was a boon.

  “Kids get trauma, too.” Nancy gave a meaningful nod down toward the boy on the surgery table. “They’re not just little adults, either. It’s a whole other challenge to work on them.”

  “I know and I’d like to, but…” Darla trailed off, her brows knitted together and her eyes cast to the side to avoid looking at either one of them.

  Her reaction intrigued him. Some sort of conflict was clearly at play, but why? And, more importantly, was it something that would come back to bite him in the end?

  He cleared his throat. “Morales, would you like to close up?”

  Even with half her face hidden, the sudden light in her eyes was apparent. “Thank you, Dr. DeMatteo.”

  He watched to verify she knew what she was doing, finding himself pleasantly surprised again. Whatever her faults, a lack of knowledge and skill weren’t among them. Though she was fairly slow at the work, she did it methodically and well. Speed would come with time.

  When the surgery was done and Jackson stepped out with Nancy, the pediatric surgeon stopped him. “I can’t believe that’s the intern you were complaining about.”

  Had he said anything about her to anyone? Other than Singh on that first day, he’d kept most of his opinions to himself. They were too complicated when it came to Morales. “I haven’t been complaining about her.”

  “Mevlyn said you were.”

  That man played dirty politics at every turn. Jackson had to hope there wouldn’t be any false gossip getting back to Darla.

  “It was a bad first impression.” Not that she had been terrible, he had to admit, but the fact that she’d immediately insulted him had colored his view of her negatively. He opened his mouth to try to explain that things had gotten better and the door behind them creaked shut. Rather than speak, he checked to be sure.

  Darla stood there, eyes wide with hurt. Damn it.

  Nancy just smiled. Maybe Melvyn wasn’t the only one with an agenda. “Hey, a couple of our volunteers for the gala have backed out. Would you be interested, Morales?”

  Darla’s shoulders settled, her features smoothing out, but there was still something guarded in her voice when she spoke. “A gala? What for?”

  Jackson considered Nancy’s smile once again. Was he being paranoid or was she really out to steal his intern? “It’s a big fund-raising event for the children’s hospital and the medical school. We usually get a bunch of interns to volunteer and chat up the donors and tell them how vital their money is,” he said. “It’s probably not something you’d be interested in.”

  Instead of agreeing with him and dismissing Nancy’s offer, Darla looked offended. “Why wouldn’t I? That sounds fun.”

  Fun for people who liked that sort of thing, maybe. Though she’d done better since her panic that first day, he still couldn’t imagine Darla enjoying the fundraiser much. He rarely did. “It can be, but it’s pretty…stuffy. Especially for the interns. You’re not really doing much but smiling and nodding.”

  Her fists settled on her hips, chin raising defiantly. It was that same spark he’d seen in her when she’d called him ignorant—the sort of fire that would serve a surgeon well—but he wondered when her vulnerable side would win out. “I can smile and nod.”

  “And do you want to do that for hours on end? In heels?”

  Her eyes narrowed, and she straightened her spine, gaining an inch or so in height. “I can wear heels.”

  Shit. This was rapidly spiraling out of c
ontrol. He raised his hands to ward off any more defensive responses from her. “I didn’t mean you can’t wear heels. I just meant it doesn’t seem like the sort of thing you’d be into.”

  She answered that with a tilt of her head and a cocked brow. “How the hell do you know what I’d be into?”

  Nancy clapped her hands together and smiled brightly. “Great! It’s settled. I look forward to seeing you there, Morales.”

  Jackson glared at Nancy’s back as she walked away, then turned back to Darla. Her soft bronze skin had gone a shade paler, her lips pressed so tightly together they’d formed a flat line. He felt a touch smug at that, because of course he’d been right.

  “And do you want to go to the gala?”

  “God no!”

  He laughed. “Can’t resist a challenge?”

  She wrinkled her nose, shaking my head. “It’s not that. I just hate being told what I should or shouldn’t do.”

  “Problems with authority? I never would have guessed you were such a rebel,” he teased. “You can go track her down and tell her that, if you want. Or you can just go.”

  Instead of an immediate answer, she looked thoughtful. He did his best not to stare when her tongue darted out to wet her bottom lip. “I don’t think my roommate volunteered, and we have to share a car. Where’s the gala?”

  “I can drive you.” What the hell was he doing? The words were out before he’d thought it through. It was the decent thing to offer, but he was already picturing the difficulty of being in a car with her alone. “It’s at a golf course outside of town, and it’s black tie.”

  “Oh.” Worry crossed her face like a cloud in front of the sun.

  Memories of his own limited wardrobe as an intern surfaced. He’d had one suit for years, but it looked good on him. Fashion wasn’t nearly as forgiving for women. “Can you do formal?”

  “Yes, yes, of course I can.” The words came out quickly, jumbling together. Her eyes flicked to the side to avoid his gaze. “I don’t walk around in scrubs and ponytails on my days off, you know.”

  “Nothing wrong with scrubs and ponytails.” The way she dressed was practical, which was better than some other interns he’d worked with who left long hair down until he yelled at them. Even better than practical, she could fill out her scrubs the way some women filled out evening gowns. Her body looked soft and inviting, in need of exploration. This time he was the one who looked away to get his thoughts back under control. “Give me your address, and I’ll pick you up around a quarter past four on Friday. It’s a bit of a drive.”

  Once she gave him her address and number, she went off to check on his patients. He watched after her, too many thoughts fighting against one another. There was potential to her, that much was clear, but what she’d said during surgery nagged at him. If trauma wasn’t her true passion, what was going to happen further down the road?

  Chapter Seven

  By the time Darla found DeMatteo to give him his updates, he was settled in at the table in the center of the attending lounge and looked to be busy grading papers. Some of his work from the medical school, she assumed. The closest thing to downtime she’d seen him take so far was when he was drinking his coffee. His constant, intense focus was impressive, but she wondered when he ever let himself relax.

  “Mr. Miller in room two-forty-three wanted to know how active he can be when he gets home, and I wasn’t sure how to answer,” she said.

  DeMatteo accepted the tablet from her to check Mr. Miller’s chart and leaned back from the laptop. “The body builder? He can’t train for at least a month after that amount of blood loss. I’d say anything more than ten minutes of walking a day would be useless stress until then.”

  Trying to imagine how the huge and impatient man would react to that news made her shudder. “I don’t look forward to telling him that.”

  “There are far worse things we have to tell patients.” DeMatteo set the tablet down when his pager went off. He checked it with a frown. “But that’ll have to wait.”

  She followed him out, expecting him to head for the ambulance bay, but instead he went for the elevator. Inside, he hit the button for the seventh floor.

  “Why are we going to obstetrics?” she asked.

  “They sent me an emergency page for one of their ORs. Do you know why they’d page a trauma surgeon?”

  That was an easy question, at least. “Any surgical intervention will create a degree of trauma, while both cesarean sections and vaginal birth can lead to hemorrhage.”

  “You’re going to spend a lot more time talking to patients and their families than writing essays. Give me the Twitter version.”

  She bit her lip. What kind of answer did he want? “They page you when something’s gone wrong.”

  “That’s right.” There was a trace of a smile on his lips when he met her eyes, but he didn’t look terribly happy. “Something’s gone wrong.”

  It would be so easy to reach out and touch him. A hand on the arm in solidarity, or even cupping his cheek. Seeing his worry before he’d stepped into the operating room made everything nurturing in her want to reassure him, but nothing she could think of seemed appropriate. Badass surgeons didn’t need comfort from interns, did they?

  As soon as the doors opened, Jackson sprinted down the hall to the scrub room. Before she’d caught up with him he was already washing his hands.

  Rather than charging forward, she hung back. “Should I scrub in?”

  He shook his head, his jaw tense. “Not this time. There’s already a surgical team in there, and it’s an emergency situation.”

  Then what am I even doing here? She kept the comment to herself, though her silence did little to quell her frustration. It wasn’t the first time someone had decided a situation was too serious to be used for teaching. When there was little she could do to help, the best she could do was watch. It just wasn’t what she wanted.

  The scrub room had a window into the operating room, letting her watch the drama unfold. She’d observed a cesarean section before and even without them paging DeMatteo, she could have guessed that things had gone badly. The baby was whisked out of the room while the staff did what they could to control the mother’s bleeding. As soon as Jackson stepped into the OR, she could see him taking charge. She could imagine the short, precise orders he was giving, not needing to shout like some doctors. He took command more effortlessly than that.

  From the massive hemorrhaging and what she could see of the poor woman, Darla guessed it was a complication with the placenta. Accreta was when the placenta attached abnormally and had difficulty detaching. The worse complications were increta or percreta, where the placenta either grew into the uterine muscle or surrounding organs. The chances of any of the complications went up with each C-section a patient underwent.

  And all of that had seemed troubling enough in the abstract, but watching it in person was so much worse. Her hands curled into fists, and she braced them on the edge of the sink as she watched, helpless to do anything but bear witness. Not wanting to stand back and do nothing was exactly why she’d wanted to become a doctor in the first place.

  After nearly fifteen minutes, what had been a losing battle officially became a lost cause and they called time of death. Jackson turned away from the scene, and his haunted eyes met hers through the window.

  Out in the hall she caught up with him, though this time he wasn’t running anywhere for an emergency. He’d pulled off the surgical gown over his scrubs and had dropped onto a bench. He didn’t look up as she approached, or when she sat next to him.

  “Are you okay?”

  He raised his head, one brow arched. He’d looked worried in the elevator. Now he looked thoroughly worn down. The tension was etched into his face, his shoulders tight as if they were supporting some great weight. “Me?”

  “Yeah. It’s not easy to lose a patient.”

  He frowned and reached up to pull his surgical cap off, then raked a hand through his thick brown hair. “I�
��ve lost patients before. It’s nothing new.”

  “That doesn’t make it easier, does it?”

  “Probably not.” He braced his back against the wall, stretching out his long, lean legs. “There’s always that guilt.”

  “You did the best you could. That’s nothing to feel guilty over.”

  “Yeah?” That urge to reach out and touch him was back again. “Then how come I still feel that way?”

  That was an easy question to answer, though she knew the answer didn’t always make much of a difference. “Because sometimes we feel things that aren’t real. We feel guilty when we did everything right or scared when we’re safe or isolated when we have friends.”

  He laughed. “Which is completely unhelpful.”

  She smiled and reached for his hand, because she couldn’t resist a comforting gesture any longer. The way his fingers slid between hers before entangling with them and squeezing made her shiver, nerve endings all at attention. It should have been a friendly touch of support, but it didn’t feel that way. “Yeah, it can be. But we can always ask people we trust for input.”

  “So what do you think my real feelings should be?”

  Did that mean he trusted her? She swallowed hard. “Sad. It’s a sad thing when someone dies, and it’s okay to feel that. Guilt is about trying to assign blame and act like things can be controlled, but sometimes they can’t be. They’re just sad.” And losing that mother—it was awful. But she’d watched, assessed the situation as it unfolded, there was nothing that could’ve been done differently. It was tragic and it was horrible, and the shock of witnessing a woman die—it wasn’t something that she’d be forgetting any time soon. But he didn’t need her tears or words that would add to the misplaced guilt he was feeling.

  He nodded, his thumb tracing over one of her knuckles. “Guilt feels more productive somehow. Letting it go is like admitting defeat.”

  “We can’t always win.”

  “But I prefer to.”

  He leaned closer, drawing her attention to the afternoon stubble on his cheeks and the warm scent of his aftershave. Where his thigh rested against hers on the bench burned a line through her scrubs. She wanted to feel his stubble under her fingers and trace the contours of his full lips with them. Or, better yet, use her own lips. She couldn’t, of course. Not at work, not with him.