by Barbara Ebel
As professional courtesy, Danny alerted the pathologist who would be working that day and stopped by the anesthesia office the day before to inquire, “Who’s doing my morning case tomorrow?”
The CRNA closest to the drug rep food spread pulled the next day’s schedule from her scrub pocket. “Dr. Ebel,” she said.
“Good. I’ll catch her before I leave and tell her what’s pertinent.” He tailed his words with his trademark chuckle. Barbara will love this one, he thought.
___________
That evening, conversation centered on Melissa’s college choice; her enthusiasm still bubbled over. Danny had also given her full latitude with her selection. Both parents marveled at her for forsaking her first choice because of her attachment to her grandfather. They couldn’t be more proud of her.
Danny told his family about his craniotomy for the next day. As he explained the lifecycle of Echinococcus granulosas, Annabel twirled the enamel trout earrings dangling from her ear lobes, which had been pierced when she turned fifteen. “Dad,” Annabel said, flippantly, “like that’s more information than we need.”
“Okay, but I may have to tell you how this ends tomorrow night,” Danny said.
Annabel stopped fidgeting and finished her chicken before Melissa and Nancy, who still sat there dismayed that a worm thingamajig could end up in someone’s brain.
___________
Danny spoke with Mr. Donaldson before Dr. Ebel slid in a radial arterial catheter for continuous blood pressure monitoring. As Danny parted the preop curtain, the Versed she had just injected into Mr. Donaldson’s IV caused his lids to slide down to half-mast. Thirty minutes later, after a bagel and his second cup of French roast, Danny stood in the operating room while his patient was put to sleep and intubated. They turned the table away from the anesthesia machine, the flurry of activity continued, and then Danny scrubbed outside the room. Bruce stopped by, promising to break later from floor rounds to peek in at Danny’s ongoing case.
Danny reentered the room. When the scrub nurse shook the sterile blue gown to unfold it, he slipped into it; and when she opened and parted the sterile latex gloves, he pushed his hands into them. Then he noticed her … her aqua eyes fixed on him. Wide eyed, undistracted except for Danny, as if she were a hypnotist, mesmerizing her subject. For a second, Danny forgot his case, the moment robbed by the salacious stare from above the pale blue mask and below the white OR bonnet.
“Dr. Tilson, good positioning?” asked Debbie, the OR circulator. She pointed to the video system, and he focused again on his work.
Danny nodded okay, so Debbie stepped behind him to tie his gown. He glanced at the IV pole for the bottle of mannitol, the osmotic diuretic, and saw Barbara adjusting the patient’s Foley bag near her side of the table. Danny sat. Everyone was ready to start and he made his incision.
Little chitchat had enveloped the room, but now fewer words were spoken after the hum of the drill. Danny rested his elbows on the armrest, his wrists on the patient’s head. The scrub nurse transferred instruments efficiently by following his procedure. Most of the noise in the room originated from the comforting beeps of the EKG. The pulse oximeter remained quiet.
Moist gray matter under the skull plate looked healthy. Danny gingerly explored to the left of his exposed site. Once he glanced over to the MRI and CT just to assure himself. There. Right there. Like a virus alert on a desktop screen, the top of the round hydatid cyst stared at him. Its fibrous capsule gave him courage. It looked substantial enough to withstand removal without splitting open. Perhaps underneath this capsule, the laminated membrane and germinal membranes also gave it further toughness.
Bruce entered, stood to Danny’s side, then took a step back. The scrub nurse had forceps poised at the edge of her instrument table. Danny followed the hydatid cyst’s edges … around, around, slithering it away from the gray and white matter, blood vessels, neurons, and memory itself. He held his breath. He took the large ball from the man’s head and placed it into a plastic cup. Life in its host ended. It was now destined for pathology.
Phew. Danny’s bottled-up tension drained from both arms. Dr. Ebel sat on her stool to chart the last five minutes and Bruce nodded and left.
“Nice job.”
Startled, Danny looked to the velvet voice he just heard. Those eyes again.
“Are you a new scrub tech?”
“I’m not new to being a scrub nurse, but I’m new here.”
“Oh, sorry. The hospital knows my position about covering my room. I want scrub nurses, not scrub techs.”
“My name is Rachel.” She gently tugged the suction tubing, checking for slack, as Danny placed the tip into the surgical site.
“Dr. Tilson, is it adequate?” she asked, rolling the words slowly off her tongue. “The amount of sucking?” She said it softly, leaning slightly forward for Danny to hear.
Danny’s pulse quickened. He lifted his head too fast, but stopped when their gaze locked. Those eyes. He gulped under his mask.
“Anybody mind if I turn on the CDs?” Debbie asked. She counted surgical lap sponges by the wall. “I’ll keep it low if you’d like. Pick your favorites Dr. Tilson, Dr. Ebel.”
“Sure. How about John Mayer’s ‘Continuum?’ That okay with you, Barbara?”
“Sure, that’ll work.”
“How’s the patient doing?”
“No problems here,” she said, reassessing the monitors. But she wasn’t so sure about her surgeon.
___________
When Danny got home, he perused The Tennessean in his easy chair, waiting for the girls and Sara to arrive. They burst through the back door after purchasing science project supplies, and scattered to set the table. Danny helped while Sara put white rice to cook in the microwave. When it finished, they spooned braised beef from the crock pot and sat down.
“We stopped by to see Pop,” Melissa said. “He smiled the whole time, Dad. We thought he knew us when we got there, but then he told Mom not to feed the customers until the food was ready.” Melissa looked down. “But I gave him a huge hug, and I swear … he understood that we all love him.”
Sara sat next to Danny, her shapely legs crossing at the knees and the ankles. “Well,” she said, leaning towards him. “We can’t wait to hear.”
“Yeah, Dad,” Melissa said. “We can’t believe you haven’t said a word yet.”
“What did it look like?” Nancy asked.
“I took it out of my patient’s brain without a bad outcome.”
“And that’s all?” Melissa asked.
Danny smiled and shrugged his shoulders.
“Kind of anticlimactic?” Sara asked.
Danny didn’t say anything.
Chapter 9
Danny snapped the power button on the desktop computer, clicked, scrolled and found what he wanted. Hematocrit, potassium, creatinine, and further down the page, he evaluated Mr. Donaldson’s postop labs drawn at dawn. Everything looked fine; next, he had to make hospital rounds, and then start seeing patients in the office at nine.
He put his white lab coat on the back of a chair and walked to the coffeepot. He poured two-thirds of a cup, split a bagel, and slipped the halves into the toaster. Two younger physicians sat in front of the television, the volume low. Several came and went from the dressing room. The bagel popped up and he spread thick pats of butter on each. He took a napkin and bused the bagel and remaining coffee to a round table.
There were three large windows facing the hallway. On the other side of the hallway were identical windows to the nurses’ lounge. It looked a lot busier in there, Danny noted, as he slid his chair out. The doctor’s lounge door opened and a woman with an untucked pink and white checkered blouse walked hurriedly towards the counter.
“Oh, Dr. Tilson, good morning.”
Without scrubs, mask, and OR bonnet, Danny knew who it was because of the voice, then the eyes. “Good morning, Rachel.”
“Perhaps the Doctors’ lounge is better supplied. I just need s
ome type of rag or wash cloth to rub this off.” She stood next to Danny and pointed to dried dirt on the leg of her blue jeans. “Good old Tennessee clay,” she said. A smile crept across her lips.
She was a blonde, more like a dirty blonde. Her hair loosely curled to her shoulders, and pearl skin gleamed over sculptured cheekbones. She brushed the spot on her jeans with her right hand and some of the clay disappeared.
“There may be a cloth in a drawer beside the sink,” Danny said. “How did you do it?”
“Do what?” She tilted her head and grabbed a little lower lip between her teeth. “Oh, that. My dog got more mischievous than usual this morning.”
“Your dog?”
“Mm-hmm. He’s a Chesapeake Bay Retriever. Normally, I unleash him for a little while every day. This morning he ran down the hill to the pond behind my town house, and when he came back, he couldn’t resist jumping on me.”
“Come to think of it, it does resemble a paw print.” Danny laughed. “Sounds like you’ve got your hands full.”
“Actually, he’s fantastic.” She stopped her animation and sunk her stare straight through him. “He has a canine good citizen certificate but, also, he’s a therapy dog.”
“Really?” The melted butter had sunk into the doughy bread so Danny took a bite. He wiped his mouth on a napkin, and as he put the napkin back on the table, Rachel’s hand approached. Her fingers touched his, gently running over them. She eased the paper napkin out of his light grasp, put it to her mouth, and moistened it. Danny stared as she rubbed the soiled spot with the paper.
“There. That made it so much better.”
Danny sat spellbound, then his pulse quickened. He sipped the last remnants of his coffee and got up. He nodded towards the door and started to walk as Rachel stayed beside him.
“What exactly does your dog’s job entail?”
“Like your rounds,” she said. “Sometimes I bring him to see patients. Especially old people who don’t have their pets any more. I used to bring him to a psychiatric facility when I lived in Cincinnati. Now I bring him to nursing homes. Like Wellington’s,” she added.
“You visit Wellington’s Life Care with him?” Danny opened the door and held it for her.
“Oh yes. Patients love my visits. With him, I mean.”
Danny took a step out the door behind her. She definitely had curves. She wasn’t the skinny model type; she probably wore a size eight. He knew those numbers because of Sara and the girls.
Rachel turned. “Nice talking to you, Dr. Tilson. Your skills yesterday were extraordinary.”
“Thank you. I try. Actually, I’m going to see Mr. Donaldson right now.”
“He’s a lucky man to have you give him a new lease on life, freeing him of that virulent parasitic ball.” She scrunched her face. She still looked pretty.
“Thanks. Later, Miss Rachel.” Danny slipped on his white coat while making his way to the elevators. Now, why did he say that, he thought? It didn’t matter, because he felt like his spirit was soaring.
___________
Melissa had made tea with honey before going to bed and had popped a Cold-eez. For two days, it felt like a sinister virus lurked in her head and her throat. By cleverly stalling its progression, she wanted to prevent an exacerbation of her asthma. But she woke at 4 a.m. coughing and lay awake for half an hour, her breathing getting slightly more laborious. She turned on the light, clutched her Albuterol inhaler from the nightstand and took a puff. On the second puff, she knew she’d exhausted the canister. She fell asleep after a while, but slept restlessly, turning the sheet into an uneven mess on one side under the lightweight comforter. When the alarm rang at six thirty, she thought about skipping morning classes, but she had to hand in an English paper and hated the catch-up consequences if she played hooky, so she gradually made her way to the bathroom.
Melissa quickened her steps to the kitchen to find Sara tying shoelaces, which meant her mother would be hitting the pavement to run after driving Nancy to school.
“Good morning. You sleep okay?” Sara asked.
“Not that well, Mom.” Melissa opened the refrigerator, poured orange juice, deliberated over the fruit bowl, and selected a banana.
“I’m sorry, sweetheart.”
Melissa put the fruit down and shoved books into her backpack, but couldn’t find her English folder. “No. What an idiot!” she exclaimed. “I’ve left all my English stuff at Pop’s house and my paper is due in the first class.”
Sara questioningly glanced at Melissa.
“Mom, I wrote it there the other night after Mary and I got back from Wellington’s. Now I have to run by Mary’s and don’t have time to pick up a refill for my inhaler.”
“I can drop by the drug store this morning for you.”
“Thanks, Mom.” Melissa finished, tossed the peel in the garbage, and picked up her blue hoody, cell phone, and car keys while Annabel and Nancy both bumped into each other going through the doorway.
“Annabel, you better hustle,” Sara said. “Karen’s mom will be out front any minute to give you a lift. And Nancy, grab a granola bar and something to drink, you’re running late. I’ll pull the car out. Meet me in the driveway.” She waved her keys and flung her shoulder bag up her arm.
Melissa gave Sara a quick kiss. “Love you, Mom. I’ll call after school to let you know if I’m not coming right home. Maybe I’ll get more info from Wake Forest today. I can’t wait to know about dorm assignments.” She beamed, cleared her throat, and then coughed.
___________
When Melissa parked her white 2002 used Acura in the driveway, Mary backed out from the garage, and braked alongside her.
Mary rolled down her window. “I’m just running to the store. What’cha doing?”
Mary’s dark red hair was pulled tight to keep it away from her face, in preparation for starting a Center Hill Lake scene. She wanted no morning interruptions, like grocery shopping, once she began the painting.
“I forgot my English stuff,” Melissa said. “I’ll lock the door when I leave.”
“Talk to you later then,” Mary said.
Melissa ran to the front door, rummaged through her backpack, and inserted her keys. She opened the stately door, locked it, and placed the keys and bag on the entryway table next to a dried floral arrangement made by her grandmother. Coughing, she hurried to the kitchen and stopped a moment to catch her breath. She started to wheeze and clutched the counter; she pulled in a deeper breath. Looking around, she didn’t see any of her schoolwork. Her chest began to feel tight, but she went upstairs aiming for her second bedroom, holding the banister as breathing became more restrictive. Sucking in, she could barely continue. It felt like breathing through a straw. Exhaling gave her more comfort; it was a lot easier and took longer.
Melissa slid down the wall, upright, in the hallway, pulling, pulling. Her pulse quickened. Working her suprasternal and neck muscles for accessory help, she tried desperately to yank oxygen into her lungs, but it seemed as if nothing went in and nothing came out. Moisture pooled in the corner of her eyes. She pulled her cell phone from her pocket, her hands changing color, turning blue. Think, she needed to think. But thoughts became foggy.
Melissa dialed the ER number. “ER,” someone said.
“It’s Danny Tilson’s daughter, Melissa. Can you send an ambulance?”
It seemed forever. Voices and noise in the background. The lady said something to someone else about Danny Tilson’s daughter. “What’s wrong?” the woman asked.
“Asthma attack,” Melissa said faintly.
“Where are you? Someone will be on the way.”
“At my Pop’s,” she said.
___________
Casey finished jotting down times and events on paperwork, holding a clipboard outside the emergency department. He had just brought in a fifty-four-year-old man who complained to his wife of double vision, became confused, and fell hard on the kitchen tile. The ER doctor and staff were busy seeing the three-
hundred-pound man who needed acute treatment, then stabilization of his brittle diabetes. Casey enjoyed the shift; the spring day smacked of summertime.
The automatic door opened behind him. “Casey, you’ve got a run.”
Casey knew the ER nurse. She held half a donut while taking a break, but volunteered to flag him down and deliver the message. She seized the opportunity. He smiled at her as he quickly went inside to the desk.
“Dr. Tilson’s daughter called in,” Mrs. Garner said from the front desk. “She needs an ambulance. Asthma attack.”
Casey flinched, then a surge of adrenaline escaped into his bloodstream. “Melissa?” he asked. “Where is she?”
“At her dad’s.”
Casey spun around, still holding the clipboard. He had to get his partner, Mark. Down the corridor, Casey peeked into the small supply room, at the coffee machine and small refrigerator in one corner. Mark sipped from a Styrofoam cup. “Let’s go,” Casey said. They exited to the now-turned-sour spring air. Casey ran to their ambulance in the circular ER spot.
“It’s Dr. Tilson’s daughter. She’s got bad asthma.” Casey pressed the accelerator, turned on the siren lights.
Mark took a new clipboard and began scribbling details on their run. Smack in the thick of commuter traffic, Casey could hardly contain his anxiousness, as the ambulance sped around a congested intersection. Traffic snarled because of a red light and Casey’s approach with the ambulance. Drivers didn’t know which direction to veer out of his way. Past the light and down the next street, he had to slow, a yellow school bus had half pulled from the curb, cautioning Casey to the presence of children.