by S A Gardner
I still didn’t appreciate the cloak-and-dagger stuff. I sure had big issues with uncertainty.
But then I also had bigger issues with loss, oppression, exploitation, brutality…
Hmm, seemed I had nothing but issues.
The only mitigation was Damian hadn’t had an opportunity to elaborate on his ban. We’d been separated since I’d gone to obtain the militants’ approval for Jake’s repeated visits, and Damian had been whisked away by their current leader to discuss a “pressing business matter.”
Leave it. Mind your bloody business, as Jake would say.
It was literally that now. Removing abdominal packs was sticky, blood-soaked business.
And then there was the world-shaking fact that Jake was across the table, working with me on our patient, as if operating together was an everyday occurrence.
He was now removing the packs that had stemmed our patient’s liver hemorrhage, so he could explore the extent of damage and implement definitive repairs.
“Mm. The packs are a bit stuck.” He flicked a calm look toward Ayesha, his demand courteous. “More saline, please.”
Ayesha at once complied, soaking the packs so he could remove them without yanking on the fragile tissues, causing renewed hemorrhage.
“Perfect, thank you, Ms. Washington,” Jake said, his eye-smile at Ayesha brief but warm.
Ayesha all but fluttered next to me. Her extreme pleasure at Jake’s treatment was a constant background buzz. During introductions, to both our surprise, he’d said he remembered her well from the time they’d worked at the same hospital. Since then, with small but constant gestures, he demonstrated his appreciation of everything she did. He sure put anyone to shame with his effortless and copious decorum.
Namely me.
Her reaction made me mortified to think I didn’t offer her enough validation. When what she did, what they all did was so out of the ordinary, I should constantly make sure they never forgot how incredible they all were. It wouldn’t only keep their morale up, but it was the least they deserved.
And to think I’d believed I was an okay leader.
I had to make a point of being more appreciative.
Starting now.
“Turn up the heat, please, Lucia.” I tried to catch her eyes. She only pushed the sliding control of the electric blanket we had our patient on without taking her eyes off Jake’s gloved fingers as they manipulated the gored organ with utmost delicacy. I tried again. “Thanks, Lucia.”
This time Lucia looked at me. In a comical double take.
God, was I habitually that gruff and dismissive with them? Did I take them for granted to the point a thanks from me startled her that much?
I barely stifled a groan of shame as Jake added, “And more heated packs, please, Ms. Morales, to the head and armpits—and raise IV fluid temperature to 108 degrees.”
As soon as she complied, he thanked her again with that same personalized recognition. And got the same barely suppressed delight he elicited from Ayesha.
Had his ordeals been responsible for the development of those impeccable people skills? Eight years ago he’d been indifferent to almost everyone, never given anyone he didn’t consider on his level much notice. Now his attention was all encompassing. Not to mention compelling. Everyone who came in contact with him fell under his thrall happily.
In the ladies’ case, it compounded his effect that his gentlemanly regard came attached to such a perfect package. The new Jake had matured into an all-round force of nature.
I dragged my focus back to our patient, Alia. She was fifteen, liked to etch and taught in the camp’s kindergarten. I tried to know what I could about my patients. Not that it was possible for me to retain much information for long. But her name, her condition would remain engraved in my psyche forever. Hopefully not as another scar.
For now, we couldn’t do enough to make sure hypothermia didn’t develop. Along with coagulation failure, hypothermia initiated the vicious circle of deterioration that caused death in multiple abdominal trauma casualties.
The scary thing was, it was aggressive fluid compensation that led to both. We referred to it as death by resuscitation.
To prevent that, I’d infused packed red blood cells and coagulation factors instead, before I’d started the damage-control surgery. Now it was the re-operation for definitive repairs.
I’d lost little Nazyr last night during a similar surgery.
I wasn’t losing Alia. Her peripheral injuries were nowhere near as catastrophic. And though it had only been fifteen hours since her first surgery, when we’d examined her, Jake had decreed she was ready for the second stage. I’d agreed. When he’d said he’d like to help, I’d almost hauled him over my shoulder and ran with him to the STS.
“Incredible first stage management, Cali,” Jake suddenly said after we’d finished exploring the abdomen and pinpointing the injuries we’d deal with. “I wouldn’t have done better.”
Now that was some over-the-top praise. I was good, but Jake had always been confident that no one could be as good as him. Not even close. Everyone had thought him an infuriating, condescending egomaniac.
Such behavior would have annoyed me into kicking anyone else’s butt into the next dimension. But from Jake, it had elicited the opposite reaction. To the radical way my mind turned, to my extreme fascination with intense distinctiveness and eccentricity, his limitless intelligence and almost supernatural skills had not only excused his behavior, it had justified it. He’d had every right to his feelings of superiority.
He was superior. And then some. And I bet with such intensive application of his skills, his mastery must have shot to uncharted heights.
So yes, his praise made me flutter even harder than the others. It elevated me to a new echelon of achievement, painted my efforts to be the best surgeon I could be with the unique brush of his approval.
When I said that out loud, it came out a lot less eloquent. “Why, thanks, Dr. Constantine. Coming from you, that’s really something. You only ever had criticism for me.”
His eyes, the only thing I could see of him beneath the surgical cap and mask, behind the visor, rose to mine, their mind-probing feature set on maximum. “I recognized your potential to be limitless, but it was still unformed, your skills yet to be integrated into your intellect and senses. I was only fine-tuning your direction before your abilities swerved on a permanently flawed tack.”
He sure had. He’d been the one who’d implanted in me what colleagues called my uncanny diagnostic sense. He hadn’t taught me for long, just a few months, but every second under his tutelage had been mind-altering, literally. It had been under his clinical whip that I’d been made into the comprehensive-approach and enterprising, precision physician I was today.
Jake had been another of those who’d shaped me.
It often struck me as weird that only men had so influenced my being. The role of women in my formation had been a passive one, the major changes they’d wrought by death or desertion. But the lack of female mentors and role models was understandable. After all, I’d breached male-ruled arenas so young, looking like a helpless cutie. I guessed it had been predestined I’d stumble on patriarchal patrons and mentors.
Being no longer that young, or a cutie, and with no arena male-dominated anymore, I certainly no longer needed either. Didn’t mean I didn’t still hanker for their approval. Not to mention their contribution. Since this whole thing had started, I’d proven time and again that I did.
And I’d made my peace with that. Recognizing my needs and letting those worthy offer me advice and support would only make me a stronger warrior.
Seemed I was maturing.
Jake had been busy examining the stapled bowels. Now he raised his gaze to mine. “Your approach and execution is beyond meticulous. I can see you’ve fulfilled your potential. As I always knew you would.”
I almost choked on my hammering heart.
Okay, so I’d already acknowledged my need for h
is approval, but this was ridiculous. Certainly not commendable. Not over the open abdomen of a patient I had yet to save.
“No satisfaction in my performance allowed until she’s out of danger,” I said, more to myself than to him. “I lost a boy last night to similar injuries.”
His assessing eyes turned to me once more. “Younger, underweight and had more extensive peripheral injuries?”
Now how did he know all that? An accurate guess, or from his “comrades”, the reason for all this suffering and death?
“Yes.” I gulped down the searing temptation to indulge in the toxic mixture of pity and rage.
“You have to accept it, Cali.” His voice came as if from inside my head, persuasive, hypnotic, like a wave of compulsion. “We have to lose some to save most.”
I raised my eyes to him, my breath lodging into my lungs.
It was there in his eyes. He had. Accepted losing patients. Succeeded in shutting out the torment and defeat and wrath of it all.
“How did you do it?”
His nod acknowledged my meaning. Of course he understood. With Jake, I’d never needed to explain.
“An epiphany, mainly.” When I bated my breath, expecting him to elaborate, he only added, “Followed by a lot of practice.”
No kidding. Around here, he had all the practice he could possibly survive.
But what had been his epiphany?
It had probably been something he’d already told me. Like the moment he’d resigned himself to making the most of his situation.
We fell silent as each of us worked on an injury. I handled the intestines, he took the spleen.
From Jake, I expected anything. In desperate cases, he’d gone for measures others considered extreme, sometimes insane. And made them work. But I was still stunned when he went for a splenorrhaphy, repairing the spleen, rather than the far easier and safer splenectomy, removing it. In our patient’s condition, I didn’t know if this was an option.
He raised his eyes to me. “Anything wrong?”
“No.” His gaze hurried me to spill the “but” my tone contained. “But I’m wondering why go for the hardest choice.”
It was almost distressing, contesting his surgical decision. Now I knew how the others felt when they had to contest any of mine. Recognizing a superior skill and experience, yet unable not to voice the concern.
His answer was calm. And final. “I consider no other choice. There is no other choice.”
My heart fired again.
All right. Okay. That was some statement.
My old Jake used to have elements of that resolve. Impossible not to when hard had been his easy, and hardest the thing that started to challenge him. But his effortless achievement had been diluted by a why-bother attitude. He’d bounded over everyone without trying, had reserved strutting his stuff when the need was big enough to provoke his conquering instincts.
But this new implacability…wow. Just wow.
His ordeals had boiled him down to his essence, unleashing his full potential.
As this had been limitless, he should now have sui generis copyrighted to his name.
I could only nod, let him do what he saw fit.
I snatched glances at his mesmerizing performance while I worked. His hands seemed to meld with his instruments into a seamless unit, flowing flawlessly through the complex motions. He concluded his procedure just as I did mine, even when it was a much more involved one.
Then came the hardest and most delicate part of the surgery. The removal of the vascular shunt I’d place to bypass the inferior vena cava injury, preparing for its repair.
Before I could enact the next step, Jake said, “Medial rotation of the liver, please, Cali.”
This would have been my next order. He’d said it first, relegating me to the role of his assistant.
I gagged on the stupid urge to challenge him, did as he asked, widely mobilizing the attachments of the liver to expose the IVC.
Pride had no place here. He was the superior surgeon.
“More suction right here, Ms. Washington. Yes, exactly, thanks. And more exposure of the portal triad, please, Cali.”
As I did, he began the repair in a blur of assurance, the vein seeming to seal under his hands as if by magic. He was finished in half the time it would have taken me.
As we started definitive closure, every muscle in my body lost tension in degrees. Not only did I feel this patient would survive, I felt all the others would, too.
This was one thing I remembered with total clarity about Jake. This effect. No matter how catastrophic injuries were, everyone had sagged with relief when he’d walked in and taken over, knowing it would be another patient saved. “Dr. Constantine to the rescue” had been a unanimous mantra.
Long-buried recollections resurfaced, swelled.
Beside the awe and adulation, there’d always been a touch of envy. The wonder if I’d ever come close to this ability. The urge to touch those virtuoso instruments he had for hands, as if to try to sense the source of their genius, to tap into it.
I’d done so after the first time I’d seen him in action, setting all of this in motion.
None of it would have happened if I hadn’t touched his hands that first day…
“Do you remember the first time we met, Cali?”
Thirty-Five
I dropped the needle holder I was suturing the rectus abdominus muscle with.
As it clattered to the ground, Ayesha snapped her gaze to me, to check if I’d fallen asleep, then rushed to hand me another one.
Goosebumps drenched me as I took it. “Quit reading my mind, Jake. This is getting spooky.”
His eyebrows disappeared beneath his cap. “You used to love it when we thought the same thing simultaneously.”
“Yeah, but now it’s unilateral. It’s not a good feeling being a one-way mirror.”
“Maybe I’ve sucked dry your mind-reading ability, boosting mine.” He palmed a threaded needle holder from Lucia, his silver-blue gaze tinged with…challenging humor?
“That would make you what? A mental vampire?” Lucia asked, only half joking.
No need to guess what tinged her eyes as they flitted over Jake. Severe attraction. And intimidation.
Like Damian, if in an almost opposite way, Jake now would be irresistible to anyone with a pulse. As for intimidation, his almost inhuman surgical skills accounted for that. Also she’d seen his influence over both militants and refugees. I could swear they all held their breaths as he approached. He’d always had charisma, but it had been laid-back and exercised at will, which wasn’t often. Now it seemed on all the time, at screaming pitch.
Witnessing his captors fidgeting under his steady power had been surreal. They’d wanted to refuse his request to come back at all, let alone the every day schedule they’d ended up agreeing to. Jake asserted it had been the eloquence of my demand for his services that had made them relent, that his only contribution was promising to put in extra hours fulfilling their own schedule, so it wouldn’t be affected by his presence here.
He could be right. But still, those militants, hardened criminals as they were, revered him.
As for the refugees, I bet they wouldn’t lavish more adoration on the messiah himself.
He now answered Lucia as he took a drain from Ayesha with another gentlemanly nod, sutured it into place. “If only. As I said to Cali, if I possessed any extrasensory powers, I would have long sent her a message across the world.”
As my heart squeezed again, Lucia seemed oblivious of the poignancy in his statement. “Maybe your powers aren’t that long-distance…yet.”
“I wouldn’t put it past Dr. Constantine to be a real vampire.”
That was Ayesha, the only one who knew Jake from way back when. When she’d first seen him, her succinct reaction to the sweeping changes in him had been, “Lord almighty and hallelujah. Jacob Constantine is risen…under the effect of red Kryptonite, no less.”
“Back when I worked at the
same hospital,” Ayesha explained. “He never went home, never slept in hospital. That unlimited energy must come from somewhere not kosher.”
Megumi—who’d been almost dozing off after she’d worked her butt off providing anesthesia for most surgeries yesterday—perked up at hearing her favorite subject. “It’s the mystique of his apparent resurrection that makes him outstanding vampire material.”
Jake cleared his throat. “He is right here.”
Not registering his protest, Lucia, more than a little superstitious and only half joking said, “But we’ve seen him in sunlight, and around lots of blood and not a fang in sight.”
The others laughed, and they launched into a discussion of what else he could be among the creatures of lore. Jake debunked each theory in ultimate good nature.
I continued working, my mind taking in snatches of conversation, straying. To his earlier question.
It had been drenched in sunlight and blood that I’d first seen him.
It had been my second year in med school. I’d been among a few selected for early hands-on surgical orientation in his hospital. Each surgeon who’d signed on to the program had been assigned four sophomores. I’d been picked for his team.
He’d later told me he’d picked me. He’d seen me at sign-up and had chosen me, for very unprofessional reasons. To his regret. He hadn’t realized how young I’d been.
At twenty-six he’d been nine years my senior. He’d also been already an attending, had served in Iraq and Afghanistan where he’d formed his mythical reputation.
I’d entered the gallery of that sunlit room that had been transformed into an OR just for him, to find him wading in the blood of a catastrophic multiple-injuries victim. I’d sat there, preparing myself for a letdown. Surely no one could live up to all that hype?
He’d way surpassed it. I’d been awestruck and entranced by his performance. And it hadn’t been because I’d been green. I’d already seen enough surgeons in action to know he left the best of them in the dust.
After the surgery, I’d ambushed him in the doctors’ room, wordlessly reached out for his hands. I’d wanted to see for myself, what they were made of, what energy ran through them.