34. Nick
34
NICK
T he scalding water and sterilizing soap burned my skin. I turned it up as hot as it would go to help myself concentrate. It wasn't Scarlett's response that had me worked up either. I could handle that. I knew when this surgery was over and Ethan was in recovery, we would sit down and talk, and I could tell her what I just discovered. And she would be shocked. But right now, I had to get my emotions under control and my mind focused.
Doing a septal myectomy on a patient Ethan's age should have been a last resort, not an emergency. But with what Scarlett told me and after having looked at Ethan's file more closely, I now understood why this was happening. Ethan had been getting worse slowly, which I knew was going to happen. People with HCM never recovered on their own, though with medication they could put off the worst of their symptoms.
But in Ethan's case he was continuously getting worse. I wanted to delay surgery in the short term to allow him to enjoy his holidays before we set something up. Scarlett knew this, which was why every time she freaked out that something was wrong, I reassured her that he was fine. I knew he would slowly deteriorate, but I knew we had time.
Then someone switched his medicine and…
I clenched my jaw and almost ran my hands across my scrub cap unconsciously. I stopped myself before ruining my scrub in, but I knew I had to calm down.
"Dr. Edwards," I heard, and I turned to see the scrub nurse step in to help me. She looked nervous. All of my nurses looked nervous. They all were following my orders as they should, not Marvin's. They all knew he had no real authority to step in and stop a surgery like this. He had to call the whole board. However, I had the power to fire any of them on the spot, but most of them just obeyed me.
If things went sideways, they knew I would be held responsible, not them. Though, that wasn't very encouraging to me. But at least if I was wrong, they were protected.
"Yes," I said, shaking my hands off. I took her sterile towel and lifted my foot from the pedal beneath the sink. The water shut off and I dried my hands and dropped the towel into the sink and turned so she could put my gown on.
As she tied me in and put gloves on my hands, I closed my eyes and imagined every single incision, every angle cut, each step I'd take to cut my child open and save his life—sternotomy to open the chest cavity and give me direct access to his heart, giving the nurse the retractor…I took a deep breath and blew it out. Next came the heart-lung bypass. It would be difficult knowing I had to stop his heart. My boy…Tears almost welled up, but I bit them back and took another breath.
Then came the aortic incision. My chest tightened but relaxed and my brain started to process each of the next steps. I could do this. I'd done it before and I would do it again. My blood pressure was lowering to normal, my heart rate returning to usual sinus rhythm, and I was ready.
"All set," the nurse said, and she backed away to allow me space to walk past.
This was the most important surgery of my life, and I wasn't going to let anyone get in my way or mess with my mind. I'd told Fiona's father off, and I saw her out there, but right now it was me, my scalpel, my son, and an emergency like none I'd ever faced.
"Excuse me, Dr. Edwards, but you may not go into that operating room." Marvin's boom behind me halted me in place. I turned around slowly, hands held in front of myself but away from my body to preserve the sterility. He had some nerve.
For a moment, I stared at him, wondering if he knew what was actually going on. If, like before, he was in on this with his daughter, he'd have a lot of hell to pay. But something told me he didn't really know. And maybe he didn't know last time either. I could see how one person could be so cruel and so sadistic that they'd try to ruin my life on purpose, but Marvin was a decent man. There was no way he'd do this to me a second time. Not without cause. And a jealous hurt daughter—who admittedly was old enough to know better—was no reason for him to attack me.
"I'm not interested in another scandal going down on my watch in yet another hospital. I know you're the boy's father, and you know state law. You are not legally allowed to operate on that boy." Marvin was unmoving, stoic, angry. There weren't enough men in this hospital to keep me from going into that OR and saving my son's life. It'd already been forty minutes. I had to do it now.
"Marvin, there is no proof that that boy is my biological child. I am dating his mother, and that is not against the law." I took a step closer to him, and I watched the nurse avert her eye and squirm a little. Even if I had to knock this joker out and rescrub, I was going into that room.
"That's crap and you know it. I've seen his file. He is your child." Marvin huffed and glared at me. He looked like he knew he was going to lose but wasn't ready to concede yet. "I can't let you do that surgery. I will call the authorities and you'll not only lose your license to practice but you'll be arrested."
It was too much. I couldn't let him get me riled up. I had just found my center. I had to cut into my own son, for Christ's sake. I had to let off the steam, tell him, even if it meant he warned Fiona and she got away.
"Well, good…" I had to grit my teeth for a second to swallow down some of the rage, and then I narrowed my eyes at him. "Because they'll have to arrest your precious daughter too…"
Marvin's eyes stormed over and his nostrils flared, but before he could respond I continued.
"That's right…I have proof that she snuck into my office to plant a code on my computers that gave her access to my patient files. She switched Ethan's medication, thus preventing him from the care he needed and effectively inducing this heart failure. On top of that, she removed the paternity results from his chart, effectively removing all physical proof that I am his father. So before you start pointing fingers at me, you need to ask yourself if throwing your own daughter in jail is worth it."
With the tiniest of squeaks, he took a step backward. I didn't have the actual proof yet, but I assumed the forensic techs at the police department could decipher if Fiona was capable of doing this, and which of her computers, or her father's computers, she used to hack into my account. I watched him retreat another step before I put my back into the OR's swinging door and let myself in.
I had to shake the interaction off, but knowing he wasn't going to come charging in had already set my heart at ease. I stepped up to the table and held my hand out for the scalpel. My team and I worked seamlessly making the initial incision. When the chest retractor was in place, we hooked Ethan up to the bypass and I stopped his heart. It was touch and go for a moment as his body adjusted to the heart and lung machine, but soon I was cutting into the septal muscle.
It was worse than I thought, and while I'd never give Fiona any credit for forcing the surgery to happen sooner, I was grateful that I was here at this moment doing what I could to save his life. Nearly three and a half hours in and were ready to take Ethan off bypass and suture him up. I hovered over his body, bloody gloves and sweaty forehead, and I was nervous.
Never once did I have a patient die on my table except for the strange accident that caused that patient's death, after which I was sued for malpractice. When it came down to it, there were other factors at play that weren't my fault. His other doctor had neglected to share comorbidities with me and that led to his death.
With Ethan, however, I knew his medical history inside and out. So when we had a difficult time getting his heart started again, I began to panic. Ethan's body had been chilled, as is standard procedure during a bypass like this, and warming him up wasn't causing his heart to restart. We'd removed the clamp, washed the cardioplegia, and I'd been massaging his heart for twenty minutes, but he wasn't responding.
"Sir, should we do the pacemaker?" the nurse asked me. As a perioperative nurse she had assisted me on a number of bypass surgeries, but I wasn't convinced the pacemaker was going to work. This was my son. I had his heart in my hands literally. Not many fathers could say they held their son's physical heart in their hands, and for the past nearly four hours I'd done just that.
"No, we're going straight to the paddles." I knew it was a risky choice, probably a bit extreme, but I felt the eyes of now three board members watching me from above. I knew they were there about halfway through.
"Sir…" the nurse protested and I eyed her.
"Get the paddles." I wasn't about to let my son die on my own table. I told Scarlett to trust me, and I was going to return her son to her arms. "Now," I told her.
I had to remind myself that it wasn't abnormal to struggle with getting a patient's heart started. I had to stay calm and not make mistakes. I couldn't look her in the eye again if I did. My entire life was on the line here and everyone in this room knew it.