Chapter 33 #2
Josie swallowed hard. The surgery had only taken two and a half hours, yet she felt like half her life had gone by since she had stepped into the OR.
The intense concentration and physical demands had her whipped, and fear had her in its grip.
How could she hate a job she’d spent the last nine years training for?
Once upon a time, surgery had seemed exciting and intellectual to her younger self, when she’d been eager to prove she had brains to match the best of them. In her mind, orthopedics was logical, clear-cut. X rays of injuries and disease— then diagnosis, treatment, prevention. Simple.
Yet why was it after a full year and two rotations of major orthopedic specialties she was feeling that she’d lost the meaning of the word logic in her life?
Her shoulders slumped as she pulled off her gloves and gown and threw them in the bin. She intended to follow Mrs. Frenske to recovery to make sure she was stable, but first she needed a minute to catch her breath and calm down her stomach, which was doing really athletic somersaults.
But shoot, something was wrong here, though given the eighty hours she was scheduled to work that week, she didn’t have time to worry about it.
She should be feeling elated that things had gone so well, she reminded herself firmly.
Mrs. Frenske had been a model patient, her body doing exactly as it should, and Josie had made no mistakes.
Josie turned to leave the cold operating room, suddenly aware of Houston’s eyes on her. Afraid he could see her confusion, she ducked her head as she went past him, focusing on the shiny sterile floor.
“Josie.”
“Yes?” The tone in his voice drew her eyes upward in spite of herself.
He had pulled his mask off, and her gaze went to his mouth. She wanted him to kiss her. To hold her against that rock-solid chest and tell her that everything was okay.
A blush began to creep across her face. Was she really so needy? He didn’t need or want her, and yet she couldn’t stop herself from wanting him.
To make matters worse, he didn’t smile, didn’t give her praise or reassure her that she had done well.
Instead he said simply, “If you don’t have confidence in yourself, nobody else will.”
There wasn’t anything she could say to dispute that. He had told her that before. He was right. “I know.”
That look on his face, of concern, labeled her first attempt in the OR with him as a dismal failure. It didn’t matter that everything had gone smoothly and that she had made no outward mistakes.
It felt wrong. Dr. Sheinberg had told her once that surgery was a calling, and she didn’t know now why she had ever thought she had it.
And even when she had been kidding herself, Houston had seen through her, seen that inside she was a bundle of nerves, as frightened as a dog during a thunderstorm.
She started towards the door again, needing to be alone.
“Josie.” His steady, unemotional voice stopped her again. “It was a nice job.”
“Thanks.” Afraid that she would bawl like a baby if she turned to him, she hit the swing door with the palm of her hand and plowed forward.
She needed space between herself and the OR. And Houston Hayes.
Josie nearly ran into Shirley from the ER. “Sorry to interrupt, Dr. Adkins, but are you finished in here?”
Surprised to see Shirley out of the ER, Josie nodded. “Yes. Just closed. Did you need something?”
Shirley hovered by the door, having hastily donned a gown and cap to enter the sterile room.
“There’s been a bad car accident out on the boulevard.
It was one o^ those torrential rains, you know, where you can’t see two feet in front of you.
Six cars collided, and we’re full up in the ER.
We’ve got an open compound femur fracture. Can we send him up?”
“Of course. Put him in three.” Josie fought the urge to ask for Houston’s opinion, conscious of him standing right behind her, silent and watching. She was the surgeon here, damn it. It was time she started acting as such, personal feelings be damned.
Twenty minutes later, after grabbing a cup of coffee and a muffin, Josie was in room three with Houston assessing the injury.
The man, who had arrived unconscious, was now being monitored by the anesthesiologist. He was in his forties or fifties from the looks of the touch of gray at the temples and crow’s feet flaring out from his closed eyes.
The remains of what had been dress pants were being cut away, and the once neat and tidy gray suit reminded Josie of a businessman.
Maybe he had been on his way to an appointment, the last one of the day before he went home to his wife and a couple of shaggy-haired teenagers.
It was Josie’s job to fix him and send him home to that family, if they existed.
The responsibility of that nearly overwhelmed hei^ and she took deep breaths to calm herself down.
She was a fantastic doctor. She was a competent surgeon.
She had spent almost a year in the ER and had never once choked when dealing with a whole range of complicated emergencies.
That thought steadied her.
Houston was relaying to her what the attending doctor in the ER had told him.
“He’s in rough shape. Bruised liver, broken ribs from the impact of the air bag, plus the compound femur fracture and a lot of bleeding.
So get his leg patched up and we’ll send him on his way to ICU with a transfusion as a parting gift. ”
Josie wasn’t used to Houston being so light in tone. As she began clamping vessels to stop the blood flow, she wondered why he was choosing a serious injury as the time for flippancy.
Then she realized it was probably for her benefit. He was concerned about her ability to handle an emergency like this. She certainly hadn’t been giving him any reason to trust her nerves given that she’d nearly choked on a simple hip replacement.
Working steadily for the next two hours, Josie concentrated on plating and screwing the broken bones back together. She felt she was gaining on the injury, when she heard the awful sound of the monitors going off, alerting them to a problem.
Josie didn’t look up, knowing that was what her support staff was for. She kept on doggedly.
“He’s arresting,” the anesthesiologist said.
Oh, Lord, help her. It was Josie’s worst nightmare coming true. This man, whose name she didn’t even know, was having a cardiac arrest right there on the operating table, with her hand still in his leg.
Houston was already moving to assist the nurse. Josie spared a glance up. “Let’s defribillate him!”
The SA held the paddles in front of the patient. Houston backed up to get out of the way. “I can’t do it with only one hand. You’ve got to.”
“I know.” She swiped her hands on her gown to give herself better leverage and grabbed the paddles.
Placing one below the outer half of the right clavicle and the other over the apex of the heart, Josie took an urgent breath. “200 J, let’s go.”
“Clear.” They shocked the man’s heart, with no result.
The monitor read flat line and the eerie bell rang loudly in the cool room as they hovered over him. The surgical assistant administered CPR for one minute before Josie nudged him.
“Again.” She couldn’t let this man die like this.
It was a severe injury, with a large amount of bleeding, but it shouldn’t be a fatal injury.
She would never be able to forgive herself if he died in front of her, in a room filled with strangers, without ever getting the chance to say good-bye to his loved ones.
The result was the same, and the staff all worked in unison to attend to the various tasks that needed to be done.
The patient was given epinephrine and lidocaine in his IV.
The positioning of the electrodes was checked, and CPR was conducted while the anesthesiologist checked for a rhythm on the monitor.
“Again,” Josie said, desperation creeping into her voice.
The nurse looked to Dr. Hayes for confirmation.
He nodded. “Do it.”
“360 J,” Josie said. “Clear.”
This time there was a response. The heart began a sinus rhythm, faint but steady. Josie’s knees went weak with relief.
“We’ve got a pulse,” the nurse announced.
The anesthesiologist sank back onto her chair; wiping her forehead. “Whew, that was close.”
With a nod, Josie went back to the fracture she had abandoned. She didn’t trust herself to speak, afraid she would start crying, and she wanted this procedure done right now. She couldn’t afford to lose it just yet.
“I’li lend you a hand,” Houston said, his calm voice nearly shattering the last of her control.
How the hell he could act so unshakable, collected, so unconcerned when a man had almost died, she couldn’t understand. She just gave him a nod, afraid if she locked eyes with him, spoke, that Houston would hear and see all her inadequacies, all her failings as a surgeon.
Houston began to work on turning the last screw in place with his left hand and Josie couldn’t help but notice that he only needed one hand to accomplish in the same amount of time what she needed two hands for.
Granted it wasn’t complex work, and he stepped back to allow her space when she needed to restore the muscles around the femur; but it felt like another blazing football field size sign that she wasn’t cut out for the OR.
Twenty minutes later she had the last suture in place and they were wheeling the man to ICU to be monitored closely for signs of distress or cardiac arrest. Josie watched the gurney go and took deep breaths.
Her hand was shaking. She wondered if it had been shaking when she had been suturing. The poor guy would have an odd-looking scar if her hand had been trembling with the needle in it.
It was the absurdity of that last thought that had her peeling off her gloves with frantic energy and heading for the locker room.
“Josie.”