8. Chapter Eight
Chapter Eight
Colter
I debate letting Annaliese take this entire surgery, start to finish. It wouldn’t really be uncommon for a second-year resident to complete an appendectomy with the attending supervising, but I’d be lying if I said that Richard’s lack of faith in her abilities doesn’t make me hesitate to see how far she can go.
She’s assisted me on countless surgeries over these last few weeks, and I quizzed her through each one. She hasn’t shown the slightest insecurity, or lack of knowledge about anything we’ve encountered. She hasn’t disagreed with any recommendation or order I’ve given her.
Until today.
Technically, yes, an ultrasound can diagnose a burst appendix, but a CT is the gold standard. Even for children, I prefer a CT so I can get a better visual beforehand. I’d be able to see if there is additional abscess or fluid that will need to be removed before I open them up.
Less surprises means less room for error.
But her stubbornness gets to me. Her passion and drive and the scrunched up look on her face when she said she didn’t order a CT got to me. She knew it was risky. She knew I’d question it, but her heart led the way.
Maybe that’s the bleeding heart weakness that Richard has alluded to. But from where I stand, it’s just that she simply cares about people, and dammit, that does something to me. It does something to me that I don’t want to think about, because it isn’t a thought I should be having about my boss’s daughter.
Oftentimes, hell, most of the time, surgery can become cold. When the patient is under anesthesia and drapes are laid over their body, it takes away the personal touch of medicine. I won’t admit it to her any time soon, but I was filled with a strong sense of pride when she stood her ground and refused to order additional testing.
That sense of pride was instantly replaced with a strong urge to spank her ass when she offered to have the kid’s Transformer in the room with us. Against the rules? No. Going to contaminate the sterile field? Of course not.
Annoying as all hell? Absolutely.
But goddamn, she's pretty. When I saw that pink flush move up her neck I had to physically restrain myself from reaching out to trace its path.
So of course, Annaliese won. So once I’m done assessing the cavity, and I’m confident that she can remove the appendix and clean appropriately, I look up to nod in her direction, but my gaze goes to that fucking robot on the desk instead.
I must squint, or maybe grunt a little, because Annaliese’s gaze follows mine, and she peeks over the shoulder of the tech across from us. When she turns back, I can see the crinkles around the corner of her eyes and the wiggle behind her mask, letting me know she’s feeling pretty damn proud of herself right now.
“Alright, Keeton.” I lift my hands off the tools, reaching for the laparoscope to prompt her to switch places. “You’re on deck.”
Annaliese stretches her neck to one side and rolls her shoulders back before stepping forward to take over.
Not everyone initially realizes that surgery is a contact sport. There are a lot of moving hands that need to be in the same place, and when the patient on the table is a child, the space to work becomes even more limited.
Since I’m holding the scope, Annaliese needs to nearly tuck herself under my arm to have proper access to the other two tool sites. I’ve been in this position countless times with a limitless number of residents, both male and female over the last ten or so years, but I can’t remember any time it’s felt like this .
My body, even though it’s covered with sterile gowns and gloves, seems to be acutely aware of how close she is to me. With the bright blue mask and surgical cap covering most of her face, it makes the depths of her coffee-colored irises seem limitless.
Her long, midnight lashes fan across her cheeks as her eyes scan back and forth. I tell myself to focus on the scope to make sure she has the necessary view of the appendix. I remind myself that she’s still in training, and that I need to make sure she doesn’t kill anyone on our table.
Those reminders ring through my head each time I catch myself looking at her face, or when I catch myself holding a breath when she moves in closer. There’s something familiar about the way she smells, like warm coconut or sunshine. It’s faint enough that I hadn’t noticed it before, but then again, she’s never been this close to me. If she were to spin her head and look up at me, our mouths, while covered in masks, would only be a few measly inches apart from one another.
I blow out a heavy breath, forcing myself to school those thoughts and watch her work. She carefully moves the small intestine out of the way, making her window so the mesoappendix comes into view.
Tools are switched, and Annaliese cautiously fires off a line of staples, perfectly cutting off the blood supply to the appendix. I watch closely, refusing to blink as she locates the base of the appendix and carefully ties it off with a textbook-style endoloop.
She clips it, removes the remaining pieces leftover from the rupture, and flushes the abdomen to wash out any remaining infection. She inspects her work twice over before she starts the process of closing the cavity.
She’s smooth yet efficient as she adjusts her instruments, closing each layer with absorbable sutures, making sure she leaves the body in better condition than she found it. It’s clean and detailed. It’s everything I’ve come to learn Annaliese does during her procedures.
But something is off with her.
The circulating nurse doesn’t seem to notice, neither does anesthesia or the scrub tech, but I’m also certain they don’t watch Annaliese like I do.
Her normally steady hands have a slight tremor to them, the faintest start of a twitch that began once she clipped the appendix. Most residents show nervous energy at the beginning of the surgery, or right before the climax, not when the hard work is done. No, it isn’t nerves that have her hands shaking. It’s not enough to cause me to step in and take over, but enough to catch my attention.
She adjusts her position again, rolling her shoulders and raising her elbows as she closes her final incision. Once she’s confident her work is done, she quickly allows support staff to take over and she steps back. I keep her movements on lock, watching as she strips off her gloves and begins to remove her gown. Her movements are hasty and that faint tremor is more noticeable now as she fumbles trying to untie her face mask. I track each step, my eyes never leaving her body as we make our way to the sinks.
Sidling up next to her, I watch her hastily scrub her hands and forearms as I lazily wash mine. Seconds tick by before I break the silence.
“Excellent work in there. Follow up with him once he’s discharged to the floor later this evening. You’re on call again tonight so I want a report first thing tomorrow morning.”
She nods, never slowing her scrubbing motion, and I wait for her snarky remark.
But it doesn’t come.
“Make sure Optimus Prime gets back to him. I don’t want to scrub in for my next procedure and find he’s still sitting at the desk.”
She nods briefly as she reaches for a clean towel and swiftly dries her hands.
I had expected at least a huffed half-smile for my Optimus Prime comment. There’s no way it pissed her off. It’s nothing compared to the jabs we’ve been lobbing back and forth since the moment we met.
“You alright?” I finally ask as I turn toward her to grab my own clean towel. She made it sound like she was familiar working with children, but I’m not sure how many true surgeries she’s had to complete on them. Even though part of being a surgeon is being able to compartmentalize your emotions from the job, I’d be lying if I said it wasn’t hard to forget that it’s someone's child on the table.
She clears her throat as she crumples the towel and tosses it in the bin at her side. “Fine.” Another rough clearing. “I have to run, but I’ll follow up as expected.”
She turns to leave, and I instinctively reach out, resting my palm on her back and curling my fingers over her shoulder to halt her movements.
She startles, pausing in place as she spins to face me. I loosen my grip a little, letting my hand slide down her arm to close over her wrist.
We’ve been pressed up against each other in the OR more than once, but it’s never been this skin on skin contact. I brush my thumb along the soft skin of her inner wrist, knowing I’m overstepping, but unable to fight the uneasy feeling in my gut that something is seriously wrong with her. I eventually loosen my grip, just a little, but not all the way because I know if I let her go, she’ll leave without answering.
“Seriously,” I say, making sure to keep my voice low. “Are you alright?”
The only response she offers is a soft, closed-lip smile as she reaches her free hand up to cover mine, squeezing once before gently pulling apart. An alarm on her watch vibrates, and she flicks her wrist away so I don’t see the message coming through. “Fine. Promise.”
Before I can call her a liar to make her stay and tell me what the hell is going on, she’s backing away from me, spinning on a heel to disappear around the corner.