3. CHAPTER 3
CHAPTER 3
“ H i, Clara. I have Taylor with me.” Sadie strolled into the theatre, with a man at least a head taller than her trailing behind. “Your medical student,” she added for the rest of the staff, who were all staring with interest at the giant of a man walking in the door.
“I’ll be with you in a minute.” Clara started all her infusion pumps, which were injecting drugs into the patient’s drip, and waited for them to lose consciousness; when they did, she lifted the mask over the patient’s face up, supporting their airway.
Then, reaching behind her, she spun the APL dial on the anaesthetic machine so she could ventilate the patient. Once she was satisfied, she turned her head to face the newcomer.
Clara couldn’t see much of him, with the hat covering his hair, the surgical mask covering the bottom of his face, and the dark-rimmed glasses that failed to hide his vivid blue eyes.
However, she didn’t need to see his face to know what he looked like; it was a face that most people were familiar with, staring out at them from movie posters and TV screens.
If he hadn’t had a hat and mask on, she would have seen short jet-black hair, usually worn artfully tousled, and a handsome face with high cheekbones and a square jaw.
What she could see clearly though, was her best friend standing next to him, waggling her eyebrows at Clara while everyone else looked at Taylor.
“Hi, I’m Clara.” Clara dropped the bag she was squeezing and lifted her hand at him.
When Taylor made no move to step into the theatre and only stood in the doorway staring at everything, she waved at him. “You need to come a bit closer.” She gestured for him to come over to the operating table.
Taylor hesitated, then took one step closer, but no further.
Clara rolled her eyes before speaking again, trying to make a joke of his reluctance to enter. “Whatever Sadie has told you about me is a damn lie. And if you want to see what we do, you need to come closer.”
Picking up the bag, she continued to squeeze it, ventilating her now unconscious patient.
“Yes. You should come closer,” Lauren murmured, and stared at Taylor until Clara took her hand off the bag and waved it in front of her nurse’s face.
“She didn’t tell me anything.” Taylor’s gravelly voice was so low it was barely audible. “It’s just, well, it’s all a bit, um, I’ve never been in an operating theatre before.” His wide blue eyes darted around, taking everything in; he winced when he saw the trolley laid out with surgical instruments, his gaze snagging on a shiny scalpel blade.
“That’s okay. Not many people have.” Clara carried on ventilating her patient as she spoke.
Sadie grabbed hold of Taylor’s elbow and propelled him over to the operating table. “You’ll see things better from here.” She deposited him right next to the bed, and Clara was sure she heard her best friend giggle as she let go of the actor’s arm.
“Great,” Clara said sarcastically, still sulking a bit that she had been burdened with Taylor when all she wanted to do was her job with minimal fuss. She was so tired.
Sadie glared at her, then gave her a swift kick on the ankle.
“Hey.” Clara protested before she took in Sadie’s glaring face and realised she should probably minimise the sarcasm and do as she had promised and teach. “Okay, so I’m about to intubate the patient. Which is where I take a laryngoscope,” she gestured at the metal instrument in Lauren’s hand, “and use it to see the vocal cords, so I can put a breathing tube, often called an endotracheal tube or ETT, through the vocal cords. Then, I’ll breathe for the patient using a ventilator for the duration of the surgery.
“I’ve waited a couple of minutes since I gave them drugs, Which were an anaesthetic drug called propofol, which is the top infusion you can see running, the next one down is an opiate called remifentanil, and I’ve injected a drug called rocuronium, which is a muscle relaxant. This paralyses all their muscles, including their vocal cords, and I can get the tube in. Make sense?”
She glanced across and up at him and was slightly startled at the intensity of the blue eyes staring back at her. Clara wasn’t convinced he had understood a word she said, but he nodded anyway.
Then, she demonstrated intubation as he studied her, explaining every step in detail. She gave a few more drugs into the drip. Checked everything on the monitor and the patient’s positioning before she was satisfied and turned to face him, finally giving him her full attention.
“And then we sit and hope the surgeons don’t stuff up, so we don’t have to do anything else until it’s time to wake the patient up,” she said loudly enough for Ron, the surgeon, to hear.
“Hey, I heard that!” Ron shouted across the operating theatre.
“You were meant to. Go and scrub and get on with your job.” There was laughter in her voice as she made a shooing gesture at Ron to hustle him out of the door to the scrub bay.
She turned back to Taylor, dropping her voice. “Are they punishing you?”
He looked at her blankly. “What?”
“I’m trying to figure out why they’ve sent an actor to an operating theatre, even if you are playing an anaesthetist in a movie.”
“I’m playing an anaesthesiologist, not an anaesthetist,” he corrected her quietly.
Clara shrugged. “Same, same. One is international, and the other is just you Americans. We’re all doctors who make people unconscious and provide a non-moving target for the surgeons. Then we make sure the patient wakes up at the end.”
“Oh, right. Okay. Anaesthetists everywhere else, and Anesthesiologists in America. Got it.” Taylor stumbled slightly over the unfamiliar words.
“Then why are they making you do this? Did you piss the director off?” Clara nudged him.
“No. My director, Mr Atrosky, wants me to look as natural as possible in the role.” He looked down at her.
“So you get the joy of hanging out with me?” she questioned.
Taylor nodded. “Yeah, he thought that me meeting a real doctor and watching some surgery would help me get in touch with my role.”
“In touch with your role?” Clara struggled to keep a straight face, she knew it was serious to him, but it was so alien to her and sounded like a load of crap.
“Yes. To make it more believable, he wants us to inhabit our roles—live them, breathe them,” he said with conviction.
“Uh uh.” She tried not to, but a snort of laughter still escaped her. She glanced at him guiltily. “I am so sorry. That was massively rude of me.”
“That’s okay. Acting is a little different to all of this.” He nodded his head towards the surgeons who were about to make their first incision. “This is actual life and death.”
“Nah. This is just an appendix; it’s bread and butter.” She grinned at him, pleased he hadn’t taken offence, mainly because Sadie would be after her if she upset their important visitor. “You’re not a fainter, are you? If you are, it’s always better to sit down, not fall down.” She indicated a chair in the corner.
“I’ll be fine.” He didn’t sound confident.
She peered at his face, which now seemed pale under his tan. “Are you sure?”
He nodded. “Quite sure.”
Her head tilted to the side, listening to her monitor as the oxygen levels changed and the patient’s heart rate kicked up. She frowned and stepped past Taylor, moving closer to her screen. She waited impatiently for the blood pressure cuff to cycle.
“Is everything okay?” Taylor moved nearer to her.
“Probably, just give me a minute.” She waved vaguely; her attention was totally off him and on her job.
“Is everything okay?” he tried again.
“Shhhh.” She frowned as the blood pressure showed far lower than she expected. “Shit.” The heart rate continued to increase.
Taylor crowded closer. However, Clara ignored the large man, who many women would claw her eyes out in their attempts to stand as close to him as she was, and pushed past him to her drug trolley, where she pulled open the top drawer and grabbed a drug out, efficiently drawing it up and labelling the syringe.
“What’s that?” Taylor followed her across to the trolley.
“Adrenaline,” she explained before she pushed back past him.
“Now, that’s one I’ve heard of. I’m quite the adrenaline junky myself,” he said as he followed her.
“Right oh,” she muttered distractedly, checking the vital signs on her monitor again.
“Yes. I enjoy flying. I’m taking flying lessons,” Taylor continued.
“Lovely.” She wasn’t listening to him at all. “Ah, shit.” Clara injected some of the adrenaline into the line and dashed over to the anaesthetic bay door, shoving it open. “Lauren. I’m pretty sure we have an anaphylaxis. Can you come and give me a hand.”
“Fuck. Are you sure?” Lauren came rushing into the room.
“Yeah. Hypotensive and tachycardic. I’ve started to give adrenaline.” Clara peered over the drapes, addressing the surgeons. “Guys, I’m going to need you to stop operating for a few minutes while I sort this.”
Ron looked up from the patient’s abdomen and nodded, pulling all his laparoscopic instruments out and stepping away from the operating table.
Clara pushed some more adrenaline down the line and waited for the next blood pressure, but it was lower again. More adrenaline and another blood pressure and it had fallen more.
“Fuck.” She emptied her syringe of adrenaline into the patient’s line and dashed over to her drug trolley to draw up more before injecting it into her patient and calling over to Lauren. “Press the emergency buzzer.” When the next blood pressure was even lower, she swore again, “Fuck. Ron, cover your wounds. I think we’ll need to start CPR soon.”
Ron grabbed some dressings off the scrub trolley and stuck them over the incisions. “Do you want me to start compressions now?” His hands hovered over the patient’s chest.
“Not yet.” She pushed the last of the adrenaline. “Come on, come on.” But the next blood pressure was lower. “Fuck it. Start CPR. Lauren, you’re timekeeping. Sam,” she yelled across at the scout nurse, “grab the emergency trolley.”
It was less than thirty seconds from the emergency buzzer being pressed to a wave of people arriving in the room with one voice rising above the noise.
“Okay, everyone. We have a twenty-one-year-old having a lap appendix.” Clara paused when the defibrillator paddles were attached to the patient. “Stop CPR, what’s the rhythm?”
The chest compressions stopped, and she checked the defib screen. “We have a PEA arrest. Continue CPR. Right everyone, this is presumed anaphylaxis, most likely to the cephazolin or rocuronium, in a patient with no known allergies and no other past medical history. He’s had two milligrams of adrenaline so far, and we’re on our first round of CPR.”
Taylor backed away until he was standing in the corner, but his height of six-foot-five meant he could still see over everyone’s head to watch the events unfolding. His gaze never left Clara, who, while she was dropping swear words every twenty seconds, was in total control of the situation and coordinating the large team of people as they all battled to save the patient’s life.
“That’s two minutes,” Lauren called above the noise of the room.
“Thanks. Stop CPR.” Clara reached forward, feeling for the patient’s carotid pulse while she the defib screen. “Okay. I have a pulse.”
She reached back and hit the blood pressure cuff to cycle again, silent as she waited for the numbers to flash up on the screen. “Blood pressure eighty systolic.”
Clara picked up the syringe of adrenaline and flushed more into the line. “Lauren. I’ll need you to set me up for an arterial line. Gemma, can you get some hydrocortisone into the patient and take the tryptases.”
Her head swivelled to the surgeon. “Ron, did you get a look at the appendix? Does it need to come out?”
“Yeah. Red and on the verge of bursting. We’ve got to do it,” Ron confirmed.
“Okay. No problems.” She swung open the door of the anaesthetic bay through which Lauren had disappeared. “And we need a central line, and I’m going to need an adrenaline infusion.”
“No problems,” Lauren acknowledged.
Clara’s eyes swept the room, catching on the actor, standing tucked in the corner, his back to the wall; he wasn’t hard to spot as he was a head taller than most people.
She nodded to him and called over. “Are you okay?”
Clara grinned wryly under her mask when he slowly nodded in return. This was far more eventful than she expected her day to be.
She spent the next couple of hours putting in more large drips, keeping the patient stable while the surgeons operated, and then transferring the patient up to the intensive care unit. She forgot Taylor was with her, a giant silent shadow, as she concentrated on her job.
He watched the efficiency with which she worked and the humour that had immediately returned when the patient stabilised. The only part he didn’t follow her for was when she walked into a room to speak to the mother of the twenty-one-year-old boy who was now ventilated in intensive care.
When Clara exited the room after talking to the boy’s family, they walked in silence together back to the theatre complex. She rubbed her neck to try and relieve some of the tension in it.
Taylor checked his watch, and after the last few hours of being silent and blending into the background—well, blending as much as you could when you’re a six-foot-five movie star, who even when people didn’t recognise you behind a mask and hat, they would still stare at you because of your height and build.
He finally spoke. “I don’t know about you. But I could use a coffee.”
“Yeah. I would love a coffee.” Her voice held her mental exhaustion.
“Which way is the café? Let’s go and grab one.” He stopped in the middle of the corridor.
She walked another twenty meters before realising he wasn’t next to her. “What are you doing?” she called back to him.
“I’m going to the café. It’s this way.” He gestured over his shoulder at the sign behind him, pointing to the coffee shop.
She opened her mouth to tell him that he needed to go back to the theatre when she remembered that he wasn’t a medical student, and instead said, “Yeah, it’s that way, one level down.” She indicated the way to go, then kept walking.
“You said you wanted a coffee,” he called after her.
“I’ll get some in theatre. The next patient is in the anaesthetic bay. But you should go and get what you want. Grab yourself some food too; refuel while you can.” She waved to him.
“Aren’t you hungry?” Taylor sounded confused.
“Yeah, I’ve got some food in my bag.” She paused, not wanting to yell too loudly.
“But you wanted coffee.” Taylor gestured down the corridor again
“Yeah.” Clara nodded.
“Don’t you want a proper coffee?”
“I would love a proper coffee.” She sighed at the thought of a chocolate-topped cappuccino.
Maybe if she asked Lauren nicely, she would nip down and grab her one. It didn’t even cross her mind to ask the actor to get her one, as she didn’t have her credit card with her to give him to pay.
“So come to the café. Take a few minutes to decompress. That was intense.”
She didn’t mean to, but she laughed out loud. “I don’t have time to decompress. I don’t need to decompress. What I just did. That’s part of the job. What I have to do now is get the next patient asleep and get the theatre list moving again.”
“Surely no one will mind if you take five minutes.”
“Every five minutes I take now adds another five minutes onto the end of the day. And then I’ll never get home.” She pointed towards the doors that would take her back to theatres. “You, however, don’t work here, so please take all the time you need. Head back up if you want to, or if you’ve seen enough for your acting, don’t feel obliged to return.” She checked her watch. “Right, I need to go. See you later.”
“I’ll come back,” he said hurriedly. “Can I grab you a takeaway coffee?”
“Nah, It’s all good.” She shook her head even as her weariness screamed at her to say yes.
“Okay,” he replied.
Clara trudged along the corridor, aware of his eyes on her back, but she resisted the urge to turn around until she heard his feet move; then she finally glanced over her shoulder to see his broad back as he strolled away.