Nick
“I'm here-I'm here-I’m here.” I push through the OR door just as the labor and delivery nurses reposition the expectant mother on the operating table.
Through the washroom window, a masked Tatum is scrubbing in with a resident, her eyes concerned, zeroed in on her patient.
Mel, the anesthetist on the case, is already inducing anesthesia, applying oxygen to the patient.
“Why'd she call STAT?” I ask her.
“Prolapse cord.”
Of course, there would be a prolapsed umbilical cord on Halloween.
My eyes dart to the patient. One of the labor nurses remains frozen at the bedside, her gloved hand still inside the patient's vagina, keeping pressure off the prolapsed umbilical cord until the baby can be delivered.
I grab the now-empty stretcher, its sheets soaked with meconium-stained amniotic fluid, and steer it out of the room.
NICU arrives just as Tatum steps into the room, gearing up in a gown and gloves. Our eyes meet as she nods a hello.
“Let's splash,” she orders after hearing the baby's distressed heartbeat one last time.
A nurse steps up and dumps a ruddy-brown colored soap all over the patient's abdomen. Others maneuver around her, covering the patient with blue drapes to finish prepping.
“Anesthesia, are we ready?” Tatum asks.
My attention shifts to Mel who gives a confident nod. “Let's do this.” I step closer to the patient adjusting her oxygen mask. “Alright, ma'am, I need you to take some nice, deep breaths for me.”
Her frightened, tearful eyes flutter closed as she follows my instructions.
“That's it. You're doing great. Just keep breathing for me.”
Mel administers the induction medications as I gently support the patient's head and jaw. Within moments, she's asleep, allowing me to secure her airway before turning the case back over to Tatum.
“We're good.”
With a blade already in hand, Tatum cuts, and within seconds, the baby is born.
“Crawford …” Mel's voice cuts through the newborn's first cry. “The end-tidal is increasing.”
My eyes snap to the monitor.
Fuck. Sure enough, the capnography shows that the patient's carbon dioxide is increasing, meaning her body is producing too much suddenly.
“Go ahead and increase ventilation.” I pull out my stethoscope and listen to the new mom's lungs. “Erikson, does this patient have any medical history? Previous surgeries?”
“No,” she answers. “No previous history. No allergies. No surgeries. Besides a prolapsed cord, this was an uncomplicated pregnancy. Why?” She stills, peering over the blue surgical drape. “Is something wrong?”
“What's her temp?” I ask Mel, noting the patient's pulse in the one-thirties.
“thirty-eight point one, sir.”
Goddamnit.
“Discontinue the volatile now, then hyperventilate with one hundred percent oxygen.” My eyes stay on the monitor, watching her end-tidal continue to climb as I pull out my phone.
“Crawford—” Tatum's voice sharpens—“what's wrong?”
“Close now, Tate. You need to close now. We’ve gotta move.”
***
“M-malignant hyperthermia?” The patient chatters, her eyes red with exhaustion. “Is that … like, cancer?”
“No, ma'am.” I shake my head. “Despite the name, it has nothing to do with cancer. It's a rare reaction to anesthesia, and your body essentially went into overdrive.”
She winces as Tatum examines her postpartum bleeding before adjusting an icepack between her thighs. “Fortunately, Mel and Dr. Crawford recognized it early and were able to treat it.” Tatum covers her up with a cooling blanket. “I'm sorry today didn't go as planned, but—”
“M-my b-baby is okay.”
Tatum smiles. “That's exactly right.”
“Th-thanks, Dr. Erikson. I'm s-sorry if I ruined your Halloween.”
Tatum smiles. “I promise, you didn't ruin anything. Made it more exciting? Sure, but ruined? Nah.”
The patient glances up at me. “Th-thank you, Dr. D-Dimples.”
“You are more than welcome, sweetie.”
“Oh good grief …” Tatum snorts, rolling her eyes. “Get some rest, mama. That pain medicine can make you really groggy.”
I ignore Tatum and step closer. Leaning on the handrail of the stretcher, I flash the patient a bright smile. “Now if you need anything else—anything at all—you let these sweet nurses know, and they'll call me.”
“I need something for my nausea,” Tatum mumbles before grabbing the patient's chart and leaving the PACU.
I finish up with the patient, clarify some orders with the recovery nurse before I catch up to Tatum in the hallway. “Whew, that was unexpected.”
“Which part?” She smirks. “Flirting with the patient or the patient flirting back?”
“I said unexpected, blondie.”
She abruptly stops and glares at me for a beat before chuckling and pushing past me. “What are you even doing here anyway? I thought you'd be doing Halloween with Grady.”
I groan. “The on-call schedule was already out, and I couldn't get anyone to take my midday shift. Plus, Halloween is Tiffany’s ‘thing.’” I air-quote the word. “She insisted on taking Grady trick-or-treating.”
Tatum looks at her watch. “You only have two hours left. You could still make it if—”
I wave her off. “Maybe, but not likely. It's fine, and Grady isn't expecting me anyway.”
“What's his costume?”
A grin spreads across my face. “A dancing dinosaur.”
Tatum raises an eyebrow. “As in Barney the dinosaur?”
I chuckle. “No, he specifically wanted to be a dinosaur … who dances.”
“And how do you do that?”
I shrug. “I got him a dinosaur costume. And I told him to dance.”
“Look at you. Dimples and creativity.”
I spread my arms wide. “What can I say?”
Our laughter is interrupted by her pager. She glances at it and huffs. “Time to get serious. I've got a patient in triage.” She reaches into her white coat and pulls out a headband with animal ears. After slipping it into her hair, she takes off down the hallway. “See you later, Crawford.”
“Hey, wait … what are you supposed to be?”
She twirls around, pointing to her costume ears. “I'm a mouse. Duh.” Laughing, she turns back around and leaves.
Shaking my head, I mosey back toward my recovery patient when my phone chirps. Seeing that it's Tiffany, I answer.
“Hey, is Grady all set?”
“Nick, hi …” Her voice is low and raspy. “Listen, about tonight ... I, um... I don't think I can do tonight.”
“What?” I glance down the corridor at a large window. “But the sun is about to set. Y'all are supposed to be heading out soon—”
“I know.” She sniffles. “I'm feeling terrible. I'm, uh … I'm sick or … something.”
“You sound awful.”
She gives a weak laugh that quickly dissolves into a cough. “I feel awful.”
“Is Grady feeling okay?”
“Grady?” she mumbles. “Yeah, he's fine. B-but Nick … he needs to go trick-or-treating. Tonight.”
I raise an eyebrow, glancing down at my phone. “Tiffany, do you maybe need to go to urgent care?”
She doesn't respond.
Tiny hairs on the back of my neck stand on end, my pulse quickening. “Tiffany? Y’there?”
“Hrmm?” She sniffles again. “I'm sorry. What did you say?”
“I … I think you need a doctor.”
“What? No, no … I just need water and some s-sleep. And you—I need you to come pick up Grady.”
“Yeah … yeah, of course. Um …” I look down at my watch before dragging my fingers through my hair. “Hang tight. Let me see what I can do, okay?”
“Thanks, Nick.”
***
Woodsmoke hangs heavy in the humid Texas air. The sweet scent of funnel cakes and buttered popcorn teases my senses as the squeals of hundreds of costumed children fill the outdoor space.
Grady's eyes are wide, taking in the candy-induced chaos. Squeezing my hand, he bops along in his Tyrannosaurus Rex costume, his tail wagging behind him. He hasn't let go of me since I picked him up from Tiffany's apartment.
I texted Julian the moment a colleague agreed to stay for the final hours of my call shift.
He sent me a flyer for a Halloween alternative at a local church, promising games, inflatables, and enough candy to keep every kid in Houston awake until Thanksgiving.
Apparently, the Christians decided to go all out for Halloween while insisting it wasn't Halloween.
“Nick! Look!” Grady tugs me toward a booth decorated with plastic dinosaurs and palm trees.
A cheerful older gentleman in a safari hat beams at us. “Welcome to the Dino Dig! God made dinosaurs too, you know?”
Did he now?
Grady sinks to his knees in front of a plastic kiddie pool filled with sand, his little hands reaching for one of the toy shovels.
“Alright, little guy, If you can find a fossil, you'll get a—”
“Don't call me little,” Grady grumbles.
The volunteer looks to me apologetically.
I shrug. “He's five.”
“He's ... passionate,” he chuckles, turning back to Grady. “Alright, sir. If you find a fossil, you'll get a prize. There's all different types of dinosaurs in there. T. Rex, Triceratops, pterodactyls—”
“Pterodactyls aren't dinosaurs,” Grady says matter-of-factly as he digs in the sand.
The volunteer glances at me helplessly.
I grin. “He's very passionate.”
“Well, look who it is!”
I freeze, dread unfurling in my gut. I force a practiced grin. “Declan. I didn't realize you could survive around so many crosses.”
He playfully punches my shoulder. “Always a character! It's so good to see you.” He steps closer to me before glancing around the crowd of people. “It's a great turn-out this year.”
That's when I notice a volunteer badge on his shirt. “Do you go to this church?”
“Oh yeah. Been coming here since I was little.” He faces me. “Hey, you should come to a service some time. We'd love to have you.”
“Oof, wish I could. But it turns out that I'm really good at sinning.”
“Well, we all fall short of the glory of God, brother—”
“He's your brother?” Grady asks, curiously looking up at Declan.
“Um …” I nervously chuckle as I quickly squat down. “No, Grady. This is Declan. Sometimes people call other people brother like a nickname.”
A crease forms between his eyebrows as he slowly nods.
“Your name is Grady?” Declan asks.
Grady nods. “Grady Stone.”
“And … how are you two …?” He points between us.