Chapter 30
THIRTY
LUKE
After I get home from Melissa’s, I log in to the hospital medical record to prepare for tomorrow’s surgeries. I like to review CT scans and ultrasounds the night before, so I can look for any anatomical quirks that might give me trouble.
But today, I scroll through the images without seeing them.
My brain is still at Melissa’s, wondering what Troy wanted to talk to her about.
What if he realized he was an idiot to let her go, and begs her to give him another chance?
Would she consider it? Part of me says no way—she’s too smart to fall for that—but another part says she might, for the sake of her kids.
I should have insisted on staying, so she wouldn’t have to confront him alone.
On the other hand, if I’d stayed, I’d have been tempted to tell Troy my opinion of him, and that wouldn’t have made Melissa’s life any easier. After all, she has to co-parent with him.
At around seven o’clock, I figure Troy’s probably been and gone, so I send her a text.
Me: How did it go?
She doesn’t reply immediately, but I tell myself she’s probably busy with the kids. It doesn’t mean Troy’s still there.
I microwave a frozen dinner and eat it in front of the TV. The chicken is rubbery and the potatoes gelatinous, and I miss Melissa’s cooking.
And finally, after I’ve watched an episode of a bad Survivor spinoff, I get a reply.
Melissa: Good. Troy and Olivia are getting married next May.
Me: Congratulations to them.
I hit the button to call her, because I need to hear her voice. Texts won’t tell me how she really feels about the news that her ex is getting married.
She answers after one ring. “Hey, Luke. Missing me already?”
And just like that, I know, and a weight lifts off my chest. It’s my girl’s voice, not the voice of a girl who’s still pining for her ex. Melissa is over Troy Thompson.
“Hey, Milly. You okay?”
“Sure. It’s not like I didn’t see it coming,” she tells me. “Apparently, I’m invited to the wedding.”
I laugh at the absurdity of it. Only Troy Thompson would invite his ex-wife to his wedding so soon after their divorce. “You gonna go?”
“Maybe. Claire’s going to be a bridesmaid and Liam will be the ringbearer, so that’d be fun to see.”
“Are you taking a plus one?”
“Only if you’re available.”
“I’m available, Melissa.”
“You don’t even know the date,” she says with a laugh.
“I’m available, Melissa.”
On Monday, my scheduled surgeries go smoothly, but my call shift is an exercise in frustration.
The resident scheduled to work with me calls in sick, and there’s a new ER doctor who seems to want a consult on every single patient with abdominal pain.
By two A.M., I’ve seen seven patients and sent six of them home.
Only one actually needed surgery, a straightforward appendectomy.
It’s close to three in the morning by the time I get home, and I have to peel myself out of bed at seven-thirty to go to the Bed Capacity Committee meeting.
This week’s meeting seems like a repeat of the last one; despite everyone’s hard work, the hospital is still overcapacity. I don’t even pretend to take notes.
Next comes a full day of clinic, and as usual, it’s overbooked.
At lunchtime, I text Melissa and imply that I’m working so hard to save lives that I barely have time to eat.
It’s an exaggeration, of course, and she knows it, but she takes the hint and invites me to dinner.
I offer to pick something up on the way, but she says she’s already planning to make chicken pot pie.
It’s something to look forward to, at least.
The clinic runs late, and it’s after six o’clock by the time I get to Melissa’s.
Like last time, Liam reaches the door first, with Melissa chasing after him.
This time, though, Melissa greets me with a kiss on the lips, in full view of her kids.
Claire giggles, and I give her a wink as we walk to the kitchen.
The chicken pot pie is perfection, and I’m pretty sure I eat almost half of it myself.
There’s homemade apple crisp for dessert that looks like perfection too, but before I can taste it, my phone rings.
I pull it out of my pocket to silence it, then see that it’s my resident, Nick Decarie.
I’m not on call—Ethan’s on tonight—but Nick wouldn’t call unless it was important.
After an apologetic look at Melissa, I hit the button to take the call.
“Luke.” There’s an urgency in Nick’s voice I’ve never heard before. “Can you come in? We’re having some trouble with a cholecystectomy.” A cholecystectomy is a procedure to remove an inflamed gallbladder. “I think Dr. Atwell’s, uh . . . sick.”
Shit. Reading between the lines, Ethan’s probably been drinking.
“Yeah, of course, Nick. I’ll be there in twenty minutes.” I give Melissa another apologetic look as I start toward the door, and she follows with a sympathetic smile that tells me she gets it.
“Thanks, Luke,” Nick says. “And, uh, Dr. Atwell doesn’t know I called you. He kicked me out of the OR when I suggested we call for help.”
Worse and worse. The fact that Nick went over Ethan’s head and called me anyway means things must be really bad.
“So who’s in the OR with Ethan now?”
“Kevin Talbot.”
Yep. Really bad. When the operation went south, Ethan banished his senior resident—the man who’s less than a year away from being a fully qualified surgeon—and kept the third-year medical student.
“Okay, Nick. Fifteen minutes.”
I hang up, and Melissa hands me my coat. “Work emergency?” she asks.
“Yeah. I’m sorry.”
“Me too,” she says, “but I get it. Come back when you’re done, if you want.”
“Yeah? It might be late.”
“So the kids will be asleep,” she says, with a mischievous look in her eye.
Twenty minutes later, I walk into the operating room to find Ethan swearing at Kevin Talbot. Kevin’s shoulders are drooping, and he looks as though he’s about to burst into tears. Two nurses are watching, silent and tense.
The anesthesiologist, Dr. Kavita Singh, is the first to notice me. “Luke!” she exclaims with relief. Like she’s a passenger on the Titanic and I’m a lifeboat.
Ethan turns, a little more slowly than he usually would, and stares at me. He’s not exactly unsteady on his feet, but it’s clear that something’s off.
“Hey, Ethan,” I say, trying to be casual. “I was here checking on a patient, and I heard you weren’t feeling well. Do you want a hand? Or if you like, I could take over.”
The room falls silent. Ethan presses his lips together and looks up at the ceiling, refusing to meet my eye. All the spectators—the anesthesiologist, the nurses, and poor Kevin Talbot—are holding their breath. Wondering if Ethan has the insight to know he’s impaired, and if he’ll go gracefully.
Fortunately, he does.
“Thanks, Luke.” Ethan steps away from the patient and strips off his sterile gloves. “I’ve got some sort of stomach flu, and Kevin can’t hold the camera straight. It’s making me nauseated.”
Kevin flinches.
“No problem,” I say. “I’ll finish this up with Kevin, and I’ll cover the rest of the night.”
“Yeah. Thanks.”
“Why don’t you call Jessica to come get you?” I suggest, worried he’ll try to drive home. “Or get an Uber?”
Ethan shakes his head. “I’m gonna crash in the call room.”
With that, he turns and walks out. As soon as the door closes behind him, everyone in the room exhales.
“Okay,” I say briskly. “Just give me a minute to scrub.”
I shoot off a text to Nick, asking him to come back to the OR, then walk back out to the scrub sink in the hall. As I rub the scrub gel carefully under my fingers, I realize the full implications of what happened tonight.
Ethan was operating drunk. Everyone in that OR must have suspected it, and we have an obligation to report it. And as the colleague who had to replace him, I’m the one who should do it.
The thought makes me sick. Ethan’s a mentor and a friend; hell, I might not have made it through residency without him. But the harm he could cause, operating drunk . . .
I take a deep breath as I head back into the OR. The problem with Ethan can wait until tomorrow. Right now, I need to focus on the surgery.
And this gallbladder is a hot mess. It’s clearly been inflamed for a while, so it’s basically glued to the liver.
To make things worse, the patient’s old and looks chronically ill, so he’s at higher risk of complications from a prolonged anesthetic.
If Ethan had been sober, I doubt he’d have brought this case to the OR in the first place.
The usual approach in this situation would be to ask the radiologist to put a drainage tube into the gallbladder, start antibiotics, and cross your fingers.
I consider aborting the surgery and trialing the antibiotic route, but since the guy’s already got incisions in his belly, I decide to push on. Kevin struggles to hold the laparoscopic camera steady—Ethan wasn’t wrong about that—and it’s a relief when Nick appears to take his place.
Even with Nick’s help, the case isn’t easy, and it takes over three hours to finish.
By the time we’re done, my head is pounding and I’m exhausted.
I dictate a procedure note, stating that I took over the case because Dr. Atwell fell ill.
Then Nick and I head to the waiting room and tell the patient’s wife the same story.
“Anything else going on tonight?” I ask Nick when we’re alone in the hallway.
He shakes his head. “No.”
“Okay. I’ll cover Ethan the rest of the night. Call me if anything comes up.”
“Sure thing. Thanks for coming in, Luke.”
“Thanks for calling me. And if you could talk to Kevin, I’d appreciate it. He’s probably shaken up.”
“No problem.”
“Thanks.” I should meet with Kevin myself, but it’ll have to be another day. I don’t have it in me tonight.