Chapter 10 - Cat
Cat
“Don’t forget to keep an eye on the blood pressure,” I instruct the resident. “Roberts?”
“Ninety-five over sixty,” the anesthesiologist replies without looking up.
“Suction.”
My command is clipped, but the OR runs smoothly. The nurse to my right slides in the tube, keeping the field clear. Each and every one of them knows my preferences and how I work. They adapt.
That’s the thing I admire most about nurses. The way they work changes to match the style of the surgeon they assist. I could never. To me, there is only one way of doing things, and I don’t care if others like it or not. This is my OR.
“There it is,” Summer says as the tear becomes visible.
It’s only a small laceration, but on a spleen, that is enough for significant blood loss. She takes the cautery and applies it, her eyes flicking up to mine for a brief confirmation. I nod.
“Good,” I murmur as the bleeding slows under the steady heat.
When the patient’s blood pressure stabilizes, I step back and look at the resident.
“Place interrupted sutures. Reinforce it. Whitman will help you decide if a hemostatic agent is necessary.” I look at the scrub nurse, who hums in agreement.
“That’s it. Close him up and move him to the trauma floor for monitoring.”
I peel off the bloody gown and gloves, toss them into the bio bin, and march away to scrub out. This resident is more than capable of finishing on her own. I like it that way.
The smell of burning tissue is still in my nose when I dry off my hands and reach into the pocket of my scrubs. My phone buzzed twice while I was in the OR. Carmen. I almost put it back when my eye catches the preview.
… La rubia…
I frown. What does she have to say about her now?
07:11 a.m. – Carmelita
Kitty Cat, you are wanted in the break room. La rubia is here.
Wait, what? I blink and stare at the words again while a rush of air leaves me. Unease twists through my stomach, and my mouth runs dry. Why is she here? What if she has spoken to other people? She has already spoken to Carmen.
This is highly unprofessional.
“?Joder!” I curse under my breath.
Why hasn’t Carmen sent her away? She is supposed to be on my side. If anybody knows how this can reflect on me, it’s her. As head nurse, she’s seen it happen plenty of times. Dios…
I grit my teeth and stride down the corridor.
The cool blue light bounces off the white walls, echoing the cold that is now gripping my heart.
Several heads turn while I make my way down to the break room even faster than I normally walk.
My heart is thudding against my ribs and my nails are digging into the palms of my hands.
This is not happening. This can’t be happening.
When I reach for the door, it swings open and Nurse Wilder steps out. She narrows her eyes but nods at me regardless. She knows... ?Cono! She knows! I feel my breath catch somewhere in my lungs, but I ignore her and push past her into the room, the laughter of Carmen and Mary already enveloping me.
“Oh, there you are!” Carmen beams up at me.
She looks pleased with herself. Pleased that she finally got to talk to la rubia. But I don’t have eyes for my friend. All I can do is stare at Mary, and I feel my heart skip a beat.
Mary tears her gaze away from my best friend, and her eyes instantly find mine.
They are gleaming and soft. God, she is so gorgeous.
Her face breaks open into a smile, and she opens her mouth.
Something in my chest tugs, and I feel myself moving toward her.
No. No! She can’t be here. If anyone sees her here, if anyone connects the dots…
“What are you doing here?” I snap before she can even say hello.
Her beautiful smile falters, and I feel my intestines twist. Carmen frowns and looks from me to Mary and back to me again. I ignore her. My jaw hurts, and I struggle to keep my breathing even, but my eyes never leave Mary’s.
“Cat… she just came to bring you co—”
I raise my hand to cut Carmen off. For the first time ever, she instantly goes quiet.
“What. Are. You. Doing. Here?”
Mary flinches, and something flickers in those big blue eyes of hers. Shame? Pain? Fear. Then she swallows, presses her lips together, and lifts her chin. She rises from the couch, slow and controlled.
My breath is shaky, but I will myself to hold her stare as she drags her gaze over me once, calculating. I see that same flash in her eyes, and I feel the bile rise from my stomach. This is hurting her. You are hurting her. I remain frozen in place.
“I was bringing you coffee,” she answers, her voice eerily stable. “But it just became abundantly clear that I misread the situation.”
Mary pauses for a moment, giving me time to respond, but the air is stuck in my throat. I can’t. My career, I—
She glances over her shoulder toward Carmen, giving her a warm but slightly sad smile.
One that doesn’t reach her eyes. I feel my breathing speed up and my heart hammer against my chest. Wrong choice, Katherina.
I want to reach for her, but I can’t move.
I can’t speak. Maria’s voice drifts toward me as if she is speaking underwater, and I blink to bring my focus back to the present.
“It was nice to meet you, Carmen. Perhaps we’ll see each other again.”
Carmen smiles back and nods softly before Mary turns around. Her head dips as she passes me.
“Doctor Durand.”
The title hits me like a blade, square between my ribs, punching all the air from my lungs. I still can’t move, but my fingers twitch at my sides of their own accord. If you let her go, you won’t see her again. The door closes behind her, and it feels as if my breath is cut off. It’s over.
“Cat?” Carmen whispers after a beat or two, and I snap my gaze toward her.
I know my eyes are blazing. It is obvious from the way she startles and swallows. Her eyes are large and filled with something that looks a lot like pity. I don’t need that.
I pinch the bridge of my nose and draw in a slow breath.
“You should have sent her away.”
“Cat, I—”
I turn on my heel and walk out without listening to what she has to say. My pulse is roaring in my ears, and my head pounds with the impact of what I just lost. I feel sick.
Behind me, Carmen calls out to me, but the thud of the closing door cuts off her voice. She doesn’t follow me out, and I have never felt so alone in my life. This day couldn’t possibly get any worse.
***
The doors slam open and the EMTs push through. The staff is already jumping in to assist. I rush toward the gurney, and my eyes drop to the young girl with a metal rod protruding from her abdomen. She looks so small, so fragile, like this.
“Maisy O’Connor, seven. Fall at a construction site,” the paramedic rattles off as the staff works around him. “Impaled by foreign object. Pulse weak and thready. Hypotensive. BP seventy over fifty and dropping. Suspected splenic and hepatic injury. Abdomen distended.”
I hiss through my teeth. This girl has every indication of internal bleeding. We have to get her into surgery stat.
“Nobody touches the rod. Whitman, get me O-neg. Peds dosing. Wilder, call in pediatric surgery. We are taking her to the OR. Now.”
My orders are calm and clipped as always, even though my blood is rushing through my veins so fast that I can hear it roaring in my ears.
I am suddenly hyperaware of my freezing fingertips as we rush toward the trauma elevator.
Adrenaline. Behind us, the doors slam open again, and wailing cries instantly fill the hallway.
The parents. I don’t look back. I can’t look back.
My eyes are trained on Maisy, on her small, pale face. She is my sole point of focus.
“Rodman, try to get a line in—sixteen gauge, she is small. If you can’t get access, we’re going IO.”
I glide my hand over her stomach, making sure not to press down or aggravate her injury. It is rock-hard. My pulse kicks up, even though I keep my face neutral. The staff rushes all around me, their faces contorted and their jaws tight. It’s different when it’s kids. For all of us.
Right as the doors slide open, the high-pitched beep of the monitor changes into a single tone, and I feel my heart skip a beat. My eyes fly up toward the monitor and instantly land on the flatline. ?Dios! No, no, no! We can’t lose her. Not like this, not now.
“Asystole,” the anesthetist calls.
“Start compressions.” I glare at her swollen belly. “Bag her. Do not stop. Let’s move.”
The weight of the command is palpable. They all understand that the pressure on her body will increase the internal bleeding even more, but we are losing her. I don’t have a choice.
One of the nurses jumps onto the gurney, their hands already pushing down hard and rhythmically on Maisy’s sternum. Their compressions continue as we rush into the OR.
“Prep for laparotomy,” I say, my voice even.
I hold out my hand and instantly feel the familiar weight of the scalpel pressed against my palm. My fingers wrap around the steel, and I move instantly. The cut is fast, clean, and the abdomen opens. Blood instantly floods everywhere. A dark, uncontrollable liquid that obstructs the view.
“Suction.”
The tube is already there before I can finish.
Good. I separate the tissue, and the abdomen instantly fills again.
The shrill, constant tone of the monitor pierces through my skull and scratches at the back of my neck.
We need to be fast. She is bleeding out.
Por favor, Maisy. Hold on just a little longer.
“Another unit in,” one of the nurses states as they switch positions for compressions.
“Push epi.”
The liver is severely damaged, and the spleen is barely recognizable. Around me, the team is focused, moving within an organized system we built together. But that system won’t be enough. There is nothing to repair. No matter where I look, no matter how hard I try, I have nothing to work with.
Everything in me stills, and I feel the cold seep deep into the core of my body. I failed her.
“Check rhythm.”
The compressions stop, and everyone freezes. The line stays flat.
I can’t bear to look up when the silence presses down on us. Blood still lapping over my fingers. Her body no longer responsive.
“Call it,” Roberts says quietly from the other side of the table.
I nod, swallow, and raise my face. The staff looks pale and wrung out.
“Time of death, seventeen twenty-two.”
I step back, my cold fingers still coated in the warmth of her blood. No one speaks. No one moves. Not until I slowly remove my gloves and nod at the team.
“Good work today.”
The hallway feels longer than usual, each step heavier than the previous one.
By the time I reach the office, I am drained.
My hands shake as I close the door behind me, and a single gasp leaves my lips.
I won’t cry. Not here, never here. But that doesn’t stop my heart from shattering into a dozen pieces.
She was so small, so little. Still innocent.
I reach for my phone without thinking—my nervous system searching for relief—but there are no new notifications. Their absence is cutting, and I throw the phone onto the floor. Tú estás sola, Cat. All alone. I have managed to push her away before we even had a chance.
The heavy weight in my chest drops to the pit of my stomach, and I slide down the wall. Don’t cry. The tears come anyway, thick and hot.
A few minutes later, Carmen finds me with my head in my hands, cheeks wet.
It is as if she has a sixth sense for when I need her.
She locks the door behind her, sinks to the floor next to me, and gathers me into her arms. My fingers curl into her scrubs as I shake against her shoulder.
Mi hermana. She is the only one allowed to see me like this.
Even if I am still angry with her. Or perhaps I am angry with myself. Right now, I don’t know.
“Let’s go wash your face and get you freshened up. I already called Rosa after the kid came in. She is making ropa vieja.”
My stomach clenches even harder, and I let out an actual sob. Carmen tenses but then pulls me tighter against her, cupping the back of my head with her hand.
“Está bien, amor. Está bien,” she whispers into my hair.
But nothing about today feels right.