Chapter Twenty-Seven
Twenty-seven.
On the very first day of my placement, Yanika takes me into an emergency duodenal perforation.
As I follow her down to theater at a brisk pace, she tells me the patient has peritonitis and probable sepsis.
“Which is better in an emergency scenario like this,” she asks casually, “laparoscopic or open?”
“I’m sorry?”
“You heard.” She suddenly swerves right past a rail of lead vests, hanging inert like sentries.
“How could I possibly answer that without assessing the patient? What if she’s got a load of adhesions from previous operations?”
Yanika runs into her office to grab her glasses. “Very good!” She’s smiling, as if I’m a four-year-old who’s just written her first correct Q.
“Yanika, I’ve only had six years off.”
“Six years might as well be six decades to some of the consultants you’re going to encounter. The fact that it was mental health–related will make it even worse.”
I had ultrapremature twins, for fuck’s sake! I manage not to say. She knows. She wishes only to prepare me. And I am prepared, I realize as I pull on a surgical cap. My body was built for this. It doesn’t matter what she or anyone thinks.
The operation is chaotic. The patient, who’s had a hole in her bowel for three days now, is catastrophically unwell and within ten minutes is on an adrenaline infusion.
In a situation like this, Yanika’s job is to get the patient on and off the table as quickly as possible—she needs to be back in intensive care.
But at every stage, Yanika hits walls. The patient’s clotting is abnormal, her liver is failing, she’s losing hemoglobin in her urine, and she’s hypothermic.
I watch from my step on the periphery of the action, completely absorbed. I have no consciousness of my own heart beating, my feet on the floor. There is only the patient’s body, bleeding, fighting, flagging.
—
Thirty minutes later, I watch my most cherished mentor call time of death.
“Welcome back, Carrie,” she says when she leaves.
I stand in the theater long after she has gone, watching two nurses washing the woman’s body.
One of them is talking to the body as she prepares it.
The floor still bears pools of mucky irrigation fluid.
In the next room I can hear another anesthetist preparing for an incoming case; soon this theater will be readied for the next patient on the emergency list. Not even death allows us to pause, in this world.
I feel around my body. Am I still here? The earth seems to have shifted; everything and nothing has happened.
The health care assistants are cleaning the room; one of them is on the phone trying to find a suitable space for this woman’s family to come in and say goodbye.
They work silently to remove all signs of mayhem.
The patient’s face is covered now by a sheet.
It’s been six years since I last stood unarmed on this battleground: confronting the tearing fragility of life, the game of roulette the universe plays with us during our short time on earth.
And yet, here I am. Two feet on the ground. Saddened, shocked. But earthed. In fact, the main message I am receiving from my body is I need some water.
This was a message I never used to hear.
I’d go hours without water back then—without food, rest, not so much as thirty seconds in a toilet cubicle to take some breaths.
I don’t know what’s changed since then, why I’m able, now, to hear myself.
Maybe it’s just time. Time spent on the moor.
Or perhaps the past few years of real happiness and stability, the first period of its sort in my life.
I go off to get water and then I call Robin.
“What are you eating?” I ask, after he’s updated me about the kids. (Raffy: has self-reported the medical condition “too many bogies.” Maeve: considering becoming a jockey when she’s older.)
“Spaghetti hoops on toast,” he says. “With two sausages on the side. I know the face you’re pulling, and I couldn’t give two figs.”
I laugh, unwrapping my boxed spring salad “with added ferments.”
“How’s it going?” my husband asks. “When do you think you’ll get back into theater?”
“I’ve already been in,” I tell him. “We had an emergency this morning.”
I put down my fork because it feels disrespectful, suddenly, to be chatting with my husband about sausages and bogies when a life has ended.
Somewhere in this hospital, that woman’s body is being prepared for the morgue, a body that was fighting spiritedly just an hour ago.
I saw her heart beating. I saw her trying to live.
“Did it go wrong?” Robin asks quietly.
I nod, even though he can’t see me.
“Did the patient die?”
I nod again.
“Oh God, Carrie. Are you OK, darling?”
I take a long breath. Then, for the third time, I nod, only this time with energy. “Yes, I am—really and truly. This is exactly where I’m meant to be, Robin. And it’s exactly what I’m meant to be doing.”
—
Robin and the kids are booked to fly over during my second week in Stockholm, while Maya comes to stay during the first. She didn’t return to the States in January because of Dad’s COVID; he’s still in poor shape and his Alzheimer’s has progressed at a distressing rate.
I was expecting this, as a clinician, but the reality has been devastating. I dread Maya’s return to Colorado.
The longer she’s stayed in the UK, the more certain I’ve felt that something is up between her and Eagle, but she insists all is fine.
Tonight, though, she dials my concern right up by unpacking a bottle of rum and several mixers on arrival.
“Cocktails,” she says briskly, as if this is something we normally do together.
Eagle and Maya gave up drinking when they were trying to have a baby.
They didn’t try for long—probably about eighteen months, but the experience was sufficient for them to conclude that children were not meant to be part of their story.
They decided not to resume drinking and I have to say, I think Maya’s been much better off without it.
She drank to blackout in her teens and early twenties.
There was one awful morning when she called me in tears, alone in an unknown house, terrified she might have been taken advantage of by some man whose identity she would never discover.
To this day she has no idea what happened.
“Is this OK?” I ask, because I feel like I must.
“Yes!” Maya says, extracting a rolling pin, which she uses to smash up bunched ice in a bag. “I relaxed the rules a while back. I’m fine!”
“Oh right…But—the thing is, you…” I hesitate. “You told me that if you ever decided that drinking might be a good idea again, I was to stop you.”
Maya snorts. “And you told us that if you ever tried to go back to surgery, we were to stop you.”
There’s little I can say to that.
“People change, Carrie. As you well know. Not drinking was the right thing back then,” Maya says, dropping crushed ice into two highballs and getting some mint out of her bag.
She always loved mojitos. “But I’m settled now.
I’ve changed completely. The odd drink here and there just isn’t the threat it once was. ”
I think back to the countless cases of liver failure and cirrhosis I saw when I was training in hepatobiliary.
There was one woman who’d committed to complete abstinence from alcohol for six months so she could receive a transplanted liver.
I’m finally learning to live, she’d said when we’d seen her in clinic five months into her sobriety.
I don’t ever want to drink again. Just six weeks later, a suitable liver had become available.
When she came in for a pre-op assessment the following week, she was drunk.
I heard she’d died six months later. She had two children under ten.
“Stop it,” Maya laughs. “Stop comparing me to whatever patient horror stories you’ve got stored in there.”
I laugh.
“Honestly. I just want to have a couple of cocktails with you. I had a glass of wine on Christmas Day and I haven’t even thought about alcohol since.
I’m not an alcoholic, Carrie; that’s not why we gave up.
I know I was a bit crazy when I was young but I was way past that when Eagle and I were trying for a baby. I barely touched it.”
“And you’re sure everything’s OK with you and Eagle?”
My sister puts down the spoon she’s using to muddle brown sugar and mint. “Carrie! I’m making one cocktail.”
“You’ve stayed an extra two months! I can’t not ask!”
“I stayed because of Dad,” she says. “As you well know. You’re beginning to sound like me. Sticking your nose into areas where it’s not welcome.”
We both laugh, and she serves me a mojito. “Now,” she says, “I want some gritty emotional drama. Tell me how you’re feeling about living four miles from Johan, for starters.” She drops a final wedge of lime into my glass. “I mean, seriously.”
I take a risk. “It’s actually four point two-six miles to his office from here.”
“You’ve put it into Maps! Carrie, talk to me. What are you doing?”
God, how I’ve missed my sister these last years.
“It’s been a little frightening,” I admit.
“Ninety percent of the time I trust myself, but sometimes I wonder. Sometimes it feels like…I don’t know.
My body. I can feel him in my body. It used to be like a sixth sense.
And it seems to have come back. I don’t like it. ”
Maya takes down her cocktail in one. “You mustn’t see him,” she says. “There are far too many gray areas here.”
“I’m not going to! I know this will pass, and I just need to ride it out. But you’re one of two people on earth I can be honest with.”
She doesn’t say anything.
“Anyone in my situation would be confused,” I say. “Wouldn’t they?”