5. Leander #2
"Understood," I mutter into the wall mic, hitting the speaker button. "Get the blood warmers running and call down to anesthesia."
I look around the room. It’s seven-forty. Shift change is happening right now, which means half the trauma nursing staff is currently down in the report room, and the second attending surgeon is still stuck in the parking garage elevator bank.
"Where is the floor nurse?" I ask, turning toward the desk.
"Nurse Higgins is in Bay One with the crush chest," the clerk calls out from the doorway, looking flustered. "And the junior resident just went down to radiology with the overnight head trauma!"
Worst timing ever.
"Call them back up," I command, pulling my mask up over my nose and stepping toward the main doors as the double doors swing open with a heavy bang.
The paramedics push the gurney through the frame, two techs hovering over a pale man in his thirties whose chest is covered in blood. The suction tube is already clogging with dark fluid, and his blood pressure monitor is beeping a rapid, frantic rhythm, sixty over forty.
"He's crashing!" the lead paramedic yells over the noise. "Lost pulse twice in the rig, got him back with epi, but his belly is rigid as a board!"
"Move him to table two on three," I order, stepping into position at the head of the bed. "One, two, three—lift!"
We transfer his weight onto the metal exam table. The patient lets out a wet, shallow gasp, his eyes rolling back into his head. His abdomen is swollen, dark purple bruising spreading across his ribs.
Internal arterial bleed.
He’s drowning in his own blood, and I have about ninety seconds before his heart stops for good.
"I need a central line kit, a ten-blade, and suction!" I call out, my hands moving fast as I cut away his blood-soaked shirt with trauma shears. "Clerk, get down that hall and bring me a nurse!"
"The clerk is already gone!" a voice murmurs beside me.
I look over my shoulder.
Kara has already stripped off her suit jacket, tossed her leather bag onto the side chair, and pulled a pair of sterile blue gloves over her hands. She snaps a plastic surgical apron over her neck, grabs the central line tray from the top drawer, and sets it right at my elbow.
"I’m not a nurse, but I know how to hold a suction tube and open a sterile pack," she tells me, her voice steady, her eyes clear and completely focused on the patient. "Tell me what you need."
I don't waste time arguing. In an emergency room, help is help.
"Grab the suction wand," I tell her, handing her the plastic tube. "Keep the field clear when I open the fascia. Don't touch the retractor unless I tell you to."
"Got it," she nods, leaning over the left side of the table without a single trace of hesitation or disgust at the open wound.
I take the scalpel, making a swift, twelve-inch incision down the midline of the patient’s abdomen. Blood surges immediately, filling the cavity.
"Suction, now," I order.
Kara moves instantly, dropping the plastic tip right into the pool of blood, drawing out the fluid with practiced, steady hand movements so I can see the damaged mesenteric artery underneath.
Her hands aren't shaking. She doesn't flinch when the metallic smell of fresh blood fills the air or freeze when the heart monitor drops into a flat, long tone.
"Clamp," I say, extending my open palm.
She grabs the vascular clamp from the tray, slaps it firmly into my gloved hand with the exact force a surgical tech would use, and holds the suction wand still with her other hand.
"Hold that vessel right there," I instruct, guiding her gloved fingers to the clamp handle. "Don't move half an inch."
"I've got it," she mutters, her fingers tightening around the metal loops, holding the bleeding artery steady while I place two silk sutures around the tear, knotting the thread tight with three fast wrist flicks.
The heart monitor stutters, then settles back into a rhythmic, steady beep, ninety over sixty. The pulse returns.
"Bleeder is controlled," I announce, letting out a slow breath through my nose. "Pressure is stabilizing."
At that exact second, the floor nurse and two junior residents come bursting through the double doors, breathing heavily, carrying extra blood bags.
"Dr. Sartori! We're here—sorry, the elevator was—" Nurse Higgins stops dead in her tracks, staring at Kara, who is currently standing at my side covered in blood spots, holding a vascular clamp inside an open abdomen.
"Take over the suction, Higgins," I order, my voice cold and calm. "Get him prepped for OR Three. He’s stable enough to move."
The medical team swarms the table, taking over the positions.
Kara steps back, stripping her blood-stained gloves off in one smooth motion and tossing them into the biohazard bin. She pulls off her plastic apron, wipes a speck of fluid from her forearm with a sterile wipe, and reaches for her suit jacket on the chair.
I step over to the scrub sink, stepping on the foot pedal to start the water, and begin washing the blood from my hands and forearms.
Kara walks over to the sink beside mine, turning on the faucet to clean her wrists.
The room behind us is a hive of noise—nurses prepping the transport, monitors beeping, residents calling out vitals but inside our small bubble near the stainless-steel sinks, it’s completely quiet.
I turn my head, looking down at her. Her hair has a few loose strands framing her cheek again, her chest still rising slightly fast from the rush of adrenaline.
"Where did you learn to handle a vascular clamp?" I ask softly under the sound of running water.
"I’m a medical lawyer, Doc." she starts, her voice low enough that only I can hear it. "I picked up a thing or two to help me better understand the cases I handle."
Interesting.
"You did well," I tell her, grabbing a paper towel and drying my hands. "You saved that guy three minutes of ischemic time."
"Thank you.” she replies, drying her own hands and turning to face me.
She looks up into my eyes, her expression completely calm, but there’s a flicker of something dark and sharp hidden beneath her professional mask, the lingering echo of last night.
"About last night," she begins softly.
"There is no 'about last night,'" I interrupt, keeping my voice quiet. "It was a mistake. An adrenaline reaction to Callahan being an idiot."
Kara stares at me for a long beat. A faint, razor-thin smile touches her lips, not hurt, just cool, dangerous amusement.
"Agreed," she replies smoothly, pulling her jacket back over her shoulders and buttoning the front. "A lapse in judgment. It won't happen again."
"Good," I nod.
"We have four compliance audits to finish by four o'clock, Dr. Sartori," she adds, stepping around me toward the exit. "Try not to keep me waiting."
She pushes through the glass doors, her heels clicking rhythmically against the hallway tile as she walks away.
I stand near the sink for two seconds, watching her go, my hands clenched into loose fists at my sides.
A lapse in judgment, I repeat silently, turning back toward the surgical bay.
But as I step back into the hallway, the lingering memory of her skin under my hands tells me something else entirely.
It tells me that line is already gone.