After Afterall

9

The ER is buzzing when I finally make it in. A group of interns is running around, nudging each other for hotter cases. I pull on a gown and take a chart from one of their hands. "What do we have?"

The orderly pushing the gurney replies, "Three car pile-up on the freeway. One passenger was pronounced DOA, but the rest from this car are coming in now. We have a sixteen-year-old female presenting with tenderness in the abdomen and heavy bruising. She was conscious in the field, but we lost her three minutes ago. She's been intubated and received three of morphine."

I read over the chart quickly for any information, but only the basics have been written up. "I've got this." I look over my shoulder to the group of interns, "You," I say to one who looks completely lost. She shuffles to my side. "Call x-ray and tell them we're coming. I need to see the extent of her injuries."

"Okay, but—"

"Do it now!" I yell before running along with the gurney towards the elevator.

I never make it to x-ray with my patient. She begins coding in the hallway and we immediately rush her to surgery. I've learned through my years that procedure is important—running the labs, doing the tests—but instinct is even more important. I knew as soon as the patient arrived she was in trouble, but Richard always asks us to run the tests first. Now is not the time for protocol.

As soon as the patient is stable and the OR is prepped, I go in. My nervous intern, whose name is Katelyn Olsen, stands by and watches on. "We have bleeding in the stomach and appendix. What would you suggest we do Doctor Olsen?"

"Um—"

"With confidence, Doctor Olsen. You will not use 'um' in my OR."

I hear her take a breath. I'm hard on her because my superiors were hard on me. It's how she'll learn because if she can't take a few pressing questions, there's no way she'll ever be able to successfully diagnose and save a patient. "We should repair the bleed in her stomach first and then remove the appendix."

"And why not just repair the tear in her appendix?"

I look over at the intern. She's so young, but I can see determination in her eye. "She doesn't need it."

"And?"

"And the recovery time is the same. Might as well remove it so she doesn't have to have a second surgery later in life in case the organ becomes inflamed."

I smile beneath my mask. "Good. I'd like you to come to my right and you'll be taking the appendix out."

Doctor Olsen's eyes go wide. "Me?"

"You." I continue to repair the stomach wall while Doctor Olsen crosses the room and stands to my right. "You know how to do this," I say quietly. "It's a textbook procedure. Take a breath, focus, and begin at the beginning." She looks over at me. I give her a nod. "I'm right here if you need me, but you won't."

\\\

I walk down the hallway to talk to the family. I have another patient waiting and I don't have much time, but talking to the family always comes first. The waiting room is full of people and everyone watches me walk in. The nurse points out the girl's grandparents. I tell them the good news and receive long hugs from both of them. Afterwards, the nurse tells me her parents and little brother all died in the accident. I don't have time to grieve for them. I have another patient.

After a few hours, I finally have a minute to breathe. All my non-emergent patients are waiting for surgery, but I still have one more car crash victim to operate on. I'm waiting for an OR to free up, so I grab a coffee during my down time. On the way back, I pass the waiting room. I hear his voice and before I know it, I'm standing and staring at the TV.