enemy to doctor - the hating game

28 surgery

Josh's POV

We are in the middle of the surgery.
Patrick administered the incisions and already inserted two out of three devices while Rosa assists him with sucking the blood off. The whole thing makes me remember why exactly I bailed out on becoming a surgeon. It's horrible.
The way that the scalpel splits her skin open and Rosa inserts the clamps, pulling apart the incision in her abdomen for Patrick to push the long metal rods and tubes into her body.
She is loosing a lot of blood. Not that it's dangerous but it's definitely more than what any of us expected. As Patrick splits her skin for the third and last time a rivulet of crimson flows down the side of her torso.
I swallow the lump in my throat and force the nausea down at the sight of my brother forcefully pushing the last device into her.
Dark spots enter my vision but I shake my head, determined to stay by her side through every second of this.

"You okay?" Rosa asks with a side glance at my fingers curling around the side of the operation table.
I nod and divert my eyes to the monitor on my side.
I read through the all somewhat normal numbers and rates that the machine measures until I come to a halt at her oxygen levels.

"Sats are down to 94." Patrick's gaze immediately lands on the monitor and his hands come to a halt as he quickly assess the situation.

"Check the BP again. If sats keep decreasing we'll have to intubate her." His attention darts back to the other monitor to his left which shows the cameras picture that is attached to one of the metal rods which he slowly begins to twist and move.

"Rosa hold this in place here." They switch hands without so much as moving the camera by an inch.

"Here. Looks like a double twist. I'll start now. Josh, keep a close eye on her sats. If they drop below 90 you have to intubate her."

I check the BP and oxygen level which has decreased to 93. Fuck.

"93. Where are the tools for the intubation?" I can hear the blood rushing through my ears and my pulse increases.
I don't want to do this. Not at all. But if I have to I definitely will.

Without so much as lifting his eyes Patrick answers "Try oxygen first. Two liters. If the sats still decrease, you know the drill. The things are under the oxygen tank to your left."

I jump into action and withdraw the oxygen mask then pull the cover from her face and push the mask onto nose and mouth. Then I flip the switch and stare at the oxygen level indicator. 92. It has to work, it has to rise.
93.
I let out a long breath I didn't realize I was holding in and announce "Rising."

Rosa shoots me a glance and pats my arm in an attempt to calm me.

"She'll get through this. Your brother is the best choice for this job. Stay calm."

I nod and continue to watch her oxygen level rise back up to 94.

"Rosa, turn the camera in a 30° angle. I need to see the positioning." Rosa moves the rod and more blood trickles out of the wound which she quickly sucks off. I continue to watch while holding the oxygen mask in place and checking all vitals every other minute. Time passes while Patrick proceeds to check the twist and extremely carefully starts the process of untwisting the ovary.
It's unnerving how long the procedure takes and I realize that we are already almost two hours in.

"I managed to untwist one. Second one is going to be more complicated. Rosa-" his words are cut off by a beeping from the machine.

90.

Shit.

"Intubate. Now!"

My lungs constrict but I quickly turn and withdraw the box with the intubation utensils. My heart starts pounding erratically and I force myself to calm my breathing.

The urgency in Patrick's voice echoes through the room once again, drowning out the ambient hum of the surgery room. My focus shifts entirely to Lucy, lying on the operating table, her oxygen levels dipping dangerously low now.
88.

"Stay calm, Josh. I'll guide you."

Step by step, I follow Patrick's instructions, the weight of responsibility settling heavily on my shoulders.

"Ensure she's in a sniffing position," Patrick's voice directs me, and I adjust Lucy's head, trying to maintain calm despite the urgency in the room.

I pick up the laryngoscope, my hands steady but heart racing.

"Open her mouth and visualize the vocal cords." As the blade enters her mouth, the challenge of maintaining precision in the confined space becomes more than apparent. The seconds felt like an eternity.

Finally, the vocal cords come into view, and a surge of relief washes over me.

"Insert the endotracheal tube carefully, ensure it's in the right place."

The tube passes through Lucy's vocal cords as I push and push and push. Doubts and fears swirl in my mind, but I push them aside, focusing solely on the task at hand.

"Connect it to the ventilator," Patrick's voice urges as the sats drop to 87, and I secure the tube, the mechanical hiss of the ventilator providing reassurance.

"Good job brother. We can finish this alone. Go, take some rest." I carefully lift Lucy's head to secure the strap around it, holding the tube in place.

"No." It doesn't take more than that for Patrick not to try again and I gently set her head back down as I watch the level increasing.

A promise is a promise. And I will stay. I will stay with her through it all until she's 100% healthy again.
I will watch her and the healing of the wounds, I will take her to her check up's, administer her daily shots and be there for her. And I will have a word with her old doctor.

The surgery takes another hour before Patrick announces the success of having untwisted the ovary and starts to remove all devices. Then he starts stitching the wounds and cleans the area, disinfects it and finally places several compresses over the stitches.

"Do we keep the tube in?" I ask as we finish the procedure and prepare her for the wake up room.
Patrick disposes off his bloody gloves and pulls on a fresh pair, then hands me a fresh set.

"No. She'll panic when she wakes up with that thing. But we keep the EKG and oximeter on for at least the next 24 hours. If her levels drop below 95 immediately put her on 2l of oxygen through the mask. Don't take a risk, she could go into shock."

I nod and remove the strap then tilt her head back again. "Hold her steady."
With one motion Patrick removes the tube and my eyes widen in horror at the red marks on it.

"Relax, that's normal. She'll have an extremely sore throat when waking up. Just put her on a good amount of painkillers and if that is not enough call me. I'll give her a local anesthesia. If she coughs blood, that's normal to a certain level.

"Thank you Pat. It means a lot." I pat his shoulder and look him in the eyes.

"Always, brother. She's my patient now. No way in hell she's going back to that asshole."

I nod and continue to attach the wires and tubes from her body to a portable monitor and hang a new IV bag up for her that Patrick hands me.
"That man's days as a doctor are over."

Pat shoots me an all knowing look and then we put Lucy back onto a gurney and push her out of the OR and into the wake up room.

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