“Clear!” Yelled the lead surgeon, holding up the paddles.
The attending physicians and nurses raised their hands and stepped back from the lifeless patient on the operating table.
I stepped back too instinctively, even though there was a pane of glass between the operating theatre and the observation gallery where I watched the proceedings.
I grimaced as the doctor applied the jumper-cables, then WHAM! The prone figure arched his back involuntarily as 20,000 volts coursed through him. Was that smoke coming off his chest? Surely not!
Even before he stopped convulsing, hands were pumping on his chest, and a nurse squeezed a hand ventilator which was taped to his mouth.
His EKG monitor blipped sporadically indicating that his heart was still beating, but it was far from a normal rhythm. His blood pressure was low… too low… and even I could tell by the frantic pace and concern of the emergency room staff that they were losing him.
The nurse on the ventilator stepped back for a moment, and from my vantage point I could clearly see the boy’s face. His eyes were open, but expressionless. There was a small smattering of blood on his face and his clothes, but there were no serious injuries that I could see. Maybe he was going to make it, but why was his heartbeat so low?
He was so young and strong. But lying inanimate on the table he looked pathetic. His eyelids fluttered, but his pupils dilated stared vacantly into space. He was not focused at all. Those eyes were haunting – unseeing – yet they revealed a pathway deep into his soul.
Was he dying? The thought of it sent a chill up my spine, and I stepped sideways so I could clearly see around the nurse into those vacant eyes. I noticed the nurse for the first time, as mopped his brow between squeezes on the ventilator. She was a matronly figure, and tended him with all the concern of a mother. I studied her expression as she quietly prayed for this poor creature’s life.
I was already in the observation room when they wheeled the kid in, and I’d watched the whole procedure with detached interest. I remembered the reaction of the visibly shaken paramedic who briefed the surgeon at the back of the hasty procession.
“Car crash victim. Male, 22, unconscious at the scene. Took a corner too fast and hit a tree. No seatbelt.” He paused there for a second, and averted his eyes. “He was wrapped around the steering column… I guess he’s probably pretty messed up inside.”
“Internal injuries?” I pondered the statement. That would explain how come he looked relatively unscathed, but seemed so unresponsive. I wondered what they could do to fix that up. Would they have to operate?
The paramedic looked exhausted, but he too stood and watched as the physicians and nurses prepped the patient. How awful it must be for someone to have to deal with such trauma day in and day out. I guessed he had supervised the extraction of the boy, and kept his fragile hopes alive as they raced him to the hospital.
He was the one I felt sorry for. Even more than I did for the kid on the table. I wondered what this man says when his wife asks if he had a good day? I guess it all depended on how many people he saved during his shift. I wondered if he’d be smiling when he got home this evening.
The Surgeon barely acknowledged the field diagnosis. As the stretcher screeched to a halt and the prostrate figure was hastily lifted onto the operating table, the surgeon immediately set to work examining his charge – prodding and probing, as the nurses went about their routine – sticking in needles, tubes, and needles into tubes.
I wondered if the girl in the foyer had been sedated. She was hysterical when they stopped her at the doors of the operating theatre. I wasn’t surprised that they’d prevented her from coming into the observation room. This was not the kind of post-traumatic exposure she needed to have stamped into her long term memory. She was quiet now, so I guessed she’d been taken to a recovery ward.
My brow creased into a frown as I subconsciously admonished her for causing such a scene and hindering the rescue personnel. Didn’t she appreciate the gravity of the situation? She should be happy that she was smart enough to wear a seatbelt and that her life was still intact. If only she’d convinced him to do the same this kid wouldn’t be here now.
The change in pace at the table snap me out of my reverie. The monitor was almost flatlining, and the staff were momentarily held in suspension – looking to the lead physician for orders.
“We’re losing him!” The nurse on the ventilator dispassionately uttered what they all were thinking. Funny – that was the same way I’d described it to myself moments earlier.
“I think he’s bleeding internally!” one of the support physicians added pointed to the victim’s bulging belly. It did look distended – even to me – and I had no medical background at all.
“We’d better open him up! Get rid of those jeans stat!” snapped the surgeon with unnerving calm. Almost before he’d finished speaking two nurses had slid shears up from the cuff to the waist, and in seconds they were peeling the bloodied rags away from his body.
“Raise!” the surgeon instructed.
I hadn’t noticed the orderlies step up and grasp his waist and thighs, but like a well-oiled machine they smoothly hoisted him a few millimeters – just enough for the nurses to whisk the shredded garments out from underneath him and into the blood bin on the floor.
Immediately two physicians moved in and prodded around his exposed stomach. They looked up at the surgeon. Nothing needed to be said – their eyes confirmed the Surgeon’s diagnosis.
“Clean up that mess, and get me a scalpel.” The surgeon barked again. I was still unclear what was happening, but as he positioned himself to the side of the kid’s abdomen, and placed the razor-sharp edge just below and to the side of his belly button, the shocking reality of the procedure dawned on me.
In morbid fascination I watched, as the surgeon seemed to move in slow motion.
In the time it took him to gather up his knife, and position himself for the incision, a nurse had swabbed the boy’s belly with iodine. She’d been rushed, and although measured, she’d splattered iodine liberally over the patient and the attendants, and I was intrigued by the way the rich brown liquid blended with the bright red blood spatters on their white jackets.
What a grisly story those uniforms told. For a split second I imagined them on an art gallery wall – providing a profound message for all who came to see.
The surgeon paused – knife hovering above the boy’s bulging belly.
I noticed a small rivulet of brown iodine running down between his legs past the macabre sight of his flaccid genitals as he lay there naked from the waist down. I admired the package, and was sure he’d pleased the girl outside with those. But now they looked macabre –shriveled and inconsequential – symbolic of his current predicament.
No one else seemed to be dwelling on his endowment. Their attention to his body was purely professional and seemed entirely focused on the race against time to save his feeble life.
The cutting motion was swift – like a hot knife through butter. In a fraction of a second he opened a six inch gash across the kid’s abdomen. It was powerful enough to cut through the entire thick muscle walls but delicate enough that it didn’t penetrate into the stomach and entrails.
But my fascination with his technique was short-lived. In milliseconds after the muscle wall snapped apart a sea of bright red engulfed the boy as the pressurized contents of his stomach cavity erupted forth.
Even the surgeon stepped back in horror at the sight of so much blood. Their diagnosis had been spot on – he’d been massively hemorrhaging inside – but even he seemed surprised at just how much blood the boy had lost.
He stared for what seemed like eternity, but was surely no more than a second or two before he regained his professional bearing. “Time?” The surgeon asked, holding up his hands and stepping away from the table.
“3:57” a junior physician muttered after consulting the clock on the wall, as another nurse leaned in from behind to pull off the surgeons blood-soaked gloves and gown.
“Log it please Heather?” He addressed the matron. She was cradling his head and a tear rolled down her face as she nodded solemnly in reply.
The Surgeon nodded to the staff, and added in a matter-of-fact tone … “Sorry fellas. Better luck next time”. He didn’t wait for a reply. He turned and walked resolutely to the door.
The mood had changed. The sense of urgency was gone, and no one said a word. There was nothing to say. There was more blood on the floor than there was left in the lifeless body now, and no amount of wizardry would bring anyone back from that. The doctor knew it, and so did all the staff. They would leave the sewing up for the undertaker.
The monitor continued it’s woeful buzzing until Heather laid the kids head back on the pillow. She reached up to switch it off, and began to remove the wires. A couple of orderlies entered with mops to deal with the coagulating mess on the floor. I imagined it’d take a clean up crew quite a while to prepare this theatre for the next patient.
I was transfixed by the events, and kept replaying them in my mind – unable to drag my eyes away from the prostrate figure on the table. I felt empty, and confused.
I wasn’t sure how long I was staring, but eventually I felt a tap on my shoulder. I looked around, but there was nobody there. Then I noticed the corridor – I hadn’t seen it before – with a bright light at the other end. A warm glow enveloped me as I realized what was happening, and I nodded farewell to the kid as I turned and walked serenely towards that light.
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