Could I Have This Dance? (19 page)

“What is it, Mr. Hudson?”

“My guest and I would like some hot tea.”

“Right away, Mr. Hudson. I’ll have it brought up.”

Elizabeth waved her hand. “I’m okay, Dale. I just hadn’t understood that Mary wasn’t Steve’s birth mother. The information just shocked me a little, I guess.”

He looked at her and deepened the wrinkles in his forehead. “I don’t see why that should bother you. What does all of this have to do with Wally?”

She didn’t know how to answer. “Oh, don’t bother with the confused ramblings of an old woman,” she responded, thankful she had her age as an excuse. She stood and walked toward the door, hoping to escape before the tea arrived, and before he asked her to explain her worries. “I really must be going. I’ll let myself out.” She quickened her pace to the door and hurried out, knowing she could get out before her host could hobble across the room.

She lifted her hand in a wave, and tossed a smile over her shoulder. The last thing she saw as the door closed was Dale rubbing the stubble on his chin.

Claire pulled the latex examining glove over her left hand and watched it tear as her diamond sliced the thin material. She sighed and twisted the ring around, diamond down, before pulling on another glove. But that felt awkward, so she pulled the glove off, removed the ring, and tied it into the waist of her scrub pants with the drawstring. The day’s business had been fast, the evening’s frantic. Lafayette trauma cases were bursting the hospital’s seams, and the team was in the trenches.

“Come on, Claire! I need you in here!” yelled Basil Roberts.

Although Basil was just one year senior to Claire, the militaristic chain of command followed in the residency program demanded prompt attention to anything asked by a more senior resident. She responded by pulling on another left glove and coming to his side in an ER trauma bay containing a twenty-two-year-old Hispanic male with a gunshot wound sustained during an attempted robbery. Apparently, he was the perpetrator, but looked as if he’d encountered a store owner who’d taken the law into his own hands.

She looked around. The O-man was in the next bay with another victim, the store owner, who had taken a shotgun blast to the abdomen. Beatrice was assisting the O-man. There were med students and nurses galore, but no trauma surgery attendings were to be seen.

Basil called to a nurse, “What’s his pressure?”

“Eighty by doppler.”

“More lactated ringers.” He looked at Josef, the medical student. “Tell blood bank I need four units of O-neg stat!”

Josef ran.

A respiratory tech placed an oxygen mask over the patient’s mouth.

The patient screamed something in Spanish. In spite of the language barrier, Claire could understand the expression of pain.

Claire checked the IVs. The patient had two, both started in the field by the Lafayette paramedics. She looked up to see Basil cutting off the patient’s clothing. When the man grabbed Basil’s hand, the resident got right in his face and rapidly spoke to him in Spanish. The man nodded and allowed him to continue.

With his shirt off, Claire could see an innocuous entrance wound over the patient’s chest, just medial to the patient’s left nipple.

She heard Basil curse. His eyes were on the monitor. The regular EKG rhythm had deteriorated into an undulating, irregular line. “V-FIB!” He cursed again, and checked the carotid pulse of the now lifeless body on the stretcher. “Claire, get an airway!” He grabbed a med student by the white coat. “Glen, start CPR!”

She obeyed while Basil called to the O-man. “Dan! We’ve got to crack a chest over here!” He looked at a nurse. “Call and get us an OR ready. We’ll need a place to put him if he makes it.” He raised his voice. “Get me a thoracotomy tray!”

Claire opened a laryngoscope blade and slid it into the back of the patient’s throat. A respiratory therapist was breathing down her neck. “Can you see the cords? Can you see the cords?”

“Let me have a tube.” She held out her hand, taking the tube and straining to see the patient’s vocal cords, to mark the entrance into the trachea, where the tube belonged. The patient was coughing up too much blood for her to see anything. “Suction, I need suction,” she yelled. The therapist complied and handed her a stiff plastic tube, which she used to clear away the secretions. “Okay, I can see better … Glen, hold CPR for a few seconds … there! I should be in.”

They hooked the endotracheal tube to an ambu bag and squeezed. The chest began to rise. Basil looked on. “Good work, Claire.”

By that time, the O-man was on the scene to help Basil open the chest. The medical student stepped back as Dan coached the second-year resident through the procedure. “This shouldn’t take but a few seconds. There,” he said, pointing to a spot on the front of the patient’s chest. “Start here and with one slash bring your incision all the way through the skin, subcutaneous tissue, and between the ribs.”

Basil complied. Once he was in the chest, he cranked open a rib-spreader to visualize the heart.

Blood. Massive amounts of jellylike red clot spilled onto the stretcher and onto the floor.

Claire and two nurses began squeezing bags of blood, infusing them as rapidly as the IVs would tolerate.

Dr. Overby’s voice was slow and steady, giving Basil enough time to follow each instruction. “There’s a hole in the aorta. Put a clamp above it. Open the pericardium. Do it longitudinally so you won’t cut the phrenic nerves. Now, put your hands around the heart, one behind and one in front. Massage it like this.” The O-man demonstrated by making a slow clapping motion with his hands. “Good, good.” He looked at Claire. “Get in here. I want you to do the cardiac massage while we get a stitch in this aorta.”

Claire put on a gown and a pair of sterile gloves. She placed her hands into the patient’s chest. The heart felt warm in her hands. She held it without flinching and began the rhythmic pumping motion to mimic the way Basil had done it only a few seconds before. She diverted her eyes to the patient’s face. It was a surreal moment for Claire.
Your heart is in my hands.

“All right, Claire, make yourself small, and continue to squeeze that heart. We need some room to work.” The O-man stepped in front of her, edging her to the side. “Give me a sidebiting aortic clamp.”

With a few swift movements, he isolated a small hole in the jaws of the clamp to stop the bleeding. “It looks like you’ve got a little volume in the heart now. Let’s have the internal paddles.”

Basil lifted the paddles. To Claire they looked like long flat spoons, the kind her grandmother had hanging on the wall of the dining room to toss salad. He placed the paddles around the heart. “Charge to twenty.”

“Paddles charged to twenty,” the nurse echoed.

“All clear.”

She pulled her hands away, dripping blood across her gown and shoes.

Basil shocked the heart. Claire watched in amazement as the heart began to squeeze.

“He’s got a carotid pulse.”

The O-man slipped his hand into the chest. “There’s pressure in the aortic root. Let’s get him upstairs where we can get this clamp back off and repair the aorta.” He looked at Basil. “You go with this one. Tell them to get a second room ready for the store owner. I’ll stay here with Beatrice. You take Claire with you. And don’t close the chest until Dr. McGrath shows up to check your aortic repair.”

Basil nodded. “Okay, team, let’s roll.”

A nurse covered the open chest with a sterile towel while Claire, Basil, and Josef maneuvered the stretcher, a heart monitor, and two IV poles toward the open elevator.

In the OR, in the absence of the attending surgeon, Claire took the
first assistant spot. Twenty minutes later, after Basil had closed the hole in the aorta and released the aortic cross-clamp, Dr. McGrath bounded into the room.

“Sorry to leave you stranded, Basil. My daughter was at a violin lesson and my wife had the twins at soccer practice. I got here as quickly as I could.”

“Things have chilled here considerably,” Basil reported with a relative calm. “Claire and I have this under control if you want to go help Dan.”

“Sure,” he said, stepping up on a stool behind Claire. “Just show me what you’ve done there, so I’ll know how to bill him.”

“You won’t get a dime from this one, boss. He was holding up a convenience store when the owner tried to take him out.”

“Seriously?”

“Right here in quiet Lafayette.”

“How’s the store owner?”

“Dan’s with him now. Evidently our patient’s buddy here blasted him at close range with a twelve gauge.” He shook his head. “The ER looks like a battle scene.” He chuckled. “Quite a bloody immersion into the trauma service for the new terns, eh, Claire?”

“Hey, this is what it’s all about,” Claire said. “This guy was dead. You saved him.”

“You helped. It’s a team effort.”

“All right, all right, we’re all cozy and sentimental here,” moaned McGrath. “I’m gonna leave the syrup to you two and go help the chief resident.”

As the attending surgeon disappeared, Patricia, the evening OR desk clerk, came strutting in. “Dr. McCall?”

She looked up. “Yes.”

“There’s a young man out at the desk looking for you. Called himself your fiancé.”

Claire rapidly looked for a wall clock. “What time is it?”

“Almost ten.”

“Oh, great. My fiancé comes to town, and I was supposed to call him to drop by for supper. But that’s when all the fun began. I forgot all about him.”

Patricia groaned. “You’re in trouble, girl.”

“He’ll get over it.”

“You mind if I tell him I’m available in case he doesn’t? He’s cute.”

Claire rolled her eyes. “Just tell him I’ll be out in a few minutes. After Basil finishes closing the chest.”

“After I close the chest,
and
you write the post-op orders,
and
you see that this patient arrives in the ICU alive,” Basil corrected.

“Yes, sir, Dr. Roberts,” Claire responded, smiling beneath her mask.

She didn’t care what he said. He could have told her she needed to clean up the floor. She would have gladly done it. She was pumped. A first assist on a chest trauma case was the ultimate carrot on a stick for a new intern. She was too excited to worry about John. She was sure he’d understand once he heard about her day.

Patricia opened the door to the hall and called out loudly enough for John and Claire to hear, “Dr. McCall’s too busy operating to pay you any mind. But I’ll give you my phone number, so …” She let the door swing shut to drown out the rest of her conversation.

“That woman,” Claire muttered. “My boyfriend will understand.”

Basil cleared his throat.

At least I hope he does.

Claire sat at the counter in the recovery room and began to write the postoperative orders. In spite of the late hour and her interrupted sleep the night before, adrenaline had prevented her from feeling fatigue. She would never forget the feeling of holding a human heart in her hand.

She finished the orders and chatted with the nurses, asking them to call if the patient changed in any way and to report the chest X ray that she’d ordered.

Meg Thompson, a nurse, looked at Claire and winced. “You’d better change those scrubs before you talk to the family.”

Claire looked down. Blood spotted the front of her scrubs. “I look like a red Dalmatian.”

“More like a holstein,” Meg offered, smiling.

When Claire scoffed at the idea of being compared to a cow, Meg held up her hands. “Hey, it’s the only animal with huge spots I could think of.”

Claire ran her hand over the front of her scrubs, her hand catching on the ring she’d tied to the cord.
John! John’s been waiting at the OR desk!

She dashed from the recovery room and down the hall, jogging past the operating rooms and the multiple rows of scrub sinks. At the front desk, behind the counter, John leaned back with his head against a computer screen. His eyes were closed, his breathing deep and regular. Claire sighed. At least Patricia wasn’t flirting with him, filling him in on all the down-and-dirty shenanigans that characterized the university surgery department. In fact, she was nowhere to be seen. John was asleep and alone.

“John,” she said softly. “John.” She nudged his shoulder.

He aroused and opened his eyes. He blinked once and shook his head, studying Claire for a moment as a look of alarm spread across his face. “What happened? Are you okay?”

“I’m okay, John,” she assured him, looking down at her spotted scrubs. “It’s not my blood.”

He twisted his face into a disturbed scowl. “Oooh, yuck. How can you stand it?”

“You get used to it. I was on my way to change. It’s not like we walk around the hospital like this.”

He rubbed the sleep from his eyes. “Where’s the ring?”

“Here.” She untied the waistband of her scrubs to release the ring. “Oh man, the setting is bloody. I need to wash it.”

He sighed. She could tell he didn’t approve of the way she’d treated the ring, but what else was she to do? If she was going to wear it at work, this was going to happen.

“You were supposed to call.”

“John, this has been an unbelievable day. I’ve seen more in the last twelve hours—” She stopped short when she saw the dejected look on his face. It obviously wasn’t the time to tell him how excited she’d been to be in the center of managing trauma, of inserting her first emergency airway, and of holding a human heart. “I’m sorry, honey. I meant to call.”

John stood up and held open his arms, then, after a careful inspection, he placed his hands on the tops of her shoulders, the only place without obvious bloodstains. He leaned and planted a kiss on her lips, careful not to let his shirt brush hers.

She giggled.

“And what’s so funny?”

“I think you’ve just invented a new kissing style. What shall we call it?”

“I don’t get it.”

“I know,” she said, offering him a quick kiss, touching only his lips, her body perched awkwardly away to avoid leaning against him. “We’ll call it porcupine kisses.”

“Porcupine kisses?” He lifted his hands from her shoulders, straight up and away into the air. “You’re losing it.”