Amy rushed into the ICU, her hair still wet from her shower, no make-up and no breakfast. She’d gotten a call that Amanda had had an MI that morning, which was unexpected. So many things could have gone wrong but a Myocardial Infarction usually occurred with a blocked artery. It turned out that the blunt force of the beating had caused a coronary artery dissection that in turn had caused a heart attack early that morning. Surgery was risky with everything else her body was going through but it was Amanda’s only hope. Dr. Meisel had called Nate, for which Amy was grateful.
Several years before, he’d developed a procedure that he’d reluctantly agreed to call the Dorough Graft. It was similar to your everyday CABG but got patients off of bypass much quicker. In Amanda’s case, that was key. Stopping the heart and allowing a heart/lung machine to do the work could be taxing and for a patient who wasn’t strong enough, it could be fatal. A Dorough Graft was usually a temporary solution but it was a bridge to get to the next procedure once the patient was stronger. Nearly every cardio-thoracic surgeon in the hospital and many residents could perform it but given a choice, she wanted Nate.
He hurried through the doors of the Emergency Department, quickly changed into scrubs and was scrubbing in minutes later. Amy joined him at the sink, prepared to apologize.
“Mornin’,” he chirped, pleasantly.
“Hi?,” she said, slowly, quizzically. “Listen, I know you wanted to be left off of this case…”
“I did,” he nodded, “but I’m here now so let’s do this.” He had a doofy smile and glint in his eye like he held some clever secret. His hair was disheveled as if he’d rolled out of bed but stuffed into his favorite scrub cap, it made little difference.
Properly, scrubbed, gowned, and gloved, they backed into the surgical theater, their patient already prepped and ready. “Damn it,” Nate shook his head laughing to himself and glancing around. It had gotten out the Dr. Dorough would be performing the Dorough Graft himself and as such, every medical student and 1st-year intern had lobbied for a seat in the gallery above.
“They’re going to be horribly disappointed when there’s not much to see,” he sighed. But he understood. “Can I get some music, please?”
His favorite Billy Joel radio piped through the speakers at his command. Amy flinched at the first note though luckily no one else had noticed.
The procedure first required harvesting a vein from Amanda’s thigh, which was delicate considering the trauma her body had been through and the broken bones that were still healing. All surgery came with risks but a Dorough Graft was nearly always used only when the patient was, as they said, “circling the drain,” and they were out of other options. There was a higher than normal probability that she wouldn’t make it through surgery or the return off of bypass but it was a better gamble than doing nothing.
They worked seamlessly, as always, the soundtrack that Amy, at least, associated with their former life together, supplying the beat.
It was different for Nate. For him, it was always this same Spotify station. Heavy on the Billy Joel (his favorite), or Styx, or The Little River Band. It was never anything modern, not with a 10 gauge blade in hand. It was like the gloves went on and time turned backward. Talk was minimal and unnecessary until it was time for the actual bypass.
“Quiet!,” Nate ordered in an already quiet room. The music silenced, they began the critical part. Molly, the perfusionist would slowly lower Amanda’s body temperature, inducing temporary hypothermia. They had no more than 45 minutes to complete the graft. Any longer could result in serious and permanent brain damage and in Amanda’s condition, further complications with the rest of her injuries.
“Thank you,” Amy whispered across the table. The first non-surgery related word spoken in 20 minutes.
“You’re welcome,” Nate nodded, without looking up. “I know how much you want this to work.”
“Whatever happens, I appreciate…” Her voice trailed off.
“You’ve done a good thing here.” Nate continued.
Amy shrugged. “Maybe. Or maybe she’s done a good thing for me.”
“How do you mean?” he asked, the rest of the O.R. team pretending not to listen to their hushed voices.
They continued their work, and Amy replied. “I don’t know. Sometimes, I just think people are sent to us for our help and sometimes they are the help. I don’t want to end up like her.” She paused, checking the clock. 24 minutes left. “What if something like this happened to me. Or if I were in an accident? I’d have no one.”
“That isn’t true.” Nate protested.
“It is. And for once I’m not having a pity party. I’m not saying no one would care, but there’s not one person who would stay by my side 24/7, not my mother, not you…”
Nate frowned. She was right. He’d have argued with her if he could, just to make her feel better but it was true. “I need a little suction,” he said gently, pointing to an area near the pericardium where a tiny amount of blood that had pooled. He glanced at the clock and returned to his conversation. “We’re cutting it close.”
Twenty minutes later, however, they stepped back to admire what seemed to be another successful Dorough Graft. The next few hours were critical but for now, they’d done well. And, Amy thought to herself, they’d done it together.
“Okay,” Nate exhaled completely for the first time in an hour. “I’m going to go shower up.” His attempt at dismissing himself so quickly wasn’t lost on Amy but she was desperate to hang on to this feeling.
“That felt good,” she stated.
“Always does when it goes well,” he agreed, avoiding eye contact as they discarded their shoe covers and gowns. “Keep me posted.”
He started down the hall when a 2nd-year resident slid to a stop in front of them. Dr. Craythorne… uh, Dr. Dorough… your patient’s family called.”
“What?” Amy piped up, eyes wide. “You’re sure?”
“Her parents called while you were in surgery. They called a lot, actually. Apparently, they were on a cruise in Alaska with no phone service. They’re trying to get here as quickly as possible.”
“Alright,” Nate sighed, ticking a glance over to Amy who looked ashen suddenly. “We’ll call from my office.”
“They caught a flight here already. They’re connecting to a flight in Seattle and are going to call again when they land.,” the young doctor informed them.
“Alright, we’ll be in my office,” Nate relented, shaking his head.
Less than 5 minutes later, they sat across from one another, his desk separating them, awkwardly awaiting a call.