“Hanna, let’s do a quick sponge count before he clamps the liver tear,” I called out.
Hanna looked up, her eyes serious. “Lap sponges, 10 out.”
It was beyond just counting. It was a mandatory safety check to reset the room’s focus before they closed a major vessel. It was a necessary pause to acknowledge the risk before the surgeon proceeded.
Had it been under a more relaxed circumstance, I would have laughed at the memory of Dr. Verma rudely questioning me some months ago in this same room.
“What the fuck is the count for? We have more important work to do, nurse!” he spat.
“It’s to ensure you haven’t left an avoidable complication behind, doctor,” I replied, my voice calm even though I was seething inside. “I’m the calm voice of safety here, and you won’t stop me from doing my job, sir.”
Dr. Smirnov’s eyes went temporarily still as he announced, “Source secured. We have the vena cava tear clamped.”
A collective breath seemed to leave the room.
I documented the time of the clamp, the estimated blood loss, and the medication dosage the doctor just pushed.
1800 ml EBL.
“Alina, we need two units of Rh-Positive packed cells ASAP,” Dr. Smirnov divulged before adding, “and call for the portable ultrasound for post-closure check.”
I grabbed the phone and dialed the blood bank, my eyes not leaving the monitor.
80/55.
BP is climbing slowly.
“Blood bank says two units are inbound,” I relayed to Dr. Smirnov, who nodded in quick acknowledgement. Then I moved to the door, opening it just a crack to make direct eye contact with the waiting young man. “OR 3 needs a portable U/S. Stat.”
Walking back to the monitor, my eyes darted to the patient.
I felt moved to renew my promise to myself to avoid any crisis as the patient was pulled back from the brink. To not stop counting until he was safely out of the room. To fight for this patient’s life and rights until he walked out of the hospital, just like the others before him.
*********
Laughter rang out from the corner we occupied in the cafe. Laughter was easy in the absence of blood. The small cafe was our first choice for mid-shift snacking: It was not close enough to the clinic that we’d run into the families of admitted patients and, they served a mean cup of espresso.
The patient from OR 3 was doing well after the successful surgery and was expected to wake up in an hour or two. My patients were also doing well in their different wards, so although the day started on a very busy note, all was going fine.
On other days, when we lost a patient or had to watch a patient languish in pain because their relatives couldn’t affordthe minimum payment for their treatment or surgery, we’d still gather at this same cafe, in the same corner. However, our laughter would be replaced with silence, and the almost-empty table would be filled with barely-touched snacks as we drowned ourselves in sad cups of black tea.
“I’ve never seen someone who works faster with their hands,” Ivan, the young resident doctor remarked as I pulled myself out of my thoughts.
I warily brought my straw to my lips as four pairs of eyes landed on me for a reason I had clearly missed out on.
“He’s talking about you,” Hanna pointed out, giggling.
“Oh…” I remarked.
“You are apparently not here with us,” Ivan uttered, chuckling.
“Uh-uh,” Amanda said. “Ivan was talking about how fast you move around in work mode.”
I chuckled. “Nobody is slow in an emergency.”
“Yeah, but you’re faster. Just take your flowers,” Ivan insisted.
“Shut up,” I drawled, taking another bite of my sweet blini.
