Elizabeth chuckled. "Versed is onboard." One of the nurses wrapped her in a lead gown to protect her from the radiation. "Marty, your job is to tell us if something hurts and go along for the ride. You’re lying on an x-ray machine. The table moves; you don't. Ready?"
"For anything, Sunshine."
Patrick injected lidocaine into his groin to numb it. "Little stick."
Elizabeth coached, "Big breath and blow out the birthday candles."
"Whose birthday?"
Patrick took advantage of the distraction to make a small cut and insert the catheter. "Marty, you’re going to feel warm and like you want to pee. Don't worry. Take a deep breath and hold it." Patrick fired the dye injector.
"Can't hold it. Hurts a lot."
Patrick's brows darkened at the first picture. "Okay, do the best you can."
"Always knew you were different." His blood vessel anatomy was not the book standard. Elizabeth pointed. "Patrick."
The first pass of the dye revealed it was more complicated than Patrick thought. The exam of the multiple layers of vessels would be long and arduous. A missed bleed could be deadly. "Beth, you’re gonna need to take over."
"Another breath. Leak in a branch of the right hepatic artery. How are you feeling, Marty?"
"Fine, Sunshine." Another thing that made him different: he did not sleep from the sedation.
"Elizabeth, drink," Patrick said. A nurse offered her some juice.
"Thanks. Marty, deep breath again and hold as best as you can." She shot more dye. "Another one. That's another one."
Patrick scanned between his two patients. “Beth, can you get to the area where you saw the other bleed?"
"I think it’s a shadow," Simms whined.
Elizabeth ignored him. "That is a bleed. Eric, Patrick, recheck the CT. What vessel does it look like to you? There are multiple layers of collateral circulation from previous injuries. He follows his own book."
"You like that about me, Sunshine." No one could hide their amusement.
She cracked and forced her shoulders back. "What happened to the strong, silent type?" The long day and the weight of the gown were tiring her, but she refused to give in when Patrick asked.
Eric placed his fingers on her throat to take her pulse. "You need to let Simms finish."
"I'm fine." She shook him off. "Left hepatic."
"I see nothing," Simms held his ground.
She read off Martin's blood pressure. "Warren, his systolic is up. Are you running fluids?"
"The systolic is only up five points; he came in dry. I'm also trying to flush his kidneys. I'm not overloading him." The anesthesiologist was defensive.
"Did I say that? Listen to me, Marty. I'm going to give you a nasty headache. It will go away."
The high in his earlier tone gone, he answered, "Okay."
"Warren, we can't let his BP bottom. Patrick, are you ready to cut? Simms, load the gel foam slurry." She bit her lip hard. The sharp pain would create an endorphin rush.
On her feet, she had stopped three leaks over two hours. Sweat began to soak from her brow through her cap despite the frigid room.
Simms repeated, "There's nothing there."
Patrick lifted his head, signaling Eric to come closer. "She's about to drop. This is her last pass, and I'm taking over."
