"Roll." The group headed with their patient to the OR. "Do we have a name?" Elizabeth's hand squeezing his heart was shrouded with a towel.
"Austin Bailey, Silverton police sergeant," Kathy said.
Elizabeth swallowed hard. Could he be Marty's baby brother? The man she hadn't seen in twenty years. The man she hurt. The man she still loved. Concentration kept Austin’s heart beating, and her own calm as she proceeded to the OR.You can do this.
"Ready?" The nurses helped her into a sterile gown and gloves.
The circulating nurse pulled up the chest x-ray. White dots were scattered throughout the chest and belly.
"Electric knife." The incision extended from the notch of Austin's sternum to his groin. More blood flowed to the floor. "Lap pads. Squeeze that blood in faster," Elizabeth said.
Her business partner and trauma surgeon, Steven Keys, stepped into the room. "Where do you want me to start?"
"The major chest vessels need repair first. Randy cross-clamped the aorta and will set up ECMO. Where the hell is he?" Elizabeth released a shard of metal into a metal bowl. "Be careful; shrapnel and bone are everywhere. A bullet entered through his right armpit. Another penetrated around the fifth rib, and a third entry is above the right kidney. He had to be turning. No exit wounds. The darn things exploded inside him." She kept massaging Austin's quivering heart, moving what little blood was available to his brain while stitching with her other.
Steven removed irreparable fragments of bone that used to be part of the ribcage's right side. "The right lower lobe is a total loss." A mangled lobe of lung plopped into a bucket. "Hold the retractor, Keith. Get me another blood gas, Warren."
"No oxygen-carrying capacity. Acidotic," Warren said.
"Eight minutes since aortic clamp," Gina said.
"There's a tear to the left superior bronchial artery. Trace the pulmonary artery. Where the hell is Randy?" Another bullet fragment dropped in the container while Elizabeth kept up a heartbeat with her other hand.
"ECMO man is here," the nurse chirped as Knox walked in. An ECMO machine could buy Austin and the surgical team time by taking the strain off Austin's damaged lungs and vessels.
"Leave Randy alone," Pietra Hahn pled for peace. "Blood loss is outpacing gain."
"Duh, Pietra." Elizabeth remained mad. "What took you so damn long? We left together. Damn it, Randy, if he dies because you were slow..." The rest of the comment stayed in her mouth.
"Randy, can you handle putting the new cannula into the internal jugular?" Steven asked sarcastically as he sutured a leaking vein.
"All up to date on the literature, Stevie. Is there a rhythm yet?" Randy squinted. "The blood-thinners will, in the end, make your cop bleed to death."
"He's not my cop; he's our patient. Run the lines. His heart will beat when we give it blood to fill it," Elizabeth grumbled. "Yes, I am aware of what is required for ECMO. Do you have a better idea of how to save this man?"
"Calm your tits, Beth. No lost time. Sheesh, you need to get laid. Hell, if you want, I'll sleep with you, baby. Think of it as a mercy fuck. My charitable contribution for the year. An orgasm might mellow you out," Randy said flippantly, waving his hand.
Then he continued, “Well, Wonder Doc, if you must know why I'm late: Dufour asked about you and the Maxwell kid and poaching my jail patient." Hal Dufour was the vice president at the facility and her father's friend. "Told him I couldn't talk because the officer needed my attention."
"Knock off the crass comments, Knox," Steven's voice rose.
"Randy, how the hell can you go from being a decent surgeon to asshole in two seconds? Officer Bailey is no different from Arthur Maxwell, yet you had no problem extending the resuscitation attempt here. Why, because Arthur was Black, or because this patient is a cop?" Another fragment pinged into the pan. "Your jail patient, as you call him, had a moderate liver laceration that failed embolization. It was your fault you didn't scrub in. It’s also not my problem you missed two pages. Where were you then?"
"None of your damn business, Wonder Doc."
"Here's the deal, Dr. Arrogance. Call it when you are in charge. Now pay attention to this surgery. The bean counters would approve: thirty-two years old at the height of actuarial viability. For all that is holy, if I wasn't up to my elbows inside Officer Bailey's..." The heart started beating weakly between her fingers. "Pulse?"
"Faint, Beth," the nurse said.
"There you go, Randy. Spontaneous circulation," Elizabeth snapped.
"Push more blood products and antibiotics. Release the clamp."
Alarms rang. All his organs appeared like a sprinkler hose charged with water. She returned to massaging his heart.
"Pack-off the bleeders. Start running the bowel. Check for any small wounds. These bullets fragmented; they don't make big holes."
Steven slid through the tacky mess on the floor. Lifting a small shard of metal, an arc of blood sprayed across his mask. After a toss into the basin, he reached for the next one. This was going to be a lengthy operation for them all.
