“So the kids will be asleep,” she says, with a mischievous look in her eye.
Twenty minutes later, I walk into the operating room to find Ethan swearing at Kevin Talbot. Kevin’s shoulders are drooping, and he looks as though he’s about to burst into tears. Two nurses are watching, silent and tense.
The anesthesiologist, Dr. Kavita Singh, is the first to notice me. “Luke!” she exclaims with relief. Like she’s a passenger on the Titanic and I’m a lifeboat.
Ethan turns, a little more slowly than he usually would, and stares at me. He’s not exactly unsteady on his feet, but it’s clear that something’s off.
“Hey, Ethan,” I say, trying to be casual. “I was here checking on a patient, and I heard you weren’t feeling well. Do you want a hand? Or if you like, I could take over.”
The room falls silent. Ethan presses his lips together and looks up at the ceiling, refusing to meet my eye. All the spectators—the anesthesiologist, the nurses, and poor Kevin Talbot—are holding their breath. Wondering if Ethan has the insight to know he’s impaired, and if he’ll go gracefully.
Fortunately, he does.
“Thanks, Luke.” Ethan steps away from the patient and strips off his sterile gloves. “I’ve got some sort of stomach flu, and Kevin can’t hold the camera straight. It’s making me nauseated.”
Kevin flinches.
“No problem,” I say. “I’ll finish this up with Kevin, and I’ll cover the rest of the night.”
“Yeah. Thanks.”
“Why don’t you call Jessica to come get you?” I suggest, worried he’ll try to drive home. “Or get an Uber?”
Ethan shakes his head. “I’m gonna crash in the call room.”
With that, he turns and walks out. As soon as the door closes behind him, everyone in the room exhales.
“Okay,” I say briskly. “Just give me a minute to scrub.”
I shoot off a text to Nick, asking him to come back to the OR, then walk back out to the scrub sink in the hall. As I rub the scrub gel carefully under my fingers, I realize the full implications of what happened tonight.
Ethan was operating drunk. Everyone in that OR must have suspected it, and we have an obligation to report it. And as the colleague who had to replace him, I’m the one who should do it.
The thought makes me sick. Ethan’s a mentor and a friend; hell, I might not have made it through residency without him. But the harm he could cause, operating drunk . . .
I take a deep breath as I head back into the OR. The problem with Ethan can wait until tomorrow. Right now, I need to focus on the surgery.
And this gallbladder is a hot mess. It’s clearly been inflamed for a while, so it’s basically glued to the liver. To make things worse, the patient’s old and looks chronically ill, so he’s at higher risk of complications from a prolonged anesthetic. If Ethan had been sober, I doubt he’d have brought this case to the OR in the first place. The usual approach in this situation would be to ask the radiologist to put a drainage tube into the gallbladder, start antibiotics, and cross your fingers.
I consider aborting the surgery and trialing the antibiotic route, but since the guy’s already got incisions in his belly, I decide to push on. Kevin struggles to hold the laparoscopic camera steady—Ethan wasn’t wrong about that—and it’s a relief when Nick appears to take his place.
Even with Nick’s help, the case isn’t easy, and it takes over three hours to finish. By the time we’re done, my head is pounding and I’m exhausted. I dictate a procedure note, stating that I took over the case because Dr. Atwell fell ill. Then Nick and I head to the waiting room and tell the patient’s wife the same story.
“Anything else going on tonight?” I ask Nick when we’re alone in the hallway.
He shakes his head. “No.”
“Okay. I’ll cover Ethan the rest of the night. Call me if anything comes up.”
“Sure thing. Thanks for coming in, Luke.”
“Thanks for calling me. And if you could talk to Kevin, I’d appreciate it. He’s probably shaken up.”
“No problem.”
“Thanks.” I should meet with Kevin myself, but it’ll have to be another day. I don’t have it in me tonight.
I head to the call rooms to look for Ethan, and I’m relieved to find him there, passed out and snoring. His wallet and keys are on the bedside table, and after a minute’s hesitation, I take the key to his Tesla off the ring and slip it into my pocket. He has no business driving tonight.
