Jason hooks his arms under Atlas’s hindquarters. Wyatt takes the chest. Together, they lift the limp, heavy dog onto the steel surgical table. The metal clangs under his weight. I run my hands under the antiseptic dispenser, the cold gel burning the small cuts on my palms, before I pull the latex gloves over my fingers with a sharp snap.
The room is freezing, but sweat beads along the bridge of Wyatt’s nose as he takes the scalpel.
“Incision starting.”
The blade cuts a long, clean line down the midline of the abdomen. The smell of copper and heated steel rises between us.I step into the space beside Wyatt, my gloved fingers taking the cold steel loops of the retractors, pulling the skin back under his direction.
“Retract.”
I pull, my knuckles locking, my shoulders cramping under the strain.
Deep inside the incision, the stomach is a dark, congested purple, swollen to twice its normal size, and twisted like a wrung towel. It blocks everything else, a bloated, suffocating mass that’s cutting off the blood flow to his spleen and heart.
Wyatt reaches into the cavity, his fingers sliding beneath the purple tissue. “Gastric volvulus. It’s rotated three hundred and sixty degrees. Spleen is engorged, but the tissue looks viable. I’m going to rotate. Jason, watch the monitor.”
He grips the congested organ, his forearms straining under the canvas sleeves of his scrub shirt.
With a slow, careful twist, he rotates the stomach back into its normal anatomical position.
The heart monitor has been beeping in a rapid, shallow cadence. Now it breaks into a wild, erratic screech. The green line on the screen spikes, then drops, a jagged mountain range of PVCs.
Jason points at the screen, his face pale under the fluorescent lights. “Arrhythmia. Heart rate’s dropping. Eighty. Sixty. Fifty.”
“Wyatt?” My chest freezes, the air in my throat turning to ice.
“Reperfusion.” Wyatt’s jaw is clamped so tight the bone shows white through his cheek. He doesn’t take his hands out of Atlas’sabdomen. “The toxins from the stagnant blood are hitting the heart.”
His slate eyes flick to mine, sharp and intense. “Lidocaine. On the top shelf of the prep cart. Draw two CCs. Push it through the IV port.”
My fingers scramble over the glass vials on the cart, my vision swimming. Lidocaine. I find the small label, my hands shaking so violently that I drop the syringe twice before I can pierce the rubber stopper. I draw the clear liquid, the numbers on the plastic barrel blurring. Two CCs.
“Bella. Now.” Wyatt’s jaw tightens under his mask.
I locate the rubber port on the IV line in Atlas’s front leg. I push the needle in and slide the plunger down.
“Monitor?” Wyatt doesn’t look up, his hands steadying the congested stomach.
“Still dropping,” Jason’s hand is flat on Atlas’s chest. “Thirty. He’s going bradycardic. Breathing’s stopped.”
Wyatt points to the head of the table. “Ambu bag. Bella. At the head of the table. Squeeze it. One breath every six seconds. Jason, start compressions.”
I drop the syringe, lunging for the black rubber bag attached to the endotracheal tube. I grip it with both hands, squeezing the rubber flat. One-one-thousand, two-one-thousand, three-one-thousand...
Jason places his palms over Atlas’s ribs, his body weight shifting in a heavy drive. The rhythmic thud-thud-thud of his hands against the ribs fills the silent room, a desperate, hollow beat.
Four-one-thousand, five-one-thousand...
I squeeze the bag again. Atlas’s chest rises, a mechanical, false life.
My eyes lock onto the monitor. The green line is nearly flat, a slow, lazy ripple that shows no rhythm, no pulse.
My counselor-calm fractures, a raw, jagged terror tearing through my ribs. “Atlas. Atlas, don’t. Don’t leave us. Please.”
Jesse’s dog. The last living thing that slept by his bed. The one who dragged me through the snow, who carries Jesse’s memory in the grey of his muzzle and the scuff of his paws. If he dies here, on this steel table, under these cold lights, the last piece of my cousin is gone.
Wyatt keeps his hand on Atlas’s flank, his voice dropping to a gravelly, flat register that sounds like a prayer. “Compressions. Keep the rhythm, Jason.”
I squeeze the bag. One-one-thousand, two-one-thousand...
