Picking Through Bones (eBook)

Chapter 1

He was ready. He’d read the books and had good teachers. He’d assisted in hundreds of open-hearts during his training. But how did one really know if he was ready for surgery?

This was different. He was the man, the one who had to make the right choices, the one who must execute the proper surgical technique. Gowned and gloved, he stood in OR-7 of Striker’s premier surgical theater, staring into his patient’s gaping chest. Looking through her breast bone, now being cut in two by a medieval bone saw, he listened to her sternum cracking apart.

He stared into her quivering heart. Streaked in crimson, her muscle fluttered meekly. It looked so small and vulnerable. The patient waited to go on bypass, but she also waited for him. He must do his job, or her heart would be broken forever.

He was reminded of Los Barriles, Mexico. And of that little girl he couldn’t help. He traveled there to go off the grid, for some camping and surfing, during spring break in college. He loved the outdoors, high or low country, wet or dry. It was all part of nature’s majesty.

She was an eight-year-old, who had been kicked in the head by a horse on her ranch. With the nearest medical care a few times zones away, she died of a blood clot in the brain before reaching a hospital.

He couldn’t save that girl, but later, he returned as a medical student with Doctors Without Borders to save many others. It was the best six months of his life.

Shortly after arrival, they began giving back to the villagers. They donated their expertise, building a small medical clinic… but mostly, it was about the caring. Over the months of scorching days and humid nights, the small team treated anything from raging fevers to delivering babies. They even performed minor surgical procedures.

Before leaving, they poured the foundation for a grammar school. As they were saying our goodbyes, the entire village assembled to throw a party in their honor, thanking them for the gift of hope. But they gave more than that: the gift of how it felt to help somebody. It was a good trade.

Now, he watched as itchy, red-blips of the patient’s pulse marched across the faceless cardiac monitor. Inside her chest cavity, a frothy mélange rippled from anemic bleeders. From out of thin air, a suction catheter materialized, slurping up the bloody stew.

“I’ve got this one, doctor,” winked the vigilant scrub nurse.

“You always have my back,” he replied.

“Don’t worry, though. I’ll leave the biggest one’s for you,” she said.

Breaking through the sterile green curtain, Dr. Jake Rhodes stretched his size 10 1/2 surgical gloves between his patient’s gaping ribs. His hands were double gloved, as always… He insisted on this. He hated messy things. It reminded him of his childhood. Everything seemed dirty. Keeping a clean home was not a priority when they spent most of their time at the family butcher shop. But the gloves also kept prying eyes away from his sores. His skin itched when he got nervous, so he scratched.

He took hold of the warbling heart.

“Looks like the warranty’s about done on that one,” chimed the anesthesiologist.

The bloated heart slumped into Jake’s hands. He could trace the patient’s hardened vessels across it’s scoured surface. Saddled with arteriosclerosis, a heart attack was imminent. Her pale myocardium was suffocating under its own weight.

“Geez,” exclaimed a wide-eyed intern. “It’s enormous—I mean, the heart, it doesn’t look real. Better start brushing-up on my gym membership.”

The circulating nurse shot the intern a look that could’ve been mistaken for silenced gunfire. “It’s not your place to judge. Besides, she can’t defend herself. But if she could, I believe she’d smack you upside the head.”

The bypass machine purred to life, as the team of gowned medics stared into the open chest cavity. Wearing the purple Striker scrubs, they waited for orders.

“Why, sugar,” drawled the circulating nurse in her saccharine accent. “That heart is beating slower than an old mule. Maybe you can try giving it a cube of sugar for a little giddy up?”

“Don’t think we’re going to get that lucky,” observed one of the assisting doctors.

Reality bullied in. The patient lay helplessly on the operating table. Impervious to the gore, all eyes were locked upon the surgeon, the man with the blade—Dr. Jake Rhodes, a fifth-year surgical resident, beginning his cardio-thoracic rotation.

Out of all the hospitals the patient could’ve been in, she came here, to Striker Medical Center, the biggest teaching hospital in New York City. And now, she was under his care, expecting the best.

Jake nodded, stating, “I’m ready to go. Let’s get started.”

Inside, he was jiggling like a bowl of Jell-O. But there was nowhere to hide. The glare of highly polished surgical mirrors burned through the years of impatience for him to get here. This was his seminal rotation in a career to complete himself. A proving ground, to show he was good enough to carry the rock. He wanted to help people. He knew he could. But more than that, he wanted to forge a solid impression with his new mentor, Dr. Wakefield.

Things had always come easy for him at school, unlike in life. Blessed with a photographic memory, he quickly rose to the head of the class, punching a ticket into the big leagues. A great education in Boston gave him the freedom to do a lot of things… and to consider what he wanted to do with his life. After seeing that poor girl in Mexico die needlessly, he wanted to save lives. Now there was someone lying on the table counting on him.

The operating room blistered to a head. “Man, I’m burning up,” he stated to no one in particular. “Someone please turn up the AC.” He reminded himself, I can do this! Most of his training had been easy, but this would be hard. Being challenged was a good thing—right? Standing at the front of the operating table, he saw that he was not alone. He had a great team assembled to help. But this was his moment.

“Dr. Rhodes, Dr. Rhodes, Dr. Rhodes,” chanted Dr. Wakefield.

As the great white headhunter of surgical residents, Dr. Wakefield’s stare cut through Jake, as he had done to so many other surgeons. Armed with a glare so powerful that Dr. Wakefield might be able to shrink tall buildings, Jake felt himself pucker inside. A mere mortal had no chance. As chief of cardio-thoracic surgery at Striker Medical Center, the man was quick with a scalpel, but even quicker to castrate fledgling surgeons. Pioneering advances in laser surgery, Dr. Wakefield had spared no expense building his reputation over the fallen bodies.

“Look, Dr. Rhodes.” he chided. “There’s blood everywhere inside the chest cavity. I can’t see a thing. How will you ever complete the task if you don’t know what you’re doing? Surely, there are bleeders somewhere in there. Now hurry up, grab your suction catheter, and clear the field.”

Dr. Wakefield was friend to no one; an infamous taskmaster, he wielded authority like a club, breaking students of their humanity. It was now Jake’s honor and burden to serve under Dr. Wakefield, as chief surgical resident in cardio-thoracic surgery, for the next twelve weeks.

“Dr. Rhodes, you don’t look well,” observed Dr. Wakefield. “Are you quite all right?”

I’m not going to let him get to me… like so many others. I will do this operation, even if it kills me. Hopefully, before that, I’ll save the patient.

“Yes, sir—sure, I’m fine,” he reassured. “ I’m clearing the field.” He ordered, “Pass me a suture please, nurse, and hurry, so I can get this bleeding stopped.”

He worked efficiently, as Dr. Wakefield commenced into one of his famous soliloquies. He couldn’t resist a captive audience.

“Observe, everyone, the patient, Mrs. Shields, lies here on the table, with a critical blockage of her left anterior descending artery.”

While Dr. Wakefield lectured, Dr. Rhodes cleared the surgical field, his hazel colored eyes cutting deep into the abyss. His freshly shaved face, usually friendly and inviting, had hardened to the task. His sandy hair, now matted under the constricting scrub cap, had lost all of the sun bleached features from Mexico.

Dr. Wakefield’s speech was interrupted by a curious intern, who asked, “How did she get to this advanced stage of arteriosclerosis?”

“That’s a good question, young man,” responded Dr. Wakefield. “What did you say your name was?”

But before the intern could answer, Dr. Wakefield resumed his discourse. “You see here, years of corpulence and lassitude, generously enriched by bovine fats and cataclysmic desserts, had taken its toll.”

“What he’s trying to say, sugar,” chirped the circulating nurse, “is that too much of a good thing is not a good thing.”

“That’s essentially correct,” added Dr. Wakefield with annoyance. “Even with her liberal licensure of plastic surgery, leaving her body an abandoned goldmine, she could not erase the inevitable date on the calendar with the cardiac surgeon.”

“We are what we eat,” said the anesthesiologist glibly.

“So it is, on this rainy morning, as she’s shares her sixtieth birthday with us, that we give her a bypass as her first present! Take a good look, everyone,” pontificated Dr. Wakefield....