At first Mitt thought the child had to be a patient who’d snuck out of her room to wander around, something he imagined wasn’t all that uncommon although surely discouraged. But then he realized that couldn’t be the case because the person he was seeing was definitely a child, whom he guessed was around ten years old. As far as he knew, there were no pediatric patients on the fifteenth floor, and the Department of Pediatrics was way down on the eighth floor, or so he’d been told.
And, Mitt realized, the girl wasn’t wearing a typical hospital johnny, the gown all patients were required to wear except for those up on the psychiatric floors. She had on a dress, and even that seemed oddly anachronistic. The child was clothed in a pale off-white shirtdress with puffy sleeves and a flat, rounded collar that appeared to Mitt, who’d been an old-movie buff as a teenager, to be right out of the 1940s or 1950s.
Mitt’s next thought, the clothing notwithstanding, was that perhaps the girl had managed to wander onto one of the elevators and was now lost and needed help to find her way back down to the pediatric floor and to her room. Marshalling a surge of energy motivated by concern for the child, Mitt started forward and was about to call out to her when the horrid cacosmia reoccurred with a vengeance. The smell was as bad or worse than it had been hours earlier in the elevator lobby on the seventeenth floor. It was awful enough to make him stop short and clasp his hand to his face to pinch his nose.
But then almost as rapidly as he’d been assaulted by the terrible odor, it vanished just as it had earlier, leaving him momentarily stunned. At the same instant, the young girl — having caught sight of Mitt — seemed to shrink back in either fright or antipathy, he couldn’t tell. Since she was illuminated from below by the baseboard lighting, only her delicate chin and the tip of her nose were apparent. Both eye sockets appeared as black holes beneath her nimbus of radiant blond hair, so blond it seemed almost phosphorescent.
“Wait!” Mitt called out as he again started toward the child. She was now about twenty or thirty feet away, close enough for Mitt to see that something shining in the half-light was protruding from her left eye socket. But the girl didn’t heed Mitt’s request. Instead, she spun around and disappeared from view back up the north corridor.
Sprinting ahead, Mitt reached the intersection within seconds. Ahead was the bank of elevators, five on a side. Turning the corner, Mitt looked up the north corridor, intending to catch up to the fleeing girl. But again, he abruptly stopped. From where he was now standing, he could see all the way to the hallway’s end, where it abutted the corridor that ran along the 15 North patient rooms. Shockingly enough, the corridor was completely empty. There was no young blond patient on a midnight foray. Instead, way at the end, he glimpsed a passing nurses’ aide carrying a tray of medications to one of the nearby patient rooms.
Slowly Mitt’s jaw dropped open in amazement and concern. He released a long breath and sagged against the wall of the corridor, letting the back of his head rest against the Sheetrock. He closed his eyes. One question burst into the forefront of his mind: What the hell is happening to me? He feared he might be losing it. Could the combination of his nonstop anxiety and physical exhaustion take a serious toll on his sanity and cause hallucinations?
Mitt took a deep breath in, held it for a moment, then let it out again through pursed lips. Somehow the fluttering sound and the physical sensation it made were reassuring. For a moment he had no idea of what to think or do. Maybe he was not cut out to be a surgical resident, and the disturbing question of whether that might be true hung unanswered in the air. Did other first-year residents have similar reactions? Had Madison gone through something equivalent a year ago? He had no idea, but her current apparent confidence was encouraging. As agitated as he felt, he wanted to grab onto anything to feel reassured.
Mitt opened his eyes, looking north once again, almost hoping he’d see the blond girl, but he didn’t. Instead, he saw what looked like the same nurses’ aide again walk past, now going in the opposite direction. She’d apparently dispensed the medication she’d been carrying and was on her way back to the nurses’ station. Somehow just seeing such a normal nighttime hospital routine gave Mitt the bit of reassurance he needed to counteract his concern that he was going off the deep end. Olfactory and visual hallucinations were worrisome symptoms, yet it all had to be a combination of stress, anxiety, and exhaustion. What he needed was sleep. It was nearly 4:00 a.m. by his watch, and he’d have to wake up around 6:00 to be prepared for rounds at 6:30, as Dr. Kumar had stressed. It wasn’t going to be much rest, but he had to think that was better than none at all.
Chapter 10
Tuesday, July 2, 9:45 a.m.
After more than two hours in operating room #4, one of Bellevue’s newest hybrid ORs, Mitt could not believe how much more interesting his second day was from his first right from the get-go. During much of his first day of surgery, particularly the first several hours, he’d seen little of the operative procedure since his line of sight had been blocked by Dr. Geraldo Rodriguez’s torso. On today’s open-heart surgery case, which was a mitral valve replacement on Ella Thompson, there had been no such problem, even though Dr. Rodriguez was again the first assistant. And good visibility wasn’t the only beneficial change for Mitt. Yesterday he’d spent the entire case using both hands to pull up and back on a retractor, which had not been easy, especially for eight hours.
On today’s case very little retraction had been needed because the cardiothoracic attending surgeon, Dr. Pamela Harington, who was the associate chief of the department, had employed an instrument called a sternal retractor. After using a vibrating bone saw to cut through the sternum vertically, she’d put in the sternal retractor and cranked it open, which fully exposed the fatty pericardium as well as sizable portions of both alternately inflating lungs. Mitt had been spellbound, especially watching the opening of the pericardium to expose the beating heart. As a medical student, Mitt had never seen an open-heart surgical case, although from a technical perspective he knew a considerable amount about the heart-lung machine that made it all possible. He’d been directly exposed to an extracorporeal membrane oxygenation machine, which operated under similar technological principals, during his third-year internal medicine rotation.
To make the situation even more engaging and personal for Mitt, Dr. Harington had taken an early and strong interest in his participation when she’d been told by Dr. Rodriguez at the beginning of the case that it was only Mitt’s second full day as a resident. That fact had clearly caught her fancy, as she was quick to say that she, too, had done her surgical training at NYU and mostly at Bellevue, although she’d gone on to do a fellowship at the Cleveland Clinic. It was obvious to Mitt that while she was thinking of him, she was mostly waxing nostalgic.
“You must be thrilled, Dr. Fuller,” she added now as she looked across at Mitt during an unexpected delay in the procedure caused by the perfusionist, who wasn’t quite prepared to go on bypass. He was still busily in the process of priming the heart-lung machine when Dr. Harington announced she was ready to insert the cannulas to divert the blood away from the heart. Mitt was on the opposite side from Dr. Harington, once again nestled between Geraldo and the anesthesia screen but with a completely open view of the operative site. “I remember my first few days as a resident as if they were yesterday,” Dr. Harington continued. “I hope you are aware just how extraordinary and exciting a journey you’re beginning. Although I’m sure you had to have worked hard to get here, you are a lucky, lucky man. All I can say is, enjoy it!”