To Mitt’s utter relief, the Perez case had gone smoothly, without so much as a hiccup, much less a death. The attending surgeon’s name was Dr. Maria Sanchez, and she was pleasant enough, with a personality somewhere between Dr. Washington’s narcissism and Dr. Harington’s conviviality. Technically Mitt thought she was superb. Since it was his first laparoscopic case, he didn’t have much to compare it to, but as he watched the procedure on the TV monitor, he could tell Dr. Sanchez was adept at using the instruments. She worked quickly with no hesitation, and Dr. Rodriguez seemed to be able to anticipate her moves. The case had required five small skin incisions with only one being approximately three inches long and the rest much smaller, a far cry from the normal approximately eight-inch incision needed for an “open” colectomy. From skin to skin, the procedure had taken less than three hours, and with such small incisions, the patient’s recovery time would be much faster.
At the end of the case, Mitt had written the postoperative orders in the recovery room under Dr. Rodriguez’s supervision, and then, in the surgical lounge, he’d done the dictation with similar assistance. All in all, it had been a positive experience, although as Andrea had said earlier, he needed to spend some time in the surgical simulation lab to gain hands-on experience using laparoscopic tools. Obviously, it was the way of the future, especially when combined with robotic surgery.
Since it was already after 7:00 p.m. and there were not that many people in the cafeteria, Mitt was able to locate Andrea easily — especially as she was waving in his direction. After heading over to her table, he went through the expected cheek-to-cheek routine before questioning: “How are you doing timewise?”
“I’m okay,” Andrea said. “No calls yet.” She sat back down at the table. In front of her was a cup of coffee she was nursing.
“Same with me at this time last night,” Mitt said. “It seems at this hour there are lots of attendings making rounds as well as residents, so we lowlifes are spared until they all leave.”
“I was told something similar by Dr. Van Dyke.”
“Let me grab some chow, and I’ll be right back. You okay with that?”
“Absolutely. I’m looking forward to comparing notes.”
Mitt nodded, then beat it back to the beginning of the cafeteria line, taking a tray and quickly selecting some food. Surprisingly enough, he wasn’t all that hungry, but he knew he needed to eat and didn’t want to wait until he got back to his apartment because he still had three admission workups to do. When he got to the drink selection area, he slowed down and was particularly careful with the cup. He couldn’t help but remember what had happened the night before.
“That doesn’t look like enough food for a growing boy,” Andrea commented when Mitt placed his tray on the table across from her and sat down.
“It’s enough,” Mitt said. “I need sleep more than I need food.”
“So, your first night on call was a problem.”
“With the burst abdominal aorta, it couldn’t have been worse.”
“I can’t imagine what that was like,” Andrea said with an expression of extreme distaste. “But that disaster aside, how would you rate your night on call from one to ten, ten being unbearable?”
Mitt chewed for a minute, thinking. For a fleeting moment, he thought about bringing up his freaky hallucinations to get Andrea’s take, but then he quickly nixed the idea. He was afraid of her response, in the same way he was reluctant to even think much about it himself. It was, in many ways, too weird.
Clearing his throat, he said: “Ignoring the bloodbath episode, I suppose I’d rate the night a five. I was busy from somewhere around eleven until about one thirty, but it was all minor stuff like dosage questions and checking people out who allegedly had fallen out of bed.”
“Well, I’m hoping to get a little sleep,” Andrea said. “With all the excitement, I didn’t even sleep that well last night in my own bed. But moving on, I heard your first two surgeries today were as disastrous as the burst aneurysm. I can’t believe your luck, or lack of it. My God!”
“Tell me about it,” Mitt responded, briefly looking heavenward before going back to eating. “Two operative deaths, one at the end of a case with a heart that would not restart after a mitral valve replacement and a second one where the heart decided to give up the ghost before the surgery had even begun.”
“So I heard. Unbelievably bad luck. I have to say, everybody’s bummed out about it. No one can remember anything similar, not only on the same day but in the same operating room. I’m sorry you had to witness it all.”
“Thank you,” Mitt said. He was tempted to bring up his thoughts about being somehow responsible but quickly changed his mind. Now that he was out of the OR and a bit of time had passed, the idea sounded preposterous even to him. Instead, he added simply, “It’s enough to make me paranoid.”
“I can imagine,” Andrea agreed. “It also makes me hesitate to ask how your final case went today. Don’t tell me if it went badly!” She laughed humorlessly.
“Well, I’m happy to report my last case went fine. No problem whatsoever, and since it was laparoscopic, I was able to appreciate what you said about needing to spend time in the simulation lab. As for the patient, she’s already left the PACU and is back in her room.
“But enough about me and my troubles,” Mitt continued. “How was your day?”
“I can’t complain,” Andrea said. “My three cases went smoothly. I even got to sew up the skin on the last two, which isn’t saying much, but we have to start someplace. Dr. Kevin Singleton, the fourth-year resident I’ve seemingly been assigned to, is a great teacher, and I’ve also been equally impressed with the attending surgeons I’ve dealt with. How about you?”
“I’ve been similarly impressed by Dr. Rodriguez, who I guess I’ve been assigned to. As far as the attending surgeons are concerned, I have mixed feelings. Dr. Washington, the vascular surgeon on my first case, seems a shade narcissistic; whereas Dr. Harington, the cardiothoracic surgeon who did the mitral value replacement today, is a bit flaky. Maybe that’s too strong. Let’s change that to eccentric.”
“That’s an interesting distinction. What led you to that impression about Pamela Harington? I’d heard from Dr. Singleton when this morning’s death was discussed that she’s one of the more popular and respected attending surgeons, particularly with the house staff.”
“That’s why I amended ‘flaky’ to ‘eccentric.’ She’s very likable and technically she seemed great, no question. But she’s an ardent Bellevue Hospital history buff, so much so that this morning when there was a delay in getting the heart-lung machine ready to go with the patient’s chest open and the heart exposed, she carried on the entire time about Bellevue Hospital history. To my surprise, she even knew specific anecdotes about my relatives, details that I was totally unaware of.”
“She sounds like my kind of surgeon, with a healthy background in liberal arts.”
“I suppose that’s one way to look at it. It just seemed odd to me under the circumstances. But, as I said, she is very likable, although what she said about my ancestors wasn’t all that positive.”
“What on earth do you mean?” Andrea was clearly taken aback. “Do you think she was intentionally trying to make you feel uncomfortable?”
“Oh, no, not at all. Quite the contrary. To be truthful, she was ultimately embarrassingly complimentary. But at the same time, she said that my medical relatives had a penchant for being on the wrong side of some important issues — anesthesia, aseptic technique, informed consent, and one even advocated the use of lobotomies.”