"Listen, Marshfield, " Zack whispered. "I just looked at her films over there. She has a fracture. Two of them, I think. C-one and C-two."
The older man froze. In slow motion, his pen wobbled in his fingertips and then fell, clattering onto the counter. "Are you sure? " he rasped.
Zack nodded. "Jesus…"
"Come, let me show you."
Moments later, Zack led a mute, badly shaken Wilton Marshfield across to Stacy Mills and her parents "Hello, Stacy, Mr. and Mrs. Mills, " he said. "My name is Iverson. Zachary Iverson. I'm a neurosurgeon."
He glanced back at Marshfield, who looked as if he were listening blindfolded to the final counts from a firing squad. Inwardly, Zack smiled. If the man was waiting for gunfire, he was in for a pleasant surprise. Hey, Wilton, relax, he was thinking. As far as I'm concerned, this business of ours has never been a contest or a game. It's life.
It's the real bananae And it's hard enough to do right even without the bullshit and the oneupsmanshipw You did the best you could, and that's all we got-any of us. There's no way I would hang you out to dzy. "Dr.
Marshfield, here, has just made an excellent pickup on Stacy's X rays," he said. "He spotted a shadow he didn't like, and wanted me to check it before he would consider sending her home. I'm afraid his suspicions were correct. Stacy, there is a small fracture-a broken bone right up here."
"I knew it, " Stacy said. "See Mother, I told you it was killing me."
"Is it dangerous? " the girl's mother asked. "It would have been, " Zack said, slipping the soft collar into place, "if it had gone undetected.
It could have been a blooming disaster. But everything is under control now. You're going to be just fine."
Mrs, Mills reached over and squeezed a stunned Wilton Marshfield's hand.
Her husband patted him on the shoulder. "Now, Stacy, " Zack went on,
"first of all, I don't want you moving your head around, okay?"
"Okay."
"Good. Then there are some things I must explain to you and to your parents about what we do for cervical fractures."
"Dr Iverson, please, " the girl's mother said. "Before you start, I d like to get Stacy's aunt-my sister-over here. Would that be okay?"
"Certainly, but I don't see-"
"She helps me understand medical things. I'm sure you know her. She's the head nurse here. Maureen. Maureen Banas."
CHAPTER TEN
Although operating room 2 at Ultramed-Davis was newer than some of the dozens Zack had worked in, the ambience was no different. The sounds, the lighting, the tile, the filtered air-tinged with the unique mix of antiseptic and talc and freshly laundered gowns-provided sensations as familiar to him, as reassuring, as the mountains. The stabilization of Stacy Mills's neck was proceeding flawlessly. Standing by the head of the table, Zack paused, savoring the sensations — the wonder of what he was able to do, and the bond he was feeling with the rest of the O. R. team. The sound system-Frank's brainchild, now installed in nearly all Ultramed's hospitals-was playing George Winston's magical treatment of "The Holly and the Ivy."
"All set? " he asked the scrub nurse. The woman nodded. "All right, then, " he said evenly. "Stacy, this is the part I told you about. We're going to twist those four screws into place on your head. I've put lots of novocaine in each spot, so they won't hurt, but it will feel funny, and you might hear the grinding noise. Everything is going Just fine. I know it's scary for you, but there's really nothing to be frightened about."
"I'm not frightened, " the girl said. "At least, not too much."
"Good. And you remember what you have to do?"
"Don't move, " she answered. "Exactly…"
Zack checked the position of the cervical halo one last time, and worked the four screws farther into place through the small incisions he had made in the girl's scalp. "Unless I tell you to, don't move."
From a spot several feet behind the O. R. team, Wilton Marshfield watched, his every breath a sigh of relief. Even though Zack Iverson had publicly gone out of his way to share credit for the pickup with him and had privately assured him that this sort of cervical fracture was the toughest of all to diagnose, he sensed that he would never be truly comfortable in the emergency ward again. He had come out of retirement and into the E. R. as a favor to Frank Iverson, and because he was bored. Now, he knew, it was time to stop. And thanks to Iverson's brother, after forty years of busting his hump, of doing his best to survive first the knowledge explosion, then medicare and the paperwork crunch, then the malpractice crisis, and now the goddamn corporate-policy crap, he could at least go out as something of a winner. "God love ya, kid, " he said softly, as Zack tightened the apparatus in place. "God love ya."
"Okay, Stacy, " Zack was saying, "that's one. Now, wiggle your toes the way I showed you. Good. Now your fingers. Good, good. We're almost there."
He stepped back for a moment and shifted his focus from the metal frame to the fine features and peaceful face of the girl/woman. Biology, organic chemistry, anatomy and physiology, boards and more boards, endless nights and weekends on duty or on call, countless meals of cafeteria food or nondescript leftovers in cardboard containers, countiess hours in the O. R. and on the wards, scattered days, and weeks, and even months of consuming self-doubt-at moments like this one, the choices he had made in his life and the price he had paid made so much sense. And when it was over, when the girl who loved to ride horses walked away from the hospital and from the split second that could have paralyzed her forever, he would take that moment and bankroll it in his mind as vindication for all the years and all the anguish, and as a hedge against those outcomes yet-to-be which would not bring smiles and handshakes and pats on the back-outcomes that, as long as they were unavoidable, were no less a part of medicine than this one. "That's it, Stacy, " he cooed as he tightened down the last of the screws. "That's it. You're doing perfect. We're all doing perfect."
With the elective surgery schedule now an hour behind, O. R. 2 was emptied out as soon as the last screw was in place and the proper position of the halo was verified. Zack accompanied Stacy Mills to the east-wing room where, for a few days, she would be observed for signs of spinal cord swelling or compression. "Well, you just take it easy, Stacy, " he said. "I'm going to go talk to your folks, and then I'll send them up. I'll be back to see you at the end of the day. Wearing this device won't be the most fun you've ever had, but like I said, it won't be forever."
"Dr. Zack, " the girl called out as he was leaving, "in the operating room I said that I wasn't scared. Well, now that it's all over, I can tell you that I really was. I just didn't want to sound like a baby."
Zack returned to the bedside and smiled down at her. "In that case, " he said, "I've got something to tell you-something I've never told any patient before." He bent over her bed and whispered, "I'm always a little frightened and a little nervous when I operate."
"You are? Really?"
"The truth. I think it helps my concentration never to forget that it's always possible that something could go wrong. There, I said it, and..
hey, Dr. Mills, I feel better already!"
"You're very silly, do you know that?"
"I hope so, " he said. As he was leaving the girl's room, Zack spotted Maureen Banas approaching down the corridor. She was in her late forties or early fifties, he guessed, with short, graying hair that looked as if it had been cut by an amateur. Although she carried herself with authority, the tension etched into her face and the lack of attention to ten or fifteen excess pounds hinted at a life that had, perhaps, not been an easy one. "Congratulations, Dr. Iverson, and thanks, " she said with an almost clinical lack of emotion. "Stacy is a very special child to a lot of people. We all owe you a great deal for what you did."