Lynn knew many of the people who worked on the floor from her monthlong elective back in October. She looked for the head nurse, Colleen McPherson, with whom she had gotten along well, but didn’t see her. When she asked another floor nurse, she learned that Colleen was in with a hip replacement patient whom they were trying to mobilize. Instead Lynn went back behind the desk to chat with Hank Thompson, the ward clerk. In the hospital hierarchy run by the nurses, medical students were low on the totem pole, but Hank had never treated her that way. He was a student at the College of Charleston and doing his own version of a work-study program.
Like everyone else, Hank was doing six things at once. He was on the phone, with a number of people on hold. While waiting, Lynn pulled up the master list of all the patients on the fifth floor on one of the monitors. It was organized according to room number. She ran her finger down all the names, looking for Vandermeer. It wasn’t there. But there were several vacant rooms, so she thought there wasn’t going to be a problem. She was pleased. It was best for orthopedic patients to be on the fifth floor because the nurses and aides were well versed in handling the usual problems that had to be faced by post-operative orthopedic patients, like dealing with the CPM, or continuous passive motion machines, which flexed and extended joints immediately after surgery. Lynn knew that Carl would have one because Weaver used them with all his ACL cases.
When Hank finished with the people on hold, he started to punch in the numbers to make another call. Lynn grabbed his arm.
“Two seconds of your time, Hank! A patient by the name of Carl Vandermeer will be coming to the floor shortly, unless he is already here. Does the name ring a bell?”
“Not that I remember,” Hank said with a shake of his head. “Who’s the doctor?”
“Weaver.”
Hank grabbed the master OR list and scanned it. “Yeah, here it is. It was a seven-thirty case.” He looked at his watch. “Should be coming up any minute, unless there was a complication.”
“It was a straightforward case. First operation. Healthy, young guy.”
“Shouldn’t be a problem. We have several rooms vacated this morning, and they have already been serviced, so they are clean and waiting.”
Lynn nodded and absently played with a paper clip. Hank turned his attention back to the phone. It occupied 90 percent of his day every day.
Lynn knew she should probably head over to the eye clinic. The lecture would be over and patients were probably lined up to be presented and examined by the medical students. Yet she knew she wouldn’t be able to concentrate until she was certain Carl was comfortable and all was in order.
Suddenly she stood up. Feeling she couldn’t just sit there, she decided she’d go down to the second floor and at least check the OR schedule. There could have been a delay in getting started. What if Weaver had come in late for some reason? What if the OR was short of nurses? There could be millions of reasons why a case could be delayed.
Lynn took an elevator down three floors. Feeling a bit like a fish out of water, she walked into the surgical lounge. It was another one of those places medical students didn’t wander around unaccompanied. Like the rest of the hospital, it too was crowded, since the OR was in full swing. Most or all of the lounge-style chairs and couches were occupied by doctors and nurses. All were in scrubs. A TV in the corner was tuned to CNN with the volume turned way down. Most people were reading newspapers, either waiting to begin or taking a quick break in the middle of cases already under way.
Fearful of calling attention to herself and possibly being ordered to leave, Lynn didn’t hesitate. She stepped into the room far enough to see the image of the OR white board in the monitor mounted on the wall. She looked for Weaver’s name and found it in OR 12. He was doing an anterior cruciate ligament, all right, but the patient’s name was Harper Landry, not Carl Vandermeer. So obviously Carl’s case was over.
Lynn’s eyes scanned around the room for a familiar face, somebody, anybody she might know however vaguely from either her orthopedic elective or from third-year surgery. But she didn’t recognize anyone. With sudden resolve she went into the women’s changing room.
Getting some scrubs, she changed quickly, using an empty locker for her clothes. After tucking her moderately long hair into a cap and grabbing a surgical mask, she checked herself in the mirror. The almost-white surgical hat emphasized her olive complexion, and without the benefit of her thick hair to frame her face, she thought her youthful, angled features and slightly upturned nose made her appear younger than she was. Combined with her height, she worried she was going to stand out like a sore thumb as a first-year medical student who didn’t belong. More to conceal her identity than to be aseptic, she put on the mask.
Satisfied, she returned to the lounge. Without hesitating, for fear she would lose her nerve, as Lynn generally followed rules, she walked out of the lounge and pushed her way through the double doors into the OR suite. She had been there before on numerous occasions during her monthlong orthopedic elective and even a few times during third-year surgery, but always accompanied. She had even assisted Weaver as well as a few other surgeons to get a close-up idea of orthopedic surgery. To her, orthopedic surgery was a lot different from what Karen had suggested. It wasn’t eye surgery, to be sure, but with newer tools it was considerably more precise than it had been.
Lynn half expected that she would be challenged, but she wasn’t. She kept moving at a good clip with the belief that any hesitation on her part would be a tip-off that she was an interloper. Her destination was the PACU, and she headed directly for it. She pushed through the second set of double swinging doors as if she belonged, but then stopped a few feet inside the room.
For most people, Lynn included, the PACU was a busy, alien world of high tech, which made students feel incompetent. The patients were on elevated beds with side rails. Most of the beds were occupied. There were no dividers between the beds. Each seemingly sleeping patient had at least one nurse, many with a nursing assistant as well. Fresh bandages covered varying areas of the patients’ bodies. Clusters of intravenous containers that appeared like plastic fruit hung on the tops of metal poles. The lines snaked down to run mostly into exposed arms, although a few were central lines going into the neck. Monitors were clustered on the wall over the head of each bed, with various electronic blips tracing lines across their screens. Plastic bags hung under the beds for drainage and urine. Several of the patients had ventilators for assisted respiration. The sounds in the room were a mixture of the electronic beeping, the cycling of respirators, muted voices of the nurses, and a low hum of powerful HVAC motors keeping the air in the room clean and cool.
Right behind Lynn, a gurney came crashing through the swinging doors, bringing in a fresh post-op patient and making Lynn jump out of the way. An OR nurse was pulling at the front. In the back was an anesthetist pushing while making sure that the patient’s breathing was not being compromised. A nurse from behind the central desk came around to help guide the gurney alongside an empty bed.
As the patient was efficiently moved from the gurney onto the bed, Lynn took a quick loop around the room, trying not to be conspicuous. None of the staff seemed to notice her. Carl was not there. She would have recognized him immediately. There were two people who had had knee surgery with CPM machines to keep their knees constantly flexing and extending. Neither was Carl.