“I guess.”
“What’s his name?”
“Milly Crawford.”
“And you don’t know what caliber hit him, right?”
“Nope; ’fraid not.”
Franklin nodded. “Well, we’ll dig around a little and find out. You coming?”
“If that’s all right.”
“Absolutely. Clean yourself up and grab some greens.” He looked over my shoulder behind me. “Harry’ll show you.” He shook his head at me again. “You look worse than your fat friend.” He vanished down the hallway through a pair of double doors, his team in pursuit, clustered around Milly’s rolling bed, carrying IV solutions, equipment, and the ever-present ambu bag. They looked like ants carting off their enormous, somnolent queen into the bowels of the anthill.
A tall, unsmiling male orderly was standing in the hall. “Come with me,” he muttered and led the way through various twists and turns to a locker room. Franklin had not been kidding; looking at myself in the mirror there, I wondered if I had more of Milly’s blood than he did. I washed thoroughly and changed into a set of “greens,” struggling for an inordinate amount of time with a pair of seemingly too-small paper slippers I’d been instructed to slip over my street shoes.
Harry, looking as morose as a basset hound, pointed at the blood-soaked clothes at my feet. “You got other stuff to wear?”
“No.”
“Better keep the greens, then. Those are gross.”
I couldn’t argue the point, so I simply nodded and followed him to the operating room.
11
Harry had explained to me that Dr. Franklin called an available operating room “a miracle” because they were usually heavily booked and, at three, grand total, in short supply. Number two was open because electricians had been replacing the fluorescent tubes in the ceiling, a mundane fact that explained the dramatic scene that greeted me as I walked through the room’s swinging door.
Operating rooms routinely share three attributes: they are clean, they are more or less filled with exotic and arcane machinery, depending on the budget of the hospital, and they are as bright as the Sahara at noon. The one I entered had the equipment, but that was it.
Milly had been shifted from the rolling bed to the operating table in the center of the room. He was naked, huge, pale, and blood-streaked, his dirty white body glowing with the reflected brilliance of a trio of tripod-mounted flood lamps. But where the rest of the room would have been lit normally by overhead fluorescents, this one was dark, its distant corners almost indistinguishable to my eyes, as yet unaccustomed to the gloom. On first impression, it seemed Milly, dazzlingly suspended, was floating in dark space, asleep and utterly passive, attended to by a flurry of some eight green-clad satellites, all laying out instruments, hooking up equipment, and generally preparing for the doctor’s arrival. He looked so out of place, his soft, spongy flesh overflowing the narrow table, one arm dangling off to one side, punctured by an IV line attached to a blood bag hooked to a nearby stand. His head was extended back, his torn mouth open and filled with a thick tube hooked to the oxygen equipment and an ambu bag, still being rhythmically squeezed by a technician. I noticed how shockingly yellow his gnarled toenails looked in contrast to his almost bloodless skin.
A far door banged open with a brief flash of light and Franklin stormed in, mask already in place, trailed by a smaller, thinner man, also in scrub greens. Franklin went straight to the tray on which the surgical tools were being laid out, and without waiting for sterility-insuring assistance, ripped open a package of latex gloves and snapped them onto his still-damp hands, muttering to the smaller man, “Don’t wait for a nurse. They’re busy and there’s no time.” His former jaunty tone had been cooled by concentration.
He grabbed a scalpel from the tray and positioned himself to Milly’s left side, the nurses and technicians still moving about, some of them with their gowns still untied in the back, one of them beginning to drape the body with large, dark-green squares of cloth.
Franklin waved her away. “Later. I want to go in now. Vitals?” he asked the woman at the head of the patient.
She nodded. “Systolic seventy, pulse fifty. Things are slowing down again.”
“Okay, Mr. Crawford, time to see if we can help you out a little.” Franklin placed the point of the blade on Milly’s sternum, just above his nipple line, and in one smooth, almost theatrical movement, sliced a deep incision from the front of the chest, across the left rib cage, and all the way to where the back met the table top, about eighteen inches long.
“Finochetto,” he barked.
A glistening steel apparatus with a crank on one end appeared from the surrounding gloom. Franklin’s surgical assistant fit the device between two of Milly’s ribs and began to turn the crank. There was a sound of wet tearing, a few sharp snaps, and finally several loud cracks as the ribs, one by one, were pried apart.
I had moved through the shadows to where I was now standing behind the two surgeons, and as the ribs yielded to the spreader, I saw a sudden frothing of pink bubbles from the lung beneath the ribs, followed by a brief, explosive cascade of blood that poured from the wound and splashed off the table, soaking both men’s pants and covering the floor. A nurse threw down a thick green sheet that both men trampled beneath their feet, absorbing some of the blood and reducing the risk of slipping.
Milly’s left lung, suddenly unrestrained, expanded a good six inches from the huge hole in his chest. It was streaked with blood, somewhat pink, but heavily marked with dull gray stripes and clusters of black spots. “Look at that-heavy smoker. As if your diet wasn’t enough to kill you,” Franklin muttered. “Give me a lap pad. Vitals?”
“Systolic fifty, pulse thirty. Almost off the charts.”
“Come on, fella, don’t crap out on me now. Keep that suction coming.” Franklin squeezed the lung, now held in the lap pad, and followed it as it deflated up into the chest cavity, his entire hand and half his forearm disappearing from view as he bent over and shoved the lung up and out of the way for a clear view of the heart’s left side, snipping away at thin connecting tissue with his other hand as he went.
“Move the light so I can see inside.” Franklin paused and spoke to his assistant over his shoulder: “Walt, I want you to move to my other side and hold this lung out of the way.”
Walt quickly accommodated this request, allowing me a brief unimpeded view of the wound and what it revealed. Milly’s chest was now totally empty, easily hollow enough to fit two footballs. Its bottom was like a water-filled grotto, the water being thick, dark-red blood, and was constantly being drained by two large-bore suction catheters hooked to a sizable transparent jug, now about half full. At the back of the grotto, high up against its far wall, a fat, bulging swelling-a sack of red flesh-was straining against its contents, some of which was dribbling down the wall to the pool below.
“Systolic forty, Doctor. He’s almost gone.”
“Not yet, he’s not. Walt, push it further up, but watch out for the major vessels.” Franklin took up his scalpel again, reached in, and sliced the bulging sack on the far wall.
“Suction here.”
More dark blood poured out as from a burst water balloon, along with several small clots. The suction tube made a sound like some obnoxious child overworking his straw at the end of a satisfying ice-cream soda.
“Blood pressure rising.”
“All right, nice goin’, Mr. Crawford,” Franklin muttered to himself. “Get some more light in here.”
Both Franklin and Walt now had their hands in the chest, and yet there was still enough room for me to see the heart itself, visible through the opened pericardial sac, rhythmically squirming like a fist in a pink mitten, closing and opening, closing and opening. With each contraction, a small spurt of blood arched out into the grotto.