Broken Oaths in White Coats novel · Chapter 3 of 24
Chapter 3: Scrubbed In
Laurel takes the needle driver from Janelle and saves the transplant while on leave, then Alastair orders security to remove her and whispers that he will tell everyone what she never wanted said.
I scrubbed in without a gown order, without a glove size and without anyone's permission.
Norma stood at the sink next to me and tied my mask herself.
"I'll chart you as the senior attending," she said. "If anyone asks, I never saw you walk in."
"They'll ask."
"Then I've got a very bad memory."
OR 4 was bright and cold, and for the first time since the gala I could breathe.
On the table lay the man from the corner bed, his chest open, the heart-lung machine running beside him.
The donor heart sat in its ice bowl on the back table.
Janelle stood at the field with her shoulders locked up. She was holding a needle driver in a hand that was not quite steady.
Across from her, the new fellow was very young and had gone grey around his mask.
"How long has the heart been out?" I asked.
Nobody had noticed me until I spoke. Every head in the room turned.
"Dr. Falkland," said the anesthesiologist, and he did not sound surprised. "Two hours and ten minutes."
That was a long time. It was not too long, but it was close.
Janelle finally looked up.
Her blue eyes found mine over the mask, wide and wet, and she did what she had done at the table the night before.
She did not apologize and she did not step back.
"He told me to," she said quietly. "Dr. Falkland said you were too tired to operate."
"Which Dr. Falkland?"
She swallowed. "Alastair."
"Move over, Janelle."
"I'm almost through the left side. I can do the left side."
"I know you can," I said. "I taught you the left side. Move over."
She moved.
I took the needle driver out of her fingers, and my hands stopped shaking the moment they closed on the steel.
The room changed around me. The whole team shifted its weight toward me and stopped waiting.
"Dr. Falkland is on this case," the anesthesiologist said clearly, to the room and the microphone in the ceiling. "I'm charting it at six-thirty. Let the record show it."
"Thank you," I said.
"Don't thank me," he said. "Save my patient."
For the next two hours the only voices in the room were mine, Norma's and the monitors'.
I sewed the new heart into the old chest, one stitch after another, and did not think about a single person outside the room.
When the clamp came off, the heart sat still for three long seconds.
Then it shook once, and began to beat.
Nobody cheered. We did not cheer in my OR.
Norma shook her head behind her mask and said, "There she goes."
I looked up and found Janelle against the far wall, staring at the beating heart with tears running down her face.
For one moment I forgot everything I knew about her.
Then the intercom clicked on overhead.
"Attention in OR 4."
It was Alastair's voice, calm and warm, the voice he used at bedsides and on stages.
"Dr. Laurel Falkland is on medical leave and has no operating privileges as of six a.m. today. Security, please escort her out of the surgical suite."
The room went quiet.
"The patient is stable," I said, loud enough for the ceiling microphone. "The graft is working. You can come and take his chart."
I closed the chest with Norma handing me every instrument before I asked for it.
Then I stripped off my gloves and walked out through the scrub room.
Two guards stood in the corridor with their hands loosely folded. Behind them, thirty people from the morning shift had come to watch.
"Dr. Falkland," one of the guards said. "I'm sorry. We have to take you down."
"Take me down where?"
"The lobby. And your things from the locker."
"I'll go on my own."
"Ma'am, we have to walk with you."
He took a half-step toward me.
A hand came down on the guard's arm, firmly, from the side.
Ben stood between us in a rumpled trauma jacket, still holding a paper cup of coffee in his other hand.
"She just did a transplant on a man who'd have died before lunch," he said evenly. "You can walk behind her. You are not putting a hand on her."
"Dr. Almqvist, the chief ordered it."
"Then the chief can come and tell me himself."
He did.
I heard his shoes first, unhurried, on the polished floor.
Alastair came around the corner of the corridor in his dress shirt, still wearing the gala cufflinks, with the board chair a step behind him.
He did not look tired, or angry, or like anyone who had been left on a stage the night before.
He stopped a few feet from me and gave me the gentle, regretful smile he used with patients' families.
"Laurel," he said, so everyone could hear him. "You operated while on medical leave. That's a license matter now."
He lowered his voice, and only I heard the rest.
"Go home quietly, and this stays between us. Or stay, and I'll tell them everything about you that you never wanted said."
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