Page 3 of Love Overdose: St. Louis

Mine were steady.

They had been steady through fifteen years of training, too many sleepless nights to count, and more surgeries than I could remember without pulling up my records. The rest of my body could be exhausted.

But my hands never shook.

“More irrigation.”

Dr. Mason flushed the surgical field while I studied the exposed vessel through the microscope. The aneurysm sat beneath my instruments like a swollen knot, its walls thin enough to turn one wrong decision into a catastrophe.

The operating room was my most treasured domain. Monitors beeped. The ventilator released a steady hiss. Metal touched metal as the scrub nurse prepared the next instrument before I asked for it. I respected this room, and it respected me in turn.

Beyond the sterile drapes laid a fifty-eight-year-old woman named Lorraine McMillan. She had three children, two grandchildren, and a husband who had held her hand so tightly in pre-op that I had to ask him to release it so we could take her back.

He looked at me with terror stripped bare in his eyes.

Bring my wife back to me.

“Temporary clip.”

The scrub nurse placed it into my waiting palm.

I positioned the clip above the aneurysm, isolating the vessel so I could work without blood rushing through the fragile bulge. Every motion had to be deliberate. A millimeter too far in either direction could compromise the artery and cut off blood flow to healthy brain tissue.

“Her pressure’s climbing,” Dr. Coleman said from behind the drape.

My hands remained suspended over the surgical field. “How high?”

“One seventy-eight over ninety-six.”

The number flashed across the monitor. A sharp alarm joined the steady beeping that had filled the room.

“Her heart rate is up too,” the circulating nurse said.

Concern tightened her voice.

“I see it.” Dr. Coleman adjusted the anesthesia. “Increasing propofol.”

No one moved unnecessarily, yet the air changed anyway. Tension carried a presence of its own in an operating room. Everyone gathered knew it was there, but none of us spoke of it. Instead, we made sure to do our part to keep everything running smoothly. I held my position.

“Dr. Valentine?” Dr. Mason’s eyes lifted toward me over her mask.

“Stay where you are.”

The aneurysm remained intact. No sudden bleeding. No swelling in the surrounding tissue. Nothing in the surgical field explained the rise.

I glanced toward the monitor without moving my hands. “Any change in ventilation?”

“End-tidal CO₂ is stable. Oxygen saturation is one hundred percent.” Dr. Coleman studied his monitors. “She may be getting light. Giving labetalol.”

The blood pressure climbed another two points before stopping. One eighty over ninety-eight. The circulating nurse shifted near the wall. “Do we need to⁠—”

“No.” My voice remained level. “Anesthesia is treating it. We wait.”

Panic made people hurry. Hurrying created mistakes. My responsibility was to make certain no one else’s fear became Lorraine McMillan’s tragedy.

The seconds stretched.

The temporary clip couldn’t remain in place indefinitely. Every moment the artery stayed closed deprived tissue of blood, but rushing forward while her pressure remained elevated carried its own risk.