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Irubbed the back of my neck, trying to ease some of the soreness from my muscles. Days with back-to-back surgeries were brutal, but there was a reason I kept my body in top form. The stronger I was, the more patients I could help. And this was one of those days I’d skipped lunch and would likely end up with a late dinner.
Sighing, I returned my focus to the patient on my table. I’d already exposed the lamina and the spinous process, and I picked up the drill to start a laminectomy. The tang of disinfectant mingled with metallic blood and whatever goat’s-milk-and-something soap my resident, Bennett, used. He lived in a van, and if I didn’t know better, I’d think he was a complete moron based on the way he dressed and talked. But the kid was smart as hell, so I forgave him his bizarre taste in soap fragrances.
“Localizing,” I said for his benefit, and dipped the drill down to make a divot that we could test with intraoperative fluoroscopic imaging to make sure we were in the right place before going any further.
“Penfield number four,” he said, handing me the dissector.
I took it from him, and despite the seriousness of this surgery, which was to remove a three-centimeter tumor from a thirty-seven-year-old mother’s spine, I felt a distracting niggle of worry that I hadn’t heard from June since before lunch. I’d sent her a message before this surgery asking her to move up my discectomy from five to four because I was ahead of schedule, but she hadn’t responded. The appointment had gotten moved, so I assumed she was still angry with me and giving me the silent treatment, but at the very least, she was doing her job.
Honestly, she had a right to be upset. I shouldn’t have been a domineering ass, but I was human, too. In the face of fear, my reaction had been to remove her from the threat. But in doing so, I’d hurt her feelings, insulted her, and pushed her away. I would have to apologize after my last surgery. Next time, because I didn’t doubt she would get more commissions, I would go with her if she felt uncomfortable.
I let the motions take over, and as we brought in the microscopic surgical equipment, I went over the procedure with my resident, asking him to lay out the process and walk me through the steps. I felt confident based on the imaging that we could remove the tumor entirely, and then we would send it off for biopsy to confirm my suspicions that it was benign.
But, as we exposed the tumor, and each microscopic cut revealed more and more problematic tissue, I realized with a sinking heart that the contrast MRI had either been incomplete, or the tumor had grown since then. It wrapped all the way down past the surgical field and to her L4 and L5 discs.
I felt tension radiating off Bennett, and I could hear his thoughts because they were mine, too.Do we keep going or do we close up and regroup?I cracked my neck, and over my shoulder, I said to a nurse, “Get June on the line, please.”
He dialed June’s direct line on the operating room speaker phone. Katherine answered. “Hello, June Matthew’s line.”
I paused, lifting my head from the oculars. “Where’s June?”
Silence stretched on for a few seconds that felt like an eon. Then she said, “She just left for lunch. How can I help you, Dr. Brady?”
Dread writhed around my suspicions. “Tell her to call me when she’s back at her desk. Immediately.”
“I will,” Katherine promised.
“Tell her to reschedule my four o’ clock,” I said. “I’m going to be here a while.”
“I’m on it,” Katherine said.
Shaking my head, I forced my focus back to the open spine beneath my equipment.
“You okay?” Bennett asked.
“Yes,” I lied. “Go update the family, please.”
It was a grueling two hours, and even though I managed to get a good portion of the tumor, it had clearly spread far past the limits of what was safe to operate on blindly. She needed updated imaging and an aggressive plan of care that assumed the opposite of my initial presumption that the tumor was benign. It was never good news to give to a patient or their family.
I let Bennett close up, and as he did, I tore off my surgical gown and gloves. I pulled my phone from my pocket and texted June another question about where she was.
No answer. No impending message dots. Nothing. I pumped hand sanitizer on my hands, and then I fast-walked down the surgical suite toward our clinical offices. If June wasn’t there, then I would have to assume she had done something truly reckless. And if she had, I was going to give her the dressing-down of her life.
I shouldered through the connecting door from the nurses’ station to the front desk and rounded on the secretaries. Maxine jumped out of her chair in surprise, but it was Katherine’s reaction that pulled my focus to her. She jumped almost imperceptibly but didn’t look up from her computer screen. In fact, she looked determined to pretend I hadn’t arrived.
I went around to the front of the desk, grateful that it was past clinical hours, and leaned on it with my forearms flat against the granite surface. I glared down at Katherine until she reluctantly looked up to me. “Hey, Dr. Brady.”
“Where’s June?” I asked.
Katherine licked her red lips before rolling them between her teeth in an uncertain gesture. “I think she wasn’t feeling well.”
“So, you took her home?” I prompted. Maxine stared at us both from behind Katherine’s back, her blue eyes huge.
Katherine scratched her neck with her long, coffin-shaped, black nails. “No, I didn’t take her home. I think she was planning on getting a rideshare home.”
Nice try. “A rideshare home fromwhere?” I gritted out.
Katherine made a pained, groaning sound before giving up. “Dr. Brady, she begged me not to tell you.”
