Nothing Lasts Forever
Chapter Twenty-one
In the doctors' dressing room, half a dozen doctors were waiting for Ken Mallory to appear. When he walked in, Grundy said, "Hail the conquering hero! We want to hear all the lurid details." He grinned. "But the catch is, buddy, we want to hear them from her."
"I ran into a little bad luck." Mallory smiled. "But you can all start getting your money ready."
Kat and Paige were getting into scrubs.
"Have you ever done a procedure on a doctor?" Kat asked.
"No."
"You're lucky. They're the worst patients in the world. They know too much."
"Who are you operating on?"
"Dr. Mervyn 'Don't Hurt Me' Franklin."
"Good luck."
"I'll need it."
Dr. Mervyn Franklin was a man in his sixties, thin, bald, and irascible.
When Kat walked into his room, he snapped, "It's about time you got here. Did the damned electrolyte reports come back?"
"Yes," Kat said. "They're normal."
"Who says so? I don't trust the damn lab. Half the time they don't know what they're doing. And make sure there's no mix-up on the blood transfusion."
"I'll make sure," Kat said patiently.
"Who's doing the operation?"
"Dr. Jurgenson and I. Dr. Franklin, I promise you, there's nothing for you to worry about."
"Whose brain are they operating on, yours or mine? All operations are risky. You know why? Because half of the damned surgeons are in the wrong profession. They should have been butchers."
"Dr. Jurgenson is very capable."
"I know he is, or I wouldn't let him touch me. Who's the anesthesiologist?"
"I believe it's Dr. Miller."
"That quack? I don't want him. Get me someone else."
"Dr. Franklin ..."
"Get me someone else. See if Haliburton is available."
"All right."
"And get me the names of the nurses in the OR. I want to check them out."
Kat looked him in the eye. "Would you prefer to do the operation yourself?"
"What?" He stared at her a moment, then smiled sheepishly. "I guess not."
Kat said gently, "Then why don't you let us handle it?"
"Okay. You know something? I like you."
"I like you, too. Did the nurse give you a sedative?"
"Yes."
"All right. We'll be ready in a few minutes. Is there anything I can do for you?"
"Yeah. Teach my stupid nurse where my veins are located."
"All right. We'll be ready in a few minutes. Is there anything else I can do for you?"
"Yeah. Teach my stupid nurse where my veins are located."
In OR Four, the brain surgery on Dr. Mervyn Franklin was going perfectly. He had complained every step of the way from his room to the operating theater.
"Now mind you," he said, "minimal anesthetic. The brain has no feeling, so once you get in there, you won't need much."
"I'm aware of that," Kat said patiently.
"And see that the temperature is kept down to forty degrees. That's maximum."
"Right."
"Let's have some fast music on during the operation. Keep you all on your toes."
"Right."
"And make sure you have a top scrub nurse in there."
"Right."
And on and on it went.
When the opening in Dr. Franklin's skull was drilled, Kat said, "I see the clot. It doesn't look too bad." She went to work.
Three hours later as they were beginning to close the incision, George Englund, the chief of surgery, came into the operating room and went up to Kat.
"Kat, are you almost through here?"
"We're just wrapping it up."
"Let Dr. Jurgenson take over. We need you fast. There's an emergency."
Kat nodded. "Coming." She turned to Jurgenson. "Will you finish up here?"
"No problem."
Kat walked out with George Englund. "What's happening?"
"You were scheduled to do an operation later, but your patient has started to hemorrhage. They're taking him to OR Three now. It doesn't look as though he's going to make it. You'll have to operate right away."
"Who?"
"A Mr. Dinetto."
Kat looked at him aghast. "Dinetto?" If Mr. Dinetto dies, you and your fucking family are gonna be wiped out.
Kat hurried down the corridor that led to OR Three. Approaching her were Rhino and the Shadow.
"What's going on?" Rhino demanded.
Kat's mouth was so dry that it was difficult to speak. "Mr. Dinetto started hemorrhaging. We must operate right away."
The Shadow grabbed her arm. "Then do it! But remember what we told you. Keep him alive." Kat pulled away and hurried into the operating room.
Because of the change in schedule, Dr. Vance was doing the operation with Kat. He was a good surgeon. Kat began the ritual scrub: a half minute on each arm first, then a half minute on each hand. She repeated it and then scrubbed her nails.
Dr. Vance stepped in beside her and started his scrub. "How are you feeling?"
"Fine," Kat lied.
Lou Dinetto was wheeled into the operating room on a gurney, semiconscious, and carefully transferred to the operating table. His shaven head was scrubbed and painted with Merthiolate solution that gleamed a bright orange under the operating lights. He was as pale as death.
The team was in place: Dr. Vance, another resident, an anesthesiologist, two scrub nurses, and a circulating nurse. Kat checked to make sure that everything they might require was there. She glanced at the wall monitors - oxygen saturation, carbon dioxide, temperature, muscle stimulators, precordial stethoscope, EKG, automatic blood pressure, and disconnect alarms. Everything was in order.
The anesthesiologist strapped a blood pressure cuff on Dinetto's right arm, then placed a rubber mask over the patient's face. "All right, now. Breathe deeply. Take three big breaths."
Dinetto was asleep before the third breath. The procedure began.
Kat was reporting aloud. "There's an area of damage in the middle of the brain, caused by a clot that's broken off the aorta valve. It's blocking a small blood vessel on the right side of the brain and extending slightly into the left half." She probed deeper. "It's at the lower edge of the aqueduct of Sylvius. Scalpel."
A tiny burr hole about the size of a dime was made by an electric drill to expose the dura mater. Next, Kat cut open the dura to expose a segment of the cerebral cortex that lay underneath. "Forceps!"
The scrub nurse handed her the electric forceps.
The incision was held open by a small retractor which maintained itself in place.
"There's a hell of a lot of bleeding," Vance said.
Kat picked up the bovie and started to cauterize the bleeders. "We're going to control it."
Dr. Vance started suction on soft cotton patties that were placed on the dura. The oozing veins on the surface of the dura were identified and coagulated.
"It looks good," Vance said. "He's going to make it."
Kat breathed a sigh of relief.
And at that instant, Lou Dinetto stiffened and hi? body went into spasm. The anesthesiologist called out, "Blood pressure's dropping!"
Kat said, "Get some more blood into him!"
They were all looking at the monitor. The curve was rapidly flattening out. There were two quick heartbeat* followed by ventricular fibrillation.
"Shock him!" Kat snapped. She quickly attached the electric pads to his body and turned on the machine.
Dinetto's chest heaved up once and then fell.
"Inject him with epinephrine! Quick!"
"No heartbeat!" the anesthesiologist called out a moment later.
Kat tried again, raising the dial.
Once again, there was a quick convulsive movement.
"No heartbeat!" the anesthesiologist cried. "Asystole. No rhythm at all."
Desperately, Kat tried one last time. The body rose higher this time, then fell again. Nothing.
"He's dead," Dr. Vance said.
"I ran into a little bad luck." Mallory smiled. "But you can all start getting your money ready."
Kat and Paige were getting into scrubs.
"Have you ever done a procedure on a doctor?" Kat asked.
"No."
"You're lucky. They're the worst patients in the world. They know too much."
"Who are you operating on?"
"Dr. Mervyn 'Don't Hurt Me' Franklin."
"Good luck."
"I'll need it."
Dr. Mervyn Franklin was a man in his sixties, thin, bald, and irascible.
When Kat walked into his room, he snapped, "It's about time you got here. Did the damned electrolyte reports come back?"
"Yes," Kat said. "They're normal."
"Who says so? I don't trust the damn lab. Half the time they don't know what they're doing. And make sure there's no mix-up on the blood transfusion."
"I'll make sure," Kat said patiently.
"Who's doing the operation?"
"Dr. Jurgenson and I. Dr. Franklin, I promise you, there's nothing for you to worry about."
"Whose brain are they operating on, yours or mine? All operations are risky. You know why? Because half of the damned surgeons are in the wrong profession. They should have been butchers."
"Dr. Jurgenson is very capable."
"I know he is, or I wouldn't let him touch me. Who's the anesthesiologist?"
"I believe it's Dr. Miller."
"That quack? I don't want him. Get me someone else."
"Dr. Franklin ..."
"Get me someone else. See if Haliburton is available."
"All right."
"And get me the names of the nurses in the OR. I want to check them out."
Kat looked him in the eye. "Would you prefer to do the operation yourself?"
"What?" He stared at her a moment, then smiled sheepishly. "I guess not."
Kat said gently, "Then why don't you let us handle it?"
"Okay. You know something? I like you."
"I like you, too. Did the nurse give you a sedative?"
"Yes."
"All right. We'll be ready in a few minutes. Is there anything I can do for you?"
"Yeah. Teach my stupid nurse where my veins are located."
"All right. We'll be ready in a few minutes. Is there anything else I can do for you?"
"Yeah. Teach my stupid nurse where my veins are located."
In OR Four, the brain surgery on Dr. Mervyn Franklin was going perfectly. He had complained every step of the way from his room to the operating theater.
"Now mind you," he said, "minimal anesthetic. The brain has no feeling, so once you get in there, you won't need much."
"I'm aware of that," Kat said patiently.
"And see that the temperature is kept down to forty degrees. That's maximum."
"Right."
"Let's have some fast music on during the operation. Keep you all on your toes."
"Right."
"And make sure you have a top scrub nurse in there."
"Right."
And on and on it went.
When the opening in Dr. Franklin's skull was drilled, Kat said, "I see the clot. It doesn't look too bad." She went to work.
Three hours later as they were beginning to close the incision, George Englund, the chief of surgery, came into the operating room and went up to Kat.
"Kat, are you almost through here?"
"We're just wrapping it up."
"Let Dr. Jurgenson take over. We need you fast. There's an emergency."
Kat nodded. "Coming." She turned to Jurgenson. "Will you finish up here?"
"No problem."
Kat walked out with George Englund. "What's happening?"
"You were scheduled to do an operation later, but your patient has started to hemorrhage. They're taking him to OR Three now. It doesn't look as though he's going to make it. You'll have to operate right away."
"Who?"
"A Mr. Dinetto."
Kat looked at him aghast. "Dinetto?" If Mr. Dinetto dies, you and your fucking family are gonna be wiped out.
Kat hurried down the corridor that led to OR Three. Approaching her were Rhino and the Shadow.
"What's going on?" Rhino demanded.
Kat's mouth was so dry that it was difficult to speak. "Mr. Dinetto started hemorrhaging. We must operate right away."
The Shadow grabbed her arm. "Then do it! But remember what we told you. Keep him alive." Kat pulled away and hurried into the operating room.
Because of the change in schedule, Dr. Vance was doing the operation with Kat. He was a good surgeon. Kat began the ritual scrub: a half minute on each arm first, then a half minute on each hand. She repeated it and then scrubbed her nails.
Dr. Vance stepped in beside her and started his scrub. "How are you feeling?"
"Fine," Kat lied.
Lou Dinetto was wheeled into the operating room on a gurney, semiconscious, and carefully transferred to the operating table. His shaven head was scrubbed and painted with Merthiolate solution that gleamed a bright orange under the operating lights. He was as pale as death.
The team was in place: Dr. Vance, another resident, an anesthesiologist, two scrub nurses, and a circulating nurse. Kat checked to make sure that everything they might require was there. She glanced at the wall monitors - oxygen saturation, carbon dioxide, temperature, muscle stimulators, precordial stethoscope, EKG, automatic blood pressure, and disconnect alarms. Everything was in order.
The anesthesiologist strapped a blood pressure cuff on Dinetto's right arm, then placed a rubber mask over the patient's face. "All right, now. Breathe deeply. Take three big breaths."
Dinetto was asleep before the third breath. The procedure began.
Kat was reporting aloud. "There's an area of damage in the middle of the brain, caused by a clot that's broken off the aorta valve. It's blocking a small blood vessel on the right side of the brain and extending slightly into the left half." She probed deeper. "It's at the lower edge of the aqueduct of Sylvius. Scalpel."
A tiny burr hole about the size of a dime was made by an electric drill to expose the dura mater. Next, Kat cut open the dura to expose a segment of the cerebral cortex that lay underneath. "Forceps!"
The scrub nurse handed her the electric forceps.
The incision was held open by a small retractor which maintained itself in place.
"There's a hell of a lot of bleeding," Vance said.
Kat picked up the bovie and started to cauterize the bleeders. "We're going to control it."
Dr. Vance started suction on soft cotton patties that were placed on the dura. The oozing veins on the surface of the dura were identified and coagulated.
"It looks good," Vance said. "He's going to make it."
Kat breathed a sigh of relief.
And at that instant, Lou Dinetto stiffened and hi? body went into spasm. The anesthesiologist called out, "Blood pressure's dropping!"
Kat said, "Get some more blood into him!"
They were all looking at the monitor. The curve was rapidly flattening out. There were two quick heartbeat* followed by ventricular fibrillation.
"Shock him!" Kat snapped. She quickly attached the electric pads to his body and turned on the machine.
Dinetto's chest heaved up once and then fell.
"Inject him with epinephrine! Quick!"
"No heartbeat!" the anesthesiologist called out a moment later.
Kat tried again, raising the dial.
Once again, there was a quick convulsive movement.
"No heartbeat!" the anesthesiologist cried. "Asystole. No rhythm at all."
Desperately, Kat tried one last time. The body rose higher this time, then fell again. Nothing.
"He's dead," Dr. Vance said.
