ADRENALINE: New 2013 edition (7 page)

CHAPTER FIVE

He checked the hallway for people, and slipped as silently as a shadow into OR#5. He knew his chances of being observed were slim because the entire complex was deserted this early in the morning. The OR nurses wouldn’t start setting up the cases for another thirty minutes, and Ken Danowski, the anesthesiologist scheduled to be in here today, never showed up before seven o’clock.

Once inside, he adjusted the switch so the operating room was bathed in dim light, barely enough to push back the shadows. He paused to take in his surroundings, sensing vaguely that he needed to rekindle his anger. He surveyed the walls first, walls he had seen a thousand times, covered with their dingy, green tiles. Puke-green was how he always referred to them. Abruptly, he had the sensation someone was watching him. Turning quickly, he shot a glance above the heavy wooden door he had just come through. There it was, just as he had known it would be—a small wooden crucifix staring down at him.

“Leave me alone,” he muttered. He turned and walked past all the laparoscopic equipment, the electrocautery generator, and the OR table toward the anesthesia machine at the far end of the room. That was it in a nutshell, he thought. Catholic hospitals were just too damn cheap. Austerity was a virtue. He remembered Sister Catherine drilling that and other such nonsense into his head in school. What a load of crap!

He stood before the Drager Narkomed 3B, one of the most advanced anesthesia machines on the market. It was a behemoth, standing seven feet tall and four feet wide, bristling with hoses, cables, and metal support struts like so many alien appendages. Thoughts of the impending hospital merger swirled through his head. Would he really lose his job? Is this how his institution, Our Lady of Mercy, would repay his years of service? Would his career be sacrificed on the altar of managed care in the name of the almighty dollar?

His gaze swept to the three vaporizers mounted on the machine at eye-level: Halothane, Forane, and Suprane, the anesthetic gases currently in vogue. His hand reached out involuntarily and caressed the cold, smooth metal cylinder of the Forane vaporizer. Sliding his hand to the top of the vaporizer, he gripped the large, finely knurled knob like he had done countless times before when anesthetizing his patients. Could they actually take away his hospital privileges and bar him from these ORs? The answer was all too clear. He reminded himself how Mercy Hospital had dealt with Good Friday.

Mercy had always closed its ORs on Good Friday out of respect. This was the decent thing to do, he thought. Since his earliest memories, he had always gone to mass on Good Friday; it was one of the holiest days of the year, for Chrissakes. Now, thanks to the gun-to-your-head, bottom-line accounting demanded by those managed care pricks, Good Friday was just another day of the week. The OR doors were wide open. Crank those little doggies through. Yee-hah! Business decision, they
had called it. Well, if the nuns could make a business decision, then so could he.

He stared beyond the vaporizers, and his thoughts returned to the haunting theme that had stuck in his brain like a catchy tune. Would those smug-faced, know-it-all bastards he called partners, walk away with his job? Especially galling were the young punks, so confident with their recent training. They didn’t have a clue what work, loyalty, and sacrifice were all about. His hands clenched tightly into fists, and he felt his heart begin to pound away in his chest. But the anger felt good.

Trembling slightly, he fetched a fresh bottle of Forane and a bottle of Suprane from the anesthesia cart. Any hesitation he had earlier was gone. He produced an empty bottle from his pocket and unscrewed the caps on all three bottles. He chuckled to himself as he thought of the ingenious fill spouts that had been engineered to prevent accidental cross-filling of the vaporizers. Too bad they wouldn’t work this time. He poured the contents of one bottle into another and played mix and match with the bottles and fill spouts. He was thus able to defeat the fail-safe mechanism and fill the Forane vaporizer with the wrong agent, Suprane. The volatile liquid gurgled quietly as it transferred. The room smelled of Forane and Suprane, but he knew the pungent odor would quickly dissipate. He cleaned up his handiwork and made a rapid exit from the room, not bothering to give the crucifix a second look. Again he took note that no one was in the OR complex to notice him.

CHAPTER SIX

Ken Danowski hadn’t gotten much sleep last night. He dragged himself wearily from his Ford Explorer out into the biting December wind. God, it’s cold, he thought as he trudged the hundred yards or so from the parking lot to the hospital. The raw air burned his sore throat and his head throbbed miserably.

He keyed in the combination to the Doctor’s locker room. Encumbered by his heavy winter parka, gloves and briefcase, he struggled with the door that seemed heavier than usual. Once inside, he walked over to his locker and set his briefcase down with a grunt. Doug Landry was standing close by with his nose buried in his own locker, rooting around for something. Ken smiled. How Doug ever found anything in there was beyond Ken. Doug was the butt of many jokes about his sloppy locker habits. But Ken knew better then to be fooled by this. Doug Landry was a sharp anesthesiologist, as sharp as they came. “Lose something in there, Doug?” asked Ken as he pried off his gloves.

“Oh, hi Ken,” said Doug, pulling his head out of his locker and revealing a big grin. “Naw, not a chance. A place for everything and everything in its place. See, right here where I left them.” He held up his narcotic keys like a trophy fish.

Ken smiled back at Doug. Even though Doug was ten years his senior, he related well to him.

“You’re kind of late,” Doug said, eyeing his watch longer than necessary. He frowned and shook his head slowly. “You probably can kiss that partnership thing goodbye.”

Ken chuckled as he slipped his parka off and stuffed it into his locker. “Whoever said anything about wanting to be partners with you turkeys?”

Doug smiled again, but soon his face became serious. “You look a little rough, Ken.”

“Yeah, the baby was up last night with croup, and I don’t feel so hot either.” Ken cringed as he recalled the scary night he had spent with his ten-month-old son. “God, I can’t stand bad airway stuff with kids in the OR. But, at home with your own kid . . .” His voice trailed off and he shook his head.

“Yeah, nothing worse than a sick kid,” said Doug. “You’re right. One night when Teddy was a baby—oh, ten years ago or so—they had to admit him to the hospital and put him in a croup tent.”

“Thank God, Ryan didn’t get that bad.” Ken peeled his turtleneck and sweater over his head and felt his hair crackle with static electricity. He instinctively sucked in his bare midsection and then smiled inwardly when he realized he was succumbing to petty machismo. All the same, he maintained his beach pose. Somehow, he thought, Doug always managed to look fit—muscular, actually—and he didn’t want to be shown up by the older man.

The hospital intercom crackled to life, interrupting the men. Ken knew it must be 7:15 as the obviously taped voice of the president of Mercy Hospital, complete with annoying background hiss, blared from the speaker. “This is Sister Emmanuel with the
morning prayer. Dear God, please help us remember that we are not alone in our suffering. We are not the only ones . . .”

Ken tuned Sister Emmanuel out; he had heard the same prayer or something similar every morning for three years now. Soothing, she was not. Fingernails across a chalkboard would be an improvement, he mused. He finished suiting up and clanged his locker door shut.

“Hey, you better say your prayers,” said Doug, also finishing with his locker. “You gotta long day ahead, pal. I saw the schedule. You’re in OR#5. Better get some coffee in you so you can stay awake.”

“Thanks for the advice,” Ken said sarcastically. “Where’d you get your degree from again—mail order, right?”

Doug laughed in response.

“That caffeine shit will kill you,” continued Ken, knowing full well that Doug was a notorious coffee fiend. He’d seen him put away three or four cups a day, twice that on a call day. “Didn’t they teach you anything in med school?”

“Med school?” Doug asked. “Whoever said anything about med school?”

Laughing, the two men headed out of the locker room. But, kidding aside, Ken knew he’d be right up there with Doug in the java department.

“Speaking of med school,” Doug said, “Have you seen Rusty this morning?”

“No, but his beat-up Jeep was in the parking lot when I came in.”

“Hmmm, I wonder where he is?” Doug paused to tie on his surgical mask. “Well, if you see him, send him over to me in outpatient surgery. The schedule’s light and it should be an easy day.”

“Okay, will do,” Ken said, also reaching for a cap and mask. “Have a good one.”

“Thanks, you too.” Ken certainly hoped he would feel better as the day went on.

Ken started to page through the medical chart of Dorothy Lubriani, his first patient of the day scheduled for a laparoscopic gall bladder removal. Her name seemed vaguely familiar to him, but he couldn’t place it. He sipped his coffee and turned to the patient information sheet to check for clues as to who she might be. She was a forty-five-year-old, married RN on disability he discovered. No other personal information was available, and this didn’t ring any bells for him. He groaned audibly when he saw a three-page, typewritten summary of his patient’s medical history produced by the patient herself and clipped to the inside of the chart. This was never a good sign, he thought. Probably has a list of allergies a mile long, too.

Ken absently rubbed his hand over his chin as he read further. The coarse stubble was rough on his hand and surprised him. He realized he had forgotten to shave this morning, one of the early casualties of a sleepless night. He forced some more coffee down. He saw Dorothy had made no fewer than nine visits to the OR in the last five years. Nothing serious—an assortment of lumps and bumps excised and a few hernias repaired. Ken let out a resigned sigh, chugged the remainder of his coffee, screwed on his best happy face, and walked across the hall to the holding area to meet his patient.

“Good morning, Mrs. Lubriani,” Ken said. He knew immediately he had seen her before, but still couldn’t say where. She was medium height, overweight, with dark hair and makeup appropriate for a night out, not the operating room. “I’m Dr. Danowski. I’ll be your anesthesiologist this morning.” Ken spoke quietly because the holding room was crowded with several other patients awaiting surgery.

“Hi, Dr. Danowski,” Dorothy said loudly in a high-pitched nasal voice. “You took care of me two years ago for my hernia. I’m so glad to get you again.”

“Ah, the hernia, of course,” Ken said, feeling himself blush slightly. He still didn’t remember her; his sluggish brain refused to cooperate. “So, how are you doing today?”

“Well, not so good, Doctor. I have the beginning of a migraine right behind this eye.” She tapped on her right temple emphatically.
“And my irritable bowel is acting up. Or do you think that’s gallbladder? No, too low. And wouldn’t you know, my fibromyalgia is singing this morning.”

Oh shit, thought Ken. He remembered her now and realized his blunder. He had violated a cardinal rule of medicine: Never, under any circumstances, ask a patient such as Dorothy Lubriani how they are feeling.

“But my asthma’s doing pretty well—only a touch of wheezing. Dr. Jefferies says the new regimen he has me on—you know, alternating the three inhalers—has been shown in recent clinical studies to be most effective.”

Ken looked around the holding area for moral support. Mike was several litters away but was too engrossed starting an IV on his patient. He didn’t look to be in a joking mood anyway. Ken returned his attention to Dorothy who had paused to take a breath. “That’s great,” he said and fought hard to keep a straight face.

“Thank God she’s asleep!” Ken said to himself as the Diprivan finally hit. He noted that Dorothy had taken a relatively large dose, probably owing to her frequent reliance on painkillers.

“Cripes, Ken. What took you so long?” asked Babs Honeywell, the circulating nurse. “I thought you’d never get her to sleep.”