It had been a long tiring night shift for Caroline.
After finishing up the last round of patient visits, she let out a deep breath and closed her eyes. An overwhelming sense of achievement brought a tiny smile to her face. Another day! Another battle done!
Cracking her knuckles and massaging her neck, she went close to the window and pulled up the blinds a bit; her daily habit of watching the early morning sun, shining bright in all its glory.
"Ready to go home doctor?" asked Erica, the head nurse.
Caroline turned towards her and with a smile on her face she replied, "Yeah, Dr. Van has already arrived to take over the shift." But that smile of hers vanished as she turned back towards the window again.
Suddenly the sky which was lit up in brilliant gold started turning grim. Dark clouds engulfed the blue tranquility like a shroud of death. The sky thundered like it was rumbling with anger.
"Ugghhh!!!" she groaned and muttered, "Looks like I am sleeping here again."
Dragging her tired and weary self from the ER, she walked towards the resting lounge, holding a hot piping cup of coffee.
After changing her clothes, when she was about to sprawl her legs and straighten her back, she heard her pager buzzing.
"Not now!" she whined and called up Erica, as she had paged her.
"What happened?"
"Sorry Carol, but you have to rush to the ER. Dr. Van is working on another code blue now and this one needs immediate attention too!"
"Condition?"
"Perforated abdomen!" Erica replied, glancing at the chart given by the ambulance team.
"Pulse?"
"Barely there, Carol!"
"Keep him steady! I am coming!"
Suppressing her yawn, she put on her Crocs back and ran towards the Emergency Room. This was nothing new for Caroline Young. Being an ER doctor in one of the largest hospitals in Seattle, she was used to spending sleepless nights and working odd hours.
"Vitals?" She asked half panting, holding her knees in her palms as she reached near the patient, but neither the nurses nor the on-call first-year resident uttered a word. Irritated, she stood upright and looked at the vital monitor and her jaws dropped.
Red Flatline.
He had no pulse.
And that drove her into a frenzy. "This can't be happening." She looked at the resident doctor and yelled, "Why the hell are you standing here instead of doing chest compressions? Do I have to spoon-feed you the protocol?" And without waiting for a response from him, she straddled the man lying on the bed.
"Epinephrine 1 mg into the IV stat! Run code blue protocol for me!" she yelled and placed her palms over his rib cage, ready to go for the first compression; while mentally picturing the patient's heart between the sternum and spine. But before she could even start, she turned back upon hearing the panic-ridden voice of Erica.
"Carol don't! He is still breathing!"
"He is what?" And she turned back towards him and saw his chest rising and falling in perfect rhythm.
She placed her stethoscope on his chest but heard nothing. There was no diastole and systole beat. Confused, she lowered her ear to his chest, but still heard nothing. She checked the oximeter attached to his index finger and his saturation levels looked perfectly fine.
"How even!"
"There is a huge puncture wound in his abdomen. The ambulance doctors have already tended to it," mentioned a puzzled Erica as she looked at equally puzzled Caroline who was still trying to figure out what was wrong with that man's heart.
"Anything in the chart about how he got the puncture wound?"
"Apparently there was a tree branch that caused the perforation."
"Get me the portable ECHO machine and give him 1 ml of vasopressor. He might go into a septic shock! We need to check for internal bleeding too."
"On it!" said Erica and sprinted to get the ECHO machine.
"You! Out from here!" Caroline lashed at the first-year resident, even though he was nowhere at fault. It was probably an outburst of hers for not being able to figure out what was wrong with the heart of the man.
The other terrified nurse injected the vasopressor in his C-Line and then left the room to get more medication if needed later. She didn't want to leave any room for a rebuke from Dr. Caroline - the Cardiology specialist at Seattle High, who was very well known as a perfectionist with a rib-rattling temper.
Caroline got down from the bed and as her eyes traversed up, she looked at his face which bore a weird calmness. It looked nothing less than angelic. His jaws and cheekbones were perfectly chiseled as if God had sculpted him in his spare time.
"What is wrong with him?" she muttered and then lifted the cloth covering his lower body. The puncture wound had been dressed, but the dressing gauze was soaked in blood and didn't look neat.
"This needs to be disinfected again," she muttered and put on her gloves. Then with the utmost care, she gently started to peel the Nico Plaster tapes which held the bandage in place.
"No way!"
She screamed as if someone had wrenched her away from her sanity, for in front of her was a perfect abdomen. No scars, no stitch marks, just dried blood; the flakes of which were now sticking onto her gloves. Her eyes were wide open in shock and for a moment she couldn't fathom the situation in front of her.
She was having a sense of lapse of judgment because, in none of her textbooks, or medical papers, she had read about a case like his.
"Is this even real!" She was about to pinch herself, but suddenly the monitor beeped, and she could see his temperature spiking up. But before she could take control of the situation, she saw him opening his eyes slowly.
His amber-coloured eyes suddenly gleamed with a flicker of blue!
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