It was about half an hour into the ventral hernia repair and Kyra had already completely lost her patience with the resident assisting her. The resident, Mike something, was a second year in the general surgery program and she had given him the responsibility of holding the camera. Many of the other attending surgeons allowed the residents to do more during the surgeries, but Kyra very rarely allowed residents that kind of responsibility on her private patients. If something went wrong, it was her ass.
“Hold the camera steady, for fuck’s sake!” Kyra yelled at Mike, peering at him over her surgical mask. “Are you trying to make me throw up?”
“Sorry,” Mike mumbled, keeping his eyes pinned on the television screen that showed the insides of the patient’s abdominal cavity.
“Okay, go left,” Kyra instructed him. He went right. “I said left! What the fuck is wrong with you?”
Kyra saw the fine layer of sweat that had formed across Mike’s brow, leaking down from under his surgical cap. He took a deep breath and she could see him checking his temper. Surgery residents were used to being abused—by attendings, by nurses, and by the job itself. Kyra had no reservations about mistreating her residents and frequently let them know if they weren’t living up to her expectations. She was one of the most despised attendings in the hospital, but she didn’t care.
No matter how angry Mike got, there was nothing he could do. If he talked back to her or stormed out of the OR, it would be his ass. He had no choice but to take her abuse.
“I’m sorry,” Mike said finally, as he adjusted the angle of the camera.
Kyra finished the surgery, barking instructions at Mike the entire time. When he finally pulled off his mask at the end, she could see that his face was very red. She was sure he’d be going back to his fellow residents to complain about her. The thought of it only served to amuse her.
“You need to improve a lot,” Kyra said to him as she yanked off her gloves. “When you’re doing surgeries by yourself, you need to be able to direct the camera as you work. As of now, you can’t direct the camera even when it’s your only responsibility.”
Mike nodded. “I’m going to go dictate, Dr. Manning.”
“Fine,” she said. I guess I’m done yelling at you.
In reality, Mike was no worse than some of the other residents, but it was only too easy to find flaws in these young surgeons. It was fun to torture them and try to make them crack. On one occasion, Kyra had a six foot three, football player of an intern burst into tears and run out of the OR. She still smiled when she thought of that.
As Kyra walked back to her office, she wondered if she had turned into a bad person. She was an incredible surgeon—in her opinion, the best in her graduating residency class. She operated on more patients than any other surgeon in the hospital. And she enjoyed her life most of the time.
Back in her office, Kyra’s mood declined considerably when she saw the court summons that had been placed on her desk yesterday. She lifted the papers off her desk and saw her own name written in bold. God, she needed a cigarette right now.
After keeping her record spotlessly clean since graduation, she was now being sued for the fourth time this year. Frivolous lawsuits, all of them, but it was still a dent in her good name. People were too lawsuit happy these days, and considering her high volume of cases, she had to expect a number of suits each year. Still, Kyra considered herself a perfectionist and this influx of lawsuits was a blow to her ego. Sometimes she wondered if she was taking on too much. Maybe she should cut back her hours.
But if she cut back her hours, what would she due with all that extra time? It wasn’t like she had any kind of social life. Her ex-husband Paul was already engaged again, but she hadn’t had so much as a date since the divorce. She was 34 years old and she knew that if she had any desire to have a family, she had to at least make an attempt to meet someone in the near future. But how? It wasn’t like there were available men dropping out of trees.
Kyra eyed her computer. She had heard a lot about online dating services and she wondered if that might be the answer. A couple of her old girlfriends had met their husbands on these websites and had advised her to try them out. At the time, she had laughed at the idea, but now it was beginning to seem like her only viable option. It would give her a chance to meet a guy at her own pace.
She typed “dating website” into a search engine and clicked on the first link that sounded reasonable. The front page was an advertisement for all the happy couples that had met using that website. The photos showed beaming men and women, obviously deeply in love. Kyra wondered if any of those women worked 24 hour shifts.
The site prompted her to make up a username and password.
Okay, why the fuck not? Kyra thought, as she wrote in the username surgeonfox, which she was pleased to see wasn’t taken. She glanced at the list of questions presented to her:
More like “graying”, she acknowledged, as she answered the question. But who was honest on sites like this?
Body type? Thin.
Have kids? No.
Kyra hesitated on this question. All her life, she had dreamed of having children, but now she was beginning to realize that this dream would likely never be a reality. She had chosen the career of a busy surgeon. She had no marital prospects in her future and she didn’t want to be a single mother. So how was she ever going to fit kids into that equation?
Kyra sighed and closed the browser window—there was no point to this. She had no room in her life for dating and it was better to just accept that. Her career would fill her life and she had to be satisfied with that.
During rounds the next morning, Ann was having a lot of trouble concentrating on her work. All she could think about was her conversation with Joel yesterday. Once again, he barely paid attention to her during rounds, instead choosing to spend his time grilling Sheldon on the many causes of hyponatremia.
The last patient they saw on rounds was Mrs. Brewster, the woman with the unexplained fevers. Ann was following this patient with Cody, and Joel looked at her to present. Ann went through all the updates on the patient, as well as mentioning the results of the CT scan. “It seems like there’s some sort of foreign body in the abdominal cavity,” Ann said. “That’s what the report said.”
“It’s a surgical towel,” Joel said flatly.
The whole team fell into silence. Raj, the senior resident, was the first one to speak up. “A surgical towel. Are you sure?”
“Am I sure?” Joel repeated. “Let’s use our reasoning skills here. The woman had surgery this month, she’s having fevers and there’s signs of an abdominal abscess. There’s a foreign body visualized on the CT and a mesh pattern seen on the plain film. What else do you think it could be?”
“I’d think any half-decent surgeon would notice something like that,” Raj commented.
Joel shot Raj a dirty look, which perplexed Ann. Joel had such high standards, she would have thought he’d be furious at a surgeon for making a mistake like that. “It happens,” Joel said.
“How awful for her,” Cody murmured. “Because of some negligent surgeon, now Mrs. Brewster has to go through a second surgery.” She blinked her almond-shaped eyes. “We should speak to the surgeon who did the operation, shouldn’t we?”
“Do you want me to make the call?” Ann offered, trying to make herself helpful.
Joel’s eyes widened and he shifted in his chair. He rubbed his knees. “No, I… I’ll call her. It’s more of an attending to attending matter.”
“Okay,” Ann agreed. She stood awkwardly before him. There were fifteen minutes left before noon and she waited for him to start grilling her on something. But he was looking in the distance, clearly preoccupied. “Um… Dr. Dergan?”
He jumped slightly and looked back up at her. He ran a hand through his short brown hair, causing it stick up slightly. “Yeah, you guys can go to lunch now.”
Ann walked away, although she couldn’t help casting glances back at Joel. He seemed so preoccupied, but it would have been strange if she asked him if he was okay. She felt like she was walking on eggshells to keep anyone from finding out what had happened between the two of them.
Joel knew it was his responsibility to call Kyra to let her know how she had left that towel in her patient, but he was trying to put it off as long as possible. He hadn’t spoken to her in a long time and he didn’t want his first words to her in six years to be: “You screwed up.”
Of course, what happened wasn’t entirely Kyra’s fault. The scrub nurses were responsible for doing an instrument count at the end of the surgery, so it was their fault as well that the towel had been missed—there were at least two layers of negligence involved here. But still… it was a large towel and the thought that the Kyra he knew could have been so careless was mind-boggling.
Joel looked down at the phone number he had scribbled down for Kyra’s office. He recognized that even if he did call her, he was unlikely to get through to her right away. She was probably in surgery right now and his call would be filtered through her secretary. So there was no reason to be afraid of calling her.
Joel had some difficulty dialing a phone with his paralyzed fingers. It was possible, but it took more concentration than he usually liked to expend. Instead, he picked up a pen from the desk, held it between his thumb and his palm, pressed the button for the speaker phone, then punched in the digits with the tip of the pen. It was one of a series of tricks he had taught himself that enabled him to use his hands without having to rely on splints. He hated how crippled the splints made him look. Without them, most people mistook him for a para.
“Hello, Dr. Kyra Manning’s office,” a chipper receptionist answered.
“Hello, this is Dr. Dergan from the university hospital,” Joel said. “I’d like to speak with Dr. Manning about a patient of hers who’s currently admitted on our service.”
“You’re in luck,” the secretary said. “Dr. Manning is between patients. I’ll see if I can put you through.”
Joel felt his heart speed up in his chest as he listed to the pleasant “on hold” music. Please let her be busy with a patient.
“Dr. Manning,” a tired voice answered.
Joel almost didn’t recognize her. Her voice was throatier than it had been six years ago, and moreover, she sounded exhausted. Still, there was something familiar there, and it took him a few seconds to catch his breath. He cleared his throat. “Hello, Dr. Manning,” he started off. He had never called her that before, except in jest. “I’m calling from the university—”
“Yeah yeah, Dr. Dugan, right?” Kyra said. She sounded very irritable. “What is it?”
Joel was shocked by her tone of voice. They had always joked that she was the one with the good social skills, but here she was barking at him before she even knew who she was. He was glad that the secretary had gotten his name wrong. He wasn’t eager for Kyra to know it was him on the other line.
“I’m on the medicine service and I have a patient, Mrs. Brewster, who you performed an open cholecystectomy on last month,” Joel said. “She’s quite ill and—”
“So that’s my fault?” Kyra snapped. “You internists don’t seem to understand that people get sick for reasons other than having had surgery.”
You internists. Joel remembered when he had thought that way back when he had sliced people open for a living. In fact, he remembered Kyra had once scolded him for it. It was like a slap in the face to hear her talking that way to him. “Dr. Manning, we discovered that you left a towel in her abdomen.”
There was a long pause on the other line. “What?”
“You left a towel in her,” Joel repeated. It didn’t give him any pleasure to be the one to deliver this news to Kyra.
“Are you sure?” Her voice was small and all of a sudden, she was the old Kyra again.
He imagined her on the other line, trying to collect herself. Trying to stay calm in the face of having made a terrible mistake. It’s what he would have done in the same situation, although he couldn’t imagine himself ever having made a mistake like this. “What proof do you have of this?” she demanded to know.
“Proof? There’s a towel in her gut!”
“Has she been operated on to have it removed?”
“So you don’t really know it’s a towel,” Kyra pointed out. “You just saw something on the CT and now you’re making wild accusations.”
If Kyra had been anyone else, he never would have allowed her to talk to him this way. There wasn’t an ounce of doubt in his mind that there was a towel in Mrs. Brewster’s abdomen and Kyra was only digging a deeper grave for herself by denying it. He was tempted to remind her of that, but he didn’t want to draw this conversation out further. He wanted to hang up before she figured out who he was. “I’m just letting you know our suspicions, Dr. Manning.”
“Oh, that’s very kind of you,” she replied, her voice laced with sarcasm. “Would you be so kind as to provide me with a callback number for you?”
“You can reach the team taking care of her through the hospital operator,” Joel said, knowing she’d never accept this answer.
“No, I want your number, Doctor… Dugan, right?”
He took a deep breath. The gig was up. “No, it’s Dergan.”
Joel cursed the fact that he didn’t have a more common name, like Smith. He could tell she was putting it together, realizing who he was. There was only one more piece in the puzzle…
It would have been unethical to lie. “Yes.”
“Oh my god…” she breathed. “Joel… why didn’t you tell me…? I mean, what was with all that ‘Dr. Manning’ business?”
“I was trying to be professional,” he replied. Unlike you.
“Wow…” All the anger was gone from her voice. “So you’re a medicine attending now…”
“I can’t fucking believe it. Joel Dergan: a medicine attending.”
He knew the question that she was dying to ask. She wanted to know if he was still in a wheelchair. Of course, she knew six years ago that they had told him he’d never walk again, but she hadn’t believed it anymore than he did back then.
“So, uh… how are you?” she asked.
“I’m fine,” he replied, trying to keep his tone distant. “How are you?”
“Very busy, as you can tell,” she said. “Jesus, I can’t believe it’s you, Joel…”
He didn’t know what to say. He was afraid she was going to want to start reminiscing and he just wasn’t up for that. “Well, anyway, I just wanted to tell you about that patient.”
“Wait,” Kyra said quickly. “Joel, do you… want to get together tomorrow? Have dinner and catch up?”
Truth be told, he did want to see Kyra. He thought about her a lot and he often missed her. Sometimes he thought about how close she’d come to being his wife. But he didn’t want her to see him. He didn’t want to talk about the way his life had turned out after he broke his neck. He didn’t want to hear about how she was living the life that he had wanted for himself. And most of all, he didn’t want to hear about her husband or about the kids she should have had with him.
“I don’t think I can make it,” Joel said.
“Don’t be so fucking annoying, Joel,” Kyra said. “Come on, you can make time to have dinner, right? We haven’t seen each other in six years!”
“Yeah, okay,” Joel muttered. He remembered how she had taken the first step when she had kissed him so many years ago. Kyra was nothing if not aggressive. It was necessary for a female surgeon.
“Would you mind terribly meeting me at my office at the hospital?” Kyra asked him.
“Sure,” he said, although he loathed the idea of going through the surgery wing of the hospital.
“It’s on the third floor,” she said. “You can get in through the front entrance, but it’s sort of convoluted. There’s a back entrance where you can take the stairs up the two flights and end up right at my office door.”
That sneaky bitch. She was giving him that alternative as a way of finding out if he could walk. He had to hand it to her, she was clever. “I think I’m going to need to go in through the front,” he said.
“Oh, are the stairs a problem?”
“Yes, they are,” Joel said tightly.
“So you still…”
“Yes, I use a wheelchair full time,” he said. As painful as it was to say it, it was easier to tell her now, before they saw each other.
“That’s okay, Joel,” she said, as if he needed to hear her say it. In some strange way, he did.
He cleared his throat. “When is your last surgery tomorrow?”
“Should be done by six,” Kyra said.
“Should be?” Joel knew how inaccurate surgery schedules could be.
“Believe me, the nurses know to get my patients in on time,” Kyra said. He remembered the harsh tone she had used to speak to him earlier and he believed it. “So unless the patient crashes on the table, I’ll be done by six.”
“All right, I think I can make it.”
“Of course you can. You’re a medicine attending.”
Joel caught the hint of contempt in her voice. He checked his anger the best he could. I was ten times the surgeon you are. “Fine, I’ll see you tomorrow, Kyra.”
To be continued...