There might be another chapter on Wednesday.
Enjoy.
...
Exhausted from all the crying and pain she had to endure. Mary fell exhausted, sleeping only a few minutes after finishing her lumbar puncture. Not wanting to disturb the sleeping girl, Foreman, Beth and I left the room in silence.
After saying goodbye to the nurse, who quickly returned to continue her work. "I'm going to deliver this to the lab," said Foreman, lifting the vials with the samples, "they owe me a favor there, so I can get us moved to the front of the list" he added before I could even offer to take it.
Nodding amused, I said goodbye in silence to the doctor. Moving in the opposite direction I headed to the diagnostics lounge. It was genuinely strange that the hallways, which would normally be half empty, that day were full of people, both patients, doctors and nurses. There were so many people that sometimes it was hard to walk without having to actively dodge someone.
Upon entering the lounge the first thing that caught my attention was the mountain of books that Chase had in front of him.
Behind Chase, standing with a red coffee cup in his hand. "Ah kid, you're back" said House with false emotion, "come, come, let's go to my office so you can tell me everything" he moved with a cheerful stride to his office door, "after all, I don't want to distract Chase from his hard work" he added winking his eye.
Lowering his head a little, betraying his attempt not to seem affected. Chase turned the page pressing his jaw.
I'd be lying if I said I didn't enjoy seeing Chase suffer, the guy had been an idiot even worse, a traitor, but I still couldn't openly mock him for it. The atmosphere was already heavy enough without Cameron to make it worse.
Ignoring Chase, I followed House into his office.
In reality outside of the successful lumbar puncture, there was nothing worth telling. Chase wouldn't miss anything.
At least medically speaking.
Taking a seat in his chair, House carelessly put his feet up on his desk. "What did you learn?" he asked after taking a sip of his coffee.
Maybe Foreman didn't understand House's reasoning for forcing him to bring me, aside from annoying him clearly, but to me it was obvious. Waiting for House's question, I took a seat in the chairs in front of his desk. "Not much beyond what we already saw in the clinic" I answered calmly.
By treating the girl those few minutes in the clinic, House and I were able to deduce many things about Mary, especially about her upbringing, or the lack thereof, not just her general mood or her manners when speaking with adults or authority figures, her clothes, shoes, how done up her hair was despite arriving from a diving competition, including the coach's expensive watch said a lot about where the girl came from.
"Upper middle class who doesn't spend much time with her parents, this generates resentment toward adults" I said thinking about everything I had been able to gather about the girl while talking to her. "She does well in school, she's not dumb at all for her age and judging by her change in behavior when she saw me as someone approachable she's more than accepted socially, she probably has many friends, no matter that she's one of the youngest on her team" I added.
Throwing his head back against his chair, clearly bored. "Tell me something I don't know" House urged.
Exhaling through my nose, I shook my head. "Nothing relevant" I raised my shoulders.
"Really?" he asked with disappointment. "What about the coach?" he added tilting his head a moment later.
"He's young and clearly well connected-" I said immediately.
"Well connected?" House asked.
"He has to be to be part of Mary's school" I thought about the mental image Mary had built of her private school in Dallas, "possibly a former high level athlete, but I doubt he achieved anything of significance" I added thinking now about the man's behavior, "even though he spends a lot of time with Mary he doesn't seem overly concerned about the girl, maybe a byproduct of her resentment toward the adults in her life" I shrugged my shoulders.
"He's not overly concerned" House commented thoughtfully, "do you think he could be doing something to the girl?" he asked raising an eyebrow.
"No" I denied immediately "I think that taking care of Mary and coaching her, subconsciously serve the same purpose, doing his job" I theorized, "even if he doesn't want to see it that way."
Pressing his lips House nodded. "What do you know about the parents?" he asked a moment later.
Before I could answer House's question his pager went off catching our attention. "What?" I asked nervously, usually House's pager only went off when there was an emergency.
"She's going to need an endoscopy" House answered after reading his pager.
Immediately calming my nerves I thought, surely like House, about reasons why an endoscopy would be required so suddenly. It was logical to think that Mary bled from the gastric tract enough for it to be visible in her mouth, the problem was why.
Unfortunately without the endoscopy images there wasn't much to do.
Settling his hands over his torso. "So, the parents?" House asked.
For several minutes House interrogated me about everything I had gathered about Mary's life and I answered only with what seemed pertinent to the case.
Satisfied, with no more questions to ask. House took his small video game console from his desk drawers, ignoring me almost immediately.
With House focused on his video games, I had nothing to do except wait, so, taking one of the latest issues of the New England Journal of Medicine. I copied House putting my feet up on his desk and comfortably read the latest medical advances of the time, I had to give it to House, it was a comfortable position to read in.
While reading a review article about sucralfate, a medication widely used to treat gastric ulcers, which I knew would be replaced not long from then by proton pump inhibitors, Omeprazole. House's office door was opened.
"We got it" said Foreman, stopping a moment later upon seeing House and then me, in the same position, practically mirrored.
Overlooking the 'we' in Foreman's sentence. "Great" said House drumming his fingers, "let's go watch a movie" he told me while standing up, moving his leg off his desk with effort.
Next to House's office, in the lounge, Chase was waiting in front of the new screen the hospital had bought for tape review. Apparently among all the new 'toys' the hospital had bought, the gastroenterologists had gotten a new video-endoscopy system that Foreman, and apparently Chase, had used for Mary's endoscopy.
Taking a small bag of candy from inside his jacket, House dragged a chair to in front of the screen, taking a seat as if he were really at the movies. Immediately after Chase started playing the video.
Watching Mary's digestive tract attentively with the best image quality that science offered at that time. "I think I've seen this movie, the ending is a bit dark" House joked.
Scoffing. "Really? I heard the ending stank" I joked immediately.
Smiling, clearly proud. "Want some?" House offered me one of his candies. Without thinking I accepted stretching out my hand, not once looking away from the screen. "Foreman?" he offered but the other doctor declined. And stretching out his hand he pretended to offer Chase, who like me stretched his hand out just in time for House to pull the candy bag away "How come you did the endoscopy?"
Frowning at House's immature joke. "He asked for help" Chase defended himself.
"Her blood pressure was high-" Foreman tried to explain.
"Foreman is not your boss" House interrupted him, "when I tell you to do something-"
Seeing for a second something on the right side of her intestine that caught my attention. "Wait" I interrupted, catching the attention of the three doctors.
Despite his feelings against me, Chase immediately stopped the recording.
Completely focused on the video. "Go back a couple of frames" I said searching the whole time for the general area where I had seen what I had seen, "there."
Leaning toward the screen. "Oh yeah" House nodded, eating another candy "that's your money shot."
Narrowing his eyes. "I don't see anything" Foreman commented, turning toward me.
"Really?" House asked, "ginormous thing on the right side of her intestine, that doesn't intrigue you?"
Leaning in the same as Chase. "Does ginormous mean really big, or really, really small?" Foreman asked, "cause I don't see anything."
Surprised that neither of the two doctors next to House saw it even though it was right there. "This dieulafoy" I said pointing directly at the screen.
"Uh" said Foreman and Chase at the same time.
"Well, we can burn off the swollen blood vessel, but it still doesn't account for her other symptoms" Foreman leaned back carelessly in his chair.
And he was right, in fact the dieulafoy made no sense at all in a girl Mary's age. She didn't meet any of the risk factors: being an older man over fifty years old, having cardiovascular or kidney diseases, taking nonsteroidal anti-inflammatory drugs or drinking a lot of alcohol. And that's why it was concerning.
Or for House, interesting.
"No, but it does tell us something" he set his candy bag down on the lounge table, "though, I have no idea what" he added raising his shoulders.
"Could be a precursor to intestinal intussusception" Foreman theorized.
Without reaching any answer to my own question. "Precursor isn't causing all her other symptoms" I denied immediately.
Nodding. "What else?" House asked.
But before anyone could answer anything, if anyone was even reaching a possible answer. Appearing out of nowhere, Doctor Cuddy stormed into the room. "You, in the lobby, now" she ordered looking annoyed at House.
"I hurt my leg" House excused himself pointing at his leg, "I have a note."
Not at all amused by House's joke, putting her hands on her hips, Doctor Cuddy shook her head frowning. "You had your hour- three, actually" she corrected herself practically spitting venom at House.
"Doctor Chase" House exclaimed with exaggerated annoyance, "I told you to tell us when our time was up" he looked at Chase with disappointment, making the other doctor shake his head tiredly. Returning his attention to Cuddy and changing his whole attitude to a more serious one, House pointed at the television screen with his face. "she has intestinal bleeding."
Leaning toward the screen. "She'll wait" Doctor Cuddy said a moment later, "two more buses just arrived, we need you all downstairs."
Noticing that the pressure of having a patient wasn't going to work this time. "No, what you need are more nurses" House chose to be confrontational, "but administration doesn't want to pay for more, so now you have doctors doing what nurses should be doing."
Making a face, offended. Doctor Cuddy tilted her head. "There are temp nurses" she declared.
"Yeah, well you could pay for a lot more" House urged with obviousness, "or doesn't the hospital have a little extra change in its pocket?" he asked sarcastically.
It was obvious that in a frugal move, the hospital or administration had decided not to hire as many temporary nurses as were necessary. In short House was right.
Pressing her jaw into an ironic smile. "Well, no thanks to you" the doctor retorted with contempt dripping from her voice, "or did you forget you nearly cost the hospital a hundred million dollars?"
"Hey" House recoiled offended with a hand on his chest as if the doctor had shot him, "thanks to me he's in the hospital, so one way or another it's thanks to me the hospital earned a hundred million dollars" he declared pointing at me arrogantly.
Raising her eyebrows, Doctor Cuddy scoffed ironically. "Yes, that's possibly the only good thing you've done for this hospital" she said with a certain air of relief, "hospital where the three of you work and, where if you want to keep working, you're going to come down this instant" she added giving her ultimatum abruptly. And without waiting for House's next 'smart' response, she turned around and left the lounge walking visibly annoyed.
Watching the door the doctor had left through. "Do you think she was serious?" House asked crossing his arms.
Without answering both Chase and Foreman stood up. Sighing tiredly at what was coming they left together behind Doctor Cuddy.
With effort standing up. "Yeah" House murmured defeated.
Moving as slowly as he could through the hospital hallways, House and therefore I, arrived much later than Foreman and Chase to the lobby where the two doctors were working in their new rows next to Doctor Wilson, who surely had been there longer than anyone.
Passing his last patient a blue form. "Look who's finally here" Wilson declared triumphantly smiling at House.
Frowning. "There are sick people around you, don't be so happy" House complained "go on kid, you have work to do" he added shamelessly moving toward a chair not far from everyone, clearly with no intention of doing anything.
About to reach the chair, taking out of his jacket the same candy bag he had in the lounge. House stopped abruptly. Appearing out of nowhere, Florence blocked his path.
With an unfriendly expression, the hospital's head nurse stretched out her hand handing a new pair of gloves to House.
Confused House tried, without success, to dodge the woman. "Ah no, that's for him" he pointed at me, "I'm going to supervise."
Not caring about House's words, Florence forced the gloves into House's hand, exchanging them for the candy bag. "These are Doctor Cuddy's orders" the nurse declared without room for debate, "PJ is needed elsewhere" she added smiling in my direction.
Noticing poorly hidden excitement in the nurse's behavior when addressing me, I immediately deduced where it was I was 'needed'.
Obviously noticing, like me, the strange change in the nurse's attitude. "Last time I checked PJ does what I tell him to do" House declared pushing the gloves into my chest.
Raising an eyebrow, the woman several heads shorter than House. Stared fixedly at the doctor in a threatening silence.
A minute later I was walking behind her back through the hospital hallways.
Noticing how all the nurses we were leaving behind were temporary nurses. "Where are we going?" I asked already knowing the answer.
Without losing a beat of her pace nor a step in her quick stride. "Something about your article, I don't know" Florence lied immediately.
Nodding impressed by the woman's ability to lie instantly. "Oh I see" I murmured, "so something about my article" I repeated "in the staff break room" I added amused.
"Yes" Florence raised her shoulders, "I'm just the messenger."
"Then why are you coming with me?" I asked raising my eyebrows enjoying the little game, "I know very well where the break room is."
Unlike me, pressing her jaw enough that the muscles at her temples tightened. "Oh I'm not coming with you, I just have things to do there" the woman said putting a clear end to my questions, luckily we had just arrived in front of the break room door "look we're here, go on open the door" Florence stopped a few steps from the door.
Scoffing amused I nodded, mentally preparing myself for what was coming. "All right" I said opening the door abruptly.
"Surprise!" immediately dozens of voices shouted at the same time.
Making my best effort to genuinely seem surprised. "Wow" I exclaimed smiling at the nurses, janitors, secretaries and general employees I had a good relationship with, "you shouldn't have" I added upon seeing a surprisingly large cake on one of the tables.
Of course everyone ignored my words, moving on to congratulations and a quick happy birthday wish, since there was still a lot of work to do.
Eating a slice of cake with the nurses who could afford to be in the room because they were on their breaks. I chatted about my day up to that point, the gifts from my parents and friends, and the plans I had with Diane. Even though I didn't really know what we were going to do.
Some time later I returned to the lobby, noticing how none of the team's doctors, including Doctor Wilson, were still there. "Doctor Cuddy isn't going to be happy" I scoffed.
Back at the diagnostics lounge, going directly to House's office I found Doctor Wilson sitting next to a woman. "Sorry" I said confused, ready to leave the office again.
Turning on his chair. "Oh no, PJ come" Doctor Wilson said standing up, "this is Doctor Petra Gilmar, she's here for an interview for the open position on the team" he added introducing me to the woman, Doctor Petra.
Smiling stiffly at the strange woman, I moved toward her at the same time the woman stood up. "Nice to meet you, PJ Duncan" I introduced myself taking her hand.
Smiling easily. "Petra Gilmar" said the woman even though Doctor Wilson had already introduced her.
Not knowing her background I couldn't speak to her value as a doctor or as a person in general, but what I could say at first glance was that Doctor Gilmar had made a great effort to impress whoever was interviewing her.
New clothes and shoes, a green pencil dress covered with a perfectly ironed jacket, heels too high to be comfortable and a hairstyle that definitely wasn't easy or quick to do. I'm not one to judge a woman and even less so in the era it was, but it was obvious that the doctor would use whatever she could, hopefully within certain limits, to get the job.
Unfortunately for her, it didn't matter how impressive her career was or how much effort she put into her appearance. House wouldn't hire anyone.
Placing a hand on my shoulder. "Doctor House personally chose PJ as his direct mentee a little over a year ago" Doctor Wilson declared proudly.
Keeping my hand firmly gripped. "Oh really?" the woman asked deepening her smile, "but you look so young" she added surprised.
Before I could say anything. "And he is" Wilson declared, "but he's also a medical genius, he was part of the last Nobel Prize" he patted my back energetically.
Opening her eyes, genuinely surprised. "Wow" the doctor murmured finally letting go of my hand.
"A very small part" I clarified with modesty.
Returning immediately to her smile. "No less impressive" the doctor commented, "now I understand why Doctor House has you as his mentee" for some reason the title, despite its consistency with my relationship with House, felt like a direct blow to the liver, "I suppose you don't have a couple of tips for me?" she asked raising her eyebrows.
"Oh ah..." I murmured, "I think that with Doctor House uh- he appreciates" I said taking a second to find the word, "honest people" I added with a certain genuineness in the words.
Nodding energetically. "Oh definitely" Doctor Wilson vouched, "the more honest the better" he added meaningfully.
Tilting her head a little, confused. "All right, be honest" the doctor commented as if she were making a mental note.
At that moment, the office door opened abruptly. "Sorry I'm late" said House noticing the woman in the room, "I was taking a dump" he added without any shame at all.
Showing no reaction at all to House's words, the woman fixed her jacket immediately, ready to formally greet House with a handshake, something that never happened, since House walked right past her straight to his chair, studying me attentively along the way.
Without losing her smile for a second, Doctor Gilmar took a seat in front of House. "I'm guessing I'm better off interviewing right after interviewing right after" she joked adapting with surprising ease to House.
She was quick.
Smiling at the doctor surprised, I nodded as a general goodbye while Doctor Wilson introduced House and the doctor, turning ready to leave. "Go to the lobby" House ordered me while opening the folder with what was surely the doctor's CV.
Sighing heavily I nodded and smiling once more at the doctor, knowing this would surely be the last time in my life I would see her, I left the office.
With no more excuses to give me, apologizing. Florence pointed me to House's row leaving me to work on my own.
Dozens of patients and with them minutes, were enough for House, who had a wheelchair in front of him, and Doctor Wilson to arrive at the lobby, discussing the interview.
I didn't need to know the context to know what I already knew. House wouldn't hire her.
Taking a seat in the wheelchair. "Ah, I needed this" he exhaled smiling at me.
"You know if you did your own row we'd finish faster?" Wilson asked, taking a pair of new gloves from one of the nurses.
Searching among the people. "And where would the fun of revenge be in that?" House asked finally finding Florence in the distance. And waiting for the nurse to see him, he smiled triumphantly playing with the wheels of his chair.
Scoffing. "Give this blue form to the security guard" I said to my last patient, moving immediately to the next one, "you're so pitty" I teased while checking the neck of the woman in front of me.
Trying to keep his balance on the two wheels of the chair. "She was so rude to me" House complained, "and all because you're an irresistible piece of candy to women older than the Bronze Age" he raised his eyebrows at the woman I was checking, causing her to scoff annoyed.
Rolling my eyes exasperated. "I'm sorry about that" I murmured smiling uncomfortably at the woman, "you heard her, I had things to do" I returned to my conversation with House.
"Speaking of that" House tilted his head, "where did you go?" he asked me.
Fortunately, Doctor Wilson pushed the chair's handles, causing House to slam the front wheels against the floor. "Don't change the subject" he said annoyed, "you're not gonna be happy with anyone" he complained moving to his next patient.
"So your advice is... hire someone I'm not happy with and be happy?" House asked narrowing his eyes.
Handing a blue form to his last patient. "No, my advice is much more subtle" he turned with House, looking at him fixedly, "stop being an ass" he declared, making the patient in my row, the woman House had offended a few seconds earlier, scoff amused.
Ripping the thermometer strip that I had just taken from the woman's mouth. "She doesn't have a fever, give her the blue form" House ordered me.
"You always find some tiny little flaw to push people away" Doctor Wilson complained.
"Oh, now it's people? I thought we were talking about fellowship applicants" House said sarcastically.
Not at all amused by House's joke. "You have a history of this" Doctor Wilson said with emphasis.
"Well, when I do decide to push you away, I hope there's a small person kneeling behind you, so you fall down and hurt your head" House joked, "ah, too tall" he added looking at me disappointed.
Ignoring House. "You had the perfect person, and you blew it" Doctor Wilson declared.
"You saw the shoes" House defended himself.
"Very uncomfortable" I raised my shoulders.
"That's what I said, validated" House smiling, pointed at me.
Shaking his head. "I'm not talking about her" Doctor Wilson said meaningfully.
"Oh Cameron" I said, "yeah you blew it" I added making House frown.
"Don't get involved" he warned me annoyed.
"I'm talking about every woman you've ever given a damn about" Doctor Wilson clarified.
"Cameron is not perfect" House said to both Wilson and me.
Shrugging his shoulders. "Well, nobody's perfect" Doctor Wilson commented.
"Mother Teresa?" House asked.
"She's catholic" Wilson answered immediately, "she would hate you."
"Julia Roberts" House offered.
This time caught by surprise Doctor Wilson took a second to respond. "No medical degree."
Smiling triumphantly. "Now who's being picky?" House asked.
Looking seriously at his friend. "You're gonna wind up alone, House" Wilson declared in an extremely gloomy tone.
Wasn't this about Cameron's position on the diagnostics team?
Before House could say anything else. "You were right" Foreman said appearing in front of us practically running next to Chase, "there's a significant bleed in her temporal lobe."
Surprised. "What?" I asked accidentally speaking louder than I would have liked.
Frowning for a second, as if he were genuinely surprised by my lack of knowledge. "Oh, welcome to the case" House said sarcastically.
Ignoring the exchange. "There's no poisons" Chase commented, "Did tox screens on her blood, urine, and hair. Nothing. Did them twice."
Nodding slowly. "All right, wait here" House ordered.
While House left, surely to look for Doctor Cuddy. Foreman filled me in on what had happened.
Following a theory of Chase's, Foreman took a bone marrow biopsy, ruling out bone cancer. What was worrying happened afterward, when Mary suddenly started experiencing absence seizures. House then theorized an intracranial bleed and with ultrasound they detected it right at that moment.
As quickly as he had left, House returned with Doctor Cuddy's authorization and the promise of an operation room ready in ten minutes. Without further ado Foreman and Chase left to prepare Mary and House and I returned to the lounge.
Sitting in front of the board updated with all the symptoms, House stayed incredibly still thinking in silence. Standing behind him, I too went over the case in my head dozens of times.
There was something we were missing.
Unable to stay on my feet in the lounge any longer, I decided to take advantage of my privileges at the hospital. Getting authorization without a problem to be present in the operating room gallery, I entered just as the surgeon was studying images from a CT scan.
Obviously one they had done as an emergency.
Raising his gaze from the images. "Ah PJ" the man exclaimed recognizing me, after a few seconds of studying me, "to what do I owe the honor?" Doctor Miller, the chief of neurosurgery, asked surprised.
"I'm involved in the case doctor" I answered.
"Ah of course, it's one of House's cases, right?" the man asked.
"Yes, Mary Carroll" I nodded.
Returning his attention to the images for a moment. "Correct" the man said smiling under his mask, at least that's how it seemed by the way his eyes closed.
Rocking on my feet in tiny movements just a few steps from the main door. "Do you mind if I invade your operating room?" I asked.
Even though I had authorization from the 'highest level', it was always good practice to ask the main surgeon, after all it was 'his' room.
"Not at all" the man said immediately, "Come in please, come closer" he urged moving his hand inviting me forward. "I was wondering when it would be my turn to have you in my operating room" he declared exhaling with clear excitement, "I know we don't get many 'interesting' cases, but it's the brain, it's always fascinating" he added theatrically.
Since I had gotten my 'privileges', visiting interesting surgeries had become a routine every few weeks and certainly neurosurgery, being such a small hospital, didn't get cases that caught my attention. I didn't know I had made that evident.
"It's not because of that, it's just that the schedules couldn't work out for me" I excused myself lying immediately.
"Ah, I'm just messing with you" the doctor scoffed, "come we were discussing the approach we would take" he added pointing at two guys next to him.
Easily, by how nervous and excited they looked to be there, I recognized them as residents, by the way they kept their arms rigidly at their sides, surely first or second year.
In general, my relationship with residents and university students, when I ran into them, was cordial and respectful. It was very different in the operating room and even more different when the residents were new.
Receiving silent nods as a greeting from the two rookie doctors, as well as looks that seemed to send daggers into my chest, I moved closer next to Doctor Miller in front of the images. "Tell me PJ, what do you see?" he asked me.
Noticing again the fixed stares of the two residents on my back. I took a step forward.
"A small hemorrhagic focus in the right temporal cortex with surrounding edema" which meant it was a microvascular lesion, "the temporal horn of the right lateral ventricle looks slightly compressed" I added pointing without touching the film.
"Absolutely correct" the doctor sang, "Although that's only what the CT is telling us. We'll know more once we're actually inside" he added a moment later looking seriously at his students, "now, Mr. Dawson" he said making the resident give a small startle upon hearing his name, "How would you approach it?" he asked pushing his hand into the empty air, as if he were going through a giant brain in front of him.
Thinking for a second in silence. "A standard right temporal craniotomy. It gives us adequate exposure in case we need to extend the exploration" the resident answered not very sure of himself.
A perfectly reasonable and textbook answer.
Nodding without showing any sign of satisfaction or disappointment. "Mr. Carter?" the doctor asked looking at his other resident.
Nervous, looking at his colleague and the doctor in front of him. "I'd do the same" the guy answered with even less confidence.
Again, giving nothing away, or at least trying to, at least to the eyes of someone truly observant. "What about you PJ?" he asked me.
Keeping my attention on the images, I debated internally whether or not to genuinely answer the doctor's question. My intention in being in the operating room wasn't to learn or make enemies in any way with the hospital's residents, it was to accompany Mary.
Despite that, the curiosity to know if my answer was correct was greater. "A limited temporal craniotomy centered directly over the lesion" I answered returning my attention to Doctor Miller and the residents beside him, the three of them were looking at me with different expressions. The doctor smiling enough that the corners of his eyes wrinkled, while the residents frowned.
"Elaborate" Doctor Miller made a small gesture with his hand.
"The hemorrhage is small. There's only minimal mass effect and no significant midline shift" I pointed at the images again, "If the CT is accurate, there's no need to expose more brain than necessary."
Raising his face. "And if the CT is not accurate?" the doctor asked.
"If there's a larger vascular lesion or the bleeding extends deeper, you can enlarge the exposure" I answered, "if it's confined to this cortical focus, a wider craniotomy only increases manipulation of healthy tissue."
For a few seconds no one spoke.
Then, Doctor Miller clapped once forcefully. "Exactly" he exclaimed with excitement, "I see that all the fame attached to your name isn't in vain Mr. Duncan" the man winked at me, "now, certainly a bigger exposure makes the surgeon feel comfortable, but it doesn't necessarily make the patient safer" he explained to the residents turning directly to them.
The two residents nodded avoiding looking in the doctor's direction, visibly bothered.
Noticing his residents' attitude, Doctor Miller let out a small amused snort. "Don't look so offended, gentlemen, I don't expect you to know these things in your first years of residency" he explained with some condescension in his voice, surely unintentional, but it was there, and the residents definitely felt it.
Noticing the disdain in the two residents' looks, I sighed discreetly.
Great.
Fortunately Doctor Miller couldn't rub any more salt into the two residents' wound, because the operating room door was pushed open by Mary's bed, along with her a group of nurses and the anesthesiologist also entered.
"Ah PJ, is this your first operation with Dan?" the doctor asked, handing a chart to one of the nurses.
Before I could answer. "PJ?" Mary asked from her bed.
"Hey" I said approaching the girl, "how are you feeling?" I asked.
Smiling in an attempt to hide her nervousness. "Like I'm bleeding from the brain" the girl joked.
"So great?" I asked holding her arm.
"Oh yeah."
Since it was an emergency surgery, even though it might not seem like it given Mary's ability to communicate, the nurses and the anesthesiologist had to prepare the girl quickly.
Already on the operating table, I stayed with Mary chatting with her. "I want to try the cake" she told me after hearing about the surprise the nurses had made for me.
"Of course" I said immediately, "once Doctor Miller gives the good to go, of course" I added raising my eyebrows at the surgeon a few steps away from me.
Seeing that the girl turned to look at him. "Ah you just want to make me look like the bad guy" the doctor complained, "how can I say no now?" he added talking to the anesthesiologist who already had his chair prepared.
Checking the medications once more. "Don't think you can" the latter joked.
Smiling, wrinkling his eyes at me. "We're ready doctor" the nurse on duty said.
"Me too" the anesthesiologist added.
Stretching his arms. "Let's go then" Doctor Miller nodded starting to prepare the Mayfield head clamp, to be able to hold Mary's head in place once she was sedated.
Preparing the general anesthesia. "All right Mary, when I tell you I need you to count backward starting from ten" the anesthesiologist said softly.
Nodding, Mary let a tear fall. "I'm scared" she admitted in a whisper.
"I know" I said pressing her hand, "I'm going to stay here" I assured her.
Swallowing nervously, Mary nodded.
"Here we go" the anesthesiologist said. "Ready?" he asked, and upon receiving her answer with a nod, he injected the anesthesia into the main line "count with me Mary, ten, nine, eight-"
"Seven, six, five, fo- four, th-" Mary continued falling asleep slowly.
Letting go of the girl's hand, I took a step back allowing the residents and nurses to do their job helping the doctor secure Mary's head.
Almost two hours later, and a textbook surgery, Mary with her head wrapped in bandages left the operating room still asleep. Outside Doctor Miller and Foreman were talking with the coach and with an adult couple, obviously Mary's parents.
When the couple thanked the surgeon, he said his goodbyes leaving Foreman behind. "Another job well done" removing the surgical cap from his head Doctor Miller smiled at me, "tell me PJ, do you have time to chat?" he asked interested.
Knowing where the conversation would head, I smiled stiffly at the doctor. "I wish I did doctor" I said, falsely sorry "but I promised House I'd return immediately after the operation" I lied using my premeditated excuse for that moment after all the surgeries I had attended. Without exception every single surgeon, after I attended their surgeries, invited me to chat about my future in medicine.
There were times when my excuse unfortunately didn't work and I had to find a way to kindly reject mentorship offers. It was strange to see disappointment so marked on the surgeons' faces.
Fortunately this time it did work. "Ah I understand, duty calls" Doctor Miller snapped his fingers regretfully, "well tell House to try not to monopolize that brain of yours like he does" the doctor patted my shoulder, "if your hands move at the speed your brain does, you have a blinding future in surgery" the man added, winking before walking away.
Yep, the same speech with different words.
Uncomfortable, rocking on my feet for a second, I sighed before going to change my clothes.
Even though I lied to the man, I really did need to return to House and the rest. Maybe the surgery had been a success, but we still didn't know what was wrong with Mary.
...
Author Thoughts:
As always, I'm not American, not a doctor, not a fighter, not Magnus Carlsen, not Michael Phelps, not Arsene Lupin, not McLovin, not Elliot, not Capone, not Tiger Woods, not Sam Fisher and not Greg Louganis.
Another chapter has passed, so new thanks are in order. I would like to especially thank:
11332223 Victor_Venegas RandomPasserby96
I think that's all. As always, if you find any errors, please let me know, and I'll correct them immediately.
Thank you for reading! :D
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