The Fellowship

by K. Darblyne

  The nurse was shocked at the display of arrogance in the new Fellow. ‘Jeez, not even an hour into the new training year and already an attitude.’

  She readied the sterile gloves for the surgeon to wear. "I’ll make sure the word gets around, Doctor," she nodded politely. ‘Yeah, that you’re one demanding bitch.’

  Garrett now stepped up to the table, extending the gloved hand, "Bovie, please."

  The surgeons were at the forefront of the battle to save the young life now. There was no time to waste, as Trivoli and Chief Surgical Resident, Rob Kreger would have to quickly find the major bleeders and stop them if at all possible. It was sure to be a team effort and one that would not be over anytime soon.

  **********

  John and Steve returned to find the E.R. aide, Marianna, starting to clean up the trauma room. They were startled to see the amount of mess that had happened in such a short time.

  "I can’t believe what a mess you guys make," she teased them.

  "Well, be glad that trauma was only in this room ten minutes," John said, "or it would be a lot worse."

  "Oh my, guess I’m a little late," Dr. McCormick poked his head into the room.

  "Sorry, doc, the patient is already in the O.R.," Steve apologized to the E.R. Attending Physician.

  "Alright then, ah…what was his name, do we even know?"

  Steve looked straight at the stout, balding physician; "We’re calling him, Lucky Doe."

  The doctor let a smile slowly crack across his face, "Let’s hope so."

  "Say, you wouldn’t happen to know who the trauma surgeon was?" Dr. McCormick asked stepping back into the room.

  "Trivoli, Trauma Fellow Garrett Trivoli." A large grin appeared on John’s face. ‘Yeah, this Trivoli rush came as close to having sex as one could get at work,’ the tall blonde nurse thought to himself. ‘This might even put a whole new outlook on the time that I spend in trauma.’

  The Physician was surprised by the expression on John’s face. "Thanks, I’ll get the information I need when they’re done in surgery," McCormick said as he started to leave.

  The nurse’s facial expression would not erase itself from Ian McCormick’s mind. He knew of John’s fanaticism with sports, his appetite for lewd comments and sexual escapades. ‘Trivoli, hmm…could have been a collegiate sports figure, or maybe someone who cracks comments like John.’ Then it hit him. That look! It was the one that most teenage boys have after their first sexual encounter or men when deep in lustful thoughts. The physician looked over his shoulder at John. ‘Oh, God, he’s getting off on men now! Jeez…I hope it’s only Garrett Trivoli,’ he thought and began to quicken his pace away from the Trauma hall, a feeling of homophobia coming over him.

  ************

  In a combined group effort, the three co-workers and Housekeeping brought the trauma room back to a state of readiness. Now, the nurses would have to try to put together some sort of paper work on Lucky Doe. Everything had happened so fast and simultaneously that it was going to be hard to chronologically come up with the chain of events that took place.

  Finally, Steve and John were satisfied with their Trauma Assessment paper work. It was sparse but told the entire eleven-minute story of Lucky Doe while he was in their care. They both knew that once Nan reviewed it, their manager would be asking why certain things had not transpired in the way of patient care.

  Steve hung his head; "Nan’s going to be on the war path over this one."

  "The patient’s still alive," John snapped. "At least I hope he is. If she has questions, let her take it up with the physicians."

  "I say, why don’t we just let her watch the tape. That should answer any of her damn questions."

  John’s face lit up; he had forgotten that all traumas were video taped for critical review. ‘Maybe I should review it, myself. I wonder…will it be as arousing the second time around?’ The thought was now evident on his face.

  "Jeez, John, I wish you could keep your mind on work instead of last night’s conquests," Steve was now visibly agitated.

  ‘Oh, but I am!’ was the younger nurse’s mental reply.

  ***********

  The operating room was quiet except for the rhythmic bleeps of the heart monitor, a constant reminder of the life they were trying to preserve. Surgeons had their own peculiar style of conduct that surrounded them in the operating arena and Garrett Trivoli was one for intense concentration, solely focusing on the patient. Spoken words being kept to a minimum. Perhaps this is why everyone paid attention when the voice of the Surgeon was heard.

  "Vitals, please." The words seemed to be spoken as a directive and not polite etiquette.

  The anesthesiologist surveyed his electronic equipment. "Heart rate, 90. BP 108 over 66. Respiration’s 14. Color appears to be good," he reported, looking directly at the patient’s face.

  Garrett breathed a sigh of relief. The biggest part of the battle was over. Now only the small skirmishes remained. A fight is still a fight no matter how big or small. The surgeon had learned the hard way many years ago. Some of the most deadly battles were those that could possibly be mistaken as insignificant annoyances. Over the years, Trivoli had learned to let instinct guide the swiftness of response, but to take care that her quest for perfection was not marred by some insignificant oversight that would conquer in any altercation.

  "Now comes the tedious part, Dr. Kreger. We run the intestines looking for any sign of perforation or nick," the surgeon looked over at the Chief Resident.

  "Doesn’t appear to be any injury to it." Dr. Kreger challenged. "I don’t think we’ll find a thing to worry about."

  An eyebrow arched high on the forehead and icy blue eyes shot like daggers. Garrett’s voice dropped to a low tone. "This, Dr. Kreger, is my patient. I will do whatever I feel is necessary to assure the success of this operation now and for the future. If you don’t agree, then I suggest you assign yourself to a different trauma fellow after today."

  Beads of perspiration gathered across the Chief’s forehead. ‘No!’ his heart screamed ‘You are the one, I want to learn from you.’ He let his eyes drop in submission and nodded his head. "I’m sorry," was all he could verbalize.

  He knew that out of the three Fellows, Trivoli had the skills and surgical expertise that he wanted, but her overall manner with the staff left much to be desired. She seemed to pit herself against them at every turn. He’d have to remember not to pick up those habits.

  "Good! Then you won’t make that mistake again." Her voice was calloused and cold, rivaling the room’s temperature for sending a chill straight to the bone.

  His eyes shot up to meet hers and he wondered if he would be able to withstand her condescending attitude for the year to come. He had been told that he could learn many things from this Fellow but no one had mentioned her brash and arrogant ways.

  Painstakingly slow but ever so diligently the two surgeons examined the loops of intestines for damage. They could find no defects but something kept the Fellow on guard, instinct was taking over again.

  "Vitals, Please."

  The O.R. staff was beginning to hate the sound of the word ‘please’ coming from the tall surgeon’s mouth. It was evident that she had no idea of the courtesy she was extending in the polite mannerism. It came off sounding more like a suffix to the word before it.

  "Heart rate 98, BP 100 over 64, respiration’s 16," the anesthesiologist reported.

  Garrett could not shake the feeling. "Raise the pressure to 120."

  The anesthesiologist pulled a syringe off the tray at his workstation. He uncapped the needle and proceeded to inject one milligram of the drug into the port of I.V. line. "Should take just a few minutes," he reassured the surgeon, "before we can see some results."

  "While we are waiting for that to take effect, let’s mop up this abdominal cavity of any free fluid."

  The circulating nurse silently kept watch of each sponge that entered the young man’s abdomen and patiently retrieved them as they were
discarded.

  "Seventeen used inside," she announced, "seventeen out."

  "Pressure is now 122 over 70."

  "Ok, let us do this one last time." The surgeons inspected each loop of bowel thoroughly, slowly checking for any sign of injury.

  "There!" The Chief Resident pointed out. "I see a drop."

  Trivoli’s eye was caught by the glistening appearance. There, upon wiping the site, one could see another droplet forming within a few seconds. It had paid off. The skilled hands of the Fellow manipulated the area of bowel to reveal a small one-millimeter perforation in the wall.

  "1-0 Silk on a curved needle."

  Garrett took the needle and put a stitch or two in to hold the area closed. Kreger clipped the silk and proceeded to dab the area; both surgeons waited to see if the stitch would hold.

  Rob Kreger silently studied the surgeon across from him and waited for the "I told you so." But it never came. He would have closed without ever checking and risked numerous complications that could have killed the young man that they worked so hard to save. ‘This one is the best,’ he silently thought. ‘I’m going to learn a lot this year.’

  Several minutes passed and the evidence was conclusive, the stitch would hold. The surgeons continued their final inspection. Both were satisfied when no other warning signs of injury could be found.

  "Is the sponge count correct?" The tall Surgeon waited for an answer.

  All eyes were on the circulating nurse as she made her final count.

  "I don’t have all day here, nurse, and neither does my patient." Garrett’s voice was antagonistic in nature.

  "Yes, Doctor Trivoli, eighteen in and eighteen out." The nurse looked over with eyes turning from shock to that of shooting darts at the brash surgeon. She was an experienced O.R. nurse and didn’t appreciate being treated in this manner.

  "Great! Now let’s close and see how he does in recovery." Trivoli motioned for the Chief Resident to do the honors.

  Rob Kreger felt a sense of acceptance by the gesture. Here was a surgeon who strived at perfection and the task of closing was offered to him. It was something that was usually given to first year residents as a practice procedure; but right now it felt very much an honor coming from Garrett Trivoli. No matter how small or monotonous the task, the Chief Resident was sure the Fellow would be meticulous down to the last detail. It was that frame of mind Dr. Kreger kept as he sewed the layers of surgically severed muscle and flesh together.

  The operation over now, Garrett addressed the other participants in the young man’s fight to stay alive. "I want to say thank you for the expertise that each of you brought to this arena today, and I will expect nothing less from you in the future. I’m looking forward to working with you again." She turned away from the group of people huddled around the dramatically illuminated form on the surgical table.

  "I’ll be opting out of her cases for the next year." The circulating nurse spoke softly under her breath to the scrub nurse who nodded in agreement.

  "Rob, page me if anything changes, I’m going to see if any family members are here for Lucky."

  Kreger nodded his head in affirmation as he began to take off his gloves and gown. "I’ll stay with him in recovery for a while."

  Stripping her mask off with one hand, Trivoli gave a small wave with the other hand and proceeded through the door. Above the O.R. desk the large wall mounted clock read 1458. ‘Seven and a half-hours of surgery, not bad for my first day. It will be even better once I have them all broken in the right way.’ Garrett thought about her empty stomach and remembered that food and drink would be necessary soon. A bathroom break and quick shower might be nice, too.

  The family came first, that is if one was found. It was Trivoli’s customary ritual to meet and inform the family immediately after any surgery. It was one way that the surgeon could help to put them at ease during their traumatic experience.

  Garrett approached the O.R. desk and waited for the Supervisor’s attention.

  "Hello, I’m Dr. Trivoli. Can you tell me if Lucky Doe has been identified yet?"

  "Sorry, doc." The older woman shook her head. "But there is a message for you from Dr. McCormick in the E.R. to call him when you are done."

  "Thanks," Garrett motioned to use the phone at the desk.

  "Go ahead, it’s extension 2744."

  The surgeon punched in the numbers and waited for someone to answer.

  "Dr. Trivoli returning a call to Dr. McCormick."

  A pause, then, "Have him page me at 1048 when he has a moment to talk then." The surgeon replaced the phone, acknowledging the woman at the desk with a slight nod of the head. "I can trust that after today you won’t have to call in to my Operating Theater to ask my name, now will you?"

  "But doc, it’s the first day of a new year. How am I supposed to know everyone’s name?" She looked annoyed at the tall surgeon opposite her.

  "Then I can assume that nobody will have a problem knowing me or my name then the rest of the year, since I’ve already told it to you." She challenged the nurse.

  The nurse drew in a long breath, her eyes turning into beady little black dots. "Trust me Dr. Trivoli, I’ll make sure everyone knows all about you." She let the residual air in her lungs come out of her nose in a snort as she watched the surgeon walk away, muttering to herself, "Damn arrogant Bitch!"

  ************

  The warm water of the shower felt good cascading down the tensed muscles of the surgeon. It was a feeling that Garrett had come to expect at the end of a surgery case, when the focus had been on the needs of the patient, every muscle, every fiber of being standing at attention ready to meet any demand. It seemed such a small price to pay in her quest for perfection. When one knew first hand of the agonizing pain that the patient was experiencing or the torment of their loved ones, perfection was all that matter. It was never going to be Garrett Trivoli that dropped the ball. The water temperature slowly increased. The soothing rhythm and heat began to loosen her sore shoulders and back. This was indeed a luxury. How many cold or tepid showers had been taken on board ship during the last three years? That never changed the reason Trivoli was here in the shower after surgery. It was more than to clean the body. The streams of water diluted the tears that were still felt inside, tears of anguish and loss over past situations and loved ones.

  Beep-beep…Beep-beep…Beep-beep!

  The reflective ritual dissolving with the pager’s cry egged the surgeon to finish. Garrett quickly toweled off and stepped outside of the shower stall.

  The pager beeped again. The swift skilled hand of the surgeon picked it up and brought it within range of the clear blue eyes. Trivoli, recognizing the number, hastily dressed in a fresh set of scrubs and found the nearest phone.

  "Dr. Trivoli here, I was paged." The surgeon waited for the person to come to the phone.

  "Dr. Trivoli, this is Dr. Ian McCormick, E.R. Attending," the deep voice said. "How is Lucky Doe coming along?"

  "We just finished surgery about 30 minutes ago. Lucky is doing a lot better than initially expected. He sustained several bullet wounds in the abdomen and one in the right upper lobe of the lung. The thoracic team placed a right side chest tube and cleaned the wound. The two bullets found in the abdomen shattered the left kidney beyond repair and penetrated the colon near the hepatic flexure. A nephrectomy and resection of four centimeters of transverse colon with therapeutic colostomy was preformed. A one-millimeter perforation was found in the small intestinal tract on close inspection and was repaired as well. Lucky Doe is now in recovery and holding his own at this time." Garrett was proud of the work that was done and it showed. After all, it was near perfect for not having people trained to her level of expectation.

  Ian was impressed with the concise but thorough report. "I had heard that it was an awesome sight in the trauma room, the team…altogether that is. I wouldn’t know first hand, I wasn’t fast enough to even see the patient come through my E.R."

  Garrett was unsure as to t
he exact nature of the statement. "Well, sir, I…"

  "I guess I’ll just have to be a little faster than normal when I know you are on trauma call," McCormick chuckled. "Never saw a first day trauma team move so fast. I understand that there are rumors that you have been secretly rehearsing for the last few years."

  "Every day is a rehearsal for the day after it. So, yes, in that respect I have been working up to it."

  "Well, Trivoli, it sounds like you did exactly the right things except let me see that patient. You know that it is my E.R. that you get to work out of on those traumas." The E.R. Physician stated in a serious tone of voice, "Next time you’re down in my E.R. make sure you introduce yourself to the staff. It seems that they don’t enjoy being ordered around by the voice of a higher being. You have a fan club with the two trauma nurses, but then again it was only a meager ten minutes of fame."