“How about reflux disease?”
“I’m fine! Really, I am. Are you sure we are not holding Dr. Mason up?”
“There is no problem about holding up Dr. Mason, believe me. Now, let’s talk about the spinal. Do you know that we have to put a needle in your back to enable us to give you the anesthetic agent?”
“Yes. I know all about it. Dr. Mason’s fellow gave me the complete rundown and assured me that I won’t feel anything.”
“That is correct. You won’t feel any pain during the operation. I will make absolutely sure of it. But tell me: Do you have any back problems that I should know about?”
“Nope. Back’s fine.”
“Good. What will happen is that when we get you in the room, you will be asked to sit on the side of the operating table with your face and head resting in a support. You will feel a pinch when I put some local anesthetic into the skin of your lower back before putting in the spinal needle. Once the medicine has been introduced into your spine, we will help you lie back down on the table. Now, a question for you: During the operation, do you want to be awake and possibly watch if Dr. Mason is okay with it, or would you prefer to be asleep? Either way, you definitely will feel no pain, and I will be with you for the whole procedure.”
“I want to be asleep! I don’t want to watch anything.” As comfortable as Bruce was with being in the hospital, there was no way he wanted to watch someone cut into him.
“Okay, fine. Then you will be asleep. Now I ask again, have you eaten anything since midnight?”
“No.”
“And you have no known allergies to any medication?”
“No allergies.”
“And you are not taking any drugs, prescribed or otherwise?”
“No drugs.”
“Excellent. Now I will start an IV and get you down to the operating room. I’ve been told Dr. Mason is nearly ready for you. Do you have any questions for me?”
“I can’t think of any,” Bruce said. For the first time, a slight shiver of fear raised a few hackles on the back of his neck. The reality of what he was facing was finally sinking in: He was in the hands of the surgical team and no longer in control of his life.
Dr. London started the intravenous line with such skill and rapidity that Bruce was surprised when it was done. As comfortable as he was with the hospital environment, he fully admitted he never liked venipuncture and always turned his head to the side. “Wow!” he commented. “I hardly felt that. I guess you have started a few IVs.”
“A few,” Ava said. She knew she was good at it, just like she knew she was good at anesthesia in general. She was also sensitive to her patients’ mental state and detected a slight shift in Bruce’s demeanor. “How do you feel? Are you anxious?”
“A bit nervous,” Bruce admitted. His voice, which had been strong and self-assured, now wavered slightly.
“I can give you something to calm you down if you would like,” Ava said, hearing the hint of anxiety.
“I would like,” Bruce said without hesitation.
With a syringe and a medication vial she had in her pocket for this very reason, she quickly gave Bruce four milligrams of her favorite premedication drug, midazolam. Then she disposed of the paraphernalia she’d used to get the IV going, released the brake on Bruce’s gurney, and without waiting for an orderly, pushed Bruce out into the main room, heading for the OR suite.
“I can feel that medication already,” Bruce admitted as he watched the recessed ceiling lights pass overhead. The fear he’d had moments earlier had miraculously already vanished. He felt the need to talk. “When do I get to see Dr. Mason?”
“Soon. I was told he is waiting on us, which is why I’m taking you down to your operating room myself without waiting for an orderly.”
If someone had asked him, Bruce would have said he felt a little tipsy as he entered OR 8 and glanced around at the scene. Almost a year ago he’d had a tour of the new hybrid operating rooms when they had been completed, so he wasn’t surprised by the exotic cream-colored booms hanging from the ceiling or the banks of video monitors or the window looking out at the central desk. As the gurney was guided alongside the operating table, he saw that the scrub nurse was already gowned and masked and busy arranging instruments. He didn’t recognize her with so little of her face visible, but he did recognize the tall circulating nurse, Dawn Williams, who he knew drove a white Ford Fusion. She recognized Bruce in return.
“Welcome, Mr. Vincent,” Dawn said cheerfully as she came around the end of the gurney to help Ava transfer Bruce onto the operating table. “We are going to take especially good care of you just like you do with all our cars.” She let out a bit of muffled laughter.
“Thank you,” Bruce said, as he put his legs over the side of the operating table to face the doughnut-shaped support for his head. His eyes scanned the room for Dr. Mason, but the surgeon was not there. “Where is Dr. Mason?”
“He will be here as soon as we let him know you are all ready for him,” Dawn said.
“Is he still in on his first case?” Ava asked as she and Dawn helped position Bruce with his head in the support. It was a general rule that anesthesia was not started until the surgeon was physically present and part of what was called the “pre-op huddle,” when the surgeon, the anesthesiologist or anesthetist, and the circulating nurse went over the case to make sure everyone was on the same page with all the details. Unfortunately, that was not always the situation with Dr. Mason and a few other members of the surgical hierarchy who were known to flaunt some of the rules in favor of maximizing their productivity. The problem was: They got away with it.
“Yes. Dr. Mason is still in OR fourteen,” Dawn said, “but the OR supervisor said Mason wants us to go ahead and get Mr. Vincent ready for him.”