He’s positioned on his right side, with his arms extended straight out, zombie-style, and strapped down to a board. They’ve got his lower leg flexed, and a pillow between his legs, and his hips are being strapped to the table.
Wynn inserts a breathing tube while Billards gets another CT. I move with the pack, analyzing the results of this new CT, listening through a haze as Billards discusses his game plan, which I’m relieved to hear is a significantly less invasive VATS approach for L1 body reconstruction.
“Not every patient at this hospital gets the VATS treatment,” he says with a shake of his head. “Only the lucky ones when Dr. Briggs or I am on call.”
VATS is the ideal procedure for an easier recovery, so this news has me shaking with relief.
As Billards talks, I can’t stop looking at Landon. I hate the sight of him up on the table with that cruel tube down his throat and props and blankets positioning him so unnaturally. I try to tell myself that he’s asleep, and he has no idea what’s going on, but that thought makes me feel ill, as well. He doesn’t know yet that the car wreck—where he was a victim of a run stop-sign, I’ve heard—could end his career, even his life if something goes wrong.
I watch silently in my surgical getup as Eilert marks his torso in four spots, for port insertion sites. We’ll need a working channel, an optical channel, a traction channel, and a suction channel. Even though Billards is in charge, I get the sense that Landon’s surgery will be mostly Eilert’s—and I hate her for it. Eilert is one of our chiefs, but she’s a resident. I want Billards at the helm.
I listen as he tells us, “We’ll be using an expandable Synthes cage. It’ll be placed in the vertebrectomy defect, gradually distracted, and locked into place to stabilize the cord.”
He and Eilert discuss the four channels at length, as he explains pitfalls of the positioning to her.
“Rutherford, I want you to construct the suction channel. That’s your job here. You do that well, you’re scrubbing out if you don’t want to do more. How do I know Rutherford is uncomfortable?” He looks around the room as he points to his head. “She’s sweating. Pale. She looks like she’s the patient. This is why we don’t perform surgery on a loved one if that is an option. At a smaller hospital, it is not always an option.”
Somehow, I remain standing as Billard talks ad nauseum and Landon lies there, frozen by anesthesia, being hovered over, poked, and prodded. Prinz arrives in surgical gear as Billard explains that for VATS to be advantageous for the patient, the surgeon must be experienced in restoring the diaphragm with the use of an endoscope.
“This is a developing subspecialty of thoracic surgery. You master this, you’ve got a gold star on your resume.” Moving closer to Landon, he continues, “Decompression will be performed using laminectomy. We have one broken fragment we’ll push forward, toward the body, before inserting screws from the rear. In a more severe fracture, we might come back in a few days later and remove the destroyed body with thoracic endoscope, but in this case we’ll be doing all that now. If all goes well, our colleague will get his chest tube out in four to five days and be discharged in perhaps ten. Surgery like this might take a toll on a geezer like me, but Jones here is a young man.”
I hold my stomach as he explains routine opening procedures. Billard is too specialized to deal with first or second year residents much, and I can tell he views the situation as something of a novelty.
So much of what he says makes me flinch—things I hear daily without batting an eye, like the warning he gives us to properly restore the diaphragm in order to avoid pneumonia and herniation of the large intestine.
He means Landon’s large intestine.
Somehow, somehow, somehow…I stay on my feet for three hours. After the first two, I’m just watching—mostly watching Landon’s vitals and the mortal hands that work the gear that’s rearranging my love’s insides. Every semi-sigh from Eilert or grunt or complaint from one of the techs makes my head spin. Every spurt of blood and BP fluctuation make my knees wobble.
I’m standing near his head, wanting so badly to touch him—just his forehead—when Eilert takes a bathroom break, and grabs me by my elbow. She leads me gently from the room.
“Rutherford, scrub out,” she says, doing so herself. “You look like you’re about to collapse.”
I nod woodenly as she heads for the women’s room. I make sure I’m out of earshot before I start to sob.
Eleven
Evie
I’m in the donut room, waiting for a page to tell me Landon’s been wheeled to ICU, when Eilert comes in. Her eyes are red. Her face is drawn. I notice tears on her cheeks, and I almost faint.
“Did something happen?” I jump up from where I’m sitting.
She gives me a look. “Your cohort just got sliced and diced. What do you mean, did something happen?”
“Is he okay?” I ask her, seeing stars.
“Jones?” she shakes her head, confused. “What do you think?”
“Did it go okay?” I half gasp.
“If by okay you mean I operated on a guy I shoot the shit with every day, a guy who hours ago was grinning his fool head off, and then I walked down to the ICU and watched him start to wake up, screaming from the surgery that I just did, then yeah, it went great.”
A sob bursts from my throat.
“Also,” she says slowly, “two of my interns have been having a relationship. If you think that’s okay, then yeah, we’re good.”
My heart stops at her words.
“Sit down. Or you can head on to the ICU. You think I didn’t see you crying while I was working on your boy? Just because I’m cutting doesn’t mean I’m blind. Why didn’t you tell me, Evie?”
I shake my head. I’m trying not to cry too loudly.
“It’s okay. He’s gonna be okay.” She wraps an arm around me, and I sob my brains out as she tells me all about the surgery, how well he’s doing and how fit he is. “I don’t think he’ll have any complications. I don’t know, of course, but I don’t think so. He’ll be on the other side again in just a few months.”
“Months,” I cry.
“Yeah, two or three. And he might fall into the next cohort, and that’s not necessarily a bad thing. Because he’s your boyfriend. He is your boyfriend? Not just your bed buddy?”
I nod, and then, because I’m such a basket case, and so riddled with guilt, I tell her everything, confessing so fully, her jaw drops. The sun’s up by the time we leave the donut room, but I’m feeling less on the verge of breakdown.
Eilert signs me in to the ICU as Landon’s next-of-kin, an easy move because he already listed me in the computer as his emergency contact.
Finally, I step into his little glass-walled room, and am stunned to see him extubated with his gray eyes cracked open.
As soon as he sees me, his jaw seems to tighten, and his eyes fill up with tears. I see his shoulders rise and fall, and see his mouth tug to the side in a small wince.