Under the Knife

The man interrupted his howling long enough to vomit bright red blood, which splattered across his bare chest in a pattern that reminded Rita of the finger paintings on display in the lobby of the children’s hospital next door.

She looked away, repelled; then, intrigued in the way of a driver slowing to get a better look at a traffic accident, pushed her way into the room. The air was heavy with odors: sweat, urine, feces, ammonia. A young doctor she judged to be an internal medicine resident stood at the head of the bed, squeaking instructions to the interns and nurses. He seemed more scared than the patient. He had an adolescent whisper of chin hair and a brush of acne highlighting his cheeks, as if a kindergartner had streaked red crayon across them.

The interns and nurses did their best to follow Dr. Acne’s instructions. All kinds of things were going on that Rita didn’t understand. None looked good: needles jabbed into veins, wires connected to electrodes, IV bags of medicine hung. The med students stood and stared. Rita sensed that Dr. Acne and the interns meant well but didn’t have a clue. It had been the second week of July, right after med-school graduation, and most of them, she knew, were almost as green at this as she was.

Suddenly, the patient heaved a long, plaintive wail and collapsed backward, unconscious, a thin stream of blood dribbling from a corner of his mouth.

Dr. Acne froze, mouth agape, staring down at his motionless charge. The room paused, collectively holding its breath as everyone processed this: comatose patient and dumbstruck leader. All eyes fixed on Dr. Acne as they awaited further instructions.

None came.

And the room erupted then into chaos as everyone just did what they thought might help, which involved a lot of shouting and arm waving.

Rita was pushed to the side of the room by a mass of bodies and pressed up against a wall. She remembered thinking that this was like watching a bunch of ants swarm aimlessly after a petulant kid has stamped on their hill: all frantic motion with no purpose.

Until another doctor swept into the room.

And changed everything.

Including the course of Rita’s life.

The first thing she noticed about him was that he was not tall—five-six, maybe, and shorter than Rita. She could barely see the top of his head through the crush of people.

But in her memory he was gigantic: a towering Greek demigod with brown hair that tumbled to his shoulders in thick waves and an impregnable air of confidence. The moment he’d stridden into the room, it was his.

Announcing himself as the chief surgical resident in charge of the patient, he divided the crowd like Moses parting the Red Sea, and emerged from the melee at the patient’s bedside. In one smooth motion, he bodychecked Dr. Acne, who tumbled into the surrounding group with an expression of relief.

The surgeon folded his arms, looked coolly around, and within seconds had the undivided attention of every person in the room, which was now deathly still, save for the erratic rasps of the unconscious patient.

The room’s attention thus commanded, he began to issue orders in a calm British accent, which, to her bland American ears, had made him sound really smart.

And really cool.

The room flew back into motion, but smoothly now, fluidly. She watched as he molded order from chaos, the junior doctors and nurses acting as a synchronized extension of his will. Under his command, you’d have thought they’d been doing this for years—an experienced, world-class orchestra responding to a renowned conductor.

Rita loved every moment of it: staring at him, mesmerized, studying every word, gesture, body movement. It dawned on her that someday, like that surgeon, she wanted to be the one in charge. She wanted to be him: the one person everyone else looked to. Unshakable. Imperturbable.

This, she realized, was what being a doctor was really all about. She could deal with all the other crap—bigoted professors and horny old men and exhaustion—if it meant that one day she got to do what this surgeon was doing.

Unfortunately, despite the renewed vigor of his treatment, the patient continued to spiral downward, and within minutes stopped breathing. The surgeon deftly slipped a breathing tube down his throat. The patient’s heart stopped shortly thereafter.

Chest compressions commenced. Under pressure from them, the stitches and staples in his abdominal incision burst apart with a series of pops, the incision split open, and his intestines spilled onto his abdomen. Glistening and smooth, bathed in pink fluid (peritoneal fluid, Rita had recited sickly to herself), they’d convulsed in intermittent waves, like giant albino earthworms, until the surgeon barked an order, and someone covered them with a large sterile dressing moistened with saline.

That was enough for Rita. She was tough. But human intestines were just too much at that stage of her career.

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