Chase stopped pacing and gazed at the C-arm and the operating rooms beyond.
“The work. The amount of work we’ve put into this. And what are we going to tell everyone? It’s going to look bad. Whatever we say. What are we going to say? We’ll have to think of something. Something credible. We can say that the patient was too sick. Or not right for the surgery. Or equipment issues. Right?”
Finney said, “All potential excuses.”
She wanted to scream at the top of her lungs: God, just STOP TALKING!
“We can spin it like that,” Chase said. “Right?” The pitch of his voice rose on right, in a plaintive way, and his broad shoulders drooped. He ran his hand down his face again.
“You can’t let him cancel the surgery,” Finney said. “You have to talk him into letting you do it today, Dr. Wu.”
No, I don’t.
The thought had popped into her mind suddenly, and with a force that took her by surprise.
Of course I don’t. I don’t need to talk Chase into anything.
She squeezed her eyes shut, then opened them, as if for the first time that day. What the hell was she doing here, anyway, trying to talk Chase into doing something she didn’t want to do? Something that would put a patient at terrible risk? She knew she shouldn’t operate. So why were they even having this conversation?
Rita tugged at her left ear.
“No,” she said aloud to Finney.
The word was loud in the small alcove.
SPENCER
Spencer’s patient eyed him up and down.
“You a prayin’ man, Doc?” he rumbled. A rancher—third-generation, he often reminded Spencer—from the arid mountains east of San Diego, he had a big barrel chest and even bigger voice.
“As a matter of fact, I am, Mr. Bogart,” Spencer replied. He was standing over the man’s gurney in the pre-op area.
Bogart’s craggy face broke apart into a wide grin. “I knew it. You look like the prayin’ type. I can always tell. Episcopalian?”
“Presbyterian.”
“Close enough. Come on, then, son. We don’t got all day.” He reached up a rough, meaty paw, and Spencer took it. He had thick calluses, and the feel of it matched the look of Bogart’s face.
“Sheila?” Bogart offered his other hand to the woman standing next to the gurney.
She was his sister, as small and mousy as her brother was large and burly. She stepped forward wordlessly, and Mr. Bogart’s hand swallowed hers.
“Sheila’s a pastor in our church,” he explained.
Bogart’s wife had passed away last year. “Goddamn pancreas cancer ate her to the bone,” he’d growled during their first meeting. “Never smoked or drank a day in her life. Pesticides, Doc. It was those goddamn pesticides. Always knew those things caused cancer. Government knew, but wouldn’t tell us. Goddamn feds. Guess it’s my turn now, huh, Doc?”
“We don’t know that, Mr. Bogart,” Spencer had replied carefully. But Spencer was in fact pretty sure that yes, indeed, it was Bogart’s turn. Spencer could read a brain MRI as well as anyone, and based on Bogart’s, he was almost certain that he had a glioblastoma multiforme—about as bad as it got in the brain-cancer department. Chances were he’d be joining his wife within about eighteen months, no matter what Spencer did. In fact, Spencer wasn’t planning on cutting out his tumor: it was too deep and too close to too many important structures that, if damaged, might leave him a vegetable for his remaining days. Spencer’s goal today was simply to get a biopsy.
Sheila the sister grasped Spencer’s free hand. He could barely feel it. It was like holding hands with a two-year-old. The three of them bowed their heads, closed their eyes, and Sheila began to pray in a clear, strong voice: the usual stuff, invoking God and the Lord Jesus Christ to guide Spencer’s hands during the surgery. Spencer had heard variations on it many times.
He knew that an outside observer might not appreciate the importance of ritual in a surgeon’s mind. But as a surgeon, he’d learned not to underestimate the power of ritual. Habit and ritual were calming to surgeons: provided reassurance and confidence, reinforced a sense of control. Spencer had colleagues who would operate only in rooms corresponding to their lucky numbers, or only on certain days of the week; or always wear the same pair of shoes while operating; or insist on using the same type of suture, sewn in the exact same pattern, with the same number of knots, when other sutures and patterns and knot numbers would have done just fine.
Since Spencer ultimately placed his faith in God, his own ritual was to cross himself and mouth a short prayer before each operation. All his operations: big and small, straightforward and complex, because he knew that, from a patient’s perspective, there was no such thing as a little or simple operation.