Why? It was commonly believed that we were all running away from something, whether we knew it or not.
Colin had ten years on me and was in his fourth month of doing what he called meatball surgery. Nuru was my patient, but I handed the scalpel to Colin. It was always exciting to learn from this man.
Colin held a penlight between his teeth and made his incision on the right side of Nuru’s chest. He followed up the incision by using a hand retractor to spread open a space between the boy’s ribs. Then he put in a tube to drain the blood that just kept coming.
I saw what Colin saw: plenty of blood and no clear source of the bleeding. And so Colin reached into Nuru’s chest and twisted the child’s lung, a brilliant move that I understood might temporarily stanch the flow.
I had clamps in hand and was ready to take Colin’s direction when we were interrupted by the awful clamor of people charging into the O.R.
Our settlement was poorly guarded, and outlaw gangs constantly roamed outside the fences. Everyone on the medical staff had been given a death sentence by the outlaws. Our pictures were posted in the nearby villages. Colin wore a T-shirt under his gown with a target on the front and back.
He had a very black sense of humor, my mentor, Colin Whitehead.
Maybe that darkness in him was what brought him here, and maybe it was why he stayed. Colin didn’t look up. He shouted over his shoulder at the intruders.
“If you’re here to kill us, get it over with. Otherwise, get the hell out of my surgery!”
A man called out, “Help, Doctor. My daughter is dying.”
Just then, Nuru’s mother tugged on my arm. To her, I was still her son’s doctor. I was the one in charge.
I said to her, “Mother, please. Nuru is getting the best care. He’ll be okay.”
I turned back to little Nuru as Colin threw his scalpel into a metal bowl and stripped off his gloves.
That quickly, Nuru had stopped breathing.
The little boy was gone.
Chapter 3
COLIN SAID, “Well, that’s it, then,” and headed off to the new patient on the second table.
Nuru’s mother screamed, “Noooooooooo!”
Her days-old infant wailed. Her little boy was dead, and already flies were circling. Sabeena started to cover him with a scrap of a sheet, but I just couldn’t stand to lose another child.
I said, “Nope, stop right there, Sabeena. I’m not done here. I’m opening his left side.”
Sabeena looked at me like, Yeah, right.
I said, “Can’t hurt, could help, get me?”
“Yes, I do, Doctor, dear. Better hurry.”
“Berna, Rafi. Someone take care of Mommy and the baby. Please.”
The procedure Colin had performed is called a limited or anterior lateral thoracotomy, a cut into the chest cavity through the side of the rib cage. Colin had opened Nuru’s right side. And now, although it was highly unlikely that I would find a torn artery in the side of the chest opposite the bullet hole, we hadn’t found the leak. And there had to be one.
Meanwhile, Nuru wasn’t breathing, and his heart had stopped. The technical term for this is “dead.”
But in my mind, he wasn’t too dead.
“Stay with me, Nuru. I know you can hear me.”
I made my incision on his left side and used the hand retractor, and as Sabeena held a penlight for me, I peered inside. The heart wasn’t beating, but blood was still filling the chest cavity from the force of gravity.
Where was the leak? Where?
Sabeena wasn’t looking at me, and I knew why.
One of the things that you started to get after a week or two in this place was that you could not save everyone. Not even close. Fifty percent was a good score, and then half those patients died in recovery.
Still, Nuru was my patient.
My responsibility.
As the flies descended on her child’s face, Nuru’s mother howled and crowded back up to the table, crying out, “No, no, you said, Doctor. You said.”
Normally, it would be insane to have parents in the O.R., but here, it was necessary for the closest kin to see what we did, the decisions we made, even to help us make the decisions. So Nuru’s mom had to be here, but I needed every one of the seconds that were racing by.
“Please give me room, Mother,” I said. “I’m sorry, but you’re in my light.”
She did what I asked. She stepped back but stood at my right arm, crying and praying, the sound of her voice cutting into my ability to concentrate like a machete to my forehead. Other people were screaming, too. Colin yelled at his patient, who was shrieking in agony. He blasted the patient’s father and cursed at our poor orderly, who had been working for a day and a half straight. I had to block it all out.
I focused my attention on the little boy and began sponging down his still-oozing left lung.