Bodies hustle as we guide the gurney to the elevator, my hands still lodged inside the patient. I'm bouncing on the balls of my feet while we watch the numbers count down. I'm not fazed by elevators anymore; too many trips like this have desensitised me to the cramped space. The hospital's only four storeys high and yet it seems to take an eternity for the damn doors to slide open. Eventually they part and then we’re racing against time again.
"Inside, inside! Move!" The intern I sent to warn the O.R., Mikey, I think he's called, makes it just in time to catch the doors. "They know we’re coming?"
"Yeah."
"He's coding, doctor." Grace tells me this as the heart rate and BP monitors start screaming. I pull my hands out of the guy and grab hold of Mikey.
"Hold him together."
Mikey looks like a rabbit in the headlights when I gesture to the patient's wound. "Wh—what do you mean?"
I take both his hands and place them where I need them. "I mean hold this guy’s fucking intestines inside his body!”
Mikey may or may not obey the command. I don't waste any more time. I lean as far as I can over the patient and start compressing his chest.
One, two, three, four, five…
The powers that be decided a while back that you don't need to give an arresting patient any breaths. Keeping the heart pumping is the number one priority here. Grace is on it, anyway. She starts bagging him, forcing regular gusts of oxygen into his lungs, and I grunt over my work.
The doors open again.
"Okay, let's move." I can't compress and run at the same time, so I hop up onto the foot rail at the bottom of the gurney and hitch a ride to the O.R. I used to see doctors do this back when I was as green as Mikey and I could never picture myself being composed enough to be that person. A lot has changed over the past four years, though.
Lex’s disappearance, trying to find her, has changed me so dramatically that I'm not the same person I was back then. I'm exactly the kind of person I need to be to excel at this instead. I'm cold. And calculating. I don't buckle under pressure. I get things done. It all started back in that hotel room. I traded a part of myself that night, sold or flat out extinguished a part of myself that would only have prevented me from doing what had to be done.
The very first surgery I performed was on my self; I'd carved out my weakness with a rusty scalpel and revelled in the glorious void that had remained afterward.
The nursing team are already waiting by the time we reach O.R. three. I've been keeping our as yet unidentified patient alive for two hundred fifteen seconds. Time is running out. Dr Massey is scrubbed and ready to go when we reach the sterile anteroom between the corridor and the O.R. Massey's good, a gun with trauma. I'm so relieved I almost grin when I see his face.
"No ID, MVA, unknown internal injuries. BP tanked between ground floor and level two." Massey nods, face already obscured behind his mask, but his eyes are steady. They say he's got this.
"Go scrub, then get your ass in here. This looks like a job for two pairs of hands." The O.R. nurses take charge of the gurney and disappear through the double doors with my patient. My patient. When you've had your hands inside a person, whether they live or die, they become your responsibility.
"Hot damn." Mikey is standing next to me, blood mottling the latex of his gloves and soaking his scrubs. It looks like he just went on a killing spree. "That was intense."
"That was sloppy," I correct him. "You can't freeze like that, Mikey. Your hesitancy could cost someone their life." I feel like I've just kicked a puppy. Mikey’s probably only three years younger than me but in our reality, three years’ worth of experience is a lifetime. Him giving me the sad eye treatment isn’t going to earn him an easy ride with me, though. We aren’t allowed feelings like remorse. Remorse means we did something wrong, or we didn’t do enough. There’s no room for wrong or not enough in this hospital.
"Are you going to save him?” Mikey asks.
Can I do it? Can I do for this patient what I couldn’t do for my own sister? I tell Mikey the same thing I tell myself each morning before I even step foot inside the hospital.
"I'm gonna try. I’m gonna do my best."
******
We lose him.
Sometimes, no matter how much blood, sweat and tears you pour into someone, your best just isn't good enough. Gary Saunders, twenty-seven, bleeds out on the table, while Dr Massey and I battle to save him. His internal organs were minced, though, and sometimes that's all there is to it. I've learned to accept outcomes like this; I feel no guilt. I'm a human being, capable of only so much. People forget when they walk through these doors that they're putting their trust in mere mortals. I'm not God. I'm not even close to a miracle worker. Some days there are people you can save and those are the lucky days. The good days that make it feel like the sun is shining that little bit brighter. But then there are shitty days, too. Days like today.
I'm in charge of telling Gary's pregnant wife that he’s dead. I get landed with this job a lot; my colleagues think I have a skill for breaking terrible news, when really I’m just the same as any of them. It still hurts like hell. The difference between me and them is that I can distance myself from the pain. I'm an expert at distancing myself from pain. If it were an Olympic sport, I'd be a gold medallist. I head to the family room and knock quietly at the door. Inside a brunette woman with a swollen belly twists in her seat, and my stomach bottoms out. The chart I’ve been carrying crashes on the floor.