SUPER SURGICAL OPERATION CADUCEUS
Preface
Located in the city of Angeles Bay is Hope Hospital. Since its inception, Hope has continuously served the community. One of the young doctors at Hope Hospital is still in need of guidance. However, because of his desire to help people, he strives to improve under the circumstances. Doctor Derek Stiles will soon realize his full potential.
Chapter One- Doctor Stiles
In Hope Hospital, in one of the consultation rooms, a harsh, but caring, woman dressed in pink scrubs shouts at a young aspiring surgeon. The words she is shouting, however, don't really matter, because he isn't paying much attention to what is going on. Her name is Fulton, Mary Fulton, and she is Derek Stiles' overseer, and although an overseer is what she feels like to Derek, she is meant to merely be his mentor and assistant. Her hair today, as it always is, is tied tightly behind her in a bun, two strands of her dark brown bangs escape from the meticulously combed front. The face framed by her loosely hanging sideburns is a stern, strict one, that of a mother chastising a child. Eyebrows that appear as though they have been stenciled on are encased by the velvety skin of her gentle face, angled on the brow above two orbs where emerald-colored irises and obsidian pupils have made their home. Derek noticed her mouth moving as he glanced around the consultation room, looking for an escape from the current situation.
The room is the fairly cozy work area for Derek, and, although it is usually relatively chilly in the room, on this particular autumn day, crisp daylight chose to filter in through one of the glass windows that dot the walls, spilling warmth onto the wooden floorboards. Even with the abundance of windows about, sunlight is a rare occurrence in the room, and the inky darkness in the box formed by wooden walls is usually cast away only by the fluorescent bulbs dangling from the ceiling, their glow directed by the conical lamp shades flooding onto his work-desk and an area, presumably an area for a patient to rest, which was generally always cordoned off by a white curtain. His work-desk is average and uninteresting: a cedar desk, a firm white lab chair with rolling wheels sitting in front, papers strewn across the top either out of laziness or lack of time to file them away, a short metal file-cabinet where the papers should be filed, patient charts, and all of the additional effects one would typically find on a consultation desk. A wooden cabinet with a glass pane is anchored upon the wall above the sloppily-kept cedar desktop, containing test tubes, beakers, and various other glassware common to every lab. The vain effort to take his mind off the matter at hand having failed, his ears perked up to hear the voice of Nurse Fulton ringing through.
"We've transported the patient to the pre-op area." Nurse Fulton is the hospital's veteran surgical assistant. At age 39, she is kind and well-liked, although has the tendency to ramble a bit much. "The injury is on his forearm, and he's still fully conscious. Blood test results should be back from the lab any minute." She sat upon one of three lab chairs in the room, situated by the window where the light of the setting sun peeking through the leaden clouds outside spilled upon the floor and occasionally her back.
A cooler, smoother, manlier voice abruptly broke the fleeting silence after Nurse Fulton completed speaking, "It looks worse than it is. He's not in any real danger. I guess he got lucky, huh?" The man let out a soft chuckle as he finished. The speaker, whom Derek had forgotten was sitting in the room, was Doctor Greg Kasal, who leads the surgical department at Hope Hospital. He looks towards Derek Stiles as a child in need of guidance, and not as a doctor entirely yet. Throughout the years he has been a surgeon, he has come to a point where nothing will rattle him, at the price of being strict and expecting nothing less of perfection from others. He has a small bit of black facial hair sitting on his otherwise hairless face, forming a triangle at his chin. The hair atop his masculine, chiseled head is combed back with a gargantuan amount of hair-gel, and his sideburns are largely untrimmed. The eyebrows hanging above his hazel eyes are fuzzy and not nearly as neat as the hair that has been pulled back unnaturally. He looked over to Derek from his seat at the desk, and put his index finger and a thumb upon his chin as though in thought, opening his mouth to speak.
"You'll be operating, Derek."
Derek darted his eyes about nervously, and, hesitantly uncompelled to speak, took a great gulp, his Adam's apple visibly moving as he did so, before he reluctantly squeaked out, "…I will?" Derek is 26 and fresh to the medical field, having just completed his residency before accepting his position at the hospital. His face is sharp and clean, and his nose comes to a small, soft point at the tip of his face. He has ears that are not particularly interesting or large, noticeable only through a glimpse of them under the mop of dirty-blonde hair nested atop his skull. The bangs of his mop drape over his forehead, and cover hazel eyes hiding behind silver, oval frames. Anxiously, he fumbled for an excuse and came up with, "I was just about to start my rounds, so…"
Nurse Fulton held a look of chagrin across her face in response to Derek's lame excuse, and words that screamed her annoyance exploded from her lips, "Worry about that later! You're not an intern anymore! Hurry up and prep for the O.R.!" Her eyebrows arched at an angle Derek had never seen on a human face before, her eyes seemed to hold a fire inside, and her tone of voice was emphatic with imperativeness. Derek had the same look on his face that a child has when they have been caught with their hand in the cookie jar.
Doctor Kasal reassured Derek calmly, "This is a simple extraction. There's nothing to worry about. Just take your time… Stay calm, keep it steady. You should be able to handle this on your own by now. Let's head to the nurse's station now, shall we?"
Doctor Kasal was the first out of his seat, he walked to the door and the rest followed suit, heading for the nurse's station, the clicking and clacking of close-toed dress shoes echoing through the drab hall behind them as they walked forward. The floor was a reflective white tile, so reflective that it could almost be used as a mirror, and the ceiling was painted white; although, as Doctor Kasal opened the door, what was beyond the frame was much different from the exterior. The floor was wooden, and a white table in the shape of an oval stretched from one side of the room to the middle. Around the table were chairs exactly like the ones the group had sat upon in the consultation room. On the far side of the room brightly lit by rod light bulbs sits a row of filing cabinets, above which a shelf is affixed, serving the purpose of supporting binders filled with various types of archived patient information (which, of course, Derek could never read through in a lifetime). They all grabbed seats around the table, Nurse Fulton sitting at the head of it, holding the patient file.
"Let's begin the briefing," her tone was serious and to-the-point. "The patient, Kevin Turk, just arrived in an ambulance. He lost control of his motorcycle and crashed through a glass door. His lacerations have begun to hemorrhage. There are glass fragments lodged near his right shoulder," she pulled out an ultrasound and pointed, handing a copy to Derek. "Our cosmetic surgeon is out at a Medical Society meeting… But, you should be able to handle the stitching, right, Derek?" She grinned slightly, "There are two main objectives in this operation: Suture any lacerations and extract fragments of glass from underneath the skin. Be thorough, and try your best not to leave any scars."
Derek, being extremely impatient, jumped from his seat at the precise moment she closed her mouth on the word scars. He gulped, My first operation, "Okay… Let's begin the operation!" The trio followed Derek to the trauma center, and, after sterilization, the three stepped into the chilly room.
Kevin Turk lay before Derek, Doctor Kasal, and Nurse Fulton on the operating table below the high-intensity lights of the operating lamp. The affected area was not in overwhelmingly bad shape, and the patient's vitals were sitting around 80. Nurse Fulton calmly looked to Derek and began to speak, "Let's begin the operation. We should start with those lacerations. Take the sutures in hand and seal the wounds."
The suture looked like a sewing needle, just like it did in medical school. The knot on the eye was tied, but it wasn't ordinary thread, Derek could tell just by looking at it- anyone could. Derek slowly, steadily closed the wound on the upper right side of the patient's chest using the suture, and was rewarded with small praise from Nurse Fulton, "Good work," she paused hesitantly for a short while, then added, "Of course, this is a basic surgery skill." It was as if she had patted Derek on the back, but then somehow had taken the pat on the back away.
Does she expect me not to know more than this?
"Now, move on to the other laceration." Suture in hand, he gently sewed the sides of the next cut on Kevin's arm together. Again, he received another tiny feather-preening from Nurse Fulton, "Well done. The lacerations are taken care of."
"Now, take the forceps in hand and grab hold of the glass fragments. Be careful not to harm the patient when you slide the fragments out." He grabbed the forceps and grasped a bit of glass, drawing out a bit of blood with it, and she gave him another 'pat on the back' statement, "Good job, now place the fragment on the tray." She held a silver tray out, waiting for Derek to place the glass shard on it. Clink! The glass lay upon the tray, and soon it was met by its friend. "All the visible glass has now been extracted. We need to take care of those smaller wounds now. Use the antibiotic gel." She handed Derek a bottle of green gel, and, the lid to the container already being removed, Derek dug his gloved finger inside and pulled out a bit that stuck to the latex of his medical-green glove. As Derek applied the gel to the two small wounds on Kevin's arm, the skin closed up miraculously before his eyes.
He was surprised, but it was explained, "Medicine has come a long way. This gel cures small cuts instantly. In the past, cure-all ointments were just gimmicks and scams… but somebody finally created a real one. Oops, I shouldn't be talking so much. Let's continue… Some glass shards are embedded in the patient's arm, as well. We'll need to extract those—make an incision in the upper epithelium." Derek slathered some antibiotic gel along the incision area.
"Scalpel, please," commanded Derek.
"Yes, Derek," replied Nurse Fulton as she handed Derek the scalpel. Derek readied his hand and gently began his incision, "Derek, there is no need to be nervous, just make your incision along the guideline…" Derek noticed there was a guideline traced on the patient's arm.
Do they seriously think I could screw that up?
He pulled the skin apart and clamped each side in place. There were three shards of glass stuck beneath the skin, noticing this, Nurse Fulton spoke, "Hm… This is serious. We can't let them get infected." One… Clink! Two… Clink! Three… Clink! Derek rubbed the miracle gel on each wound, and fibers grew to connect each side of them, as if sewing the tissue back together."Very good! Now, suture the wound the same way you have before. Make sure the stitches aren't too wide or too narrow." Doctor Kasal took the clamps out, and Derek carefully sutured the two flaps of skin together.
"Derek, that wasn't the best you could do, was it? The patient might be scarred for life, ha," chuckled Doctor Kasal.
"Sorry, Doctor," apologized Derek sincerely.
"Hey, don't apologize to me," Doctor Kasal said as he nodded at the patient in front of them.
"I am sorry, Kevin," Derek legitimately felt sorry, but Nurse Fulton thought the two of them were joking around.
"Derek, Greg, would you two cut it out?! We're just about done, but you shouldn't relax yet!" Nurse Fulton didn't seem to understand. "Disinfect the sutured area with antibiotic gel." Derek reached into the jar and pulled out another glob, rubbing it along the area he just stitched up.
I am so sorry if that scars…
"That should heal up nicely. Now we just apply the bandage. Just roll out the fixing tape along the entire length of the incision."
She doesn't think I can even apply a bandage on my own? Ouch.
The fixing tape applied, Nurse Fulton chimed happily, "And, we're done. Good job, Doctor Stiles."
Did she just call me doctor? That can't be what I just heard, right?
"Make sure you review what we went over today."
"I think that might scar. If I were to grade you, you would get a C, Derek," laughed Doctor Kasal.
In the operating room, Nurse Fulton and Doctor Kasal had just witnessed Derek's very first operation. Derek was feeling pleased with himself. "See? You're catching on. That wasn't so hard, was it?" Nurse Fulton seemed pleased too.
"I couldn't have done it without my lovely assistant," flirted Derek.
"I definitely see improvement," Nurse Fulton briefly paused, "but flirting isn't everything. Seriously though, keep practicing and you'll do just fine."
The next day came, and Derek was seated in the consultation room once again with Nurse Fulton. She seemed to be saying something, but he was too busy looking out the window to notice. "Judging from the MRI, the tumor is in his stomach. It's benign, but you should be prepared for anything. Any questions, Doctor Stiles?"
Boy, it's cloudy out today, too. "Huh," it was obvious Derek's mind was elsewhere, "Oh? Yeah, I'm fine," he paused only slightly before finishing with, "Thanks anyway."
Nurse Fulton looked increasingly displeased and exasperated as she shouted, commanding Derek's attention, "Are you even listening!? I know you're stressed, but this happens to be your job. Are you getting enough sleep? You need at least 6 hours a night! Don't you remember med school? The patients depend on you!" Completely unaware of what was going on, Doctor Kasal popped his head in as he walked past the tense room. Derek swiveled his chair to face the door.
"Derek, don't forget our follow-up with Mr. Jenkins this afternoon." He glanced inside the room for a moment longer, and then stepped in. "Have you read the report?" Derek jumped slightly at hearing "read" and "report."
"…I haven't, actually," he hung his head in shame.
Doctor Kasal walked into the room and grabbed a seat from against the wall, then set the chair next to Nurse Fulton's chair and sat backwards in it facing Derek, resting his chin on his hands as his hands gripped the edge of the back rest, "You need to shape up—this is real life," stated Doctor Kasal matter-of-factly.
"You've been here three years, Derek. We shouldn't still be babysitting you," she turned to Doctor Kasal and smirked, "Maybe we need to open an investigation… 'Dr. Stiles's impaired medical and social development.'" Doctor Kasal turned to look at Derek.
"Harsh," sighed Derek, "Cut me some slack, Mary."
"You're not a resident doctor anymore, Stiles. You know that," Doctor Kasal nodded to Nurse Fulton, "Oh, and Mary… I spoke with Doctor Hoffman."
"Thank you very much." A grin stretched across Nurse Fulton's face.
"Wait, you spoke with the director?" Derek paused to think, "About what?"
"Don't worry. It's none of your business," quickly snapped Nurse Fulton.
"It's a personal matter. Just forget about it," said Doctor Kasal.
"Are you going on vacation or something? …I wouldn't mind a nice long cruise, myself," his mind drifted far away to a cruise ship, "Sun, the sea—"
"Okay, okay, that's enough. Let's get back to the operation," reprimanded Nurse Fulton.
Again, they walked down the familiar tiled hall leading to the nurse's station, and after taking their seats, Doctor Kasal began to speak, "Today, we need to excise a tumor in the distal stomach. In tests from two years ago," she pulled out previous test results and gave them both copies, "it was small and benign. However, it's grown rapidly and started to hemorrhage. At this rate, it might become malignant. After talking with Mr. Laurie, we've decided to remove it. There is one objective in this operation: Excise and remove a tumor from the distal stomach. That is all. But, you'll need to use the Powell Procedure to remove the tumor. First, drain the tumor's cytoplasm to decrease its size. Then, when you excise it, the cells can't metastasize, resulting in a smaller incision. There seems to be a trend toward this type of removal. It's a good idea for you to learn it. Now, begin the operation! Work quickly, but stay calm!"
"Understood! Let's begin the operation!"
"Oh, and do this right, and we can go for dinner, all three of us- my treat. We'll talk about it after this and the follow-up with Mr. Jenkins."
The bone-chilling cold of the operating room was only subdued slightly below the operating lamp above the team. Nurse Fulton spoke to them, "This will be a laparotomy. You'll need to open up his abdomen. You've done this before, so remember to stay calm. Disinfect the area and make your incision." As she finished her sentence, she handed Derek the gel and scalpel. Slowly he made his careful incision after having disinfected the guideline with antibiotic gel. The stomach was exposed to the surgeons, and the flaps of the incision were clamped open for ease of access.
"We're going to treat a tumor, but," she paused as a slight look of worry dashed across her face, "Hmm… His vitals are dropping." She turned around and walked to the cabinet, got a vial of green liquid out, and set it on the operating tray next to a syringe. "Use this, this is stabilizing gel. Using it should bring his vitals up." Derek took the syringe in hand and placed the applicator in the vial of viscous slime, pulled the plunger up, and then nervously placed the syringe in a vein near the stomach, afterwards pushing the plunger back down. Being so nervous, he had not filled the syringe completely.
"We should probably administer a little bit more," reassured Nurse Fulton. "Fill the syringe completely this time." Derek did as he was told and filled the syringe full of the sickly slime, "Now, stick it in that vein there, and pump all of it inside." As he did so, the level in the syringe dropped slowly. "Vitals are… stabilized."
"Now we can begin. At first glance, it looks like nothing is wrong. However, yesterday's test revealed something in the lower stomach. We will need to use the ultrasound to find the affected area…" Derek grabbed the oddly shaped device and flipped a switch on the side. On the top of the ultrasound wand was a small screen that showed what was being detected. As he scanned the area, the device communicated with a soft ping, ping, ping… "It was right there, I think," Nurse Fulton seemed slightly uncertain, but then shook her head as if reassuring herself, "I lost it because the ultrasound was too far away. If you scan directly over the tumor, it should be visible for a while. Expert doctors can perform this operation without visual aid, but you should confirm the location of the shadow first."
Ping, ping, ping… "There it is! Here is the scalpel! Now, make an incision over there," her words threatened to collide together as they flew out of her mouth like bats from a cave. Derek made the incision at the lower right edge of the stomach, and a tumor came into view. "Hmm… It's pretty big. Looks like we did this just in time. As Doctor Kasal explained, we'll be using the Powell Procedure. Pick up the drain and drain the cytoplasm of the tumor, don't move the drain!"
Derek flipped a switch on the side of the operating table, and the drain came to life in his hand with a whir. The plastic tube quickly filled with fluid from the tumor, and the tumor went from being oddly colored to a red like that of a bruise or irritated skin. "That's it! We have completed step one: Drain the cytoplasm. But, cytoplasm will continue to ooze out if we don't do anything. Excise it with the scalpel." Taking the knife in his hand, Derek cut around the tumor. The patch of cells came loose, and he removed it with the forceps. "Well done. You're doing well so far! But, removing the tumor is only the beginning. You need to apply a synthetic membrane to stop the bleeding. Grab one of the membranes with the forceps and lay it on the wound."
Derek did precisely as Nurse Fulton requested. "That's good. Now let's affix the membrane. Apply antibiotic gel to the membrane." As Derek applied the gel, the fibers of the membrane slowly sewed themselves into the fibers of the surrounding cells. "That's enough gel. The membrane is beginning to meld with the tissue. It's made of protein, so there's no chance it will be rejected. Massage it in to help the process along."
Derek took his gloved index and middle finger and massaged the membrane gently, it felt like leather against his touch at first, but slowly it smoothed out to match the feeling of the tissue around it. "Good, now seal the patient." He took the clamps out of the patient cautiously, and then sewed the flaps of skin that made the incision together. Working under the bright lamp had made sweat start to form on his brow. Nurse Fulton spoke gently, "You can relax now, Doctor Stiles. The operation is complete." There she goes again… I know it wasn't just me this time. She actually DID call me a doctor.
Doctor Kasal laughed, "C." The operating room was much calmer now, as if an air had been lifted from it, the only sound echoing through the room for a moment was the relieved breathing of the surgeons and nurse alongside the aided breathing of the patient, and the beeping coming from the electrocardiograph hooked him. "Nice work, Derek. It seems you value accuracy over speed. Just remember that the patient's safety always comes first."
"You're getting better every day. Keep up the good work!" Nurse Fulton had a huge grin on her face, no; a smile on her face was what Derek was seeing- a smile showing her beautiful teeth. An awkward silence floated through the operating room once more…
After all scheduled patients had been visited, including the check-up with Mr. Jenkins, two doctors and a nurse sat exhausted in the consultation room. Derek's stomach began rumbling, "So, Doctor Kasal, what are we having for dinner? I am starving,"
"Haha, me too. How about that new place on the city walk?" Nurse Fulton obviously wasn't going to let Doctor Kasal live this down, either.
"I guess I have no choice," shrugged Doctor Kasal, "What was the name of that new place again?"
"I don't even care, as long as it is Chinese I am good to go," Derek chimed triumphantly.
"My husband took me for Chinese last night! Let's get some Italian."
"How about since I am the one paying you guys will eat wherever I go? That only seems fair."
"No way, that wasn't the deal. You offered it as a treat if things went smoothly today."
"Derek is right, Greg."
"Doctor Kasal, not Greg."
"Oh, a name is a name. What do you think about Mexican?"
"No, that tears my stomach up," laughed Doctor Kasal, trying to bring notice to the irony.
"Can we just go to the city walk and see what's there? If I have to wait for food much longer I'm going to pass out," Derek appeared slightly exhausted.
"Whose car should we take? Oh wait, which is sort of obvious," Doctor Kasal smirked, "By the way, my shift is over- call me Greg."
The three of them walked down the hall out of the consultation room, having gotten cleaned up and changed into their 'street' clothes. Derek looked rather pleased with himself, Greg appeared slightly annoyed but well-humored all the while, and Nurse Fulton seemed to be contemplating the options for dinner in her mind. They took the elevator down to the first floor, and exited out to the ambulance bay in the west wing where Greg had parked his car. "I call shotgun," shouted Nurse Fulton as a gleeful expression drew across her face.
"I wanted to ride shotgun…"
"Derek, you can ride shotgun on the way back."
The gates to the hospital creaked open, and Greg drove his car through smoothly. The road was lit by street lamps, and the moon was high in the sky. They passed by a bus full of passengers, public transit 126, Derek noticed. His mind reflected to a television show he had seen recently where a trauma team had to operate on victims of a freeway accident.
"Hey, Greg, how often do you see patients from freeway accidents?" The car was gliding along the road when they came to a tunnel, the lights in the concrete ceiling overhead illuminating the inside of the car.
"Every so often we get a few. In the time I have worked at Hope we have had tons. Vehicle accidents are really common around here."
"There was this one night a few of the nurses were hysterical, and I saw trolley after trolley roll through; Derek, you wouldn't have believed it. It was a mess. One of the nurses knew one of the victims of the accident, and… Because she let her feelings get in the way… he…"
"He died, Mary. I was in the room when it happened. There was nothing we could do… Although the nurse certainly wasn't helpful with how upset she was. We calmed her down, but-"
"She was focusing on herself instead of the patient. After a while, Derek, she just broke down in the middle of the room and we had to have her escorted out."
"That is a lesson you are going to need to learn, Derek. Alright, we're here." Derek had a smile across his face a mile wide.
"So, there's a nice Italian place over there." The night rolled on as the three enjoyed one another's company throughout the laughter-filled the evening…
The following day, clouds continued to gather overhead as Derek was dropped off by a taxi near the gate of Hope Hospital. Derek was anxious to begin work today, ecstatic over how well he performed the previous day. He felt like he could climb a mountain and still have energy, like he could fly into space, like he had won the lottery, he was on cloud nine- he felt like a god. He pressed the button that signaled the desk clerk in the ambulance bay to buzz him in. The rusty gates slowly squeaked open, and Derek walked towards the west wing where the ambulance bay was.
Derek walked into the ambulance bay and greeted Nancy Fergwitz, the beautiful, blonde, German desk clerk who had buzzed him in, with a smile. He turned a corner, taking the elevator, moving in the direction of the consultation room. He poked his head into the familiar workplace and, quickly noticing that there was not a soul to be found, continued down the hallway towards the nurse's station. From the room he was headed towards, he heard a familiar voice grow increasingly clearer as he got closer and closer, "…And so, since my husband's been relocated to a different office," Derek walked into the room and analyzed the situation swiftly, his smile fading from his face. It was Nurse Fulton, as he had thought. "I'll be leaving Hope Hospital, effective immediately. I'm really going to miss this place, and all of you…" As she said that, she looked at Derek with a look of sadness in her eyes, the type of sadness you see a mother feel as she watches her child go to school for the first time. "But, I promise to continue my work as a nurse, wherever life takes me! You all taught me that helping patients is its own reward." Greg was seated across from Nurse Fulton, and it looked like he was ready to speak.
"It was a pleasure to have you on staff, Mary. Good luck with the new job." Derek was crestfallen as he took a seat next to Greg.
"I can't believe you're leaving. This is all so sudden…"
"What will you ever do without her, Derek?" Greg chuckled playfully, elbowing Derek as he finished his rhetorical question.
"…Actually," Nurse Fulton started, "Derek's the only reason I'm a little hesitant to leave…" she sighed, "I even spoke with my husband about it last night. I told him there was a kid here that depends on me… He asked me how long I'd been working at a pediatrician's! Ha ha!" Nurse Fulton laughed, her brilliant teeth sparkling in the light as she did so.
"Ah c'mon… I'm not that bad…" A deep, bass voice broke the silence after Derek finished his sentence, and it filled every corner of the room.
"Is Mrs. Fulton still here?" The speaker was an elderly man, obviously a doctor, Derek had never met before.
"Oh, hello Doctor Hoffman," answered Nurse Fulton. Derek immediately recognized the name, as it was his boss. He had never seen him, even when taking up the job at the hospital.
"I'm not interrupting anything, am I?" The doctor is Doctor Hoffman, or Robert Hoffman, who is 62 years old. He has crows' feet at his eyes, and his brow is heavily contrasted against the rest of his face. His white hair has had plenty of time to grow, and on this particular day, as with every day, he has combed it over to the right side of his forehead. The strands of hair make what looks like a curved, snowy wing pointing downwards. His beard is as white as the rest of his hair, forming a square around his chin and neck. He is the director and founder of Hope Hospital. On duty, he wears his double-breasted white lab coat with two black buttons, vertically separated by a space of one or two inches, on each side about four or five inches below the lapels. His ties are uninteresting, being solidly colored as they are. His choices of pants are equally, if not more so, uninteresting, being shades of neutral browns, blacks, and grays. He used to be a renowned surgeon, but works in management now.
"No, of course not, Doctor Hoffman."
"I came to say goodbye, since I won't be around tomorrow. Thank you for many years of dedicated service. You're a fantastic nurse," his brow furrowed above his silver spectacles, "Probably our best. On behalf of our entire staff, I'd like to say thank you."
"Oh… Sir, the pleasure was mine. I wish there was some way I could thank you for this opportunity."
"Well, you're not going to stop nursing, are you? If you continue to help people, then that will be thanks enough."
"Of course, sir! Helping people is my life. It's just," a pained look was drawn across her face for a moment, "I wish I could stay and learn from you a little longer."
"Don't be modest. You already know everything I have to teach. I am afraid Doctor Kasal surpassed me as a surgeon long ago."
"Doctor Hoffman," Doctor Kasal whispered in disbelief.
"Good luck with your new job. Don't be a stranger okay?" He paused and turned for the door, "Well, I have matters to attend to. If you'll excuse me…" With that, Doctor Hoffman walked out the door of the nurse's station.
"I'd hoped to see Doctor Hoffman in action more often, but he stopped operating on patients after that incident," Nurse Fulton seemed to be reflecting on an event. Doctor Kasal swiveled his chair slightly to face Derek.
"Derek, let's discuss the next patient."
"Yes, sir," responded Derek politely.
"This is my last operation here…" Nurse Fulton looked into Derek's eyes as a mother looks into the eyes of a child before they walk off to start school, "Don't let me down, Derek."
"Yesterday's operation went very smoothly. I want you to handle Mr. Spence's operation today. It's another tumor excision. Just be careful, there's more than one this time—don't overlook any," warned Doctor Kasal.
"This is the last time I'll be assisting you, Doctor Stiles. If you can handle this operation, I'll feel much better about leaving."
"…." Derek was silent, he appeared deeply saddened.
"Oh…" Nurse Fulton noticed the sadness in Derek's eyes, "I didn't mean to upset you," she paused and gathered her strength, "… but WAKE UP, Doctor Stiles! There's only ONE person you should be thinking about during an operation, and that's the patient! Do you understand?"
"Y-Yes, ma'am!"
"Let's review the main objective of today's operation: Excise and remove all tumors from the pancreas. Now, think back to yesterday's procedure, and begin."
"Here goes… Let's begin the operation!"
Derek disinfected the incision site, and cut into the flesh above the pancreas. After pulling the skin open and clamping it into place, the pancreas came into view. It was inflamed, and two small inflammations were sitting on the pancreas. "The pancreatic membrane is inflamed, so we'll need an anti-inflammatory. Use the blue fluid. That is the anti-inflammatory."
After pulling the plunger up on the syringe, it filled with a murky, ocean-colored liquid. It didn't really look healthy to pump into the body, but he jabbed the needle into the inflammations and they gradually went down. "Good, the swelling's gone down… Let's move on to the tumors. Three tumors have been identified in the patient's pancreas." Ping, ping… "Doctor, it was there, I saw it!"
"Here?" Ping…
"There it is!" Derek put the ultrasound wand down and picked up the scalpel, cutting the pancreatic membrane and revealing a tumor. He flipped the switch on the cart and grabbed the drain. Like in the operation before, a fluid was circulated through the drain as the tumor appeared to be irritated. He cut the tumor out, affixed a membrane, and moved onto the next one. Ping, ping… Slice, drain, slice, drain… "That takes care of the tumors we found in our test. You're really improving, can you tell? You seemed really focused today… I guess my work here is done!" Derek sealed the incision carefully. "I think we can both relax, Derek. You're doing great!"
"You did a great job, Derek. I have nothing to worry about. I can tell that you'll make an excellent surgeon. Please continue using your abilities to help the people of Angeles Bay."
The scene was pretty much the same as the day previous as Derek stood in the nurse's station, except for the large crowd of people sitting at the table in the room. Nancy was standing at the head of the table, "You have been instrumental in the care of the patients for many years here at Hope Hospital. Your dedication is profound, and we all have fallen in love with your motherly attitude and your compassion as well. I am speaking about Nurse Mary Fulton, who is going away. And so, we all feel you deserve a gift of appreciation. Thank you for your 18 years of service, Mrs. Fulton."
"Thank you so much… I'm a little embarrassed," replied Nurse Fulton. Greg stood from his seat at the table to speak.
"Mrs. Fulton was more than a great nurse—she looked after us, as well… She will be missed."
"Are you sure you're not glad to be free of my nagging?"
"What are you talking about? I'm worried Derek will start coming to work late again. You're the one who kept him in line, Mary," the room filled with laughter.
"…Ah geez… I'm standing right here, guys… You don't need to worry. I'll be fine without Mary's help. I may be young, but I'm still a doctor!" Derek spoke up for the first time, having come to terms with his title.
"That's good to hear," Mary looked very pleased, but then began to grin, "So, no more sobbing phone calls from you, huh?"
"Wh-What!? I wasn't crying!" Derek appeared surprised and suddenly defensive over her revelation of this fact to the group.
"I'm just teasing, Derek. You've grown up so much since you joined us and… and," tears welled in her eyes a little, "I'm proud of you. Work hard, and you'll surpass even Dr. Kasal, one day… I believe in you."
A nurse Derek didn't know spoke, "She's not here yet. She called in about an emergency—that's all she said."
"…Is something wrong?"
"They must be talking about my replacement. Since I'm leaving, she's going to be your new assistant. I was supposed to train her this afternoon, but… HR said she was very reliable… I hope everything's okay."
"Sorry I'm late! I'm Angie Thompson, the new nurse. I'll be starting here tomorrow." The young nurse spoke from the door to the nurse's station. She is 21, and is Mary's replacement. Derek was bewildered by how she wore her pink scrubs as he got an eyeful of the new employee. She wore black pantyhose on her slender legs that rose to meet the skirt of her uniform, and the skirt was much shorter than Derek remembered it being on the other nurses. In her arm she gripped a metal clipboard against her chest. Derek was surprised at how beautiful the fresh face was, her pointed chin was perfect, and her eyes were a majestic green. Her blonde bangs were combed to the sides, covering her ears from the front and coming down to her shoulders, the back of her hair ending at the mid of her back. She is part German, and was born into a very well-educated family. She also holds an International Nursing License. "Is Mary Fulton here? I'm ready to go over protocol now." Her voice was gentle, calm.
"It's very nice to meet you."
"Wow, she's a nurse? Isn't she a little too-?" Derek was cut off before he could finish. Angie walked into the room.
"What's that, now," Angie asked defensively.
"Wha- Huh? No, nothing… Pardon me."
"I was on my way here when a man on the bus suffered a heart attack. I took him to a nearby emergency room and helped with the procedure. Of course, the paperwork took forever to fill out, so… yeah!" Disappointingly, Angie was now shaping up to be a brat in Derek's mind.
"Sounds like you had a rough morning," Greg chimed in.
"Well don't you worry about being late. I completely understand."
Everyone from the meeting before had since filed out, and only Angie, Derek, Mary, and Greg remained in the room, when suddenly Nancy popped her head in the door. "Excuse me… Is Miss Thompson here? There's someone on the line from St. Francis Hospital…"
"Thanks, I'll be right there. Please excuse me…" Angie quietly exited the room, and the sound of her shoes clicking down the hall signaled the fact she was further, and further, and further from the room. It seemed safe, so Greg wanted to talk about the new encounter.
"She's certainly something…"
"It sounds like she knows her stuff. What do you think, Derek?" Derek was afraid to reply with what he really thought.
Derek found himself walking down the white hallway once again the next day, and opened the door to the consultation room. "Good morning."
"Hello, Doctor Stiles. You were supposed to be here fifteen minutes ago. Your patients shouldn't have to wait just because you're behind schedule," She was shaping up to be more of a stickler than Nurse Fulton ever was, even at her most annoyed with Derek.
"… Uh, I'm sorry?"
"Anyway, I'll call in the first one. Mr. Cox, the doctor will see you now." Mr. Cox walked in behind the nurse. "Please have a seat, Mr. Cox."
"Y-Yo, doc," Mr. Cox had his hand on his forehead, holding it as though he had a headache.
"During today's surgery, we'll be removing the polyp in your throat. How are you feeling? It's important for us to know about any changes to your condition. If anything's wrong, it could cause problems."
"I… I really don't know…"
"Huh?"
"I've been doing concerts for seven years, while working part time… So I finally land a contract with a big record producer… and my throat's screwed up. What if something does go wrong? I lose my dream forever? All because of this polyp thing?"
"W-Well, we're going to try our best. Just relax, okay?"
"You're going to try!? I… I always tried my best… I practiced late, stayed in shape… But if that's all I needed, I woulda' had a contract years ago! It takes a lot more than trying to write a hit single," Mr. Cox began to break down and sob into his hands.
"C'mon, try to stay positive. I'm sure you'll be alright. Really."
"Dex, Nate, Tisha… You fronted the money for this operation, and I let you down… It doesn't look like I'll be able to pay you back, guys…" The mood was very somber as Mr. Cox spoke to himself.
"I need to take your blood pressure, Mr. Cox. This way, please."
"Y-Yeah," Mr. Cox was still sobbing, visibly shaken, "Whatever…" He walked over to where the nurse had directed him, and Nurse Angie stayed behind. She appeared infuriated, ready to punch Derek at any moment.
"Why didn't you just tell him everything would be fine," she yelled angrily at Derek.
"Wait, what?"
"Didn't you read your own notes, moron? He's completely nervous! Our job is about MORE than just treating illnesses… Proper bedside manner is essential to a patient's recovery! Things you say directly affect these people's attitudes. Don't you get it!?"
"Y-Yeah… I do."
"I hope you're a little more serious during surgery this afternoon."
Nurse Angie stomped off to where she ordered the patient to go, presumably to take his blood pressure. It was early in the morning still, and the operation wasn't until noon. He took the chance to visit Mr. Spence, who was still healing from his operation the previous day. This is the perfect chance to try that bedside manner stuff.
"Knock knock. Guess who it is?"
"Is Nurse Fulton with you?"
"No, it's just me. I am the one who operated on you, Mr. Spence."
"Oh. What happened to Nurse Fulton?"
"Well, her husband was relocated, so she had to move away. We have a new nurse working here, though. I don't know what to do… She is so incredibly strict."
"Ah… My wife is like that, too. The most important thing to remember is that she is ALWAYS right."
"But… What if she isn't?"
"Well, she still thinks she is. And trying to change that would be like trying to turn a charging bull."
"So, basically, I can't win?"
"No. She will have to figure out on her own that she isn't always right. And when the woman has made a mistake, don't say, 'I told you so,' instead be there to fix the problem she has made. That's just how the world works." He started to laugh, and then coughed a bit.
"Good advice, and you might not want to laugh so much. But, gee, the time really flew by. Isn't it sort of odd how the clouds have been hanging outside for so long? They haven't budged an inch in days."
"I noticed. I was hoping to actually eat my lunch and take a nap… so…"
"Oh," Derek snapped his fingers as he remembered something important, "I have an operation to perform!" Derek dashed from the room and into the hall, nearly tripping as he turned the corner towards the nurse's station. In actuality, the talk had only taken about ten minutes, but it was half an hour until noon when he had went to visit Mr. Spence- Derek doesn't really check the time.
"Derek, you were nearly late. I have been expecting you! Where have you been?"
"Yes, Derek, where were you? Don't try telling me, 'I was doing my rounds, Doctor Kasal.'"
"I was practicing bedside manner."
"Oh."
"Oh. Good… But that isn't an excuse to almost be late! Now that you're here, we should start the briefing. Let's review today's patient, Mr. Cox. He started feeling pain in his throat about a month ago… He's been coughing up blood since then, and now has trouble breathing. Since Mr. Cox is a rock singer, it's likely that a polyp has formed because of strained bronchial tubes. Obviously, it is now hemorrhaging. We tried a nebulizer treatment, but his condition is getting worse. It's nothing life-threatening, but considering the patient's career… It's serious enough to warrant surgical intervention. It's still possible for him to recover completely. What's your opinion, Doctor Kasal?"
"That sounds like a good plan."
"Are you ready, Doctor Stiles? This operation has three objectives: Drain the overflowing blood, locate the problem area, and use the laser to remove it. This is a delicate operation, so we'll need the magnification tool. Remember to treat the patient very carefully."
"…Nice work, Angie. Derek, good luck."
"…Okay. Let's begin the operation!"
Situated in the O.R., Doctor Stiles stood over Mr. Cox as he was lying upon the operating table. Cautiously taking his gloved hand, he slathered antibiotic gel along the incision site on the patient, and then cut into it with the scalpel.
"Operating on the pharynx requires precision and the utmost care," Nurse Angie reminded Derek, as if he didn't already know. The edges of the incision were clamped open for Derek, and the affected area was revealed beneath the ultra-bright lights of the operating lamp.
"The outer membrane of the trachea has started to hemorrhage… That should be our focal point. It's hard to see the affected area, so we'll need to magnify it. This is a newer piece of equipment; let me explain how it is used. In your case, the device goes over your glasses. The zoom area is programmed to synchronize with your eye movement- simply train your focus over a specific area and say 'magnifier- zoom in', and to zoom out… You get the rest, right?"
"Thanks, Angie. Magnifier- zoom in." Suddenly, the area he was focusing on appeared closer up. Although it was at a very low quality first, it quickly refined and sharpened. "Is that lag normal?"
"I'm not claiming to know much about the advanced computers nowadays, Derek," Doctor Kasal explained, "But I believe that, yes, that lag is normal."
"First, we need to drain the blood so the polyps are exposed."
Derek set to work, "Angie, flip the drain please," Derek requested as he was handed the drain. The drain hungrily sucked and was filled with blood that circulated out of the affected area.
"The source of the bleeding seems to be a small group of polyps. But, there's no way we can excise them—they're too small. Use the laser instead." Derek found the drain in his hand taken and a thin, metallic cylinder with a button on the side and a glowing, blue point on the tip violently shoved at him. "The laser will continue to burn until you lift it away. But, applying it for too long may cause additional bleeding. Please be careful to precisely apply the laser only where necessary. Let's begin. Slowly burn away the polyps."
There were seven polyps total, and one by one Derek methodically aimed the laser, pressed the button, zapped the bumps, and applied antibiotic gel for them to heal. As he tried burning off the third consecutive polyp, hemorrhaging occurred. "Hmm… I don't think it's possible to burn away polyps without damaging nearby tissue. The capillaries in the trachea's outer membrane are damaged, and have caused further bleeding. You're going to need to adjust the procedure accordingly. We need to apply antibiotic gel immediately after using the laser. If blood starts to collect, drain it quickly to maintain visibility. Stay calm, Doctor Stiles. If you're careful, everything should be fine."
A few moments later, Derek had zapped away the other four polyps, and Nurse Angie had to speak her piece, "All the polyps have been removed. It… could have gone better, but I guess it's not too bad, for you."
Did she just insult me again? Geez.
"Another section of the membrane is starting to hemorrhage!"
"Magnifier- zoom out," the area quickly returned to its original size, and the entire affected area was visible once again. This time, it was the upper membrane that was hemorrhaging.
"It looks like there are several other polyp-affected areas. We'll need to treat all of them."
Derek honed his eyes on the upper membrane, and simply spoke, "Magnifier- zoom in." The area in question quickly appeared closer after a short amount of image refinement and sharpening. The next area was drained, and there were only six polyps in the upper membrane. Skillfully, Derek took aim and operated the laser to obliterate the polyps, applying gel each step along the way. "Magnifier- zoom out." He focused on the lower membrane once more, "Magnifier- zoom in," and his high-tech device did so after the short bit of lag he had had to wait through twice already. Derek took the drain in hand and deftly drained the blood, only to reveal a massive amount of polyps- numbering around ten or fifteen, Derek guessed just by sight. After he had burned off six of them, he was told to wait by Angie.
"Doctor Stiles! The patient's vitals are critical!"
"Magnifier- zoom out." Derek quickly maneuvered his hands, grasped the syringe, and filled it with green stabilizer, plunging it into the patient and sending the vitals back up. "Magnifier- zoom in." He burned off the remaining ones, only to be alerted to another problem location- the upper membrane again. Then finally, after two more rounds of this, Angie was satisfied that that was all of the polyps.
"…That seems to be all of them. Let's close the patient up. Suture the incision."
"Magnifier- zoom out." Derek sutured the incision closed after the clamps were removed.
"(…So I've really been assigned to this inexperienced guy…?) Er… That is, good job, Doctor Stiles."
"Yes, I would say that earns you an 'A', Stiles." After Mr. Cox had time to recover from the operation later in the day, Derek decided he should go to visit him. It was about three o'clock by the time Derek walked into his room.
"Well, Mr. Cox, your operation was a complete success!" Derek's closed eyes appeared to smile along with his mouth as he was overjoyed with his gain of an 'A' from Doctor Kasal.
"…uh…"
"Don't try to speak yet—your throat needs a little rest. Don't worry, though. In a few days, your voice'll be as good as new. Maybe you could hook me up with tickets to your concert? Heh heh…" Derek laughed a little to himself at this thought. Angie on the other hand, did not think it was so funny.
"…"
The next day…
Derek had just finished seeing his last patient as they said, "Thank you so much, Doctor!"
"Take care, now. Well, that looks like the last walk-in for today… Angie, let's begin pre-op at around one o'clock, okay?" Angie appeared displeased.
"Don't you think we should have examined him more carefully? There were signs of cyanosis, which could indicate asthma. If that's the case, he needs to see a physician right away."
"…Really? I didn't think it was anything serious."
"You need to start acting like a real doctor, Mr. Stiles!"
"You're overreacting… I'm sure he'll be fine."
One o'clock finally rolled around, and it appeared that Doctor Kasal was absent. Derek felt unsafe, at the mercy of Nurse Angie the Brat as they both sat at the table in the nurse's station. "Since Doctor Kasal is at a conference, I'll be briefing you today."
…I think you'd be briefing me even if he was here. Derek grimaced at the thought of having to deal with this for the remainder of his career.
"We're extracting a stage 1 tumor from the small intestine."
"So… If we take it out, the patient will fully recover."
"However, the blood test results were… unusual."
"We can ask Doctor Kasal about that once he gets back. If I extract the tumor, he should be fine."
"That's technically correct, but—"
"I'm pretty confident. I've extracted tumors several times already. This'll be a snap."
"…Okay. Keep the two operation objectives in mind, then: Treat the inflamed epithelium in his small intestine and excise and remove all tumors in the small intestine. If you're ready, let's begin."
"Let's begin the operation!"
Yet again, the heat radiating from the lamp overhead was not helpful for the young surgeon. He steadied his hand along the disinfected incision site on the patient's lower left abdomen, and Nurse Angie held open the flaps of the incision with clamps. Angie let out a girlish shriek of surprise, "What is this!? The entire intestinal membrane is inflamed. What's going on? Only the small intestine should be affected… Doctor, I think we need to close up the patient and re-examine him."
"Let's continue operating, Angie. Those symptoms aren't uncommon," Derek explained through his surgical mask.
"…I understand… In that case, proceed with tumor excision." The only difference between the other tumor excisions he had performed and this one was the fact that he was operating on the intestines and that the entire area was covered with inflammations. This called once more for the murky, blue liquid to be sucked into the syringe and pumped into the inflamed sites. "I know you've done this before, so I'll try to stay out of your way." One by one, Derek injected the anti-inflammatory into the inflamed areas. The areas reduced significantly at this. "Treatment of the visibly inflamed areas is complete, but…"
After he made his incision to reveal the tumor found by the ultrasound, he grabbed the drain and sucked away the tumors cytoplasm. "The Powell Procedure, huh? You must be studying the latest procedures." It was as he said- a snap. "The first tumor's been excised. At least we're making progress." Moments later, he cut out another tumor… "Doctor Stiles, the second tumor's been excised, but… something's not right." Eventually, a third, and then the fourth and final tumor was removed. "We treated the patient as planned, but he's not improving. His vitals aren't stabilizing. There must be something else—"
"The patient's vitals don't usually stabilize right after the operation."
"…But…we need to at least check his blood test results!"
"…" Derek was silent, wondering whether he should take Mr. Spence's advice, or just keep pressing. Mr. Spence's advice won over. "Hm, okay… What would you suggest?"
"Try using the ultrasound again… Just to be safe." Ping, ping, ping… "Check the entire area carefully." Ping, ping, ping, ping… "…" Ping, ping, ping…
"I don't see anything, Angie."
"But I was certain… Sorry for second-guessing you, Doctor."
Thank you so much, Mr. Spence… "Don't worry. We're both still learning from experience, right?"
"…I guess. You should finish up by suturing the incision." Angie removed the clamps from the patient, and with suture in hand Derek sewed the incision closed. "We're finished, Doctor Stiles. I've decided to take up this grading thing, too. I would give you a 'C', Doctor."
Derek was filling out a post-op report in the nurse's station when suddenly Angie walked in, "Doctor Stiles…"
"Oh, hey Angie. Thanks for your help in there."
"I'd like to have a word with you about that last operation." Derek took this opportunity to be sarcastic, however unwise it was.
"Hmm…? Was there something wrong with my bedside manner?" Angie didn't seem to notice the sarcasm, however, so Derek dodged a bullet.
"No, it's about the patient, actually… His white blood cell and globulin counts are rising rapidly. I also noticed inflammation along the patient's peritoneum… We should re-examine him immediately and consult his regular doctor."
"I agree with you… But I'm afraid it'll have to wait until tomorrow. I'm sure he'll be fine until then. I'm supposed to help with the next symposium, so I'm meeting with some of the doctors from St. Francis's to learn the ropes and everything."
"But—"
"These are very busy people, and I can't just blow them off… We'll do it first thing tomorrow, though, okay? I promise!"
"But…!"
It was evening, and the doctors from St. Francis wanted to talk to Derek more at the Citywalk…
"…Too bad I have work tomorrow. I would've liked to talk a bit longer. Oh well, at least now I'm ready for that symposium thing!" Ring, ring, ring… "Hm…? Oh, my cellphone!" It was Angie's voice on the other end when Derek answered.
"Doctor Stiles! Where are you!? The patient is in critical condition! Get back here!"
"…What!?" Derek's expression suddenly changed from excitement to shock to seriousness. "T-Taxi! Take me to Hope Hospital, and step on it!"
When Derek arrived at the hospital, the taxi dropped him off at the front gates. Nancy buzzed him in, and he rushed inside, into the elevator, and down the hall to the nurse's station. He was out of breath as he stood in the doorway, "Angie," pant, pant, "Where is the patient?" Angie's face appeared dark, seething with a silent rage.
"A tumor metastasized behind his lungs, which began swelling… It festered, and half an hour ago, the tumor ruptured… The patient is in shock, and suffering acute peritonitis… The other doctors are operating on him as we speak. Follow me, Mr. Stiles… You need to see the result of your carelessness!" Derek was mortified at his grave mistake. His choice nearly caused someone's death! He followed Nurse Angie to the room the patient was being operated upon in, and he saw doctors working quickly to stabilize him. Doctor Hoffman walked to the room, seeing Derek at the door.
"Mr. Stiles, I wish to see you in my office for a word." The tall elderly gentleman led Derek back down the hall, and up a set of stairs. They made a turn into a small office, and along the walls were small rectangular windows, but behind Doctor Hoffman's desk was a larger window. Derek noticed that there was a Master's Degree in Osteopathic Medicine and a Master's in Administrative Health. Doctor Hoffman went and sat down at his desk. He cleared his throat, "I understand you didn't have much information to base a decision on… and I do admit the tumor was difficult to see from the X-ray. However, the laboratory left you several memos about the patient. I understand they pointed out his extremely high numbers." Doctor Hoffman had papers in his hand, his glasses on the end of his nose as he perused the laboratory documents he was speaking about.
He furrowed his brow, and removed his glasses as if disappointed and agitated at once, "…More than that, you dumped your responsibilities onto a nurse immediately following a very delicate operation."
Derek had not taken a seat, and simply stood there, dumbfounded, struggling for an excuse to alleviate his guilt and embarrassment. "It wasn't… I mean-" Derek heard Nancy's voice from behind the door.
"Ms. Thompson, WAIT! What are you-!?" Angie threw open the door angrily.
"Please excuse me for interrupting, Dr. Hoffman… I understand this is a little rude, but I have to say something."
"…What is it?"
"It's about… the negligent attitude Mr. Stiles has displayed thus far. I warned him about this patient at least three times, but he said that there were important personal matters he had to take care of. Then he just walked out, without another word. Mr. Stiles… Maybe you didn't harm the patient directly… But..." Angie's voice rose with her anger towards the attitude of Derek, "How can I work under a doctor who doesn't even try to act like one!? It doesn't matter how small or groundless a suspicion might be… the patients are depending on you to take care of them!" Her eyes flashed with glints of rage, "Why did you become a doctor? Do you even know!?" Derek was unable to form coherent strings of words to make a sentence as heat flushed his cheeks and ears in humiliation.
"I—That is, I…"
"You don't deserve to be here! You… you're not a real doctor!"
"…!" Derek was utterly devastated with guilt and he went to the Citywalk to clear his head. "I really screwed up… I… ignored a patient… I was trying my best… I didn't think it was anything serious… But, a patient almost died—and it was all my fault… Being called 'Doctor Stiles' doesn't make me a good doctor… What was I thinking? I'm no doctor… Not if I keep making mistakes like that." A man was putting things away near Derek on the sidewalk, his friend helping him. Derek overheard their conversation. The girl was the first to speak.
"It looks like the clouds are still hanging there…"
"Yeah, it looks like rain." Another person popped out of the front doors to the store.
"Hurry up, you two! We need to get all our displays inside!"
"Rain… Maybe that'll help calm me down," Derek spoke to himself, "Maybe then I'll feel better." The rain started pouring down out of the dark clouds in the sky, the same ones that had been hanging there a week ago. Derek soon was drenched, and one of the workers putting away displays noticed him.
"S-Sir? It looks like you're completely soaked… Did you come from a hospital? You might wanna' head back pretty soon."
"…They don't want me there. I'm apparently useless as a doctor, anyway…" The man got a call on his cellphone, and he reached to answer it.
"Hey! Yeah, it's me. You'll never believe this… Huh? Well, you can guess if you want…. Nope. It's even better! There was this crazy accident with a bus and an SUV—it was nuts! The drivers flew into the street, and… huh? I am not messed up!"
"…An accident? We usually handle emergencies… but Doctor Kasal's out of town," Derek had a sudden realization, "…That means there aren't any emergency doctors on call!" "Taxi! Take me to Hope Hospital, and step on it!" He met Nancy at the front gate, "There was an accident on the freeway, and so I directed them here! Where are the patients now?"
"Hurry to the nurse's station! No time to explain to you!" Derek dashed up the stairs, not taking the time to wait for the elevator to reach his floor. He sprinted down the hall and nearly slid past the nurse's station, but gripped the door frame and pulled himself inside. Derek's face was serious and cool.
"Where were the accident victims taken, Angie?" Angie was crying, hysterical about something that had happened.
"Doctor Stiles… The patient… He was suffering cardiac arrest, and… and… I couldn't resuscitate him! The other nurses are busy, and… With Doctor Kasal gone, I can't…Wh-What am I supposed to do? The patient is going to die! But, I can't… I can't even…" The situation was critical, and it appeared incredibly bleak from the way Angie described. Derek, however, was not deterred.
"Calm down! Take me to the O.R."
"O-Okay…"
"What's the situation?"
"After the accident, the ambulance brought him here… his heart isn't beating… I tried reviving him, but—" It was obvious that the patient had been this way for a while now, and the bloody, motionless body on the operating table under the familiar high-intensity lights seemed dead.
"Angie!" Angie was hysterical, bawling with her fist over her mouth.
"What do I do…!? I need help! I… I…" It was Derek's turn to show his rage.
"Angie!" Derek's voice shook her to the core.
"D-Doctor Stiles…"
"The only person here who needs help is the patient! And we're the ones who are going to help him! It's up to us, and only us. We're going to save him! I can't do this without you, Angie. I want to save his life. Pretend this is a normal procedure. Calm down, think things through."
"…F-First we need a pulse… We have to get a pulse."
"Understood! Let's begin the operation!"
"W-Well, h-he's flatlining! We have to do something…! W-We need to recover his pulse. Apply antibiotic gel along his chest area." Derek's hand dove into the container of gel like an eagle to prey, retrieving a perfect amount. He touched the gel to the patient's chest… "Try massaging the heart…" Derek rubbed up and down the patient's chest, applying pressure every so often in the rhythm of a pulsing heart. The electrocardiogram jumped back to life from a flatline to a painfully slow beep. The patient had just barely been resuscitated. "Th-There's a pulse… We did it! (That… Was amazing…) Vital's have reached low 30's…! But, he's not in the clear yet." Angie had finally gathered her composure.
"…That sounds more like the Angie I know."
"Doctor Stiles… Are we going to save him?"
"Of course we are."
"…Understood! First treat the wounds that have started bleeding." Along his chest were many deep lacerations, some with shards of glass protruding from them. He took the suture and sewed the three large lacerations closed, and then rubbed antibiotic gel along the three smaller wounds. There were four shards of glass embedded within his epithelium, and Derek easily removed these with the forceps, afterwards dabbing antibiotic gel onto the now empty holes. "External wounds have been healed. Bleeding seems to have stopped, but his vitals are dropping fast! He suffered a lot of damage to his chest… What else could it be? Perform a lobectomy! I think there might be something in his chest!" Derek disinfected the incision area to gain entry to the thoracic cavity, and the heart was revealed to him after Angie clamped the incision open. There were seven shards of glass stabbed in his still-beating heart. "…No… You can't-! Don't take this the wrong way… I don't think you have the skill to treat it like this… We recovered his pulse, so maybe we should wait for Doctor Kasal's help… No, the longer we wait, the lower his chances at survival… I-I don't know what to do! Either way, I won't blame you… This is your decision."
It was imperative that Derek's hands not falter. Derek took a breath, and focused on the area at hand. He grabbed the forceps, and then quickly extracted a shard of glass with one hand, and applied antibiotic gel onto the wound with the other. "It's alright, I trust you…" He removed another shard of glass and applied the gel. "Be careful around the pericardium… We're fighting against blood loss!" Soon, there were only three shards left. "No problems… Continue treatment." Finally, all the glass shards were removed from the heart. But the patient quickly went into cardiac arrest. Derek had to massage the heart directly. "We have a pulse! Wh-what the hell!?" Suddenly, a large horizontal laceration tore through the pericardium of the heart as an obtuse glass shard revealed itself. "How could something like that be lodged in the pericardium!?" Derek removed it and sutured the cut closed.
The heart began to quiver and shake as it erupted into hemorrhaging all over, and the entire myocardium of the heart was bisected vertically. "This is bad…" Derek focused harshly on the area before him, and his hands tensed. He felt his vision flash, and the world around him seemed to slow. Colors faded from view, and what was in front of him became grayscale. "Dammit! Don't die on me!" In a blur, Derek sutured the vertical laceration closed.
(H-He sutured the myocardium in a split second!) "I… I think we're finished. Let's close him up." Angie removed the clamps from the patient, and Derek sutured the incision closed. "I could feel him slipping away… I was so scared, Doctor. I froze, and all I could think about was running away… But you didn't worry at all. You stood your ground, and did what had to be done. You… You are a real doctor," for the first time, Derek saw a smile flash across Nurse Angie's face, "Thank you… Doctor Stiles."
"I've never felt that way before… I'm starting… to understand. His condition's stabilized. Let's keep an eye on him."
"Yes, Doctor."
"We need to contact the other doctors, and—"
"I'm way ahead of you. Most of the off-duty doctors are coming in. I also called Doctor Kasal."
"Good work… Thank you."
"I think you should rest. That was a long surgery…"
"Yeah… If it's okay, I think I will. Angie…"
"Yes?"
"…Everything you said this morning was true." Angie was silent. "But… I'm going to stay here as a doctor… I'll try harder… I'll become a better surgeon, and make you proud."
"…If that's the case… Don't come to work late, and don't leave without doing your paperwork."
"…I'll do my best."
"And, there's one other thing…"
"Huh?"
"Please fix your hair before coming to the hospital… Sometimes it's embarrassing to work beside you."
"Heh… I'll be more careful," Derek yawned, "Okay, I'm taking a nap. Wake me up if anything changes."
"I understand. Have a good rest… Doctor Stiles."
Chapter Two- Healing Touch
Derek wakes in the consultation room, glances at the ceiling with bleary vision for but a moment, shoves off the covers that were over him, and swings his legs over the edge of the bed. He steadies himself with his hands upon his knees, and slowly rises to stand. He rubs his eyes, yawns, and then he realizes the hospital seems to be empty. Giving the room a once over, he walks to the work desk littered with different papers, pens, and pencils.
The lab chair is cold as he sits upon it, and the light from the desk lamp hurts his eyes as he glimpses it at his side. Swiftly, his hand lunges at it and dims it down to a level where it doesn't hurt quite as much. The pain from his eyes being blinded by the light fades, but as it does, the memory of what had transpired in the operating room only seven hours ago replaces it. What the heck happened during that operation? It almost felt like time was slowing down… Did I really do that? I knew exactly what to do, but I don't know how I knew that… Ugh… Now I am just confusing myself…
Doctor Kasal's voice shattered his thoughts as it penetrated his mind, "Derek! Pay attention!"
"…Huh? I-I mean, I was."
"Stop daydreaming, and start taking your job seriously!"
"I'm sorry."
"We need to have a meeting about Mr. Pratt's operation.