PST 18:47:07
It is only when they reach the operating room that they discover the extent of Bella's injuries and immediately get to work on her fragile, broken body. These doctors have their work cut out for them this evening and they won't stop until they are successful in saving Bella Cullen's life.
From behind the operating table doctor Gerandy peers up from behind his goggles at his surgical staff. They are all very much aware that every life that comes through these doors is precious and that the care they can administer is time sensitive. For the woman spread before their them, ready to receive their efforts, this has never been more true or hit closer to home.
The damage caused by the now removed rebar to her internal organs is extensive. The team of surgeons directs the staff around Bella's small mangled form with poking and prodding. There are multiple injuries and as they are ticked off by the surgeons, a nurse in the corner is furiously typing them into the tablet she carries with her like a lifeline.
Quickly, a deep rooted tension builds within the room.
As her injuries are cataloged, the doctors observe the most critical and time sensitive. These are the injuries that need to be tended to more quickly than the others. The most important being to her face and skull.
However, there are so many that it seems too difficult to distinguish which is more important or life threatening than the other. This is where years of experience come into play. Where Dr. Gerandy's gut reactions are marked as failures or miracles.
As the staff treats and drains Bella's collapsed lung, another small group is working on setting her broken femur into a splint; she is fortunate enough that the break had not severed her femoral artery.
At least she was able to dodge one bullet in this mess.
Apart from those, her shoulder has been dislocated and her right arm broken in two places. She's ascertained multiple cuts, abrasions, and lacerations from both the impact and the rescuing first responders of the fire crew who cut her helpless form from the wreak.
Her external injuries look much worse than they are potentially, and in the long run, those can be treated with time. Her internal injuries however, are an entirely different story.
Doctor Gerandy knows that a rigidness of abdomen can only mean one thing, despite the that she's bleeding out. That's the least of their problems, because her face is beginning to swell at an alarming rate and that fact alone is stirring the panic within him.
They are still waiting on their neurological consult to appear with the CAT scan results. The films should be in the hands of Dr. Wagner by now. Unfortunately, he has yet to show his face.
The obvious signs of swelling in her head and face and now more predominant. would like to know now, if they need to operate to relieve the pressure building around her brain. Time is precious and as he stares down at Bella, he grows frustrated and angry. There is no time to lose here. The longer they wait, the potential brain injuries Bella may have sustained can grow into much larger problems. If they don't relieve the swelling near her brain, things will get much worse for her.
"Where the fuck is Wagner!" Dr. Gerandy growls.
Looking around at his staff, they blink at him in a sudden shock.
Dr. Gerandy never curses.
"I'll have him paged again." A mousy nurse with curly brown hair that spills from the sides of her surgical cap answers. Before she steps toward the phone in the operating room, Dr. Gerandy speaks up.
"While you're at it," Dr. Gerandy voice rumbles in rage. "Have them page me someone else, too. I will not lose Isabella Cullen on my table because that jackass can't answer a fucking page!"
The room is silent as the tension within it builds.
"I need to open her up." Dr. Gerandy decides after a tick of the clock, his eyes flicking up to the surgeon standing across the table offering his assistance.
A nurse on his right steps in and slathers Bella's chest and belly with a sticky orange solution, before she reaches over and punches a thick plastic tube into the side of Bella chest, directly under her armpit. The second it's in, a steady suction of blood and mucus rattle down the tube and into a clear bag that gathers it.
As doctor Gerandy makes the first incision into Bella's abdomen, his eyes never leave his work. By the time his team has placed in the spreader bar, clamped her arteries, and pushed and tucked her major organs carefully away, they begin their efforts to save Bella.
Doctor Gerandy reaches in and clamps off Bella's damaged spleen, before making a few cuts into her soft tissue. The damaged organ easily gives and then a flow of blood fills her chest cavity. Realizing the problem, Dr. Gerandy quickly searches for the bleed.
"She's loosing too much blood," he murmurs, as a scrub nurse leans forward and dabs his forehead with gauze to remove some sweat.
Doctor Gerandy is frustrated, but calm and cool. He's been a trauma surgeon for eighteen years. No one in this hospital is a match for his skill, a side from the Chief of Resident's, Doctor Carlisle Cullen.
"Order up two more bags of-" Doctor Gerandy glances sidelong at the charts laying out for him at his far right. "Shit! She's AB neg, call down to the lab and have them push up two units ahead!" He barks.
AB negative is a rare blood type. Only one percent of the population carries the blood type. Although Bella can receive a transfusion of Negative O, (which is in plenty of stock, considering O is considered a universal blood type). However, Doctor Gerandy is not taking any chances. If the hospital has AB negative in stock, Bella will get every last drop that they have. Right now, in this hospital, Bella is his number one priority.
He knows it will be a miracle if she survives this.
As he works, he starts to think of the Cullen's and how they will react to the news of Bella accident. The absolute last thing he needs in one of the Cullen men barging into his OR.
After a moment of nips, tugs, and sutures, Doctor Gerandy peers up from his work for only a moment. " Janet," he shifts his eyes to his head nurse who is stationed at Bella's head. She is focused intently on Bella, stoking her hair gently and whispering encouraging praise. She's so focused, she hardly hears the doctor address her. "Janet," He tries again. Janet is poised next to the anesthesiologist who is keeping Bella sedated and comfortable. At the second sound of the doctors voice, he gives Janet a gentle nudge. When Doctor Gerandy finally has her attention, he begins to speak softly.
"I need you to discreetly walk down to both Edward's and Carlisle's offices, see if either of them are still in the building."
"Yes, sir." Janet mutters politely.
"And Janet," he calls to her as she goes, now focused solely on the open chest cavity in front of him. "I want a security detailed staged in front of these doors. No one besides the surgical staff is admitted in here."
Turning to meet his eye, she nods. "Yes, sir."
Before she steps away from Bella, she affectionally touches what used to resemble the apple of her cheek, but is now too swelled and bruised to identify. "Stay with us, sweetheart." She whispers, and then turns toward the door, where she strips off her blood spattered surgical gown and gloves.
Before she steps into the hallway outside of the OR, she can already see Chief Carlisle Cullen just down the hall. When she sees his face, clear of all worry and unease, she knows that he hasn't been alerted to his daughter-in-law's accident, or her current condition. She watches as he smiles at a nervous staffer as she practically flees from him.
Carlisle seems oblivious, as this behavior is normal among his staff; especially the younger, newer nurses. Carlisle is devilishly handsome and equally charming. Though he never strays from his wife, he was well known for his friendly flirtatious behavior. All the girls ate up his attention and all the men looked up to him. Not because he was such a ladies man, but because he was an amazing physician and a wonderful colleague to work beside.
Janet feels frozen as she watches Carlisle approach the surgical board. She wonders what will happen the moment he sees Cullen, I scribbled in the space for trauma #3.
Quickly, she hatches a plan in which she hopes to distract him. Unfortunately, she's too late.
It's then, everything seems to happen all at once, because it's just to late for anything Janet could possibly carry out. These events are in motion, and like an out of control freight train, there's just no stopping them now.
Faster than she thought it could happen; Carlisle is glancing across the dry erase board, reading the patient's names, surgery, and surgical teams.
The elevator behind him opens up to reveal a disheveled and panicked Doctor Wagner, clutching a set of films.
Then, behind her, all of the machines have sounded in alarm. Bella's blood pressure has just bottomed out. She's gone into cardiac arrest, and the rules of the game have officially changed.
Doctor Gerandy knows that now to save her life, they'll need to crack her sternum and break her ribs. Her most vital organ will be as his mercy as he fights to keep her alive.
It only takes Janet a moment to spring into action. She whirls back into the OR, grabs the phone and asks that security be sent up immediately. Next, she turns to Doctor Gerandy to alert him that Carlisle Cullen is on the surgical floor and that Dr. Wagner is just at the end of the hall.
All eyes are on her.
"Keep him out of this OR until security can get here." Gerandy snaps, his eyes never leaving Bella's vulnerability as he works feverishly.
With a heavy breath, she turns from the OR just in time to see Wagner running a full court press up the hall and past Carlisle. When he gets to the doors he slips past her and rushes into the room to scrub in and join the team helping Bella fight for her life.
For Janet, it feels like time stops as she watches Chief Cullen turn to the white erase board in question. Obviously, he knows that Doctor Wagner runs for no one.
Then, it' like lightning.
Stunning, sharp, and bright.
Carlisle Cullen has found the name under trauma #3 and Janet has never see him so pale in the fifteen years that's she's known him. It takes him a moment, but when he does recover, he's breaking into a sprint up the hall towards her.
With a heavy heart and squared shoulders, she steps out from the sliding doors and takes a deep breath.
When Janet readied herself for her shift earlier this afternoon, she hadn't been prepared for what awaited her at Northwest Memorial on this night. She'd had no idea of the grueling night that was set before her, and she was definitely not prepared to have to prevent Carlisle Cullen from coming into this OR.
But she will, even if it costs her a place as an employee here at Northwest Memorial.
