FireCacodemon: As promised, I'm back with another chapter of Trauma Center: A Pathogenic War!
Derek: Trauma Center Second Opinion/Under the Knife belongs to Atlus.
FireCacodemon: Well, on with the next chapter.
Chapter 11:
Thrombi Detected
Fresh week at Hope Hospital and Derek was looking forward to it. He had spent a good few minutes trying to get his hair tamed but it just wasn't happening. He just hoped that Angie was going to accept his effort instead of just feeling embarrassed about working with him. Derek wasn't sure what was up with Gemma in the morning, she had managed to get into his sock draw and covered his socks with her fur and scent. If any patients had cat allergies then he was going to have to pass them to someone else. Not something that he wanted to do but the patients came first before his own feelings. Walking through the doors of Hops Hospital, Derek was greeted by Angie and a fresh cup of coffee. Taking the cup Angie looked at Derek's hair and frowned.
"Before you complain, I spent a good five minutes trying to tame my hair and it didn't work," Derek told her.
"Five minutes isn't going to tame anything, try a good thirty minutes," she gently shook her head but smiled none the less. They both went to get changed into their hospital uniform before they could even start their job today.
"Stiles, Thompson, over here please," Greg called to the two as they both walked onto the ward. Looking at each other confused for a second the two of them made their way over to Greg. Seeing as Greg had a smile on his face both of them had an idea on what was going to happen. "I'm going to hand you Mr. Pratt operation. Angie, can you prep the OR for that?" Greg asked Angie.
"Yes sir," Angie nodded and left to prep an OR for them. Derek watched Greg before he was handed a file. Derek opened up the file and started reading the patient's notes. He was going to be operating on a man called Jesse Pratt, there was multiple thrombi present due to a waste blockage so immediate removal is required.
"Why am I receiving this?" Derek asked Greg.
"Because after the way you handled the emergency operation, you've clearly shown that you are capable of more challenging operations. You should be happy, this isn't something I'd give to just anyone." He smiled, Derek remained suspicious.
"The room is ready," Angie had returned before all three of them walked towards the briefing room.
"We'll be operating on Mr. Pratt. He's been suffering from dizziness and nausea recently. From the tests it shows that wastes accumulated in his spleen, and are now blocking a few blood vessels there. So today's operation will be the removal of the thrombi which is building up. We administered a contrast medium about thirty minutes ago in his IV so you should be able to find the waste using the ultrasound. You'll need to look closely so magnification will be used too. Once the shadows of the waste show up, try clipping the nearby area with the forceps," Greg said.
"Then once the area is clipped, the thrombi won't be able to move so an incision will be made before draining out the thrombi?" Derek asked and Greg nodded.
"You're really showing how much you picked up in med school," Greg couldn't help but smile as Derek started to shine. He didn't have anything to worry about but he'll still be there assisting Derek so that if something did go wrong, he could easily take over and make sure the patient survived. "Oh, before we do this, I need to speak to you after the operation Derek." Derek nodded; he hoped that it was the test results from another hospital.
"The objective of this operation is to remove all thrombi in the vessels," Angie reminded Derek. "Be careful too, if further waste blockage occurs, the patient's vitals will drop."
"Remember to work quickly, but with precision," Greg also reminded Derek. Derek didn't need to be told twice on how he should handle the operation. If he really wanted to impress Greg, he would try and remove them all together or near enough as close as together as possible. That wasn't going to be the case this time, much like the tumours which oozed out more cytoplasm before he could cut them out. He didn't want to try and remove everything at once; instead he was going to focus on getting most of them out while keeping an eye on other thrombi. As long as none escaped from him as well as checking the vitals then everything was going to be good. Smiling, Derek struck the pose.
"Let's begin the operation!" He demanded before they all walked into the OR, all scrubbed up and in the correct gear. All the equipment had been sterilised and ready to be used and Mr. Pratt was placed under anaesthesia. Everything was ready for the operation to take place.
Trauma Center: Calm before the Storm – Chapter 11: Thrombi Detected
Mr. Pratt's vitals were at eighty and the test results weren't good either. The spleen needed treating right away. Grabbing the antibiotic gel, Derek disinfected the area before making the incision and opened up the patient. It wasn't long before they had full vision of the spleen and the five to six vessels they needed where the thrombi was going to appear.
"The contrast medium is working well. We've confirmed the problem area," Angie said. She continued shortly after. "The thrombi causing the vessel blockage are originating here. Dr. Stiles, please work carefully. Here's the magnification tool so that you can view the vessel area." She handed him the magnification tool. He moved it over the spleen and it wasn't long before he could clearly see what he was doing.
"Ultrasound please?" Derek asked and Angie handed over the tool. He searched around with the ultrasound and he grabbed the forceps not too far away and clipped where the thrombi were located. "Scalpel?" Derek asked and Angie handed him the scalpel. "Please get the drain ready as I'll be needing it very shortly," he told Angie and she nodded. Once he made the incision on the thrombi, he was handed the drain and he managed to drain two of the five thrombi away but the other three got away. Derek repeated the process until all the first five were removed from Mr. Pratt's spleen.
"The thrombi seem to be diminishing, and blood flow has improved." Angie commented as his vitals stayed in the high seventies. Derek finished the fifth thrombi extraction. That was when things went bad. Once the fifth thrombi had been removed...the change in the blood flow had caused the suspended thrombi to move too. The situation was getting bad and Derek noted that Greg looked ready to pounce and assist Derek. A simple nod from Derek told Greg all he needed. Greg walked up to the table and was ready to get his hands stuck into the operation.
"What do you need me to do?" Greg asked Derek.
"I'm going to clip and then make the incision, Dr. Kasal, can you then please drain away the thrombi. We'll apply the gel when all the thrombi have gone. Nurse Thompson, can you please keep an eye on the patient's vitals for us? If it gets low alert us and inject stabiliser into the patient," Derek replied to Greg's question as well as dishing out orders of his own to Angie. They both nodded and the operation continued with all three of them working together. With Derek and Greg working together, no thrombi passed through the spleen so the vitals didn't drop from them, but rather dropped from the fact that there were incisions in the spleen which were bleeding ever so slightly. Having all the tools they needed, the operation went smoothly. Angie looked up at the vitals as they worked to see that it had dropped down to sixty-eight over ninety nine which was nice to see seeing as his vitals started at eighty over ninety.
"No thrombi detected. Treatment is complete," She smiled when both Derek and Greg sighed in relief. Mr. Pratt was going to be okay and there weren't any more thrombi in his spleen. With the original five thrombi removed, they had to deal with another fifteen thrombi in the patient's spleen. Both of them worked well that no thrombi passed through the spleen and the loss of vitals was just down to the incisions.
"Nice work there Dr. Stiles," Greg looked at Derek and smiled behind his mask. "You didn't panic when the thrombi started moving faster and instead took charge and made sure that Mr. Pratt pulled through."
"Wouldn't you do the same?" Derek laughed slightly. "Sutures please," Derek asked. Angie handed him the sutures and Derek worked to stitch up the incision. Once stitched up, the gel was applied and a bandage placed on top. The operation was a success.
"Amazing work the both of you. That was impressive team work."
"Yeah, you sure felt like a senior surgeon in there," Greg nodded.
"Let's just get Mr. Pratt out of here and then you can inform him when he wakes that it was a success," Derek smiled as he went to leave the room, Angie followed with Greg following shortly after.
"You might actually be a pretty good surgeon, Dr. Stiles," Angie walked next to him with a smile on her face.
"What's that supposed to mean?" Derek asked with a small chuckle.
"You were practically a different person in there. How can you be childish outside the operations but then dead serious when in there?" Angie asked him. Greg hung back to watch the two younger staff. It was nice to see the two of them getting along after having the rocky start. Angie was smiling more while Derek was just the same happy-go-lucky doctor.
"I'm not always childish..." He playfully pouted at Angie. She took the joke which made the situation better.
"Maybe not all the time but if you were that focused more often, and then I wouldn't have to worry as much," after that Derek stopped walking and just looked confused at Angie. She didn't seem like the type of person to worry about him but maybe he could be wrong.
"I thought you only worry about my appearance?" He questioned her.
"I worry about other things too Dr. Stiles."
"So...do you worry about me?" Greg smiled as he watched Angie place her hands behind her back and deliberately look cute for Derek. A happy expression on her face was enough to tell them both that she was enjoying herself a lot more. A lot different from how she was when she originally started working. No longer was the cold expression plastered on her face now, it was replaced by a warm smile.
"I definitely worry about your patients." She giggled as Derek let out a sigh.
"Derek, I'd like you to come to my office," Greg reminded Derek.
"Oh yeah, mind if I grab something to eat first?" Derek asked and Greg nodded.
"I'll see you in my office soon then, grab me a cup of coffee please?"
"Sure," Derek smiled.
Trauma Center: Calm before the Storm – Chapter 11: Thrombi Detected
Derek arrived at Greg's office and made sure that he rested the two cups of coffee on his chest in their holders with his arm keeping them balanced and knocked with his free hand. Hearing Greg's voice, he pressed the door handle down and gently pushed open the door. Once his free hand wasn't needed anymore he moved his hand to move the coffee off his chest. Greg smiled as Derek walked into the office and placed down some coffee for Greg.
"Take a seat," Greg offered. Derek nodded and took a seat across from his desk.
"Did...you get the test results back?" Derek asked and Greg nodded.
"Again, the tests came back negative; slight elevation in white blood cells but not to the point when we're worried." Derek nodded.
"Maybe I was over reacting..." Derek said but Greg shook his head.
"It affected your work; you had the right to be concerned. What...did it feel like?" Greg asked Derek. "You might already be bored of the question but it would interest me in knowing what it felt like."
"Sounds like one of those dramatic hospital dramas on television but...it just felt like my chest was on fire. Like my lungs just ruptured but...from the tests...it turns out to be nothing and just my body thinking it's in pain," he gently rubbed his chest unconsciously. Just remembering what happened was bringing back bad memories. He mentally slapped himself as he tried to throw away the memory before he felt upset.
"Why did you run?" Greg asked the second question.
"I couldn't call myself a doctor because I let some pain get in the way of my job..."
"I'm glad you came back. It would have been a shame to lose you." Greg smiled as he took a sip from the coffee.
"I'm...sorry?" Derek asked confused. "I'm still just a rookie doctor; I'm nowhere near as good as you are. I'm still nobody." Greg shook his head hearing Derek say that.
"It doesn't matter what rank of doctor you are, you're still somebody to the patients you treat. They put their trust in you to help them. Sometimes it's the rookie doctors that have the most impact."
"Greg...I get the feeling that something is going to arrive here very soon...something that'll spark memories of the past..." Derek whispered. It was now Greg's turn to look confused.
"What do you mean?" He asked.
"Hmm? Oh, never mind, forget it." He smiled at Greg. Greg wasn't sure how to respond to what he had just heard. What caused him concern was that he near enough had the same feeling.
"You really are a strange one."
Trauma Center: Calm before the Storm – Chapter 11: Thrombi Detected
Derek had returned onto the ward and the events of the day carried on like normal. The patients who he had operated on were a friendly bunch of people and thanked him for the work that he had done with Angie by his side. Of course he tried to be as professional as possible around them but seeing their smiling faces often brought him to smile too. He ignored his paperwork for now (much to Angie's annoyance) and just focused on talking to the patients. He enjoyed it and wouldn't trade it for anything in the world. Making sure that the patients were comfortable was something else that a doctor could do to help them recover. Like Greg had said, even rookie doctors such as himself, could make a difference to the patients' mood if he really wanted to.
Angie was keeping an eye on him. There was something wrong and she knew it. The way Derek smiled...it seemed forced and only Angie seemed to notice it. Derek's fake smile which he hoped was a general smile of happiness. While he wore it, his aura shifted to something unsettling. There were occasional times when she thought he was someone else in Derek's place, like he had another personality which just held dark thoughts in his head. She wasn't sure Derek was aware of it or if he was...knew how to stop it. There was also the chance that he had just grown used to it to the point.
"Hey, Dr. Stiles?" Angie asked Derek once he had finished with another patient.
"What's wrong Angie?" Derek asked her with the smile on his face.
"You still have your paper work to do," Angie reminded Derek, dropping his mood instantly.
"Come on, it isn't that bad," Angie smiled. He nodded and they both left to get the paper work started and hopefully finished before the end of their shift.
Trauma Center: Calm before the Storm – Chapter 11: Thrombi Detected
Angie had started to walk home with Derek more now than she had done in the past. He wasn't sure if it was because of the pact that they made before of if she was generally warming up to him. He didn't complain as it meant that he had company on the way home and it was a lot better than walking home alone where anything could happen. It wasn't like Gemma came out of her territory and all the way over to Hope Hospital just to see him. She much preferred to wait for him to come back to her.
"So, not even St. Francis knew what was wrong with you?" Angie asked him and Derek shook his head.
"I don't know if I should be worried about that or just relieved that there was nothing wrong," he smiled.
"Well, you're okay now. So let's just focus on that," Angie smiled happily as they continued to walk.
"I won't be around on Sunday. If you're working on Sunday then you'll get a day off from me," he laughed.
"Why won't you be around on Sunday?" She stopped walking and asked him. Derek had to stop too.
"I'll be going to see my mother who's out of town. Nothing big or anything I promise."
"Do you see her every Sunday?" He nodded.
"Yup, it's kind of a tradition now. I've never forgotten a single day and I don't plan to start forgetting any time soon."
"What if you're called in?"
"I'll send mother a text and then go to work?"
"At least your priorities are right," she nodded and they both continued to walk. "What are you expecting tomorrow?" She asked after a short pause in conversation.
"Hopefully, more patients to treat and we'll be able to discharge others so they can return to their families."
"Heard the rumours that doctors are always the worst patients?"
"I don't exactly have the best record for that, seeing as I ran away from the hospital without being discharged. I came back but the nurses weren't too pleased to see me after that."
FireCacodemon: Noticed that the HT didn't activate again~? :3
Derek: You're planning?
FireCacodemon: Planned. :3
Derek: Huh...how many chapters do you have currently written?
FireCacodemon: 13?
Derek: o.o
FireCacodemon: baebydeng - Yup, they were friends and Derek's Healing Touch will become active pretty soon. There's a special patient I'm waiting for~
Derek: ...I'm kinda scared now.
FireCacodemon: *Hand on Derek's shoulder.* You'll be fine. Believe me, it gets worse for everyone a lot later in the story.
Derek: That's what I'm worried about...
FireCacodemon: I'll be back again on the 25/08/2016.
