Kate's patient was still fighting for her life almost two hours into surgery. The patient had suffered two cardiac arrests already during surgery and Kate and her team struggled to stay on top of the multitude of injuries.
Saxon Sinclair strode into the OR holding a surgical mask over her face. "Dr Morgan, how are things going here?"
"It's a mess Sax, half this kid's intestines ended up in her chest. Got the cardiac and lung injuries under control and we're almost done fixing the diaphragm tear. We've packed the abdomen and pelvis and we'll start exploring now. Ortho will need to wait to tomorrow to fix the pelvis and legs"
"Vitals now?" Sax asked.
"Shaky at best. BP's hovering around 70 over 50 no matter what I do, pulse is tacky at 140"
"I'll give you a hand"
"We're okay. I'm sure you're needed elsewhere"
"No, I'm free now. We just finished up with the last patient from the crash. I'll scrub in"
"Thanks Sax" Kate sighed in relief. This surgery was exceptionally hard and she really could use another senior attending. The residents were fine but they needed constant guidance and handholding. It slowed them down considerably. Kate felt more and more crappy the longer she operated.
Sax scrubbed in and stepped up to the table.
"Evans, get out of the way" Kate snapped.
"Just move to my left Evans" Sax said calmly.
Sax looked at Kate who was a study in concentration, her eyes not leaving the field. Kate's hands were steady as they always were. Her surgical cap was soaked with sweat on the forehead. She was breathing hard and fast, her mask puffing in and out at a way too rapid rate. Sax knew Kate's body language in surgery like she would her own child. Kate wasn't feeling well, that much was obvious.
"Dr Morgan, I can take over. Go home and get some rest" said Sax.
"No, I'm fine, I'm right in the middle of this. I can't stop now" Kate huffed.
"Kate I've got this"
"I said no okay, I'll finish up"
"Alright. Get me up to date"
Kate rattled off what she's already done.
"Kate…" Sax said softly.
"Yes?" Kate said, hands deep in the kid's abdomen.
"Kate!" Sax said louder.
Kate looked up into Sax's eyes.
"Deep breath, relax your shoulders" said Sax.
Sax was Kate's mentor and everyone knew it. She didn't feel embarrassed by Sax stepping in to ground her.
Kate took a deep, shaky breath and let it out. She took another deep breath and rolled her shoulders and consciously relaxed them.
"Okay let's do this" said Sax and started assisting Kate.
"There it is, renal artery tear among other things. Damn look at that kidney. It's ischemic"
"Do you think you can save it Dr Morgan?" asked the resident.
"I can try"
"There's also a rip in the descending abdominal aorta, clamped for now but we need to move, she needs blood flow restored soon or she'll go into multiple organ failure due to lack of circulation."
"How is this kid still alive?" Sax mumbled.
"Dr Morgan's been absolutely incredible so far" said an adoring resident.
"She's not even close to being out of the woods, focus please" Kate said.
"Come closer kids, you'll want to see this so you can tell your grandchildren you saw one of the greatest surgeons in the world do the near impossible" said Sax to the interns and residents observing.
"Sax you really should be humbler" Kate laughed but she knew Sax wasn't referring to herself.
"Dr Morgan everyone"
"No pressure huh" Kate mumbled.
"I have no doubt you can do this" said Sax.
Another hour hours later Kate took a deep breath to get rid of the light-headedness overcoming her. Sax had asked once every fifteen minutes if she was okay to continue. Sax wasn't convinced she was but Kate was pulling off one of the most impressive surgeries Sax had ever seen and that said a lot. What Sax could see of Kate above her surgical mask looked like shit. Her eyes were puffy and droopy and had dark circles under them. Kate closed her eyes and took another deep breath.
"Dr Morgan, we're pretty much done here. You're welcome to scrub out. I'll close and get her through post op. I'm on until 6 tomorrow morning"
"Might as well finish now" Kate mumbled.
She felt dizzy as fuck and noticed her hands were trembling. She felt short of breath. She quickly put the scalpel back in the scrub nurse's hand. She tried to pull herself together. Her vison went fuzzy for a few seconds at a time. She felt a chill come over her and sweat broke out over her forehead again. Kate just stared at open abdomen in front of her, black spots crept into her vision. She closed her eyes for a few seconds desperate to just stay up.
Now that everything was under control with the patient and they were almost ready to close up Sax seemed a lot more relaxed and was chatting to and joking with the anaesthesiologist as she worked, she wasn't paying much attention to Kate. Kate tried to pull herself together but it got more and more difficult.
"Uhm… Dr Sinclair… Can I please ask you to finish up. I need to be excused" said Kate sounding weak. Sax's head snapped up.
"No problem, we're almost done here anyway. Less than five minutes and we'll close. Go home and get some rest. We'll see her through post-op and settle her in the TICU. Evans, write the post-op notes and I'll sign them off" said Sax.
"Thanks" Kate said softly but didn't step away from the table. She let out a slow breath that puffed out her surgical mask. She stood with her hands in the air staring out in front of her.
"Go Kate, we've got this" said Sax looking up. She frowned. "You okay?"
"Yeah…. Fine" said Kate and took two steps back.
"Dr Morgan, brilliant job today" Sax winked. Kate just nodded. Even that action had her head spinning.
Kate slowly turned around and started walking towards the OR doors. A few steps from the door she stopped. The room was tilting, her breathing was ragged and she felt as if her heart was beating out of her chest. Kate closed her eyes and put her hand out to steady herself against a wall, a trolley… anything. There was nothing. Suddenly everything went black.