“Bingo. Come on, I’ll have one of the other residents get his history.”
The shrewd, middle-aged doctor who oversees the neurosurgery department has never played favorites, which also means it’s been a challenge to get noticed. There’s no way in hell I’m missing this chance now that he’s offered it to me. It will be my first time scrubbing in, so I definitely won’t be performing any part of the surgery, but for some reason my teeth ache with the need to at least observe this surgery.
My wrist still tingles from the force of the patient’s grip, and I can’t help the flutter in my chest when I step into the OR, scrubbed and ready to go. Even though I’ll only be observing, it’s still one of the most profound moments of my entire life.
I take a deep breath, wanting to take in every detail. All I get is a lungful of surgical mask, but my senses are heightened. The cardio surgeon already has the patient’s chest open and is repairing a perforated lung, relaying a subdued play-by-play as he works. An orthopedic surgeon and Dr. Yao stand at the ready. I tamp down the nervous energy in my belly as I wait and watch.
The surgery turns out to be straightforward and relatively quick. They marvel that the bullet missed his heart, but still don’t look optimistic when they turn him over to us. They’ve already taken an X-ray and determined that the bullet is indeed lodged against his eighth thoracic vertebrae. If this surgery doesn’t go well, he could wind up a paraplegic.
We carefully position him face-down, the enormous C-arm imaging machine curving around and above the surgical field so we can have an X-ray visual of the procedure while it’s underway. His back is covered in a yellow surgical incise drape surrounded by another blue drape. Through the transparent material a hyper-realistic tattoo of a black and white koi fish swimming through water is clearly visible.
“Impressive ink,” Dr. Yao says. “Shame we have to cut into it.”
Of all the tattoos I’ve caught glimpses of on his body so far, none have been as striking as this one. When Dr. Yao makes the first incision down the center of the spine, I can’t help but wince at the slice that cuts straight through the fish’s side.
I lean in as Dr. Yao begins talking through the steps of the procedure. He glances at the X-ray every few seconds as he deftly maneuvers his instruments into the incision to extract the slug lodged there.
Out of the blue, he says, “Did you know that koi fish are symbolic? Black and white ones like this signify transformation. Rebirth.”
I nod. I’ve watched Dr. Yao from the gallery, and he’s always spouting off random trivia in between teaching surgical technique. He goes on about what different colors of koi tattoos symbolize while I look on, soaking up every nuance of his movements.
The entire procedure seems deceptively simple as it’s happening. I can feel the weight of the instruments in my fingers even though I’m not holding them myself, and when Dr. Yao surprises me with a question about the next step, I’m ready with the answer without even thinking. The corners of his eyes crinkle and he nods.
“Good job, Nicolo. When ortho’s finished, see to the patient’s superficial wounds and stay with him in recovery to make sure he’s stable.”
I’m positive he can sense my wide grin behind my mask, but I only nod once to maintain the illusion of professionalism. “I’d be honored, sir.”
Once the bullet is out, I exhale, then step back and observe as ortho slips in to insert a pair of small screws, which are all that’s required to hold the fractured vertebra together. Then I watch with bated breath as they stitch the wound. I can breathe easier when it’s done and the tattoo looks as good as it can with a line of stitches down the center of it. He’ll have a scar, but with an artist talented enough to create a work of art like this, he can surely get a touch-up that’ll make it look good as new.
The surgery a success, I float on an adrenaline-fueled cloud as I scrub out, then meet the patient in recovery. I finally have a chance to review his chart, and I learn his name is Julian Santos, Jr. On the way there, I checked in on the other patient, his brother, Maddox Santos, who is zonked out on painkillers but otherwise doing fine, and I’m happy to have good news to tell Julian when he wakes up. Maddox only sustained a flesh wound, the bullet passing clean through the muscles over his hip.
Julian is breathing on his own, which is a good sign. His chest is covered with a gauze bandage and wrapped to immobilize several broken ribs, but there is still an impressive amount of ink visible on his torso. I’m more and more intrigued as I clean and treat each of the dozens—hundreds—of small wounds. Most are bruises and minor contusions, but in some places the skin is broken enough to need bandages, and there are several serious burns as well.
He came in wearing only jeans, which we cut off shortly after he arrived. They likely protected his legs from damage, but I take a purely clinical peek beneath the sheet to check below his waist anyway. His muscular legs are unblemished, and I drop the sheet again quickly, face flaming though I can’t help my small smile at what appeared to be another very healthy and impressive feature.
Shame on you, Callie. What would your mother say?
I bend over and begin suturing one of the deeper cuts in the flesh beneath his collarbone, where whatever bludgeoning weapon he was hit with dug in deep. When
