won’t hurt a bit,” I said, then I got to work, sliding the scope into his throat, talking quietly through it, looking up at the screen as Caden’s esophagus and stomach were revealed. Healthy tissue, the beautiful web of blood vessels, the grayish walls of the stomach pulsing and moving with life.
And there, in the lower part of the stomach, I saw the toothpick, now black from stomach acid, sticking out of his duodenal wall. Using the endoscopy forceps, I gently grabbed it and slowly pulled it out. “Ta-da,” I said, holding it up so my patient could see. “We got it, Caden. You’ll feel a lot better tomorrow.”
“Good call,” Jabrielle murmured.
“Thank you,” I said. “I’ll order up some antibiotics, but he should be right as rain. In the future, big guy, eat more carefully, okay? This could’ve done a lot of damage. It could’ve slipped through into your liver, and that would’ve been really bad.”
“Thank you so much, Doctor,” the mom said. “We had no idea!”
“My pleasure,” I said. “He seems like a great kid.”
I pulled off my gloves, shook her hand, tousled Caden’s hair and went out to write the prescription.
Felt a little heroic.
If left untreated, that toothpick could’ve caused sepsis. It could’ve been fatal. Though it didn’t happen too often, I think I could firmly say I’d saved a life tonight.
Just then the doors to the ambulance bay burst open, and a pack of people ran down the hall next to a gurney. “Drive-up gunshot to throat” barked someone—Bobby, it was my honey! “Extensive blood loss in vehicle, get the Level One infuser running with four units of O positive. Call the blood bank for a mass-transfusion pack, and call trauma code for Room One, now! Stop sitting on your asses, people! Move!”
The place exploded with action, people running in every direction, doing as their lord commanded. I inched toward the room where the action was, hypnotized. Good God. It looked like half the man’s throat was missing, a meaty hole about the size of a fist, Bobby’s hand inside it.
“I’m clamping his carotid with my fucking fingers!” Bobby yelled. “Where the hell is the surgeon?”
Indeed, Bobby’s arm was drenched in blood, his scrubs sprayed with arterial spatter. The rest of the team buzzed around the patient, cutting off his clothes, inserting lines.
“No, you can’t intubate, idiot!” Bobby barked at an intern. “Can you not see my hand in his throat? Bag him, you moron!”
I sure didn’t miss residency. The ER doctors had been brutal.
Dr. McKnight from Surgery burst in, pulling on her gloves, a face shield already in place to protect her from blood-borne diseases. Someone draped her in a gown. “Clamp,” she snapped. “Now!” If there was anyone more, ah, self-confident than an ER doc, it was a surgeon. “Keep your hand there, Bobby, and don’t even breathe. You lose your grip, he bleeds out in five seconds. How the hell did he make it here with a pulse?”
Then a nurse saw me gaping and closed the door. I wasn’t ER staff, after all.
I snapped out of my awestruck stupor and closed my mouth. Janitorial was already mopping up the trail of blood, and half the residents—including Jabrielle, who shot me a dirty look, since I made her miss the good stuff with my boring endoscopy—hovered at the exam room window to see if the guy would make it.
The other patients in the unit were quiet in their exam stalls out of respect, it seemed—a TV-worthy trauma had just passed through their midst.
I wandered back to the triage desk. “Hi again, Ellen,” I said. “That’s some—”
“You done with that consult?” Ellen asked.
“Oh, yeah. Um...he swallowed a toothpick. I did an endoscopy and—”
She gave me the stink eye and picked up her phone. Right. She was busy, and I was an irritating doctor who made her life harder...which was true for a lot of nurses, especially in the ER. All the more reason I bent over backward to make sure they knew I appreciated them. But Ellen wasn’t the type to drink in the milk of human kindness, so I slunk to the computer and entered the report.
Just as I finished, the door to Bobby’s exam room opened, and out came the team again, heading for the elevator up to the surgical floor. I could hear the beeping that indicated a regular heartbeat. Somehow, they’d saved his life or at least given him a chance.
Dr. McKnight got on the elevator with the transport team, and as the doors closed, she called, “Nice work, people. Bobby, awesome job!”
The doors closed, and applause broke out throughout the department.
The next shift of ER staff was coming on, already aware that there’d been a good save, already jealous it hadn’t happened on their shift.
Bobby and his team were in no hurry to pass the torch, either. They high-fived, made much ado about their bloody clothes, their part in the drama, Dr. McKnight’s speedy and delicate end-to-end anastomosis.
Bobby didn’t say much—he didn’t have to, because it was clear he was their god.
Finally, his eyes stopped on me. I smiled, proud of him, even as that little irritating voice said it was about time he’d seen me.
“Oh, hey,” he said. We’d been together long enough that I could tell he’d forgotten I was working tonight, too. “Uh...we were gonna order a pizza and stick around to see how the patient’s doing.”
“Sure. Of course. Hey, Bobby, that was amazing. I saw a little bit.”
He shrugged modestly. “Were you waiting for me?” he asked.
The irritation flared again. “No, I was on a consult. Twelve-year-old ate a toothpick. I scoped him, and it doesn’t look perfed. Think we caught it before he got septic, too.”
“Cool. Well, you want to hang out with us?”
I suppressed a sigh. I didn’t. I wanted to go home and take a walk with Bobby and Boomer and get pad Thai. If we stayed here, I’d have to call Gus, our dog walker. I wanted to tell Bobby about my good call, my instincts of guessing what had caused the pain, which was what separated good doctors from mediocre ones.
But he was the one who’d had his hand in a man’s throat.
“Sure,” I said.
“Cool. Just let me get washed up.” He left, stopping so the janitor could shake his hand.
Five minutes later, we went into the staff lounge, where the rest of the team was already in full adrenaline-junkie-chatter mode. More congratulations were given. More high fives. More jokes.
“Who’s gonna get the pizza?” Jabrielle asked.
Everyone looked at me, the outsider. The boring gastroenterologist (who had also saved a life tonight, though that story wouldn’t get aired).
“I’ll do it,” I said. “What would you like?”
Despite
