Read Oxygen for Free Online

setting her up with my son.”
    “ I’m taking Alicia out on Saturday,” I say. “You’re both out of luck.”
    Alicia does a quick shimmy on her step stool. “Dancing. She’s taking me to learn the tango, right, Dr. Heaton? We’re both wearing high heels and low-cut dresses—getting out of these ugly scrubs.” Her accent rings exotic in the words and I’m almost looking forward to our imagined date.
    Brad taps me on the shoulder. “OK. I’ve got three lunch breaks to give in an hour.” He picks up Jolene’s anesthesia page and looks over the dots and dashes that mark blood pressure, heart rate, ventilator settings—sort of a two-dimensional snapshot of her physiology. “A drug rep left pizza in the lounge. Give me a quick rundown and go before the food’s all gone.” He raises his eyebrows. “This patient’s only eight?”
    “She’s small for her age, so be careful with your doses. Her face is padded, but I’d check for any pressure points again if the table’s moved.” I fill him in on Jolene’s history and my plan for her anesthetic, point out the drugs I’m giving: fentanyl—a narcotic to blunt her pain, a little Propofol to deepen her sleep, anesthetic gases. It’s almost impossible to talk to Brad without focusing on an enormous Adam’s apple that rides up and down the column of his trachea below his surgical mask. He’s just out of his residency, still swaggering between academic confidence and inexperience, and I catch myself talking to him more like a teacher or mother than a colleague. “Are you comfortable with pediatrics?”
    “Sure.” He looks over my setup, checks the row of labeled syringes, gathers in the data he’ll need to take care of Jolene while I eat. “Leave your key in case I need more narcs. And eat a lot—cases are piling up out there, so who knows if you’ll get dinner.”
     
    When I get back from lunch twenty minutes later, I sense more tension in the room. The cyst tracks deeper than Stevenson had expected, and he’s getting short-tempered again. Brad looks relieved to see me.
    “She’s been stable,” he says, then leans closer to my ear and whispers, “Wish I could say the same for your surgeon.”
    “Sorry. Thanks for lunch. Did you change anything?”
    “Gave a little Propofol, a cc of fentanyl, turned your gas up some.” He puts the fentanyl syringe into my hand as he slips out of the room.
    Alicia looks up at me and wiggles her eyebrows in imitation of Stevenson. She’s learned to ride the waves of his moods. I look over the surgical drapes and see a much bigger incision than when I left. Jolene’s heart rate increases and her next blood pressure is up, a sign that beneath the sleeping layers of consciousness her body is reacting to pain. I screw the syringe of fentanyl into her IV line and inject more into her. Within minutes her pulse returns to normal and her blood pressure drops.
    Someone has changed the background music to classical, Erik Satie’s Trois Gymnopédies , an effort to soothe the sleeping giant of Stevenson’s temper, no doubt. He reaches for the scalpel again to open up Jolene’s sacrum. I inject another dose of fentanyl, this time in advance of the electrical jolt of pain that will sear up her spinal cord when he cuts intact skin.
    That’s when an alarm sounds. The flashing numbers on the machine behind me show Jolene’s airway pressure rising. It’s probably a kink in the breathing circuit. Or maybe a plug of mucous in her endotracheal tube. The monitors are sensitive and often register some inconsequential change. I reset the alarm but it immediately blares again; the machine strains to push oxygen into her lungs.
    I throw a lever and begin to ventilate Jolene by hand using a breathing bag—but there is too much resistance. She might be reacting to the surgery, coughing against the ventilator. Another monitor alarms—her blood pressure has dropped by twenty points and her heart rate is going down.
    Mindy looks up