Nightingale (Sequel to Solider Boy)

Two

Melody stood at the OR table, breathing in the sterile smell of the room as the patient  was moved onto his side by her team. Even with the draping's, she could see the blotchy bruises the car crash had left all over his body. 

I need to do this quickly, she thought, the sooner the bleeding in his chest is under control the better chance he has to survive.  "Scalpel," she said, holding out her hand automatically as the self-same tool as placed in her hand and her other reached out to touch the patient. She let the blade hover over his skin, directly beneath the shoulder blade and moving until it was directly between the fifth and sixth rib.

"Doctor Blake," Melody said, her voice carrying in the still space. "What is the purpose of this procedure?"

"To see and reach the lungs or other parts of the thoracic cavity."

"And why do we need to do that in this man's case?"

"CT scans showed he was bleeding into his chest as a result of the accident." 

Melody nodded, his assessment was correct. She moved her wrist, sliding the blade through the skin, blood beading up along the path of the six inch cut. "Chest tube," she held out her hand for the next tool, a hollow plastic tube. Simple but effective. Now it was a simple matter of guiding in and suturing into place. "Hold that steady," she ordered the intern as she looked at the scrub nurse. "Suture," and then it began again, the threading of the black line through skin to pull the broken body back together.

"Doctor Frasier," the intern asked softly as Melody pulled her suture through again, the tube becoming more stable as she did so. "Do you think he will live?"

"I do not know." Melody wasn't sure why he wasted time asking such a question. There was not enough data to form a hypothesis. 

"But you've seen a lot of cases like this haven't you?" Doctor Blake persisted. "You've seen-."

"No two cases are exactly alike," she cut him off as she completed her suture. "Gauze." She dressed the wound then, another stabilizing agent as well as an aide against infection.

"Shall I turn on the drainage system Doctor Frasier?"

"Yes."  The scrub nurse flipped a switch and the blood began to slide thickly through the tube. 

"It's working!" Blake exclaimed and Melody sighed as she stepped back from the table. To say it worked now was jumping to conclusions. In the transfer to recovery, the patient could easily have an air leak or worsen due to the trauma that been inflicted on his body.

"Take him to recovery," she instructed Blake, "monitor him for air leaks, check his breathing and when you leave tonight, make sure the night shift knows what I expect." 

"Yes Doctor Frasier," he muttered as the scrub nurses moved around them as  a single unit to prepare the patient for the next stage. 

Melody herself walked out into the scrub room and the moment she was over the threshold, she came alive again and everything hit her at once. The way Gerald Goldstein, a fifteen year old child had looked even smaller and more fragile as he laid on her table. The way his fair skin had been marred and bloody by the gashes and scrapes on his skin. The swollen, bruised face. The way his mother had screamed at her as she and her team spirited him away to the OR for an emergency procedure while his chest cavity filled with blood...Bile rose up in her throat, hot and painful as she ripped off her bloody gloves, her hands trembling as she turned on the faucet and scrubbed at her skin. He's just a boy, Melody thought, her chest tight with pity  as she saw his face in her memory. He shouldn't be here, he shouldn't have been in that car.