A Degree in Murder

Chapter Five: The Substitute

Eleanor sent her response via email a few days ago. In her mind, there was no good reason to walk to the administrative block to give a simple answer. Until I can figure out the meaning behind her words, it's best that I keep my distance from her. There were better ways to spend thousands of joules of energy.

I can put my energy towards this little pickle.

With one of her subordinates calling in sick and no one available to fill in for her, Eleanor decided to take her place. It had been several weeks since she last shared the operating room with the obstetrics and gynaecology department. She picked up the bag containing her surgical scrubs, walked out her office and perched on her secretary's desk.

"Good morning Ryan. I need you to help me with something," said Eleanor, a broad smile on her face.

"Good morning Dr Priest. How may I be of assistance?" replied Ryan Newman, clasping his hands together and placing them on his desk. Although he had considerably less experience compared to most of the other applicants, Ryan blew Eleanor away with his abstract thinking, boldness, intelligence and hunger. In some respects, she saw a little bit of herself in him.

"Do you know which case the obstetrics and gynaecology department have on their list? The one Dr Shirley was supposed to do with them?"

"The list was forwarded to the department two days ago and I sent it to all the other doctors in the department, in case something like this ever happened. I thought you had gone through it," said Ryan, a perplexed look on his face.

He's too damn efficient.

"I saw it in my email but never bothered to open it. As you know, it was supposed to be Dr Elizabeth Shirley but she suddenly fell ill," replied Eleanor defensively.

"I expect more from you, boss lady," said a disappointed Ryan. "Anyway Dr Shirley was scheduled to join the gynaecology department for a BTL procedure on a thirty one year old in OR two."

"That does sound interesting but I guess I'll find out more when I get there," said Eleanor, resuming her journey. Three minutes later she arrived at the women's changing room adjacent to OR two. She quickly changed into her pink floral surgical scrubs, secured her stuff in a locker, washed up and went into the OR.

"Good morning Dr Souza. Where's the patient?"

"Eleanor? I didn't know you would be joining us today. Anyway she'll be wheeled in shortly," replied Eduardo Souza, handing her the file.

"Anything I need to be concerned about?" asked Eleanor, reading through the patient's medical history. She had found some important information and wanted to find out if there was anything she missed.

"Apart from what you're looking at, nothing comes to mind. Her Lab results are at the back."

Eleanor finished reading through the file and closed her eyes. She began listing all the important points in her head: thirty-one year old female diagnosed with rheumatic heart disease, three months postpartum, no known food or drug allergies and currently on heart failure medication due to complications during pregnancy. Her main concern was the hypotension most of the common induction agent anaesthetics caused, something to be avoided in this patient. No sooner had she come to a conclusion than the patient was wheeled in.

Eleanor went into full doctor mode once the patient was transferred from the gurney to the operating table. With her brightest smile she introduced herself to the patient, explained the procedure and asked if there were any questions. When Eleanor saw that there were none, she proceeded to attach the pulse oximeter, ECG leads and the blood pressure cuff. All readings were within normal range for her patient's age, height and weight. She connected the other end of the IV line to a bag of clear fluid called Normal Saline and let it run at a slow rate. Satisfied with her prep work, she placed a mask on the patient's face and asked her to take slow, deep breaths. When she passed out, Eleanor gave Dr Souza the signal to begin. It would take no more than thirty to forty minutes.

Eleanor kept a close eye on the machine displaying the vitals. Although the machine could be calibrated to alert her when something went wrong, Eleanor preferred to do it manually. Machines were prone to error, she was not. When she saw the patient's face, she began to wonder what was going through her mind. She was significantly younger than Eleanor, perhaps with a dream of having more children of her own down the line. A dream that she could no longer pursue due to the risk it posed to her life. Surrogacy and adoption provided good alternatives but for some people, nothing could replace the original.

And that's the way life is sometimes, unfair as it may be.