My dad started to pull away from me as I climbed the ranks at the hospital. He was still the chief but I think he was trying to avoid rumors of nepotism that plagued me, especially after I began acing every surgery. I went to work and occasionally went back to the apartment I lived in with my cat, Gogo. My mom and dad expressed concern that I was making work my entire life. I thought: So what? How else can you be the best?
I met Lizzy Reid one Monday as I stood over her hospital bed and examined her chart. The fifteen-year-old was asleep when I walked in but began to awaken while I read through her medical history. She looked up at me through piercing green eyes and smiled. Her skin was tan and lush. It was hard to believe she had a faulty heart.
“Hi, Doc,” she said shyly, reaching her hand out to me.
“Elizabeth, I’m Doctor Meyers. It’s nice to meet you.” I shook her hand and went back to reading her chart.
“You can call me Lizzy.” I didn’t respond. “You seem kind of young for a surgeon.”
“I assure you I’m old enough.”
“Oh.” She shrugged and looked away. She mumbled something to herself.
“What’s that?” I asked.
She smiled coyly. “Oh, I was just thinking out loud. Just wondering something. I’m just super curious about stuff.”
“What do you want to know?”
Her lips flattened and her tone went harsh. “I wonder if they teach bedside manners in medical school anymore?”
I couldn’t help but laugh. I placed her chart into the slot at the front of her bed, slipped my pen into the pocket of my white lab coat, and crossed my arms over my chest.
Smiling I said, “Technically it’s ‘manner.’ ”
“Same difference,” she shot back.
“Maybe you’re right.” I put my stethoscope in my ears and warmed up the diaphragm on my arm, rubbing it back and forth. “Can I have a listen to your heart?”
“Thank you for asking, Doc. Your manners are getting better. And thanks for warming that up,” she said as she pulled the top of her gown down just enough for me to slip the chest piece in. I heard the atrial bigeminy right away but I expected it from her ECG results. Her heart sounded like a musical beat. Instead of boom-boom . . . boom-boom . . . boom-boom, it sounded like boomboom-boom . . . boomboom-boom. I moved the stethoscope and heard a deep heart murmur caused by an interatrial septal defect.
“Well?” she asked.
Her parents entered the room with concerned faces.
“Doctor Meyers,” the mother said. “We heard you’re the best around.” She reached out to shake my hand.
Lizzy spoke up and jutted her thumb toward me. “You mean this young guy is the best?”
“Elizabeth,” her mother scolded then turned back to me. “Sorry about that.” She shrugged. “Typical teenager. I’m Meg and this is Steve.”
I shook their hands, picked up the chart, and began writing down notes. Without looking up I said, “Elizabeth’s condition is very common. She has an irregular heartbeat but it shouldn’t have any long-term effect on her health. What we’ll need to address, and the reason she was feeling light-headed during exercise, has to do with a minor defect in her heart. We’ll use a catheter to correct it.”
“Will you have to open her up?” Steve asked.
“No. We’ll go in through her upper leg into the femoral artery, which leads to the heart. At first the pressure of the heart will hold the device in place. Eventually new tissue will grow over the septum, which will correct the oxygen levels in her blood. I’m confident she’ll be able to go back to her usual activities in a month or two.”
“That’s it. She’ll be fine after that?”
“That’s the hope, Meg.” I grinned confidently but I could tell my attempt at charming Lizzie’s mom was ineffective.
“Okay smart guy, how many times have you done this?” Meg asked.
“Four times, and I’ve assisted and observed a similar procedure on a patient of the same age. It’s textbook, and there’s little risk of complication. But, keep in mind, that doesn’t mean there’s no risk.” I went to Lizzy’s bedside and observed her vitals. “We can schedule the procedure for this afternoon.”
“I trust you, Doc,” she said, “even though I still think you look too young.”
I finally smiled at her. “You’re going to be fine . . . better than before.”
Her eyes sparkled as she smiled back. I wondered briefly what she would look like in ten years. A vision flashed through my mind of her in a wedding dress and then another of her holding an infant. Struck by my uncharacteristically sentimental reaction, I shook my head in an attempt to eliminate the thought.
“What?” Lizzy said.
“Nothing.” I offered a short nod to Lizzy’s parents, left the room, and gave my instructions to arrange the surgery.
Later that day in the operating room, as my surgical team and I watched the X-ray screen and fed the line up from Lizzy’s leg, her pressure started to drop. A few moments passed as I calmly ordered the administration of medicines and gave instructions to the other surgeons and nurses, but her blood pressure continued to plummet. The anesthesiologist looked at me intently, waiting for me to make a decision.
There is something to be said about knowledge and experience in the medical field. You can know every fact and read every case study, but when you have less than ten seconds to make a decision your experience is mainly what is tested. Your ability to be confident in your answers comes from knowing the positive outcomes in study and the negative outcomes from your own goddam mistakes.