The Operator

You are a trauma surgeon.

You recently finished your residency.

Your just starting to make some decent money,

you work long hours and

because the hospital is understaffed

you’re often called-in, when you’re on-call

On Saturday Night you are out with the boys

for Frank’s bachelor party.

You are on-call, so you plan to go to the party,

but not drink.

Frank points out that:

“…a little cocaine wouldn’t hinder your abilities. It’s a stimulant. 

If anything, you’d be more awake,

if you had to go in late at night to fix someone up.”

You conclude that Frank makes

a fair point.

You partake in a few rails of coke,

at first

but, then you get that feeling, like

you are doing pretty ok, no

not just pretty ok, you’re doing

Pretty Fucking Good,

truth be told, you are on top of the Fucking World

The Social Club is clean and the girls

are pretty.

Candy, the ivory-skinned beauty

with blonde hair, perfect tits and

a large round bubble of an ass,

beautifully adorned with a bright red thong

grinds on the boner in your pants.

All of which made you forget

that you weren’t supposed to drink

so, quite understandably,

when the waitress brought you a martini,

that you didn’t order by the way,

you drink it, and a couple of others

without thinking.

While Candy was all very pleasing to look at

and the weight of her was pleasing on your lap,

you immediately conclude that it is all just

a waste of time. 

What are you doing?

What is the rest of the party doing?

“There is no sex at the Social Club, so what are we all doing?”

You thank Candy,

put a few twenties into her thong,

and it occurs to you that,

the inner feeling of being on top of the world,

that is not currently being matched by

the surroundings

You need to get to the top of the world

with Frank of course. 

You have a brain-wave. 

You Google helicopter rides

and connect with a service in the City

that can accommodate you and Frank and

a couple of others from the party, not all of them,

but that’s fine because they seem to be enjoying, The Social Club

and everyone can’t be part of everything

This is going to be an exclusive thing. 

Frank is onboard.

And, after a few more lines

off the back of the toilet in the men’s room,

and one or possibly two shots of tequila at the bar,

you find yourself in a mere twenty minutes

aloft in a helicopter,

the city lights, blurring as the pilot banks hard

and fast around the steel and glass towers.

Now you feel on top of the world.

“We’re on top of the world boys,” you declare

Frank and the others agree, and it is in this moment

of shared reverie that you get the call from

the Medical Director herself,

“we need you, we need everyone, six patients enroute multiple GSW.”

“I’m in a chopper, I can be there in minutes,

I’ll have the pilot land on the roof.” 

In all your life you have never uttered words

That made you feel more like a man in charge of things,

You are King-fucking-Kong.

You tell the pilot to land on the helipad of

Our Sisters of Mercy Hospital,

“I’m a surgeon” you declare, “I am needed in the trauma ward,

this instant, it’s a medical emergency.”

The pilot is only too happy to oblige for a sizable fee.

“I’ve got this, I’ve got this, right?” you ask/tell Frank. 

“Oh, you got this bro.  Don’t sweat it.  You have enough coke

in you, that it will completely off-set the alcohol.”

Frank knows what he’s talking about, he parties a lot.

You are thrilled to see that a number of the residents

and nurses have come to the rooftop to witness your epic arrival.

“This is baller,” you announce.

“Totally baller” Frank responds.

Moments later you’re scrubbing in with your colleagues, and

the head of trauma surgery.

“How are we gonna divie this up?”

She asks. 

“I’ll take the one with the most GSWs,” you proclaim.

“Well, that’s not your call,” one of your colleagues chides.

“No, he can have it,” the head says, “the patient took six to the chest,

one in the right, two in the left leg, and

multiple cardiac arrests.

You want that, you got it.”

“That’s right I do.”

It’s a shit show from the jump, literally.  

The adrenaline has sobered you up some, but you’re still buzzing,

which is a good thing because this guy is a goner.

The liver is partially obliterated, you pack that with gauze,

that’s going to be the next surgeon’s problem,

he goes into cardiac arrest, you defrib, bring him back,

you finish packing the liver, then you notice fluid and floating particles,

the GI tract has been perforated, it’s leaking into the cavity,

you ask your nurse for re-section instruments,

before she can get the tray his blood pressure drops,

there is blood streaming from the table,

but the visible wounds seem to be under control,

“Everyone, we got get him up on his side,” you command.

“I think he’s bleeding out from his back.”

On his side there is a large dressing that is soaked through,

You pull it off.

“Goddamn it, there’s an exit wound the size of a fucking softball here!”

you shout. 

“Why the fuck wasn’t this on the chart?”

“It wasn’t bleeding like that on admission,” comes a feeble response.

“Fuck!” you respond.  “Get me the cauterizer.”

You cauterize the blood vessels that are bleeding uncontrollably,

And he goes into cardiac arrest again. 

You have him flipped onto his back, defrib, and bring him back.

Then back on his side to finish cauterizing his blood vessels,

re-pack that wound, dress it, and put him on his back

so you can get back to that perforated GI,

“Suction,” you call out.  It’s a mess in there.  You can see and feel

four sections of the GI that are going to have to be resected. 

He arrests again, you bring him back again,

This is delicate work.  You call for the loupes,

one slip with scalpel and that’s more perforations to deal with

and you are losing steam fast, it’s been hours, your team is lagging.

Even the anesthesiologist, who frankly hasn’t been doing much,

failed to catch the blood oxygen level dropping,

despite the warning chimes.

You call it, “What am I hearing, is that oxygen dropping?”

 “Oh, oh, yeah.”

 “Fuck, ok what’s causing that, I thought his lungs were clean?”

 “He was breathing fine before.”

 “Ok, get him on a ventilator and while you’re at, lets give the guy some

meds, will you.”

Before the anesthesiologist can get the breathing tube inserted,

They guy arrests for the fifth time.  You bring him back.

Back to the GI resectioning.  As you carefully suture the second to last,

section of GI tract, he goes into cardiac arrest. 

You spend a half-hour with the defrib and manual chest compressions,

But this time you don’t bring him back.

You are now thoroughly spent. 

The crash from the booze and the coke

was held in check all this time with adrenaline. 

Now it has given way to despair, losing the patient,

the world is ending. 

And while the world is ending, and while you would like to take

an eternal shower to wash away the last six hours, and crawl into bed,

and sleep for a million years,

now you must go and explain to the patient’s family what has happened.

You’ve been trained in the speech.  You’ve had to do it before. 

“He fought really hard,” you tell them. 

“It was a long fight, and he gave it everything he had.” 

Really, you’re talking about yourself.

And then you have a small out of body experience.

You can hear and see yourself say the words, as an observer

and as you do, you wish you could take them back.

 “You know it might have been different, if his goddamn chart showed the

softball sized exit wound in his back.”

The patient’s mother moans, another family member shouts,

 “Wait, what?”

It was the exhaustion talking, but you know that no explanation will fix it. 

You turn and walk away. 

You go home, too tired to think.  You have that shower. 

You steam up the entire bathroom,

and then scrubbed clean, you go to sleep

in fresh linens,

and sleep the dreamless sleep of the dead. 

You are awakened by your phone, it’s the Medical Director,

she asks you to come to her office.    

As you enter her pristine and spacious corner office,

“I am going to have to ask you to submit to a blood draw for drug testing.”

 “What?”

 “I’m afraid I received a warrant for this draw.  I would prefer not to have a scene with police and everything, so I’m asking you to do the draw, and I want you to tell me what I can expect on that draw.”

 “What’s going on?”

 “The family of the patient you treated last night are claiming that you said that the ER nurse failed to put a significant injury on the chart.  That nurse in turn has claimed that when you landed on the roof of the hospital in your helicopter, you were clearly intoxicated.  All of which begs the question, why didn’t she intervene then, before you were in surgery.  Anyway, given the new board requirements on these things, law enforcement had to be called, and when they checked with the pilot, he confirmed that everyone appeared pretty messed up on the flight.  He couldn’t say for certain that you were, but he said that there was some discussion about someone being able to do surgery because the cocaine and alcohol would cancel each other out.

This is really important, if you disclose to me that you have a problem before the drug test, then you have ADA protection for your job.  You will probably lose your license to practice for a while, but after in-patient treatment, followed by out-patient treatment, you may be eligible for re-instatement, and the hospital would be required to hold your position open for you until you were deemed fit to return to work.”

The rationality of what the medical director told you,  

and the hope of an escape route out of all this appealed to you,

so much that you forgot the very basic rule that your friends

who are attorneys have all drilled into you,

“tell them you want to talk to an attorney”

You should have, but instead you blubbered about an addiction problem

which was bullshit, you just like to party.

You put on a little show

and the Medical Director, she put on a little show of concern and caring,

and expounded about how the disease of addiction

was rife within the medical profession,

even touching rising young professionals like yourself. 

It turns out there wasn’t a warrant for the blood draw,

you just gave that up. 

After you were charged as a criminal for negligent homicide

your lawyer explained to you that a plea was necessary,

because the blood draw you gave was pretty damning, and

those statements to the medical director,

they were something called admissions, and could be used against you.

And Frank, he was going to testify against you as well,

His new wife was disgusted to learn that he had been carousing

with a homicidal drug addict, and demanded that he cooperate. 

And the lawyer explained to you that after you are convicted,

you will lose your medical license,

and because the crime relates directly to the practice,

it will be very difficult for you to get it back,

and those job protections that the medical director told you about,

those don’t apply to convicted felons.