The Surgeon Read Online Free PDF Page A

bleeding worse.
    As if things could get any worse.
Her back ached and her arms were trembling from the effort to maintain pressure on the liver. A drop of sweat slid down her cheek and soaked into her mask.
    Lab was back on the intercom. “Trauma Two, I’ve got STAT results on John Doe.”
    “Go ahead,” the nurse said.
    “The platelet count’s down to a thousand. Prothrombin time’s way up at thirty, and he’s got fibrin degradation products. Looks like your patient’s got a roaring case of DIC.”
    Catherine caught Barrows’s glance of amazement.
Medical students are so easy to impress.
    “V tach! He’s in V tach!”
    Catherine’s gaze shot to the monitor. A whipsawing line traced jagged teeth across the screen. “Any pressure?”
    “No. I’ve lost it.”
    “Start CPR. Littman, you’re in charge of the code.”
    The chaos built like a storm, swirling around her with ever more violence. A courier whooshed in with fresh frozen plasma and platelets. Catherine heard Littman call out orders for cardiac drugs, saw a nurse place her hands on the sternum and begin pumping on the chest, head nodding up and down like a mechanical sipping bird. With every cardiac compression, they were perfusing the brain, keeping it alive. They were also feeding the hemorrhage.
    Catherine stared down into the patient’s abdominal cavity. She was still compressing the liver, still holding back the tidal wave of blood. Was she imagining it, or did the blood, which had trickled like glossy ribbons through her fingers, seem to be slowing?
    “Let’s shock him,” said Littman. “One hundred joules—”
    “No, wait. His rhythm’s back!”
    Catherine glanced at the monitor. Sinus tachycardia! The heart was pumping again, but it was also forcing blood into the arteries.
    “Are we perfusing?” she called out. “What’s the BP?”
    “BP is . . . ninety over forty.
Yes!
”
    “Rhythm’s stable. Maintaining sinus tach.”
    Catherine looked into the open abdomen. The bleeding had slowed to a barely perceptible ooze. She stood cradling the liver in her grasp and listened to the steady beep of the monitor. Music to her ears.
    “Folks,” she said. “I think we have a save.”
     
    Catherine stripped off her bloody gown and gloves and followed the gurney bearing John Doe out of Trauma Two. The muscles in her shoulders quivered with fatigue, but it was a good fatigue. The exhaustion of victory. The nurses wheeled the gurney into the elevator, to bring their patient to the Surgical Intensive Care Unit. Catherine was about to step onto the elevator as well when she heard someone call out her name.
    She turned and saw a man and a woman approaching her. The woman was short and fierce-looking, a coal-eyed brunette with a gaze direct as lasers. She was dressed in a severe blue suit that made her look almost military. She seemed dwarfed by her much taller companion. The man was in his mid-forties, and threads of silver streaked his dark hair. Maturity had carved deeply sober lines into what was still a strikingly handsome face. It was his eyes that Catherine focused on. They were a soft gray, unreadable.
    “Dr. Cordell?” he asked.
    “Yes.”
    “I’m Detective Thomas Moore. This is Detective Rizzoli. We’re from the homicide unit.” He held up his badge, but it might as well have been dime-store plastic. She scarcely looked at it; her focus was entirely on Moore.
    “May we talk to you in private?” he asked.
    She glanced at the nurses waiting with John Doe in the elevator. “Go ahead,” she called to them. “Dr. Littman will write the orders.”
    Only after the elevator door had closed did she address Detective Moore. “Is this about the hit-and-run that just came in? Because it looks like he’s going to survive.”
    “We’re not here about a patient.”
    “You did say you’re from Homicide?”
    “Yes.” It was the quiet tone of his voice that alarmed her. A gentle warning to prepare herself for bad news.
    “Is