Читать книгу Surgeons, Rivals...Lovers - Amalie Berlin - Страница 8

ENZO MET DR. TAKEO OOTAKA at the ambulance bay doors. Normally, sprinting a block would do very little to his heart rate. Not today. Today he was winded by the time he jogged through the automatic doors. Winded and annoyed. Off his game.

The older Japanese surgeon stood waiting, leaving Enzo no time to work out his problem. He barely had time for a good breath. Ootaka stared past Enzo to the empty ambulance bay, a look that demanded answers.

During the past four years, and especially the past year when he’d largely been Ootaka’s primary assistant, he’d become used to anticipating Ootaka’s questions from his expression alone. So he answered, “I ran ahead. It was faster on foot and I wanted a better chance to brief you.”

And it’s hot, he wanted to say. Hot and muggy, which no doubt contributed to his elevated pulse and respirations.

He took another deep, cleansing breath and launched in, giving the pertinent details even as he heard the sirens drawing closer to the building. “Massive bruising, likely fractured sternum, probably some ribs, too, but structure mostly intact.”

From where the ambulance bay was located, he could see the vehicle turning into the parking lot. If he wanted to ask, it was now or never.

“I expect that there will be a need for surgery.” He waited only long enough for the usually taciturn surgeon to nod, and added, “I’d really like to stay with the patient and assist you.”

Underhanded? No. Smart.

She’d been the one ahead of the curve with the diagnosis and field aspirations. While he wouldn’t ever claim the spot of underdog, or let himself be relegated there, winners made their own fate. Preemptive maneuvers. Offense, not simply defense.

Besides, Davis had to learn sometime that the laid-back Southern lifestyle wouldn’t fly in the city—something she clearly needed to work on, in addition to learning some leadership qualities. Let that be her second New York lesson: if you want something, you have to fight for it. Everyone wanted something, so chances were if you wanted something, then someone else wanted to take it away from you.

And that was enough justifying. What in the world was wrong with him?

He blew out a steady breath as his vitals came back under control.

“Let’s see what we have, then.” Ootaka finally spoke as the ambulance rolled to a stop, triggering the automatic doors. They moved off to one side to clear the route for the stretcher.

Ootaka stood with his hands at his sides, placid and waiting attentively. No indication anything was amiss.

Never in his entire career so far had Enzo ever felt this rattled in front of his mentor.

Only one person in the hospital had ever been able to rattle him, and they had an unspoken agreement of avoidance.

Even while watching his fellow residents fall out of the grizzled surgeon’s favor, Enzo had always been the one in control and confident in his abilities. He knew Ootaka’s rules. He understood the detached perfectionism that made up nearly the entirety of his operating-room demeanor. His professionalism, steadfast confidence and resolve were perfection in Enzo’s eyes. Ootaka was precisely the kind of surgeon Enzo wanted to be. The best. Second to none after Ootaka retired. There could be no better place to learn that than Ootaka’s OR.

Tension rolled over his shoulders and down his arms. Not like Ootaka’s relaxed stance. In the reflection of the glass doors he could see his own arms… hanging at his sides, but stiff, ready for a fight. He rolled his hands at the wrist and settled. Shaking his arms out would only look even more affected.

He couldn’t avoid Davis as he did Lyons. Did he even want to? He took an inventory of his goals. Staying on top would mean a better understanding of whether she truly was a threat or just another future ex-contender. Having a good understanding of his obstacles was the only way to overcome them. It was the not knowing that had him rattled. Once he had figured out the situation, there wouldn’t be any weird emotional responses to taint Ootaka’s opinion of him.

Whatever it took. Even if it meant angering a new colleague when she figured out he’d outmaneuvered her. But what did that matter to him? Another fact for her to get used to. She would’ve had to anticipate the sharp learning curve to come into the program this late in the game, and there was zero chance of her assisting on her first day anyway.

Ootaka never trusted one of his patients to anyone with untested skills. In that light, his request wasn’t anything more than a formality when you got down to it. Asking first just showed initiative, a good practice. He wouldn’t feel guilty about it.

Bonus: it’d give Ootaka an easy out if Davis came in asking, because she’d definitely want to assist. Helpful, like someone he’d want around for the next two years. As she exited the ambulance, Enzo added, “There was another resident on the scene. The transfer, Davis. She rode in the back with the patient.”

“I wondered why she wasn’t here yet.”

In addition to untested surgeons in his OR, Ootaka also hated tardiness. The man kept an updated list of sins that could get you banned from his OR forever. She probably hadn’t a clue about them. His action now might actually save her career—give her time to learn the rules before she went in blind and violated them. It was a good-guy thing to do. The idea that her competence might come into question because she’d been late saving a life didn’t sit well. He could throw her a bone, let Ootaka know she’d made the call and aspirations.

“She—”

As the first word came out the two EMTs, Davis and the gurney rolled in, the little motor on the wrist cuff whirring to take another reading.

Ootaka cut in, “Who diagnosed the cardiac tamponade?”

“I diagnosed Mr. Elliot’s tamponade, Dr. Ootaka.” She immediately answered the question while still passing through the sliding doors.

All the mousiness he’d glimpsed earlier was gone. That was something at least. She recognized Ootaka on sight, which really shouldn’t surprise him—she’d transferred in for his fellowship if the rumor mill was to be believed. She’d have done some research.

Though Ootaka was hard to miss. He had a kind of forbidding quality to his expression, even when he was in a good mood. Smiles actually involving his mouth were rare. Ninety percent of his expressions were in the eyes.

“The aspirations are what stabilized Mr. Elliot.” He rolled with the name they must’ve discovered on the way. “Brought him back into normal sinus rhythm. He was in V-tach before the serosanguineous fluid was drawn off.”

She still wouldn’t be asked to assist, but she deserved to observe. It’d be the honorable thing to do, help her get a foot into Ootaka’s OR in a way she probably couldn’t unwittingly screw up.

At the scene he’d noted at least three behaviors Ootaka would cut her over: inability to speak with authority; lackluster leadership skills; and visible displays of emotion. From the sidelines she’d be able to get a feel for things without being in the spotlight.

“It had stabilized him, but he’s popping more PVCs than he was, and his blood pressure range is narrowing again,” she added, directing all attention to the patient and the display on his wrist. “One hundred over seventy-five.”

Enzo had gotten used to being the main one to answer questions or brief Ootaka on patients. It was only to make sure that he knew the whole situation that Enzo tacked on, “Pressure had normalized to one hundred and forty-three over eighty-five after the second aspiration.”

“One hundred and forty-three over eighty-one,” Davis corrected.

Right. No more giving her credit. Those four measly points didn’t make any difference to the situation, other than highlighting that he’d made a tiny mistake. Not precisely underhanded but kind of snotty all the same. Apparently she was capable of a modicum of backbone. But squabbling over insignificant details wouldn’t impress Ootaka, so he held his tongue.

Ootaka nodded in the direction of Trauma 1 and led the way. In less than a minute the stretcher was locked into position amid the equipment in the trauma suite, all gloved hands on deck.

“Davis,” Ootaka directed. “Another aspiration.”

Davis? Damn.

A larger hypo than the ones she’d used on scene landed in her hand. A nurse took over the job that Enzo had performed earlier, swabbing the chest.

Again he watched Davis carefully position and guide the needle into the man’s chest, then another flow of bright blood pulled back into the hypodermic. Not so watery as it had been on the second draw.

“For the third draw, it’s a lot thicker than it was even the first time.”

Enzo locked his jaw to keep quiet. Something he never did with the other residents… but this was Davis’s show.

Davis withdrew the needle and concluded, “His chest isn’t simply filling with serum again. There’s bleeding. He’s got a tear somewhere.”

“He does,” Ootaka confirmed. “Going to have to go in. Correct call, DellaToro.”

Of course it was. Enzo stepped forward again. Before Enzo could do more than nod, Ootaka turned to Davis. “Welcome to West Manhattan Saints, Dr. Davis. An OR has been prepped. You’re with me.”

Enzo’s head jerked back as if he’d been slapped.

Ootaka had invited her to surgery.

A slower step back to get out of the way again and Enzo found himself blinking, as if clearing his vision would do something to clear up what he’d just heard. But nothing had changed. The situation settled like lead in his belly.

Ootaka was definitely impressed with her.

The man told all the first-year residents they couldn’t assist him until he’d seen them in the OR to weigh their ability. They observed, he gave them small tasks, and gradually built up to assisting. Usually other surgeons did much of the initial surgical instruction, Ootaka was next-level surgery. And if you didn’t meet his expectations…

It wasn’t so much that Ootaka made a production of letting the resident know they were no longer welcome—big displays of emotion were the same as big displays of drama—he simply stopped extending invitations. It usually took the resident a few weeks to realize they were no longer welcome or even on his radar. Enzo had even seen the man forget the name of residents once he’d stopped shining attention on them.

Davis wasn’t precisely a first year, but it was her first year at WMS. Ootaka had never seen her perform.

A pericardial aspiration by hypodermic, while tricky, didn’t compare to using a scalpel…

The team wheeled Mr. Elliot out of Trauma 1 and down the fastest hall to the OR, leaving Enzo to find something else to do.

A now-familiar Scottish brogue came from just outside the door. “Kimberlyn got Ootaka already? Caren said she was good.” He looked around the door frame.

“Don’t make me hit you, Sam.” Enzo stepped out, uncrossing his arms to let them hang, feigning the relaxed appearance he’d rather others see. He just couldn’t get his shoulders to loosen up. “What are you doing down here anyway? Aren’t you supposed to be with the babies?”

“I came to make sure Kimberlyn had made it, actually. We were going to walk together today, but I ended up needing to leave early for an errand.”

“Miss Scarlet needs an escort?”

Sam gave a low chuckle. “She really did get under your skin.”

“She’s not under my skin. It was a quick reference to that dark-haired Southern pretty girl thing she’s got going on.” Enzo had lied, and he wasn’t a liar. It was a point of pride that he could be blunt and honest about anything. She’d thrown him off his game for a third time. “It takes more than a strong base of medical knowledge to impress Ootaka. She’s got steady hands, but her leadership is nonexistent. Couldn’t even rally some rubberneckers at the accident to call 911 or to push the vehicle off the patient.”

“Want to grab a pint after your shift? You can find some pretty lass to take your mind off Cricket.”

“Yes,” Enzo answered, because a beer sounded good, as did the idea of finding a pretty lass. Someone more his flavor. Not dark and soulful. Davis probably wrote poetry and wore black all the time when she wasn’t in scrubs. Also not a lass. That sounded entirely too much as if it could fit Davis, and he’d rather have someone real. Overly emotional just didn’t do it for him, either.

Hold on. “Did you call her Cricket?”

“It’s her nickname. Don’t tell her I told you.”

Enzo snorted, but nodded to his friend—Dr. Cricket’s new housemate—and headed off to look at the surgery board. Maybe they’d be in one of the surgeries with an observation gallery so he could at least watch…

A short walk and he stood, looking the whiteboard over. Head of surgical residents Dr. Gareth Langley had taken one of the rooms with a gallery. The name Lyons stood out on the list. He looked only long enough to determine he wouldn’t accidentally walk in on that man’s surgery, then moved on. Ootaka had indeed reserved the last gallery.

If he hurried, he might even avoid accidentally running into Lyons on the way. That had been the other bit of information to stand out on the board: times and approximate duration. His father was the last person he wanted to see today. Or any day. The fact that they frequently shared a hospital made it impossible to avoid him altogether, but Enzo did his best. Always did, and he imagined Lyons did, as well. In four years they’d managed to avoid saying even a single word to one another and that level of avoidance couldn’t happen without two people actively working at it.

He relaxed only when he’d stepped through the door leading up to Ootaka’s gallery.

In his time in the program nearly all of his competition had fallen by the wayside. Winning this fellowship was a marathon, but Davis was here to sprint the last leg. An immediate invitation into Ootaka’s OR definitely meant she had started the sprint and he felt as if he was standing still, which was ridiculous. She couldn’t cover that much distance in one surgery.

Time to get his head back in the game. Observe the new surgeon. See how much of what Sam had said was actually correct. See if she really was a threat to his goal or if his mind was playing tricks on him. However unlikely the possibility might be, he needed to judge for himself. If her backbone wasn’t full-on displayed, it didn’t matter how much she knew. She wouldn’t threaten his position as favorite horse in the race for Ootaka’s final fellowship.

But it might do the pit in his gut some good to see her getting the unavoidable dressing-down coming her way.

God, he sounded like a petulant child wanting Daddy’s approval. His stomach churned.

No one could survive Ootaka’s surgery without learning his particular rules. He should feel sorry for her.

If her arrival hadn’t felt like another shadow he’d have to fight his way out of, he might actually muster some sympathy.

The only way to find whatever was bleeding inside Mr. Elliot’s chest was to crack it.

Kimberlyn had been in a few thoracic surgeries since the accident, during the last months of her first year back… but seeing a chest open still made her scar burn.

This was someone else’s sternum, someone else’s pain.

The words danced through her mind on repeat every time she started to feel her chest tighten or her heart speed up.

Mr. Elliot deserved undivided attention, and the likelihood he’d one day have his own scar to fixate on hinged on the talent and skill of his surgical team. Mainly Ootaka, but she mattered.

Luckily, Ootaka was the best. One day she’d be that good—another mini-Ootaka to save those poor wretches who had to be cut out of ugly car crashes. Just as she had.

Ootaka’s fellowship was the reason she’d come north. He announced last year that it was the last fellowship he was going to do, which was why she had ended up transferring to West Manhattan Saints when she’d been set up perfectly and had enjoyed her former hospital.

Waiting two years to apply for his next fellowship? No longer an option.

The intention toward trauma hadn’t really existed before her accident. She’d thought about it but had floated between cardiac, cardiothoracic and plain old general surgery, too.

Her life had become a series of dominoes that day…

As much as she hated what had happened to Mr. Elliot, his pain was her good fortune. It had gotten her noticed immediately. Now she just needed to perform well in this surgery. Keep Ootaka’s attention. Build his appreciation and belief in her. Do everything in her power to make this year count. Keep her promise: save the good people like Janie from the bad people like her.

Or, better, save the victims so the idiots who’d caused the wreck could learn and avoid turning into her. Normal lives for all involved. Two birds, one stone. That was a worthy goal. That would make her worthy.

Which meant outshining Ootaka’s star pupil, Dr. I’m-Running-Ahead…

“Suction.”

So Ootaka started her with the basics. Minding the blood was important enough. Suctioning it off where he needed to see what he was doing, keeping an eye on the pressure to alert him when they needed to give fluids…

Which was now.

“He’s lost a… bit of blood,” she began. Assisting a surgeon for the first time always meant getting used to the way they liked to do things. Very few things were standard when it came to OR etiquette. Hence her needing to ask, “At what point do you like to hang blood?”

“Are you saying that you believe we should be doing so now, Dr. Davis?” Ootaka never took his eyes off the patient, but movement in the corner of her eye pulled her gaze up. Someone in the gallery.

Enzo. Could he hear them up there?

Okay, she was being paranoid. Why would that matter? If he could hear, maybe he’d just pick up on how to be professional and not sneaky with a colleague.

Focus on the OR, not on who lurked above it.

“Yes, Dr. Ootaka. I would like to give him some packed red now.”

“Better. In my operating room, do not couch your concern for the patient in question. You’re a surgeon. Asking questions you know the answer to makes you sound uneducated. Save your questions for when you really don’t know the answer.”

Right. She could do that. Most of the surgeons she’d worked with preferred deference, but maybe that was their way of keeping a hierarchy in place. Ootaka’s air and reputation did that well enough—maybe he had no need to force protocol through some etiquette dance.

“Yes, Doctor. I’ll remember that.” While she usually handled change well, not knowing how she was to behave wasn’t one of those changes she could just float with. If she wasn’t supposed to ask questions, did that mean she should just do what she thought was best? Mr. Elliot was Ootaka’s patient now, not hers.

He did glance up long enough to look her in the eye. “Yes?”

“Does that mean for me to go ahead with what I think is the right decision, or—”

“No. Announce first with clear intentions and reasons. Always reasons.” He’d started to sound a little annoyed, so she was happy when he immediately switched back to the subject. “Why packed red cells?”

As far as reprimands went, it wasn’t much of one, but all corrections made her cheeks burn. Luckily, the surgical mask kept anyone from noticing, even if the inside of her mask was getting a bit stuffy.

Before moving to carry out the task of replenishing the man’s blood, she answered Ootaka. Minimize chance of rejection or reaction. Saline could do the job of plasma for now. Oxygen depletion to traumatized tissue was best avoided, so red cells were her choice. Reasons anyone in medical school would know, let alone a fifth-year surgical resident.

But at least there was some comfort in the sameness—questions and answers accompanied all lessons, no matter what hospital or surgeon you were with. She looked up at the galley again, and this time Enzo was looking at her. Not just watching the table. When she looked up, his gaze was locked on hers. Her belly trembled.

How was she supposed to keep her eyes on the patient with him staring? Correction: staring and smirking? Or was that a grimace?

Ignore him.

With the Q&A finished, she ordered the packed cells and another bag of saline.

So he could hear them. Whatever. Not that she expected any less from her competition. Caren had warned her he could be a jerk. He’d wanted to assist. She’d seen it in his eyes when Ootaka had invited her into his OR. And what was that about him being right about the need for surgery? She had to wonder what else he’d told Ootaka after running to get there first. She should’ve run with him. Only that would’ve meant leaving Mr. Elliot—and even for a couple of minutes she couldn’t have made herself do so, knowing that neither of them would be with him.

What she needed to do was not think about him as an attractive man. Focus on the jerk, not the jaw. The arrogance. And all that jaw did was frame a smirking mouth.

Jerky, not to mention manipulative. Keep our patient alive indeed. Those words had assured she’d stay put.

But, worse, they’d made her feel important enough that she’d hardly questioned why he wasn’t riding with them in the ambulance.

They’d made her underestimate him…

Later she’d send Caren a crankygram—an email she’d no doubt check in a couple of weeks. Maybe she could find Tessa after the surgery ended to get information. See if her new friend knew Enzo’s tactics. Plot some ways to outmaneuver him, or at least figure out his usual manner of manipulation. It would certainly behoove her to know what his weaknesses were. Aside from arrogance.

Or maybe just vent. His attempt to maneuver the situation hadn’t worked out so well for him this time. Maybe she didn’t need to try to learn to do that. Maybe it was just a case of where the cream rose, and she just needed to focus on herself and… stuff. That’s what she’d like. Avoid confrontation. Be pleasant and easy to work with. Be the person that everyone liked, or at least felt no overt hostility toward.

Be exactly who she’d been before the accident. That’d be awesome.

And impossible.

Think later. Pretend Caren had been overreacting when she’d focused on how hard Kimberlyn would have to fight for the fellowship.