"As you can see, the appendix is highly enflamed, like to rupture at any moment ..."
Harper nodded vaguely, studying the X-Rays and ultrasound scans thoughtfully. There was something else going on here; she had a gut feeling this wasn't going to be a straight forward operation. The patient - a young man in his late teens - had presented with all the perfect signs of acute appendicitis; right illiac fossa pain, especially on palpitation of the left illiac fossa, abdominal spasms and localised rigidity indicating imminent peritonitis ....but it was almost too perfect. She had a nasty suspicion she might find herself removing a tumour while she was in there.
But there was no need to worry the patient, or his parents, with that. Whatever happened in theatre, it was vital that they were all as relaxed as possible; any undue stress to the patient could complicate matters awfully for them all. The anesthetist was standing next to her, and the look he gave her said he knew exactly what she was thinking. Harper sighed to herself, nodded to him, and moved over to speak with the family, who were hovering with pale faces beside their son, who was blissfully out of pain and looking around in sleepy interest.
"Howard?" The three of them looked up at her, apparently startled to be addressed by a young woman in surgical scrubs. Harper smiled reassuringly, reaching out her hand to greet first Howard, and then his parents. "I'm Doctor Lacey, I'll be operating on Howard today. I wanted to come over and introduce myself, perhaps answer any questions you might have about the procedure."
"M'I gonna die?" was the first mumbled question, and Harper was hard pressed not to chuckle softly. How many times had she heard that question ...
"Not if I have anything to do with it, you won't," she assured him firmly. "It's a very straightforward procedure, barring any complications. When you wake up, you'll have a small scar, about 2 to 3 inches across just here." Her fingers touched his abdomen lightly in the correct place. "You'll feel pretty bruised, and moving around will be painful for the first few days, but that will pass. I've not lost anyone to appendicitis before, and you're not going to break my winning streak."
As she had intended, he smiled lazily, reassured by the firm confidence in her voice. To her relief, his parents were also relaxing as the anesthetist came over.
"This is Doctor Foreth, he's your anesthetist," she introduced him. "He's going to put you under now, and I'll see you when you wake up."
Amid the quiet thanks from the worried patients, she moved away, to scrub up and prep for surgery. Well, that was the hard part out of the way. the actual surgery was nothing to talking people through their worries before they went under. Her eye caught on the scans again, and she frowned. Hopefully things were just straightforward. She did not want to lose the boy on the table, or in the days after. It always left a gaping hole in the heart, when you lost a patient, and it was worse when the diagnosis was so straightforward.
Still, this was the way it worked. Scrubbed up and ready, she entered the operating theatre just as Foreth nodded, certain that Howard was under completely. With the assistance of her operating team, Harper made the first incision, and instantly knew something wasn't right. The muscle she encountered under her scalpel was necrotic, not a usual symptom of appendicitis. She swore softly, and suddenly the room was a hive of business. This wasn't an appendicectomy at all; they were operating on ischemic colitis with bowel perforation. This was going to need resectioning of the bowel.
As they got to work, opening the incision further and isolating the section of bowel they needed to remove, Harper cursed in the back of her own mind. Cursed herself for not relying on her gut instinct to ask for more investigation, and cursed the diagnosing doctor for not picking up on the actual problem. Yes, the boy's appendix was enflamed, but only as a result of the dying tissue in his large colon. She was going to have words with that one. Just as soon as Howard was right again. And she'd explained the horrific mistake to his terrified parents.
What a way to end her first week at work. Maybe she would have been better off at Riverview, after all.
Harper nodded vaguely, studying the X-Rays and ultrasound scans thoughtfully. There was something else going on here; she had a gut feeling this wasn't going to be a straight forward operation. The patient - a young man in his late teens - had presented with all the perfect signs of acute appendicitis; right illiac fossa pain, especially on palpitation of the left illiac fossa, abdominal spasms and localised rigidity indicating imminent peritonitis ....but it was almost too perfect. She had a nasty suspicion she might find herself removing a tumour while she was in there.
But there was no need to worry the patient, or his parents, with that. Whatever happened in theatre, it was vital that they were all as relaxed as possible; any undue stress to the patient could complicate matters awfully for them all. The anesthetist was standing next to her, and the look he gave her said he knew exactly what she was thinking. Harper sighed to herself, nodded to him, and moved over to speak with the family, who were hovering with pale faces beside their son, who was blissfully out of pain and looking around in sleepy interest.
"Howard?" The three of them looked up at her, apparently startled to be addressed by a young woman in surgical scrubs. Harper smiled reassuringly, reaching out her hand to greet first Howard, and then his parents. "I'm Doctor Lacey, I'll be operating on Howard today. I wanted to come over and introduce myself, perhaps answer any questions you might have about the procedure."
"M'I gonna die?" was the first mumbled question, and Harper was hard pressed not to chuckle softly. How many times had she heard that question ...
"Not if I have anything to do with it, you won't," she assured him firmly. "It's a very straightforward procedure, barring any complications. When you wake up, you'll have a small scar, about 2 to 3 inches across just here." Her fingers touched his abdomen lightly in the correct place. "You'll feel pretty bruised, and moving around will be painful for the first few days, but that will pass. I've not lost anyone to appendicitis before, and you're not going to break my winning streak."
As she had intended, he smiled lazily, reassured by the firm confidence in her voice. To her relief, his parents were also relaxing as the anesthetist came over.
"This is Doctor Foreth, he's your anesthetist," she introduced him. "He's going to put you under now, and I'll see you when you wake up."
Amid the quiet thanks from the worried patients, she moved away, to scrub up and prep for surgery. Well, that was the hard part out of the way. the actual surgery was nothing to talking people through their worries before they went under. Her eye caught on the scans again, and she frowned. Hopefully things were just straightforward. She did not want to lose the boy on the table, or in the days after. It always left a gaping hole in the heart, when you lost a patient, and it was worse when the diagnosis was so straightforward.
Still, this was the way it worked. Scrubbed up and ready, she entered the operating theatre just as Foreth nodded, certain that Howard was under completely. With the assistance of her operating team, Harper made the first incision, and instantly knew something wasn't right. The muscle she encountered under her scalpel was necrotic, not a usual symptom of appendicitis. She swore softly, and suddenly the room was a hive of business. This wasn't an appendicectomy at all; they were operating on ischemic colitis with bowel perforation. This was going to need resectioning of the bowel.
As they got to work, opening the incision further and isolating the section of bowel they needed to remove, Harper cursed in the back of her own mind. Cursed herself for not relying on her gut instinct to ask for more investigation, and cursed the diagnosing doctor for not picking up on the actual problem. Yes, the boy's appendix was enflamed, but only as a result of the dying tissue in his large colon. She was going to have words with that one. Just as soon as Howard was right again. And she'd explained the horrific mistake to his terrified parents.
What a way to end her first week at work. Maybe she would have been better off at Riverview, after all.