Fredric Stern - The Endorphin Conspiracy

“Good bet she is, but that may be the least of her problems.” Santos removed his flashlight from the red tackle box and gently pried her lids open. “Pupils are mid-dilated, barely reactive. Not a good sign. How are her breath sounds?”

“Okay on the right side, decreased on the left. She may have a collapsed lung. Could be from a rib fracture.” Ceravolo examined the large bruise over the child’s left rib cage.

“Large scalp laceration, but her skull seems all right,” said Santos, carefully wrapping her head with gauze.

Ceravolo started a saline IV and ran it in as fast as it would drip. She got the neck brace and the backboard out of the chopper.

Gently, they lifted their fragile cargo into the compact, high-tech quarters of the helicopter. As the chopper began its ascent, Santos and Ceravolo applied the electrodes that would monitor all of Jessica’s vital signs, including her heart rhythm. Rick momentarily glanced over his shoulder and signaled for them to put on their headsets. There was no other way to communicate easily over the thunderous noise of the helicopter.

“She gonna make it?” he asked.

“Too soon to tell, but her chances are better than they were ten minutes ago,” Ceravolo said.

“Her vitals seem to be stabilizing,” said Santos.

“Looks like you two have things under control. Don’t you think it’s time to call in? Wouldn’t want to piss off the boss on a Sunday night,” said Rick.

“Guess you’re right. I’m sure he’s going nuts waiting to hear from us. Patch us in. Tell him the radio was out for a while,” said Ceravolo.

“You tell him. He’s on the line now,” said Rick. “Good luck.”

“Shit,” muttered the medics in unison.

“What the hell’s been going on? How’s the girl?” boomed the voice of Dr. George Spiros.

“Vitals weak but stable. Probable closed head injury, pupils five millimeters and sluggish. May have a collapsed lung and internal hemorrhaging. This pobrecita has had better days, Dr. Spiros,” Santos said.

“Have you given her any dopamine?”

“No. Just normal saline, as much as her little vein can take. Her pulse is regular at 120, her BP 75 over 35. We’re bagging her at 24 breaths per minute.”

“Ceravolo, you there? I haven’t heard from you today. How’s the girl’s cardiac rhythm?”

“A little fast, but regular.”

“Sounds like we’ll need the neurosurgeons as well as the general surgeons on this one. What about that crazy Parks Department guy? Anything left of him?”

“The coroner’s picking up the pieces,” Santos said.

“Can’t say I’m upset about that. What’s your ETA, Davidson?”

“Two minutes, sir.”

“Good job. But call me sooner next time. See you at the landing pad in two.”

“Roger.”

They breathed a shared sigh of relief, and the helicopter thundered north, flying high above the once- majestic Hudson River.

Enrique Santos, seasoned medic, devout Catholic, and father of five, reached into his pocket, and clutched his rosary beads in one hand, caressed little Jessica’s blood-stained, bandaged forehead with the other. Dios mediante—God willing—you will make it, pobrecita.

“Nice job assisting in the OR, Karen,” said Geoff. “You’ve really gotten your feet wet in a big way on the first day.”

Geoff looked at his wrist, checked his watch. One-thirty p.m. So much for morning rounds. He inserted his ID card into the security panel outside the NSICU. A green “enter” sign illuminated, and with a whoosh, the doors parted.

“Thanks. I really like being in the OR, and it helps to have a good teacher.”

Geoff and Karen entered what amounted to a decompression chamber, where white coats had to be removed and kelly green jumpsuits donned. They cleansed their hands with the disinfectant soap, then put on surgical gloves.

“Ready?” Geoff asked. The door opened and he stepped into the room, Karen following right behind him. The antiseptic aromas of iodine cleanser and surgical adhesive wafted their way, the distinctive scents reassuring, familiar, to Geoff.

“Well, Dr. Davis, I thought you’d never get here,” said Cathy Johannsen, charge nurse of the day shift. Cathy was about thirty-eight, had long white hair pulled back in a pony tail, sparkling blue eyes and a fine, chiseled nose emphasizing her Scandinavian decent. She was a bit too big bottomed for Geoff’s taste, though many of the male residents considered her a knockout. “Cathy, with you in charge, I knew everything would be under control. All I have to do is sign the orders.”

“I wish it were that simple,” she said, “It’s good to have you back, Geoff. I hear you had a long morning.”

“A typical day at the Trauma Center. Good experience for Dr. Choy, here.” He motioned to introduce Karen Choy. “Sorry. Let me introduce you two properly. Cathy Johannsen, Dr. Karen Choy, first year resident.”

The two women shook hands. “Pleasure,” said Cathy. “You’re lucky. You have a great teacher.”

Geoff smiled, cleared his throat. “Where’s the team? We need to be briefed on recent admissions.”

“Over by bed eighteen, the little girl with the head injury,” she said, pointing to the opposite end of the ward.

Geoff looked around the room. It had been a long time. The scene was surreal, not unlike a modern version of Dr. Frankenstein’s laboratory. There were rows of bodies, all ages, shapes, sizes and colors, in various states of consciousness. Most were comatose, having lost control of their bodily functions to machines—machines that did their breathing, filtered their blood, regulated their IV infusions, monitored their core temperature, pulse, and blood pressure. Other machines measured the pressure inside their skulls caused by brain swelling from injuries. Connecting these bodies to each of these machines were tangles of tubes, wires, bolts, and needles protruding from skulls and every natural and man-made orifice imaginable. All of the machines and monitors were linked by cables to a central computer at the nursing station staffed by a team of monitor technicians twenty-four hours a day. No bodily function escaped detection and control.

Except the brain. Brainwaves had been studied for years with the electroencephalogram, and changes in brain pressure could be followed with intracranial pressure monitors, but the physiology of consciousness had remained a great mystery. Until the PET scan. Geoff and Karen drifted toward bed eighteen, where they joined up with the rest of the team.

“Ah, Geoffrey, my friend, good to see you back in the saddle,” Kapinsky said. “We almost gave you both up for lost.” He put his arm around Geoff’s right shoulder.

Geoff stiffened, grabbed Kapinsky’s arm and removed it from his shoulder. “Sore shoulder. Hurt it working out the other day.”

“Sorry, chief. Hey, let me introduce you to your team.”

Introductions were made all around, Geoff analyzing the new group of doctors he’d be responsible for. There were two first year residents: Karen Choy, whom he had already spent half the day with, and Brian Phelps, bearded, intense, humorless, and at thirty-two, older than usual for a first year neurosurgical resident.

Geoff acknowledged the two medical students assigned to the team. Both were women, wide-eyed, uninitiated to a brutal, clinical rotation like neurosurgery. Then there was the gnat, Howard Kapinsky. Short,with thinning, frizzy brown hair, mud brown eyes, a substantial nose, and his perennial, pencil-thin attempt at mustache. Kapinsky, the momma’s boy from Sheepshead Bay.

The rift between Geoff and Kapinsky had developed over the years, Kapinsky envious of Geoff’s strapping good looks, accomplishments and family background, Geoff disgusted with Kapinsky’s servile behavior and endless brown-nosing.