80. Dream A Little Dream Of Me: part 2
I was intrigued by what we were going to attempt to do with our patient. She showed me the case studies on it. Bailey, Hunt and Webber were all there. It seemed like a good until Derek walked in. "What's going on?" He asked us.
"We're going ahead with the freezing." Webber said while turning around to face Derek. Apparently the Chief was the one that wanted me to be here.
"Without my consent?" Derek asked him, I was wondering how this would go. "No, I don't think so." He added as an answer.
"You really want to be the doctor who doesn't give his all to keep a man from wheelchair-bound for the rest of his life?" Hunt asked, I really did like this man.
"Get out of my patient's room!" Derek shouted at him, he needed to keep his wig on.
"I don't take orders from civilians." Hunt said, I looked away and just looked at Callie.
"Listen, you arrogant, little- -" Derek started before Webber blocked him from moving.
"Shepherd." Webber said to him.
"Okay, right now this patient is stable. He may never walk again, but if you try this, he could throw a clot, go into organ failure, and he could die." Derek said to us, those were just risks that we had to defeat.
"We're going ahead with the freezing." Webber said to him, clearing it up to him.
"Hmm. Ever since this morning you've been pissing on everything with a pulse trying to prove you're not number 12, and you're not. But right now, with this decision, you act like number 12. Good luck with the patient, Dr. Torres." Derek said before walking out, we all went silent. I didn't know what we were going to do instead. Were we still going to go ahead with the freezing or not? We were though.
"That chill you'll feel is the cold saline rushing through your veins to lower your core body temperature." Callie said while hanging the bag up.
"And if it works, I walk?" He asked us.
"If it works, our hope is that you will walk again." I said to him with a smile.
"Ooh. Wow. Okay, uh...I'm- -I'm getting cold." He said to us, I looked at Callie.
"His temp' still 96.8, Chief. Shall we lay another cooling blanket on him?" Callie asked him for reassurance, I was actually glad that I was here. No one else would experience this.
"That's up to you, Dr. Torres. You're taking point. That's what the Chief of a number one teaching hospital does. He handpicks talented surgeons and lets them take point. Right, Dr. Bailey?" Webber said making the three of us smile.
"Couldn't agree more, Chief." Bailey said with a smile.
"Warm and toasty, that's what I'm feeling." Mr. Loomis said to us, was that a good thing. The monitor started beeping erratically.
"His pulse is falling. Are you sure- -" Bailey started asking, I looked at Callie hoping she knew what to do.
"Yeah, down to 52." Webber said to us with a hint of worry in his tone.
"Yeah, it's normal for his pulse to fall." Callie said, I was hoping that she was right.
"Okay, h-how much longer we got?" He asked Callie.
"Not too much longer, okay? You're doing great." Callie said to him reassuringly.
"Keep thinking warm and toasty." Bailey said to him with a smile.
"Okay. I'm trying." He said to us.
"Good." I said to him. Callie chuckled a little.
"Number 12, my ass." Bailey said making us all chuckle. It was hard to believe that I was handpicked for being an excellent surgeon. I saw Alex walk over to our room.
"Dr. Bailey." He said making her sigh. She walked over there and started talking.
"Philip, you're doing great. I'm giving you more sedative and a paralytic to stop your shivering, okay?" Callie said to him, he must be so cold.
"Okay, okay." He said to her. She started giving him the sedative and the paralytic.
"Okay, we'll need to intubate, Bailey." Callie said to us afterwards.
"All right, coming down. One, two and three and down." Webber said to us as we started putting him down.
"He's down to 90 degrees. I think that's, um, too low. I-is that too low?" Callie asked us, she was the one that did the study, we didn't.
"You did all the research." Webber said to her, I looked at her.
"I think it's too low." Callie said before the monitor went off. "Oh, my god." She said in a near whisper.
"Okay, so what now? Is this gonna resolve? Do they recommend lido or amiodarone? Dr. Torres?" Bailey asked but she was just silent.
"Dr. Torres, just breathe." I said to her in a whisper.
"Uh, Dr. Torres?" Bailey said to her.
"He's barely got a pulse." Webber said to her.
"Uh, uh, should we do C.P.R.?" Callie asked, she was panicking.
"No, he- -lets t-try to avoid jostling Shepherd's spinal decompression unless absolutely necessary." Bailey told her, I looked at Callie. She wasn't looking to good.
"Oh, crap. Crap." She said while breathing out.
"His heart is like,y to stop, soon. What are you gonna do, Dr. Torres?" Webber asked her, this was a worrying time.
"I don't know." She said to us in a whisper. "I-I don't know." She said in her normal voice. "I don't..." She said in a whisper. I was starting to panic now, maybe we should've just listened to Derek. We decided to start him on ecmo and then we paged Hahn, she didn't seem so happy when she arrived.
"You started him on ecmo? You're taking out all his blood and replacing it?" Hahn asked us annoyedly.
"It was the only thing to do, Dr. Hahn. We don't want to jostle his spine, and this will give his heart some rest. Now we need you to monitor him until we get him back on. Now are you in or not?" Webber said to her, it took her a while before she decided.
"All right, we all ready to wean?" She asked us all.
"Let's do it." Webber said to her and we started.
"It looks like he's tachycardic. Should we shock him, give him adenosine?" Bailey asked, I wanted to know what we should do.
"Well, normally I'd say yes, but this man's an ice cube." Hahn replied, so really we couldn't do naff all.
"Dr. Torres, in any of your research, was there anything to suggest what to do in a situation like this?" Webber asked us, he'd put his glasses on.
"I don't- -I don't- -I mean, um...I think I messed up here. I mean, I don't know. I mea, maybe- -maybe- -maybe he would've been fine on his own. Maybe- -maybe- -" Callie said, she was in a lot of panic and stress and worry.
"All right, look at me. Look at me. Focus. You're trying something new. There's nothing wrong with new. Breaking new ground, pushing the boundaries, it comes with the job. So, Dr. Torres, take a breath, stop panicking and just tell us. What did your research say?" Hahn said to Callie, she seemed a bit calmer now.
"My research showed that...that, um...arrhythmias can occur at a certain threshold. His appear to be between...uh, 91.5 and 92 degrees." Callie said to us, this was good we knew more.
"He's around 90 right now." Webber said while looking at the monitor.
"Okay so..." Callie started before thinking.
"We could use the ecmo to help bring him back up." Bailey suggested, that sounded like a good plan.
"Yes, but not too quickly, because that can cause problems of its own." Callie said making me and Hahn smile a little.
"All right. Looks like we have some warming to do." Hahn said before we started warming him up.
"Time to watch something new happen." I said with a happy. We did it and we waited a little before leaving. Now that put me up a point on being the best surgeon out of my brother and I. I was hoping that Mr. Loomis would be able to walk again. I found Alex and we had a talk. May I add that I made him jealous by talking about what I witnessed. He went to get coffee whereas I went to get some food seeming as it was officially the next day and I wanted breakfast. I was tired so I went find a bed that I could crash on for a quick nap. I was tired, I'd been working nonstop.
When it came to the end of my shift, I got ready before heading home when I got there the babysitter was watching Tv quietly. "I'm sorry, I was called onto another case." I said to her while putting bag down.
"It's fine, he's currently sleeping as he should be." She said to me while standing up and picking up her stuff.
"Thank you so much for staying, I'll pay you extra." I said to her with a smile.
"There's no need." She said while walking over to the door. "I'll see you tomorrow Dr. Y/l/n." She said to me.
"See you tomorrow." I said to her before she walked out, I shut the door behind her. I went to my room and changed before going to bed. Today was definitely full of complications and trying new things but we made it work.
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It was a new shift, we called for announcement so we all gathered together, Webber walked into the room. "Listen up, people. Listen up." I heard him shout, I shut myself up and looked at him. He slammed the door and everyone stopped talking. "We used to be the best surgical program in the west, an upstart program that no one ever heard of that blew everyone out the water. Then overnight, we got old...entrenched and sloppy, just like everyone else. We've been resting on our laurels. You have all been failing- -failing to take the initiative, failing to ask the tough questions, failing to practice your skills, failing to give opportunity to practice skills. And I let it happen.so you ah e not failed. We have failed. Well, it stops, and it stops now. People sliding over general surgery as though they will never see anything but a heart or a brain through the course of their career, as though blood from the heart doesn't make its way through the whole body or the nerves don't travel past the brain stem. It's shoddy teaching, and it makes for shoddy surgeons. We've failed. Get it? We all have, and it stops now. The surgical training protocol is officially changing, people. The bar has been raised. Consider yourself on notice." Webber said to us before leaving and slamming the door behind us. Wow, I didn't quite know what to think. Could I lose my job?
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