Chapter 9 - EXAMINING THE PATIENT
I walked through the sliding automatic doors of Operating Room Alpha,
stepping into a cathedral of chrome,
glass,
and glowing monitors.
The surgical team stood at attention around the massive operating table,
their eyes fixed on me with a mixture of reverence and awe.
Senior scrub nurse Brenda nodded respectfully,
handing me my sterile surgical gown and gloves with practiced efficiency.
I slipped my hands into the sterile gloves,
ensuring a snug,
flawless fit without a single wrinkle.
Richard Sterling lay unconscious on the table,
draped in blue surgical drapes from neck to toes,
surrounded by invasive monitoring lines.
I stepped up to the table and leaned over the patient,
performing my own rapid pre-incision physical assessment.
I palpated the femoral pulses,
checked the arterial line waveforms on the overhead monitor,
and reviewed the live transesophageal echo feed.
The dissection had clearly advanced over the past hour,
extending perilously close to the left carotid artery take-off.
If we did not establish cardiopulmonary bypass within the next fifteen minutes,
the aortic wall would rupture catastrophically.
I looked up at the circle of masked faces surrounding the table,
my voice cutting through the ambient hum of the anesthesia machine.
I announced clearly: 'Team,
listen to me closely.
This is a Stanford type A dissection with arch involvement.
We have zero margin for error.'
Every head nodded in unison,
acknowledging my absolute command of the procedure.
I instructed the perfusionist to prepare for full heparinization and initiate retrograde cerebral perfusion protocols.
The anesthesiologist confirmed that systemic blood pressure and central venous pressure were stabilized within acceptable parameters.
I held out my right hand,
palm upward,
waiting for the instrument.
Brenda slapped the heavy steel handle of the surgical scalpel firmly into my palm with practiced precision.
I positioned the blade over the center of Richard Sterling’s sternum,
aligning it perfectly with the midsternal notch.
The entire room went dead silent,
the collective breathing of twenty people suspended in unison.
I pressed the blade downward through the skin and subcutaneous tissue,
opening a clean,
bloodless path along the midline.
The Sterling rescue mission had officially begun,
and there was no turning back for anyone involved.
Blood welled up slightly at the margins,
instantly suctioned away by the vigilant surgical assistant.
I moved downward with rhythmic,
confident strokes,
exposing the glistening white sheath of the sternum.
May you like
The electric sternal saw was handed to me,
humming with latent power as I brought it into position against the bone.
