The Final Push

Ten minutes later, Higgins was at the sink outside OR Eight, scrubbing for surgery. He watched through the window as John Doe was positioned on the table, painted from chin to knees with iodine antibacterial solution, and draped with sterile sheets. With his wet hands held high, Higgins backed through the door and made his way to the instrument stand, where he dried off and gowned himself without assistance, the way the OR nurses had taught him.

Conrad Porter was standing over the patient, scalpel in hand.

Dr. Frank Larson, the attending trauma surgeon, stood across from Porter. “Make a big incision, xiphoid to pubis,” he said. “This is trauma surgery, not plastic surgery.”

Higgins approached with quiet dread. He was tired, confused, and full of hate. This was going to be a long, difficult case, and he couldn’t afford to be distracted. 

“Hurry up, Higgins,” Porter said. “We can’t start without you.”

He moved in close to the table, on Porter’s left. The grinning skull—now with a sickly, jaundiced appearance thanks to the antibacterial paint—stared up at Higgins.

“Get both suckers in your hands. When I open him, blood’s gonna spill out of this guy.”

Conrad Porter was right. As soon as he entered the abdomen, blood poured from the wound. Higgins stuck both suctions into the abdominal cavity and tried to aspirate as much as he could while the chief resident completed the incision.

Dr. Larson said, “We have a major arterial bleeder, and it’s bright red, possibly the aorta. Keep the lap sponges coming. We’ll need a lot of them.”