He had started the temporal lobectomy as soon as Ranade had inducted Lisa under general endotracheal anesthesia. There had been a panic immediately after Lisa’s seizure although everyone acted superbly. Mannerheim had succeeded in grabbing Lisa’s flailing hand before any more damage had been done. Ranade, the real hero, had reacted instantly, injecting a sleep dose of one hundred and fifty milligrams of thiopental IV, followed by a muscle paralyzer called d-tubocurarine. These drugs had not only put Lisa to sleep, but had also terminated the seizure. Within only a few minutes Ranade had placed the endotracheal tube, started the nitrous oxide, and positioned his monitoring devices.
Meanwhile, Newman had extracted the two inadvertently deeply embedded electrodes while Lowry removed the other surface electrodes. Lowry also had placed moist cottonoid over the exposed brain before covering the site with a sterile towel. The patient had been redraped and the doctors regowned and gloved. Everything had returned to normal except Manner-beim’s mood.
“Shit,” said Mannerheim, straightening up to relieve the tension in his back. “Lowry, if you’d rather do something else when you grow up, tell me. Otherwise hold the retractors so I can see.” From Lowry’s position the resident could not see what he was doing.
The door to the OR opened, and Philips entered, carrying the X rays.
“Watch out,” whispered Nancy Donovan. “Napoleon is in a foul mood.”
“Thanks for the warning,” said an exasperated Philips. It irritated him that everyone tolerated Mannerheim’s adolescent personality, no matter how good a surgeon he was. He put the X rays up on the viewer, aware that Mannerheim had seen him. Five minutes passed before Philips realized that Mannerheim was deliberately ignoring him.
“Dr. Mannerheim,” Martin called over the sound of the cardiac monitor.
All eyes turned as Mannerheim straightened up, shifting his head so that the beam of his miner-like head lamp fell directly on the radiologist’s face.
“Perhaps you don’t realize that we are doing brain surgery here and maybe you shouldn’t interrupt,” Mannerheim said with controlled fury.
“You ordered localization X rays,” said Philips calmly, “and I feel it is my duty to provide the information.”
“Consider your duty done,” said Mannerheim, looking back into his expanding incision.
Philips’ real concern was not the electrodes’ positions, because he knew they were perfect. It was the orientation of the posterior or hippocampal electrode in relation to the formidable posterior cerebral artery. “There’s something else,” said Martin.
Mannerheim’s head shot up. The beam of light from his head strafed the wall, then the ceiling, while his voice lashed out like a whip. “Dr. Philips, would you mind taking yourself and your X rays out of here so that we can finish the operation? When we need your help, we’ll ask for it.”
Then in a normal voice, he asked the scrub nurse for some bayonet forceps and went back to work.
Martin calmly took his X rays down and left the OR. Changing back to his street clothes in the locker room, he tried not to think too much; it was easier on his mood. Heading back to Radiology, he allowed himself to ponder about the conflict in his sense of responsibility that the incident evoked. Dealing with Mannerheim called on resources he never imagined he’d need as a radiologist. He hadn’t resolved anything when he arrived back at the department.
“They are ready for you in the angiography room,” said Helen Walker when he reached his office. She stood up and followed him inside. Helen was an extremely gracious thirty-eight-year-old black woman from Queens who had been Philips’ secretary for five years. They had a wonderful working relationship. It terrorized Philips to think of her ever leaving, because like any good secretary she was instrumental in running Philips’ day-to-day life. Even Philips’ current wardrobe was the result of her efforts. He would have still been wearing the same boxy clothes he’d worn in college if Helen hadn’t teased him into meeting her in Bloomingdale’s one Saturday afternoon. The result had been a new Philips, and the contemporary fitted clothes suited his athletic body. ”
Philips tossed Mannerheim’s X rays onto his desk, where they merged with the other X rays, papers, journals and books. It was one place Philips forbade Helen to touch. No matter what his desk looked like he knew where everything was.