Outside of OR room 18, Thomas met Peter Figman scrubbing. He was a baby-faced, slight fellow who appeared as if he didn’t have to shave yet.
Thomas had seen him on numerous occasions but never had the opportunity of working with him. He had a reputation of being smart, dedicated, and of having good hands.
As soon. as he saw Thomas, Peter launched into a detailed presentation of the case. The patient had been stabbed during a hockey game at the Boston Garden but was in stable condition, although there had been some trouble with his blood pressure when he’d first been admitted to the emergency room. He’d been typed and crossed for eight units of blood, but none had been given yet. The first thought had been that the knife had punctured one of the great vessels.
While Thomas listened to the presentation, he took a surgical mask from the box on the shelf above the scrub sink. He preferred the older-style masks that tied behind the neck and head as compared to the molded masks that were secured with a single elastic band behind the head. Tonight, however, he kept dropping one or the other of the straps. Then the mask slipped from his grasp and fell to the floor. Thomas cursed under his breath and took another. As he reached into the box, Peter noticed that the older man’s hand had a slight tremor.
Peter stopped his presentation. “Are you all right, Dr. Kingsley?”
His hand in the box, Thomas slowly rotated his head to look directly at Peter. “What do you mean, am I all right?”
I thought maybe you weren’t feeling well,” said Peter timidly.
Thomas snapped the mask out of the box, pulling an extra one with it which fell into the scrub sink. “And why did you think I might not be feeling well?”
“I don’t know, just a hunch,” said Peter evasively. He was sorry now he’d said anything.
“For your information, I feel perfectly fine,” said Thomas, making no attempt to conceal his anger. “But there’s one thing I will not tolerate from the residents, and that is insolence. I hope you understand.”
“I understand,” said Peter, eager to drop the subject. Leaving the resident to finish his scrub, Thomas pushed through the OR door. “For Christ’s sake,” thought Thomas, “doesn’t the kid realize I was just awakened from a deep sleep; everybody has a little tremor until they have a chance to fully wake up.”
The OR was a buzz of activity. The patient was already fully anesthetized and junior house staff were in the process of prepping the patient’s chest. Thomas walked over to review the X rays. Then, while his back was to the room, he held up his hand. The tremor was slight. He’d had worse.
“Just wait until that cocky kid rotates on cardiac surgery,” Thomas mused with some satisfaction.
Thomas parked himself in the back of the OR and watched carefully as the case began. He was ready to intervene if needed, but to Peter’s credit, he was a good technical surgeon. Thomas quizzed all the residents about possible hemopericardium. None of them, including Peter, had thought of the diagnosis despite the fact that it had been discussed at the last death conference. When Thomas was certain the case was routine and would go smoothly, he stood up and stretched. He wandered over to the door.
“I’ll be available if anything goes wrong. You fellows are doing a good job.”
When the OR door closed behind Thomas, Peter Figman glanced up and whispered: “I think Dr. Kingsley’s had one-too many tonight.”
“I think you’re right,” said a junior resident.
Thomas had felt a sudden sleepiness steal over him as he’d sat in the OR.
Fear of nodding off had driven him out. On the way to the surgical lounge he took several deep breaths. He couldn’t remember how many Scotches he’d had with Doris. He’d have to be more careful in the future.
Unfortunately, the lounge was occupied by two nurses on their coffee break. He’d planned to stretch out on the couch but decided he’d use one of the cots in the locker room instead. As he passed the window, he glanced out and noticed a light in one of the offices across the way in the Scherington Building. Counting the windows from the end, Thomas realized that it was Ballantine’s. He looked up at the clock over the coffee maker. It was close to 2:00 A.M.! Had the janitor just forgotten to turn it off?