Kat pulled away and hurried into the operating room.
Because of the change in schedule, Dr. Vance was doing the operation with Kat. He was a good surgeon. Kat began the ritual scrub: a half minute on each arm first, then a half minute on each hand. She repeated it and then scrubbed her nails.
Dr. Vance stepped in beside her and started his scrub. “How are you feeling?”
“Fine,” Kat lied.
Lou Dinetto was wheeled into the operating room on a gurney, semiconscious, and carefully transferred to the operating table. His shaven head was scrubbed and painted with Merthiolate solution that gleamed a bright orange under the operating lights. He was as pale as death.
The team was in place: Dr. Vance, another resident, an anesthesiologist, two scrub nurses, and a circulating nurse. Kat checked to make sure that everything they might require was there. She glanced at the wall monitors—oxygen saturation, carbon dioxide, temperature, muscle stimulators, precordial stethoscope, EKG, automatic blood pressure, and disconnect alarms. Everything was in order.
The anesthesiologist strapped a blood pressure cuff on Dinetto’s right arm, then placed a rubber mask over the patient’s face. “All right, now. Breathe deeply. Take three big breaths.”
Dinetto was asleep before the third breath.
The procedure began.
Kat was reporting aloud. “There’s an area of damage in the middle of the brain, caused by a clot that’s broken off the aorta valve. It’s blocking a small blood vessel on the right side of the brain and extending slightly into the left half.” She probed deeper. “It’s at the lower edge of the aqueduct of Sylvius. Scalpel.”
A tiny burr hole about the size of a dime was made by an electric drill to expose the dura mater. Next, Kat cut open the dura to expose a segment of the cerebral cortex that lay underneath. “Forceps!”
The scrub nurse handed her the electric forceps.
The incision was held open by a small retractor which maintained itself in place.
“There’s a hell of a lot of bleeding,” Vance said.
Kat picked up the bovie and started to cauterize the bleeders. “We’re going to control it.”
Dr. Vance started suction on soft cotton patties that were placed on the dura. The oozing veins on the surface of the dura were identified and coagulated.
“It looks good,” Vance said. “He’s going to make it.”
Kat breathed a sigh of relief.
And at that instant, Lou Dinetto stiffened and his body went into spasm. The anesthesiologist called out, “Blood pressure’s dropping!”
Kat said, “Get some more blood into him!”
They were all looking at the monitor. The curve was rapidly flattening out. There were two quick heartbeats followed by ventricular fibrillation.
“Shock him!” Kat snapped. She quickly attached the electric pads to his body and turned on the machine.
Dinetto’s chest heaved up once and then fell.
“Inject him with epinephrine! Quick!”
“No heartbeat!” the anesthesiologist called out a moment later.
Kat tried again, raising the dial.
Once again, there was a quick convulsive movement.
“No heartbeat!” the anesthesiologist cried. “Asystole. No rhythm at all.”
Desperately, Kat tried one last time. The body rose higher this time, then fell again. Nothing.
“He’s dead,” Dr. Vance said.
Chapter Twenty-two
Code Red is an alert that immediately brings all-out medical assistance to try to save the life of a patient. When Lou Dinetto’s heart stopped in the middle of his operation, the operating room Code Red team rushed to give aid.
Over the public address system Kat could hear, “Code Red, OR Three…Code Red…” Red rhymes with dead.
Kat was in a panic. She applied the electroshock again. It was not only his life she was trying to save—it was Mike’s and her own. Dinetto’s body leaped into the air, then fell back, inert.
“Try once more!” Dr. Vance urged.
We don’t threaten people, doc. We’re telling you. If Mr. Dinetto dies, you and your fucking family are gonna be wiped out.
Kat turned on the switch and applied the machine to Dinetto’s chest again. Once more his body rose a few inches into the air and then fell back.
“Again!”
It’s not going to happen, Kat thought despairingly. I’m going to die with him.