The only red in the operating room was the digital clock on the back wall, blinking steadily above the C-arm tucked neatly beside the anesthesia workstation. “Tourniquet time, six forty-two a.m.,” Alia Brooks croaked as she sat down on the stool. She was the second-year orthopedic resident on call last night and had slept in the call room for a blissful four and a half hours before this, the first case of the day. She wasn’t sure how Saanen would react if she said her thoughts out loud. Would he page the other resident, or would he tell her to suck it up and get used to the lack of sleep? She hadn’t done many scaphoid ORIFs before.
Dr. Errol Saanen stood across the hand table, with perfect posture. His lean figure belied the tension in his muscles. When Alia first met him at a research conference in med school, she would never have guessed that the poised man would appear so lanky in scrubs and lead. He was the only one in the room completely at ease. Alia wiggled her fingers, trying to get the blood flowing, yet she couldn’t get them to feel any less cold or stiff under the gloves. Despite changing into new scrubs before rounds at 6 a.m., she felt her sweat seeping into the fabric. Her warm breath escaped her mask with each exhalation, jetting upward right at her eyelashes. At least she wasn’t having a migraine today, probably a result of the two ibuprofen tablets she snuck in with her burnt coffee.
Between Alia and Saanen, the patient’s left arm lay prone, covered in blue drapes. Only an island of skin was exposed just over the wrist. The extensor tendons glistened in the bright operative lights. “Can I get the self-retractor? . . . And some irrigation please?”
Alia continued teasing apart the extensor retinaculum of the fourth compartment. She could sense the weight of Saanen’s piercing green eyes on her hands. He studied each movement as she finally reached the scaphoid capsule. “What do you see, Alia?” She wasn’t used to Saanen calling her by her first name. “Well, I see the dorsal carpal branch of the radial artery here,” she said while pointing it out with her Metzenbaum scissors. “We want to avoid disrupting its capsular attachment to the scaphoid.” Saanen simply handed her the 15-blade scalpel. Alia straightened her back and slid the stool forward an inch. Cutting into the scaphoid capsule, a bead of blood surfaced. The only reminder that this arm belonged to someone still alive.
“So, cashews—” Saanen posited, “those will kill you, right?”
Alia barely lifted her eyes towards Saanen, her attention entirely on the deep dissection to expose the fracture site without accidentally nicking the artery. A few moments later, she finally took a breath in. “It’s not the worst thing that can happen on call,” she murmured.
“I haven’t had anaphylaxis since I was three.”