Chapter 10 chapter 10
Chapter 10
Natalie pushed through the sliding doors of the City Hospital, her heels striking the well-polished floor with urgency. Her heart tightened as she thought of the person fighting for his life as he waited for her to save him.
The scent of antiseptic, the faint hum of overhead lights, and the steady beeping of distant monitors washed over her like a familiar noise in a storm, overlapping the rapid beating of her heart.
Upon seeing her, nurse Naomi, her assistant, rushed toward her.
“Dr Hart, thank God you are here. The patient is decompensating.”
Natalie took the white lab coat from Naomi and draped it on her body at lightning speed. She shrugged her arms in the sleeves as she walked.
“What’s the status?” Natalie asked.
The two women moved quickly toward the Cardiovascular Acute Unit. As they entered, Natalie saw several medics clustered around bed 3. The monitors flashed red, and the ECG was tracing irregular spikes.
Naomi read the patient’s report from the tablet she was carrying.
“Frank, male, in his early fifties. He collapsed while jogging. Severe chest pain, perspiration, and hypotension on arrival. Initial troponin levels are extremely elevated. Echocardiogram shows a large anterior wall motion abnormality.”
Natalie frowned upon hearing the report, “So we’re dealing with an acute myocardial infarction with cardiogenic shock?”
“Yes, and there’s more.” Naomi swiped to another page before she continued, “The CT scan reveals a significant blockage in the proximal left anterior descending artery. There’s also suspicion of a ventricular septal defect forming, possibly from necrosis.”
Natalie stopped in her tracks for a moment, “A post-infarction VSD forming this fast means the patient is at an extremely high risk. He needs immediate surgical intervention.”
When they reached the bedside, the man was pale and barely conscious. The oxygen mask was obscuring with each shallow breath. Machines surrounded him, an intra-aortic balloon pump already inserted and cycling, assisting his failing heart.
“BP?” Natalie asked in a raspy voice.
The ICU resident quickly answered as he wiped the sweat off his forehead. “Systolic barely holding at 80. We’ve maxed out norepinephrine. The balloon pump is also giving some support, but he’s barely holding on.”
Natalie pulled the patient’s chart from the end of the bed and flipped through the data with quick, efficient movements; lab values, imaging, rhythm strips, vitals trends. They all appeared in front of her, making her mind work at an abnormal speed.
Her mind raced as she thought of the best possible medical procedure for this rare case.
“Coronary artery bypass grafting? Viable, but risky with instability.” She murmured.
“Percutaneous closure? Too early, and structural damage looked extensive.” Natalie mumbled.
She looked at her watch, and time was ticking. The patient could not wait another minute.
“Open surgical repair of the septal rupture? High mortality, but the only chance.”
The moment her mind settled on the procedure, she snapped the chart shut and immediately gave out instructions, “Prep the OR. Full cardio-surgical team on standby. We’re doing emergent repair of a post-infarction VSD with concurrent bypass.”
After Natalie’s orders, everyone moved around busily, and in no time, the OR was ready to welcome its new visitor.
Before she went to the OR, Natalie leaned close to the patient, her voice calm but firm. “You’re in safe hands, buddy. I will give you back your life.”
The patient’s eyelids fluttered, but he couldn’t respond.
…
The bright, sterile OR lights illuminated everything with demanding clarity. Metal trays and surgical knives gleamed. The perfusionist regulated the cardiopulmonary bypass machine, its tubing coiled neatly like translucent veins.
Natalie scrubbed in, methodically, her mind already in surgical mode. She stepped into the operating room, fully gloved and gowned in her surgical scrubs, and nodded to her team.
“Time is of the essence; let us begin.”
The anesthesiologist confirmed, “The anesthesia has already been administered. You can begin the surgery, Dr. Hart.”
Monitors beeped softly, displaying the continuous ECG, arterial pressure, and the oxygen saturations.
Natalie examined the imaging projected on the large display: angiography, echo slices, and the CT scan, where the septal defect appeared as a rough dark rupture.
The OR was filled with controlled motion as:
The perfusionist adjusted flow rates.
The scrub nurse laid out the sternotomy instruments.
The resident double-checked the cardiac bypass cannula.
Natalie’s voice cut through the room, steady and authoritative. “We’ll repair the septal rupture first. Then we graft the LAD. I want clean margins and minimal cross-clamp time.”
The team nodded in understanding.
Seconds later, the rhythmic beep of the heart monitor changed as the patient was placed on cardiopulmonary bypass, the machine taking over the circulation, so Natalie could operate on a still, protected heart.
She began the delicate work, her hands moving steadily like they had a life of their own.
She inspected the damaged area, a tear where infarcted heart tissue had weakened and given way.
The rupture was worse than the imaging suggested, extending deeper into the septum.
But Natalie was labeled as the best surgeon for a reason. She guided the team through the repair, layering reinforced surgical patches, restoring structural integrity, and then moved to the LAD graft, ensuring new blood flow around the occluded artery.
Every movement was precise!
Every order was crisp!
Every second was critical!
Hours later, the patient was in the Cardiothoracic Recovery Unit, intubated but stable.
Natalie stood beside the bed as she rolled her shoulders to release the tension of the long surgery.
The ICU nurse approached and reported, “The repair is holding. Vitals are improving. Perfusion looks good.”
Natalie exhaled sharply. “Although he has a long way to recovery, he managed to survive something that most people don’t, and that is already a win. He needs to be closely monitored for the next forty-eight hours. In case of anything, reach out to me directly.”
Natalie looked at the patient one last time before heading out to brief the family anxiously waiting outside.
“Doctor, how is he? We heard that the surgery was really difficult. Will Frank make it?”
Natalie placed her hands in her lab coat pockets, and her face broke into a smile. “Don’t worry, Frank is a fighter, and he will make a full recovery. Though it might take a while, given that his condition was critical, he will be fine.”
“Thank you, doctor. We don’t know what would have become of us without you.”
“It is my duty.”
…
Natalie headed to her office, feeling the tension in her shoulders. She removed her lab coat and hung it on the wall. She sighed deeply and just as she was about to call Naomi to make her a cup of coffee, Sean entered the office.
“Coffee is not good for you after such a long surgery. Drink this instead. Your favorite chamomile-honey latte.”
“Wow, Sean, you are a lifesaver. Thank you.”