The head of the emergency room is Doctor Little says Dr. Sabre, if you ever see him. Dr. Venido has designated you as a surgical nurse and here is the key if they call you. There exists an elevator in the far hall that has a key receptacle next to the door. Insert the key and turn it in, it will open and take you directly to the surgical suite on the top floor. We call it the Penthouse. At the sign-in, there is a basket, put the key in the basket and go to the sign-in door and key in the combination we gave you. If you have to leave in a hurry, you don’t need a key to go down in the elevator, just to go up. Good luck.
There is an incoming trauma. A construction worker got hit by a wrecking ball and it tore off part of his skull. You will assist. Go up in the elevator. They are waiting for you. The charge nurse turns like a soldier and walks away.
The Wracks walk down the hall on the first floor and see the elevator at the far hall. He inserts the key, turns it halfway to the right, the door opens and he enters. There is one button in the cab, it glows yellow and he pushes it and the doors close. The wracks feel the cab go up, it stops and the door opens and he sees another hardwood door with a small window reinforced with wire. A small console is on the right. He pushes the code they gave him, the door opens with a metallic click and he enters. The charge nurse says, scrub in, gown up, and go to room one. Dr. Less will be waiting for you there to begin. Head injuries are dangerous because general anesthesia causes death in these patients so do not talk because the patient is semi-conscious. The surgeon and the anesthesiologist are waiting.
The Wracks scrubs up as they taught him in the dog lab at the Autonoma., put on a gown, a mask, and little shoelits, and walk backward like they taught him at school through the suite door. The anesthesiologist puts gloves on him and he steps up to the table. The patient is propped up in a sitting position with tubes sticking out of him his back occiput hangs off his head, and the blood drips down, and he looks upwards to the maker hoping for forgiveness.
We are going to reattach his scalp and bone back to his skull, and hope that it takes and heals. If we remove the flesh and put it in a plate, he might not survive the surgery. Wracks unpack and hand me eighteen gauge silk from the crash cart. The wrack complies. Hold his head still while I begin the suture. Dr. Less has a large needle that curves like a fish hook attached to the silk and begins to reattach the scalp and bone to the head. Use the aspirator to pick up fluid so I can visualize then swab the area with betadine. I will say the Wracks. The anesthesiologist glues his eyes to the heart monitor and injects valium, a little at a time to keep the patient still. Dr. Less sews and sews and the Wracks cuts and blots and then he asks to open another suture pack of silk. During impetuous circumstances, time flies and soon the patient has his head back, hair and all. He blinks and starts to cry. We are done says Dr. Less. Scrub out and sit with him in recovery until he goes to ICU. Thank you for your assistance today. It was a pleasure working with you.
The ICU team comes and gets the patient who is breathing fine and has his Cath bag put on his lap. The Wracks goes down in the elevator. It seems to take a long time. So this is Medicine thinks the Wracks. I just want to sit in a consult and hand out antibiotics at the Bu. It is night now and the Wracks gets in the sports car that he borrowed from his brother’s first wife. Someone has broken in and taken the stereo. He will have to replace the stereo and never use the car again.
They call it the obelisk. Like an obsidian sliver pointing up into the sky, the moon coming up, it exists. It is black, the opaque windows are black and there are doors only in the front and the back that face the parking lot. They say it is the main trauma unit for the county. Before this summer the Wracks never knew it existed and it is part of the major exclusive university of Los Angeles. Before his end, he will rotate through pediatric surgery, pediatric neonatology, and the Neuro. The wrack does not want to go to the neuro but the unseen hands with non-olfactory money have put him there.
Where the fuck have you been scrub, says Dr. Little. You are supposed to clean up trauma units. If I catch you hiding again, I will fire you and inform your mentor. Dr. Venido sent me says the Wracks; I was up in the Penthouse. That can’t be says Dr. Little, you are assigned here to the E.R. to help out. I will have a word with him.
I wish you would say the Wracks, I wish you would. I know what I am getting into.
It is night now and the freeway has cleared and the Wracks drive back to Tranquil Hills to tell the Fonz’s wife that her car got ripped off.