"Scalpel." Hawkeye waited a beat for the familiar feel of the scalpel in his hand, and quickly incised the skin on the calf of a full-bird Colonel. The officer had been in earlier that week for a piece of shrapnel in his shoulder, and had developed a blood clot in his calf, probably from lying on his back for three days. Margaret had actually been the one to pick it up. She was doing her usual assessment on him, and his calf had seemed warm to her. She had pressed his foot into a flexed position, and he had all but screamed in pain. It was called a positive Homans sign, and was a classic sign of a blood clot, so now it had to be dealt with. The removal was fairly easy--cut down to the affected vessel, insert a long tube with a deflated balloon on one end into the vessel. Then, inflate the balloon, and pull the tube out. That would bring with it the long, stringy clot.
Hawkeye guided the tube into the vessel with a clamp, and gently ran the length in. He glanced sideways at Margie Cutler, who was assisting. She noticed him looking her way, and said "Do you need something, Doctor?"
He nodded. "Yes, Lieutenant. I need you! Now! Meet me in the Supply Tent as soon as I finish this guy." He grinned at his own wit.
Margie rolled her eyes. "No thanks, Doctor. Though it is dismal to imagine a night without you," she finished sarcastically. "What I would really like is a chance to play the doctor in here."
He grinned. "If playing Doctor is what you want, I think I can oblige you."
She rolled her eyes. His jokes would be funny, if they weren't so common. And if, for once, they weren't directed at her. Of course, when he said it to other women, they weren't funny to her either.
"You know, Captain, you would have a higher success ratio if you weren't so obnoxious." That was Margaret. She was the "Rover" for that shift. She was overseeing what went on in the OR. She took pity on Margie Cutler. "Lieutenant, would you like to grab some coffee? You came right off the nights shift, I'll take over here."
Margie was surprised by the kindness, but grateful. "Thanks, Major. I'd appreciate it." She waited until Margaret was gloved, and stepped aside.
Margaret took the place beside Hawkeye, who was ignoring the switching, trying to draw the clot out as carefully as possible. He succeeded, and it was time to suture. He held his hand out. First the vessel. "Catgut." Margaret adjusted her feet so that she would be closer in, and handed over the catgut and needle.
He glanced over at her, and said, a bit irritated, "Major, if you don't step back, I'll be sewing around your B-cups."
Margaret sighed audibly, and stepped back. Jerk. She glanced over to see how Trapper's operation was going. He was repairing some holes in a Corporal who had taken a chest full of shrapnel.
Hawkeye's voice snapped her out of her reviere. "Thanks, Major, I'm finished here." He stepped away from the table, and called for a corpsman to take the Colonel back to Post-op. Margaret wandered over to where Bigelow was assisting Trapper, who was making the final check of the chest cavity before he closed. She saw something that she hoped Trapper or Bigelow saw as well. Trapper was still looking around when Bigelow said something. "I see some bubbles there, doctor. May have missed a small tear in the aorta."
Trapper had seen the same thing just then, and glanced at Bigelow from the corner of his eye. "Where'd you go to medical school, Bigelow?"
She, unlike Cutler, didn't put up with it. "Where'd I attend med school? Right here, Doctor, in the School of Hard Knocks. And it doesn't take an MD degree to know that bubbles mean a hole somewhere."
Trapper had to smile grudgingly at her brass. She knew she was right. So did he. Surely enough, once he located the source of the bubbles, he had found a slight lac in the aorta. Two small stitches, and he was ready to close.
Henry was about finished,too. He held out his hand for the necessary silk.
"3.0 silk, please."
Ginger was assisting him. "3.0 silk, Doctor."
Henry was in a hurry, he wanted to get some sleep too. "Move that pretty bottom, honey. I want to get this done in time to catch up with my dreams."
"What a session," Hawkeye sighed as he tossed his surgical hat into the hamper. "I tell you, what I really need is a drink, followed by about 30 hours of sleep."
Trapper stretched and agreed. "I'm beat. Lets check the still. There should be a cache of fine lighter fluid there."
Fade to the Swamp
Hawkeye slurped down the rest of a martini, and fell facedown on his cot, still wearing the scrubs he had operated in. "Night Trapper."
Trapper, in the same supine position, answered "Night, Hawkeye."
Hawkeye woke to the sound of the dreaded announcement. "Rise and shine, campers. We've got wounded!" He hauled himself out of bed and stumbled off to triage in the compound. When he got there, Lieutenant Dish said to him, as she bent over a patient, "Possible pneumothorax, get him into Pre-op STAT. I'll be right behind you to get the chest tube in. Monitor his vitals, Hawkeye." And she moved toward another patient to assess him. Hawkeye obeyed, listening to his lungs as he jogged alongside the corpsmen who were taking the patient into Pre-op, where Margaret waited. She raised her eyebrows as if to say "Well?"
He set the litter down and said "Pneumothorax, lung sounds absent in the right lobe."
She first listened to the lung sounds, and, satisfied that Hawkeye had been correct, nodded, grabbing a syringe. She inserted it in the space between the fourth and fifth ribs, and slowly allowed the air in the pleural cavity to fill the syringe. "Bulls eye. Hand me a scalpel, please."
Hawkeye handed it to her without a word.
She took it and slid it into the space that the needle had occupied. She held her hand out. "Clamp."
He gave it to her.
She picked up with the clamp the piece of catheter tubing that he had placed next to her, and she used it to guide the tube along the scalpel and into the space. That done, she quickly shoved the other end into a cork that plugged a bottle half-full of water. Hanging the bottle above the level of the patient to allow the vacuum to restore the balance of pressure in the chest cavity, she stood and headed back to the compound.
In the OR
Hawkeye stood beside a gloved Bigelow as she operated on the abdominal wound of a patient.
"Metzenbaums," she requested.
He slapped them into her hand. "Mets," he replied.
"Sponge," she said, tossing the scissors down and holding her hand out.
He handed her the clamp that held the sponge. "Sponge."
She held out her hand again, but said nothing.
He looked at her sideways. "Did you want something?"
"Depends, only if you're offering your body." She laughed. "Want to meet me in the Supply Tent later, Cute Stuff?"
He shook his head. That struck him as somewhat rude, but said nothing. Across from him, Trapper was assisting Ginger. He seemed to have spaced out a bit, and was rudely jerked back into the present by Ginger. "Clamp, Captain. Shake that lovely bottom, this kid doesn't have all day." As if to punctuate that statement, Margaret walked by and smacked his rump, laughing as she did.
Hawkeye glanced up, in time to catch Trapper's look of persecution. He was about to comment, when Bigelow said " Suction." He complied, and they completed the procedure in a silence broken only by requests for instruments and dirty comments directed at Henry, Trapper, and himself.
She was about to close the patient when Hawkeye noted a familiar smell.
"Bigelow, I'm catching a whiff of bowel. There could be a small hole in the sigmoid colon."
She cast him a derisive look. "Where did you go to nursing school, Hawkeye? Let me do my job, and you do yours." With that, she ran through the sigmoid colon, and found a slight nick. Not bothering to say anything about it, she dropped three stitches to close it, and finished the operation. "So, Hawkeye," she said, snapping her gloves into a trashcan. "Want to join me for a drink at Rosies? Or better yet, your place."
He rolled his eyes. "Some other time, Bigelow."
Ginger looked over Trapper's shoulder. "Well, I'm finished here, Sheila. Whaddya say, you wanna grab a drink, than share a doctor later?"
Sheila grinned. "Sounds great! I wish we got some fresh ones once in a while. I'm tired of the same old thing."
Fade to Post-op
Hawkeye carried a bath basin and cloth over to a patient. He started a conversation with the patient, noting how uncomfortable he felt. How bizarre, this feeling. He was extremely uncomfortable, giving somebody else a bath. Of course, he rationalized, he'd never done it before. The first bath one gave was bound to be the hardest. The patient was in too much pain to be bothered by a breach of privacy. He looked over at Dish, who was assessing the wound of a patient across the room from him. He sighed, and picked up the bedpan of the patient he had just bathed. He carried it to the latrine, where he emptied it and washed it out. When he returned to post-op, he did the same thing with two other patients. After his final return from the latrine, he went on to changing bed linens. Five beds later he was done, and he went on to bringing around trays. He paused to chat with every patient who was awake enough to eat, and then made rounds giving the medications that were due. After that, it was bedpans again. Finally, his interminable shift was over. He was about to walk away from his last patient, when the patient began gasping for breath.
"Dish," he called, reaching out and palpating the carotid pulse of the patient. It wasn't there.
She came immediately, and sat the patient upright. "Get me a backboard," she barked.
He grabbed the board under the cot, and the patient was laid back on it. Dish began CPR, while Hawkeye picked up a syringe.
"Epi, 1:10,100," Dish said.
He drew it up and injected it into the IV port.
Dish gave chest compressions, and Trapper, who had been with another patient, squeezed the AMBU bag once per 5 compressions.
Hawkeye placed his fingers in the man's groin, and said "Halt compressions." They did, and he felt for a femoral pulse. He got one, weak but steady.
"I've got a pulse."
The crowd that had ensued made choruses of "Great job, Dish!" and "What a save!" and "Good thing you were there, Dish!"
Hawkeye mumbled his congratulations, and moved on to give report to Henry, who was taking the next shift. It had been a long day, all he wanted was a good nights sleep.
Dish jogged up to him, cornering him in the changing room. She leaned into him, with his back against a corner, and kissed his lips softly. "How about a drink later?"
He ducked under her arm. "I don't think so, Dish." Before she could reply, he was gratefully striding out of the changing room and back to the Swamp. He downed a martini and flopped down on his cot, fast asleep by the time his head hit the pillow.
He awoke to the sound of silence. Blessed, beautiful silence, punctuated only by Trapper's snores. He stumbled out of bed and tied his bathrobe around his waist. Uncertainly, a but warily even, he walked across the compound and into post-op. There, he saw a beautiful site. Henry was sitting on the edge of a patient's bed, writing on the chart. Ginger was also perched on the end of a bed, talking to a patient while giving him a bath. She seemed so...confident...about it. Probably, Hawkeye realized, because she did it every day.
He walked into the middle of the room, prepared to relieve Henry. But, he realized that he was a few minutes early, and walked over to Ginger, who was grabbing the bedpan from under the bad. He took it from her and said "I've got it, you go on."
She stared at him, surprised.
He took the bedpan and headed for the latrine.
When he returned, he took report from Henry and settled in to review the chart. A moment later, Margie Cutler called him from a bedside. "Doctor, he's in cardiac arrest!"
He rushed over, the motions in the room slowing as they always did in an emergency. Things seemed to be in slow motion. He sat the patient up, and Margie shoved the backboard under him. Hawkeye began the compressions, and Sheila squeezed the AMBU bag as it was necessary. Margie picked up a syringe, and administered the epinephrine that Hawkeye asked for. In a moment, he stopped the compressions, and Cutler felt for a pulse.
"I've got a pulse. You got him back, Doctor!" She smiled.
"We got him back. Good job," he replied.