St Ophie’s General Hospital, Level Nineteen.
It was half past eleven on a Sunday evening. Ethan’s hands had been marinating in blood for almost three hours.
As usual, he was the only one without gloves in the operating room. This was the easiest way to spot if a Healer was in surgery: skin to skin contact with the patient. That, and the conspicuous glowing dot at his temple which marked the vitals’ monitor all Healers had to wear while on the clock. Judging by the uncomfortable trip of his heart every few seconds, Ethan guessed his own monitor was likely flickering yellow.
Right on cue, one of the nurses said: “Doctor Faulkner, your VM is at amber seven point nine.”
“I’m good,” said Ethan, barely moving his lips, and definitely not moving his hands.
It was a necessary distraction, but Ethan could still sense a tell-tale…slip, the way his power wanted to float back up and pull at the surface cuts, the sluggish bleeding that oozed. It was like a hot and cold rush just before fainting, a brief flash and Ethan was suddenly hyper-aware of a torn nail on the patient’s left fourth finger, a cluster of bruises at the base of her foot, a tear along the line of her –
He gasped, blinking hard, once, twice; breathed out very slowly through his nose. His own skin was numb and prickling, and he knew if he had to keep the transference for much longer, he was going to get echo feedback of the anaesthesia.
Opposite him, Ivy Caroe did not look away from the scoped display, but her brow furrowed.
“How are we looking?” she said, “the graft’s in place when you’re ready.”
“I think we’re okay for tissue advancement,” said Ethan, aware of the strain in his own voice. Ten hours into his shift, and there was a throbbing pain behind his eyes, concentrated somewhere between his monitor and the arm of his surgical glasses.
“Feels fine…but I’m a little shaky,” Ethan continued, “can’t tell for sure. The incision is distracting. Sorry —”
“No, looks good from here. Blood pressure?”
“MAP at 68.”
“I can also feel th — Scarpa’s trying really hard to close,” said Ethan, eyes still fixed on the point between his index fingers and admitted: “can’t hold on for much longer.”
“Shouldn’t have to. You’ve been remarkably fast, given the complications. Chin up, last mile now,” said Caroe, “on my count, let’s seal. Three…two…”
She was one of London’s most sought after pediatric surgeons, and one of the few telekinetic surgeons who actually employed their Aptitude while operating. Usually fine-motor control in a good old fashioned human or robotic hand was still better in ninety-percent of medical situations. But here, with a particularly delicate patient with marfan… Ms Caroe was definitely the only person Ethan had ever seen to operate independently without motion mimicry. It bore from years and years of practice: her hands steady while a miniscule blade lifted slowly from the open heart laid out between them.
People often asked what it was like, healing. Ethan had never had, or found, a particularly satisfactory answer. The truth was, normal people could not describe the sensation of healing themselves, and it was the same with Healers. Perhaps they could identify the itch and the pain… but it was akin to asking how does it feel to breathe? How did you expand the lungs, sir?
Under the magnification, the tissue was rapidly growing over the edge of the graft, fusing into the mesh like a creeping timelapse.
“Steady, steady,” said Caroe, “keep it to the scaffolding, you’re already at the anterior edge.”
In a certain way, healing was automatic. The body knew how to heal itself, mostly – all it needed was time. The crux of secondary or transference healing lay in the where rather than the how for the Healer: a strange, natural ability to remind cells what they were meant to be; what they had forgotten at the edges of the womb.
“…past amber eight,” said one nurse, “Doctor Faulkner, can you hear me?”
Left to run on autopilot, the patient would have woken up without a single scar and a dead Healer on the hospital floor. Conscious, localised regeneration was harder than it looked, especially when what one was looking at was delicate thoracic aortic surgery.
Healing is like …breathing, Ethan had tried once to explain, you can stop breathing if you choose to, but it’s hard – and at some point you lose control. The body takes over. The metaphor wasn’t great: afterall no one had ever died from breathing for others.
“Is it safe to move him now, Ms Caroe?”
“Yes, we can pull him off the bypass at the same time.”
Someone grabbed Ethan’s wrists and jerked him back from the operating table. The abrupt switch and new skin contact mid-healing was like an electric jolt to the base of his neck.
“Shit!” said Ethan, the world rushing back so fast he stumbled, “sorry, sorry —”
“You need to sit down,” said Anna, fingers tapping at the monitor on his throat, and then lifting Ethan’s glasses so she could check the one at his temple.
“No, I can still help with the —”
“Ethan,” said Caroe, “we’ve been neglecting poor Andrew all evening. Patient’s stable. We will finish up.”
The lights overhead made him wince, and all Ethan could see was his hands, soaked red halfway to the elbows. The third year surgical resident — Andrew — had stepped up to take Ethan’s place, gloved hands moving obediently at Doctor Caroe’s calm bullet points. Andrew spared a glance at Ethan over Caroe’s shoulder, gaze sardonic and not at all friendly. It did not help that Ethan technically outranked him whilst being four years his junior.
Ethan looked away, too tired to care about hospital politics.
The room slowly focused as his eyes adjusted in the absence of surgical lenses. The child’s vitals bleeped steadily, and it took a long moment before Ethan’s own heart slowed to match the wheeze of the bypass.
“You’re still amber. Want me to come out with you, sweetie?” asked Anna, at a whisper, “it’s the end of your shift, right?”
She looked like she was ready to start washing Ethan’s hands for him. Ethan hastily shook his head, and retreated.
Ethan had barely scrubbed the blood clean from his nails and was dumping the gown and cap into their respective cloth bins when his work phone went off. Uncapping his water bottle, he shoved his ear piece back in. He wanted to pour ice over his face, but settled swallowing as much water as he had left.
“This is Ethan,” he said, and then promptly ended up in a coughing fit.
“…are you also dying? Because that’s inconvenient for me right now.”
“Unfortunately alive,” said Ethan, “was about to clock off..”
“You’re needed in trauma bay twelve…are you able to come? How’s your VM lookin’?”
Ethan smacked the bottle against his own face with a groan, pressing the cold surface against his eyes for a blissful second. There was a film of exhaustion clinging to his throat with every inhale and swallow. He didn’t bother checking his monitor: he knew what colour it had settled on. There was a reason Healer’s had lower caps on shift hours.
“I’ve been in with Ms Caroe for three hours so I’m on mid-amber,” said Ethan, recapping the bottle and shrugging on his jacket.
He ducked into the corridor and began walking, side stepping a gurney coming the other way, “I should be fine at least to stabilise whatever it…wait, did you say trauma twelve? Why are we using a containment room? We have an Aptee?”
“Yep, individual with Aptitude,” said the nurse, “EMS said firestarter so everyone is antsy. 27 year old female, old-fashioned gunshot wound, left chest, so maybe walk a little faster.”
“Just came in?” asked Ethan.
“Minutes ago. I know you’ve just come off an operation but both Lauren and Michael are flat out right now, and Doctor Latham is with St Mary’s until Wednesday —”
“No, you’re right to grab me. I’ll be fine,” said Ethan, pushing open the door to the emergency department with his shoulder, “see you…literally right now, hi.”
He was greeted by a wall of noise. At the nurses’ station, Abbey waved a little maniacally, throwing down a pad of post-its and meeting Ethan half way as they strode towards the containment rooms situated at the other end of the trauma bays.
“Oh no,” she said, eyeing his monitor, “that is not a good colour in you.”
“I thought orange was in this year,” said Ethan dryly, taking the offered mask and tying it over his mouth, “you said a gunshot wound? Just the one?”
She nodded, and they both flattened themselves against the wall as another EMT team ran past. Despite St Ophie’s being the largest level one trauma centre below Level 20, like all other A&E departments, things always felt stretched thin.
“Healer’s here,” said Abbey into her earpiece, and then to Ethan, she said: “I think poor Lasya almost fainted when she realised there was no one except her and Doctor Kelsey.”
“That’s because Vegas gets snarky on night shifts. Is Lasya a new emergency reg?” asked Ethan, “don’t think I’ve met her.”
“I wish,” said Abbey, “FY1. Pretty sure she graduated, like, yesterday.”
Unlike the operating rooms, trauma bay 12 had no windows. In its place was a long screen set into the wall, showing a high-camera angle view of the room. Ethan could easily pick out Vegas from the busy cluster of people, her red hair pulled back in a messy bun. On the screen, the woman on the bed was barely visible as the EMTs pulled the ambulance bed away to make room for the rest of the ER staff.
Abbey opened the door for him, and Ethan was thrust into the claustrophobia of that was low ceilings, bottled voices and controlled chaos.
It wasn’t the balm of an operating room, but it was calming to Ethan all the same.
“ — systolic’s at fifty, Doctor Kelsey,” one of the nurses was saying.
“Well shit,” said Vegas, “and oh-two sat’s barely in the eighties…is that second IV going?”
“Working on it,” another nurse replied, “what do you want?”
“Second unit of PRBCs. Are we keeping track?”
“Yep, type and screen?”
“Yes, thanks Jack,” said Vegas. Turning to a young woman with dark hair and big eyes, Vegas said: “let Lasya do that IV.”
The eyes got bigger. She was clearly the new first year.
“Hang a litre of NS, rapid infusion,” Vegas continued, casting about the room, “where the hell is — Ethan, there you are. We got a gun shot wound, left chest, BP in the 50s. Been pushing fluids.”
She paused, hands moving deftly in a well practiced sequence: tapping over the stethoscope at her ears, the bell of it on the patient’s chest, stained by a leaky dressing. After a moment, she switched to the other side.
“Sounds bilateral,” she announced, meeting Ethan’s eye.
The corner of her mouth quirked.
“Actually, Lasya – have you ever intubated?” said Vegas.
The girl froze.
“Um, no,” she said.
“Hand that IV back, you’re on the ET tube,” said Vegas, triumphant in a way that spoke of someone who took the ‘teaching’ part of ‘teaching hospital’ very seriously. That or someone who had a hardass for a registrar and wanted to pay it forward, thought Ethan, watching his friend step back from the fray, her arms crossed. Jack was grinning to himself.
Lasya handed over the sixteen gage to Jack and yanked open a nearby drawer. She visibly hesitated at the array of ET tubes. Ethan began setting up the ultrasound machine.
“Try a seven,” he prompted, when Vegas just let the pause sink, gaseous to the ground.
Vegas shot him a stink eye as Lasya tore the packaging and began threading a stylet through. The newbie gave Ethan a brief mayday stare before laser-focusing on her own hands and the clear tubing. An EMT, covered in blood, was rattling off the rest of the stats to Vegas.
“BP was seventy over palpable. She was barely responsive when we got there, and it was raining hard. Scene was too loud to hear breath sounds, but we put an ARS in for any tension pneumo —”
“Doctor Kelsey, dressing’s not holding…” said Lasya.
As if on cue, the patient made a violent lurch; the wet gurgling cough bringing bright blood splashing up into the clear tube. Lasya flinched, almost yanking the tube right back out of their patient’s throat. Ethan winced, and accidentally squeezed the ultrasound-jelly bottle too hard.
“Oh my god,” said the newbie, instinctively stepping back, as Jack reached over to suction the patient’s mouth, “oh shit, sorry —”
“Alice, hook up that oxygen please,” said Vegas without blinking.
To her first year, she said: “Lasya, do you need to leave the room?”
Lasya visibly steeled herself, swallowing hard.
“Good. Put pressure on that dressing.”
Ethan jammed the ultrasound probe under the patient’s xiphoid, eyes trained on the screen. The excess gel was cool against the inside of his arm. Ethan turned his wrist carefully: he had to get a proper subxiphoid view.
“Hurry with that F.A.S.T.” Vegas called, leaning over to look at the ultrasound display as well, “we’re dumping fluids but her BP isn’t coming up. She might have a…”
Several things happened at once:
A warning beep shrieked through the room, drowning out Ethan’s own scream as he accidentally made skin contact with the patient. At the touch, something seized in his own chest. The pain was there and gone, Vegas grabbing the probe with one hand and shoving Ethan back protectively with the other. He dry-retched, clutching at his ribs. Someone was calling his name.
“Well, here we go,” Jack muttered.
On the screen, there was a thick swathe of ink around the outline of the heart.
Ethan and Vegas shared one, brief, dreaded look.
© Frances Wren 2019, all rights reserved.