Cutting for Stone - Abraham Verghese [205]
As Deepak spoke, B. C. Gandhi looked at me and rolled his eyes. He was reminding me of something hed told me just the previous night. “You can be a cretin, but if you have the Queen's accent, next thing you know you are on Johnny Carson and he'll laugh at anything you say.”
B.C. was being facetious, but on the sitcoms I caught while going in and out of patients’ rooms, I had so far seen a black but very British butler serving a black American family; an eccentric Englishman who was the neighbor to a rich black family on the Upper East Side of Manhattan; and a rich British widower with a pretty Brooklyn nanny.
Mr. Walters had hung on Deepak's every word. At last he'd said, “I have faith in you. But for you-all, there wouldn't be any doctors here. I have faith in someone else, too,” he said, pointing to the ceiling.
The day of surgery, I rose at four-thirty to review the steps of the operation in my Zollinger's Surgical Atlas. Deepak had let me know that it was my case, and I would stand on the right while he assisted me. I was thrilled and nervous. It would be my first time to work directly with the Chief Resident.
But Popsy had ruined our plans. I stood on the patient's left, awaiting the legendary Dr. Abramovitz. I had yet to meet him. There was no sign of Deepak.
AND SUDDENLY POPSY WAS THERE, his head perilously close to the operative lights. He had a deeply furrowed face, kind blue eyes, the pupils rimmed with gray but retaining a curious, little-boy quality. His mask hung just under his nose, wire-brush hairs poking out from his nostrils. He held out his gloved hand for the knife. Sister Ruth hesitated, glancing at me before putting it in his palm.
Popsy made a sound in his throat. The scalpel quivered in his fingers. Sister Ruth nudged me. Before I could do anything, Popsy made his incision. It was bold. Very bold. I dabbed and I clamped tiny bleeding vessels, and when Popsy didn't move to tie them off, I did. Popsy handled the forceps to pick up the peritoneum. He couldn't get purchase on the tissue.
For good reason. In one spot his skin incision had cut through fascia and peritoneum. Liquid matter, looking suspiciously like bowel content, welled into the wound. Ronaldo peered over the anesthesia screen and his eyebrows disappeared under his surgical cap.
Popsy tried again with the forceps, but the instrument slipped from his fingers and clattered to the floor. He brought his hand up, minus the forceps. “I touched the side of the table …” He was looking at me, as if I might dispute his account. “I've contaminated myself.”
“I think you did,” Sister Ruth said hastily when she saw that I was tongue-tied.
“You did, sir,” Ronaldo said.
But Popsy still looked at me.
“Yes, sir,” I stammered.
“Carry on,” he said. He shuffled out of the room.
“POPSY, WHAT DID YOU DO?” Deepak muttered under his mask as he brought out the injured loop of small intestine. I stayed on the left side of the table. “They say there are old surgeons, and bold surgeons, but no old-bold surgeons. But whoever said that never met Popsy. Fortunately it's a small-bowel tear and we can just stitch it over.”
“I tried to—” I stammered.
“We have a bigger problem,” Deepak said. He pointed to what looked like a small barnacle on the surface of the bowel. Once I saw that first one, I saw them everywhere, even on the apron of fat that covered the bowel. The liver was misshapen, with three ominous bumps within making it look like a hippo's head.
“Poor man,” Deepak said. “Feel his stomach.” The stomach wall was rock hard. “Marion, you biopsied the ulcer when you ‘scoped him, right?”
“Yes. The report said benign,” I said.
“But this was a large ulcer on the greater curvature?”
“Yes.”
“And which ulcers in the stomach are more likely to be malignant?”
“Those on the greater curvature.”
“So your suspicion for malignancy was