Cutting for Stone - Abraham Verghese [76]
At once, the colon bullied its way out like a zeppelin escaping its hangar. He covered the sides of the wound with wet packs, inserted a large Balfour retractor to hold the edges open, and delivered the twisted loop completely out of the wound onto the packs. It was as wide across as the inner tube of a car tire, boggy, dark, and tense with fluid, quite unlike the flaccid pink coils of the rest of the bowel. He could see the spot where the twist had occurred, deep in the belly. Gently manipulating the two limbs of the loop, he untwisted, clockwise, just as Cope said. He heard a gurgle and at once the blue color began to wash out of the ballooned segment. It pinked up at the edges.
He felt through the bowel wall for the rectal tube that Nurse Asqual had inserted. He fed it up like a curtain rod in a loop. When the tube reached the distended bowel, they were rewarded with a loud sigh and the rattle of fluid and gas hitting the bucket below. “And down the coil contracts and you will see, the parts arranged more as they ought to be,” Ghosh said, and the probationer, who had no idea what he was talking about, said, “Yes, Dr. Ghosh.”
Ghosh flexed his gloved fingers. They looked competent and powerful—a surgeon's hands. You can't feel this way, he thought, unless you have the ultimate responsibility.
AFTER HE CLOSED, as he was stripping off his gloves, he saw Hema's face in the glass of the swinging doors. It disappeared. He charged after her. She ran, but he soon caught up with her in the walkway. She stood panting against the pillar. “So?” she said when she could speak. “It went well?”
They were both grinning. “Yes … I just untwisted the loop.” He couldn't hide the pride and excitement in his voice.
“It could twist again.”
“Well, his choice was either me or nothing, since the other doctor here would not help.”
“True. Good for you. I've got to go. Almaz and Rosina are watching the babies.”
“Hema?”
“What?”
“You would have helped if I got into trouble?”
“No, I was just stretching my legs …” Despite herself, a twinkle showed in her eyes. “Silly. What did you think?”
With Hema, even sarcasm felt like a gift. He fought the instinct to jump forward, the eager puppy too ready to forget the cuffing it had received minutes before.
“Just yesterday,” Hema said, “I drove past the spot where we saw that first hanging, and I thought about it …” She seemed to study him meditatively “Have you eaten anything today?”
That was when he noticed: His beloved, his Madras-returned, unmarried beauty, was more magnified than ever. There were succulent rolls visible between sari and blouse. The skin under her chin was gently swollen like a second mons.
“I've not eaten since you left for India,” he said, which was almost true.
“You've lost weight. It doesn't look good. Come by and eat. There's food, tons of it. Everybody keeps bringing food.”
She walked off. He studied the way the flesh on her buttocks swung this way, and that, about to sail off her hips. She'd brought back from India more of herself to love. It was the worst time for this, but he was aroused.
He dressed and found himself thinking about the operation again. Should I have tacked the sigmoid colon to the abdominal wall to prevent it twisting again? Didn't I see Stone do this? Colopexy I think he called it. Had Stone spoken to me about the danger of a colopexy and warned against it, or had he recommended it? I hope we took out all the sponges. Should have counted once more. I should've taken one more look. Checked for bleeders while I was at it. He recalled Stone saying, When the abdomen is open you control it. But once you close it, it controls you.