J.R. Ward the Black Dagger Brotherhood Novels 5-8 - J. R. Ward [37]
“We need an ultrasound of his abdomen while I buy us some time with his heart.” With the more pressing injury ascertained, Jane wanted more information on that knife wound. “And as soon as that’s done, I want both machines checked. Some of these chest images have an echo.”
As a resident went to work on the patient’s belly with the ultrasound wand, Jane took a twenty-one-gauge spinal needle and plugged it into a fifty-cc syringe. After a nurse Betadined the man’s chest, Jane pierced his skin and navigated the bone anatomy, breaching the pericardial sack and drawing out forty ccs of blood to ease the pericardial tamponade. Meanwhile, she gave out orders to prepare OR two upstairs and get the cardiac bypass team on the ready.
She gave the syringe to a nurse for disposal. “Let’s see the abdominal.”
The machine was definitely misbehaving, as the images were not as clear as she’d like. They did, however, show some good news, which was confirmed as she palpated the region. No major internal organs appeared to be affected.
“Okay, abdomen appears sound. Let’s move him upstairs, stat.”
On her way out of the chute, she put her head into the bay where Estevez was working on the nurse. “How’s she doing?”
“Coming around.” Estevez shook his head. “Her heart stabilized after we hit her with the paddles.”
“She was fibrillating? Christ.”
“Just like the telephone guy we had in yesterday. Like she’d been hit with a load of electricity.”
“Did you call Mike?”
“Yeah, her husband’s coming in.”
“Good. Take care of our girl.”
Estevez nodded and looked down at his colleague. “Always.”
Jane caught up with the patient as the staff wheeled him down the chute and into the elevator that went to the surgical suite. One floor up she scrubbed in while the nurses got him onto her table. At her request, a cardiothoracic surgical kit and the heart/lung bypass machine had been set up, and the ultrasounds and X-rays taken downstairs were glowing on a computer screen.
With both hands latexed and held away from herself, she reviewed the chest scans again. Truth be told, both of them were subpar, very grainy and with that echo, but there was enough to orient herself. The bullet was lodged in the muscles of his back, and she was going to leave it there: The risks inherent in removing it were greater than letting it rest in peace, and in fact, most gunshot victims left the chute with their lead trophy wherever it ended up.
She frowned and leaned in closer to the screen. Interesting bullet. Round, not the typical oblong shape she was used to seeing inside her patients. Still, appeared to be made of garden-variety lead.
Jane approached the table where the patient had been hooked up to the anesthesia machines. His chest had been prepped, the regions around it draped in surgical cloth. The orange wash of Betadine made him look like he had a bad fake tan. “No bypass. I don’t want to use up the time. Tell me we have blood for him on hand?”
One of the nurses spoke up from the left. “We do, although his blood didn’t type.”
Jane glanced across the patient. “It didn’t?”
“The sample reading came back unidentifiable. But we have eight liters of O.”
Jane frowned. “Okay, let’s do this.”
Using a laser scalpel, she made an incision down the patient’s chest, then sawed through the sternum and used a rib spreader to pull open the heart’s iron bars, exposing—
Jane lost her breath. “Holy…”
“Shit,” someone finished.
“Suction.” When there was a pause, she looked up at her assisting nurse. “Suction, Jacques. I don’t care what it looks like, I can fix it—provided I get a clear shot at the damn thing.”
There was a hissing sound as the blood was removed, and then she got a good gander at a physical anomaly she’d never seen before: a six-chambered heart