An Evergreen Christmas

  Holly exited her patient’s room, Clifford and Candice following behind her like ducklings. Noel, seated at the pre-op station, bounced his pen against the teal Formica desktop, catching it repeatedly. He glanced up at her, smiling, missing the ballpoint’s trajectory. It flew from the counter’s beveled edge, ricocheted off the medication cart, and leapfrogged five times in the air before landing at a nurse’s feet.

  Noel blushed. “Oops! Sorry. I guess it’s time for breakfast.”

  Old Nurse Ryan frowned. She bent over and picked up the pen. “Please, Dr. Green, take him off my hands.”

  “Gladly,” Holly said. She crooked her finger at Noel. “Let’s go, Dr. Clumsy.”

  “Hey, I was doing well until you distracted me.”

  “I distracted you?”

  “Yep, that’s what happened.”

  The nurse shook her head and handed him his pen. “Good thing you’re operating in different rooms.”

  “I think we make a good team,” Noel said.

  “I’ll vouch for him. He’s better with a scalpel.”

  Holly picked up her bag of scones. Noel grabbed the edge of the bag, opened it, and peeked inside.

  “Are those scones?”

  Holly nodded. “Surprise! But we’ll patronize the cafeteria and buy their coffee.”

  “I love those,” Candice blurted out.

  Clifford gently grasped her arm and pulled her away. He shook his head at her. “We’ll meet you in the O.R., Dr. Green.”

  Candice protested. “But…”

  “We’ll get a quick bite on our own,” Clifford told her.

  Candice grinned. “Oh, I get it.”

  Holly and Noel walked away.

  “Kids,” Noel said.

  “Uh huh. So says the juggler.”

  Noel shrugged. “Let me see those scones.”

  “Oh, no. These babies will never see the ground.”

  “Come on. Let me try!” he teased.

  Noel chased her down the hall.

  Holly hugged her bag. “No!” She laughed.

  “Give me those scones, Green!”

  “No way, Shepherd.”

  They playfully tussled all the way to the cafeteria.

  ***

  Noel pointed to a table far in a corner. Holly had her eye on the same one. They slid into the wooden seats and faced one another. He propped his hands on the table and leaned toward her.

  “This is nice of you.”

  “You brought cookies the other day. I’m just trying to keep up.”

  He laid his hand on hers. Her pulse picked up pace. Could he tell? Could he feel the beat of her wrist? She pressed her hand harder onto the table, disguising the flutters she could not control.

  Noel’s eyes pressed into Holly. “You don’t need to keep up with me. I’m not going anywhere. And the cookies were an excuse to stop by.”

  She took a deep breath. “Okay.” Oh, more than okay! “Let’s enjoy the scones.”

  Noel pushed back his chair. “I’ll get us coffee and some plates.”

  “I had a latte this morning. Just get me a small cup, two creamers and two sugars.”

  “You got it!”

  She watched him trot off to the cafeteria and halt in line with the other nurses and docs waiting to grab a quick breakfast, ready to whip her head straight ahead should he turn his head toward her. But he didn’t. Apparently he was too busy chatting with the nurses surrounding him. Holly frowned. Squinting, she tried to identify the culprits. She recognized the two O.R. nurses. The other one she thought was from ICU. The line moved, and so did Noel and his fan club. Why should she care? Noel was a congenial guy. He certainly wasn’t going to exist in a vacuum.

  Noel exited the cafeteria counter, smiling, with two Styrofoam capped coffees, two plates, and zero nurses. Ironically, the only nurse that took a shine to Holly, was the one not partial to him.

  “Here you go.” He set her coffee beside her plate.

  “You’re popular with the nurses today,” Holly sheepishly prodded.

  “I’m a novelty.” He scrunched his face. “Once they get to know the real me they’ll scatter, warning everyone that I’m heading for the O.R about to make rounds.” Noel furrowed his forehead. “My team will declare mutiny and when word gets out, medical students will fight to be on a different team.” He arched his eyebrows. “Maybe yours.”

  She chuckled. “Not likely.”

  Holly ruled the surgical floor with an iron fist. In return, she expected the best from her team and the nurses. No slackers! Her intensity had gotten her where she is now, the best surgeon at Granite State Medical Center. Well, now tied with Noel. But he had an advantage. He had a way with people, staff, and patients. His humor and genuine bedside manner garnered attention and respect. The staff, with the exception of Nurse Ryan, who had probably been at the hospital since its doors opened, avoided her, perhaps rightfully so. Holly had long raised her shield. Noel was the first to stick around long enough to peek behind her armor. And her patients liked her. Well known in the community for her surgical skills, patients flocked to her office. But they were not interested in her personal past. Mrs. Shale was her first exception.

  Noel took a sip of his coffee, keeping his eyes focused on hers over the brim of his cup. He set his drink down. “Why don’t you think residents and students want to be on your team? They looked happy today. They learn so much from you. They leave you being better doctors.”

  Holly grasped her hot coffee with both hands and quietly slurped. She set the cup gently on the table. “I’m a hard ass.”

  Noel cracked a smile. “Nah!”

  “Okay. I can stand to lighten up a bit.”

  He nodded. “Yes, you can.” He wagged his finger. “Now if I can only get on Nurse Ryan’s sweet side.”

  Holly propped her elbow on the table and dropped her chin into her palm. She grinned. “I’ll see what I can do.”

  Noel grabbed the paper bag and rustled it open. “Let’s finish these scones before we head off to the O.R.”

  He bit into one and chewed, swallowing it in seconds. Holly ate as quickly, too. She was used to eating on the run.

  He swiped a paper napkin across his lips. “I’ve got two cases this morning, and then,” he glanced at his watch, “we have the first of our two dates: Mrs. Shale’s room at noon and Chez Jacques at 7:30. Remember, I’m picking you up at seven.” Noel winked. “Let’s synchronize our watches.”

  Holly laughed. She glanced at her watch. “I’ve got 7:15 a.m.”

  “Seven fifteen it is,” he said.

  They gulped their coffee and crunched their scones in preparation for their respective 7:30 operating room start times. Having peeked at his O.R. schedule earlier, she knew his itinerary for the morning but she’d not admit she had checked it out.

  “The scones were delicious,” he said.

  Noel stood and cleared their cups and plates while Holly pushed back her chair. As she got up got from the table, she spied Clifford and Candice across the room. When they noticed her, they bolted from their table, tossed their trash into the waste receptacle, and scooted out of the cafeteria.

  Noel grinned. “They’re eager to please, aren’t they?”

  “Both are doing well. Candice, the medical student, has improved substantially, and you met Clifford, my intern, the day before.”

  “Yeah, good hands.”

  “He has potential.”

  Noel nudged her. “They’re learning from the best.”

  Holly arched her eyebrows. More points for him!

  Noel rested his hand on Holly’s shoulder.

  She fought not to inch closer to him. “Clifford learned a lot during your case, Noel.” Okay, public display of affection under control. God, the man is sexy! But how long could she hold out?

  Noel nodded. “We both taught him well on that one.” He searched her eyes and leaned in closer. “We should operate more together.”

  All right. Heartbeat ready in rocket mode. Easy! Ea
sy! Holly took a quick breath. “I’d like that.” Good! Short and to the point. Hold off, Holly. Don’t be so eager.

  Holly and Noel walked together along the operating room corridor, garnering the attention of their colleagues and O.R. staff who all turned their heads toward the couple. By afternoon, they’d be the stars of the hospital rumor mill. Perhaps she should stop caring what other people thought.

  “See you at high noon.” Noel said. “I’ll score us an incentive spirometer each. Then we’ll whip Mrs. Shale’s lungs into shape.”

  “Deal!” Wow, fun and sexy! This was the first time she couldn’t wait to get through her day. Instead of curling up in her bunny slippers, she’d be curled up in Noel’s arms, of course after Chez Jacques.

  They parted for their respective O.R. rooms. Holly couldn’t help it. She glanced back at him. He was already looking at her.

  ***

  Holly’s patient lay on the operating room table, her eyes darting about the cold, white tiled room. The stark walls were only interrupted by a row of silver stainless steel glass cabinets housing an assortment of surgical supplies. The circulating nurse called a time out, a necessary recitation identifying the patient, the intended procedure, the stated consent form, the patient’s medical allergies, and the O.R. staff present, including Dr. Green as the surgeon of record. Everyone in the O.R. suite confirmed the correct data. Holly held the woman’s hand while the anesthesiologist pushed the syringe filled with sedative into her IV. The woman’s eyelids fluttered and her hand relaxed away from Holly’s grasp.

  “She’s out,” the anesthesiologist said. Holly waited until he inserted a breathing tube through the woman’s mouth and into her airway before stepping outside of the O.R. to scrub. Clifford and Candice were already waiting at the scrub sink, blue bouffant scrub caps on, and light blue surgical masks covering their noses and mouths. Holly, wearing her own flower print scrub cap, grabbed a mask and tied the ribbons from the ends behind her head. They leaned over the stainless steel sink next to one another, and scrubbed their hands with antiseptic sponges from elbows down under the faucets.

  Holly rinsed the lather from her hands and shook the excess water from them. Droplets flew from her fingertips, splattering onto the sink back. Holding her wet hands above her waist, her elbows bent, she nudged the O.R. door with her backside. She glanced at Clifford and Candice who stood like speechless subjects, letting their queen enter first. “Are you guys ready?”

  They nodded.

  She tilted her head into the O.R. “Well, come on. A chance to cut is a chance to cure.”

  They hurried their pace. Holly smiled beneath her mask. While the O.R. nurse cleansed the woman’s left breast with Betadine, a sepia tinted antiseptic solution, Holly led Clifford and Candice over to the screen mounted on the wall displaying radiologic views of the woman’s mammogram and breast ultrasound. She reviewed the digital films with them, pointing out the problematic mass, and quizzed them on the differential diagnoses of a breast lump, nodding with approval at their correct list.

  “I’m impressed. You’ve both prepared well for this case.”

  The crinkle of their eyes above their masks disclosed their pride.

  Yes, her day was right on schedule.

  They moved to the O.R. table. Candice stood next to Holly while Clifford and the surgical scrub tech, took their places opposite them. Holly arranged blue sterile towels around the woman’s breast, leaving the suspicious area exposed.

  “Scalpel,” she said.

  The scrub tech handed it to her. As Holly incised the skin above the breast mass, she heard Candice’s breath hitch. Without turning her head, she asked, “Ms. Baxter, are you all right?”

  Candice cleared her throat. “Yes, I’m fine.”

  “Good. Then hold this retractor here so I can excise this mass. Clifford, give me exposure on your side.”

  Neither Clifford nor Candice spoke, only doing as Holly ordered them.

  Holly scooped out the shooter marble sized mass and handed it to the scrub tech. “Please send this to pathology for a frozen section.”

  “Will do,” she said. The scrub tech plopped the pearly white lump into a container and handed it to the circulating nurse.

  They waited around the surgical table for the pathologist’s preliminary tissue diagnosis.

  Holly glanced at the scrub tech who had known her for years, anticipating every move Holly made in her O.R. “These two are awfully quiet,” Holly said. “Aren’t they?”

  The scrub tech dutifully nodded. “Yes, they are, Dr. Green.”

  Holly turned and searched Candice’s eyes. Her ink spot pupils shouted female fear, fear of the sensitive issue at hand. Holly contemplated her own angst at every breast biopsy, at every excision, especially on women her age or younger, prompting self-exams that would fade until the next case struck. She focused on Candice’s frightened eyes.

  “It’s scary operating on women with breast lumps,” Holly said softly. “And they’re scared, too. But we’re here to give them answers, good or bad, and get them the best treatment possible. You’re helping in that process today.”

  She heard Candice swallow hard and watched the lump in her throat rise and fall. Holly rested her gloved hand over Candice’s hand.

  “Dr. Green and I have operated on many breast lumps,” the scrub tech added. “Even with the benign looking ones, we hold our breaths.”

  The tension in Candice’s hand eased beneath Holly’s touch.

  She winked at Candice.

  “Holly, it’s Doug,” Dr. Netz’s voice blared over the O.R. speaker. “I have the frozen section results. Looks to be a fibroadenoma with clear margins.”

  Holly grinned beneath her mask. “Thanks, Doug.”

  “You’re welcome. Have a good day.”

  “And it’s a good day for her. Her lump is benign as I expected. She’ll need follow up mammograms and breast exams.”

  Candice sighed. The scrub tech gave her celebratory high five.

  “Okay, ladies and,” she glanced at Clifford, “gentleman. Let’s close.”

  Holly let Clifford suture the subcuticular tissue and had Candice cut the suture ends. She finished the incision with a cosmetic closure.

  “Your instrument count is correct,” the scrub tech said.

  “Good job, everyone. Dr. Jackson and Ms. Baxter, dress the wound. I’ll meet you in the waiting room. We’ll speak to her husband together. Afterwards, I want you to go to the surgical ward and finish your notes and orders. I’ll come up later and cosign them.” She glanced at the anesthesiologist. “You can wake her up now.”

  She patted Candice on the back before leaving the O.R. Holly hustled to Noel’s O.R. room and peeked inside it. His back to her, he was still on his first case. The timing was perfect. She’d finish her next two surgeries right about the same time he’d complete his cases for the day. Barring any emergency surgeries, they’d be off at 5 p.m. when the on call team began their vigil.

  Holly met Clifford and Candice as planned. Their faces beamed with accomplishment. She recalled that heady feeling as a medical student and then a surgical resident when she’d get her chance to perform in the O.R. Pure adrenalin. There was nothing like it. There still isn’t. Well, except when she was with Noel.

  Holly and her team entered the waiting room. The woman’s husband shot up from his seat, his forehead furrowed. He clenched his hands together. She watched the anxiety dissolve from his face as she relayed the good news. He released his hands. His shoulders relaxed. The man shook Holly’s hand, thanking her, and acknowledged Clifford and Candice. Everyone left that room happy.

  As they walked out of the waiting room, Candice said, “It’s so nice to give people good news.”

  “Yes, it is,” Holly said. She’d not deflate the elated medical student’s surgical dreams with tales of somber news. Candice would learn soon enough that not every case ended well.

  After Clifford and Candice took off, Holly went to the recovery room and as s
he promised she sat at her patient’s bedside until the woman was alert. She squeezed the woman’s hand and announced the bright prognosis. Tears streamed down the woman’s cheeks. Her patient hugged her. Holly’s day was getting better by the moment and her night promised to cap off a fabulous 24 hours.

  Her next two cases flew by without a hitch. As always Holly’s favorite scrub tech anticipated all her instrument needs, her hand offs crisp. The residents and medical students were eager to learn, and no one accidentally contaminated her surgical field. A banner morning it was!

  Her cases done for the morning, Holly dictated her last operative report in the recovery room. The telephone receiver pressed to her ear, she caught Noel out of the corner of her eye. She was right. They did finish their surgeries at the same time. He leaned over her, his breath on her cheek, and scribbled a note on the pad in front of her. She raised her finger while continuing to dictate. Noel tapped his index finger on his note, and then made funny faces at her, trying his best to make her laugh. She pressed the pause button on the phone.

  Clutching the receiver in her hand, she shook her head and laughed. “You’re distracting me.”

  “Oops, sorry,” he teased.

  Noel plopped into a chair and picked up the receiver from the phone next to Holly. He began to dictate at the same time as she, speaking a bit louder, a mischievous grin on his face. It was like trying to count while someone else shouted out random numbers. She rushed through her dictation and hit the “end” button, and then stuck her tongue out at him. She could never figure out how the hospital transcriptionists were able to comprehend their lightening fast summaries. Holly read Noel’s note while he finished his dictation. It read, “Meet me in Mrs. Shale’s room.” Holly tapped him on his shoulder before she left and nodded.

  Noel paused his dictation. “You beat me, Green. But I’ll win the first annual incentive spirometry challenge. Be afraid, Green. Be very afraid.”