“No, it’s not,” Peterson is saying. “That’s a lot of pressure on the cord.”
A moment later, Eilert bursts in. “How’s he doing?”
I guess someone called her.
I step over to Landon as I try to fill her in. I stroke his arm before I realize my mistake, but no one notices as Peterson catches Eilert up and we start stabilizing Landon for the trip up to the third floor.
Every minute, more people flood into the room. Billards, a nice guy about my dad’s age, arrives eating a granola bar and quickly reviews the images. He tosses his wrapper and tells us, “OR four is open. Let’s get rolling.” He looks to Peterson, and then Eilert. “More fluids. I want to know more about reflexes, spasms, weakness if he rouses.” Then he looks to me. “You’re in his cohort group?”
I nod.
“Okay. You’re scrubbing in. Sometimes you’ll find it’s someone that you know,” he says in cryptic tones. “This is good training.”
I look down at Landon. My head’s pounding, and my stomach’s twisting.
“Take some deep breaths,” Eilert says.
“What about the pneumothorax?” Prinz asks.
“I don’t think we’ll need a chest tube,” Peterson says.
I’m swimming through time. I’m moving, helping, but I’m somewhere else. In the basement of my parents’ house. In Landon’s bedroom here in Denver. On his cool, brown sheets. Back in the Lyft. All I can think about is the look on his face after we scrubbed out together, earlier today. The way he looks as he moves over me. His eyes and his mouth in motion.
I don’t want him to have an L1 fracture! He’s a surgeon, not a patient!
I think about the fix for his back and have to grab his bed rail when I realize we’re probably going to have to take a left-sided thoracolumbar junction approach. It’s a heavy-duty surgery with an absolutely brutal recovery. I can’t even stand to think about doing such a thing to Landon. Again, I’m on the verge of breaking down.
By the time we start to scrub in, everyone is discussing point of entry. I’m swallowing back bile.
I make it into the OR and see him spread out on the table, being shepherded through early anesthesia by Pat and Wynn, the anesthesiologist/nurse anesthetist pair we scrubbed in with earlier.
He’s positioned on his right side, with his arms extended straight out, zombie-style, and strapped down to a board. They’ve got his lower leg flexed, and a pillow between his legs, and his hips are being strapped to the table.
Wynn inserts a breathing tube while Billards gets another CT. I move with the pack, analyzing the results of this new CT, listening through a haze as Billards discusses his game plan, which I’m relieved to hear is a significantly less invasive VATS approach for L1 body reconstruction.
“Not every patient at this hospital gets the VATS treatment,” he says with a shake of his head. “Only the lucky ones when Dr. Briggs or I am on call.”
VATS is the ideal procedure for an easier recovery, so this news has me shaking with relief.
As Billards talks, I can’t stop looking at Landon. I hate the sight of him up on the table with that cruel tube down his throat and props and blankets positioning him so unnaturally. I try to tell myself that he’s asleep, and he has no idea what’s going on, but that thought makes me feel ill, as well. He doesn’t know yet that the car wreck—where he was a victim of a run stop-sign, I’ve heard—could end his career, even his life if something goes wrong.
I watch silently in my surgical getup as Eilert marks his torso in four spots, for port insertion sites. We’ll need a working channel, an optical channel, a traction channel, and a suction channel. Even though Billards is in charge, I get the sense that Landon’s surgery will be mostly Eilert’s—and I hate her for it. Eilert is one of our chiefs, but she’s a resident. I want Billards at the helm.
I listen as he tells us, “We’ll be using an expandable Synthes cage. It’ll be placed in the vertebrectomy defect, gradually distracted, and locked into place to stabilize the cord.”
He and Eilert discuss the four channels at length, as he explains pitfalls of the positioning to her.
“Rutherford, I want you to construct the suction channel. That’s your job here. You do that well, you’re scrubbing out if you don’t want to do more. How do I know Rutherford is uncomfortable?” He looks around the room as he points to his head. “She’s sweating. Pale. She looks like she’s the patient. This is why we don’t perform surgery on a loved one if that is an option. At a smaller hospital, it is not always an option.”
Somehow, I remain standing as Billard talks ad nauseum and Landon lies there, frozen by anesthesia, being hovered over, poked, and prodded. Prinz arrives in surgical gear as Billard explains that for VATS to be advantageous for the patient, the surgeon must be experienced in restoring the diaphragm with the use of an endoscope.
“This is a developing subspecialty of thoracic surgery. You master this, you’ve got a gold star on your resume.” Moving closer to Landon, he continues, “Decompression will be performed using laminectomy. We have one broken fragment we’ll push forward, toward the body, before inserting screws from the rear. In a more severe fracture, we might come back in a few days later and remove the destroyed body with thoracic endoscope, but in this case we’ll be doing all that now. If all goes well, our colleague will get his chest tube out in four to five days and be discharged in perhaps ten. Surgery like this might take a toll on a geezer like me, but Jones here is a young man.”
I hold my stomach as he explains routine opening procedures. Billard is too specialized to deal with first or second year residents much, and I can tell he views the situation as something of a novelty.
So much of what he says makes me flinch—things I hear daily without batting an eye, like the warning he gives us to properly restore the diaphragm in order to avoid pneumonia and herniation of the large intestine.
He means Landon’s large intestine.
Somehow, somehow, somehow…I stay on my feet for three hours. After the first two, I’m just watching—mostly watching Landon’s vitals and the mortal hands that work the gear that’s rearranging my love’s insides. Every semi-sigh from Eilert or grunt or complaint from one of the techs makes my head spin. Every spurt of blood and BP fluctuation make my knees wobble.
I’m standing near his head, wanting so badly to touch him—just his forehead—when Eilert takes a bathroom break, and grabs me by my elbow. She leads me gently from the room.
“Rutherford, scrub out,” she says, doing so herself. “You look like you’re about to collapse.”
I nod woodenly as she heads for the women’s room. I make sure I’m out of earshot before I start to sob.
Eleven
Evie
I’m in the donut room, waiting for a page to tell me Landon’s been wheeled to ICU, when Eilert comes in. Her eyes are red. Her face is drawn. I notice tears on her cheeks, and I almost faint.
“Did something happen?” I jump up from where I’m sitting.
She gives me a look. “Your cohort just got sliced and diced. What do you mean, did something happen?”
“Is he okay?” I ask her, seeing stars.
“Jones?” she shakes her head, confused. “What do you think?”
“Did it go okay?” I half gasp.
“If by okay you mean I operated on a guy I shoot the shit with every day, a guy who hours ago was grinning his fool head off, and then I walked down to the ICU and watched him start to wake up, screaming from the surgery that I just did, then yeah, it went great.”
A sob bursts from my throat.
“Also,” she says slowly, “two of my interns have been having a relationship. If you think that’s okay, then yeah, we’re good.”
My heart stops at her words.
“Sit down. Or you can head on to the ICU. You think I didn’t see you crying while I was working on your boy? Just because I’m cutting doesn’t mean I’m blind. Why didn’t you tell me, Evie?”
I shake m
y head. I’m trying not to cry too loudly.
“It’s okay. He’s gonna be okay.” She wraps an arm around me, and I sob my brains out as she tells me all about the surgery, how well he’s doing and how fit he is. “I don’t think he’ll have any complications. I don’t know, of course, but I don’t think so. He’ll be on the other side again in just a few months.”
“Months,” I cry.
“Yeah, two or three. And he might fall into the next cohort, and that’s not necessarily a bad thing. Because he’s your boyfriend. He is your boyfriend? Not just your bed buddy?”
I nod, and then, because I’m such a basket case, and so riddled with guilt, I tell her everything, confessing so fully, her jaw drops. The sun’s up by the time we leave the donut room, but I’m feeling less on the verge of breakdown.
Eilert signs me in to the ICU as Landon’s next-of-kin, an easy move because he already listed me in the computer as his emergency contact.
Finally, I step into his little glass-walled room, and am stunned to see him extubated with his gray eyes cracked open.
As soon as he sees me, his jaw seems to tighten, and his eyes fill up with tears. I see his shoulders rise and fall, and see his mouth tug to the side in a small wince.
I step slowly closer to him, wondering if he’ll send me away. When he doesn’t—just looks at me with his pain-dazed eyes—I lean down and stroke his hair and cheek. His gaze lifts slowly up to mine, eyes rolling for a second as he struggles to keep them open.
Finally, in a scratchy voice, he whispers, “Evie…are…my legs okay?” He inhales, wincing, and fresh tears sting my eyes. I nod quickly. “You’re okay. Your tone and reflexes are okay. Try not to talk, Landy. I know you can’t feel much, but you’re just out of surgery. Did someone talk to you already?”
He blinks, then sinks back into his sedation. I spend the day beside him, stroking his hands and cheeks—seemingly the only parts of him that aren’t hurt—and pouring over his labs and his vitals like the psycho cross-breed of a helicopter spouse and overzealous doctor.
I test his reflexes myself and spend hours analyzing every fresh scan, particularly the MRI he gets toward the afternoon to check the innervation near L1. His nerves are fine. His nerves are fine. He’s breathing fine. His chest tube’s fine.
For the next two days, Landon sleeps, and I work in a kind of numb, efficient stupor, stopping by his room all through the day and playing with his hair, kissing his hands, kissing the bridge of his nose.
I can tell he won’t remember any of it. He’s pale and sweaty, his eyes dazed from painkillers. He hasn’t even gotten up yet. When he does, he might tell me he hates me. How selfish that I even think about that.
If only I hadn’t been so selfish. If only I’d just told him when we first talked. My punishment is every second he’s in bed.
On the second night, his eyelids lift a little. His eyes roll around the room, and when they land on me, he croaks, “Which…one?”
“It was L1,” I say quietly.
He nods once, and I can see him struggle to re-focus. “Evie?”
“Yeah?”
His mouth goes sad and soft. “I’m…sorry that…I didn’t…stay.”
For just a second, he gives me this pointed look, and I know without a doubt what he means.
That’s how I know all hope’s not lost.
The third day, Eilert lets me know they’re going to cut back on Landon’s morphine and try to get him out of ICU. She gives me the day off, and I’m so grateful, I cry in the donut room over a strawberry cruller.
When I get to Landon’s room, his bed is elevated more than I’ve seen it since surgery. He’s sitting mostly upright, with his middle wrapped in bandages, and over those, a hard brace. He looks heavy-lidded and tight-jawed, the way that people only ever look when they’re in pain, and taking big-gun drugs.
I stop there in the doorway, my body freezing as his gaze finds mine. When one side of his mouth twitches in a small-smile greeting, I nearly faint with relief. The sensation is followed by a heavy wave of guilt. I step slowly inside the little glass room, folding my arms around myself.
Landon rests his head against the back of the bed and shuts his eyes. His lightly bearded face is tight. I can see pain in the tension of his shoulders, in his shallow, careful breaths.
When I murmur, “Hi,” his eyes peek open, and the misery I see there…
I swallow as tears sting my eyes.
“You had a baby.” His voice is rough and monotone, with no inflection. His eyes on mine are flat, his pale face a mask of apathy. I think of what he must be thinking—I did this to him, me with my horrible lie—and I feel like I might be sick.
I want so much to say I’m sorry—more than anything, I want to throw myself at his feet and beg forgiveness, not just for letting someone have our baby, but for letting years pass without telling him it happened. I’d do anything to be forgiven, but everything I have to say is meaningless. What good will it do now? I wipe my eyes and nod slowly.
His eyes shut. “What…was it like?”
“What part?” I rasp. I step a little closer to his bed, inhaling deeply.
Landon looks down at his blanket-covered lap, and then back up at me. His face looks neutral. So impassive that I know he’s schooling it. “Did you hold her?”
“Yeah.” I press my lips together, blink my leaking eyes. “I fed her. For the first night.” My voice wobbles.
Landon swallows, the corners of his mouth tugged sharply downward for a second.
“She was perfect, Landon. I loved her more than anything I’d ever seen…except for you.” My voice cracks, and I shake my head, breathing deeply so I don’t break down completely. “We looked for you…during the pregnancy. So I could get your take on things. We even ran an ad in the newspaper,” I say thickly.
Landon bites the inside of his cheeks, tears welling in his eyes, and I close the distance between us. I sit in the chair beside his bed, then stand and move the bed rail down. I sit there on the edge of his mattress, wanting to touch him but not sure if I still can.
When he doesn’t recoil, I take his hand in both of mine. With my sweaty fingertips, I stroke his knuckles. I can feel his guilt. It’s loud like mine, expanding in the air between us.
“It’s not your fault,” I murmur, looking at him so he can see I mean it. His eyes look so damn sad. I sigh. “Landon…when you got to the ER—when you first got here the other day—do you remember being upset?”
He nods once, eyes closing. The man from the group home Landon ran away from tried to hold him down and hurt him once, when he was sleeping. Before that, the man had kicked him. One of his currently broken ribs has been broken before. So it’s no wonder the restraints on the backboard bothered him.
“I’m so glad you left, and I get why you ran.” He would have been punished from leaving the awful group home, sent to juvie, probably. I kiss his fingers, then settle his arm in my lap, with my arm over his, so I feel like we’re snuggled up together.
“That was the right thing—what you did. It’s what I would have wanted, had you asked. But since my parents held your letters,” my voice cracks, “I didn’t know that you had written. That’s the only reason I didn’t write you back. And since I didn’t…” I breathe deeply. “How would you have known to come to my house? How would you have known? You didn’t know.”
He shakes his head, a ghost-slight movement.
“I hate it that you had to run like that. And that I wasn’t with you,” I whisper. “But you don’t ever have to say you’re sorry. Ever.”
His face looks tired as he says, “Why, Evie?”
I search his voice for anger, but I hear none. Still, I let go of his hand and get back up so I have the distance that I need to answer honestly. Standing by his bed, I shake my head. “I couldn’t do it. I was seventeen, and my heart was in a million pieces. It wasn’t some kind of or…selfishness that stopped me. I promise it wasn’t. I would have given this all up if it had felt lik
e the right thing.”
Once again, my eyes leak, as I look into his eyes and tell him this—my darkest secret. “I knew someone else could do it better. The Deckerts—her…parents—they wanted her so badly, Landon. Their whole world was right for her, and mine just wasn’t. I feel like I should hate myself, like maybe something’s broken with me. That I didn’t…act really illogical and run away to somewhere. Raise her in the trees.” I wipe my eyes, and Landon manages a small smile. “But really, I’m just grateful that it worked out like it did. I love them, the Deckerts. I love her. I see her, Landon. That’s part of the reason I came here for school. Their family had moved here.”
He nods, tight-lipped, and I can’t read his face. Does he hate me? Does he blame me? How could he not?
After a moment, though, he reaches for me, and I sit back down on his bed with my breath held. His eyes on mine are warm and kind, not blaming. My fingers grip his, and I try to give him more.
“When my heart stopped hurting for a baby right then, I knew she’d have a good life. And she does.”
He swallows, nodding.
“Do you hate me?” I ask, through my aching throat.
“Evie…I could never hate you.”
“Do you wish you could?” I whisper.
“No.” He shuts his eyes. His shoulders, drawn up tightly, slowly deflate. For a long time, he’s just still, his big hand limp in mine. I think he’s asleep when, in a murmured rasp, he says, “I found my mother, Evie. She has…four…other kids.” His hand twitches, and his eyes crack open. “Sorry,” he says hoarsely. “I…took somethin’ earlier.”
“Don’t be sorry at all. You need that stuff.” I set his hand back on his lap and push the pillow by his head a little closer. I’m leaning in to place a kiss on Landon’s cheek when Billard walks in, looking so serious, it sends a shot of panic through me. He walks up to me and looks down, pushing a finger up against his horn-rimmed glasses.
“I’m sorry, next of kin,” he says in a friendly tone. “I hope you’re not too scarred from being in the OR.”