It's Nothing Personal (2 page)

“No, Rebecca.
 
I’m hoping she’s young and healthy, so
it shouldn’t take me more than a couple of minutes.”

“Well, since Hillary and I are done with our
count, I’m gonna go see the patient and then hopefully score some coffee before
Dr. Hoover shows up.”

“Go for it.
 
I’ll be right behind you,” Jenna
replied, without looking up.

Rebecca scurried off to meet the patient,
leaving Jenna and Hillary alone in the operating room.

Jenna finished checking out a 2 cc vial of
Versed.
 
With her narcotics in hand,
she exited the Accudose machine.
 
The machine clattered as its drawers automatically locked.
 

For several minutes, both Hillary and Jenna
quietly went about their respective tasks.
 
The silence made Jenna uneasy.
 
She barely knew Hillary, who was relatively new to St. Augustine.
 
They had worked together only a few
times.
 
While Jenna had to concede
the newcomer always conducted herself professionally in front of the surgeons,
she also saw an element of “white trash” in the scrub tech.
 
Hillary had bleach-blonde hair with
black roots, brown eyes encircled with heavy eyeliner and mascara, and an
excess of tattoos and facial piercings.
 
However, her impression was based upon more than Hillary’s physical
appearance.
 
Hillary’s manners were
unrefined.
 
She pictured Hillary
more as a bartender in a seedy watering hole than as a healthcare
professional.
 
If Jenna had to
choose two words to describe the scrub tech, they would be “dark” and
“scrappy.”
 
Hillary had the air of
someone who had lived a hard life.

There was something else about Hillary that
put Jenna on edge.
 
She had not
noticed it until the two of them were alone.
 
Jenna had a disconcerting feeling that
Hillary was watching her.
 
Yet,
every time Jenna glanced at Hillary, the scrub tech was looking in another
direction.
 
The sense of paranoia
made Jenna feel foolish.
 
She tried
to put it out of her mind as she engaged Hillary in small talk.

“So,” Jenna asked, “how
do you like St. Augustine so far?”
 

“You know, it’s been fine.
 
Everyone’s been pretty cool.
 
I’m not used to your winters,
though.
 
What’s up with all the snow
and ice?
 
I was sliding all over the
place on my way in.
 
It scared the
crap out of me.”

“Well, you get used to
it, I guess.
 
Where’d you come
from?”

“I just moved here from California.
 
I’ve been going through some pretty
rough shit lately.
 
I have a little
girl who lives with her dad in San Francisco.
 
I’m just trying to get my life back on
the right track so I can regain custody.
 
I haven’t seen my daughter in over a year.”

The fact that this person Jenna hardly knew
would divulge such intimate, sordid details about herself left her feeling
anxious to leave.
 
She glanced up at
the clock, which read 7:45.

Jenna moved over to her
anesthesia cart.
 
The cart was
nothing more than a glorified, multi-drawer tool chest containing non-narcotic
drugs and anesthesia supplies.
 
She
drew up the remaining intravenous medications needed for the case.
 
Per her routine, Jenna took all of her
syringes, opened the bottom drawer of her anesthesia cart, and concealed them
in a bin beneath bags of intravenous fluid.
 
After stashing her medications, Jenna
took one last glance around to make sure everything was in order for the start
of her first case.
 
Satisfied, she
grabbed her stethoscope and headed out of OR 2.

On her way out, Jenna told Hillary, “Well, I
hate to cut things short, but I need to go see the patient.
 
Good luck with everything, and I really
hope things work out for you.”

“Thanks, Doc.
 
Think I have enough time to break scrub
and go get some coffee?”

“I can’t imagine why not.
 
My guess is we won’t be bringing the
patient back to the room any sooner than fifteen minutes from now.”

By the time Jenna walked out of the
operating room, Hillary had already ripped off her sterile surgical gown and threw
it into the waste bin.

Jenna could not shake the eerie feeling she
got from being alone with Hillary.
 
The woman conveyed a sense of danger.

Hillary was finally alone in the operating
room.
 
Unfortunately, Jenna’s
suspicions were correct.
 
The scrub
tech had been secretly watching Jenna as she hid her drugs and knew exactly
where to look.
 
Hillary opened the
bottom drawer and lifted the bags of IV fluid.
 
Immediately, she found what she craved.
 
She plucked the 5 cc syringe filled with
clear fluid and labeled with a blue “Fentanyl” sticker from the pile of other
medications.
 
Slipping two fingers
into her breast pocket, Hillary pulled out an identically labeled syringe
filled with saline.
 
Swapping one
syringe for the other, she covered the drugs, and closed the drawer of the
anesthesia cart.
 
Everything was
exactly as Jenna had left it.
 
Hillary smiled as she headed to the locker room.
 

CHAPTER 2

Jenna reached the preoperative patient area,
which was bustling with surgeons, anesthesiologists, residents, nurses, and lab
technicians, all in constant motion.
 
Ignoring the chaos, Jenna maneuvered her way toward the dry-erase board
that served as the OR schedule.
 
She
searched the board for her patient and darted off to room four.
 
Jenna delivered three rapid knocks on
the door and entered.

She grabbed Michelle Hollings’ chart from
the table at the foot of the bed.
 
After confirming she had the right patient, Jenna introduced
herself.
  

“Hi, Michelle.
 
I’m Dr. Reiner.
 
I’m going to be your anesthesiologist
for your breast augmentation with Dr. Hoover today.
 
It’s nice to meet you.”

Jenna shook Michelle’s petite hand.
 
Moving in closer, Jenna noticed that Michelle’s
fingernails were decorated with hot pink polish and little, sparkly flower
decals.
 
Jenna also caught a glimpse
of Michelle’s diamond nose ring.
 

“Nice to meet you, too,” replied
Michelle.
 
“This is my boyfriend,
Bradley.
 
He’s the one footing the
bill.”

Jenna turned her attention to an attractive
man in his forties seated at Michelle’s bedside.
 
Dressed in a black suit and sporting a
Rolex watch, Bradley seemed like an unlikely match for Michelle Hollings.
 
He looked up from his Blackberry and
grinned.

Jenna smiled politely at the boyfriend.
 
“So is this a present for you or her?”

As Jenna asked the question she noticed the
gold band on Bradley’s left ring finger.
 
There was no corresponding ring on Michelle Hollings’ hand.

In response to Jenna’s question, Bradley’s
expression transformed into a guilty sneer.

At the same instant, the patient and her
boyfriend blurted out, “Both,” and started laughing.
 
Jenna chuckled as well, trying to hide
her distaste for Michelle’s choice in men.

On the other hand, Jenna could appreciate
Bradley’s interest in Michelle.
 
The
young woman was extremely attractive.
 
She had long blonde hair, beautiful green eyes, and a perfect body.
 
Jenna glanced at Michelle’s vital signs,
mostly because she was dying to know Michelle’s height and weight.
 
Exactly as Jenna suspected, Michelle had
ideal dimensions, standing at 5 feet, 10 inches tall and weighing 115
pounds.
 
Jenna, who stood 6 inches
shorter and weighed 15 pounds more than her patient, was inwardly envious.
 

“All right then,” said Jenna, as she
reviewed Dr. Hoover’s history and physical from the chart.
 
“From what Dr. Hoover has to say about
you, you have no health problems, you don’t take any medications except birth
control pills, and you have no allergies.
 
Is all that correct?”

“Yep, pretty much.”

“And no smoking, drugs, or excessive
drinking?”
 

“Nope.”
 
Michelle shot Bradley a conspiratorial grin.

“I see they did a pregnancy test on you this
morning, which was negative.
 
Have
you had any problems with anesthesia in the past?”

“Nope.
 
Usually, I do pretty good.”

“I assume you’ve had nothing to eat or drink
since midnight, right?
 
You didn’t stop
at Starbucks for a latte on the way in?”

Michelle giggled nervously.
 
“Unfortunately, no.
 
No latte, or anything else for that
matter.
 
But it does sound damn good
right about now.”

“Well, I thank you for being a compliant
patient.
 
I have only one last
question.
 
Do you have any loose,
missing, or chipped teeth?
  
Anything in your mouth that’s not permanent?”

“Just my tongue ring,” said Michelle, opening
her mouth and proudly displaying a silver stud.

“That will have to come out before we take
you back,” Jenna said firmly.
 
“Any
other piercings will also need to be removed.”

“I was afraid you’d say that,” pouted
Michelle.
 
“Does that also include
my piercings . . . down there?”
 
Michelle dipped her head in the direction of her crotch.
 

Jenna tried to sound unbiased.
 
“Yeah, even the ones down there.”

Over the course of the next few minutes,
Jenna performed a quick physical exam.
 
She peered into Michelle’s mouth and assessed her airway.
 
Next, Jenna listened to Michelle’s heart
and lungs, which sounded completely normal.

After Jenna finished examining Michelle, she
said, “Now’s the time where we have to go through the risks associated with
anesthesia, and then I need to get you to sign the anesthesia consent.
 
Even though I have to tell you all the
things that could go wrong, I want to start by reassuring you that I do not
anticipate any problems.”

Michelle sat up straight, signaling Jenna to
continue.

“The most common complaints after surgery
are nausea, vomiting, pain, and a sore throat.
 
I will give you anti-nausea medication
to help prevent you from feeling sick and narcotics that will hopefully allow
you to wake up pain free.
 
However,
the nurses in the recovery room have more medicine, if you need it.
 
If you get a sore throat, lozenges help,
and it should resolve in a few days.”
 

Jenna paused for a moment.
 
She could see the glazed-over look in
Michelle’s eyes.
 
After giving
Michelle a moment to process the information, Jenna continued.
 

“It’s rare, but sometimes we can have
serious complications from anesthesia.
 
For this procedure, I have to intubate you, which means that I put a
breathing tube down your throat and into your windpipe while you’re
unconscious.
 
Then I use a
ventilator to help you breathe during the surgery.
 
That was why I looked in your mouth and
asked about your teeth.
 
Those
things help tell me if it should be easy or hard to get the tube in place.
 
Based on my assessment, your airway
looks very easy.
 
However, there is
a small chance that I could chip a tooth, cut your lip, or damage a vocal cord
while trying to place the tube.

“There is also a possibility that you could
have an allergic reaction to any of the medicines that I give you.
 
If I see any indication that something
like that is happening, I have other medications in the room to treat you.

“The most serious complication, and this is
true for any patient, any surgery, and any type of anesthesia, is a serious and
potentially life-threatening heart or lung complication.”
 

With the mention of the possibility of
death, Michelle Hollings clutched tightly to Bradley’s hand, but otherwise
maintained her composure.
 
From what
Jenna could tell, Bradley did his best to look interested and concerned, but
she also caught him checking his Blackberry several times.

“Michelle,” Jenna asked, “do you have any
questions about the anesthesia or the risks?”

“No.
 
I’m just ready to get on with it.
 
I’m looking forward to my new rack,” Michelle grinned.

“Me too,” said Bradley, a bit overly
enthusiastic.

With that, both Dr. Jenna Reiner and
Michelle Hollings signed the appropriate lines on the anesthesia consent
form.
 
Jenna left the room and ran
into Rebecca in the hallway.