Eight years of college, seven years of residency, and countless surgeries on the brains of my patients leave me with one statement to share with you all: brain surgery is the most-complicated surgery in medicine, and easily the most unpredictable. I had told Heather Stillwell she had a fifteen percent chance of surviving the operation, but even the fifteen percent survival rate came with risks. A person could survive the operation but come out of it with impaired movement or speech, or any number of other negative side-effects.
In truth, she had, maybe, a five-percent chance of waking up in recovery fully-functioning. I told her that a half-hour before I went to work. One last chance for her to back out. One last chance for me to end this insanity.
“Five-percent is better than zero, Doctor Andres. Besides, I trust you.”
I smiled. It was weak. Surely she could see my doubt, this intuitive woman who had somehow convinced me to stop fleeing my past.
“Whatever happens, Doctor Andres, it will be all right.”
“You’ve probably earned the right to call me Joel.”
“I’m ready, Joel. Thank you! Let’s do this. I’ll see you on the other side, and we’ll have a victory dinner, my treat.”
Nine a.m., on the dot, the first incision. The clock on the operating room wall seemed to mock me, taunt me, keeping track of crucial moments, constantly reminding me that my hubris, my ego, my self-assurance, it was all folly, for man can never play God with good consequences.
Fold back skin and muscles. Check for bleeding. Suction. Each step crucial, each step performed with precision, a walk in the park, done many times, find a rhythm, keep moving with confidence.
Nine-thirty, open the skull, done many times, find a rhythm, keep moving with confidence, check for bleeding, check breathing, check heartbeat, all vitals reading strong. The nurse wipes my brow. Preliminaries completed, now we get down to it.
Nine-forty, the tumor is exposed. The pace slows. Twenty years of preparation, twenty years of training, twenty years of experience come down to the next hour, live or die, millimeters separating vitality from lifeless, playing God in a sterile environment. The nurse wipes my brow once more. Vitals remain strong, and then they don’t. The warning buzzer sounds the alarm, blood-pressure dropping, heartbeat too rapid, her body rejecting the invasion. Those are the moments when training kicks into high gear, an encyclopedia of medical knowledge flashes before my eyes, possible causes, related actions to take for each cause, choose one, hope for the best, prepare for the worst, and just as quickly as it happened, it stops. Vitals return to normal, the buzzer ends, a collective sigh can be heard from the operating team, one possible disaster averted.
Ten-fifteen, the clock on the wall, an unemotional chronicler of time, coldly, impersonally keeping track of minutes, unaware that each minute is precious life for the woman on the table.
The nurse wipes my brow. We continue!
Nerves and blood vessels are avoided, a dance of precision with instruments, for sections of the brain no larger than a pea can be crucial for movement, thought, speech, all manner of normal life.
Fluid forms, the precursor to swelling. Fluid is drained. Vitals remain stable at ten-fifty-five.
The tumor is removed. The nurse wipes my brow. A glance at the nurse monitoring the vitals. She nods. All is well. Heather is a fighter, no doubt about it, unable, unwilling to relax her grasp on life, but we are not done. I’m not ready to close her up until I explore a bit, make sure all is well inside, make sure the tumor has not caused secondary problems I was unaware of, for brain surgery is all theory and textbooks until the knife makes that first incision and theory becomes reality.
At eleven-thirty I release a breath held for far too long. My assistant asks if I want her to close Heather up.
“No, I’ll take this from start to finish,” and I do, closing the skull, returning scalp and muscle to their rightful place, one last look at the vitals, all is well, all is as it should be, start to finish, about as smooth an operation as I could have asked for, and from the viewing gallery overhead I hear applause, my peers letting me know their appreciation for the job just completed.
“Let me know the minute she wakes up in recovery. I’ll be in the lounge,” and I leave Heather in the capable hands of the team, walk on wooden legs to the doctors’ lounge, collapse into a chair and weep.
“Did we beat the odds, Joel?”
Heather smiled beneath the bandages, reached out a hand to me, which I took.
“So far, yes, but we’re not out of the woods. The next twenty-four hours will tell the tale. Now, answer some questions for me. What is your name?”
“Do you know why you are here, Heather?”
“To remove a tumor from my brain.”
“What is your profession, Heather?”
“I’m a school teacher, or at least I was, and I plan on being one again as soon as you stop with these questions and admit that you did it, you successfully saved my life. Thank you, Joel!”
My throat seemed to close. Tears formed.
“Squeeze my hand, Heather. Good. Now lift your left leg. Now your right. Good!” I checked her vitals. All good.
“What do you want for your victory dinner, Joel? Any restaurant of your choosing. You’ve earned it.”
“How about dinner at your house. You cook.”
“I make a mean mac n cheese. If that’s good enough for you then dinner is on me in two weeks, the 14th, seven p.m., you bring the wine.”
She did make a fine mac n cheese. Turns out Merlot compliments mac n cheese just fine.
“What’s next for you, Joel? Back to the hospital, more lives to save, the legend of Joel Andres grows into the future?”
A dog barked outside of her Greenlake home, north Seattle. Spring had finally arrived, the rains had calmed, shirtsleeve weather was upon us, a time of rebirth, of dusting off dreams and making them a reality.
“I’m retiring, Heather. You were my Grande Opus. I might as well stop while I’m sitting on top of my profession, on a winning-streak.”
She smiled at me, far-removed from the woman who walked into my life a month earlier, now filled with hope, now with a future as yet unwritten.
“What will you do once you retire?”
“I think I’ll travel. I’ve never taken time to see anything. Asia, Australia, Africa, hell, Europe, they are all waiting for me, and there’s no better time than now to enjoy life while it’s still being patient for me to do so.”
She smiled again. The dog stopped barking outside. Somewhere a horn honked. Somewhere a garbage can lid clanked. She began clearing the table, taking dishes to the sink. Poured a second glass of wine for us both, handed one to me, sat down on the couch across from me, smiled again.
“I like to travel, Joel, and the future is calling both of us.”
2021 William D. Holland (aka billybuc)