Ch. 28 – A Doctor’s Armor

It was finally time to move Tony up to the operating table.

Derrick kept his eyes closed as he bounced up and down, feeling the stress drain out of his muscles. It was a relaxation technique he had used for basketball back in the day. Stress held you back—made you weaker—and Derrick needed all the strength he could get.

The gas cylinder cart was lined up next to Tony, so he would only have to lift Tony’s torso. Although, ‘only’ was an understatement. Derrick crossed Tony’s arms, gingerly moving them to avoid disturbing the compression bandages and IV catheter, and squatted close to Tony’s head. Tony’s torso squashed Derrick’s hands as he stuck them underneath the man and pushed them in, towards the bottom center of Tony’s torso, so he could make a stable base with which to lift the man onto the gas cylinder cart.

“Alright, bring it in, bring it in, Derrick,” he whispered to himself. “I can do this without hurting my back.”

Derrick got himself closer to Tony, to bring their centers of gravity closer. He drew in a deep breath of air, and locked it into his lungs, and then pushed the air out against his closed mouth, and braced his abs, feeling power gather around his back. Pushing with his legs and butt, his locked fingers dug into Tony’s back as Derrick lifted him off the ground. Pressure built up in Derrick’s face, around his pursed lips, as the air stabilizing his core threatened to burst out under Tony’s weight. Now, to move him over the cart.

Derrick’s feet seemed rooted to the ground, and his instinct told him that his knees would buckle if he moved an inch to the side. But he had to try anyways. Derrick’s quads and butt burned as he scraped his foot along the rug. Good. Progress. Rebalancing himself over that foot, he then tried to move the other, burning himself on the rug from the sheer friction alone.

A rough object, probably a dried food crumb, dug into his sole as he moved the last few inches to the cylinder cart, and set Tony’s torso down on it. The blood rushed back into his hands, and Derrick gasped for air, falling down onto his butt. Various food crumbs poked him through his sweat soaked underwear.

Derrick got up off the floor and aligned himself with Tony’s legs, bracing his core, and lifting those onto the cart as well, until Tony was entirely loaded up into the cylinder cart.

The straps attached to the sides of the cart—meant to secure the gas cylinders it was transporting, to prevent them from falling out—barely fit around Tony’s waist. They wouldn’t be enough to secure him, as his torso and legs would be flopping around if the cart was moved.

Derrick ran to Tony’s room, grabbed a few dirty, oversized t-shirts shirts off the ground, and tied them together into makeshift straps. The stench stood out in the clean operating room air.

And then Tony spoke.

“What’s going on?” Tony mumbled, eyes half-closed. “Fugg. He got me. Derrick, am I gonna be okay?” The characteristic rumble of his voice was gone. It was flat, deflated.

“You’re gonna be fine, Tony,” Derrick said, as if asserting so would make it true. “Stay with me. You gotta stay alive until we get all your nasty laundry done, okay?” Derrick took a deep breath. “I’m going to tie you to the cart, alright? And we’re going to get you up onto the operating table,” he said.

He fastened the t-shirts firmly around Tony’s torso and legs, strapping them to the cylinder cart as well.

It was time to get Tony up to the operating table. Derrick would have to pull the cylinder cart off the floor, and then either sit it upright, or lay it down on something at an angle, so that it would be easy to get Tony off of it and onto the operating table.

What was high enough and strong enough to set the gas cylinder cart on? Nothing he could see, at least. So the best option was to lower Tony slowly onto the operating table from a fully upright position, and that would be easier if the cylinder cart was parallel to the operating table.

But Derrick would need something to lean the cart against as he pulled it up, so that it wouldn’t move forward on its wheels when lifted. Derrick scanned around the room and tsked.

“All these tools, but not a damn thing that I can lean this cart against!”

The operating room was kept relatively empty to promote cleanliness and sterility, stocked with only the necessary equipment and electronics, so there were very few heavy objects that wouldn’t also break under pressure.

“Shit, wait—” The plastic box of used syringes they had kept forgetting to dispose of was half-hidden behind the storage cabinet. As terrifying as the idea was of pushing Tony’s cart into a box of used syringes, the box itself was fully closed, and remarkably sturdy for a sharps container. And it was full enough to be heavy; hopefully heavy enough to keep the cart from sliding forward as Derrick lifted it. “Okay, perfect.” The used syringes in the box jangled as Derrick slid it across the floor and toward the operating table.

There was a clean path to moving Tony without snagging either the oxygen line or IV line, but it required a firm grip and a steady hand.

Tony hadn’t suffered any spinal injuries, but there was no guarantee his airway would stay open during the move if his head shifted. The collar still had dried blood stains from the operation on Ah Jun, but Derrick had cleaned it off the best he could.

Derrick slid the collar’s plastic height adjuster, giving a bit more slack than usual to avoid creating unnecessary intracranial pressure, and then slid the collar under Tony’s neck and fastened it. The collar fit snugly over Tony’s bulky neck, but it didn’t seem to be choking him.

Derrick moved to the head of the cart, knelt down, and grabbed the handles. If he had known he would be lifting unconscious people by himself, Derrick would’ve paid more attention to building muscle.

Derrick hardened his grip, and then pulled the top of the cart off the floor. The handles threatened to slip out of his grip, but he held on, as a sudden fall from any height would shock Tony and aggravate his wounds.

Derrick pulled the cart up, and then switched his grip as the cart passed forty five degrees from the horizontal. It would have been impossible to pull it any further, as the handles had already come up to Derrick’s armpits. He squatted down and put the handles on his shoulders, and then pushed up with his legs. The box that Derrick had placed in front of him slid along the floor, unable to support the weight of the cart, which rolled forward and away from Derrick’s center of gravity, pulling the oxygen and IV lines taut.

Derrick stumbled forward along with the cart and braced himself, pulling the handles back into his chest with all his might to keep them in place. His biceps and forearms burned.

This isn’t gonna work. He set the cart back down and wiped the sweat off his brow. He was hot and parched. He needed something heavier than the box, maybe the operating table itself, but its base was recessed from the edge of the table, meaning that he’d be pressing Tony’s waist into the table when he lifted him. Or . . . right, he could place the box against the base of the table, and then push the base of the cart against the box. That would do the trick, but he would need to move things around.

Derrick rotated the oxygen concentrator and the medical IV pole around the operating table, so that the lines would have slack when Tony and the cart were oriented to face the table.

Derrick grabbed the carts handles, and pulled again, and this time the bottom of the cart was blocked from moving forward by the operating table’s base.

Sweat streaming into his eyes, Derrick screamed internally as he brought the cart up for the second time. His lower back came dangerously close to giving as he hefted the handles up to switch his grip, and then pushed the cross bar off his chest until Tony and the gas cylinder cart were sitting upright.

Tony tilted forward from his own weight, straining against the straps. The cart held strong, supported by its wide base.

After sucking in air for a few moments to recover, Derrick wedged himself in between the cart and the operating table, and steadied Tony’s chest against his as he undid a strap with both hands. Tony’s body jerked forward as the strap came undone, and Derrick braced himself against the operating table, the rigid frame of which dug into his hip, even through the padding.

His left glute and hamstring burned as Derrick used his hip as a pivot to support Tony’s weight. He lowered Tony onto the operating table as gently as he could, until most of the man’s torso was supported on it. Steadying Tony with one hand, Derrick undid the straps around Tony’s legs, and then lifted those up too. A layer of sweat covered his arms and legs by the time Tony was finally on the operating table.

The light-headedness was getting worse, and Derrick staggered around as he searched for sanitizing wipes. He couldn’t start a surgery in such a state. “I’ll be right back,” Derrick wheezed, between ragged breaths. He ran to the kitchen and filled and downed three glasses of water.

His nose and lips were buzzing, and each gulp of air felt like it was burning in his lungs.

He snipped off the rest of Tony’s clothes, grabbed the box of sanitizing wipes, and wiped down his body.

The compression bandages had been soaked through with blood. Derrick peeled one off, and inspected the bleeding. The wounds themselves looked clean—thankfully nothing from the carpet had gotten into them. But Derrick would still need to rinse them thoroughly and apply new bandages before making an incision.

Making an incision. On Tony, no less. Derrick couldn’t stop himself from shaking.

Colored lines continued jumping across the monitor, still cyclical, but showing a trend toward hypoperfusion, which meant that Tony was still hemodynamically unstable. Derrick pinched and released Tony’s fingertip, watching the speed at which the redness returned to it, indicating the blood refilling into the capillaries. Slow. So Derrick’s initial diagnosis was probably correct. He would have to do an abdominal exploration.

Derrick put the sanitizing wipes, fluid, and swabs down, dragged the area rug out of the operating room, and then wiped down the area around the operating table, before switching gloves.

He setup the mayo tray, and got all the tools in place, unpackaging them onto the sterile work surface. It was finally time to gown up.

Derrick tossed his gloves in the biohazard bin, changed into a set of emergency scrubs, and went toward the handwashing station.

He scrubbed carefully, like Tony and the textbooks had taught him—no, even better than that. Tony’s life was on the line, and Derrick was not going to give his mentor a surgical site infection.

Careful not to touch it to the dirty parts of his body, he grabbed the gown that he had already unpackaged, and tied it up on himself.

Slipping on one glove after the other, he was sealing himself in his armor. A doctor’s armor.

Derrick adjusted the sterile drapes that he had placed over Tony to retain his body heat, and placed the one with the opening cut into it on top of the incision site.

It was time to clean Tony’s wounds and start the anesthesia. And then it would be time to cut.