Ch. 29 – Tagging Out

Derrick took the scalpel in his left hand.

His right prosthetic hand was beginning to run out of juice, so it was better to reserve the battery for fine manipulations that required both of his hands. He didn’t have any spare batteries, or time to charge the prosthesis. He pressed the gloved prosthesis against Tony’s skin, keeping it taut between the static digits, so that the scalpel would cut smoothly.

He had practiced cutting with his left hand before, back when his prosthesis had been out of commission, but never on a human.

And he was about to cut open Tony.

Derrick swallowed dry, staring at the black dotted line—drawn in marker—on Tony’s skin, and lined up his scalpel. Keeping the skin taut with his mechanical right fingers, he slid the scalpel down and across Tony’s skin.

The scalpel caught on Tony’s flesh, and jerked once before it began gliding and making a clean incision. Blood welled up and dribbled out, wetting the scalpel a crimson red.

He took out the electrocautery, and felt the heat from its superhot tip rising through the air. He took it to Tony’s abdomen, burning and cutting through fat and flesh, until the incision was finally deep enough. Derrick put the electrocautery down, picked a retractor up from the mayo tray and propped the incision open, exposing the abdominal cavity and viscera.

Blood pooled in the cavity, just like the ultrasound had suggested, obscuring Tony’s wounds from view. It slurped up into the suction device, but more blood appeared—seemingly from nowhere—to replace it.

Shit, he was sweating. Derrick leaned back to let the sweat forming around his scalp drip backwards instead of into his eye; there was no one there to wipe the sweat for him, and he couldn’t risk it dripping onto Tony’s wound, on the chance that it made it past his surgical cap. It was going to be a tough surgery.

#

Derrick could feel the pulsations from the abdominal aorta as he tied up and snipped the sutures that closed the laceration on Tony’s liver. Derrick’s own heart had been and still was pounding in his chest; he still couldn’t believe he had done it.

The catastrophic hemorrhage in the abdominal cavity had stopped after closing wounds in the viscera. That was the good news. But Tony’s blood pressure was still dropping, despite the ongoing infusion of the oxygen-carrying blood substitute.

The highest stab wound might have penetrated into the chest, but Tony’s diaphragm didn’t seem injured. Which meant that he might still be bleeding there, and possibly around the heart. Derrick might have to do a thoracotomy, sawing off the sternum to gain access to Tony’s heart, esophagus, and lungs, where the wound might be. But he had never done it before. Derrick blinked tears away as he pulled gauze out from the red, pulsating mess that he was trying to forget was actually Tony’s abdominal cavity. He couldn’t do this, but he had to.

“Derrick,” he said to himself, voice cracking from the strain. “You are going to diagnose this. And if you need to cut his chest open, you’re going to cut. No one’s coming to help you. THIS IS IT,” his voice rose to a shout. “IT’S DO OR DIE. ARE YOU GOING TO SAVE TONY OR NOT?”

Footsteps sounded in the shop. He could hear them between his labored breaths and the pounding pulse in his ears.

Shit. It was the worst time to have company. Please just be thieves. If they stuck to just rummaging around the shop, it would be fine, but if they came into the operating room while Tony was cut open on the operating table, Derrick would have to keep them away at all costs. If they broke the sterile field and infected Tony, every second chance at survival that Derrick had fought to give Tony might be wasted.

a voice called from the shop. Who was it? It sounded familiar, but Derrick’s parched throat, his bloodshot eyes, and the sweat running down his back made it hard to focus on recalling. Whoever it was, the reassuring tone they took only made them more suspicious.

Derrick picked up the scalpel. It was the only weapon he could touch, without breaking sterility, with the hope that they might just go away and let him get back to saving his mentor’s life.

The footsteps got closer. the voice said.

Derrick drew the scalpel up, and prepared to toss it at the entrance to the operating room. he yelled.

The shop was silent, and the sound of the air flow from the ventilation system filled the room. came the voice.

Ah, that’s right. A dangerous voice for a dangerous asshole. Derrick asked.

The door clicked open, and Theo’s foot came through the doorway.

Derrick yelled.

Theo said. He stayed near the entrance, speaking through the half-opened door.

The surgery on Ah Jun. It felt like an eternity ago; what had even happened . . . Alan had requested they switch out Ah Jun’s implant after they had finished the first surgery—wait, how did Theo know about that surgery? Derrick and Tony hadn’t told him, and Derrick didn’t remember Alan mentioning it in the shop, either. There was a chance that the two White Leopards had talked about it after leaving Hack Alley, but Alan had seemed strangely averse to answering his fellow gangster’s questions. Derrick asked, scalpel still gripped tightly in his hand.

Pain in his head? Tony had performed the cochlear implant receiver surgery without any issues. Unless it was . . .

The ripped sterilizer bag! Derrick knew something was up with that! It could’ve been caused by a micro-defect in the implant receiver’s surface, invisible to the naked eye. Even though Derrick and Tony had looked over the receiver, they never would have known.

But Derrick should have seen it coming! Back when he had taken the implants to New Shore City, to get them sterilized at Nathan’s hospital, Nathan had mentioned that he had to rerun a sterilizer cycle because the sterilizer bag had ripped. It might have been the exact same implant that got stuck in its bag, and ripped it, when Derrick was trying to pull it out of the bag.

The anesthesia machine beeped twice, interrupting his thoughts. “WARNING. PATIENT TEMPERATURE OUT OF BOUNDS. RECOMMENDED FLUID TEMPERATURE EXCEEDS UPPER LIMIT. WARM FLUID TO RECOMMENDED TEMPERATURE?”

“YES, PROCEED,” Derrick shouted, hoping that the machine’s automation would work this time. Tony’s incision was radiating heat. If they didn’t warm up the anesthesia fluids to make up for the heat loss, his core temperature would be too cold.

Theo called out, his voice half drowned out by the anesthesia machine’s confirmation.

But was it smart to tell Theo about what had happened? Where was Ah Jun, in the first place? Was he being kept safe somewhere, or had he already passed away . . .

Well, if Ah Jun had already died, Theo probably would’ve come straight in with his gun out, and not have waited patiently at the entrance.

Shit, he couldn’t avoid the conversation after all. <. . . I don’t know for sure, but I can guess—> If Derrick were to admit that they switched the receivers, he would have to explain how Alan was planning to implant a torture device in Ah Jun. Alan didn’t seem to be with Theo in the shop, but they might still be working together. Derrick asked.

Derrick put the scalpel down—he could hear the footsteps of multiple Leopards in the shop, so he was outnumbered and lacked the element of surprise. So he just told the truth. Derrick paused. He had made a mistake, back then. If Tony had known that the receivers had ripped a bag not once, but twice, he might not have okayed the operation.

Theo asked, his voice measured and even.

Theo stifled a yawn before continuing. God, hurry up! Theo said.

So it was a White Leopard who had stabbed Tony! And it was Alan, the very man who’d asked Tony to save his friend. Gangsters didn’t give a fuck how much you helped them. Derrick glanced down at Tony, and then the monitor displaying his vitals.

Theo pushed open the door a smidge, and poked his head through.

Derrick screamed.

Theo’s jaw dropped, and then clenched.

Wait. This was his chance. Derrick had never done a thoracotomy before, but there was guaranteed to be someone at that hospital that could. And a gang of White Leopards would be more than enough manpower to transport Tony and the critical transfusion gear needed to keep him from going into shock.

Theo asked.

Derrick had watched Tony perform cochlear implant surgeries many times in the past, usually for elderly Chinatown residents, but he had never been the lead surgeon on the team.

Theo said, smacking the doorway with his palm.

Derrick had seen the cochlear implant surgery enough times to spot intentional sabotage.

Derrick’s pulse quickened. He needed to move fast.

Theo nodded at a few of his men, who nodded back and marched towards the shop’s exit, presumably to pull their van up and get it ready.

Theo closed the door, and Derrick was alone with Tony again. His mentor was still deep under anesthesia, and had no idea what was going to happen.

Derrick removed the retractors, grabbed his suturing tools, and started threading the needle though Tony’s skin, closing up the surgical site.

Derrick had done all he could for his mentor. It was time to find a more skilled pair of hands for Tony, even if he had to walk into a van full of gangsters to do it.