Dr. Valeria Mesmerich is going over a month's worth of morbidity and mortality reports, shaking her head in utter dismay. It's 4 a.m, an hour before she's scheduled to go on duty at the big, fancy, prestigious hospital where she worked very hard to get a job. Four years of medical school, five years of a residency in cardiothoracic anesthesiology (she saw lots of beating and flopping hears in that stint), and post-doc work all led to her huddling over a laptop in a tiny, windowless cubicle tallying the number of sick, dead and dying patients she has been privileged to work on.
Hmm. She starts reading about Patient B, who was rushed in with a blood clot early in the week. Not good. The patient turned out to be a poster child for bad health: diabetes, balky heart, high blood pressure, benign tumors, flat feet, what have you. Valeria had prepped him for general anesthesia for surgery to repair a leaky heart valve. It had all been well and good until the patient hadn't woken up. Valeria feels her blood pressure go up. She reads further, knowing what's in store. It turned out that the patient had an allergy to one of the drugs in the anesthetic cocktail dripped into his veins. The report concludes that the patient will wake up -- eventually.
Valeria flips to the next page. Heart transplant patient. The meds were fine, the patient died.
Next page. Lung cancer surgery. Yes! Valeria allows herself a self-administered back pat. The right meds. The right outcome. The patient lives.
Valeria shelves the report and readies herself for a full day in the hospital. She is one very busy anesthesiologist. She's the chief anesthesiologist for the heart-lung transplant team. She loves it, playing around with chemicals; it's the swaggering, "master/mistress of the universe" cardiologists that get under her skin. She also does pre- and post-op care for patients in the intensive care union. Added to that (and to her huge income) is a partnership in a big cardiovascular anesthesia/critical care medical practice.
"Calling Dr. Mesmerich, calling Dr. Mesmerich."
The voice screeches over the hospital PA system. Valeria leaps out of her chair -- why couldn't she ever be on time for anything??? -- and heads off to meet her first patient. It's 5 a.m. She needs to mainline more caffeine.
Minutes later, she's in the room of Jeff Link, a 65-year-old smoker with, as he says, "a bit of a drinking problem." He has hardening of the arteries and a heart on its way out. He's not the best candidate for a heart transplant, but he has money and political clout, and a donor match. Key members of transplant team are already assembled, including the chief surgeon, Dr. Herman Mengelestormtroup.
"Dr. Valeria. I'm touched we have the pleasure of your company." Mengelestormtroup is looking at her as if she were a lower form of life. Valeria lets it go. He is one more jerk of a surgeon who happens to be a genius at his job, though his attitudes about gender haven't made it out of the 19th century. Maybe one of these days he'll start referring to her by her last name. Valeria smiles at him, and launches into an explanation of her plan of action for surgery.
Jeff the patient interrupts her just as she is explaining how she is going to insert the pulmonary artery catheter.
"Doc, will I die? Will all this hurt? Gonna be a hole in my chest? Give it to me straight."
Valeria knows the patient is losing it, psychologically, and soft-pedals the truth. Well, sugar-coats it.
"Mr. Link," she says, adopting her most soothing and honeyed tone. "All operations have risks, but each of us is highly trained and will do nothing that will expose you to unnecessary risk. You'll wake up and remember nothing about the operation. That's what general anesthesia can be. And you'll have a brand-new heart. You're a very lucky man."
Jeff looks skeptical but happier, and lapses into a smoker's coughing fit.
"And Mr, Link. Remember -- no more smoking."
Jeff coughs in agreement.
Valeria leaves just as Mengelestormtroup starts his spiel and hurries to her physician's lair to set it up with drugs, drips, lines and anesthesia equipment. Just as she finishes, Jeff is wheeled in and she intubates him, administering the anesthetics, and he goes out like a light. Then off to the surgical theater, where she monitors Jeff's blood pressure, adjusts the medication and controls breathing. She and the team are totally in sync, like a well-oiled surgical machine, and the operation is a success. It took a mere five hours, with no complications.
By now, it's 2 p.m. Valeria grabs a bite to eat from the hospital vending machine (she likes Lunchables -- hey, she has to have some vices) and taps out, on her laptop, a report on the transplant surgery for the intensive care nurse. Nurse Dina Summer, aka Ratchet, is a no-nonsense woman who rules over intensive care with the zeal of a prison warden. Dina listens as Valeria gives her a rundown of that day's surgical slice-and-dice.
"So, A-OK?" Dina says.
"Yes, even the…"
"Fine. Thanks. Bye. I have work to do."
Dina marches off to the ICU.
Valeria makes sure to check on Jeff -- hey, Dina's just background noise when she gets into her moods. Jeff is groggy, but alive. She checks his vitals. A-OK. And it's off to her next transplant patient. Same protocol, same team. With any luck, Valeria will make it home by 11 p.m.
But then, she's a doc, and her time is not her own. She's on call 24/7/365, so she may get a call at 4 a.m. to get to the hospital for a transplant emergency. Some weeks may be 30 hours, other weeks may be 100. And forget scheduling time with friends and family, because who knows when she'll have free time or how long it will last. It's a good thing she's single with only a cranky Persian cat to worry about. She does have that bit of flexibility.
But that's small potatoes, she reminds herself. She's in the business of taking away pain and saving lives. What could be better than that?