“All right, Fierce, get over here. You want to see what it’s all about, it’s time to watch the master.”
Sam Fierce’s heart was racing faster than a woodpecker on crack. He was scrubbed and ready to go. He knew he wouldn’t be assisting in this surgery, just observing, but he had to start somewhere. All residents did at different points.
He’d assisted on plenty of surgeries in the ER, but now he was ready to focus more on a specialty field. Surgical oncology. Removing masses from organs, more specifically. Tricky, tough, and not for the faint of heart.
He didn’t want to go into general surgery. Not orthopedics either. He wanted something more detailed. Something not everyone could or wanted to do.
He wanted to be different. He wanted to thrive. In a family as big as his—being the oldest of all his siblings and cousins—he wanted to stand out. That’s what he was going to do. He was going to make a name for himself among all the Fierces.
The fact that he was in the OR with Dr. Salamone was enough to make him feel like he was rushing down the stairs on Christmas morning hoping Santa left him everything on his list. But this was his first scrub in and it was just an honor to be in the room.
They were removing a small mass attached to the kidney from a thirty-two-year-old male. It should be cut and dry. Pretty simple, if having a mass removed from an organ was simple. The biopsy had already confirmed cancer two weeks ago, but if it was localized like everyone was hoping, the patient might be good to go with just removal. Lucky dude that could go live the rest of his life with his young wife in the waiting room.
The anesthesiologist was monitoring vitals, the nurses were setting everything up and Sam was standing to the side while Dr. Salamone did what he did best. “Want to make the first incision?” he asked Sam, who stood there wide-eyed. Thankfully the mask was on his face covering the fact his jaw had just dropped. Holy shit, yeah. “It’s all marked and ready to go. Come make the first cut, then step back to give me room. This is a teaching opportunity for you. I’ve heard nothing but good things, and I want to see how steady you are when you’re put on the spot.”
All his nerves were pushed to the side and his confidence was ready to make sure his ego put his money where his mouth was. “Oh, I’m steady, no worries there.”
Sam stepped up, took the blade and made the cut exactly where it was marked, then stepped back and handed it off.
“Nice and straight. Ask any questions that come to your mind.”
“Will do,” Sam said, but so far he knew what was going on. And he still was quiet as could be, observing everything, until forty minutes later the machines started going nuts. The patient’s heart rate was dropping fast.
Sam stepped further back to give everyone room before he was asked. He was smart enough to know when to help and when to move aside.
“What’s going on?” Dr. Salamone asked. “There’s no excessive bleeding here.”
The anesthesiologist answered, “His oxygen levels are dropping too.”
Sam watched as everyone was calm and doing what they needed to. But twenty minutes later that calm had evaporated in the room like a sun shower in Hawaii. Come and gone just as fast. The patient now lay on the table with Dr. Salamone calling the time of death.
It seemed as if it was nothing Dr. Salamone had done, but rather a reaction to the anesthesia. At least that was the best guess at the moment, but it reminded Sam that anything could happen even if it wasn’t in his hands.
“Come on, Sam, time to tell the wife.”
“Am I doing it?” he asked. This would be the first time he’d have to do this, and though he knew it was part of the job, he wasn’t sure he was quite ready just yet. Mentally he was trying to prepare himself and think of what the hell he was going to say.
“No. I’ll do it. You’re still observing.”
Sam nodded his head and pulled his gloves and mask off and tossed them away in the labeled red box while the nurses picked up the OR for the maintenance team to come in and clean it before the next patient. There would be no cleaning these memories from his mind for a long time though.
Once they were out in the hall, Dr. Salamone turned to him and said, “Sorry you’re having to do this on your first time with me, but like I said, you have to be prepared for everything.”
Sam couldn’t believe how calm Dr. Salamone was. He was the best Duke Cancer Center had when it came to surgical oncology. Hell, he was the best in North Carolina in Sam’s eyes. In his late forties and still improving every day. All this had been said about Dr. Salamone time and again. He hoped one day those words would be attached to his name.
“I see that,” Sam said back, not sure what else he was supposed to say, just glad he wasn’t the one breaking the news to the family.
They made their way to the waiting room where the patient’s wife was sitting. She looked up from where she’d been staring at the TV on the wall. When she saw them, she stood up. “How’s Paul? How did he do?”
“Come into another room with me,” Dr. Salamone said without any emotion in his voice. It wasn’t cold, it wasn’t sympathetic, it was just…stale. Businesslike. Controlled.
“What’s going on?” she asked, the tears already forming in her eyes, Sam could see.
“Let’s go where it’s more private,” Dr. Salamone said.
The three of them found a smaller room and Dr. Salamone said, “Cindy, I’m afraid that Paul didn’t make it. It appears he had a reaction to the anesthesia administered and he stopped breathing shortly after the procedure started. We did everything we could.”
“You’re joking, right? This can’t be happening.”
Sam looked at Cindy. She was young, probably younger than her husband, maybe closer to his age of mid to late twenties. It just made him feel as if a blade was cutting through his own chest right now with nothing to numb the pain.
“I’m afraid not. An autopsy will be conducted, with your approval of course, for the exact cause. There is always a small percentage of patients this happens to and since he’d never been under before, we just didn’t know how he would have reacted.” Dr. Salamone reached his hand out to steady Cindy and helped her to a chair. “I’m deeply sorry. Is there someone we can call for you?”
This was the first time Sam had seen Dr. Salamone show any emotion. It wasn’t pretend; he was truly empathetic to the situation. It was almost as if he had to get the words out first and make sure they were nice and clear and understood. Now he was the person that Sam could look up to even more.
“My mother. Paul’s parents. I don’t know what to say to them,” Cindy said, crying now.
“We can take care of getting someone here for you if you give us the numbers,” Dr. Salamone said softly.
Cindy pulled out her phone and Dr. Salamone handed it to Sam. “Can you make the calls please?” he asked, nodding his head to leave the room to do it.
“Don’t tell them Paul died over the phone,” Cindy said. The tears were running down her face. She was staring at him, desperation mixed in with grief. “I don’t want them driving here knowing that. Try not to make it sound horrible for them.”
“Not a problem,” Sam said, walking into the hall to call the names she’d pointed to on her phone. He heard her sobbing uncontrollably on Dr. Salamone’s shoulder asking how she was going to go on without her husband. She’d never been alone. They’d just bought a house. How could she do it on her own? So many things he’d never thought of when he was dealing with the patients and not their actual lives outside of the hospital.
He learned something today, something that modern medicine could never teach him.
He learned that he’d never be able to put a wife through that. He was a Fierce and Fierce men took care of their significant others. If he didn’t have one, he wouldn’t have that added stress in his life. That added pressure that he wasn’t sure he could deal with when he was trying so hard to do everything right.
The perfect son.
The perfect surgeon.
The perfect husband was never going to happen.