Page 1 of My Heart Before You

Prologue?

“What do we have?” Colin asked the emergency physician after briefly glancing at the tall man lying on the stretcher.

“Sixty-two-year-old male. Awake and oriented. Type A aortic dissection diagnosed by CT scan. Came in tachycardic and hypertensive. I put him on esmelol to lower his BP.”

As the ER doc spoke, Kitty, the OR nurse manager, and one of her nurses arrived in the trauma bay.

A quick scan of the bleating monitors displayed that for the moment the man was stable enough to transport. “Okay, we’ve got it from here. Thank you, Dr. McKale,” Colin said.

“Thanks for responding so quickly,” she replied, helping them push the patient towards the elevators.

Once they started their descent, Colin assessed the man's pallor, flared nostrils, and hyperventilation, but it was the blueness of his eyes shining with terror that made the back of his throat tighten. From the subtle tan of his skin to his sandy-grey hair, the man closely resembled his father. Colin drew a short, painful inhale as the emotions he’d been stifling for five months threatened to take him down like a rogue wave.

“I’m Dr. Abernan.” An unintended quaver crept into his words before he swallowed against the burnt taste in his mouth. “We’re taking you to surgery to fix your heart.”

As the man nodded, Colin clenched his fist around the cold bed railing, and pushed the stretcher into OR six.

A sensation of gratitude swept his body as he vigorously scrubbed the antimicrobial soap over his hands and forearms. He wanted everything to go well for this man and having Kitty on staff would help that wish become reality. The sharp middle-aged woman always impressed him with her efficiency and experience.

“He’s crashing,” Kitty called out before disappearing through the swinging door.

Drying his hands, he immediately pushed through the door with his back. “What’s happening?”

“Patient’s in PEA,” the anesthesiologist answered, finishing his intubation.

Electronic lines and beeps falsely displayed a steady cardiac rhythm, but Colin understood that his patient's heart was immobile within his chest.

Kitty helped him gown as quickly as possible as he called out, “Scalpel.”

Taking the slender tool in his hand, he began an emergency thoracotomy. The metallic scent of blood spilled into the room as he cut along the man's ribs. The sound of his own focused, steady breaths blocked out the alarming machines. In less than sixty seconds, he could see the chest cavity was completely filled with blood.

“Shit,” he muttered under his breath.

Blood poured from the opening he’d made in the man’s side. “Suction!”

The OR staff flew around him as he worked rapidly to visualize the heart and lungs in the opening between the man’s spread ribs. Pushing his gloved fingers against the slippery heart, he found pressure flowing from the aorta.

“Clamp.”

His forearms pricked with tension as he worked as fast as possible, but he couldn’t gain proximal control of the bleeding.

“I can’t see. Get me another suction canister.”

As Colin tried to stop the rapid outflow of blood, he finally saw that the tear in the man’s heart went all the way through his aortic valve. Ice swiftly flushed through his veins and settled hard in the pit of his stomach.

“Give me another clamp!” he shouted.

When the scrub tech handed him the instrument, he rooted around futilely trying to bring the two sides back together.

“Dr. Abernan.” Kitty’s soft voice was barely audible over the incessant cacophony of alarm bells.

Ignoring the tightness behind his eyes and the fact that the patient had clearly bled out, he gestured to the scrub tech. “Clamp.”

The small tool landed, heavy, in his outstretched hand. His grip closed rigidly around the instrument for a few heated seconds before he threw it from the surgical field across the room. A metallic crash sounded as it hit the wall, ricocheted to the ground, and slid several feet.

“Damn it.”

His scrub tech jumped as the rest of the frigid room collectively held its breath.

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