Page 106 of Unravel Me

“GDV requires surgery to correct.”

“And it will? The surgery will work, and Pepper will be okay?”

I look down at the beautiful, docile St. Bernard on the examination table, the pink bow she wears on her collar. Big brown eyes stare back at me, and I wish I could lie. “Surgery is not a guarantee.”

“What’s the mortality rate?”

“The survival rate—”

“I asked for the mortality rate, not the survival rate. I want to know what the chances are that my dog dies if I let you put her on that table.”

I clench my fists in an attempt to still the violent tremor in my hands. “In uncomplicated cases, the mortality rate is about fifteen to twenty percent. Depending on how long the stomach has been twisted and whether other issues are present during surgery, the mortality rate can jump as high as thirty-eight percent.”

She nods, staring at her dog. “I need some time to decide. Maybe I’ll bring Pepper home, and we’ll see how she does over the weekend.”

“Mrs. Greene, with all due respect, GDV is a life-threatening emergency and requiresimmediateintervention. It’s crucial we relieve the pressure on Pepper’s internal organs as soon as possible.”

Her eyes pool with tears, and she looks to Dr. Holmes at my side, like my professor might tell her I’m wrong.

“Rosie is correct,” she says simply. “And the longer a dog goes without treatment, the higher the mortality rates are. Untreated, a dog with GDVwilldie. Is surgery a guarantee? No. But we can guarantee we will do everything in our power to help your girl. Your other option is euthan—”

“No. I won’t consider that.” Tears slide down her cheeks, and I fight to keep myself in check, biting my tongue to draw the pain out of my chest as Mrs. Greene stares down at her best friend. “I don’t understand how this happened.”

“There isn’t any rhyme or reason,” I tell her gently. “It does tend to favor bigger dogs, like Pepper, but it can happen to any dog.”

She wipes at her tears. “Can I have a few minutes alone with her?”

“Of course. We’ll start prepping for surgery.”

Dr. Holmes follows me into the operating room, watching as I organize the required instruments. “Is this how you imagined finishing off your first week of fourth year?”

“Prepping for surgery? I’d hoped so, honestly. I’ve been so eager to be on this side of the glass. But for GDV?” I think about Pepper, unconscious in her mom’s SUV when she rolled up here, how Mrs. Greene said she was sick all morning. “No, this isn’t how I imagined finishing this week.”

But truthfully, it’s on par with how it’s been going. There was no easing into the year. We jumped right into the emergency setting at the campus clinic, and there hasn’t been a quiet moment since. I’m exhausted, barely keeping my emotions in check, and last night I passed out on my bed with my shoes still on and my dinner—an apple—half-eaten in my hand. I’m beyond grateful to be here, but I can’t wait for a break.

Dr. Holmes hands me Pepper’s chart as she’s rolled into the room. “Can you tell us about Pepper before we get started?”

I smile down at the sweet, gorgeous girl as she stares up at me. “Hi, sweetheart,” I murmur, stroking the brown spot between her eyes. “Pepper is a three-year-old, one-hundred-and-twenty-seven-pound St. Bernard. Her mom reported that she didn’t seem well earlier this morning. She didn’t eat breakfast, was quiet and lethargic, and was favoring her bed, all of which are unusual for Pepper. Mom brought her in when she collapsed trying to walk to her water dish.” I smooth my hand over her ears, giving her a scritch. “And she’s got the most gorgeous brown eyes.”

“She certainly does, doesn’t she?” Dr. Holmes fixes her mask over her mouth and pulls on her gloves. “All right, let’s make sure we keep Pepper comfortable, and let’s get started.”

I don’t release Pepper’s paw from my hand. Not when we put her under anesthesia, and not when I hand Dr. Holmes the scalpel so she can make the first cut into her abdomen. I don’t let go when her stomach suddenly ruptures before surgery can even really begin, and I don’t let go when the energy in the room becomes frantic as Dr. Holmes works as fast as she can, does everything in her power to save her.

I don’t let go, even as I watch her pulse drop lower and lower, until she flatlines right there on the table in front of me, her paw still warm in my grasp.

I don’t let go when Dr. Holmes touches my shoulder, tells me this is the toughest part of the job and she’s sorry I had to see it so quickly.

I don’t let go until the room empties, until it’s time for the moment I dread, something I’ve spent these years hoping I’d somehow never have to do.

“Does it ever get easier?” I ask on a whisper, peeking at Pepper’s mom through the small window in the door.

Dr. Holmes hesitates. “Never.”

“I was afraid of that.”

“Rosie.” She catches my arm, stopping me before I can open the door. “You did great today. You were thorough and quick with your assessment of Pepper earlier, allowing us to get her onto that table as quick as we did, even if we were still too late. Give yourself some grace. We need to keep our emotions in check here, yes, but I don’t need you to be a robot. If you need to cry after this, scream, swear…give yourself the grace to feel what you need to feel. I find we can’t move on until we do.”

I nod, and before I lose my nerve, I push through the door.

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