Page 16 of Rules of the Heart

From that point on, everything was a blur. Valerie was frantically working reactively in the ER. It wasn’t long before she was pulled into a surgery. The patient’s heart was pierced by a piece of shrapnel and Valerie had to get it out quickly before the patient bled out from the inside.

Of course, it couldn’t be that simple. There had been no time for a full scan, and no indications of any head trauma, but sometimes these things could be deceptive. About an hour into the surgery, alarms started going off, even though things were going about as well as could be expected from Valerie’s side.

She glanced at the monitors and swore. “Someone bring the portable CT in here!”

In the time it took to get the machine into the OR, Valerie’s patient had deteriorated badly, but there was nothing she coulddo except keep going on the heart repair until she figured what else was wrong.

She glanced up at the scan and felt her heart clench at what she saw. She’d seldom seen brain bleeds that big or fast.

“Fuck. We need Dr. Ashton in here. Stephanie, go get me Ella, now.”

“I think I saw her heading into surgery in OR2. I think Dr. Roth is fr—”

“No! I need Ella. Get Dr. Roth to take over her surgery and get me Ellanow!”

Dr. Roth was a good surgeon, but Valerie needed Ella’s talented hands. She wasn’t an expert on neurosurgery, but even she could see that a bleed this severe was almost certain to be fatal within minutes. If anyone had a chance of fixing this, it was Ella.

Stephanie rushed out of the room and returned two minutes later with Ella. Ella scrubbed at top speed and hurried into the room, breathing hard. She didn’t so much as greet Valerie, her eyes already on her patient. Valerie was too busy with her own work to worry about pleasantries.

The patient’s heart was going haywire trying to keep up with the chaos happening in his brain.

“More suction. Darrin, get over here! Put your hand here, hold this bleed while I sew it up.”

Valerie glanced up to see one of the senior residents carefully placing his hand where Ella directed.

She looked back down at her work, trying to coax the heart into beating just a little longer. Soon Ella would have this under control… or none of it would matter anymore.

Time seemed to move strangely as Ella and Valerie worked in tandem on the patient’s heart and brain. They exchanged only short sentences related to what they needed to do, but Valerie could still feel the tension thick and heavy between them. Shehad no chance to examine it now, and perhaps that was a good thing.

“This isn’t working. Darrin, bring the CT here. I’m going to operate looking through its eyes.”

That got Valerie’s attention. “You can’t do that!”

“Yes, I can. I can’t see through brain tissue, Valerie, but the CT can. I’m going to watch the scanner and operate based on what I see there rather than what I see with my own eyes.”

“No! It’s against hospital policy.”

“I don’t care about stupid hospital policy,” Ella said through gritted teeth. “I care about saving my patient’s life.”

“It’s against hospital policy for a reason—it’s too dangerous!”

“No, it’s not. This technique has been used in a number of hospitals all over the world. Just because it hasn’t become mainstream yet doesn’t mean it’s not valid.”

“I don’t care where else it has been used. Here, it’s against the rules.”

“Fuck the rules. Darrin, bring that machine here now.”

“Don’t you do it if you value your job, Darrin.”

“If you value this patient’s life, you’d better do as I say.”

Darrin hesitated for only a moment before giving Valerie an apologetic look. “I’m sorry, Valerie, but I swore an oath.” He brought the CT machine over to Ella, who removed her gaze from the patient’s brain and looked at the screen as the scans started to show up live.

Valerie was practically ready to explode with rage. She was on the point of physically yanking Ella away. Only the knowledge that doing so would cause Ella’s scalpel to drag through the patient’s vulnerable brain tissue stopped her.

She opened her mouth to order Ella once again to cease and desist, but before she could, a blood vessel in the heart burst under the pressure of trying to account for the brain injury as well as the fragile repaired heart chamber Valerie had just fixed.

She forced herself to take a deep breath and focused on the patient’s heart. She could scream at Ella later. This was exactly what she’d been afraid of when Ella had first come to work here. Not only was Ella tossing the rules aside like garbage, but she was convincing other doctors to do it with her.

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