Surgery Under Fire

Nurse Jane Miller kept her gloved hands up, with the fingers outstretched, as she studied the comatose patient lying on the operating table. Mid-thirties, strong features, chiseled, some might say. Even in her sleep, her face might have been cut from stone. Was she a good soldier? Time enough for musings later.

The nurse took a deep breath, keeping her lips tight so she wouldn’t suck her mask into her mouth, and rearranged her priorities. She always had to do that before surgery as kind of a mental preparation. Some sang songs or recited poetry, but she restated her priorities. It cleared the mind and set the purpose in granite, kind of like the patient’s face. The patient was the first priority, the only priority. Soldier or not, she’d given her trust to those in the operating room believing they’d save her life. Nothing else mattered except for the patient, but because of that, everything mattered. The doctor in charge, Harry Nugent, was next in the priority list. He’d hold the knife and shout the commands. He needed to concentrate, and to do that, he needed to do things his way. After the doctor came the surgical instruments, scalpels, clamps, forceps. All sterilized and ready to go. There were others in the room, the anesthesiologist, nurses, and observing interns. The anesthesiologist and the nurses had their own priorities. As for the interns, they were recycled wallpaper. They didn’t even make the list.

Everything was ready. She nodded to Nurse River, a regular in this room, who nodded back. She knew her job as well as a Broadway stage actor. They’d done enough surgeries together it was like constant rehearsals. The head nurse smiled beneath her mask at a stray thought. It wasn’t an accident it was called an operating theater.

A low rumble filled the room shaking bottles and rattling the medical instruments. The rumble became a whistle, the whistle became a shriek, and then the shriek became a whump that felt like a blast of air against clammy skin. “Mortar shell!” the nurse screamed, and the milling interns looked about with buggered eyes. “Where’s Doctor Nugent?”

“He’s not here!” River yelped. Another rumble filled the air, the gentle sound of sudden death, and then more rumbles joined in like eager campers singing a round. River’s eyes darted around the interns like seeker bullets, and then she pointed to one standing in the middle. Good girl, Jane thought. Always pick the scared one, the soul prepared to flee. “You! Move it! Get the doctor before we’re all blown to hell!”

The doors slammed open and a heavyset man strode in. He kicked out and knocked the scared intern to the floor. “Duck and cover, you fool!” he shouted. He had an old voice, one worn thin from heavy drinking and cheap smokes, but in the theater, it rumbled like the mortar shells. The sprawled intern held his uncontaminated hands high as he lay on his tail. “All of you, on the ground, now!” The heavyset man kicked at the next intern, and then aimed for the next. The group got the hint and ducked down. “I don’t need your hands, so stay down!”

Another sound began, not rumbling, but something like a distant whoosh. Jet fighters. The newcomer glanced to the back of the room where the sound seemed to be coming from. “I am Doctor Nugent, and we are taking heavy fire.” As soon as he said the last word, the whoosh roared to great intensity and ended with a clap that rattled the nerves. “Our first priority is always the patient, but don’t be stupid. If your hands aren’t currently stuck in blood and guts, keep out of the way and stay down. Miller! Is the patient ready?”

“The patient is ready,” Nurse Miller said. Dr. Nugent stepped up the table and held out his hand. There was a tiny clap as the nurse gave him the scalpel. He examined the patient’s exposed skin, and then began the first cut. Nurse Miller was quick with the forceps and sponges and only a few drops of blood escaped her. The doctor began his second, deeper cut, and the nurse used her instruments to widen the opening. Muscle and organs pulsated and steamed. The nurse knew what to expect, but her hand was always in shock at the sudden heat the living body’s furnace. Healthy flesh became obstacles to their goal. Working together, the nurse and doctor moved the healthy organs aside.

There was a heavy thump that struck at the base of the spine. Wars sounds were like solid objects. The nurse screamed and jerked her hand causing a bit of internal matter to shake like bloody jello. A few of the interns screamed as well, but they didn’t have their hands stuck in guts. “Are you hit?” the doctor yelled, and Nurse Miller shook her head. “Focus! Focus on the patient!” He looked around the room. “This is noise, damn it! Nothing but noise! Do your job, or get down!”

“I can handle it,” she said, and the two of them turned back to the patient. Stupid! How could she be so stupid? She knew her priorities. The patient always, at all times, came first. Cowering interns, the sounds of war, all were background that didn’t matter. Save the patient, fix the patient, focus on the patient. Let the noise become something soft, something sweet. It was rock music, the thump of a base guitar and the rattle of sticks on a snare drum. All she heard was her son, Kevin, and his friends practicing their version of music in the garage, while she stood at the kitchen counter preparing a turkey dinner. Her husband sliced through the flesh with his trusty knife and she moved giblets aside, a chef striving for the goal. Someplace, in this bird, was the sweet meat, and she and her husband had to find it to save the turkey. It was a nice dream, quiet and traditional. Except her son’s guitar was making some kind of clacking racket and her husband was shielding the turkey with his body.

“Machine guns!” Dr. Nugent yelled, and the nurse blinked as her husband became the doctor shielding the patient, and the strumming guitar became rapid gunfire. “Get down!” Nurse Miller’s legs gave way and she crouched while keeping her bloody hands aloft. Blood and muck, keep them up. There was more gunfire, single shots coupled with rioting stutter, and then silence. The doctor and nurse straightened up. “Almost done,” he whispered, and the two of them dug their hands back into the body. “Bet you never thought a simple appendectomy could be so exciting, huh?” The nurse didn’t trust herself to answer. He yanked a bit of bloody flesh out of the patient and tossed it over his shoulder. One of the interns scrambled to get out of the way. “Nurse, can you finish up? I’ve got another surgery in operating room two.”

“Go,” she said, picking up the suture needle and thread. “I’ve done this before.” The doctor nodded, and then rushed out of the operating room, ducking and covering as he went. As soon as the doors closed, the cowering interns stood up, gazing around like foreign tourists gaping at towering skyscrapers. “Are any of you sterile,” she asked them, but they all shook their heads. She looked back down to the patient and started the first suture.

“Who the hell was that?” one of the doctors asked. The scared one. Always the scared one. There was the distant clap of an explosion and something like a scream. Heavy trucks gunned their engines, and then purred as if moving out. The nurse heard angry shouts, and then more gunfire. “I mean, is he nuts or what?”

“He is your boss,” the nurse replied. She kept her eyes on her work, focusing on the patient. The patient came first, always. “Doesn’t that make you feel special?” The intern seemed about to say something else, but she cut him off. “He’s the head surgeon, and he does things his way. When you grow up, if ever, you can do things your way.” Missiles streaked overhead, and then a distant rumble filled the room. It promised to become a shriek that would deafen the ears. “However, this is now my operating room, and we’ll do things my way.” She glanced past the interns and nodded to the other nurse. “River, if you would be so kind.”

River turned to the music deck and clicked the eject button. The shriek was cut off in mid-squeal and the compact disk was spit out. The head nurse could read the words, “Sounds of War”, scrawled on the label. A moment later, she was stitching bloody flesh together to the lilting strum of a bass violin.