"Right," Pearce replied, waiting for some indication that Wynter wanted company on the way to the operating room. When Wynter turned and walked away, Pearce shrugged and let her go. Watching her disappear up the stairs, she wondered how they had gone from their friendly and relaxed dinner the night before to this uncomfortable silence. She wondered, too, if she had been a guy whether Wynter would have minded that little scene with Andrea quite so much. She'd never been sensitive about being gay, because she didn't care who had a problem with it. But it saddened her to think that Wynter might. Fuck.
With a sigh and a shake of her head, she tossed her empty coffee cup into the trash. She headed toward radiology to check on the X-rays that had not been officially read the night before. She wasn't going home. She would have nothing to do except lie around and think, and that was exactly what she did not want to do.
v "What changes can we expect to find in the patient's peripheral blood following this procedure, Dr. Thompson?" Ambrose Rifkin asked Wynter as he made a midline incision in the abdomen of a twenty three-year-old woman extending from the xiphoid at the lower end of the sternum, curving around the umbilicus, and stopping several inches below.
Wynter hadn't known which case she would be assigned to scrub on when she'd left the hospital the night before. Even though she'd taken a copy of the OR schedule home with her to review the upcoming cases, she had never looked at it. She'd fallen asleep instantly and, despite her plans, slept through the alarm she had set an hour earlier than usual. She had awakened with barely enough time to shower and kiss her daughter goodbye.
Ronnie, wide awake, had greeted her with a smile and upheld arms. Despite the little time she had, Wynter sat on the side of the bed as the three-year-old clambered into her lap. They had an animated conversation about something the child had seen on a video that Mina had apparently played for the kids. Wynter didn't recognize the names or the references, but she nodded excitedly and faked her way through the discourse. She scooped the little girl up and held her close, losing herself for a few moments in the unique smell of childhood, brushing away the sadness that consumed her when she realized how much of her daughter's life she was likely to miss in the next two years.
Now, she scrambled through her memory for the answers to a fairly esoteric question. If the chairman had asked her about the blood supply to the spleen or the differential diagnosis of hemolytic anemia, she might have fared better. However, the adage Better wrong than uncertain played through her mind, and she said with conviction, "An elevated white count and megakaryocytosis."
"Hmm. Pack that bleeder off back there, would you please,"
Rifkin said to Wynter.
As Wynter carefully placed a surgical sponge behind the spleen, she caught movement out of the corner of her eye and saw the OR door open. Pearce walked in. Surprised, Wynter quickly checked the plain faced wall clock. It was almost 1:00 p.m.--Pearce should've been gone hours ago. Wynter looked back to the surgical field, peripherally aware of Pearce quietly approaching until she stood next to the anesthesiologist and looked over the top of the sterile sheet.
Without taking his eyes off what he was doing, Rifkin said, "What can we do for you, Dr. Rifkin?"
"There's a patient in the emergency room with a dissecting abdominal aneurysm. He needs to come up right away."
The chief continued to work, quickly and precisely. "How big is it?"
"Eleven centimeters. It involves the left common iliac too."
"What's your plan?" Rifkin held out his right hand and requested a vascular clamp. "Satinsky."
"We can open the aneurysm and place the graft in situ, then jump to the femoral on the left," Pearce replied immediately.
Rifkin straightened and looked across the table at Wynter, who raised her head at his movement. "Finish removing this spleen, Dr.Thompson. Dr. Rifkin will lend you a hand."
With that, he stepped back from the table and indicated to the circulating nurse to untie the back of his gown. He stripped it off along with his gloves and tossed the bundle in the direction of the used linen container. It drifted to the floor several feet short of the bin.
For several heartbeats, Wynter was speechless; then she said, "Yes sir," just as Ambrose Rifkin walked out. Wynter quickly moved around to the opposite side of the table where she would have the appropriate view and exposure to complete the procedure. Five minutes later, Pearce stepped up into the first assistant's position.
"Hi," Pearce said.
"Hi," Wynter replied, gently palpating the posterior surface of the spleen. There did not appear to be any unusual adhesions that might tear and lead to hemorrhage. She opened her right hand, palm up, and extended it toward the scrub nurse, who stood so close to her right side that their shoulders brushed. "Metzenbaum scissors, please."
Pearce leaned over and looked into the abdominal cavity. "Man, that really is big."
"Mmm. Could you pull a little harder on that retractor."
"Did he ask you about the peripheral blood tests after splenectomy?"
Wynter's eyes flickered up quickly and then back to the field. "Is that one of the standard questions?"
"Uh-huh."
"Thanks for the heads-up," Wynter muttered.
"How far did you get?" Pearce grinned behind her mask. It was a rite of passage, and although she would ordinarily have warned Wynter about the kinds of questions various attendings asked, everyone got caught on the splenectomy question.
"Leukocytosis and megakaryocytosis."
Pearce whistled softly. "Very good. Did he ask you the follow up?"
Wynter clipped and then divided the splenic artery and vein.
Carefully, she removed the hugely engorged organ. "No. You walked in."
"I saved you, then. He was going to ask you what distinguishes the red cells after splen--"
"Hal Jolle bodies," Wynter said.
Pearce blinked. "Very impressive, Dr. Thompson."
Pleased to hear the surprise and the grudging respect in Pearce's voice, Wynter smiled to herself. She was even more relieved to see that the spleen had come out without inordinate bleeding. Now all she had to do was be sure that all of the major vessels were appropriately tied off, and then they could irrigate the abdomen, wash out any bits of debris, and close.
Forty minutes later Wynter and Pearce rolled the patient's stretcher into the recovery room and turned her care over to the nurses. As they walked back toward the lounge, Wynter said, "What are you still doing here?"
"What do you mean?"
"You're post-call. You're supposed to go home right after rounds in the morning."
For an instant, Pearce was genuinely confused. She never went home during the day, whether she'd been on call the night before or not.
"Oh. Things got busy and I lost track of time."
"Uh-huh." Wynter had a feeling that Pearce often lost track of time when it suited her to stay at work. She respected her for her ambition, but didn't share her single-mindedness. She had a life outside the hospital, and even though at the moment that consisted primarily of her daughter, that was reason enough to leave when she could. Pearce looked tired, and for a second, Wynter contemplated urging her to leave, but then she decided that what Pearce Rifkin chose to do was none of her business. "Do you think I should go down to the emergency room to see if the chief needs any help?"
"I was just going down to make sure that the patient gets up to the OR before he blows that aneurysm and bleeds to death down there."
Wynter stopped in the middle of the hall and turned into Pearce's path. "I'm on call tonight, and I'm supposed to be the most senior resident in the house today. I'll go down and take care of it."
"Why don't you go check on the boys and make sure things are under control on the floors."
"Pearce," Wynter said quietly. "I know you're the chief, but--"
"That's right, I am," Pearce replied just as quietly.
Wynter flushed, realizing that Pearce's suggestion had not been a request. "Right." She pivoted and started toward the elevators, wondering if she would have any opportunity at all to manage things on her own if Pearce was always around.
"I'll page you when the patient is in the holding area," Pearce called after her. "You can scrub the case."
Convinced that she was never going to understand Pearce Rifkin, Wynter halted once more and looked back. "You sure?"
"Yeah," Pearce said with a grin, wondering why the hell she was giving up a great case. "You take it. I'll just hang around to put out fires until you're free again."
"Okay. Thanks," Wynter said, frowning slightly. She didn't get her, not at all.
v Six hours later, Wynter made her way wearily toward the surgeons' lounge, her scrubs soaked with sweat, her body feeling as if she'd spent the day performing manual labor. The case had been difficult, as all major vascular emergencies were. If they could not remove the diseased portion of the patient's aorta and replace it with an artificial graft, the patient would lose his leg or die. It was one of those procedures that needed to be done right the first time, because there were no second chances. Nevertheless, Rifkin had been calm and cool and methodically proficient. He'd even let Wynter perform a portion of the anastomosis, sewing the Gore-Tex graft into the section of diseased artery. It had surprised and thrilled her.
She was halfway to the soda machine in the surgeons' lounge when she realized that the resident sacked out on the couch, whom she had initially ignored since it was such a common sight, was Pearce. They were the only ones in the room. An empty pizza box sat in the middle of the coffee table in front of the sofa where Pearce slept. Wynter was willing to lay odds that had been Pearce's supper.
Pearce lay on her back, one knee slightly bent, an arm dangling half off the edge of the green vinyl sofa. Her face was unlined, youthful, beautiful. Wynter watched the slow, steady rise and fall of her chest, noting the swell of her breasts and the long hollow curve down her abdomen to the jut of hipbone. Her hand was open, supplicant, waiting.
Wynter was glad they were alone--she didn't like to think of strangers seeing her this way, so innocent and exposed. She had the urge to cover her, to protect her from prying eyes while she slept.
She debated letting her sleep and then decided that Pearce would want an update on the case. Plus, she really did need to go home. She leaned over the sleeping woman and gently shook her shoulder. "HeyPearce."
Pearce opened her eyes, which were hazy and unfocused. After a few seconds, she smiled. Wynter bent over her, her eyes soft with welcome. It was a wonderful way to wake up. "All done?"
"Yes," Wynter said softly, resisting the urge to brush the damp strands of hair off her cheek. When Pearce sidled over to make room, Wynter sat next to her without thinking, their hips lightly touching. "It went great. Thanks for letting me do it."
"No problem." Pearce stretched lazily, her hips coming off the sofa as she raised her arms over her head and rolled her shoulders.
Her scrub shirt had come untucked while she slept and rode up now to expose an expanse of smooth, tanned belly surrounding a tight, shallow navel.
Wynter tracked the path of fabric over flesh and was struck by the unexpected beauty of muscles playing beneath soft skin. She saw bodies every day of her life, clothed and unclothed, in every stage of health and disease, but she couldn't remember ever seeing anything quite so lovely.
Pearce followed Wynter's gaze, and the muscles in her belly twitched as if stroked. In an instant, she was aroused. She searched Wynter's eyes, wondering if she knew what her glance had stirred, hoping that her own hunger did not show. Her voice was hoarse when she said, "I should probably get home."
Abruptly, Wynter stood, backing away as she spoke. "Yes.
Everything is quiet here, I take it?"
"As the grave." Pearce swung her legs to the floor and rose.
Wynter was already feeding coins into the soda machine with her back turned. "You should get some dinner. You can't afford to lose any more weight."
Wynter turned, her expression questioning. "What do you mean?"
"You look thinner than I remember you. Surgery residencies will either pork you up or cause malnutrition."
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