“No. I was chatting with the patient.”
“Imagine that,” he muttered.
“Excuse me?” She looked at him, but there was nothing but cool, calm blue eyes staring back at her.
Mrs. Frenske was wheeled in then and Houston didn’t answer. Still very much in charge, despite his diminished role, he began directing the attending staff to place Mrs. Frenske on the table.
The anesthesiologist spoke calmly and carefully to the patient, advising her to count to ten as he placed the mask over her face and put her under. Mrs. Frenske only got to three before succumbing to the anesthetic.
Her vitals were monitored, equipment checked, she was positioned on her side, and the leg was scrubbed. Everything was ready.
For Josie.
Her hand shook just a little as she made the initial incision in the skin over the upper side of the buttock. Houston talked her through it, guiding her to the blood vessels that needed cauterizing to minimize the bleeding.
Sweat began to bead on her forehead.
The panic returned full force. What was she doing here? This dear sweet old woman’s life was in her hands and she was a totally inexperienced amateur. Her hand stilled.
The cold room turned hot. Sweat trickled down her breastbone, her throat closed up.
Houston gave her left shoulder a tap with his splint, careful not to use his good hand, which was scrubbed and sterile, should he need to assist.
“Hey,” he said. “You’re doing fine. Let’s go.”
Quickly she turned and caught his eye above his mask. He nodded again, and she saw confidence there. He did trust her. He wouldn’t have let her do this at all if he didn’t.
With a deep breath, she returned the nod and concentrated on opening up the fibrous capsule and the labrum of the hip socket so she could dislocate the head of the femur.
Josie had to saw off the diseased head of the femur and enlarge the cavity of the cup-shaped acetabulum to make room for the metal cup that would hold the new artificial hip.
It was straightforward. She just had to do it.
The voice of the nurse, reading off stable BP and oxygen levels, barely penetrated her absorbed brain. She concentrated on holding her hands steady, working with precision, and moving along at a reasonable rate. She tried to mimic the confidence that Houston had and minimize the number of times she paused in uncertainty.
They were using a cementless implant, so when she carefully placed the new cup into position she secured it with screws, which required a great deal of strength and arm muscle. It probably took her twice as long as it took Houston.
But she did it, and she sighed with relief.
As the nurse wiped the sweat from her forehead, she moved to the femur and began the delicate process of reaming out the long axis of the bone, using a broach instrument for the final shaping.
Houston murmured, “Good, there you go. You’ve got it.”
Josie tested a trial stem for fit, and decided on thecorrect size to use. Suddenly unsure, she looked to Houston for assistance. “Larger?” she asked through her mask.
“What do you think?”
“Larger. It’s not sitting in the canal snugly enough.”
He nodded again, shifting on his stool. “I think you’re right.”
From there it was a matter of fitting the stem and head prosthesis components together with a hammer, then reassessing the fit. Josie tested the hip to gauge its range of motion and stability.
The components were rechecked and the stem secured in place. She made sure there was no debris left in the area.
As Josie was backing away to allow the surgical assistant to close the wound, she felt an enormous relief surging through her.
Thank God it’s over,was all she could think.And I never want to do that again.Horrified at her unreasonable thoughts, she watched as the anesthetic was reversed, and Mrs. Frenske was readied to be transported to the recovery room to begin the process of adjusting to her new hip.