“I don’t think so,” I say, giving her a quick smile. “Does Brandon?”
Leila nods, then starts rambling about the complex atherectomy that Brandon is planning for this afternoon. I listen impassively, wolfing down my lunch as quickly as possible. Romantic relationships between proceduralists and members of the interdisciplinary team happen so frequently that I don’t think the hospital could stop them from working together even if they wanted to, but it’s still curious to me that the smiling couple has come rushing right back to work as soon as possible.
I don’t have time to think more about it before my phone screen lights up again on the table. Leila’s gaze drops to the screen reflexively before jumping up to me, beaming.
“Oh my god, you’re talking to Julian,” she says, raising her fists in excitement. “I’m so glad. He hasn’t shut up about you since the wedding.”
The look I give her could probably cut steel. I’m still formulating my response—because she genuinely sounds pleased for her friend, and I’m realizing that most of my annoyance is because I don’t want Pamela to be lurking in the halls and waiting to call me a cougar in the group chat—when the door opens again and Brandon marches inside.
Leila twists to smile up at him and it’s as if I’ve become a part of the furniture. Brandon’s hands fall on his wife’s sides, and suddenly his shoulders drop and the tense frown lines at the corners of his mouth loosen. I’m reminded of the Brandon I met in medical school, the one whom the residents used to send into patients’ rooms after delivering bad news. The one who could charm a snail out of its shell, a person out of their tragedy.
“Hey, kitty,” he says gently.
Leila unfurls into him like a curling leaf reaching for the sun. Her lips brush his stubbled chin, and he relaxes like she’s just injected life back into him.
My stomach turns. I feel like I’m witnessing something indecent. By the time Brandon notices me, I’m already tossing my empty bowl into the trash.
He releases her. The instant they step apart, a shadow falls over his face once more.
“Sean,” he starts.
I don’t let him finish.
“All yours,” I say, gesturing toward the empty reading room. Then I flee.
The lab gets busy fast. The simple diagnostic coronary angiogram I allowed the floor team to add on to my schedule during lunch turns out to be a nasty lesion that takes me and my fellow, Aaron, an hour and a half to fix up. Then our first patient of the day sits up too early in postop and opens his femoral artery access site, and it takes Aaron almost forty-five minutes of holding pressure to stanch the bleeding.
Miraculously, we make it through the rest of our cases before five thirty. I rip off my gown, tear the shoulder strap off on my lead apron, and am about to step into the control room, home free, when Pamela’s voice rings into my headset.
“Keep your lead on, Sullivan,” she says. “I think they might need you in the other room.”
I peer through my window, across the control room, and into Brandon’s. I can’t see much around the equipment, but I can see Brandon’s movements, frantic and harried, his gown soaked through with blood.
Before I can make sense of the chaos, the side door to the supply room blasts open and Leila and Larry rush out, hands full of unopened gear.
“What’s going on?” I ask, following them into Brandon’s room, where shit is most definitely hitting the fan.
“RCA dissection,” Leila explains, handing a package over to the nurse who is running Brandon’s lab. “What’s your glove size?”
“Six,” I say, and she scrambles to retrieve a set for me as I open up a gown.
“Is that Sean?” Brandon says, from behind the table. “Thank god. I need a hand.”
He gets me up to speed as he works—“Proximal RCA CTO, got the wire past the lesion, definitely in the true lumen, dissected to the first acute marginal after we ballooned”—and together we talk through the plan and delegate tasks: “I’ll prep a balloon pump.” “What do you think? Covered stent?” But as we do, I make a few troubling observations. This case is a two-man job at minimum, but Brandon’s fellow is nowhere to be found. The images Brandon flicks through of his attempts to fix the blockage demonstrate that this was a predictably tough case, and yet he appears woefully unprepared. There are no necessary meds on the table, no venous access site, none of the safeguards we lecture our fellows about every other week.
It’s unlike him. For all his faults, Brandon is a damned good interventional cardiologist, and a careful one too. Of all my colleagues, he’s the one I’d trust the most to work on my mother. This feels…reckless for him. Haphazard.
I look to Leila. She stands a few feet away from the table, her hands tucked into the top of her burgundy lead apron, stone-faced, irritated, and colder than I’ve ever seen her. As if he can’t help it, Brandon looks up to meet her gaze. She pulls her own away.
Brandon’s movements slow. Even among the chaos, I can sense his despondency behind his mask.
All the while, the patient’s blood pressure is plummeting.
“Brandon,” I hiss, just as Larry shouts, “Pressure!” into the mic from the control room.
The patient’s heart rate drops: within a few beats, I know he’s in complete heart block. I curse, grab a needle, jab into the vein in his groin.
“Pads on the chest,” I tell the nurse, and then, to Leila, “Get me a pacing wire.Now.”