Beth slammed her locker closed, and adjusted her green scrubs. She pulled a blue bouffant cap over her hair and stepped into the OR hallway. As she made her way to the front desk, her work clogs echoed in the deserted hallway. She picked up the posting slips labeled for her room, and flipped through them rapidly.
Seven trauma cases! Beth thought. Why do I always get stuck doing all of the trauma cases every Monday?
It was springtime, and it seemed that everyone had lost their minds. Intoxicated motorcyclists turned their shiny bikes into scrap metal, fights ended with gunshot wounds, and early morning joggers magically became invisible to early morning commuters.
And let's not forget the college students on Spring Break, who think that a five story dive into the hotel pool amidst a cheering, drunken audience instantly labels them a hero. Beth thought.
Beth shook her head and donned a mask before entering her assigned OR. As Beth and the scrub tech methodically prepared the room for the first case, the door swung open and banged against the wall. Beth jumped.
"What the heck?" Beth asked, and turned to deliver a tongue lashing, but she stopped short.
Dr. Davis strode into the room with a computer bag slung over his shoulder. His tall, lanky frame was bent slightly forward. His permanent scowl matched his nasty disposition. No one liked to work with Dr. Davis.
"We have a lot to do today, so let's get cracking!" he announced. Carelessly, he tossed his computer bag onto Beth's desk. All of the supplies that she had carefully laid out on the desk fell to the floor, displaced by Dr. Davis' bag.
What a total jerk, Beth thought as she bent down to pick up the mess.
"What are you doing?" Dr. Davis asked. He put both hands on his hips and regarded Beth like a child.
"Well, Dr. Davis, I had the room almost ready, but now I have to clean up and re-organize the supplies that you need," Beth said with thinly veiled sarcasm.
"Didn't you hear me? Let's GO! I have seven cases today, and we need to get a move on!" His overly tanned forehead reminded Beth of worn leather as he raised his eyebrows with impatience. With a dramatic sigh, he walked out of the room.
The scrub tech peeked over her mask at Beth and gave her a sympathetic look. Beth rolled her eyes and made an inappropriate gesture at the backside of the surgeon, eliciting a giggle from the tech.
In the pre-op area, Beth scanned the whiteboard that neatly listed each patient name and holding room. Locating her patient, she walked to the room and whisked back the privacy curtain with her right arm. A slight, unkempt man in his 50s with stringy hair and few teeth opened his eyes wide and leered at her suggestively. The hospital gown draped loosely over his thin frame, and made him appear childlike. The smell of stale cigarette smoke permeated the close quarters of the pre-op room. A very overweight man had somehow stuffed himself in the small visitor's chair. Pockets of fat bulged under the armrests. An image of Buddha instantly sprang to Beth's mind as she stepped over the clear bag labeled 'Patient Belongings'.
Beth introduced herself to the patient, and leaned forward to compare the patient's armband information with the paperwork from pre-op.. She fought a wave of nausea as her nose was assaulted by a revolting bouquet of alcohol, cigarette smoke and body odor.
She cleared her throat and began the interview.
"Sweetheart, Mr. Walton is my daddy. My name's Billy," the patient said in a thick country accent. He leaned to the side in his chair, and placed his elbow on the armrest. Beth pretended not to notice when his elbow comically slid off the armrest.
"Alright, then. Billy, can you tell me in your own words what procedure you are having today?" Beth asked.
"Ain't that in my chart, lady? Dang, I hate it that y'all don't know what in the heck you're plannin' on doin' to me! What kinda hospital is this anyway?" He snickered, and glanced at his friend.
"We routinely ask every patient to verify with us that they know what procedure is being done. It's a safety check. Sort of like 'checks and balances,'" Beth replied.
"Sorry lady, but any check you git from me ain't gonna balance. It'll prolly BOUNCE!" He broke up into laughter, showing off reddened gums and a few rotting teeth. Billy reached a hand out to his friend, and they slapped a high five.
Beth tried not to show her irritation as she asked the question again.
"I'm gittin' my leg fixed up. I busted it all to hell 'n back when I fell off the porch last night. Ain't that right, Jimmy?" Billy said, raising his chin.
Chuckling, Jimmy answered. "Yep, that's right. I told you not to go shootin' that 'possum. They ain't no danger to you. You shoulda left it be!" Jimmy said, and shook his head.
Billy slapped his thin hand on the armrest. He frowned at Jimmy and yelled, "But it was scarin' my ol' lady. I just meant to scram it away. What's so wrong with that, Jimmy?" His face turned red with anger, and the veins in his neck popped out like strings on a marionette.
Awkwardly, Jimmy leaned over the girth of his rotund belly. "You was off yer keister drunk, Billy! Ain't no wonder you fell off the porch. I still cain't believe yer shotgun didn't make Swiss cheese outta the side of yer trailer. Then you'da REALLY been in a heap o' trouble with Jo Ellen!"
Hoots of raucous laughter echoed in the small holding room.
Beads of sweat popped out on Beth's forehead as she thought of Dr. Davis tapping his foot, wondering why his patient wasn't in the OR yet.
The sooner I can finish this interview, the sooner we get back into the OR, and the sooner I can get finished with Dr. Personality. Beth thought.
"OK, Billy. Let's finish up here. Have you had anything to eat or drink since midnight?" Beth asked.
"Nope, no ma'am. I ain't had NUTHIN!" Billy cut his eyes over to Jimmy, who barely contained a laugh.
Suspicion vibrated in every bone of Beth's body. Beth raised her eyebrows and asked, "So you didn't take a swig of juice, water, or coffee? Just a little one?"
Billy hesitated, and Beth softened her voice.
"Billy, this is important," she said.
"No, no ma'am. No way." He fidgeted uncomfortably in his chair, and didn't meet Beth's eyes.
A young anesthesia resident waited just outside the curtain for Beth to finish the interview. Becoming impatient, she elbowed past Beth and took over the interview.
"I think it's clear that the patient hasn't had anything to drink," she said to Beth with disdain. The resident turned her back on Beth, effectively ending further conversation between Beth and Billy. "Now, Mr. Walton, have you had any problems with your heart, lungs, breathing..." Her high pitched voice delivered questions in a rapid fire mannerism.
Angrily, Beth stalked out of the room and searched for the attending anesthesiologist, Dr. McKenna.
Dr. McKenna was a large African-American man, weighing in at 265 and topping out at 6'6". He had an imposing nature about him that would turn the most combative man into a docile sheep with one steely glare.
"Hey Big Mac, I have a problem," Beth said as she approached him.
Dr. McKenna was writing notes in a chart, and looked up at Beth with heavy lidded dark eyes. Even though Beth had known him for many years, his direct gaze still intimidated her.
"What's the problem?" he asked. He sat back in his chair and crossed his trunk like arms. Immediately, he took on the role of mentor, and offered Beth a rare smile.
"When I interviewed our patient, he stated that he hadn't had anything to eat or drink, but I don't believe him. He didn't meet my eyes when he responded to the question, and his friend was snickering. Your resident took his answer at face value and all but dismissed me when she took over the interview," Beth said.
With effort, the giant man raised himself from the chair and sighed. "I know, I know. You want me to scare the truth out of him, because your malarkey-o-meter is alarming, right?"
"I just want to make sure the patient is safe for--"
"I got this," Dr. McKenna said, and waved a hand at Beth.
Dr. McKenna ambled into the room and introduced himself as he encompassed the patient's slight hand in his giant brown paw.
He pulled a chair close to the patient, and sent the resident scurrying out of the room with one look.
"Mr. Walton, I understand that you haven't had anything to eat or drink this morning, right?" He leaned forward and balanced his elbows on his massive legs as he sat in the chair.
"Uh, no sir. I ain't had nothin', promise," Billy said, and held a tattooed arm up as if taking an oath.
"Well that's some good news. I was just about to tell you about this guy who told me that he hadn't had anything to eat or drink for two days! Can you imagine?" he said as he crinkled his brow and widened his eyes. Billy shook his head rapidly and unconsciously scooted back in his chair.
"Turns out he had a whole two liter of Sprite on his way to the hospital because he was so thirsty." Dr. McKenna tilted his head as he stared at Billy. Dr. McKenna chuckled, and Billy laughed nervously.
"You see, when we put you under general anesthesia, we put a tube down your trachea-your windpipe, so you can breathe. The trachea and the esophagus-the tube that goes from your mouth to your stomach, are right next to each other, kind of like neighbors. They have to live next to each other, but they don't necessarily get along. If there is anything in your stomach when I put the tube down your trachea, the contents of your stomach will come up in an impolite kind of way, creeping into your neighbor's lawn and causing all kinds of fuss. So now you can understand that it's actually quite dangerous to put a tube down your trachea if your stomach is full, because whatever is in your stomach can go right into your lungs," Dr, McKenna said.
Leaning toward Billy, he continued in a conspirative stage whisper.
"We had quite a time with this cat, having to resuscitate him and all. He just about died," Dr. McKenna said.
Just outside of the privacy curtain, Beth and the anesthesia resident were completing paperwork. Beth barely contained her laughter as she processed Dr. McKenna's newfound dialect and his artful way of educating patients. As Beth succumbed to a chuckle, the resident locked eyes with her. A slow grin spread across the resident's face. Beth and the resident stopped what they were doing to listen. They heard feet shuffling, and then a big sigh.
"ALRIGHT! Ooo-KAY! Jimmy here told me that I was gittin' on his nerves cause I was bein' jittery and all while we was in the car comin' up here. He was cussin' me and sayin', 'Dang you, Billy! We got a ways to drive yet, and I ain't about to put up with your moanin' and groanin'! I had to take offa work today cause Jo Ellen cain't drive your dumb butt to the hospital!'" Billy said.
He looked over at Jimmy, who stared sheepishly at the floor. Jerking his thumb at Jimmy, Billy continued.
"He pulled into the Citgo off the highway 'bout 60 miles from here and bought me a 40. He said it was ok cause when he was readin' the directions I got from the doc, it said that I could have me anything CLEAR. Well, ain't beer a clear?"