The Surgeon: A Rizzoli & Isles Novel: With Bonus Content

moved.
    I hold a tube of her blood in my hand, and am disappointed that it is cool to the touch. It has been sitting in the phlebotomist’s rack too long, and the body heat this tube once contained has radiated through the glass and dissipated into the air. Cold blood is a dead thing, without power or soul, and it does not move me. It is the label I focus on, a white rectangle affixed to the glass tube, printed with the patient’s name, room number, and hospital number. Though the name says “Jane Doe,” I know who this blood really belongs to. She is no longer in the Surgical Intensive Care Unit. She has been moved to Room 538—the surgery ward.
    I put the tube back in the rack, where it sits with two dozen other tubes, capped with rubber stoppers of blue and purple and red and green, each color signifying a different procedure to be done. The purple tops are for blood counts, the blue tops for clotting tests, the red tops for chemistries and electrolytes. In some of the red-top tubes, the blood has already congealed into columns of dark gelatin. I look through the bundle of lab orders and find the slip for Jane Doe. This morning, Dr. Cordell ordered two tests: a complete blood count and serum electrolytes. I dig deeper into last night’s lab orders, and find the carbon copy of another requisition with Dr. Cordell’s name as ordering physician.
    “STAT arterial blood gas, post-extubation. 2 liters oxygen by nasal prongs.”
    Nina Peyton has been extubated. She is breathing on her own, taking in air without mechanical assistance, without a tube in her throat.
    I sit motionless at my workstation, thinking not of Nina Peyton, but of Catherine Cordell. She thinks she has won this round. She thinks she is Nina Peyton’s savior. It is time to teach her her place. It is time she learned humility.
    I pick up the phone and call Hospital Dietary. A woman answers, her speech pressured, the sound of trays clanging in the background. It is near the dinner hour, and she has no time to waste in chitchat.
    “This is Five West,” I lie. “I think we may have mixed up the dietary orders on two of our patients. Can you tell me which diet you have listed for Room Five-thirty-eight?”
    There is a pause as she taps on her keyboard and calls up the information.
    “Clear liquids,” she answers. “Is that correct?”
    “Yes, that’s correct. Thank you.” I hang up.
    In the newspaper this morning, Nina Peyton was said to remain comatose and in critical condition. This is not true. She is awake.
    Catherine Cordell has saved her life, as I knew she would.
    A phlebotomist crosses to my station and sets her tray full of blood tubes on the counter. We smile at each other, as we do every day, two friendly coworkers who by default assume the best about each other. She is young, with firm high breasts that bulge like melons against her white uniform, and she has fine, straight teeth. She picks up a new sheaf of lab requisitions, waves, and walks out. I wonder if her blood tastes salty.
    The machines hum and gurgle a continuous lullaby.
    I go to the computer and call up the patient list for 5 West. There are twenty rooms in that ward, which is arranged in the shape of an
H,
with the nursing station located in the crossbar of the
H.
I go down the list of patients, thirty-three in all, scanning their ages and diagnoses. I stop at the twelfth name, in Room 521.
    “Mr. Herman Gwadowski, age 69. Attending physician: Dr. Catherine Cordell. Diagnosis: S/P emergency laparotomy for multiple abdominal trauma.”
    Room 521 is located in a parallel hallway to Nina Peyton’s. From 521, Nina’s room is not visible.
    I click on Mr. Gwadowski’s name and access his lab flowsheet. He has been in the hospital two weeks and his flowsheet goes on for screen after screen. I can picture his arms, the veins a highway of needle punctures and bruises. From his blood sugar levels, I see he is diabetic. His high white blood cell counts indicate he has an infection of some sort. I notice, too, that there are cultures pending from a wound swab of his foot. The diabetes has affected the circulation in his limbs, and the flesh of his legs is starting to necrose. I also see a culture pending on a swab from his central venous line site.
    I focus on his electrolytes. His potassium levels have been steadily climbing. 4.5 two weeks ago. 4.8 last week. 5.1 yesterday. He is old and his diabetic kidneys are struggling to excrete the everyday toxins that accumulate