Barbara Ebel [Ebel - Corruption in the Or

Corruption in the O.R.

by Barbara Ebel, M.D.

The Outlander Physician Series

Book One: Corruption in the O.R.

Copyright 2019 by Barbara Ebel, M.D.

All rights reserved. No part of this book may be reproduced, stored, or transmitted by any means whether auditory, graphic, mechanical, or electronic without written permission of both publisher and author, except in the case of brief excerpts used in critical articles and reviews. Unauthorized reproduction of any part of this work is illegal and is punishable by law.

eBook ISBN-13: 978-1-7324466-7-0

This book is a work of fiction. Names, characters, places and events are the product of the authors imagination or are used fictitiously. Any resemblance to actual events, persons, or locations is coincidental.

Contents

CHAPTER 1

Hi, Im Dr. Viktoria Thorsdottir. Sometimes I go by Doctor Viktoria. Makes it easier on everyone.

Helen Grant popped her head up from the glowering stare she gave the IV in her hand. A nurse had stuck her five times to make a catheter spear into a feeble vein, and she was ready to call all health care workers incompetent. Her sullen annoyance intensified when she laid eyes on the thirty-nine-year-old physician.

Id like to see the male, silver-haired attending, please.

That doctor you spoke to is the emergency room physician. He doesnt practice anesthesia.

Of course, you do? She shook her head as if to eject lice crawling around in her scalp. Just my luck.

Yes, Maam. Im the anesthesiologist.

The woman yanked the sheet up on the hospital gown covering her breasts. Humph, she interjected, barely audible. Just so you know, Im no novice. Ive been through this before. Damn diabetes causes the skin on my foot to disintegrate and pus-out like some rancid scene in a horror movie.

That cant be easy on you.

Youre damn right.

May I ask you some questions?

My husbands not here right now.

Do you need him around in order to talk to me? Your surgeon has put you on the OR schedule before his first patient who is late to arrive. I would hate for your case to be delayed. Apparently, you have a nasty infection in your foot which needs attention.

Mrs. Grant pondered the question while Viktoria continued a more thorough visual summary of the womans appearance. Along with being an aged sixty-two years old, the patient was bordering on morbid obesity and her exposed skin was tough and dry, like a reptile who basked in the hot Florida sun.

Helen Grant shoved her cursed right foot out from the side of the sheet, as if showing off a trophy. All right then. Go ahead. Same old questions, Im sure.

Viktoria asked the woman the pertinent questions she needed answered, but she didnt learn any surprises from Mrs. Grants health history and physical exam. She surmised that her patient was a bit of a rarity because Type II diabetics nowadays were, in general, under better control than years ago.

Mrs. Grant, however, lived her days the way she wanted, chugging down canned sodas, sugary snacks, and TV dinners. She expected her oral hypoglycemic medication and recent insulin prescription to manage her glucose all by themselves, and she had grown a huge wall of denial that her own lifestyle was to blame.

The ER record noted that the woman was found eating a bag of pretzels after shed been evaluated, but it didnt stop Viktoria from redundantly asking the relevant question. When did you last eat or drink?

I dont know.

Mrs. Grant, if youre a frequent flier, any anesthesiologist in the past would have told you that recent food in your stomach is always a concern to us.

My husband took away the pretzels at 3 a.m. Its boring spending the middle of the night in an ER waiting for all the tests, and watching people come in and out and poke on you. But I aint ate nothing since then. The snacks gave me something to do. But youve never been on the other side of hospital care. Youre just a baby. How long you been working here anyway?

This is my first day.

Helens eyes shot wide open. Youre joking.

No. I provide staffing assistance for anesthesia departments that are short-handed, especially in under-served areas. Dont worry, Im an experienced anesthesiologist.

Get out! Helen rolled her eyes. Like I said, just my luck. Not only are you a woman doctor, but you wouldnt know where the life-saving oxygen is.

The tanks are green and Im not color blind. Theyre the same everywhere and in the usual places, like hooked into anesthesia machines. But I can ask the person in charge of the anesthesia schedule today to turn over your case to someone else if youre uncomfortable with me.

Thatll delay my surgery?

Most certainly.

Helen pouted her lips. Never mind. Lets get on with it.

A general anesthetic would be preferable for your case, Viktoria said. She explained the risks and benefits as she scrutinized Helens IV. It was a small-bore catheter and was only seeded halfway in the vein. By the looks of the womans arms, the nursing staff had done as good a job as possible.

Mrs. Grant withdrew her hand. Over my dead body. Not again. Dont even think about making me your pin cushion.

Your veins have seen better days. For your case and your postop care, chances are you will need something bigger. Ill do my best to put you to sleep with this one, but I may need better access after youre asleep, such as a central line.

They told me that need would come someday.

Those lines carry a greater risk of infection, injury to a lung, or bleeding.

Helen twisted her dry lips. But you said youre experienced.

Every medical procedure carries a risk no matter who does it.

All right. Be careful, in particular since you dont like me.

I didnt like vegetables when I was growing up. Tasteless vegetables and people are two different things.

Much to Dr. Thorsdottirs intent, Helens face went blank as she tried to sort that out, so Viktoria took the opportunity to slip out. She took an elevator upstairs, made her way past the OR front desk, and rechecked the days schedule.

Written in magic marker on a white board in the hallway, the changing schedule was the gospel itinerary for the OR staff, anesthesia department, and surgeons. Same as earlier, Helen Grant had been written into Room 7, taking the place of a no show elective case. With the help of the anesthetic tech, Viktoria had previously set up her room with the necessary anesthetic equipment and drugs, but now she added a central line kit.

Her first patient had been correct, however, about the need to find out where everything was. Since it was Viktorias first day at the community hospital in northern Pennsylvania, she still needed to check out the preop area and recovery room. She noted the open door to the preop area where elective patients were waiting to go back to the OR, and then she strolled into the recovery room and sat behind the long counter. Several nurses were preparing for the day, but two of them were at the bedside of a patient being checked in. One nurse swiftly applied monitors to a male adult while the other one listened to the report from the CRNA who had just done his case.

The pretty woman holding an anesthetic record was a CRNA, or certified registered nurse anesthetist. She did not wear a plastic name badge like the anesthesiologists Viktoria had already seen in the hallway. The woman wore a deep red unisex three-pocket scrub jacket and from where she sat, Viktoria could make out, CRNA embroidered after her name.

A nurse leaned over for a pen and Viktoria smiled. Is that case from the middle of the night?

Yes, the woman said. Car accident. Lucky guy to only suffer an arm fracture. Are you this weeks hired help in the anesthesia department?

I signed on for a month.