Chapter 3 FIRST MAJOR NEUROSURGERY

At the Morgan University Hospital, doctors and nurses moved around, attending to patients in their various departments. An ambulance suddenly drove into the hospital compound, and paramedics quickly rolled a woman out on a stretcher. They pushed open the double doors that led into the emergency ward.

Nurses and doctors rushed towards them, while the woman's parents were asked to wait at the reception.

"She sustained blunt force trauma to the head from a fall" the paramedic explained quickly. "She was unconscious on arrival, GCS score is 6. We've stabilized her, but her vitals are dropping fast."

"Is the chief surgeon around?" one of the doctors asked.

"Yes, I'll go get him now" a nurse responded and hurried off, while the emergency team began attending to the patient.

Meanwhile, inside the doctors' resting area, Dr. Regina Coles was enjoying her short break. She was eating and video chatting her best friend, Cara.

"How's work going on your side, Miss Diplomat?" Regina asked, grinning.

"Not as stressful as yours" Cara answered. "Where's Samantha? Is she staying with you now?"

"We're not in the same department, but hopefully we'll get to work together in the future. And yes, she's living with me now" Regina said. "Her uncle's wife let her down badly, so I took her in. She's been helpful in the house. Somebody has to replace you here and keep me company."

"You better not be replacing me!" Cara said with a playful look. "We've been besties since we were babies."

"I'm joking" Regina laughed. "No one can ever replace you. Samantha just keeps me company at home and she's a good cook"

"Your place is so beautiful compared to mine" Cara said.

"Girl, this is Vanceney City where the president and the elite lives. You can't compare it with Mae city in Kalcuta. The First Lady really tried for us though with the best accommodations" Regina said.

"So, are you on break now? And what's up with that Kate girl?" Cara asked.

"Yeah, I'm on break. As for Kate, I have no business with her. She hangs around the operating room but barely does anything. Her dad is the hospital's CEO, anyways" Regina said.

"Is your supervisor treating you well at least?" Cara asked.

"Dr. Cyprus is amazing. I'm glad I'm working under his guidance" Regina smiled. "By the way, you never told me about that guy I saw on your status."

"Oh, Gina! That's the new guy I mentioned. He's helping me process my transfer to Vanceney. I want to come over. Mae and Kalcuta is dead boring without you" Cara said.

"I thought..." Regina started, but a call interrupted her. "Cara, I have to go. Let's talk later" she said quickly before answering her call "Yes, Chief, on my way"

She immediately threw on her lab coat and rushed out.

In the hallway, a group of doctors passed by as they whispered among themselves.

"Wait... The Chairman's around?" one asked, shocked.

"Yes, he just returned from overseas. We better be extra careful" another said.

"He won't be leaving soon. There's a neurosurgery case. You know how he loves to watch the neurosurgeons and cardiothoracic perform" someone else said.

"Well, those are the toughest surgeries, but I trust Dr. Cyprus and the cardiothoracic team."

"Too bad Dr. Cyprus doesn't have more neurosurgeons in his department" one of them sighed. "It's just him, one resident, an intern who knows nothing, and the CEO's daughter. Meanwhile, cardiothoracic has five competent doctors."

"That's exactly why the Chairman values Dr. Cyprus so highly. He doesn't want him to leave yet" another added as they entered their department.

Regina arrived in Dr. Cyprus' office where he was already seated with Kate and an intern.

"Sorry I'm late, Chief" Regina said as she quickly took a seat. Kate scoffed at her.

"We have a new case. Emily Abraham. She had an argument with her husband and was pushed down the stairs. She was found unconscious and brought in here" Dr. Cyprus briefed them.

"How long has she been unconscious?" Regina asked, while Kate and the intern listened.

"Thirty minutes, but she's been stabilized. I've asked for the OR to be prepped and her CT scan to be done" Dr. Cyprus said.

"While she was being moved for the scan, her GCS dropped even lower and her pupils are blown" Kate added.

"That suggests a subdural hematoma" Regina said.

"Exactly. If the bleeding is much, we'll need to open up her skull immediately" Dr. Cyprus said. Just then, a lab tech entered.

"Here's Mrs. Abraham's scan, Dr. Cyprus" he said, handing over the clear film before leaving. Dr. Cyprus studied it briefly, then passed it to Kate, who passed it to Regina, then the intern.

"Dr. Coles is right. It's a subdural hematoma, and the bleeding is much" Dr. Cyprus confirmed.

"There's a midline shift as well" both Kate and Regina said at the same time.

"She's got no time left, does she?" Gabriel, the intern, asked as he handed the scan back to the chief surgeon.

"No" Dr. Cyprus said grimly. "There's a massive clot on the right hemisphere pressing against her brain. If we don't relieve the pressure now, she'll fall into a coma that's if she's not already halfway there."

"We should go for a craniotomy" Kate said.

"No. We'll start with a burr hole to reduce the pressure. If it's not enough, we'll move to full craniotomy. The bleeding is causing her brain to shift" Regina explained. Kate looked irritated.

"You're both right. Gabriel, get the OR ready and call Dr. Mary, the anesthesiologist" Dr. Cyprus said. Gabriel walked out.

Meanwhile, the Chairman, the CEO, and Mrs. Frankfurt were walking down the hallway after leaving the VIP section.

"What about the patient's family?" the CEO asked.

"They're waiting patiently, hoping the surgery goes well" Mrs. Frankfurt answered.

"You're really going to watch the surgery, brother?" the CEO asked.

"You know I love watching neurosurgeries and I want to see how the new residents are doing, Kate especially" the Chairman said.

They moved to the viewing area in the OR, just as Emily Abraham was wheeled in quickly. Inside, Dr. Cyprus, Regina, and Kate were already in their scrubs and preparing for the surgery.

"Dr. Morgan, you'll be leading this one" Dr. Cyprus said as they entered the hand washing room.

"Let Regina take the lead while we assist, right?" Kate suggested, looking directly at Regina.

"There you go, Dr. Coles" Dr. Cyprus said, and Regina's nerves rose. She had only ever observed surgeries or studied them but had never performed one before.

"Yes, Chief" she answered nervously as she washed her hands.

In the operating room, the patient was unconscious and ready. The beeping of machines filled the room. Dr. Mary was about to scrub in Dr. Cyprus, but he signaled her to dress Regina instead. Dr. Mary raised a brow in surprise, but Dr. Cyprus nodded firmly. She obeyed and helped Regina with gloves while Gabriel set up the tools.

"The Chairman is watching" Dr. Mary whispered, and everyone turned slightly to see six eyes from the observation gallery watching. Kate bit her lip. Her granduncle was watching. She instantly regretted suggesting Regina lead the surgery.

"Vitals are steady. Dr. Mary, monitor her BP. We can't afford any drop during the incision" Dr. Cyprus warned.

"She's stable for now. Blood pressure is within range" Dr. Mary said.

"Alright, Dr. Coles. This is your first major neurosurgery under me. You'll make the first incision" Dr. Cyprus said.

"Yes, Chief. I'm ready" Regina said nervously, her hands trembling slightly. "Scalpel."

Gabriel handed her the scalpel while Kate and the observers watched closely.

"Make a small incision above the ear. Go gently, the dura underneath is fragile" Dr. Cyprus guided her.

Regina began cutting, her hand steady. "I can see the bone now" she said.

"Good. Use the drill for the burr hole. Dr. Mary, keep an eye on intracranial pressure."

"Pressure is holding steady" Dr. Mary confirmed.

Regina drilled cautiously through the skull. Blood soon appeared, dark and threatening. Dr. Cyprus helped suction the excess blood.

"There's the hematoma. It's larger than expected. I'll suction carefully to avoid disturbing nearby tissues" Regina said.

"Exactly. Take your time" Dr. Cyprus encouraged her.

"Her BP is spiking! Intracranial pressure rising!" Dr. Mary suddenly alerted.

"Step back now" Dr. Cyprus ordered gently and then took over. "Dr. Mary, give her another dose of mannitol."

As he worked quickly to remove the clot, the tension in the room thickened.

"Vitals are stabilizing again" Dr. Mary said moments later.

"Clot's out. Time to close up" Dr. Cyprus said, stepping back for Regina to finish. Kate assisted with the sutures. Together, they carefully closed the incision and secured the bone flap. Regina exhaled deeply, steadying herself.

"Vitals are normal. No signs of further bleeding" Dr. Mary announced.

"She'll be moved to the ICU now. Next 24 hours are critical. Good work, everyone" Dr. Cyprus said. In the observation area, the Chairman sat back in relief.

The team walked out of the OR, removing their gloves and masks as they wiped sweat and cleaned their hands. Regina dabbed her forehead.

"That spike in pressure... I didn't expect that" she said. Kate silently observed her as Dr. Mary walked away.

"That's why you must always be ready for anything. The brain is unpredictable, especially after trauma. But you handled it well for your first major surgery" Dr. Cyprus said as they all walked to his office.

"But what if the clot was deeper? Or she had made the wrong incision? She could have..." Kate began, but Dr. Cyprus cut her off.

"She didn't. She did everything she was trained to do. The surgery was successful, despite how serious it was" he said.

Inside the office, they all sat down.

"I felt like I was losing control for a second" Regina admitted her fear "but I knew I couldn't panic."

"There will be more surgeries ahead. Each one different. Keep learning" Dr. Cyprus advised.

"I'll go through her chart again later" Regina said.

"I'll join you, Dr. Coles" Gabriel said cheerfully.

Kate just sighed in annoyance.