Dr. Jeff Schiller turned sideways and used his hip to shove open the doors to operating room seven. It had been just over three hours since he had consulted on Isabella’s case. Moving toward the center of the room, he waited for his scrub nurse, Beth, to drop a sterile towel on his freshly scrubbed arms and hands. A common sense thinker who rarely took no for an answer, Schiller seemed old school for a physician who was only five years out of his residency.
The second nurse in the room was already in the process of applying an iodine jelly to Isabella’s abdomen. When she was finished, Schiller and his chief resident, Sam Erving, draped the surgical field with four sterile towels, followed by a large drape that covered Isabella’s entire torso. Beth pushed her small metal table containing all of the sterile instruments closer to the surgical field. Just as Schiller was about to call for the scalpel, the doors to the operating theater swung open.
He looked up. “Are you sure you don’t want to scrub in?” he asked Madison. “We’re just getting started.”
“I’m fine just watching. I did enough gynecological surgery as a resident to last me a couple of lifetimes.”
Schiller opened his outstretched hand and Beth handed him the scalpel. Normally, he would have allowed Sam to do the case with him assisting, but because of the special nature of the illness, he decided to do it himself.
“Let’s go,” he told all present, making a careful incision across Isabella’s lower abdomen. After four years, Schiller and Sam had done hundreds of cases together. Each knew the other’s moves as well as two seasoned trapeze performers would. The result was invariably an effortless operation that unfolded in perfect synchrony.
Madison moved to the head of the table. Standing next to the nurse anesthetist, perched on a metal stool, she had an excellent view of the procedure. Five minutes after the skin incision, Schiller opened the final layer of the abdominal wall giving them access to the organs of the abdominal cavity. After setting the exposure with a large retractor, he reached an exploring hand deep into Isabella’s pelvis.
“Apart from the obvious tumor,” he began, “the other ovary’s normal. So is the uterus.” Another minute passed. “I don’t feel any enlarged lymph nodes and there’s no fluid in the abdomen, which is a good sign.” Schiller allowed a lungful of air to slip out. Finished with his exploration, he pulled his hand out of Isabella’s abdomen and stepped back for a few seconds. “Okay, let’s get this thing out of here.”
The two worked for the next few minutes dividing all of the arteries, veins and attachments of the ovary. When everything had been divided, Schiller gently rocked the tumor out of the abdomen and placed it into a stainless steel bowl held over the operative field by the scrub tech.
“Send it for both frozen section and permanent per protocol,” he said to her.
Schiller looked up over the anesthesia screen at Madison. “That should do it. We’re going to close. Assuming this works, when do you think you’ll see signs of recovery?”
His question made her stomach roll. “I don’t have the first damn clue,” she told him.