Surgeon Boss, Surprise Dad

He placed the tissue in a specimen tray. The pathologist would check to see if the forty-two-year-old’s breast cancer had spread outside the lump that weeks of radiation had shrunk to a more surgically manageable size.

Resisting the urge to shake his hands back and forth to ease the tingling sensation burning his fingertips, he finished removing her left breast tissue and began examining the left axillary nodes. He’d remove a few of those to send to pathology, too. All he’d have left was to clean up the surgical site to make reconstruction easier at a later date and to sew up the incisions he’d made. If his hands kept bothering him, he’d let the nurse sew up the incision. Although not his normal routine, doing so was a common enough practice that no one would think too much of it.

He’d yet to remove a single node when the anesthesiologist became alarmed.

“Her oxygen sats are dropping,” the doctor said, increasing the amount of oxygen he was delivering and simultaneously checking placement of Beverly’s mask. “Something’s not right.”

“Pulse is up,” the nurse said at his side. “Blood pressure is slightly elevated. Is she going into shock?”

Squelching the voice in his head asking if he’d somehow done something wrong, if he’d missed something because of his distraction with his hands, Adam did a quick assessment of his patient. Erythematous welts began appearing on her skin.

“She’s breaking out in a rash,” he said. “DC the anesthesia. Stat. She’s reacting to it.” He turned to the nurse. “Give epinephrine subcutaneously stat and then add diphenhydramine to her IV line.”

“Yes, sir,” the nurse said, giving the injection seconds later.

Adam hoped no one noticed that he massaged his fingers through the rubber gloves. What was wrong withhim?

His gaze met the nurse’s. He feigned calm, reassuring himself that she’d think his hand motions were due to stress, worry over his patient. He was worried abouthis patient. “We’ll finish once she’s stable.”

Adam stayed with his patient until her vitals settled down, and he felt confident he could proceed without fear Beverly was in greater danger than normal.

Two hours later he propped his head against the doctors’ lounge wall. The cold concrete soothed the throb in his skull. He ran over everything with Beverly’s mastectomy, trying to recall if he’d done anything out of line, anything that might have made a difference in her outcome. He hadn’t. Sure, he was tired, his right eye blurred and his fingertips burned. But even if he’d been at his best, he couldn’t have prevented Beverly from reacting to the anesthesia.

Fortunately, they had gotten her severe allergic reaction under control before the situation had become even more critical. Before he’d been forced to deliver bad news to Beverly’s waiting family.

“You OK?” Dr Roger Bell asked from behind him.

Startled, he raised his head. He hadn’t heard the orthopedic surgeon enter the lounge.

“I heard what happened this afternoon,” his friend said. “Dr Krick told me if you hadn’t realized what was happening so quickly you might have lost the woman. Good going, man.”

Adam shrugged. He couldn’t let go of the idea that he might have somehow been at fault. “It’s my job to keep my patients safe.”

Was he compromising his patients’ safety just by operating on them? But he couldn’t put his life on hold while he awaited test results. Tests he needed to reschedule and have done so he could await results. Why was he procrastinating?

“But not your job to predict the future,” Roger countered, pulling items from his personal locker. “No one can say when someone’s going to have an unexpected allergy like that. Not even you.”

Hearing his earlier thoughts from an excellent surgeon like Dr Bell reassured him that what happened with Beverly truly hadn’t been his fault. Still, he couldn’t quite shake his guilt.

“Just thought you should know that those in the OR with you this afternoon were impressed with how quickly you came up with the correct diagnosis and credit you with saving the woman’s life. The nurses are saying you’re brilliant.” Dr Bell added the last with a grin.

Brilliant? He’d been tired, distracted, wrestling with his fingers, and hadn’t been at his peak. Far from brilliant. “Like I said, I was just doing my job.”

Dangling a shower bag and fresh clothes, Dr Bell closed his locker. “I was surprised to hear you were back today. I figured you’d take off a while with Liz. I was really sorry to hear about her grandfather.”

Adam nodded at his colleague. “I’ll let her know.”

Roger lingered rather than hitting the showers. “You planning to make an honest woman of her now that she’s free?”

None of your damn business, was what he wanted to growl, but instead he met his friend’s eyes. “Liz and I have no definite plans for the future.”

He couldn’t make plans with Liz until after he’d had the tests Larry had ordered, until he knew what the hell was going on with him.

Until he knew if he had a future to plan.

“Your lab results all came back perfect,” Larry, the family physician Adam had been good friends with since he’d moved to Robertsville, said. From the look on Larry’s face, not everything had come back perfect, though.

“The MRI?”

Larry took a deep breath, met his gaze head on. Premonition filled Adam. This was going to be bad. Very bad. Like maybe he didn’t want to know after all bad.

“I wish I could say it was perfect, too, but it wasn’t.” Larry didn’t seem in a hurry to tell Adam the results, seemed to be struggling with how to wrap his tongue around the words.

“Just get on with it,” Adam spat out, no longer willing to wait patiently for the results of the scan he’d gone for yesterday morning.

Did he have a brain tumor? It was the explanation that kept running through his mind. Then he’d tell himself he was being foolish, a hypochondriac of the worst kind. Of course his scan was going to come back normal. Of course he was going to be just fine and have a future with Liz.

Brain tumors didn’t happen to regular guys like himself. Not in the prime of their lives.

“Your MRI showed demyelization of gray matter in your brain.”

Demyelization? The breakdown of the protective lining around nerve cells? But…

“What does that mean?” Even as he asked, possibilities ran through his mind. Demyelization. An autoimmune response. His body was attacking itself? Why the hell would it do that? Why now?

Larry took another breath. “It means I’m going to schedule you to see a neurologist in Jackson.”

“A neurologist?”

Larry looked at him oddly. Adam imagined he did sound a bit odd, but Larry was talking about his body, his life, his future. Could he help it if he was asking questions that as a physician he should know the answers to? Questions he did know the answers to? A neurologist specialized in diseases of the brain and nervous system. Demyelization diseases such as…no, he wouldn’t go there. Wouldn’t think the worst.

“There’s a specialist in Jackson. He’s involved in multiple sclerosis research.”

Damn it. He’d just decided not to go there. With Larry saying the words out loud, he couldn’t help but go there.

“MS?” Did he sound as blown away as he felt? MS. He could end up paralyzed, completely dependent on others for even the most basic of things. He didn’t have MS. He couldn’t have MS.

“I want you to see Dr Winters. I put in a call to his office as soon as I got your report. He’s out of town at a convention until next week, but you’re scheduled for an early morning appointment on his first day back in the office.”

“MS?” he repeated. There had to be a mistake. The MRI must be wrong. This wasn’t happening to him.

“With the demyelization, I have to consider MS on the list of differential diagnoses. You know that. You’ll need further testing before any diagnosis can be confirmed, but I suspect Dr Winters is going to verify my suspicion.”

Adam winced, knowing what that further testing would involve. “A spinal tap.”

Larry nodded. “And evoked potential testing, where an electrical impulse is applied to various parts of your body to see how the nerve cells conduct the impulse and if there’s any demyelization of the peripheral nerve cells.”

Adam attempted to digest what he was being told. MS. Him. It couldn’t be true.