Page 48 of Under Southern Stars
The high-tech video laryngoscope didn’t help. Second attempt. Failed.
The patient’s sats hit the seventies. His lips are turning blue.
“Can’t visualize,” Singh said, frustration bleeding through his usual calm. “Everything’s swollen shut. We need a surgical airway! Where’s ENT?”
“Still in surgery,” I report. “We need—”
“We need to cric him.” Dr. Cameron Lee’s voice cuts through the tension, surprisingly calm and decisive. He’d appeared at the foot of the bed at some point, drawn by the overhead page for a difficult airway, his usual preening arrogance stripped away, replaced by a laser focus.
My eyes meet his. No time for ego, no time for our usual dance of polite antagonism. Just the patient. “Sophia, where’s the cric tray?” he asked, his voice devoid of any of its usual flirtatious lilt.
“Mayo stand, right corner!” I was already anticipating, had made sure it was there.
He moves with a speed and focus that momentarily stuns me. He grabs the kit, his hands steady. “Scalpel. Trach hook. Bougie.” He barked the requests, and Nate was there, slapping instruments into his palm. In a move that was both shocking and brutally efficient, Lee literally jumps from the floor onto the bed with both feet in one smooth motion, straddling the patient’s chest to get the angle and leverage he needed.
Damn the man, but he can move when a life is on the line. Hands of a surgeon, alright.
I was coordinating, calling out vitals, “Sats are 72 and falling!” making sure suction was ready, trying to keep Tasha, who was white-faced and trembling but still managing to bag the patient under Nate’s guidance, from completely losing it. “Focus, Tasha, I need you,” I said, my voice sharp but, I hoped, not unkind. She nodded, her eyes huge.
Lee made a swift, decisive incision. There was a horrifying, wet, tearing sound, then a gush of dark blood that Nate was instantly suctioning. “Tube,” Lee grunted. He threaded it in. “Ambu to the tube.”
Nate connected the bag. Squeezed. We all held our breath. A faint mist in the tube. A slight rise in the chest. “I’m in,” Lee said, his voice tight. “Sats coming up. 82…85…” The collective exhale in Trauma One was almost a physical force. The kid wasn’t out of the woods, not by a long shot, but he had an airway. He had a chance.
Dr. Lee slid off the bed, his movements economical. He gave a few curt post-procedure orders to the respiratory therapist who had just arrived, then stripped off his bloody gloves and walked out of the trauma bay without a backward glance. As he passes me, I catch a glimpse of his face. It’s pale, almost grey, a stark contrast to his usual confident flush. He looked like he was about to be sick.
Our eyes meet briefly. He knows I’ve seen it. I give the slightest nod—acknowledgment, not judgment—and he’s gone.
The aftermath was a flurry of activity—securing the new airway, getting lines, drawing labs, calling report to the ICU. Ichecked on the patient, then my team. Tasha was leaning against a wall, tears streaming down her face.
“I should have seen it sooner,” she whispered, her voice choked. “He just said his throat was sore…”
Nate put a steadying hand on her shoulder. “You did good, Tasha. You recognized he was in trouble, and you got Sophia. That’s what matters. Epiglottitis is a zebra, especially in an older kid or young adult. Most of us will go years without seeing one.”
I nodded, adding my own reassurance. “Nate’s right. You escalated appropriately. That’s the job.” She still looked unconvinced, but the raw panic was easing from her eyes. She needed more experience, more confidence, but she hadn’t frozen. She’d called for help. That was a start.
“But—”
“No buts.” Nathan appears at her other side, solid and reassuring. “You did good, Tasha. The patient’s alive because you acted fast.”
She looks between us, tears threatening. “I’ve never seen…I didn’t know…”
“And now you have,” I say. “Next time, you’ll recognize it faster. That’s how we learn.”
“Come on,” Nathan says gently. “Let’s get some water. You did good today.”
He leads her away, and I see her lean into him slightly—not romantic, just seeking comfort from someone steady. There’s something there, something that could grow. I file it away for later consideration.
The trauma bay slowly returns to normal as the patient is wheeled up to surgery. I’m updating the computer when my phone buzzes.
Jack: Rodriguez says evening shift is slow. Coffee delivery in 20?
