fall out of the grizzled surgeon’s favor, Enzo had always been the one in control and confident in his abilities. He knew Ootaka’s rules. He understood the detached perfectionism that made up nearly the entirety of his operating-room demeanor. His professionalism, steadfast confidence and resolve were perfection in Enzo’s eyes. Ootaka was precisely the kind of surgeon Enzo wanted to be. The best. Second to none after Ootaka retired. There could be no better place to learn that than Ootaka’s OR.
Tension rolled over his shoulders and down his arms. Not like Ootaka’s relaxed stance. In the reflection of the glass doors he could see his own arms… hanging at his sides, but stiff, ready for a fight. He rolled his hands at the wrist and settled. Shaking his arms out would only look even more affected.
He couldn’t avoid Davis as he did Lyons. Did he even want to? He took an inventory of his goals. Staying on top would mean a better understanding of whether she truly was a threat or just another future ex-contender. Having a good understanding of his obstacles was the only way to overcome them. It was the not knowing that had him rattled. Once he had figured out the situation, there wouldn’t be any weird emotional responses to taint Ootaka’s opinion of him.
Whatever it took. Even if it meant angering a new colleague when she figured out he’d outmaneuvered her. But what did that matter to him? Another fact for her to get used to. She would’ve had to anticipate the sharp learning curve to come into the program this late in the game, and there was zero chance of her assisting on her first day anyway.
Ootaka never trusted one of his patients to anyone with untested skills. In that light, his request wasn’t anything more than a formality when you got down to it. Asking first just showed initiative, a good practice. He wouldn’t feel guilty about it.
Bonus: it’d give Ootaka an easy out if Davis came in asking, because she’d definitely want to assist. Helpful, like someone he’d want around for the next two years. As she exited the ambulance, Enzo added, “There was another resident on the scene. The transfer, Davis. She rode in the back with the patient.”
“I wondered why she wasn’t here yet.”
In addition to untested surgeons in his OR, Ootaka also hated tardiness. The man kept an updated list of sins that could get you banned from his OR forever. She probably hadn’t a clue about them. His action now might actually save her career—give her time to learn the rules before she went in blind and violated them. It was a good-guy thing to do. The idea that her competence might come into question because she’d been late saving a life didn’t sit well. He could throw her a bone, let Ootaka know she’d made the call and aspirations.
“She—”
As the first word came out the two EMTs, Davis and the gurney rolled in, the little motor on the wrist cuff whirring to take another reading.
Ootaka cut in, “Who diagnosed the cardiac tamponade?”
“I diagnosed Mr. Elliot’s tamponade, Dr. Ootaka.” She immediately answered the question while still passing through the sliding doors.
All the mousiness he’d glimpsed earlier was gone. That was something at least. She recognized Ootaka on sight, which really shouldn’t surprise him—she’d transferred in for his fellowship if the rumor mill was to be believed. She’d have done some research.
Though Ootaka was hard to miss. He had a kind of forbidding quality to his expression, even when he was in a good mood. Smiles actually involving his mouth were rare. Ninety percent of his expressions were in the eyes.
“The aspirations are what stabilized Mr. Elliot.” He rolled with the name they must’ve discovered on the way. “Brought him back into normal sinus rhythm. He was in V-tach before the serosanguineous fluid was drawn off.”
She still wouldn’t be asked to assist, but she deserved to observe. It’d be the honorable thing to do, help her get a foot into Ootaka’s OR in a way she probably couldn’t unwittingly screw up.
At the scene he’d noted at least three behaviors Ootaka would cut her over: inability to speak with authority; lackluster leadership skills; and visible displays of emotion. From the sidelines she’d be able to get a feel for things without being in the spotlight.
“It had stabilized him, but he’s popping more PVCs than he was, and his blood pressure range is narrowing again,” she added, directing all attention to the patient and the display on his wrist. “One hundred over seventy-five.”
Enzo had gotten used to being the main one to answer questions or brief Ootaka on patients. It was only to make sure that he knew the whole situation that Enzo tacked on, “Pressure had normalized to one hundred and forty-three over eighty-five after the second aspiration.”
“One hundred and forty-three over eighty-one,” Davis corrected.
Right. No more giving her credit. Those four measly points didn’t make any difference to the situation, other than highlighting that he’d made a tiny mistake. Not precisely underhanded but kind of snotty all the same. Apparently she was capable of a modicum of backbone. But squabbling over insignificant details wouldn’t impress Ootaka, so he held his tongue.
Ootaka nodded in the direction of Trauma 1 and led the way. In less than a minute the stretcher was locked into position amid the equipment in the trauma suite, all gloved hands on deck.
“Davis,” Ootaka directed. “Another aspiration.”
Davis? Damn.
A larger hypo than the ones she’d used on scene landed in her hand. A nurse took over the job that Enzo had performed earlier, swabbing the chest.
Again he watched Davis carefully position and guide the needle into the man’s chest, then another flow of bright blood pulled back into the hypodermic. Not so watery as it had been on the second draw.
“For the third draw, it’s a lot thicker than it was even the first time.”
Enzo locked his jaw to keep quiet. Something he never did with the other residents… but this was Davis’s show.
Davis withdrew the needle and concluded, “His chest isn’t simply filling with serum again. There’s bleeding. He’s got a tear somewhere.”
“He does,” Ootaka confirmed. “Going to have to go in. Correct call, DellaToro.”
Of course it was. Enzo stepped forward again. Before Enzo could do more than nod, Ootaka turned to Davis. “Welcome to West Manhattan Saints, Dr. Davis. An OR has been prepped. You’re with me.”
Enzo’s head jerked back as if he’d been slapped.
Ootaka had invited her to surgery.
A slower step back to get out of the way again and Enzo found himself blinking, as if clearing his vision would do something to clear up what he’d just heard. But nothing had changed. The situation settled like lead in his belly.
Ootaka was definitely impressed with her.
The man told all the first-year residents they couldn’t assist him until he’d seen them in the OR to weigh their ability. They observed, he gave them small tasks, and gradually built up to assisting. Usually other surgeons did much of the initial surgical instruction, Ootaka was next-level surgery. And if you didn’t meet his expectations…
It wasn’t so much that Ootaka made a production of letting the resident know they were no longer welcome—big displays of emotion were the same as big displays of drama—he simply stopped extending invitations. It usually took the resident a few weeks to realize they were no longer welcome or even on his radar. Enzo had even seen the man forget the name of residents once he’d stopped shining attention on them.
Davis wasn’t precisely a first year, but it was her first year at WMS. Ootaka had never seen her perform.
A pericardial aspiration by hypodermic, while tricky, didn’t compare to using a scalpel…
The team wheeled Mr. Elliot out of Trauma 1 and down the fastest hall to the OR, leaving Enzo to find