“Wow, aren’t you lucky? Well, don’t worry. This won’t be any worse than having your wisdom teeth removed,” Dani assured him, as she shaved his chest with a pair of clippers. “And it definitely won’t be as bad as an appendectomy or tonsillectomy.”
Nick could tell she had seen right through his attempt to downplay his nerves. “At least I’ll be able to eat afterwards, right?” He was trying to stay positive, but it was hard to look on the bright side when he was stuck in the hospital with a failing heart, a best friend who might never be the same, and a hurricane heading straight for them. There just wasn’t much to feel hopeful about at that point.
“You bet! I’ll bring you anything you want,” Dani promised with a smile.
Nick forced a smile back, but all he really wanted was the one thing she hadn’t been able to provide: his family. There was an ache in his chest that he knew had nothing to do with his heart condition. He missed Lauren and Odin so much, it hurt.
“All done,” said Dani, setting down her clippers. “You’re dolphin-smooth now.”
He chuckled. “It doesn’t feel all that different, to be honest,” he replied, as he ran his hand lightly over the left side of his chest. “I barely had any chest hair to begin with.”
“I’ve shaved much furrier patients before, that’s for sure,” she admitted.
Nick wrinkled his nose. “Doesn’t it gross you out to wash other people’s bodies and wipe their butts and stuff? I’ve always wondered that about nurses.”
Dani shrugged. “Not when they look like you,” she said, without missing a beat. Nick raised his eyebrows, and she blushed. “Sorry - that was inappropriate; I shouldn’t have said that.”
“Hey, no need to apologize here,” said Nick, smirking. “I’m glad you don’t think I’m gross.”
She smiled back, still blushing. “Of course not. In all honesty, though, it takes a lot to gross me out. I’ve pretty much seen it all - the good, the bad, and the ugly. And sure, some parts of my job are less pleasant than others, but they’re no less important. I like taking care of people,” she replied, pulling his blanket back up to cover his bare chest.
“That’s admirable. I could never do it,” Nick said, shaking his head. “Is that why you became a nurse?”
“Not exactly. When I was a kid, I was at the beach one day and witnessed a man drowning. I saw the lifeguards pull him out of the ocean, just like on Baywatch. By the time they got his body back to the beach, he wasn’t breathing, so they started CPR. Most people, myself included, were just standing around watching, not sure what else to do, but I remember this off-duty nurse running up to help them resuscitate him. She and the lifeguards worked on this guy for what seemed like forever, but it was probably only a few minutes, because by the time the ambulance arrived, they’d already brought him back. It was so scary, but cool at the same time,” said Dani, a faraway look on her face. “Anyway, that’s when I decided I wanted to go into the medical field, so I would know what to do in an emergency and could help save lives like they did that day.”
“Wow,” said Nick, his eyes wide. “That’s a great story. I’m sure glad you were there to save mine.”
“Me too. I mean, what if I’d never run into you? What if you never smiled at me?”
He smiled at her now, recognizing his own lyrics. “What if I hadn’t noticed you too?” he returned. “And you never showed up where I happened to be?”
“Well, you would be dead by now,” replied Dani with a shrug.
Nick snorted with laughter. It shouldn’t have been funny, considering she was probably right, but her flat tone and comedic timing were perfect. He couldn’t help cracking up.
“I’m sorry; that was insensitive,” she said, smiling sheepishly. “In case you couldn’t tell, I have a pretty twisted sense of humor. You almost have to, working in this place.”
“I understand,” he said, smiling back. “Personally, I appreciate your twisted sense of humor. You don’t ever have to apologize to me; I’m pretty hard to offend. I’d rather see your real personality than have some strictly-professional robot taking care of me. It’s boring enough in here without someone to talk to. I like talking to you.”
She beamed. “I like talking to you, too.”
“Will you be with me during the surgery?” he asked hopefully. Several minutes had passed since he’d last thought about the implantation procedure, and he was grateful to Dani for taking his mind off it temporarily. It would help to have her in the room to distract him while Dr. Elizabeth put in the ICD.
“I sure will. I’m assisting Dr. Elizabeth with it. We’ll try to keep it as painless as possible, I promise,” Dani replied, patting his shoulder. “I’m going to give you some medicine through your central line now - an antibiotic to lower the risk of infection, a painkiller to take the edge off, and a sedative to make you sleepy. It won’t knock you all the way out, but it’ll help you relax. You might even be able to doze off during part of the procedure.”
“That’d be nice,” said Nick, starting to feel nervous again. He lay back and listened to the steady blip of his heartbeat as Dani injected the drugs into his IV. When she was done, she gave him a gauzy surgical hat to cover his hair. “Do I look like a mushroom in this?” he asked, making a face at her.
Dani shrugged. “Not any more than you did with your bowl cut back in the nineties.”
“Whoa… sick burn!” he said, pretending to be hurt by her words.
“Hey, you said you wanted to see my real personality. Well, here I am!” She grinned and struck a pose, holding her gloved hands up on either side of her face.
He laughed. “Love it.”
Dani raised the head of his bed so he was sitting up straight. “Here,” she said, handing him his plastic, portable urinal next. “You’ll want to empty your bladder before we start the procedure. It can take a few hours, and you’ll have to lie still on your back the whole time, so it will be awhile before you can go again.”
“Awesome,” said Nick sarcastically. She turned around so he could pee in semi-privacy, but a second nurse, Patrick, walked in while he was still in mid-stream.
“Elizabeth wants to know if he’s almost ready,” Patrick addressed Dani, ignoring Nick.
“Almost,” Dani replied. “Are you here to help me transport him?”
“Yeah, sure.”
When Nick was finished, Dani handed the urinal to Patrick to empty while she hooked him up to a portable oxygen tank and disconnected the pieces of equipment that were permanently attached to the wall. “We’re just going to wheel you down the hall to a different room for the procedure,” Dani explained to Nick, as she lowered the head of his bed again. “Let one of us know right away if you start having chest pain, palpitations, or anything like that, okay?”
Nick nodded. A pleasant drowsiness had descended upon him, as the drugs took effect, and he felt surprisingly calm all of a sudden.
Dani and Patrick didn’t bother trying to transfer him onto a gurney that time. They just rolled his whole bed into the hallway, following the red line on the wall to a room around the corner, where Dr. Elizabeth was waiting.
“Hi, Nick,” she said. Half of her face was hidden behind a surgical mask, but he could tell she was smiling. “Are you ready?”
“Ready as I’ll ever be,” Nick replied, his nervousness returning. He took a deep breath and held it as they helped him slide from his bed onto a padded table.
“Just lie back, relax, and breathe,” Dani said reassuringly, as she and Patrick hooked him back up to more monitoring equipment. Nick tried to take her advice, but he felt another flood of anxiety when he noticed Patrick applying a large pacer pad to the center of his chest.
“What’s that for?” he asked, his voice rising with panic as he remembered the pain of the external pacing he’d endured two days earlier. He thought the whole point of this procedure was to prevent him from ever having to go through that again.
“It’s just a precaution, in case your heart were to go into another arrhythmia before the ICD is installed,” said Dani. “If all goes as planned, we won’t need to use it, but we want to be prepared for anything.” She helped Patrick roll Nick onto his side so they could stick the second pad onto his back, as before. He prayed they wouldn’t need it.
Hang in there, he told his pounding heart, trying to help it relax. But his anxiety only increased as they strapped him down to the table, using soft restraints to tie his wrists to the sides of the table so he couldn’t touch the sterile field as they worked. They covered his body with blue sterile drapes, leaving only the left side of his chest exposed.
“I’m going to put some antiseptic solution on your skin to prevent bacteria from getting into the incision,” said Dr. Elizabeth. “This may feel a little cold.” Nick shivered as she painted his chest with something wet and cold. “Now I’m going to inject a local anesthetic to numb the area,” she said next. “You’ll feel a little pinch at first, but afterwards you shouldn’t feel any pain, only slight pressure.” He winced when he felt the needle slide underneath his skin, but soon a pleasant, tingly feeling spread through the left side of his chest, and afterwards, he felt nothing.
Once Nick was nice and numb, Elizabeth began the procedure. He closed his eyes and ignored her running commentary, trying to pretend he was at the tattoo parlor instead. It reminded him of the time he’d gotten the pair of Blackfoot Indian footprints tattooed on his chest. Getting the tattoos in the first place was painful, but it had hurt even worse to have them removed. This wasn’t half as bad as that had been, he reasoned with himself.
“How are you doing, Nick?” the doctor asked him every few minutes, and each time, he answered that he was fine. As she had promised, he felt no pain, only the pressure of her poking, prodding, and pulling on his chest. It wasn’t exactly comfortable, but it wasn’t unbearable either. The worst part was having to lie flat on his back, unable to move, while she threaded the wires into his heart. It didn’t hurt, but he could feel his heart flutter and race as it reacted to this intrusion into its chambers. He heard Dani recite his heart rate and blood pressure readings on a regular basis, but they stayed within the acceptable ranges, and no arrhythmia occurred. As the procedure continued without complications, Nick began to relax again.
“We’re almost finished,” Elizabeth said finally. “Everything went well. The ICD is in and hooked up to your heart, but before I sew you up, we have to test it and make sure it works the way it’s supposed to. Dani’s going to give you another dose of sedative to put you into a deeper sleep so you don’t feel anything as we’re doing this.”
“Does that mean you’re gonna make it shock me?” Nick muttered.
Dr. Elizabeth nodded. “We need to know the device will work if your heart were to go into a rhythm that required defibrillation. After you’re asleep, we’ll induce ventricular fibrillation with a small shock, then wait for the ICD to recognize a dangerous arrhythmia. Once it does, it should shock your heart to reset its rhythm. If it doesn’t work, we’ll use the external defibrillator,” she explained, placing her hand over the pad on his chest. Now he knew the real reason Patrick had put it there.
Nick groaned, hating her plan. His heart had already proven itself to be pretty unreliable over the past few days. What if they weren’t able to shock it back into beating the right way? What if it just stopped beating, period? He didn’t want to be defibrillated, and he definitely didn’t want to die.
“It’ll be okay, Nick,” Dani said softly in his ear as she bent down to inject the sedative into the IV in his neck. “We don’t call her the Queen of Hearts for nothing. Dr. Elizabeth has done this test tons of times before; she’s got it down pat by now. You’re gonna be just fine.”
Swallowing hard, Nick nodded. Dani had never let him down before; he had to believe her when she promised he would be fine. As he felt the sedative take hold of him, he squeezed his eyes shut and prayed she was right.
***
“He’s out,” said Dani, as she watched Nick’s features relax. “Get ready to shock him.”
Elizabeth adjusted the settings on the touchscreen of the computer that controlled the ICD. “Charging,” she said. “Clear of the patient.”
Dani took a step back from the table, keeping her eyes trained on Nick’s torso. Her breath caught in her throat as she watched it twitch when the shock was applied. Then she turned her attention to the telemetry monitor, where the once-consistent waveform had suddenly descended into chaos. The current of electricity had disrupted the intrinsic rhythm of his heart; it was no longer beating but barely trembling, the blood pooling inside its chambers instead of being pumped to the rest of his body. “V-fib,” she whispered, as the monitor began to wail.
“Let’s see if the device detects it,” said Elizabeth, watching the screen. Dani looked back at Nick, holding her breath as they waited. “Here we go,” Elizabeth said a second later. “It’s charging. Stay clear.”
Another second passed before Nick’s body jerked again, jolted by the fourteen joules of electricity that had just surged through his chest. Dani watched the waveform on the monitor spike and dip as it registered the shock, briefly flatlining before returning to a normal sinus rhythm. “Back in sinus,” she announced to the rest of the room. Then she pressed two fingertips to the carotid artery in Nick’s neck and felt the fluttering of blood flowing through it. “Pulse has been restored.”
Nick was already starting to regain consciousness. He let out a loud groan, in obvious discomfort.
“It’s okay, Nick,” Dani said automatically, applying pressure to his shoulder to hold him down. “It’s over. You did great.” Across the table, she exchanged glances with Elizabeth, who was looking triumphant.
“It worked. We’re in business now.”
***
