The Sheikh Surgeon's Proposal
And how couldn’t she? Her knowledge was extensive, her work ethic impeccable, her people skills inimitable. Everyone recognized that and was giving each talent and asset its due.
He felt her eyes darting to him now, or rather to his hands, felt their gaze along his every nerve ending as she took in that he’d already started fluid replacement on one patient.
He looked up at her, needing that gaze to mesh with his, needing the connection. She didn’t look back, turned to the other patient. He gritted his teeth, kept on working.
Ten minutes later, resuscitation was over and everyone reported the condition of their casualties. Then the helicopters were there and Janaan rushed after Malek to organize the airlift.
He directed his men’s efforts while she directed their medical team in resuscitation before extrication.
It took over three hours of grueling work, and not a few accidents, the worst resulting in one of his men fracturing his femur, to get everyone out and resuscitated.
With triage sorted out, they loaded casualties on gurneys in preparation for transferring them to the ambulances or OR. Rafeeq went to ready the anesthesia station.
Janaan stood there taking stock. He approached her, needing some contact, some response. She still refused it.
Suddenly she asked, “Who will you start with?”
He didn’t answer right away. Not because he hadn’t made a decision but because he needed to bring the debilitating spurt of joy and relief at her acknowledgement of him again under control.
“This man.” He pointed to the moaning man on the second gurney from where she stood. “His crush injury is the worst.”
Her nod told him she thought so too. So had she only been making sure his judgment was the same as hers? Or had she been trying to initiate conversation?
No. Janaan didn’t resort to things like that. That had been a legitimate question. To which he hadn’t given a complete answer.
He had to add, “I may have to amputate.” At her gasp, he rushed on, “I won’t know until we have him on the table. But I just need you to be ready for the possibility.”
She nodded, her color at high level. And he couldn’t deny his need. He needed her with him.
“Will you assist me?” he rasped.
Her eyes swung up to him, letting him in again, blazing her relief to be included, her eagerness to be of help. To be with him again?
“Hada abbi.”
Both Malek and Janaan jerked around at the adolescent voice, found a boy of no more than thirteen standing two feet away from them, covered in the yellowish dust, as if he too had been pulled from the rubble, undernourished, underdeveloped, swaying.
Malek took a stride towards him, his hand held out to support him, and the boy hiccuped a sob and stumbled back.
“Aish beeh? Aish rah t’sa’woh b’abbi?”
Malek closed the gap, took the boy by the shoulders, gently, carefully, talked to him, low and soothing. And the boy’s sobbing escalated into all-out weeping.
“Malek?”
Janaan’s trembling whisper touched him before her hand did. He first called Saeed, gave him orders, turned the boy over to him then turned to Janaan.
“This man is Aabed, Nabeel’s father. Nabeel told me he was standing next to him when the cave-in happened. He pushed him away at the last moment. Nabeel has six younger brothers and sisters and he said he’s too young to be the man of the family.”
That vast compassion flared in her face, burned him. “What did you tell him? What did you tell Saeed to do?”
“I told him he has nothing to fear. I told Saeed to take care of him. Now we’ll take care of his father.”
“Is he under yet, Rafeeq?” Malek asked.
Rafeeq adjusted his anesthetic/oxygen delivery then raised his eyes. “Go ahead.”
“Administer cephalosporin, please, Rafeeq.” Malek raised his head at the moment’s silence that greeted his order. “Yes, now, and tetanus toxoid. Infection with the state of circulation in his leg is taking root as we speak. We can’t be too aggressive or too early in treating it.”
He returned his eyes to the field of surgery, Aabed’s left leg. It was blue, cold and pulseless. Not to mention grossly swollen up to the groin.
Jay eyes followed Malek’s, the only thing she could see of him now, and shivered at the terrible intensity that prowled in their depths, like a caged lion pondering a way out.
She couldn’t bear it. “What will it be, Malek?”
Malek was silent for a moment more. Then he exhaled. “I’ll start with a fasciotomy. If we don’t get definite distal pulses at the end of the procedure.”
He’d have to amputate. Then Aabed would lose his ability to stand on his own two feet, his only means of supporting his family. And Nabeel would lose his childhood to the struggle of keeping his family from starvation.
“He won’t.”
Her heart fired at Malek’s whisper. Had she muttered her fears out loud?
As Malek held her gaze, she knew he only shared her thoughts, was reaching out with the promise. Nabeel, like Adham, would get the best chance at life. He’d make sure of it.
Then he moved his eyes back to his task, made a transverse incision across the thigh, dissected the subcutaneous tissue to expose the iliotibial band, made a straight incision through it in line with its fibers. She carefully reflected the fascia for him, exposing the intermuscular septum, watching the poetry in his every move, the genius and healing flowing from his fingers.
“Cautery, please, Janaan.”
His baritone sent its gentleness through her on an almost un-containable wave of longing. She clamped down on the tremors, coagulated all vessels in the now pale, spongy muscles. She withdrew, fell back into the reality of his nearness, the feeling that he seemed to be seeking her again, still afraid to believe it, expecting it to end at any moment.
She watched his every move as he made a two-centimeter incision in the fibrous septum, releasing the building pressure in the muscle compartments of the thigh which were now cutting off circulation and causing the starting necrosis of the whole limb.
“Metzenbaum scissors, please, Janaan.” It was in his hand as he uttered its name. He used it to extend the incision. “OK. Anterior and posterior compartments released. Please measure pressure of the medial compartment.”
She did, bit her lip. “Elevated,” she rasped.
He inhaled, nodded, made another incision to release the adductor compartment. After two minutes he said, “And now?”
She measured again, felt her heart boom at the reading.