*****
“Dr. Martin to the ER, STAT! Dr. Martin to the ER, STAT!” Dr. Harold Martin looked up at the scrub nurse as he just completed his last scalp suture. “Jesus,” he mumbled, “I think they have a camera in here or something. How does that ER always know when I am just finishing a case? Just once it would be nice if I could even get my gloves off before they page me down there again!”
He was tired and clearly didn’t want any more work for the day. This was his third case, each of which lasted in excess of two hours, so he had been on his feet for over six hours. His eyes were tired of squinting through those microscopic lenses he had to wear too. Besides that, it was Friday afternoon, and he had a fishing trip planned for the weekend. “Why can’t these damn people have their emergencies during regular business hours?” he growled as he ripped off his gloves and pushed through the OR doors. As an afterthought, he held one door open with his foot and yelled back to the nurse, “Mary, just wheel Mrs. Malone over to recovery. Use my standard post-op orders and I’ll be right back to check on her and add anything else she might need.” With that, he let the door slam behind him and headed down to the ER.
Dr. Martin reached the triage desk just as Carmella was being wheeled in through the double doors. She was unconscious, with a 4-inch scalp laceration on her right forehead. The neck brace was still in place, stabilizing her neck. The monitor attached to her showed a heart rate of 140 and BP of 100/60. “Vitals stable?” he questioned one of the paramedics.
“Yes sir,” he replied. “She was unconscious when we arrived. We applied the neck brace before moving her. She sustained a blow to the right side of the head. Her left pupil is dilated and nonreactive.”
Dr. Martin did a quick neuro check of his own, then spoke to the ER staff. “Start a keep-open IV with normal saline, then give her a 25-gram bolus of mannitol over 15 minutes in 100 ml. We need to keep fluids to a minimum to minimize swelling. Follow that with 2 grams of methylprednisone in 100-ml NS over an hour. Get a CT scan of her head and x-ray of her neck on the way to the OR. Call up there and tell them to prep for a possible emergency craniotomy. Have the radiologist call me ASAP with the results. I’m going up to recovery in the meantime. Make sure someone stays with her at all times and call me for any change in vitals or seizures. Ok, let’s move!” he shouted brusquely as he turned to leave.
Carmella, meanwhile, was finding all this most entertaining, almost like watching a soap opera on TV. To the degree that she could, Carmella determined that she was in some sort of higher vibrational frequency than that which was typical of earthly life-forms. Her perception was way beyond the norm, and she was able to be in multiple places at once. Time seemed nonexistent to her, and she was able to move about freely with no physical impediments—through walls, doors, whatever. There continued to be this overwhelming sense of her being loved and cherished, coupled with the realization that she was an eternal spiritual presence, bonded in some unique way with a spirit infinitely greater than herself, yet present within her. There was no verbal communication, really, just an awareness of everything and everyone all at once. It was just too much for her to process at the moment, especially with all that was going on in her body.
She floated along beside her unconscious self as she was wheeled out of the ER to radiology, and watched as the CT scan and neck x-rays were completed. She literally felt the fatigue of the radiologist and his anxiousness to get home. She simultaneously experienced the empathy and concern shown to her by the emergency tech who accompanied her for the tests. It was as if everything and everyone were all connected in some way. She sensed Dr. Martin’s anxiety in the recovery room as he picked up the phone and listened to the radiologist’s report. “Got a pretty good-size pancake in there!” he called up to Dr. Martin. “Looking to be about 11 mm thick with a midline shift of 7 mm. Looks like I’ll be goin’ home way before you!” he joked. “I’ll send up the pics,” he added almost as an afterthought.
“Damn,” muttered Dr. Martin, “I was afraid of that. How about her neck?”
“No problem there. Only apparent injury was to the head.”
“Well, that’s one bit of good luck for her,” Dr. Martin replied with a sigh of relief. “Ok, have the tech get her up here, we’re ready to go.”
“Aye, aye, Cap’n,” the radiologist snickered. “Maybe I’ll catch you at the lake tomorrow!”
“If I’m not too tired!” grumbled Dr. Martin. “Hey, thanks a lot for gettin’ that done so quickly. This girl needs all the help she can get!”
“I’m with you there, man. Take care!” said the radiologist as he hung up the phone.
Wow, thought Carmella, this is way better than nursing school—I can be everywhere at once and know what everybody’s thinking! You guys better do a good job, ’cause Carmella’s got her eye on you, she laughed as she floated along, following her body to the operating room.
*****
Dr. Martin was just finishing his scrub as Carmella’s body was wheeled past and into the OR. “Shave and prep the right side of her head,” he yelled through the doors to the nurse. “I’ll be right in.”
As the body was transferred to the operating table, the nurses began to prepare for the surgery. Her IV was already in, which was good, and she was already unconscious, which was even better. They shaved, cleaned, and prepped her skull, placing the drapes to cover all areas but the operative site. The anesthesiologist meanwhile had intubated her, and was busy connecting all the equipment needed to monitor her condition during the surgery. A mask was placed over her face, and a general anesthetic was administered. At that point, Dr. Martin took over, securing her head with three Mayfield head pins, in order to keep it perfectly still during the operation. The CT scans were on a monitor, showing him the exact location of the bleeding area, and he was ready to begin the incision.
“Mary, scalpel please,” he asked, looking over at his scrub nurse.
“Scalpel,” she repeated, placing the knife in his hand.
With that, Dr. Martin carefully made his incision and reflected the scalp back to expose the area of the skull under which the bleeding had been found. Carmella had a front-row seat as she hovered over the table, taking in all that was happening to her. She gasped as the doctor reached for his air drill to make an initial hole in the skull. I can’t believe I am watching someone drilling into my skull! she exclaimed to herself. Oh my god, it’s just like a carpenter drilling into a piece of wood!
Using an additional attachment, Dr. Martin cut through the skull and opened a flap of bone to reveal the brain beneath. Carmella gasped. I never even imagined what my brain would look like! she squealed, staring down at her exposed brain. I sure hope he knows what he’s doing! she added with a hint of hesitancy, even though she already “knew” that the operation would be a success. In some manner she had already perceived that it was not her time to “cross over” and that soon she would be returning to her body. She only hoped that she would remember her wonderful and amazing out-of-body experience once she dropped back to a lower frequency and re-entered her body. In the meantime, though, she watched as her doctor cut through the dura mater around her brain to reveal the bleeding area beneath it.
Calling for various instruments and tools, Dr. Martin gradually removed a fairly large (at least to her!) blood clot from her brain, and then cauterized a couple of lingering bleeders that were still oozing small amounts of blood. When he was satisfied that he had removed everything, he placed an intracranial pressure monitor, closed the dura, and approximated the skull, using a titanium plate to hold the bone together. He finally sutured the scalp back together in layers, checked with