Chapter 20—BLOOD PRESSURE DROPPING.

BREA

“Begin the blood that has been prepared. Keep her oxygenation stable, and tell me immediately if anything changes.”

Doctor Jason's voice was calm, but I could hear the tension underneath it. “The bleeding appears heavier than it did a moment ago.”

“I know.”

The nurse increased the suction as more blood entered the field. I moved carefully, trying to identify whether there was another injured vessel contributing to the bleeding. “Don't lose the field,” I instructed. “I need to see where this is coming from. If the blood obscures the area, I can't safely control the source.”

The suction cleared the field for a few seconds.

Then blood surged again.

It happened with such force that a warm spray struck my gown and splashed across the protective shield over my face. The nurse beside me recoiled instinctively, but I immediately steadied my hand.

“Keep working.”

“Doctor, there's a lot of bleeding.”

“I know. Increase the suction and stay with me.”

Doctor Jason stepped closer. “The pressure is falling again.”

“How low?”

“Sixty-eight over forty.”

I could hear the concern in his voice now.

I looked toward the anesthesiologist. “How is she responding to the blood?”

“She is responding, but not quickly enough. Her pressure is still unstable.”

“Then we control the bleeding now.”

My voice remained calm, even though my heart was pounding. I reached for the bipolar forceps again and carefully approached the bleeding vessel. The blood made visibility difficult, so I asked for suction and waited until the field cleared. “There,” I said. “I can see the vessel. Doctor Jason, I need you to hold this tissue gently away from the field. Do not pull. Just give me enough exposure to reach it.”

He positioned himself immediately.

“Like this?”

“Exactly. Hold it there.”

The nurse continued suctioning while I worked. The bipolar forceps touched the vessel, and I applied controlled energy to seal it. The bleeding slowed but did not stop completely.

“Again.”

I repeated the maneuver carefully.

The flow reduced further.

“Once more.”

The nurse's eyes remained on the field as she handed me what I needed.

I worked again, keeping my movements deliberate despite the pressure building inside my own skull. My headache had returned, sharper than before, but I refused to acknowledge it. The patient had no idea that I was exhausted. She did not know that I had been in a car accident hours earlier. She did not know that my son was waiting outside the theatre.

All she knew, if she knew anything at all, was that her body was fighting to survive.

I was not going to let her fight alone.

“Blood pressure?” I asked.

The anesthesiologist looked at the monitor. “Seventy-four over forty-six. It has stopped falling.”

“Good. Keep supporting her.”

I returned to the bleeding vessel.

“There.”

The source had finally become visible enough for me to control it properly. I worked slowly, sealing the vessel while Doctor Jason maintained exposure. The suction continued beside my hand, removing the remaining blood and keeping the operative field visible.

The monitor beeped steadily.

Then the anesthesiologist spoke.

“Pressure is coming back up.”

I did not immediately respond.

I wanted to see it myself.

“What's the number?”

“Eighty-two over fifty.”

A breath I had not realized I was holding escaped me.

“Good.”

Doctor Jason glanced at me. “The bleeding has almost stopped.”

“Almost isn't enough.”

He nodded.

I continued examining the area, looking for any additional source of bleeding. The brain tissue had been under pressure, and every movement now needed to be measured. I used the suction to remove the remaining blood while the cottonoid patties protected the surrounding tissue. When I was satisfied that the major bleeding had been controlled, I carefully inspected the operative field once more.

“There's no active bleeding from the area we've treated,” I said. “Keep monitoring closely. If anything changes, I want to know immediately.”

“Yes, Doctor.”

I glanced at the monitor.

The numbers were improving.

Slowly, but they were improving.

The room seemed to breathe with me.

Doctor Jason looked toward the anesthesiologist. “How is she now?”

“Her pressure is eighty-nine over fifty-five and improving. Oxygen saturation remains stable.”

I nodded.

“We continue.”

The rest of the procedure required patience rather than panic. I continued clearing the remaining blood, checking the operative area carefully, and making sure there was no further source of hemorrhage that we had overlooked. The instruments changed as the procedure progressed, each one serving a specific purpose. The suction kept the field clear, the forceps allowed me to handle delicate tissue and materials with precision, the retractors maintained exposure, and the surgical tools allowed me to work through each stage without unnecessary movement.

At one point, Doctor Jason passed me the instrument I needed before I even asked.

I looked at him.

“You're learning quickly.”

He gave a faint smile behind his mask. “I'm trying to keep up.”

“Then keep doing exactly that.”

The atmosphere had become calmer, but nobody relaxed. We all knew that a successful operation was not simply about reaching the bleeding and stopping it. We needed to make sure the patient was stable before we could consider ourselves finished.

After another careful inspection, I finally looked toward the anesthesiologist.

“How are her vitals?”

He checked the monitor.

“Stable. Blood pressure is ninety-eight over sixty-two. Heart rate is settling, and oxygen saturation is good.”

I closed my eyes briefly.

Not from exhaustion this time but from relief.

“Good.”

Doctor Jason looked at the surgical field.

“The bleeding is controlled.”

“Yes.”

He looked at me.

“You saved her.”

I shook my head slightly.

“The entire team did.”

His eyes moved around the room before returning to me.

“Maybe. But you were the one who found the source and controlled it.”

I looked down at the patient.

A few hours ago, I had been driving away from Beacon Crest because I could not bear the thought of seeing Michael again. I had been running from my past, from the memories I had spent years trying to bury, and from the pain that had returned the moment I saw him standing in that hospital corridor.

Now I stood in an operating theatre covered in someone else's blood, exhausted, shaken, and painfully aware of how quickly life could change.

I had almost lost this patient.

But I hadn't.

“Let's finish properly,” I said. “We still have work to do.”

The team resumed the final stages of the procedure with the same concentration we had maintained from the beginning. Once I was satisfied that the bleeding remained controlled and the surgical field was stable, we carefully completed the procedure and prepared the patient for transfer.

When the final checks were complete, I finally stepped back.

“She's stable enough to leave the theatre,” I said. “Move her to recovery and keep her under close observation. I want neurological checks performed regularly, and if there is any change in her condition, I want to be informed immediately.”

The nurse nodded.

“Yes, Doctor.”

I looked at the patient one last time.

Her monitors were steady.

Her blood pressure was holding.

She was alive.

For the first time since I had opened my eyes in that hospital bed, I allowed myself to breathe.

“Good work, everyone.”

I lowered my hands.

Only then did I notice how badly they were trembling.

And somewhere beyond those theatre doors, my son was waiting for me.