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Grey Sparrow Journal

Issue 30, July 31, 2017
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Broken Pieces

 

by Malikah Goss

 

 

 

A plane crash was an unusual event in Baring, Montana. The hospital staff of Baring Memorial Hospital were well-versed in mishaps like tractor accidents—careless men pulled into their fields by low-hanging clothing caught in the motors of their threshers—or the aftermath of fly-fishing accidents: the curved metal of lures poking through fingers, or even cheeks. Doctor Patricia Lambert had lost count of the number of drunken college boys who’d tried pulling out the lures, leaving ragged holes in their bodies; she could almost suture in her sleep. Her mediocre performance in medical school was enough for the daily traumas in Baring, but when the victims of a plane crash were rushed into her emergency room, she was wholly unprepared.

 

            A commercial red-eye, headed from New York to San Francisco, suffered an electrical malfunction and crashed into the arid farmland at the base of the mountain range that ringed the town. Decades ago the land was full of orchards, producing fruit. Now they only produced dust. Most of the people on the plane died, but the survivors—two flight attendants, an unaccompanied minor and a handful of passengers —had ended up at Baring Memorial, the closest trauma center.

 

            “Doctor Lambert? The last crash survivor is pulling in to the ambulance bay. Possibly some internal bleeding, and a broken pelvis.” The head ER nurse called out the vitals as Patricia fumbled through a tracheotomy on the flight attendant who’d stopped breathing just as the paramedics wheeled him through the door.

 

“Dammit! Get me another trach tube,” Patricia yelled out as the first tube bounced across the floor. On her second try, she lined up the breathing tube with the incision she had made. “Page Doctor Waldman,” she shouted to one of the nurses. “Tell him we’re sending this one up with smoke annihilation…I mean inhalation. He needs to be on a monitor immediately.”

 

            As the team wheeled the flight attendant away, Patricia mentally kicked herself for the verbal flub. Although she was the chief resident, she was the only doctor on staff from outside the Midwest, and constantly worried that the other doctors were skeptical of her abilities. After wasting four years of time, and her parents’ money, at Brown University (she took classes like “Are there Extra Dimensions Under Your Bed?” as pass/fail and was rarely seen in an actual lecture hall), she chose the path of least resistance. Unlike her friends who had solid goals for becoming teachers, accountants, or actors, Patricia couldn’t imagine leaving the comforts of dorm-living, let alone pursuing a career. Her parents dreamed of having a doctor in the family. When she scored well on the MCATs and was admitted to the prestigious Einstein Medical School, she saw it as a sign to continue having someone else be concerned with her utility bills and meals.

 

            “Name on the driver’s license says Soledad Vargas,” the paramedic read from the notes. “She presented as dehydrated, so we hung a bag of saline. There’s an obvious pelvic fracture. Administered 2ccs of Demarol in the field.”

 

            Patricia looked over the paramedic’s notes as she helped wheel Soledad Vargas down the hall. “Let’s get an x-ray and prep her for surgery.”

 

You have what it takes to be extraordinary.

 

Patricia wanted to believe her mother’s words, as they ran through her mind. Throughout her years in school, she’d wanted to make her parents proud, but couldn’t deny the temptation to skate by on her mediocre talent for memorizing facts. After graduating fifth-to-last in her medical internship, Baring Memorial was the only surgical residency she’d been offered. She knew she should be grateful after her dismal performance—the bottom three in the class had failed to match anywhere, leaving one heading off to business school and the other two scrambling to find any job to help pay their student loans. Patricia was lucky to be at Baring Memorial, but when her classmates bragged about their residencies and fellowships at Hopkins and Cedars-Sinai, she wanted to pound her fist against the wall.

 

The woman grabbed Patricia’s wrist, her skin hot and dry from the smoke at the crash site. The grey of the woman’s irises were clear. Patricia could see threads of green in them.

 

“Dance,” she croaked. Patricia replaced the oxygen mask, pulling away from her grip.

 

“We’ll take good care of you. Don’t worry.” Patricia watched them wheel the woman into the elevator. She felt off-kilter from the short exchange. There was something familiar about the woman’s face. And her name…In the midst of signing patient charts, the pieces clicked together. Years earlier, just before she’d started at Baring, Patricia and some friends went to Barcelona, where she’d seen Soledad Vargas dance flamenco. The experience of watching Soledad dance—clearly a star in the dancing world—had humbled Patricia and now she felt a tingling anxiety building inside, as the magnitude of what she needed to do settled in on her.

 

On the whole, Patricia was skilled enough at her job. She was a better orthopaedic surgeon than her colleagues who’d graduated from third-tier medical programs.  But her ability to fix Soledad’s injuries would likely dictate whether the woman would dance again.

 

“She wants to talk to you, doctor,” one of the nurses said, poking her head into the scrub room.

 

“Why? We really need to get started soon.” Patricia hoped the nurse couldn’t hear the whine in her voice.

 

“I know, but she said she can’t go through with the surgery without speaking to the doctor first.”

 

“Fine. I’ll be right out.” As Patricia scraped under each of her fingernails, her hands shook with a mixture of anxious excitement and fear: this was Soledad Vargas.

 

After three carafes of wine, in a small café, and hours of flirting with the sun-soaked men at the adjacent table, Patricia found herself heading into a crowded amphitheater, pitch dark except for a bright spotlight on the raised circular platform.

 

            Patricia was always surprised by how frigid the operating room was, the thermostat set at fifty-eight degrees. She approached the operating table and came around to face Soledad.

 

            “The nurse said you wanted to talk with me? We should get started soon, get that fracture fixed.”

 

            “You’re very young.” Soledad Vargas’ breath was labored, but her eyes were alert, pupils dilated. “Are you the best?”

 

            Patricia felt her tongue stick to the roof of her mouth.

 

            “Doctor Lambert’s one of our very best surgeons,” the scrub nurse interjected. “You’re in good hands, Ms. Vargas.”

 

            As Soledad nodded, her eyes closed.

 

            “Her pressure is dropping, Patricia. I’m going to put her under now,” the anesthesiologist said.

 

“What are we doing here?” Patricia tugged at the arm of her friend Carrie, a blonde Californian about to head off to a fellowship in pediatrics at Sloan Kettering.

 

            “Shh.” One of the men from the café shushed her, as a woman walked out onto the platform. Her skin was the color of oiled bronze, her back highlighted by the deep cutout of her fitted bodice. Her hair was russet, shiny and pulled back in a severe bun, a sharp side-part revealing the bright pink of her scalp. Around her waist she wore a black, fringed shawl, knotted on the side. The shawl sat atop a six-tiered, cobalt blue skirt that billowed to the ground in a swirl of ruffles, reminding Patricia of a mermaid’s tail. Her top was the same cobalt blue, with three-quarter sleeves that ended in more ruffles. Patricia couldn’t see the woman’s face. Her back was to the audience.

 

Now Patricia was glad she couldn’t see Soledad’s face. Soledad was laid on her side; her hip, surrounded by surgical napkins, was now the deep brown-red of the iodine used to prep the area. Patricia made her first incision.

 

            “Retraction.”

 

            One of the assisting interns dabbed away the blood caused by the retractions, revealing the bruised joint muscle. Beneath that, the pelvis, whose shape so often reminded Patricia of the continent of Africa, had been cracked, separating just above Kenya. She took a deep breath as she gently moved Soledad’s bladder aside. It had a tear, where the rough edge of the pelvic bone had scraped it.

 

            “I need suction,” she said to her surgical team. “There’s a lot of bleeding here.” Once the field of view was clear, she could get to work. She neatly sutured the outer wall of the bladder before diving into the major part of the surgery. “Luckily the femoral head isn’t broken.” She looked up at her intern. “No need for a hip replacement.” With a steel hip replacement Soledad would definitely never dance again, the way she did that night.

 

            The woman’s arms lifted, long and lithe above her head, her fingers curved forward. Next came her feet. At first Patricia thought she was still listening to the guitar, but the notes were sharper, lower than those the instrument could create. The dancer swooped her arms down, grabbed the fabric of the skirt around her hips and lifted, revealing the swift movement of feet encased in heeled tap shoes. Patricia tried to follow the rhythm of the dancer’s steps, along with the feel of the guitar music, but the woman seemed to be simultaneously dancing in, around, on top of and below the distinct rhythm of the guitar. Although her feet barely moved across stage, they still created a rapid-fire sound. Chakka-ch-chakka chakka. Chup, chakka, chup chup. Each note was an individual entity and a partner to the one before and after it.

 

            As Patricia pieced Soledad back together with screws she wondered if she’d been heading toward this moment all along. A broken pelvis was one of the hardest injuries to treat for orthopedic surgeons. But she needed to fix Soledad—make her dance again.

 

            Finally the woman turned around. She had striking features: high cheekbones, deep-set eyes with long lashes that cast shadows across her cheeks. She had a thin top-lip and full lower one, both enhanced by a slick of bright red lipstick.

 

            When the guitarist stopped, the woman’s dancing took on new fervor, clacking and stomping in half circles. She swallowed up the stage with her presence. Patricia perched on the edge of her seat when the dancer began clapping an alternate rhythm to the one her feet were tapping. The movement felt on the brink of cacophony. Just as it seemed the dancer couldn’t keep up the differing rhythms and the persistently faster pace she’d established, she gave two loud claps, swung the fabric of her skirt though the air and stopped. There was a moment of silence before the entire theater erupted in applause.

 

            “Shit! Get me some suction in here!”   Seeing the ooze of blood and bile, Patricia knew she’d done something wrong.

 

As the field cleared, Patricia could see that she’d screwed the two pieces of the inner ring of the pelvic bone too tight, cracking the ileum like a baseball hitting a window, hairline fractures radiating out from the center. Part of the ileum had chipped as well, nicking the lower intestines. It was fixable, but the fractures would weaken the pelvic bone; it would always be fragile.

 

            “After we clear this debris I’m going to need a seven grade suture and the mesh patches.” Patricia moved quickly to fix her mistake. She kept her eyes on Soledad’s body, open and vulnerable to her, but could feel the apprehensive looks her surgical team was giving her.

 

            ¡Soledad! ¡Te quiero! (Soledad! I love you!)

 

            ¡Quiero casarsele! (Marry me!)

 

            Within minutes the stage filled with bouquets of flowers. The woman did not acknowledge the flowers nor the audience; she turned her back to the crowd and glided off the stage.

 

            “Patty, let’s go. There’s a disco down the block. They say it’s got good dancing,” Carrie said pulling Patricia’s arm. But she couldn’t move; she could barely breathe. How could she go into the strobe-light-spotted disco, gyrate her hips and pump her arms against sweaty men, and call it dancing? It would seem like a lie after what she’d just witnessed.

 

***

 

Eight days later, Patricia knew the extent of the damage. She’d needed to cut Soledad open a second and third time, to assess whether the sutures and mesh patches were holding everything together. In the last surgery she was able to remove the drain inserted for fluid build-up and her team rigged Soledad up in a harness, so that her hip was stabilized.

 

            “Doctor Lambert? Mr. Vargas is still waiting.”

 

            “Thanks.” Patricia filed a set of  paperwork for one of the other survivors—the unaccompanied minor who’d managed to escape with only a concussion and a broken tibia. It was a clean break, easily fixed.

 

            She pushed open the waiting room door with the meat of her shoulder. Family members of the other survivors had camped out on hard plastic chairs, their heads bent in prayer.

 

            “Teodoro Vargas?” Soledad’s husband had called frequently for updates, as he hurried to rent a car and driven to Montana from the Bay Area. All the families of the survivors had driven.

 

            A short, barrel-chested man with shoulder-length black hair straightened up from leaning against the cheery floral wallpaper-covered wall.

 

            “Are you the doctor?” Teodoro Vargas had maroon shadows underneath his eyes, but his pupils were clear and alert.

 

            “I’m Doctor Lambert. I’ve been treating your wife.”

 

            “How is she?”

 

            “She’s recovering from surgery. I can take you to her—”

 

            “Yes, yes. Take me to her.” His hand clamped around Patricia’s elbow. She could see tears welling in his eyes and resisted the urge to wiggle out of his grip.

 

            “I have to warn you, even though she’s stable, her condition is still critical.” He silenced her again by gripping the cuff of her coat with his other hand.

 

            “Take me to my wife.”

 

            The two walked down the hallway, making a series of left and right turns, stepping out of the way of bustling hospital workers. Patricia opened her mouth to tell him about the time she had seen Soledad dance, but instead bit her lip and kept walking. They stopped three doors from the end of the hallway and she placed her hand on the doorknob, preventing him from entering the room.

 

            “Mr. Vargas, your wife’s condition is very serious.” She shifted into formal doctor mode. “Because of the force of the plane crash and where she was seated, her body was thrown about quite a bit. She suffered multiple cuts and bruises, but the injury we were most concerned about was her broken pelvis.”

 

            He pushed Patricia aside and opened the door. She followed silently behind him. Soledad lay still on the bed, her hair kinked out in matted waves around her shoulders. Her bruises created a camouflage pattern around her collarbone.

 

            “Luckily there was only one break in the pelvic ring, which we were able to join—”

 

            “Who is we?” He laid a tentative hand atop Soledad’s, careful not to jostle her.

 

            “I beg your pardon?”

 

            He looked Patricia in the eye. She balled up her hands in the pockets of her coat and tried to maintain eye contact. She could feel adrenaline pumping through her, making her feel antsy. She finally ducked her head, breaking eye contact.

 

            “You keep saying ‘we.’ Is there someone else I should be talking to about my wife?”

 

            Patricia pulled her hands from her pockets, crossed and uncrossed her arms. She pulled Soledad’s chart from the end of the bed. Her own scrawl filled the spaces noting medication dispersal, blood pressure and other vitals.

 

            “I mean I. I was your wife’s surgeon. I was able to repair the fractures with surgical screws. A piece of bone chipped, puncturing the lower intestines, but we—I was able to repair it, as well as relieve the pressure against the blood vessels that were constricted because of the break.”

 

            “But she’ll be okay?”

 

            “I don’t want to sugarcoat things for you. What your wife has been through was traumatic to say the least. She has a lot of healing and physical therapy ahead of her. If she works hard she’ll be able to walk again with little sign of the surgery…”

 

            “But?”

 

            “I’m sorry, but in my—in my professional opinion (I broke her), she’ll never dance again.”

 

            He sat on the edge of the bed opposite of the broken hip, leaned down and smoothed the stray hairs from Soledad’s forehead. His mouth moved as though in prayer or song. Patricia couldn’t tell if he hadn’t heard her or was choosing to ignore her diagnosis. She needed him to hear her, to understand what she’d been unable to do.

 

            “Mr. Vargas, did you hear what I told you? Your wife will never dance again.”

 

            “Teo. My name is Teo.” He said it so quietly Patricia had to lean in to hear him. “What’s your first name, doctor?”

 

            “Patricia,” she replied after clearing her throat. He stood up and walked over to her. As he raised his arms, Patricia flinched, afraid that he was going to hit her. Instead, he wrapped his arms around her. Unsure of how to react, she left her hands at her sides.

 

            “Thank you, Patricia. There are so many people who have lost family. Thank you for saving mi amor.”

 

            When he pulled back, she could see his face was wet with tears. As he moved back to Soledad’s side, Patricia lifted her arm, a delayed reaction to his hug. She could see that Soledad was beginning to stir. Patricia had managed to avoid being in the room when Soledad was awake. Now she headed for the door.

 

“Wait! Doctor, she’s awake.”

 

Patricia approached Soledad’s bed with apprehension. She could see the woman fighting against the soporific effects of the pain killers. Soledad pulled at the blanket covering her torso.

 

“Just relax, Mrs. Vargas. You’re in the hospital. You’ve had surgery.”

 

“Sí mi amor.” Teo patted his wife’s hand. “Cuidado.” He propped Soledad’s head up to feed her a handful of ice chips. “This is the doctor who fixed you.”

 

Patricia kept her gaze on the floor.

 

“I’ll just leave the two of you. A nurse should be in to check on her—” Patricia sucked in a breath of surprise as she felt Soledad grab her hand. She watched as the woman struggled to speak.


“Gracias.” Soledad’s eyes were wet with tears and as she finally gave in to the drugs, closing her eyes, a tear slid down the side of her face, into the dark recess of her ear canal.

 

Patricia pulled her hand from Soledad’s and left the room, closing the door softly behind her.

 

            “Doctor Lambert?” A young nurse approached Patricia, a clipboard in her hand. “Can you sign the transfer orders for Mr. Klein? He’s stable. Blood pressure and heart rate holding.” She took the clipboard and signed. The nurse looked beyond her, through the window of Soledad’s room. “You know they’re still finding bodies a few miles from the crash site? I bet she feels like she won the lottery. I can’t even imagine what that all must’ve been like…”

 

            Suddenly Patricia couldn’t breathe.

 

            “Are you okay?”

 

            Without responding, she jogged down the hallway, eventually sprinting for the doctors’ lounge, slaloming between orderlies, nurses and patients.

 

            Bursting into the lounge, she was glad to find it empty. The room was cold; someone had left the window open. She sank down on the lower bunk of a mattress so thin she could feel the bottom of the springs. She tried to slow her breathing, inhaling for two, exhaling for three.

 

            One, two…one, two, three.

 

            She looked at her hands, her pale palms crisscrossed by dark brown lines. Her mother had told her the longest line, stretching from the outside of her palm across the middle, was her lifeline. She was destined to have a long life.

 

            And what about Soledad’s life? Would not being able to dance be the same as dying? Patricia reflected back on all she had done to piece Soledad back together. Maybe if she’d studied harder in medical school, instead of relying on the prestige of her program and her parents’ belief in her ability to catapult her across the finish line, she would’ve known when to stop tightening the screws. What could Soledad do now? Was there a Baring, Montana for dancers?

 

            Hot tears smeared those dark brown lines, as Patricia cried into her hands, wishing she could believe her mother’s words, even now. Wishing, for Soledad’s sake, she had been extraordinary.