The elevator came to a stop and both women exited, making their way to the trauma suite. Danni silently offered a prayer for the patient’s safe keeping and quickly readied herself to assist in the patient’s care. Garrett gowned and prepared mentally for the next battle.

Rosie turned the corner of the hall and smiled silently to herself at the sight of both Danni and Garrett standing ready and waiting. ‘Way to go, Danni.’

"So, everything alright?" Rosie looked at the nurse as she donned her lead apron.

"Yeah, and you?" Danni returned the cryptic verbiage.

"I‘ll be okay. You know how fast I bounce back." Rosie winked at her co-worker.

Garrett cleared her throat, "Sorry about the gender confusion."

"Not your fault, doc." The nurse assumed her assigned position next to the Trauma Fellow. "I think the air will clear on this one."

Garrett smiled under her mask. She sniffed the air lightly and commented, "I think it smells pretty clear already." There was a glare to her eye and sarcasm in her voice.

"Well, you would have liked it if you were a guy. Trust me, doc." Rosie was being apologetic.

"Trauma in the Department…Trauma in the Department."

The atmosphere hurriedly became sober. Garrett surveyed the room and saw everyone at their stations as the stretcher was wheeled in. The peculiar shape of the young patient’s head grabbed the surgeon’s attention. It was apparent that the young woman had been the victim of an aggressive attack. The blood pooled in large clots underneath the short matted hair. It was impossible to ascertain it’s true color. The blood was oozing everywhere. The patient was transferred off of the helicopter stretcher on the long board that was underneath her and the Fellow gingerly started assessing the battered woman’s head. The skull felt soft and with no true form. The bone fragments were easily moved under her gentle touch. The surgeon swore under her breath at man’s savageness to his own kind. It was something that she would never understand.

"X-ray, get the chest and abdomen and a lateral C-spine. Karen call for Neurosurgery and alert CT Scan that we will need a very quick head." The surgeon snapped off her blood-covered gloves and reached for a new pair. The whole time, her eyes kept surveying the patient’s body for bruising or any evidence of further trauma. Seeing none, Garrett began to evaluate the woman’s body starting at the shoulders and working her way to the feet. The skilled hands swiftly felt for bony integrity while her eyes scanned the area for asymmetry. The surgeon slowed her assessment when she reached the abdominal area. This was her prime area of expertise. It was an area that could hide injury and she knew it all to well. The painstaking ritual of examining the abdomen for softness or rigidity or rebound tenderness was now addressed. Feeling no rigidity the surgeon sighed in relief. But the knowledge of protocol dictated that the patient would receive one of two courses of treatment, Diagnostic Peritoneal Lavage often referred to as DPL or exploratory laproscopy surgery while neurosurgery would operate on her brain and skull. Time was of the essence for this young patient. Trivoli chose appropriately to run to CT Scan for the head and do the exploratory surgery in the O.R.

Garrett looked over at the charge nurse, "Is CT Scan ready for us?"

The nurse nodded her head as she talked on the phone.

"Danni, let’s pack her up and move her over to CT." The surgeon was in control; "Neurosurg can see her there."

"Neurosurg will be down as soon as they can. Dr. Shevchik doesn’t want you to delay the CT Scan, he will meet you there." Karen bellowed out loud and clear for all to hear as she hung up the phone.

"Okay, people, you heard that. Now let’s move out." The voice commanded obedience.

Danni hastily transferred the EKG monitor wires to the portable unit. Rosie connected the Bag Valve Mask and oxygen tubing to the small portable tank and turned off the room supply. The young intern positioned at the patient’s left thigh hurried to finish the last of the blood draws from the femoral stick that he had accomplished only to drop one of the tubes causing it to shatter on impact with the floor. All action stopped and an uneasy hush fell over the room, standing out loader than any freight train hurtling noisily down its rickety old track.

The cold eyes of the surgeon shot daggers at the cause of the delay. All eyes fell on the lowly intern as he hung his head looking down at the floor where his inadequacy had been made known. The surgeon’s eyes fell also on to the floor where instead of a shatter test tube and wildly patterned blood splatters, she saw the marring of not only her shoes but also that of her perfection in treating the patient. How could she make them understand that it had to be perfect, she had to be perfect?

With disgust at her now failed attempt at perfection this time around, she sighed. Laying the blame at herself for allowing it to happen, for letting an imperfection to slip by her. ‘You let this happen. You are to blame.’ The voice inside of her head screamed at her. She tried to pick up the pieces of her failure as she brushed past him without saying a word. Slowly, the rest of the group followed suit and resumed the effort to mobilize the patient. The intern stood back against the side of the room watching the stretcher go by.

Within a minute the entourage of players in this drama made their way into the hall and down to the CT Scanner. The pace was even and slow to accommodate the Respiratory Therapist who was using the Bag Valve Mask to artificially breath for the intubated patient. It was a team effort and everybody knew his station as they entered the scanner. The stretcher was positioned next to the scanner table. The well-practiced maneuver of transferring the patient to the scanner was accomplished with little effort and the team logrolled the patient while the surgeon evaluated the back of the patient. Satisfied that no obvious injuries were there, the Fellow removed the blood stained clothing from under the patient throwing them to the floor. The spine board was then removed and the patient rolled on to her back and positioned for the head scan. The Respiratory Therapist connected the endotracheal tube to the ventilator. The doors were closed and the group made their way into the control room for the Scanner.

The technologist was busily typing onto the computer screen the patient’s information. With several motions, the screens quickly changed and the machine began to hum as it acquired the images of the young woman’s traumatized head. They all watched closely as each image was displayed across the screen. The sight was enough to turn your stomach. The bones of her skull were literally in pieces. The soft tissue was expanding with blood and the brain tissue showed extensive bilateral subdural hemorrhages. The young woman’s prognosis was not good at all. ‘What could she have possibly done to deserve this?’ Garret was appalled at the thought. No one deserved this treatment. Her heart ached for this patient and whatever family she had.

The surgeon looked up from the computer screen to see Danni trying hard to keep her emotions in check. She was a professional but that didn’t mean that she didn’t feel. A tear was gathering in the corner of her eye and slowly spilled over, running down her cheek. The young nurse brushed it away with the back of her hand, hoping that no one had noticed. Little slipped past Garrett without her noticing. It was just her nature, being always on top of things as they happened around her.

"Well, what do we have?" Dr. Shevchik questioned as he entered the room. He took stock of the faces as he made his way over to the computer screen. He didn’t like the hushed atmosphere and the shocked look on some of the faces. He reached the screen and stood frozen as the technologist quickly scrolled through the images. "Jeez, I don’t think we can do much for this one, but let me call my Attending at home." The neurosurgeon let out a long whistle. "What the hell did she get hit with?"

Garrett stood next to him. She stared at the patient through the leaded glass in the control booth and said stoically, "Baseball bats."

The neurosurgeon made a phone call to his Attending and relayed the details of the patient and her injuries. The discussion lasted only two or three minutes before the phone was placed back into its cradle. The man took in a deep breath and announced, "The boss wants to give it a try because of her age. We’re going to the O.R."

The team looked at each other and you could sense the small spark of hope that was beginning to take hold. Without any direction each knew what had to be done and went into action. Bodies were moving, doors opening, telephone calls to alert the O.R. of their need for a room, all happening simultaneously. She had a chance, slim as it was, but that was not going to stop them. They were here and they were willing to give it their all. Before anyone realized it, the patient was removed from the scanner and transported to the operating room.

The hand off at the O.R. was smooth and orderly. They were waiting at the desk when the trauma team came through the door. It was beginning to be an expected site, Trivoli and her crack team whisking in another traumatized patient. The rumors were already starting. This doctor was making a name for herself, no one had ever been so calm and in control as Garrett Trivoli, not on their first day. Although it was the team that accompanied her that was beginning to look battered and beaten up by her all consuming drive for perfection.

Danni and Rosie waited for their portable equipment to be assembled, while they handed over the accumulated paperwork to the nurse at the desk.