It’s 2:30 a.m., and pagers across UC Medical Center begin to beep insistently with a message that a surgical patient on the second floor needs urgent, life-saving care.
Two nurses run by at full speed as Dr. Jay continues his brisk, steady pace toward the room with the flashing lights: White, green, red, red. White, green, red, red. The lights and the sound of calm, but loud, voices in the patient’s room show the intensity of the situation — a "code," in hospital-speak.
The patient’s heart had stopped beating in the middle of the night, and Dr. Ham and others gathered in the room are performing chest compressions.
Dr. Jay enters the room and takes a position at the head of the bed.
"May I see the monitor, please?"
Then: "Epi, please."
After only a matter of seconds, Dr. Jay determines that the patient needs an airway. He carefully inserts a tube into the patient's trachea, creating a pathway to provide the patient with oxygen. These and other efforts would ultimately save the patient’s life that night.
Afterward, Dr. Jay heads back to the OR, while Dr. Ham heads for the trauma residents’ lounge to refuel with a salad while completing notes and reviewing scans in his patients’ charts.
Ever the teacher, Dr. Jay has answered many questions already tonight. But while striding down the same hallway he’s traveled at least six times already, he fields one more:
"Do you ever get used to being wide awake in the middle of the night?"
"It’s like being in Las Vegas," he jokes. "There are very few windows, so you don’t actually know what time it is."
Among the two dozen operating rooms on the second floor of UC Medical Center is one that has a single word on the door: “Trauma.” No matter what else is happening in the hospital, that room is reserved 24/7/365 to provide emergency surgical care to trauma patients.
Tonight, Dr. Rice and Dr. Person are in the third hour of surgery to reconnect parts of a young patient’s small intestine, which had been separated as a result of multiple gunshot wounds. The patient has already undergone one surgery, and there are likely more in the future.
The surgeons move in perfect harmony. They work calmly and quietly together, both fully focused and using a myriad of skills to suture, tie, staple, cut and repeat as two pieces of intestine are returned to a continuous tube, repairing the patient’s digestive tract.
Light jazz music had been playing earlier, but now the only sound in the room is the steady beep of the heart monitor as the two surgeons, a scrub nurse, anesthesiologist and circulator — a nurse assigned to keep the flow moving and replenish supplies — focus upon their patient.
Multicolored cords hang like long, tangled hair from a mobile computer station near the head of the bed. Every now and then, Dr. Rice lifts a foot and rotates her ankle.
"Time to scan," says Lin, the scrub nurse.
Everyone takes a step back from the bed as Dr. Rice sweeps a large, circular, wand-like instrument over the patient’s open cavity three times, listening for an indication that a microchipped sponge or gauze might have been missed in the visual inspection. Hearing no beeps, the surgeons begin the work of closing the incision that extends from the patient's breast to belly.
For Dr. Jay and many other physicians at UC Medical Center, teaching young physicians this delicate dance — a surgical ballet, you might say — is what sets an academic hospital apart from others.