Suspense with medical drama element

Richard Mabry is a retired physician, so I wasn't surprised to see that the main character in chapter one is a surgeon. This one grabbed me from the start and didn't let go.

CAUGHT IN THE TORRENT
Richard L. Mabry

Prologue

He watched her stride purposefully toward her car. She thumbed the remote, threw her purse and a backpack onto the passenger seat, and climbed in.

[The second sentence shows good writing instincts. “She thumbed the remote.” Thumbed is concise. One word versus “pushed the button on”. And there’s no need to elaborate because the type of remote is made clear in the rest of the sentence.]

She pulled out of the parking garage. He followed, keeping a couple of cars between them.

He gradually closed the gap until he was directly behind her. He watched her head, alert for any movement toward the rearview mirror. No, she seemed oblivious to his presence.

[Normally, you want to simply show what the other person is doing instead of saying “he watched” what she was doing. In this case, he is following the woman and watching her, so it’s more acceptable. But it’s not great. The first sentence of the book would be stronger with some sort of action on his part. And the second sentence in the paragraph above could be stronger, too.]

Now her hand beat time on the steering wheel, her head bobbed rhythmically. He hoped she wasn’t listening to some of that awful heavy metal stuff. He liked to have music playing when the time came. But it didn’t matter what she preferred, did it? He always got to make the choice.

[Creepy (and by that I mean great) foreshadowing.]

She rolled through a stop sign with only a tap of her brakes. He came to a full stop before following. Two blocks further, she put on her blinker and turned onto a quiet residential street. He stayed a cautious hundred feet behind her.

Her brake lights came on. She wheeled into a driveway and stopped. He drove well past before easing to the curb.

He slumped down in the seat, silently cursing the loose spring that jabbed him, and adjusted the rearview mirror until it captured her image. He watched her until she disappeared through the front door. Then he eased upward in the seat, started the pickup, and pulled away.

He knew he’d be back. [He knew is another thing to avoid. We’re in his head, so he’s the only one who could know it. Cutting straight to the point is much stronger.]

Chapter One

"Okay, get him on the table and prepped. Move it, people!" Dr. Ben Merrick’s voice echoed back at him from the green tile walls of Operating Room One.

He strode to the table in the rear of the room, broke open a gown pack, and shoved his arms into one of the sterile garments. While the circulating nurse tied the strings of his gown, he snapped on a pair of latex surgical gloves.

Ben turned his head to look at the boy who lay on the gurney like a blood-spattered rag doll, his face almost as white as the sheet that covered him. Intravenous lines snaked into both arms. A small green tank between his knees fed oxygen into his nostrils via a plastic cannula.

Ben knew every second was precious. He barked, "Rick, John, move him over—now!"

Out of the corner of his eye, he saw the anesthesiologist and the surgical resident lift the patient onto the operating table and use blunt-nosed scissors to cut away the last of his clothing.

Ben pivoted toward his scrub nurse, Kathy, who was rummaging through a jumble of surgical instruments from an opened sterile pack. She pointed to the ones she had selected as essential, now lined up on the Mayo tray and ready. He nodded his approval.

"John, pour some Betadine on his belly," [Since every second is precious, maybe his order should be cut to “Betadine.” And if anyone doesn’t know what John is supposed to do with Betadine, it’s explained in the next paragraph.] Ben said. "We don't have time for the niceties here."

John picked up a plastic bottle and doused the boy’s abdomen with antiseptic solution, turning its fish-belly pallor to a coppery red. Before the last drops had run down the patient’s flanks, Ben grabbed the edge of the gray-green draping sheet Kathy was holding. With practiced efficiency, they spread it over the boy’s abdomen, centering the opening in the sheet on his navel, leaving only an impersonal rectangle of skin exposed. [Impersonal rectangle. Great description.]

“Is that it?” Ben asked. There were affirmative responses all around. He stepped to the operating table. "Give us some light here.”

Willing hands adjusted the ceiling-mounted, high intensity lights to focus their glare on the boy’s bare belly. “Better,” Ben said.

Ben turned to his right. Kathy nodded and held up a scalpel, handle first.

He saw that John, now gowned and gloved, was in place across the table from him.

Ben looked toward the head of the table where the anesthesiologist was holding a black rubber mask tightly against the boy’s face and rhythmically squeezing the bag of the anesthetic machine. "Rick, keep giving him oxygen, but no anesthetic unless he starts moving. I don't think he's feeling anything right now."

Ben took one deep breath, then held out his hand for the scalpel. Without hesitation, he plunged the razor-sharp blade in a single motion through skin and fat. He dropped the scalpel on the instrument tray and made a snipping motion with his first two fingers. Kathy slapped a pair of heavy scissors into his palm, and he began to separate the muscles of the boy’s abdomen.

Ben threw a quick glance at his assistant. "Keep up with me, John. Just clamp the skin bleeders, we'll tie 'em off later. We’ve got to get to the source of this bleeding."

Ben moved back as a gush of dark blood spilled over the side of the incision. “I’m through the peritoneum now. John, get that suction in there. Lap pads, Kathy.” Ben stuffed the large absorbent pads into the depths of the incision. "It's dark in there. More light. John, put in a self-retaining retractor."

The resident inserted the device, and brilliant cones from two portable spotlights illuminated the depths of the wound. "Okay, Dr. Merrick?" John asked.

Ben nodded once. He held out his hand and made a pinching motion with his thumb and forefinger, signaling for a surgical clamp.

Come on, Ben. Don't think about who this is. This is surgery 101. You can do it in your sleep. Open the belly, find the bleeding point, clamp it off. Steady. [I like that it isn't revealed until now that he knows the boy. And it's left as a hint. Mystery is what keeps me reading. No need to tell everything up front.]

He struggled to keep his focus, barely hearing the standard question: “I’ve got surgery starting at 0135. Right?” He kept working.

“John, suction there. Kathy, I’ll need more lap pads to soak up some of that blood.” Ben felt motion beneath the drapes. He looked up toward the head of the table. “He’s moving, Rick.”

"I've been giving him just a whiff of nitrous,” the anesthesiologist replied. “I’ll paralyze him with some Sux, then breathe for him."

The boy’s inert body jumped momentarily [unnecessary adverb, since we see the body relax in the next sentence.] when the curare-like drug hit his muscles. Then it relaxed and lay still.

Ben fidgeted while the anesthesiologist inserted a tube into the patient's windpipe and connected it to an automatic respirator.

"That’s good, Rick. Just enough nitrous to keep him still," Ben said, anxious to resume his search for the source of the bleeding that threatened the boy’s life.

"Doctor, the blood bank sent up two of the units you ordered. They're cross-matching more." [I’d like to see a new paragraph here. Then Ben’s dialog (below) can stay with his action and avoid a speaker attribution.] Ben glanced up and saw the night supervisor in the doorway holding two plastic blood bags.

"Give 'em," Ben said. “And get the rest up here as soon as they’re ready.”

Too many interruptions. Concentrate. Ben narrowed his focus to the area bounded by the self-retaining surgical retractor. He squinted, straining to see the pulsations of blood that would lead him to their source.

"Ben, he's losing blood faster than I can pump it in." Rick’s voice sounded calm, but his meaning was clear. "His pressure’s almost nonexistent."

Ben’s eyes remained riveted on the operating field. He pointed with the hemostat in his hand. "John, put a ribbon retractor right there and suction next to it. I think we’re getting close.”

The lights felt hot, and Ben sensed sweat trickling down his back, his chest, his neck. Someone dabbed his brow, but he couldn’t tolerate the distraction. “Not now,” he snapped.

"Ben, did you hear me?” Rick’s voice had lost any pretense of calmness. “I said, he has almost no pressure and his pulse is irregular. He's almost bled out."

"Keep him oxygenated, Rick. We’re close to finding the bleeding point.”

The flood of bleeding into the abdominal cavity had slowed to a trickle now. "Here it is," John said, pointing with the tip of the suction tube. Ben felt his throat tighten when he realized what he was seeing.

"There's a tear in the aorta.” Ben held out his hand. “Aortic clamps, Kathy. Rick, try to—"

Ben’s words were swallowed by a high-pitched scream from the cardiac monitor, followed by Rick’s cry, “He’s arrested.”

Excellent writing. Very few rough spots to interrupt my enjoyment. I wouldn’t be surprised to see this in print in the near future.

Check out Richard’s blog, Random Jottings, which is full of great writing resources, and thoughts on writing.