It helped Mott to think of blood as the enemy, the foot soldiers of an opponent that would willingly sacrifice its entire army to defeat him, the surgeon. All the enemy needed was a chance—a hand that jerked suddenly at the wrong instant; a small tremor of the fingers, barely perceptible to the naked eye; the cautery lingering too long in one place. Any such mistake would do. Mott had learned long ago that his opponent was a patient one; that he would take full advantage of whatever mistake he might chance to make.
As Mott returned to work, his skilled and practiced hand tugged once too often and too long at the rubbery mass of tissue that ran along and within the crucial vein. Suddenly, as the tumor rolled back, the field was awash in dark red, that irritating color of blood devoid of oxygen that announces a vein is open and the enemy's foot soldiers are on the move. Jimmy P's blood percolated into the field with a determination and gusto that only a liquid can muster. It didn't jet out in a stream, rather it rolled out across the land like the waters of a flood overtaking all in its wake. The amount of blood was truly phenomenal, but Mott's response was immediate and equal to the task as he grabbed a sponge and pushed it into the opening in the boy's head. He aimed to block the egress of the foot soldiers. In this he was only partially successful.
"Suction, I need suction," he said in the peculiar way that a surgeon has of addressing everyone and no one at the same time, nonetheless expecting an instant and measured response. Though sweat beaded his forehead, his voice was a calm one; this battlefield was familiar territory.
"I've got some bleeding here." A crater had opened.
"He's tachy," said the anesthesiologist as he peered over the drapes. He worked feverishly to support the blood pressure and watched as his sleeping boy's heart rate skyrocketed. Having no more blood to give at the moment, he gave salt water instead. Jimmy P's circulation, reminiscent of a closed hydraulic system, was beginning to shut down as blood, the vital oil that primed that system, poured out from the surgical wound at the top of his head. This had the effect of lowering the pressure in the lines, the miles of arteries and veins that coursed here and there throughout Jimmy P's body like the most intricate plumbing system ever devised. His body's natural response was to increase the heart rate, to accelerate the pump—a protective mechanism that could go only so far before it too failed. The climbing heart rate was thus ominous, a sign of impending doom.
"I can't keep up," the anesthesiologist reported. The crater was growing faster than dirt could be shoveled into it.
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