Blood

***

She was hard in the hospital, hard as any battle-hardened soldier I had worked with, or worked on. Here, though—stretched out in my bed like a cat in the sun, practically purring under my touch—here, she was all toned curves and smooth skin, soft lips, softer sighs.

I didn't deserve her, but here she was. Soft and hard, fragile but damn near unbreakable.

***

The trauma room was a chaos of nurses and residents. Cristina intubated, and a nurse took over bagging. Looked like an open-book fracture of the pelvis, broken femur. The catheter drained blood, but a ruptured bladder was low on the list of priorities.

She came in with a man, who told us how a truck had run the red and t-boned into the passenger side of their rental car. One of the interns was stitching up a laceration on his forehead, but he wouldn't keep still, kept looking towards where we were working on his wife.

They were on their honeymoon.

There's only four or five quarts of blood in the human body. You can lose a whole four cups before you start to feel the effects. Had to be at least that much on the floor, and her thigh was swollen and tense from the blood pooling inside. Still in her body, yes, but not doing any good if it isn't in circulation.

"Get two units O-neg, type and crossmatch. Tell pathology to get ready for a massive transfusion protocol," I yelled.

One of the interns skittered away to take care of it. The husband finally waved away the doctor trying to suture his forehead, the gash only half sewn shut, and came to stand just outside the doorway where we were working.

"N-no blood," he said.

Cristina whipped around, shock and confusion etched on her face, slipped on the bloody floor and fell on her outstretched arm, still holding the ultrasound probe. The machine almost toppled after her.

"What?" she asked, struggling to get to her feet.

"We're Jehovah's witnesses."

"Yang, go get that x-rayed." She was holding her right arm splinted against her side, obviously in pain.

"But she's bleeding out! She'll die without a transfusion."

"No blood. No blood."

"Yang, get out of here. Sir, your wife's condition is very serious. We need to perform surgery to stabilize her pelvis, stop the bleeding. But she will need blood."

He looked ready to cry. Yang glared at me and edged her way out of the room.

"I know…I know. But she wouldn't want it. She…it's a sin. She wouldn't want it. In her wallet…there's a card."

One of the nurses went to the pile of clothing we had cut from her body, pulled out the wallet.

And read: "No blood transfusion. As a God-fearing Christian and a believer of Jehovah's word, the Bible, I hereby demand that blood, in any way, shape, or form, is not to be fed into my body; however, blood substitutes may be used in case of extreme loss of blood. Signed: Sherry Carter."

"Call down to pathology. See if we even have any substitues. Tell them not to bother with the type and crossmatch."

"Th-thank you, doctor. Thank you."

***

"So she's dead already?" Cristina asked, glaring, when I came into the room.

"No. She's in surgery. Vascular will try to ligate the artery, Callie will pin everything back together. Urology will probably wait til she's more stable."

Her x-rays were on the light board: a simple ulnar fracture, before and after reduction. I sent away the intern—she looked at me gratefully, and I could just imagine Cristina criticizing her technique for the last half hour—and sat down to finish casting her arm myself.

"What's her hemoglobin?"

"Just under five."

She made a sound of disapproval. I kept on dipping plaster bandages into water, wrapping them around her arm.

"The chief is calling every hospital in the city, asking for Polyheme. Mercy West is one of the clinical trial sites."

"It's just unbelievable. Who the hell refuses blood transfusions to their dying wife?"

"Maybe it's more important to them to be saved by their god than to be saved by us."

Again, that same sound of disapproval.

"We don't have to agree with it, we don't even have to understand it, Cristina. But we have to respect their decision."

I finished casting her arm in silence. Made her lie back on the bed, with her broken arm resting on a pillow at her side.

"If anything ever happens to me, do everything. Everything."

The look on her face made me wonder if she was remembering her dad.

***

When I got off shift she was still in the ER, half-asleep. Groggy from the painkillers. I took her home, carried her up to the apartment. Peeled off her shoes and socks, and settled her in bed.

In the army, no one ever refused blood. Our problem was we never had enough.

But here, with over a hundred units down in pathology, every blood type, ready to be used…here, I find a patient who would rather die that live with someone else's blood in their veins.

And I didn't agree with it. I didn't understand it. I hated standing by watching the puddle of blood on the floor grow with every passing minute. Hated standing by when I know I could've done more for her.

Still, the choice is theirs. And we must respect that choice.

***

The next morning she begged the Chief to put her back on surgery.

"You can't even wash your hands, Dr. Yang, let alone suture anything. You are not setting foot in an OR until that cast is off!"

It had been a rather public argument at one of the nursing stations on the third floor. I tried to hide in patient notes, listening, but hopefully not noticed.

"Fine, then I'll just cut the cast off."

"You aren't setting foot in the hospital if that cast comes off before five weeks. Look, you can rotate on medicine for a month. Hell, take some vacation time, or do outpatient clinic for a few weeks. We'll count it as elective time, so you won't graduate late. Just take care of yourself, Cristina," he put a hand on her shoulder, worry in his eyes. "Let it heal."

She looked like she wanted to say more, or maybe cry, but managed to nod and say: "Yes, chief. I'll take a week off and then do outpatient."

"Good, good. I'll arrange it with medicine."

I walked over after Webber had left.

"A week off? I bet this is the first vacation you've had in at least a year."

"That's not true," she sulked. "I take a long weekend her and there."

"But never a full week."

"No."

"Go out with me."

"What?"

"I want to take you out for dinner, a real date. Go out with me. Tomorrow. I'll pick you up at seven."

She looked confused.

"Okay," she finally answered.

"Great," I smiled. "Now get out of here."

***

Callie opened the door, looked me over.

"Wow. You clean up pretty well."

"Thanks…I think."

I guess she really hadn't ever seen me in anything but scrubs, or jeans and a faded sweater at the bar.

"Have a seat. Cristina's still getting ready. She won't ask for my help."

"That sounds like Cristina," Stubborn, independent. Fragile, beautiful.

Finally she came out, in dark gray pants and a lighter camisole, a purple wrap-around sweater, one sleeve pushed up above the black cast, hair a wild mass of curls cascading down around her face.

"Callie, I can't get my hair—oh, hi, Owen."

"You look amazing."

"So do you."

Callie came up behind her and pulled her hair up in some sort of complicated twist, while we stood and stared at each other, oblivious.

"Have fun, you two," she called, her voice all too knowing, as I escorted Cristina, her hand at the crook of my elbow, out the door.

***

Oysters on the half-shell, martinis, a bottle of red with her rack of lamb—which I had to cut—and my steak. A private booth at Cascadia with a candle burning on the table between us. The first date we should have had, but somehow skipped.

She knocked over my wineglass reaching for the bread basket, and I watched the burgundy stain spread slowly across the white tablecloth. Too familiar—too much like spilled blood.

"I'm so sorry, Owen." She was blotting at the tablecloth, looking me over to check for stains. A waiter came over with towels, new napkins, and a fresh glass.

Tearing my attention away from the memories that threatened to overwhelm me, I turned to her, instead.

"It's fine, Cristina. It's just wine."

***

February 28, 2009