Donovan's Paradigm by Lynn Price

Author:Lynn Price
Language: eng
Format: epub
Publisher: Behler Publications, LLC

In addition to the poster and toilet plunger, there were various framed photos planted about her desk and on the wall. Peering at the pictures, Erik got a small glimpse into the world of the woman sitting across from him. He was particularly taken with one photo of her playing beach volleyball dressed only in a lime green two-piece bathing suit. She appeared to be serving the ball with several of her friends in the foreground. Seeing Kim's eyebrows knitted in concentration as she read the file, he commenced to focus on the wonderful curves of her body grinning at him from the beach.

“Wow, this poor guy has really been around, hasn't he?” Kim commented, closing the file and looking at Erik.

He dragged his attention back to the confines of her office. “Six doctors in ten years definitely classifies him as having been around,” he agreed. “Each of them told him it was purely cosmetic and not to worry about it. Meanwhile, the kid's heart is displaced to the left side of his chest along with limited lung expansion, which showed up in a routine stress test I gave him two weeks ago.”

“Unbelievable. I can see why this guy's confidence is scraping bottom of the barrel.”

“So, you interested?”

Kim hesitated. “I'm not sure.”

“How many procedures have you seen?”

“Two. The first one was back when I was a med student. The surgeon used the Ravitch procedure and it was pretty gruesome. The other one was a slight modification of the Ravitch procedure and looked less brutal, but it was still pretty awful.”

The Ravitch procedure was a particularly nasty operation, requiring a long incision down the chest. The breastbone is cut and fractured, then re-wired with a bar. Most surgeons hated the operation for its sheer crudeness and recoiled from performing it at all.

“Ever heard of the Nuss procedure?”

She nodded. “Vaguely. A bar is inserted under the ribcage without having to break the ribs, right?”

“Right. It's the least invasive surgery I've ever seen to correct this deformity.” Erik took the x-rays out of their jacket and stuck them on the light box mounted on the wall and turned on the light. With the end of a pen, he pointed to the images while explaining the procedure.

“In a nutshell, we'll use general anesthesia and place an epidural catheter in for pain maintenance after the operation. The chest is pumped with carbon dioxide so I can push aside the lungs for a better view of what I'm doing. I'll make two lateral incisions on either side of the chest for insertion of a curved steel pectus bar under the sternum that will pop out the depression in the chest. But before I can put the bar in, I'll need to create a pathway for the bar to follow. I do that by inserting an introducer, which is a long, angled, blunt-ended rod across his chest, it'll go from my side to yours, where you'll suture it into place for me. In order to actually see

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