Chapter 8
The Boxcar


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Upstairs in the OR
   Monica and her team of surgeons had started the first surgery on Emily and Zander's daughter Lila. Monica was in the process of locating the exact spot that she needed to clamp off the arteries to put little Lila on the heart-lung machine for the operation. It was a difficult task considering the blood vessals were the size of of a single spaghetti noodle. Monica found the position for the clamp and put it into place. Lila was now legally dead, and would be until the heart-lung machine was turned off, which would be in about 3 hours if everything went well.
   Monica quickly found the valve and extra blood vessal which shouldn't be open and severed one side of the vessel. This was the easy part. The hard part was to sew everything into its proper place exactly right and then getting the tiny walnut sized heart to start beating again.
   An hour into surgery Monica had removed the extra blood vessel and the valve controlling the flow of blood into the lungs had been corrected so that it allowed all the blood to go the proper direction. Now Monica was faced with sewing up the tiny holes remaining in the heart muscle where the two ends of the vein had been. This would take another hour of delicate surgery, and this was only the first baby. She still had 2 more of these procedures to do today.
   Everything continued to go smoothly and Monica held her breath as she slowly removed the clamp and allowed the blood to return to the heart from the machine. Two agonizing minutes later a faint heartbeat could be heard in the OR as Lila's heart restarted on its own. Monica had saved her granddaughter. Now she just had to close up Lila's chest and prepare herself to start on Lucky and Elizabeth's son Lorenzo.
   Lorenzo's surgery went as well as Lila's had so Monica was cautiously optimistic a few hours later when she started operating on Nikolas and Autumn's daughter Leilani. She was the smallest of the three babies and had been experiencing the most complications, but Monica was confident that she wouldn't have any serious issues.
   Leilani was on the heart-lung machine and now Monica had to mind the clock as she slowly searched for the ends of the extra vessel. The end connected to the heart had been severed but when Monica went to sever the end connected further up the heart, near the pulmonary vessal where the blood should be flowing into, she discovered that the vein was no longer soft and pliable. It showed signs of a blood clot having been lodged in it. Monica had to stop the surgery for a few moments to try to find out if there was a clot loose in the heart someplace which could possibly kill the baby when she restarted her tiny heart. As the time quickly slipped by Monica decided that there wasn't a blood clot currently, but that the baby would need to be watched for signs that the clot was still present.
   Monica finished repairing the damage to the heart and started to remove the clamp from the vessals to restart the heart. Two minutes went by and Leilani's heart still hadn't restarted, then three minutes went by. Monica re-clamped the vein and again fed the baby's blood into the heart-lung machine. Something wasn't right and if Monica didn't figure it out soon Leilani wouldn't live to go home to her parents.
   Ten tense minutes later Monica discovered that there indeed was a blood clot lodged in the baby's heart. It was in the Aorta which is the main artery carrying blood back to the rest of the body. Monica spent 15 precious minutes removing a pea sized clot from the aortic arch (the part that curves from the heart down towards the rest of the body). Finally after the delay Monica again unclamped Leilani's heart and waited for it to start beating on its own. Three minutes later Monica sighed in relief as the baby's heart started beating normally and her color improved.
   Monica had successfully saved all three babies, but there could still be problems for them further down the road. Time would tell if they would overcome their premature birth or what problems were in store for them in the future. Monica changed her scrubs to get rid of the blood stained garments and hurried downstairs to tell the anxious family members and friends that for now all three babies were ok.

Chapter 9