CHAPTER 44: VICTORY

Meanwhile, the air of the operating room thrummed with the pulse of machinery, monitors beeping in steady cadence, ventilators hissing softly, suction lines poised like coiled snakes. Screens lined one wall, glowing with real-time vitals, heart rate, oxygen saturation, intracranial pressure, all rendered in stark blues and greens.

Devon scrubbed in at the sink, the ritual as sacred as it was meticulous. Hot water cascaded over his hands, antiseptic foam bubbling as he counted seconds, thirty for each palm, each finger, each nail. His mind was already on the patient, a 52-year-old woman with a glioblastoma multiforme, a malignant beast burrowed deep in her left temporal lobe, dangerously close to the Wernicke’s area. The tumor was aggressive, its tendrils infiltrating speech and memory centers, threatening to steal her words, her thoughts, her life. The pre-op MRI was etched in Devon’s mind, a shadowy mass, irregular and ravenous, demanding nothing less than perfection to defeat it. One misstep, and she’d wake silent, or not at all.

"Ready, Doctor?" the lead scrub nurse asked, her voice muffled through her mask as she adjusted the sterile drapes over the patient’s shaved head, secured in a Mayfield clamp. Her hands were steady, practiced, but her eyes betrayed awe, she’d seen Devon work miracles before.

"Always," Devon replied, his tone smooth, confident, a hint of his trademark charm cutting through the tension. He stepped into the pool of light, the team snapping to attention. The anesthesiologist monitored the screens, her fingers poised over the controls. Two scrub techs flanked the Mayo stand, their trays gleaming with instruments, scalpels, rongeurs, bipolar forceps, the ultrasonic aspirator humming faintly in standby. The circulating nurse hovered at the periphery, ready to fetch whatever Devon demanded.

They all knew their roles, but in this room, Devon was the conductor, and they played to his rhythm.

"Scalpel," he said, his voice a quiet command that carried absolute authority. The first tech slapped the blade into his palm with a crisp snap. Devon made the incision, a sweeping, curved horseshoe along the temporal scalp, precise as a calligrapher’s stroke. Blood welled, bright and immediate, but the scrub nurse was there in an instant, dabbing with sponges, her movements a silent echo of his intent. The skin parted cleanly, revealing the pale bone beneath.

"Bovie at 20," Devon instructed, and the second tech adjusted the electrosurgical unit. The faint sizzle of cauterized vessels filled the air, the acrid scent mingling with the sterile chill.

He worked with deliberate speed, peeling back tissue to expose the skull, his hands a blur of controlled power. "Perforator drill," he called, and the tool was in his grip before the words fully landed. The high-pitched whine pierced the room as he drilled burr holes, bone dust swirling like fine snow, sucked away by the vacuum.

"Clean field," the scrub nurse noted, her sponge work flawless, keeping the site clear. Devon connected the burr holes with the craniotome, the saw’s vibration thrumming through his gloves. With a gentle lift, the bone flap came free—a perfect circle of cranium, handed off to the second tech for safekeeping in saline. Beneath lay the dura mater, the brain’s protective membrane, pulsing faintly with the patient’s heartbeat.

Devon’s breath steadied, his focus narrowing to a pinpoint. He incised the dura with microscissors, folding it back like a velvet curtain to reveal the brain’s glistening surface, convoluted, delicate, a landscape of life itself. The intraoperative ultrasound flickered on the screen, its probe guided by his hand, showing the tumor’s shadowy outline. "There you are," he murmured, not to the team but to the enemy within. The glioblastoma was a monster, its edges blurred, infiltrating healthy tissue like roots in soil.

"Awake mapping," he ordered, his voice unwavering. "Lighten sedation." The anesthesiologist adjusted the IV drip, and the patient’s eyes fluttered open, groggy but responsive. Devon leaned in, his tone gentle but firm. "Can you say ’hospital’ for me?"

"Hos...pital," she slurred, her voice fragile but clear.

"Good. Now count to ten." As she complied, Devon used a low-voltage electrode to stimulate the cortex, mapping safe zones.

A zap too close to the tumor, and her words garbled, "Sev...six...uh..." He marked the boundary, his mind cataloging every nuance. The team watched, silent, learning from each precise movement, their roles secondary to his mastery.

"Ultrasonic aspirator," he called, and the device was in his hand, its tip vibrating at ultrasonic speeds to emulsify the tumor’s core. He plunged it in, the wet gurgle of suctioned tissue filling the room as the malignant mass dissolved into a pinkish slurry.

The field was a battleground, gray brain matter, red vessels, the tumor’s sickly hue. Devon’s hands moved with surgical artistry, teasing out fragments, navigating the delicate web of neural pathways. His mind flashed to his first glioblastoma case at 25, a patient others had written off, now living because of his audacity. That fire still burned, hotter with every victory.

The monitors shrieked, a sudden spike in intracranial pressure. "Bleeder!" the scrub nurse shouted, as blood flooded the cavity, a rogue vessel torn by the tumor’s adhesive grip.

"Pressure’s at 190 over 110," the anesthesiologist warned, her voice tight. "Risk of herniation."

Devon’s pulse spiked, but his hands were stone. "Bipolar at 15. Suction, keep it dry." He clamped the forceps, sealing the vessel with a sharp pop, the blood clearing under the nurse’s swift work.

The tumor had shifted, pressing closer to the speech center, a complication that would have rattled lesser surgeons. Devon didn’t flinch. "Microdissector," he said, switching tools, his fingers teasing the mass free with touches so light they seemed impossible. The room felt smaller, the lights hotter, every eye locked on him.

"Talk to me," he said to the patient, his voice calm despite the chaos. "Name some colors."

"Blue...red...yell..." She faltered as he probed, her words slurring into nonsense.

"Stop, there’s the edge." He adjusted, excising the final fragment with a flick of his wrist. The cavity emptied, the brain relaxing, its pulse steadying. The monitors calmed, their beeps slowing to a reassuring rhythm.

"Pressure’s down, 160 over 90," the anesthesiologist reported, relief palpable. "She’s stable."

Devon exhaled, the tension uncoiling like a spring. "Hemostasis check. Floseal for oozers." The team packed the site with hemostatic agents, ensuring no leaks. He sutured the dura watertight, his stitches so fine they were nearly invisible. The bone flap returned, fixed with titanium plates, click, click, click, each sound a note in his victory.

"Scalp closure," he said, but instead of delegating, he took the stapler himself, his hands finishing the job with the same precision.

As the team wheeled the patient to recovery, Devon stripped off his gown, tossing it into the bin with a flourish. "Well done, everyone," he said, his voice warm but commanding. "She’ll be talking your ears off by tomorrow." The team nodded, their faces glowing with the pride of working under a legend. They’d learned more in these four hours than in months of training, and they knew it.

In the scrub sink area, Devon washed up, the water sluicing over his hands, washing away the blood and sweat. His reflection stared back, eyes sharp, jaw set, a man who’d just danced with death and won. The high was electric, better than any drug, any conquest. But beneath it, a quiet thought lingered, not doubt, but a hunger. How many more could he save? How many more could he defy? He pushed it aside, striding into the hallway, where nurses parted like a sea, their whispers trailing him like a wake.

"Another one for the history books, Dr Devon," the circulating nurse called after him, her voice tinged with awe.

Devon flashed a grin over his shoulder. "Just another day at the office."